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Eur
. J. Pr
osthodont. Rest. Dent.,
V
ol.13, No. 1, pp 000-000
©
2005
FDI
World Dental Press
Ltd.
Printed in Great Britain
Determination of the Occlusal V
ertical Dimension:
Use of Maxillary and Mandibular P
osterior T
eeth
Measurement in Edentate Subjects*
Nuran Dinçkal
Y
anikogl
u
†
,
M. Üstün Gülda
g
†
and Zeynep
Yesil
Duymu
¸
s
†
Abstract
-
Deter
mination of the occlusal vertical dimension (OVD) is one of the most important steps in making
dentur
e
s
.
Various techniques
have been used to make these measur
ements. Unfortunately, there is no universally
accepted method available for clinical use. The aim of this study was, therefore, to develop a technique to
deter
mine OVD
for complete dentur
es by using parameters obtained fr
om natural posterior dentition. The
silicon impressions were made from the posterior region of the mouth from dentate patients in maximum
inter
cuspation. The measur
ements wer
e
made to deter
mine the distance between the depth of maxillary and
mandibular mucobuccal reflections and the relations of the posterior teeth to the mucobuccal reflections. The
mean distance between the mucobuccal reflections was 36.14 mm. in the first premolar region, 35.57 mm. in
the second premolar region and 32.44 mm. in the first molar region for the right side. The findings of this study
can be used as a guide for the construction of record bases and occlusal rims and for establishing the occlusal
vertical dimension in edentulous patients.
KEY WORDS: Occlusal vertical dimension, Posterior teeth
INTRODUCTION
One of the most important phases in complete denture
construction is to determine the correct vertical dimen-
sion of occlusion
1
. In the
Glossary of Pr
osthodontic T
e
r
m
s
,
vertical dimension is defined as “the distance between
two selected points, one on a fixed and the other on a
movable member”. There are two vertical dimensions of
particular interest: occlusal vertical dimension and rest
vertical dimension.
Rest vertical dimension is “the distance
between two selected points measured when the
mandible is in the physiologic rest position”, while occlu-
sal vertical dimension is “the distance measured between
two points when occluding members are in contact”
2
.
The
occlusal vertical dimension is usually stable but
changes after extraction; the dentist has to determine this
lost dimension when constructing a complete denture
3
.
There is no universally accepted method of determining
the occlusal vertical dimension in edentulous patients
because of the wide variation existing in the physical
characteristics of patients
1,
4
.
Several techniques have been
reported as useful tools, including the use of pre-extrac-
tion records, physiologic rest position, phonetics, patients’
perception, facial measurements, maximum biting force,
cephalometric radiographs and swallowing
1,3–9
Record bases and occlusal rims prepared on master
models are necessary for determining the horizontal and
vertical maxillomandibular relations in edentulous patients.
It
has been recommended that if possible and/or avail-
able, some pre-extraction measurements should be used
in determining the dimensions of the occlusal rims during
laboratory construction. Previous studies on determina-
tion of vertical dimension have, however
, often dealt with
the measurements in the anterior region
4,10–13
.
The aim of this study was to develop a technique that
would assist the determination of OVD for complete
dentures by using parameters obtained from the natural
posterior dentition. This information may be of value as
an aid in establishing the vertical dimension in edentu-
lous subjects.
MA
TERIALS AND METHODS
Forty five subjects were recruited for the study, 24 men
and 21 women between 20 and 35 years of age. They
had all of their natural teeth. Each subject was instructed
to close in maximum intercuspation (MI). A putty sili-
cone impression material (Coltene speedex, Coltene AG)
was mixed according to the manufacturer’s direction and
an occlusal impression in the posterior region was made
in maximum intercuspation. By perforating the impres-
sion material at the tubercle contact points during biting,
the thickness of the impression material between the teeth
was minimised. After the material had set, the impression
was removed from the mouth. For complete recording
of the buccal vestibular sulci, the borders of the impres-
sion were shortened and refined with a light-body
silicone impression material (Coltene speedex, Coltene
AG) which was injected into the depth of the mucobuccal
reflections of the maxillary and mandibular vestibular sulci.
After the material had been set, the refined impression
†
DDS, PHD
*
Presented at the 24
th
Annual Conference of the European Prosthodontic
Association, Goningen, Netherlands, 23–26 August 2000.
was removed and the following measurements were
made on the impression
using a millimeter rule and Boley
gauge: (a) the distance from the height of the mucobuccal
N.D. Y
ANIKOGLU, M.Ü. GÜLDAG AND Z. DUYMUS
¸
Table 1.
Distance from the depth of the maxillary mucobuccal
reflection to the tip of the buccal tubercle of the maxillary posterior
teeth
Tooth no.
Mean distan
ce
Range
S
D
C
V
(mm)
(mm)
(mm)
(
%
)
1
4
20
.
40
16–22
1
.
68
8
.
37
1
5
19
.
38
15–22
1
.
91
9
.
86
1
6
17
.
29
15–20
1
.
52
8
.
77
1
7
16
.
00
13–19
1
.
41
8
.
84
2
4
19
.
82
15–23
1
.
68
8
.
49
2
5
19
.
13
16–22
1
.
77
9
.
23
2
6
17
.
22
15–20
1
.
43
8
.
29
2
7
15
.
96
13–19
1
.
