Key Points
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Correct diagnosis and treatment planning is crucial.
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A diagnostic wax up is essential to allow conservative preparation and prototype fabrication and thus verifying any change in the occlusal scheme.
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A thorough understanding of occlusion is essential for any rehabilitation case be it functional or aesthetic.
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Changes in vertical dimension can allow for more conservative dental rehabilitations.
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All porcelain resin bonded restorations can be a conservative treatment modality for increasing vertical dimension.
Key Points
Aesthetics and cosmetics
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1
Aesthetic changes with four anterior units
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2
Smile lifts - a functional and aesthetic perspective
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3
Increasing occlusal vertical dimension - why, when and how
Abstract
Cosmetic dentistry has evolved with the advent of more robust porcelain materials and ever-stronger bonding agents. This series of three articles aims to provide a practical overview of what is now possible both functionally and cosmetically from the preparation of a small number of teeth, through a whole smile, to full mouth rehabilitation. A complete diagnosis is the starting point to planning any cosmetic or functional changes. Guidance is given on the techniques used but adequate training must be considered essential before embarking upon modification in occlusal schemes or even minor adjustments in smile design. Understanding vertical dimension and how and when it can be changed has always been a challenging prospect for the general dental practitioner. This article aims to discuss the rationale behind changes in vertical dimension and demonstrate how it can be achieved in general practice assuming adequate hands-on postgraduate training has been completed.
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References
Lucia VO . Modern gnathological concepts. p 272. St Louis, MO: CV Mosby, 1961.
Smith DM, McLachlan KR, McCall WD jnr . A numerical model of temporomandibular joint loading. J Dent Res 1986; 65: 1046–1052.
Carlsson GE, Ingervall B, Kocak G . The effect of increasing vertical dimension on the masticatory system in subjects with natural teeth. J Prosthet Dent 1979; 41: 284–289.
Kohno S, Bando E . Die funktionelle anpassung der Kaumuskulatur Bei Starker Bissagbung (functional adaptation of masticatory muscles as a result of large increases in vertical dimension). Dtsch Zahnarztl ZI 1983; 38: 759–764.
Dawson PE . Evaluation, diagnosis and treatment of occlusal problems. pp 280–285. St Louis, MO: CV Mosby, 1989.
Lucia VO . Modern gnathological concepts. pp 41–56. St Louis, MO: CV Mosby, 1961.
Manns A, Miralles R, Guerrero F . The changes in electrical activity of the postural muscles of the mandible upon varying the vertical dimension. J Prosthet Dent 1981; 45: 438–445.
Christensen J . Effect of occlusion raising procedures on the chewing system. Dent Pract Dent Rec 1970; 20: 233–238.
Dahl BL, Krogstad O . Longterm observations of an increased occlusal face height obtained by a combined orthodontic/prosthetic approach. J Oral Rehabil 1985; 12: 173–176.
Lindauer SJ, Gay T, Rendell J . Effect of jaw opening on masticatory muscle EMG – force characteristics. J Dent Res 1993; 72: 51–55.
Hammond RG, Beder OE . Increased vertical dimension and speech articulation errors. J Prosthet Dent 1984: 52: 401–406.
Blank JT . Scientifically based rationale for use of modern indirect resin inlays and onlays. J Esthet Dent 2000; 12: 195–208.
Lucia VO . Centric relation: Theory and practice. J Prosthet Dent 1960; 10: 849–856.
Acknowledgements
Thanks to Luke Barnett Dental Ceramics for their outstanding work and attention to detail. We are also indebted to Roy Higson for providing us with an occlusal learning pathway (www.ipsoseminars.org) and his continued support.
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Bloom, D., Padayachy, J. Increasing occlusal vertical dimension — Why, when and how. Br Dent J 200, 251–256 (2006). https://doi.org/10.1038/sj.bdj.4813305
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DOI: https://doi.org/10.1038/sj.bdj.4813305
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