Occlusal Vertical Dimension Research Articles

Relationship Between Mandibular Position, Activation of the Masticatory Musculature and Free-Throw Accuracy in Female Basketball Players.

Current research relates jaw clenching to athletic performance, in terms of force and agility. However, the impact of jaw clenching on sports accuracy is unclear. To analyse the impact of jaw position and chewing type on free-throw accuracy and electromyographic (EMG) activity of masticatory muscles during free-throws. Cross-sectional study with 25 female basketball players aged 18-44. Each participant executed 18 free-throws under three different jaw conditions: mandibular rest, maximum intercuspation, and with interdental cotton rolls, in randomised order. Chewing type and jaw position were not associated with shooting accuracy (p = 0.106; p = 0.778). There was a positive correlation between EMG activity of the right masseter and free-throw accuracy at maximum intercuspation (rs = 0.402; p = 0.046). In contrast, negative correlations were found with other muscles when the occlusal vertical dimension was altered (rs = -0.619, p = 0.001; rs = -0.490; p = 0.013; rs = -0.534; p = 0.006). The chewing type affected the EMG of the left masseter in the altered occlusal vertical dimension (H = 6.969; p = 0.031). Significant differences in EMG recordings were observed across different mandibular positions during free-throws (p < 0.001). While jaw positioning and chewing type do not impact free-throw accuracy in amateur female basketball players, the EMG activity of masticatory muscles is linked to shooting performance. This highlights the need for further research on motor behaviour of masticatory muscles in precision sports, especially for athletes using intraoral devices.

Advanced Adhesive Approach to Support a Minimally Invasive Full Mouth Rehabilitation.

Patients who exhibit severe loss of tooth structure are challenging to rehabilitate. Conventional treatment of these patients may require adjunctive procedures of surgical crown lengthening, elective endodontic therapy and placement of posts and cores to retain full coverage crowns as part of a full mouth rehabilitation. Minimally invasive approaches to treatment of these patients provides opportunity to conserve tooth structure and to reduce adjunctive procedures by using an advanced adhesive approach to retain all ceramic partial coverage restorations as part of a full mouth rehabilitation. The use of an advanced adhesive approach to perform a full mouth reconstruction restoring occlusal vertical dimension (OVD) is described. This approach emphasizes preserving healthy tooth structure, maximizing restoration adhesion to enamel and dentin, maintaining pulpal vitality and minimizing adjunctive dental procedures. The preparation design focuses on being defect-oriented to remove only diseased or undermined tooth structure. The all ceramic restorations are additive, where indicated, to further aid in preserving tooth structure. An advanced adhesive approach using an immediate dentin seal and resin coating over exposed dentin and composite resin cement under rubber dam isolation is used to lute the restorations. The restorations are fabricated using micro-layered lithium disilicate ceramic to maximize the esthetic appearance of the rehabilitation where needed. An advanced adhesive approach to full mouth rehabilitation should be considered as a treatment option for patients exhibiting tooth surface loss as an alternative to conventional full coverage restorations when clinical parameters allow.

Utilization of digitally milled verification jigs for recording jaw relations in complete-arch implant rehabilitation: A digital clinical report.

This clinical report introduces a digital approach that utilizes milled verification jigs to acquire the jaw relations for the fabrication of monolithic zirconia implant-supported fixed complete dental prosthesis (IFCDP), in patients without a conversion implant prosthesis. The procedures employ photogrammetry for precise data acquisition, combined with image-based capture in 4 dimensions (ICAM4D), to design and mill verification jigs that accurately record the occlusal vertical dimension (OVD) and centric relation (CR). This approach streamlines the clinical workflow by reducing the number of patient visits and associated costs while enhancing precision and predictability. It eliminates the need for conventional steps and analog definitive casts in the fabrication of IFCDP without a conversion implant prosthesis.

Digital Approach Provides Predictability in Increasing the VDO in Erosive Wear: Clinical Technique and 9-Year Follow-Up.

