Occlusal Vertical Dimension Research Articles

The Vertical Dimension of Occlusion: To Raise or Not to Raise?

The Vertical Dimension of Occlusion: To Raise or Not to Raise?

Practical aspects regarding the correlation between the occlusal vertical dimension and the facial aspect of edentulous patients

An important stage in the workflow of obtaining com­plete dentures for edentulous patients is represented by determining and registering the occlusal vertical di­men­sion (OVD). The dentist has an important role in this cli­ni­cal stage, and all the data that will be transmitted to dental laboratory must be correctly applied by the den­tal technician. The data are related to occlusal ver­ti­cal dimension, smile line, midline and canine line.

Rehabilitation with minimal increase in occlusal vertical dimension in a patient with excessive tooth wear and edge-to-edge bite

Rehabilitation with minimal increase in occlusal vertical dimension in a patient with excessive tooth wear and edge-to-edge bite

Full mouth rehabilitation of a patient with excessive worn dentition by increasing vertical dimension of occlusion: a case report

Full mouth rehabilitation of a patient with excessive worn dentition by increasing vertical dimension of occlusion: a case report

AGE ASSESSMENT OF THE DYNAMICS OF MORPHOLOGICAL REARRANGEMENT OF BONE TISSUE OF THE ARTICULAR PROCESSES OF THE HUMAN LOWER JAW DEPENDING ON THE LOSS OF THE MASTICATORY TEETH

Aim: To analyze morphometric changes in the structure of bone tissue of the mandibular articular processes and establish their densitometric dependence on the masticatory teeth loss in people of I-II periods of adulthood. Materials and methods: We analyzed 136 digital CT recordings of human temporomandibular joints. The research subjects were divided into three groups based on the degree of dentition defect acquisition: the first - a limited defect, the second - a final defect, and the third - a preserved dentition (control); by age into two periods of adulthood of postnatal human ontogenesis. Digital statistical analysis of the bone density is presented as M±σ (mean and standard deviation). We compared the experimental groups with the control group using nonparametric statistical analysis. Results: Changes in the vertical dimension of occlusion due to limited masticatory teeth loss acquire variable morphometric features, causing an interrelated process of bone atrophy of the cellular part and the trabecular layer of the mandibular processes. The density of bone tissue of the cortical layer of the articular-fossa quadrant (A-Fh/q) of the articular head of the mandibular process increases on the right with limited defects and decreases with final defects. Indicators of bone densitometry of A-Fh/q on the left is characterized by a decrease with limited defects for individuals of the I-st period of adulthood and an increase in the final defects in the II-nd on the left and right. Conclusions: Multifactorial pathomorphological compensatory processes ensure bone density, but with a change in values on the right and a decrease on the left. Morphometric values of trabecular layers, the most vulnerable areas of the neck and base of the mandibular articular processes, indicate the reconstruc¬tion of their bone tissue with limited defects; in the first period of the adulthood, they decrease with a significant predominance on the left.

Treatment of reduced interocclusal space with a cone crown telescopic denture after increasing the vertical dimension of occlusion: A case report

Treatment of reduced interocclusal space with a cone crown telescopic denture after increasing the vertical dimension of occlusion: A case report

Restoring Dental Rubbles Using an Overlay Removable Partial Denture Fabricated with Digital Technology - A Case Report

Regressive changes of natural dentition may be a physiologic or pathologic process which proceeds to drastic occlusal wear. Loss of incisal or occlusal edge morphology due to functional or parafunctional activity of teeth can be regarded as physiologic whereas frictional action of a foreign body on the teeth or loss of tooth substance due to a chemical process involving bacteria may be termed as pathogenic. These result in loss of occlusal vertical dimension and may elicit occlusal instability compromised function and aesthetics.The treatment modalities for the same are confined to fixed prosthesis for restoration of the lost vertical dimension. But this technique in general is expensive technique sensitive and complex. An Overlay Removable Partial Denture ORPD though rarely reported in the literature can be considered as one of the alternative interim or even a permanent dental prosthesis. The proposed paper is a case report of worn dentition rehabilitated with ORPD. This approach was found to be non-invasive simple and cost effective. The patient on short term follow-up reported with optimal aesthetics and masticatory efficiency. Overall satisfaction and quality of life improved after the treatment.

