Determination of the occlusal vertical dimension (OVD) is an integral part of complete dentures fabrication Due to the lack of teeth, the clinician faces the challenge of how to accurately establish the OVD of the new denture Therefore, the purpose of this review article was to present, discuss and critique the available methods used in determining the OVD for complete dentures patients This review identified two main streams to determine the OVD: (i) pre-extraction methods and (ii) post-extraction methods For the pre-extraction methods, the OVD of the natural dentition is transferred to the new dentures mainly by intra-oral measurements, profile tracing and cephalometric analysis The post-extraction methods rely on mandibular rest position, facial aesthetic appearance, swallowing pattern, craniofacial landmarks measurements, cephalometric analysis, phonetics and existing dentures In general, all the available techniques have merits and are helpful for routine clinical use However, they are empirical in nature, controversial and lack the scientific support Further, there is no single accurate method for OVD determination To overcome the limitations of the techniques, the clinician will benefit from applying combination of techniques to approximate the OVD

Determination of occlusal vertical dimension for complete dentures patients: an updated review.

PURPOSE: The aim of this study was to investigate whether wearing complete dentures during sleep can improve the apnea-hypopnea index (AHI). MATERIALS AND METHODS: A total of 34 edentulous patients (16 men and 18 women, mean age: 72.5 +/- 8.8 years) completed the study. Portable sleep recording was performed for two nights in patients' homes. All patients wore complete dentures one night and slept without dentures the other night. Information about medical history and denture use was obtained for all patients. The occurrence of obstructive sleep apnea syndrome (OSAS) was calculated in edentulous patients, and the effect that wearing complete dentures during sleep had on the AHI was evaluated. RESULTS: Twenty-seven of the 34 patients suffered from OSAS with an AHI > or = 5. The mean AHI in patients sleeping with dentures was lower than that of those without dentures (13.3 +/- 10.0 versus 17.7 +/- 14.6, P= .022). Nineteen of these 27 patients showed a decrease in AHI while eight showed an AHI increase, of whom four showed increases of more than 5 points when wearing dentures during sleep. CONCLUSIONS: Wearing complete dentures during sleep improves the AHI of most edentulous OSAS patients. In contrast, some patients suffer from AHI increases due to the use of complete dentures. Also in some patients, any significant change in AHI associated with the usage of complete dentures went unnoticed. Thus, careful attention should be given when complete dentures are recommended for edentulous OSAS patients.

Effects of wearing complete dentures during sleep on the apnea-hypopnea index.

Background
Establishment of proper occlusal vertical dimension (OVD) is one of the important tasks for successful prosthodontic therapy. An ideal method for determining OVD in terms of cost, time, and instrument requirements has been sought in prosthodontics by various investigators. However, no such single method has been formulated. In the current anthropometric study, the relationship of the length of the thumb to the OVD was tested in two ethnic groups of Nepal, Aryans, and Mongoloids. The result of this study can be useful in determining proper OVD in edentulous patients.

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An anthropometric study to evaluate the correlation between the occlusal vertical dimension and length of the thumb.

Determining and recording appropriate occlusal vertical dimension (OVD) in the treatment of the edentulous patient is an important but critical procedure in practice. Incorrect determination of the OVD may result in failure of complete denture treatment. Many methods have been advocated to determine the vertical dimension in edentulous patients. However, there is no single precise scientific method for determining the correct OVD. These methods include the use of physiologic rest position, swallowing, phonetic, aesthetic, facial measurements. A combination of some of them is recommended for a simplified clinical determination. Moreover, the application of several accepted tests is advocated to verify the established OVD.

Vertical dimension in the treatment of the edentulous patient

The construction of a complete restoration of the dentition by the surgical placement of endosseous titanium implants that support a fixed prosthesis in each jaw is possible. The positionings of the implants and teeth in the prostheses are important factors for a successful long-term result. Distribution of the occlusal biting forces over as many implants as possible is important. Off-axial occlusal biting forces should be diverted to the anterior jaws where the forces are not as great. The posterior teeth should be designed with flat occlusal surfaces that separate during excursionary mandibular chewing movements. Medial mandibular flexure caused by the contraction of the medial pterygoid muscle can be addressed by constructing the prosthesis in segments, so as not to have a rigid entity encased in flexing bone that may induce stress in the bone, potentially leading to loss of implant integration and failure. Segmenting also ensures an appropriate fit of the prosthesis with respect to casting and porcelain firing distortion. Lip support by means of a flange in the prosthesis may be necessary when there has been a large amount of bone loss from edentulous resorption. Cleaning and routine maintenance of the prostheses every 3-6 months is essential.

An Overview of Complete Artificial Fixed Dentition Supported by Endosseous Implants

Statement of problem Measuring vertical dimension is a soft-tissue measurement. Therefore, inaccuracy may occur. Purpose The purpose of this study is to compare the accuracy of the Willis gauge method with the caliper method. Material and methods The Willis gauge measures the distance between the septum of the nose and the chin. The caliper method measures the distance between reference points on the tip of the nose and the chin. Twenty predoctoral students applied both methods 10 times in measuring the rest vertical dimension (RVD) and the occlusal vertical dimension (OVD) of a single edentulous patient. The measurements obtained from one experienced clinician were selected as controls for the interocclusal distances (IOD) for the Willis and the caliper methods, respectively. One-sided t tests and a 1-sided nonparametric test were used to determine significant differences between the 2 methods (α=.05). Results The variances in the RVD values for the Willis gauge method were higher than for the caliper method for most students. A Wilcoxon signed rank test showed that the accuracy of the OVD measurements for the caliper method was significantly better than for the Willis gauge method ( P =.001). This was not the case for the RVD measurements ( P =.073).The average IOD for the Willis method was significantly higher than the control IOD ( P =.026). The average IOD for the caliper method was not significantly larger than the control ( P =.1303). Conclusion This study showed that the use of the caliper method by predoctoral students was a significantly more reliable method of measuring the OVD for the patient evaluated.

D.G Nel

Papers

A comparison of the accuracy of two methods used by pre-doctoral students to measure vertical dimension