This clinical case describes a digital workflow using face scans and CAD/CAM technology for a full-mouth rehabilitation with increased vertical dimension of occlusion (VDO) with adhesive lithium disilicate restorations after 9 years. A healthy, 46-year-old man displaying severe tooth wear, underwent an extensive full-mouth rehabilitation involving an increase of the VDO through laminate veneers and adhesive partial coverage lithium disilicate restorations. Anatomical landmarks of the face and reference planes were captured using a digital face scanning system. The anatomical position of the maxilla was registered with a transfer device. Digital data sets of the intraoral situation combined with a facial scan enabled precise virtual planning, guiding minimally invasive preparations. Long-term provisional restorations, milled from high-performance polycarbonate, were used to test the novel VDO before the final lithium disilicate restorations were fabricated. This approach provided a time- and cost-efficient treatment solution. No failures were observed at the 9-year follow-up. Utilizing face scans and design software enable a virtual visualization and comprehensive quality control for patients with dental wear, resulting in significant time savings and increased predictability for the dental technician, dentist and patient. The described digital workflow optimizes the planning and implementation of a comprehensive adhesive full-arch rehabilitation with an increase of the VDO. The clinical long-term follow up result of CAD/CAM assisted minimally invasive lithium disilicate restorations after 9 years demonstrates to clinicians a reliable treatment concept for patients with dental wear.

Importance of an Evaluation Phase When Increasing the Occlusal Vertical Dimension: A Systematic Review.

To assess whether an evaluation period is necessary for patient and clinical success when increasing the occlusal vertical dimension (OVD) for a full mouth rehabilitation. A systematic search was conducted in six databases: MEDLINE, Web of Science, Scopus, CENTRAL, VHL, and EMBASE. The eligibility criteria of this systematic review used the PICO framework to address the following research question: "In dentate adults requiring an increase in occlusal vertical dimension (OVD) (P), is an evaluation period of the new OVD (I) superior to no evaluation period (C) in terms of success (O)?" Study characteristics, survival, and success rates were extracted from each article. No language restrictions were applied. Study quality was appraised using Cochrane's Risk of Bias 2 tool and Newcastle-Ottawa Scale (NOS) according to the study design. The electronic search yielded 1188 titles after duplicates were removed. One RCT and 103 non-comparative articles were found relevant to the search question. Out of the 103 articles, 80 had an evaluation phase and 23 did not. The included RCT revealed that removable devices tended to cause chewing difficulties, unclear speech, and esthetic discomfort. Therefore, the use of a removable appliance to functionally or esthetically evaluate OVD was not indicated prior to the definitive treatment. Esthetics was the highest reported parameter preoperatively for the non-comparative studies, at 85% with an evaluation and 86% without. At present, there is lack of evidence that an evaluation period improves clinical and patient-reported outcomes when increasing OVD for full mouth rehabilitations. Thus, an increase in OVD can be successful with or without an evaluation phase. The evaluation phase helps the clinician manage patient expectations and assist with the treatment sequencing. This phase is most effective with fixed restoration, such as temporary crowns or adhesive restorations. However, there is limited evidence that this phase improves clinical or patient-reported outcomes.

Correlation between vertical dimension of occlusion and length of fingers in dentate subjects.

Objective: To determine whether there is a correlation between finger length and the vertical dimension of occlusion in dentate individuals attending the prosthodontics department at Muhammad Dental College, Mirpurkhas.Methodology: During this cross-sectional study 2023-2024, 218 patients with crown &amp; bridge were included. Clinical an-thropometric measures were taken. The subjects received instructions to softly bite on their back teeth, keep their lips in passive contact, and keep their heads well-stabilized in order to retrieve the VDO. A Vernier caliper was then used to measure the distance. Each parameter was measured three times and average value was recorded.Results: Average age of the patients was 25.39±2.58 years. The parameters for index finger length (r=0.669; p=0.0005), little finger length (r=0.666; p=0.0005), and the length of the tip of the thumb and the index finger (r =0.663; p=0.0005) had the highest correlations with VDO.Conclusion: It is concluded that this procedure is simple, cost-effective, and non-invasive, therefore it might be used in routine practice to ascertain the vertical dimension of occlusion. Keywords: Dentistry practice, Vertical dimension of occlusion, Prosthodontic therapy

Correlation between Vertical Dimension of Occlusion, Finger Length, and Commissural Width in Dentate Persons with Different Facial Forms: A Clinical Research

