Changing the occlusal vertical dimension (OVD) has been one of the most controversial issues of restorative dentistry. The modification of the OVD may be indicated whenever it is necessary to harmonize dentofacial esthetics, provide space for planned restorations, and improve occlusal relationships. The OVD should not be considered an immutable reference, but rather a dynamic dimension within a zone of physiological tolerance that can be altered as long as the dentist respects the envelope of function. However, vertical changes in the relationship between the maxilla and mandible may have some biological, biomechanical, esthetic, and three-dimensional (3D) functional implications because the initial references of maximum intercuspation and anterior tooth relationships must be reconstructed and adjusted in a new dimension of space. This article aims to present a critical review of the relevant OVD literature and provide the clinical objectives and subjective parameters necessary to guide the clinician and laboratory technician during treatment involving OVD alterations.

Occlusal vertical dimension: treatment planning decisions and management considerations.

Interdisciplinary approach for increasing the vertical dimension of occlusion in an adult patient with several missing teeth.

Figure 1 Le Pr Jean-Daniel Orthlieb. Jean-Daniel Orthlieb (Fig. 1) est certifie en anthropologie et en prothese fixee, docteur en sciences odontologiques et docteur d’Universite. Il est professeur des Universites a la faculte de chirurgie dentaire de Marseille (Universite de la Mediterranee), vice-doyen charge des enseignements et responsable de l’enseignement de l’anatomie dentaire, de la physiologie manducatrice et de l’occlusodontologie. Il dirige la consultation « Accueil et planification » qui a pour charge d’etablir les projets therapeutiques globaux de l’ensemble des patients du centre hospitalo-universitaire. Ancien president du College National d’Occlusodontologie, il est membre de l’European Academy of Craniomandibular Disorders et president de l’International Academy of Advanced Interdisciplinary Dentistry. Il est l’auteur de plus de 100 publications nationales et internationales consacrees a l’occlusion et aux dysfonctionnements de l’appareil manducateur (DAM). Il a publie, en tant qu’auteur ou co-auteur, plusieurs livres traitant d’occlusodontologie.

[The occlusion-orthodontics relationship: an interview with Jean-Daniel Orthlieb].

Background/Aim. The vertical dimension of occlusion is a very important parameter for proper reconstruction of the relationship between the jaws. The literature describes many methods for its finding, from the simple, easily applicable clinically, to quite complicated, with the use of one or more devices for determination. The aim of this study was to ex- amine the possibility of determining the vertical dimension of occlusion using the vocals "O" and "E" with the control of values o btained by applying cognitive functions. Methods. This investigation was performed with the two groups of patients. The first group consisted of 50 females and 50 males, aged 18 to 30 years. In this group the distance between the reference points (on top of the nose and chin) was measured in the position of the mandible in the vertical dimension of occlusion, the vertical dimension at rest and the pronunciation of the words "OLO" and "ELE". Checking the correctness of the particular value for the word "OLO" was also performed by the phonetic method with the application of cognitive exercises when the patients counted from 89 to 80. The obtained difference in the aver- age values i n determining the vertical dimension of occlu- sion and the "OLO" and "ELE" in the first group was used as the reference for determining the vertical dimension of occlusion in the second group of patients. The second group comprised of 31 edentulous persons (14 females and 17 males), aged from 54 to 85 years who had been made a complete denture. Results. The average value obtained for the vertical dimension of rest for the entire sample was 2.16 mm, for the word "OLO" for the entire sample was 5.51 mm and for the word "ELE" for the entire sample was 7.47 mm. There was no statistically significant difference be- tween the genders for the value of the vertical dimension at rest, "ELE" and "OLO". There was a statistically significant difference between the values f or the vertical dimension at rest, "OLO" and "ELE" for both genders. There was a statistically significant correlation between the value for the vertical dimension at rest, "OLO" and "ELE", for both groups of subjects. Conclusion. Determining the vertical dimension of occlusion requires 5.5 mm subtraction from the position of the mandible in pronunciation of the word "OLO" or 7.5 mm in pronunciation of the word "ELE".

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Determination of vertical dimension of occlusion by using the phonetic vowel "O" and "E" Odreivanje vertikalne dimenzije okluzije pomou samoglasnika O i E

[Temporomandibular joint, occlusion and bruxism].

During an extensive prosthetic reconstruction, the choice of the vertical dimension of occlusion (VDO) is frequently presented as the main point to obtain a success of treatment. Probably, it is a sensible opinion to think that there is an optimal adaptive space concerning the vertical dimension (VD) rather than a magic point. The practitioner may play with the VD, if a strict rotation around the hinge axis is utilized, if the facial type is not worsened and if lip closure is kept in a natural position. In case of temporomandibular osteoarthritis, non progressive large changes of VD have to be avoided. The decision making will be described in relation to different factors, such as overjet, overbite, prosthetic space, mandibular morphology, profile, vertical and horizontal skeletal type. A decision-making table is proposed to visualize the trend of these different factors.

Vertical dimension of occlusion: the keys to decision

En soi, le terme « malocclusion » est nettement insuffisant pour fonder sur ce « diagnostic » des études épidémiologiques, des mécanismes étiologiques et pathogéniques, ou pour dégager des indications thérapeutiques. Comprendre une malocclusion n’est pas seulement s’intéresser aux rapports d’occlusion plus ou moins défectueux, mais impose de les situer dans leur cadre squelettique, comportemental, et surtout d’évaluer leurs impacts sur les fonctions de l’appareil manducateur. Les dysfonctions occlusales recensent les anomalies de l’affrontement occlusal, susceptibles de diminuer les capacités fonctionnelles de l’appareil manducateur (altération, réduction ou impotence) et/ou d’entraîner des fonctions manducatrices dommageables pour les structures. Entre « eufonction » et « pathofonction », il n’existe pas de frontière nette. Le dysfonctionnement de l’appareil manducateur est polyfactoriel. C’est donc toujours par la sommation des anomalies structurelles, associées à des facteurs parafonctionnels psychoémotionnels et à des fragilités de terrain que pourrait s’exprimer la symptomatologie [1]. Toutes les études épidémiologiques sont confrontées au problème essentiel de l’identification de telle ou telle anomalie ou

J Jouvin

Papers

Vertical dimension of occlusion: the keys to decision

Dysfonctions occlusales : anomalies de l'occlusion dentaire humaine

Au quotidien de l'article : Dysfonctions occlusales : anomalies de l'occlusion dentaire humaine