vertical dimension of occlusion

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22-10-2024

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Understanding the Vertical Dimension of Occlusion: A Guide for Dental Professionals

The vertical dimension of occlusion (VDO) is a crucial concept in dentistry, impacting everything from facial aesthetics to chewing efficiency. It represents the distance between the upper and lower teeth when the jaws are closed in a relaxed position, and its accurate determination is vital for various dental procedures, including prosthetics, orthodontics, and TMJ treatment.

What is the Vertical Dimension of Occlusion?

According to a comprehensive review by Dr. Giancarlo P. Touati and Dr. Robert A. Walker published in the Journal of Prosthetic Dentistry (2009), VDO refers to the "vertical distance between two specific points, one on the upper and the other on the lower arch, when the teeth are in occlusion." This distance can be measured in millimeters or centimeters and is considered the most important measurement in dental prosthetics.

Why is VDO so important?

VDO plays a vital role in:

• Facial aesthetics: An incorrect VDO can lead to changes in facial contours, resulting in a collapsed appearance, altered lip support, and even a strained expression.
• Chewing efficiency: Optimal VDO ensures proper tooth contact and allows for efficient mastication. This helps prevent food impaction, ensures proper food breakdown, and reduces strain on the chewing muscles.
• TMJ health: The temporomandibular joint (TMJ) is directly affected by VDO. An incorrect VDO can lead to TMJ disorders, including pain, clicking, and limited jaw movement.
• Speech: VDO influences the way we speak, impacting vowel sounds and articulation.
• Dental prosthetics: Accurate VDO is essential for creating successful dentures, crowns, and bridges, ensuring proper bite and functionality.

How is VDO determined?

There are several methods used to determine VDO, including:

• Resting Vertical Dimension (RVD): This is the distance between the upper and lower teeth when the jaws are in a relaxed, neutral position. RVD can be measured using calipers or by observing the resting position of the lips and chin.
• Occlusal Vertical Dimension (OVD): This is the distance between the upper and lower teeth when they are in full contact in the biting position. OVD is typically determined by using a facebow or by analyzing the patient's bite with a dental articulator.
• Phonetic Method: This technique uses the sound of the patient's speech to determine VDO. The patient is asked to say words like "M" and "B," and the dentist measures the distance between the teeth while they are pronouncing these sounds.

The Impact of Incorrect VDO:

• Over-closure: This happens when the VDO is too small, leading to a shortened face, difficulty in opening the mouth, and strained muscles.
• Under-closure: This happens when the VDO is too large, causing excessive space between the teeth, difficulty in chewing, and a distorted facial appearance.

Managing VDO in Dental Treatment:

• Prosthetics: The dentist uses VDO measurements to create dentures, crowns, and bridges that fit the patient's unique bite and facial structure.
• Orthodontics: Orthodontists utilize VDO information to guide tooth movement and ensure the correct bite alignment.
• TMJ treatment: TMJ disorders can often be linked to an incorrect VDO. Dentists use VDO measurements to identify the source of the issue and develop appropriate treatment plans.

Conclusion:

Understanding the vertical dimension of occlusion is essential for dental professionals. Accurate VDO measurement is crucial for various dental procedures, ensuring proper bite, function, and aesthetics. By carefully considering VDO, dentists can provide patients with optimal oral health, function, and a beautiful smile.

Further Information:

• "Vertical dimension of occlusion" by Dr. Giancarlo P. Touati and Dr. Robert A. Walker, published in the Journal of Prosthetic Dentistry (2009)
• "The Vertical Dimension of Occlusion" by Dr. Mark J. Hersh, published in the Journal of the American Dental Association (2004)
• "Occlusion and Vertical Dimension" by Dr. David R. Anderson, published in the Journal of Clinical Dentistry (2013)

Note: This article has been written based on information from the mentioned scientific sources. It is intended for general knowledge and information purposes only and does not constitute medical advice. Always consult with a qualified dental professional for any concerns related to your oral health.