Improvement of cosmetic and masticatory disturbance due to decreased occlusal vertical dimension by using a prosthesis: A case report

Improvement of cosmetic and masticatory disturbance due to decreased occlusal vertical dimension by using a prosthesis: A case report

Occlusal splints-types and effectiveness in temporomandibular disorder management

BackgroundOcclusal splints are routinely used in dental offices to diagnose and treat abnormalities of the masticatory system. There are different occlusal splints, each of which can address various conditions. They may treat individuals with temporomandibular disorders (TMDs) and bruxism or be used for occlusal stabilization and dentition wear reduction. MethodsThe literature in the National Library of Medicine's Medline Database was reviewed using the Mesh terms 'occlusal splints' AND 'Temporomandibular Disorders. ConclusionOcclusal splints can treat a wide variety of TMDs. They can treat bruxism, headaches, postural imbalances related to TMDs, and decreased vertical dimension of occlusion (VDO). However, there is no clear evidence that occlusal splints are superior to physiotherapy in treating TMDs. In the long-term follow-up, they were equally effective as other therapies.

A TERTIARY CARE HOSPITAL’S DENTATE PATIENTS’ RIGHT RING FINGER LENGTH AND VERTICAL DIMENSION OF OCCLUSION HAVE AN ANTHROPOMETRIC CORRELATION

OBJECTIVE: To determine if there is an anthropometric relationship between dentate patients’ right ring finger(RRFL) length and vertical dimensions of occlusion (VDO) when they attend a tertiary care institution to have theirroot canal-treated teeth crowned.STUDY DESIGN: A cross-sectional studyDuration and place of study: BKMC Mardan, KPK, from August 2019 to Feb 2020METHODOLOGY: A cross-sectional study was done. The study was done at the outpatient prosthodonticsdepartment at BKMC in Mardan, KPK, from August 2019 to February 2020. Each participant sat on a dentalchair with their heads raised while a computerized Vernier scale recorded their VDO. Second, the finger was RRFLrecorded from tip to palmar digital crease farthest point. The data collection form includes age, gender, residence, andpurpose of visit to assess whether the measured lengths—the VDO and the RRFL—are related.RESULTS: There was a significant relationship (r=0.4057) between age and VDO and RRFL in the 18–25age bracket (p = 0.000336). The age group from 26 to 30 has a p-value of 0.028398 and an R-value of 0.2549.The gender-related correlation between VDO and RRFL in the male group was r = 0.3465, with a p-value of0.002493. The female group had a p-value of 0.01717 and a correlation coefficient of 0.2763.CONCLUSION: RRFL and VDO have a favorable association, suggesting that it might help determine VDO.For accurate VDO selection, using this reference point in conjunction with further measurements is advised.KEYWORDS: Prosthodontics, Vertical Dimension of Occlusion, and Right Ring Finger Length

The mechanism for regulating the isometric contraction of masseter muscles is involved in determining the vertical dimension of occlusion.

We previously demonstrated that accurate regulation of isometric contraction (IC) of jaw-closing muscles to counteract the ramp load applied to the jaw in the jaw-opening direction is achieved through the calibration between the two sensations arising from muscle spindles (MSs) and periodontal mechanoreceptors (PMRs). However, it remains unclear whether this calibration mechanism accurately works at any jaw positions, i.e., any vertical dimensions of occlusion (VDO). In the present study, we examined the effects of altering VDO on the IC of the masseter muscles in complete dentulous and edentulous subjects. At a VDO higher than the original VDO (O-VDO), the root mean square (RMS) of masseter EMG activity increased more steeply with a load increase, resulting in an over-counteraction. The regression coefficient of the load-RMS relationship significantly increased as the VDO was increased, suggesting that the overestimation became more pronounced with the VDO increases. Consistently also in the edentulous subjects, at a higher VDO than the O-VDO, a steeper increase in the RMS emerged with a delay in response to the same ramp load whereas a similar steeper increase was seen surprisingly even at a lower VDO. Thus, the edentulous subjects displayed a delayed overestimation of the ramp load presumably due to less and slowly sensitive mucous membrane mechanoreceptor (MMR) in alveolar ridge compared with the PMR. Taken together, the accurate calibration between the two sensations arising from MSs and PMRs/MMRs can be done only at the O-VDO, suggesting that the O-VDO is the best calibration point for performing accurate IC.NEW & NOTEWORTHY Since 1934, the vertical dimension of occlusion (VDO) in edentulous individuals has been anatomically determined mostly by referring to the resting jaw position. However, such a static method is not always accurate. Considering the dynamic nature of clenching/mastication, it is desirable to determine VDO dynamically. We demonstrate that VDO can be accurately determined by measuring masseter EMG during the voluntary isometric contraction of jaw-closing muscles exerted against the ramp load in the jaw-opening direction.

Analiza e shablloneve të kafshimit në artikulator

Loss of vertical dimension of occlusion occurs when the patient loses height between the maxilla and mandible. The reproduction of the new prosthetic surface, the new vertical dimension, and automatically the horizontal di- mension due to rehabilitation is one of the most challeng- ing phases in rehabilitation. The importance of registra- tion, transfer to the articulator, and analysis is described in this review paper.

