Safety of increasing vertical dimension of occlusion: A systematic review

Faculty of Dentistry, University of Western Australia, Crawley, Western Australia, Australia.
Quintessence international (Berlin, Germany: 1985) (Impact Factor: 0.73). 05/2012; 43(5):369-80.
Source: PubMed


To review all the literature investigating the implications of increasing the vertical dimension of occlusion (VDO).
A comprehensive electronic search was conducted through PubMed with the aid of Boolean operators to combine the following key words: "occlusal vertical dimension," "increasing vertical dimension," "bite raising," "occlusal space," "resting vertical dimension," "rest position," "altered vertical dimension," "mandibular posture," "temporomandibular joint," and "masticatory muscles." The search was limited to peer-reviewed articles written in English and published through August 2011. Further, the literature search was endorsed by manual searching through peer-reviewed journals and reference lists of the selected articles.
A total of 902 studies were initially retrieved, but only 9 met the specified inclusion criteria for the review. From the selected studies, four variables were identified to be relevant to the topic of VDO increase: magnitude of VDO increase, method of increasing VDO, occlusion scheme, and the adaptation period.
Considering the limitations of this review, it could be concluded that whenever indicated, permanent increase of the VDO is a safe and predictable procedure. Intervention with a fixed restoration is more predictable and results in a higher adaptation level. Negative signs and symptoms were identified, but they were self-limiting. Due to the lack of a well-designed study, further controlled and randomized studies are needed to confirm the outcome of this review.

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Available from: Jaafar Abduo, Jun 26, 2014
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    ABSTRACT: The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.
    Preview · Article · Jan 2013 · The Journal of Korean Academy of Prosthodontics
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    ABSTRACT: Decrease of occlusal vertical dimension (OVD) due to loss of teeth structure and destruction of the occlusal plane by severely worn dentition may cause cross bite or temporomandibular joint disorder by following change of facial feature or the loss of anterior guidance. Full mouth rehabilitation via an increase of the OVD can be considered to avoid this problem and proper evaluation of patient's OVD is essential. An 80 year old male visited for overall prosthodontic treatment, cross bite due to continuous wear and following decrease of the OVD were observed. We analyzed the existing occlusal relationship using the diagnostic cast, the radiographic evaluation and clinical test, and then proper increase of OVD was selected. The new OVD on diagnostic wax up was placed by the temporary restoration. After 3 months of observation period, final restoration with fixed partial dentures and implant overdenture were made. Throughout the follow-up period of 8 months, the aesthetic and functional improvement can be obtained.
    Preview · Article · Jan 2014 · The Journal of Korean Academy of Prosthodontics
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    ABSTRACT: Increasing the vertical dimension is essential to resolving problems associated with deep bite. Restorative dentistry, orthodontia, and oral surgery are the three disciplines that can help to gain the vertical dimension necessary in these patients. This clinical report presents the results of increasing vertical dimension with a full-mouth restorative treatment procedure for a 40-year-old male patient who exhibited severe deep bite. After clinical evaluation, extraoral examination showed a reduction of the lower facial height and protuberant lips, wrinkles, drooping, and overclosed commissures. In addition, intraoral examination showed a severe anterior deep-bite articulation, and upper incisors were in contact with the lower incisor labial tissue. A removable partial denture was made at increased occlusal vertical dimension (OVD) to use in the first stage of rehabilitation. Diagnostic wax-up was performed at the increased vertical dimension. Then, provisional crowns were fabricated according to this increased vertical dimension. Interim prostheses were used for 3 months as a guide for preparing the definitive restorations. The adaptation of the patient to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, definitive restorations were completed, and routine clinical assessments were made after 1 week, 1 month, 3 months, and 6 months, then after 1 and 2 years with visual and radiographic examinations.
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