Correlation between Vertical Dimension of Occlusion, Finger Length, and Commissural Width in Dentate Persons with Different Facial Forms: A Clinical Research

Rehabilitation of low occlusal vertical dimension with CAD-CAM restorations

Rehabilitation of low occlusal vertical dimension with CAD-CAM restorations

Full-mouth rehabilitation with lithium disilicate ceramic crowns in hypoplastic amelogenesis imperfecta: a case report and review of literature

BackgroundAmelogenesis imperfecta (AI) is a group of genetic disorders characterized by tooth discoloration and enamel defects. Patients with AI always exhibit generalized attrition and defective tooth structure, leading to the loss of occlusal vertical dimension (OVD). Appropriate rehabilitation is challenging and essential to improve patients’ aesthetics and function.Case presentationThis case report presents a comprehensive management of a 30-year-old woman with hypoplastic AI. A 52-month follow-up revealed satisfactory full-mouth rehabilitation performances of lithium disilicate ceramic crowns after clinical crown lengthening, with increased vertical dimension.ConclusionsPatients with severe hypoplastic AI require proper full-mouth rehabilitation. Using full-crown lithium disilicate restorations to increase the OVD by 2‒4 mm is a safe and predictable recommendation for such cases. In addition, patients with AI require complex and comprehensive management. The long-term effects of full-mouth rehabilitation with lithium disilicate ceramic crowns still necessitate further follow-ups.

Assessment of the Vertical Dimension of Occlusion Using Palm Width and Finger Length.

Background and Objectives: The vertical dimension of occlusion's (VDO) assessment is a highly important issue in the everyday dentist's practice. Patients with unstable occlusion, lost occlusal stops, extensive tooth loss in the lateral area, or complete edentulism need a proper assessment of the VDO before the prosthetic restoration is carried out. Subjective and objective methods were used over time for the restoration of VDO. The study aimed to investigate the possible correlation between finger length, palm width and the vertical dimension of occlusion. Materials and Methods: Assessment of the VDO for 236 subjects, Romanian and French dental students, was performed using the Willis Bite Gauge. The left hand of the subjects was scanned using a flat-bed scanner, and then measurements of palm width and finger length were carried out for each subject. Comparison between VDO values and finger length/palm width was conducted using one-way ANOVA and Student t-Test. Results: Higher VDO average values were found in French subjects compared with Romanian students. The same results were found according to gender; in both female and male subjects, lower values of VDO were found in the Romanian group. Higher values were obtained for women within each group when comparing to men. Statistically significant correlations of the analyzed parameters and VDO values were found. Higher statistical correlations of the studied variables were found for men compared to women in both groups. The highest statistical correlation was obtained between the VDO and the palm width measured at the fingerbase, followed by the middle finger length. Conclusions: The results showed the highest statistical correlation between the vertical dimension of occlusion and the palm width measured at the fingers' base. Statistical correlations were also found between the VDO and the middle finger length. Simple formulas using finger length/palm width can be used for a rapid VDO determination.

The "Smile Design and Space" Concept for Altering Vertical Dimension of Occlusion and Esthetic Restorative Material Selection.

This article introduces the smile design and space (SDS) concept for managing the vertical dimension of occlusion (VDO) in full-mouth reconstructions and its influence on the selection of esthetic restorative materials. Limitations of traditional VDO adjustment methods are being addressed through a facially driven treatment approach that enhances esthetics improves function and minimizes invasiveness. The SDS concept involves detailed evaluations of the incisal edges of the maxillary central incisors in relation to the upper lip at rest and at full smile. This includes analyzing variations in incisal exposure due to differing lip mobility, which can significantly impact gingival esthetics, particularly in cases with gingival exposure during smiling. The concept employs a strategic formula to determine the necessary alterations in VDO based on specific dental relationships and wear patterns. The SDS concept provides guidelines for full-mouth reconstructions, emphasizing minimal invasiveness and the integration of esthetics with functional dynamics to enhance the predictability of clinical outcomes and reduce complications associated with traditional restoration techniques. The SDS concept enhances the precision of full-mouth reconstructions through individualized adjustment of the VDO, tailored to the esthetic and functional requirements of each patient.