Assessment of Occlusal Vertical Dimension Change in Mechanical and Virtual Articulation: A Pilot Study.

The aim of this clinical study was to investigate the change in occlusal vertical dimension (OVD) with dental casts mounted on a mechanical articulator using an average axis facebow and on a virtual articulator mounted using the Bonwill triangle and the Balkwill angle and compare these groups with OVD change observed clinically in patients. Casts were obtained from each patient (n = 14) and mounted on a semi-adjustable articulator in the facebow preservation group (FPG) and on a virtual articulator using average anatomic values in the average mounting group (AMG). Customized mandibular anterior splints were virtually designed at an OVD increased by 3, 6, and 9 mm. Digital buccal scans were performed with the anterior devices in the participants' mouths in the intraoral group (IOG), AMG, and FPG at the different OVD increases accordingly. While no statistically significant differences (p > 0.05) were observed in the posterior interocclusal measurements with the incisal guide pin raised by 3 mm and 6 mm among all groups, a 9 mm increase resulted in a significant difference between AMG and IOG. The interocclusal posterior-to-anterior opening ratio observed clinically was 1:1.575. Increases in OVD up to 6 mm on dental casts mounted using average anatomic values performed similarly to the actual intraoral changes.

Complete oral rehabilitation with direct and indirect composite resins: a minimally invasive approach on severely compromised teeth.

The rehabilitation of severely worn teeth is a complex challenge for dental practitioners. There are many different types of dental materials and restorative techniques, and there is not a single way to achieve the desired result. This clinical report demonstrates a complete oral rehabilitation with composite resins when using an indirect application and direct techniques, with the support of the Lucia Jig technique, the Willis technique, and diagnostic waxing for the vertical dimension correction. The wide clinical improvement was achieved with the recovery of the function, the esthetics, and the increase of vertical dimension of occlusion through the planned treatment. The proposed treatment maintained the natural teeth, without the intense wear by the application of the composite resins instead of ceramics, together with excellent conditions for the patient to control the posttreatment and extend the durability, with the correct follow-up of appointments. Young patients with extensive dental wear and the loss of vertical dimension should not be directly submitted to ceramic treatments, with preparations for full crowns. Oral rehabilitation using composite resins, either directly or indirectly, allows for the recovery of the function and esthetics, without the intense predictable dental wear, and reduced financial investment.

Correlation between facial measurements and vertical dimension of occlusion among Tunisian populations: An anthropometric study.

Background. Establishing an accurate occlusal vertical dimension (OVD) is a crucial clinical step during full-mouth rehabilitation. Various techniques have been suggested to evaluate OVD, but none of them is practically reliable, and each one has its shortcomings. The correlation between facial proportions and the lower third of the face is a reliable method but needs to be verified in many ethnic groups. Therefore, this study aimed to determine the correlation between OVD and various facial measurements in a Tunisian ethnic group. Methods. A cross-sectional study was conducted between November 2020 to January 2021. The participants were randomly selected from dental students, dental surgeons, and the patients referring to the University Dental Clinic for dental treatments. Seven facial measurements were clinically recorded using a digital caliper. The correlation between OVD and facial measurements was analyzed using Spearman's coefficient and linear regression analysis. Results. A total of 201 dentate participants (134 females and 67 males) were included in the study. The mean OVD in male subjects was higher (67.60±4.49) compared to female subjects (60.72±3.84). The total facial height was positively correlated with OVD in both genders. OVD was statistically correlated with the height of the upper lip. This correlation was highly significant in males while it was weak in the female group. Conclusion. Facial proportions and linear equations are non-invasive, simple, and reliable methods to predict OVD, especially in males.

Implant-supported overdenture- An alternate treatment option for severely resorbed mandibular ridge

Rehabilitation of the patient with resorbed ridge has been a challenging procedure. Replacement with complete dentures has been the most common traditional standard of care. But there were many drawbacks in the atrophic mandible which includes lack of comfort, retention, stability, and inability to masticate. To overcome this drawback implant-supported over-denture came into use. The advantage of implant-supported over-denture over other treatment modalities are as follows: decreased bone resorption, reduced prosthesis movement, better esthetics, improved tooth position, better occlusion, increased occlusal function, and maintenance of the occlusal vertical dimension. In this article, we discussed the placement of two implants in the inter-canine region of the mandibular ridge and providing a conventional denture. Three months later this complete denture was converted into implant-supported mandibular over denture.

Retrospective 1- to 8-Year Follow-Up Study of Complete Oral Rehabilitation Using Monolithic Zirconia Restorations with Increased Vertical Dimension of Occlusion in Patients with Bruxism.