33
8
.
34
Table 2.
Distance from the depth of the mandibular mucobuccal
reflection to the tip of the buccal tubercle of the mandibular poste-
rior teeth
Figure 1.
Measurements from the height of the mucobuccal reflec-
tion of the maxillae to the tip of the buccal tubercle of the maxillary
posterior teeth.
Tooth no.
Mean distan
ce
Range
S
D
C
V
(mm)
(mm)
(mm)
(
%
)
3
4
17
.
27
15–20
1
.
37
7
.
94
3
5
17
.
40
15–22
1
.
53
8
.
79
3
6
16
.
07
13–20
1
.
63
10
.
14
3
7
15
.
43
13–19
1
.
57
9
.
36
4
4
17
.
87
15–21
1
.
52
8
.
49
4
5
17
.
78
14–21
1
.
68
9
.
43
4
6
16
.
42
14–20
1
.
63
9
.
93
4
7
14
.
73
12–18
1
.
57
9
.
34
Table 3.
Distance from the depth of the maxillary to the
mandibular mucobuccal reflections with the teeth in maxi-
mum intercuspation.
Tooth no.
M
ean distance
M
i
n
i
m
u
m
M
a
x
i
m
u
m
S
D
(mm)
(mm)
(
mm
)
14/44
36
.
14
31
.
4
41
.
9
2
.
56
15/45
35
.
57
30
.
4
41
.
5
2
.
73
16/46
32
.
44
27
.
5
39
.
0
2
.
72
17/47
30
.
20
25
.
6
34
.
7
2
.
60
24/34
35
.
39
30
.
4
40
.
8
2
.
59
25/35
34
.
67
27
.
2
41
.
8
2
.
86
26/36
31
.
93
25
.
7
41
.
4
2
.
74
27/37
28
.
94
23
.
2
33
.
5
2
.
53
Figure 2.
Measurements of distance between the mucobuccal
reflections.
reflection of the maxillae to the tip of buccal cusp of the
maxillary posterior teeth (
Figure 1
); (b) the distance from
the depth of the mucobuccal reflection of the mandibu-
lar vestibule to the height of the mucobuccal reflection
of the maxillary vestibule in the first and second premolars
and in the first molar region (
Figure 2
). The measure-
ments were made by the same investigator
.
At the end of all these procedures, the mean values, stand-
ard deviations, ranges and coefficients of variation (CV)
for the measurements were calculated.
RESUL
TS
The range of mean distance from the depth of the
maxillary mucobuccal reflection to the tip of the buccal
tubercle of the maxillary posterior teeth varied between
15.96 mm for the maxillary left second molar and 20.40
mm for the maxillary right first premolar (
Table 1
). The
mean distance from the depth of the mandibular
mucobuccal reflection to the tip of the buccal tubercle of
the
mandibular
posterior teeth varied from 16.07 mm
for
the mandibular left first molar to 17.87 mm for
the
mandibular right first premolar (
Table 2
). The
mean
distance from the height of the maxillary
mucobuccal reflections
to the depth of
the mandibular
mucobuccal reflections is presented in
Table 3
. The
mean distance was the longest for the first
premolar
region, 36.14 mm and the shortest for the first
molar
region, 31.93 mm.
DISCUSSION
For a denture to be functionally and esthetically pleasing,
a correct occlusal vertical dimension should be measured
and established
7
.
The current studies of the occlusal verti-
cal dimension have focused on the anterior determinant
in particular
. McGrane
10
established a 40 mm distance for
his patients. He speculated that the distance from the
incisal edge of the maxillary central tooth to the buccal
vestibule adjacent to the maxillary labial frenum was 22
mm. Also, the corresponding distance for the mandibular
000
DETERMINATION OF THE OCCLUSAL VER
TICAL DIMENSION
incisor was 18 mm. Fayz
et al
.
5
, reported these measure-
ments to be slightly less than those suggested by
McGrane
10
. The mean distance between the depths of
the mucobuccal reflections in the central incisor region
was 34.2 mm for the right side and 34.06 mm for the left
side.
According to another study by Güldağ
et al
.
12
, the mean
distance between the depths of the mucobuccal reflec-
tion in the maxillae and mandible was 37.05 mm in the
right incisor region and 36.89 mm in the left incisor
segment. The corresponding distance for the right and
left canines was, on the other hand, 39.70 and 39.35 mm.
The results of the current study could be used to format
some guidelines that can be helpful in positioning artifi-
cial teeth.
CONCLUSION
The average distance of the maxillary vestibu-
lar folds to
the tip of the mesio-buccal tubercle for the
first molar
and for the first premolar was approximately
17.25 mm and 20.11 mm, respectively. These measure-
ments provide a good starting point for the construction
of
record bases and occlusal rims and may need very
limited modifications for each case. The parameters
determined in this study may be helpful in the selection
and positioning of artificial posterior teeth during
complete denture construction.
MANUF
A
CTURER’S DET
AILS
•
Coltene speedex, Coltene AG, CH 9450 Altstatten,
Switzerland
ADDRESS FOR CORRESPONDENCE
Nuran Dinçkal Yanikoglu, Department of Prosthodon-
tics, Faculty of Dentistry at Atatürk University, Erzurum,
Turkey. E
-
mail:
ndinckal@atauni.edu.tr
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000