A novel approach for posterior bite collapse in an adult with crossbite anterior using a 3D-printed bite riser

Background: Managing an adult patient presenting with an anterior crossbite in conjunction with posterior bite collapse (PBC) is a difficult challenge. Purpose: The purpose of this case study is to highlight the accuracy that can be attained with the utilization of a three-dimensional (3D) printed bite riser in the correction of PBC accompanied by an anterior crossbite in an adult patient with Class III malocclusion. Case: A 64-year-old male complained of being unable to chew properly. Extraoral examination revealed a concave profile with a protrusive mandible. The patient exhibits a 5 mm anterior crossbite and has missing lower posterior molars, resulting in bilateral PBC. The cephalometric analysis revealed skeletal Class III patterns (SNA: 82.19o; SNB: 86.34o; ANB: -4.15°), with protrusion and counterclockwise rotation of the mandible (SN-OP: 3.84o). Case Management: By utilizing a 3D-printed bite riser in conjunction with temporary anchoring devices (TADs), it is possible to resolve the issue of an anterior crossbite accompanied by PBC. This is achieved by repositioning the elongated posterior segments on both sides of the maxilla to generate vertical space for mandibular tooth rehabilitation, retracting the anterior segment, and narrowing the lower arch. Simultaneously, the crossbite on both sides was corrected, a Class I and ideal overbite and overjet were achieved, the occlusal vertical dimension increased, the occlusal plane angle was corrected (7.51o), and an acceptable ANB angle (-1.36°) was accomplished. The treatment lasted 18 months and yielded sustained results after a one-year retention period. Conclusion: Integrating 3D printing technology in orthodontic treatment offers numerous options for managing challenging cases such as PBC while also reducing the treatment length. The patient was satisfied with the results achieved.

COMPARISON OF FREEWAY SPACE DISTANCE OF WILLIS METHOD WITH DIGITAL PHOTO ANALYSIS METHOD IN BANJAR TRIBE

Background: The face's vertical dimension or vertical height is the distance between two anatomical points, namely the points on the maxilla and mandible. In measuring the vertical dimension, vertical dimensions of rest (DVR) and vertical dimensions of occlusion (DVO) must be measured. The difference between the vertical dimension of rest (DVR) and the vertical dimension of occlusion (DVO) is called the freeway space (FWS) or interocclusal distance. Freeway space is a key requirement for optimal comfort and function of a partial or complete denture. Each individual's freeway space distance is the movement of muscle function, which can be measured by direct methods such as the Willis method using calipers and the digital photo analysis method using computer software. Two measurement methods can be used to measure freeway space distance direct and indirect. Purpose: To analyze the difference between freeway space distance measured by the Willis method and by digital photo analysis of Adobe Photoshop and Corel Draw graphic design software in the Banjar tribe (a review of students at the Faculty of Dentistry, Universitas Lambung Mangkurat Banjarmasin). Methods: This study is a quantitative study with an analytic observational method and a cross-sectional approach. This study was conducted by collecting data simultaneously at one time by comparing three different methods on the same sample without being given any treatment. Results: One Way ANOVA test is 0.296 (P&gt;0.05) which means there is no significant difference. Conclusion: There is no significant difference between the results of measuring freeway space distance using the Willis method with a digital caliper and digital photo analysis with Adobe Photoshop and Corel Draw software.

Myths surrounding vertical dimension of occlusion in restorative dentistry: A scoping review.

This scoping review aims to clarify the concept of vertical dimension of occlusion (VDO) in prosthetic dentistry, addressing prevalent myths, and controversies regarding its clinical management and impact on the stomatognathic system. This paper critically examines common beliefs about VDO alteration and its effects on temporomandibular disorders (TMD) through an extensive literature review and an international survey. The survey included 862 general dentists and prosthodontists and explored their approaches to altering VDO and their perceptions of the clinical implications. The literature review provided a thorough analysis of existing research on VDO modification techniques, the adaptability of the stomatognathic system, and the relationship between VDO changes and TMD. The survey revealed insights into dentists' perspectives on VDO, showing that while many practitioners test a new VDO due to concerns about patient adaptation, a significant majority observed that patients typically adjust well to a new VDO regardless of the technique used. The survey highlighted differing beliefs about the need for a gradual process and trial phase for VDO alteration, as well as the stability of modified VDO. Literature review suggests the stability and adaptability of VDO changes due to muscle adaptability and indicates no direct causal or curative link between VDO changes and TMD. Traditional methods for determining VDO in complete dentures may not be suitable for worn dentition, underscoring the need for tailored approaches. This paper suggests that the traditional belief in the need for a prolonged trial phase for VDO alterations may be reconsidered in light of evidence supporting the adaptability of the stomatognathic system. Moreover, it emphasizes the importance of distinguishing between methods suitable for complete dentures and those for managing cases of worn dentition. The purported link between VDO alterations and TMD is also found to lack scientific evidence, highlighting the need for individualized patient care based on current evidence and clinical judgment.