Aim: The aim of this paper is to perform a retrospective assessment of the clinical performance of the complete oral rehabilitation of patients with bruxism treated with implants and teeth-supported veneered and non-veneered monolithic zirconia restorations with increased occlusal vertical dimension. Methods: In this retrospective follow-up study, 16 bruxer patients, mean age 59.5 ± 14.9 years, were treated with 152 veneered and 229 non-veneered monolithic zirconia and followed for a mean of 58.8 ± 18.8 months (range 1–8 years). The patients were examined clinically and radiographically, annually. Clinical data were extracted from the medical records. In the recall appointments, modified California Dental Association (CDA) criteria were used to evaluate the restorations. Implant and restoration survival and success rates were recorded and analyzed. Results: The cumulative survival rates of implants and restorations were 97.7% and 97.6%, respectively. Nine restorations were replaced: three due to horizontal tooth fractures, two because of implant failure and four had secondary caries. A total of 43 biologic and technical complications were recorded. In the veneered group, the predominant complication was minor veneer chipping (16.4%), which required polishing only (grade 1). In the non-veneered group, the main complication was open proximal contacts between the implant restorations and adjacent teeth (14.5%). Conclusions: The survival rates of restorations and implants in patients with bruxism are excellent, even though veneered zirconia restoration exhibited a high rate of minor veneer chipping, which required polishing only. The biologic complication of fractured single-tooth abutment may occur.

Occlusal Considerations and Multidisciplinary Approach in the Rehabilitation of Generalised Tooth Surface Loss

Tooth wear is prevalent in the society and often-time affects an individual’s daily life. This case demonstrates the management of non-carious tooth surface loss with loss of occlusal vertical dimension using multidisciplinary approach involving periodontics, endodontics and prosthodontics. The tooth surface loss was graded moderate to severe anteriorly and affecting the patient’s overall appearance and self-confidence. Rehabilitation of this case involves restoring the anterior teeth at an increased occlusal vertical dimension, using reorganised approach and allowing relative axial tooth movement posteriorly. Clinical Relevance: The author believes the understanding of available conservative treatment options, occlusion concepts, proper material handling and satisfactory communication with other disciplines and the laboratory aid a clinician in achieving the best treatment outcome and better patient satisfaction.

RELATIONSHIP BETWEEN INTERPUPILARY DISTANCE AND VERTICAL DIMENSIONS OF OCCLUSION

Background: The determination of the vertical occlusion dimensions is one of the most important aspects in the treatment of edentulous patients. A widely discussed biometric indicator that is suggested for determination of the vertical occlusion dimensions is the interpupillary distance.The aim of this research was to study the relationship between the interpupillary distance and the vertical dimension of occlusion among individuals with natural dentition. Material and methods: Subjects of observation in the study were100 representatives of Bulgarian population, aged 20 to 25. Three reference points were marked: Pronasale, Subnasale and Gnathion. Every person was photographed enface with professional digital camera in strict standardized conditions. With help of the computer program were marked the pupil centres, connected the clinically marked points and then the distances between them were measured. Data were subjected to statistical analysis. Results:Stronger correlation was established between interpupillary distance and the distance Subnasale - Gnathion (for men: r = 0.6858 for women: r = 0.6584), compared to the correlation with distance Pronasale - Gnathion (for men: r = 0.5714 for women: r = 0.5805). Conclusions: Clearly expressed correlation was established between the interpupillary distance and the vertical dimensions of occlusion. The interpupillary distance could be applied as an additional landmark during determination of the vertical dimensions of occlusion. For achievement of optimal results, this method could be used along with other clinical methods.

Correlación entre la dimensión vertical de la oclusión y diferentes medidas faciales en una muestra de adultos sudaneses

Aim: This study aimed to evaluate the correlation between vertical dimension of occlusion (VDO) and various facial measurements in a sample of Sudanese adults. Material and Methods: A total of 113 dental students (33 males and 80 females) with a mean age of 21.7±1.26 years were enrolled in this study. Different facial measurements including (Eye-Mouth, Eye-Eye, Eye-Ear, and Ear Height) were compared with two different measurements of VDO: N-Gn (from the tip of the nose to the tip of the chin), and Sn-Me (from the base of the nose to the bottom of the chin). Pearson’s correlation coefficient test was utilized for the correlation between the measured parameters. A p-value of less than 0.05 was considered significant for all analyses. Results: A significant positive correlation was shown between all measured facial distances and both measured VDO distances. Though, the strongest correlation was seen for the eye-mouth distance (r= 0.725, p<0.001), while the weakest was for ear height (r= 0.254, p= 0.007). A paired t-test revealed a significant longer N-Gn distance than Sn-Me distance. Also, it has been shown that there were no significant differences between right and left sides of the face. Conclusion: The distance measured from the outer canthus of the eye to the angle of the mouth can be used to predict Subnasale-Menton (Sn-Me) distance.