Treatment decisions of patients with Class II Division 2 malocclusion and severe tooth wear: a systematic review

BackgroundThe treatment strategy for patients with severe tooth wear associated with Class II Division 2 malocclusion remains a major challenge for dental practitioners.ObjectivesTo systematically review and summarize the literature on treatment strategies, restoration procedures and clinical outcomes for Class II Division 2 malocclusion patients with severe tooth wear.MethodsA literature review was conducted using Pubmed, Embase, the Cochrane Library, and Web of Science to identify eligible articles. Publications until October 16th, 2023 were searched independently and cross-checked by two researchers.ResultsOf 1513 articles screened, 10 reports detailed treatment processes, including six males and four females aged 34–68 years old. Four articles recorded pre-treatment freeway space (FWS) values ranging from 5 to 9 mm. All ten cases had significant occlusal vertical dimension (OVD) loss and the increase in OVD after treatment ranged from 1 to 7 mm. Pre-prosthetic orthodontic treatment was performed in two cases, in one of which only the maxillary region was orthodontically treated. The most common restorations provided were full coverage restorations. In most cases, temporary restorations were applied before the permanent restorations for eight weeks to six months. Four different sequences of final restoration were proposed. Follow-up ranged from four months to six years and included seven patients, one of them showed symptoms of temporomandibular disorder (TMD).ConclusionsA multidisciplinary team (MDT) approach to treatment is recommended. Consideration of pre-prosthetic orthodontic treatment is essential. Commonly used cephalometric measurements for anterior teeth include the interincisal angle and collum angle. The increases in OVD ranging from 1 to 7 mm can be effectively accommodated. Temporary restorations are recommended to accommodate the OVD, and the transition periods of 8 weeks to 6 months help the patients adapted well. Four different sequences for final rehabilitation have demonstrated positive clinical outcomes. Full crown restorations have emerged as the preferred choice for the ultimate restoration of these patients.

A novel formula for estimating the vertical dimension of occlusion using panoramic radiography

BackgroundThis study aimed to develop a new formula to easily estimate the vertical dimension of occlusion (VDO) by using the distance between the mental foramen on a panoramic radiograph.Subjects and methodsA total of 508 dentulous subjects were selected from outpatient dental clinics at the College of Dental Medicine, Al-Azhar University. The vertical dimension of the occlusion was measured using a single calibrated calliper. For each subject, a digital panoramic radiograph was taken with fixed exposure parameters. The intermental foramina distance (IMFD) was measured. The data were collected and then analysed using the IBM SPSS version 20.0 software package. (Armonk, NY: IBM Corp.). Linear regression was used to determine the relationship between the intermental foramina distance (IMFD) and the vertical dimension at occlusion (VDO).ResultsPearson’s correlation analysis revealed that there was a strong correlation between the intermental foramina distance (IMFD) and the VDO. Thus, a novel formula was developed for determining the VDO using panoramic radiography.ConclusionThe novel formula developed herein facilitated the determination of the VDO among prosthetic rehabilitation for subjects who lost vertical dimension due to loss of posterior teeth or severe wear of natural posterior teeth. Further studies are needed to determine the clinical applicability of the derived formulae for edentulous subjects.

Orofacial Features, Oral Health-Related Quality of Life, and Exposure to Bullying in Osteogenesis Imperfecta: A Cross-Sectional Study.

Osteogenesis imperfecta (OI) is a rare genetic disease that is responsible for bone fragility, but also for dental malocclusions and dentinogenesis imperfecta (DI). The aim of this study was to assess whether the severity of dental malocclusion influenced the oral health-related quality of life (OHRQoL) and exposure to bullying in a paediatric OI population compared with a control group. Dental and occlusal characteristics were noted during oral and radiographic examination. The severity of malocclusion was assessed using the PAR index. P-CPQ, COHIP(34), and BCS-A questionnaires were used to evaluate, respectively, externally and self-perceived OHRQoL and bullying. We included 39 patients with a mean age of 11.3 (±4.8 SD) in the OI group, and 45 patients with a mean age of 12.3 (±3.2 SD) in the control group. There were no significant differences between the two groups in terms of occlusal vertical and transverse dimensions. Patients with severe OI, presenting with bone fractures, bones deformities, and short stature, had significantly more anterior (p < 0.05) and posterior openbites (p < 0.05) and more DI (p < 0.05) compared to patients who had moderate or mild OI. Self-perceived OHRQoL was negatively impacted by the disease (p = 0.01), particularly in the domains of oral health (p < 0.05) and self-image (p < 0.001), but not by its severity. Exposure to bullying did not differ significantly between the two groups, although more patients with OI reported being teased (21.4% face to face and 7.1% online vs. 14.6% and 2.4% in the control group). Interventions for dental malocclusion and oral health in OI patients would help to improve their quality of life and self-image.

Augmented Reality Filter to Evaluate Vertical Dimension of Occlusion

Augmented Reality Filter to Evaluate Vertical Dimension of Occlusion

Increasing Vertical Dimension of a Case with Full Mouth Rehabilitation: Case Report.

Introduction: Bruxism is one of the most frequent causes for occlusal tooth wear, with the loss of tooth structure caused by mechanical wear between maxillary and mandibular tooth surfaces, case report was conducted to improve the patient oral health, and to maintain the new vertical dimension since it was lost by teeth clenching. Case description: this paper presents a 50 years old male suffering from severe bruxism, which implicated the appearance and function of the patient, he was transferred to TIU dental hospital for full mouth rehabilitation treatment. Discussion: The rehabilitation of patients with extensive occlusal wear is complex and difficult to solve, becoming thus one of the biggest challenges of dentistry, a proper planning of a prosthetic rehabilitation should not attribute the re-establishing of occlusal vertical dimension (OVD) to new prostheses at the risk of the patient doesn’t adapt to a new condition of vertical dimension. Conclusion: Tooth wear causes dimensional changes in facial morphology and OVD decrease. The correct determination of occlusal vertical dimension represents a factor of success in the rehabilitation treatment. Keywords: Vertical Dimension, Rehabilitation, Full Mouth, Bruxism.

Influence on the temporomandibular joint induced by mandibular malpositioning caused by vertical dimension elevation and occlusal loss in adult rats: An imaging, histological and immunohistochemical study.

Mandibular malpositioning may result in an abnormal concentration of stresses within the temporomandibular joint (TMJ) in adult rats, which may further lead to a series of pathological changes, such as articular cartilage wear, subchondral bone sclerosis and osteophyte formation. However, the pathological and adaptive changes in condylar cartilage caused by different stress distributions are still controversial. The aim of this study was to observe the effect of sagittal changes in mandibular position on condylar cartilage by changing the occlusal vertical dimension (OVD) in adult rats. Fifteen-week-old female rats were divided into three groups: control (CON), increased OVD (iOVD) and loss of occlusion (LO) groups. An occlusal plate and tooth extraction were used to establish the animal model. TMJ samples of the experimental and CON groups were observed and investigated by bone morphological, histomorphological and immunohistochemical staining analyses at 3 days, 1 week, 2 weeks, 4 weeks and 8 weeks. Weight curves were plotted. Micro-computed tomography showed that, compared with the CON group, cartilage destruction followed by repair occurred in both experimental groups, which was similar to the trend observed in haematoxylin-eosin staining. All experimental results for the iOVD group showed an approximately similar time trend. Compared with the iOVD group, the toluidine blue and immunohistochemical staining results in the LO group showed no obvious change trend over time. Compared with occlusal loss, an increase in OVD caused faster and more severe damage to condylar cartilage, and subchondral bone repair occurred later.