Occlusal Vertical Dimension: Best Evidence Consensus Statement

Abstract

Purpose Patients in need of extensive prosthodontic treatment may need restoration of their occlusal vertical dimension (OVD) due to tooth wear, tooth loss, or changes that have occurred to existing prostheses over time. Prosthodontic treatment is based on the clinical application of the available evidence regarding interocclusal distance (IOD), the positional stability of rest vertical dimension (RVD), and the effect of altering the OVD. Hence, the purpose of this consensus document is to examine available data related to IOD, RVD, and alteration of the OVD. Materials and Methods The search was limited to Clinical trials, Randomized Controlled Trials, Systematic Reviews and Meta‐analyses. Key words were healthy patient, mean, range, interocclusal rest distance; healthy patient, mean, range, freeway space; and dentistry, interocclusal gap, and no citations appeared. Dentistry, interocclusal distance, revealed 5 not relevant citations. Dentistry, inter occlusal rest space, and dentistry, interocclusal rest distance, both had the same single not relevant citation. Dentistry, freeway space revealed over 7,000 citations. Dentistry, occlusal vertical dimension, revealed 253 citations, 7 of which were related to the search question but only 1 which was different from the previous search. Mandible, rest vertical dimension, age changes, found 7 citations, none relative to the question. Expanding the search to include journal article found 260 citations with only one relevant to the question. Mandible, rest vertical dimension, alteration, harm revealed no citations; mandible, occlusal vertical dimension, alteration, revealed 15 citations, 1 of which was relevant; mandible, occlusal vertical dimension, changes, revealed 75 citations, none of which were relevant; mandible, occlusal vertical dimension, rehabilitation revealed 10 citations, none of which were relevant. Expanding the search strategy to include Journal article, mandible, occlusal vertical dimension, alteration, received 159 citations, 4 of which were relevant; mandible, occlusal vertical dimension, restoration revealed 208 citations, 1 of which was relevant. Numerous other articles were culled by going through the reference lists of the aforementioned articles. Results For IOD, 27 articles were found relevant to the search question, which confirmed a mean of 3.0 mm with ranges from 1 to 9 mm. Five articles revealed little evidence as to whether the RVD changes during life. For OVD, 20 articles, including 4 systematic reviews, revealed some evidence that skeletal growth continues from mid adolescence into mid adulthood; strong anecdotal evidence that some unopposed teeth will continue to erupt; no clinical evidence to support the concept that abraded teeth in occlusion in a patient with bruxism will undergo continuous eruption; and some evidence from clinical case reports that restoring OVD in patients with severe abrasion is a successful treatment. Conclusions There is a range of dimensions for the interocclusal distance (IOD) with many normal dental p...

Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review

“…Frequently among patients that take long-term medications for chronic pathology such as hypertension or dyslipidemia hyposalivation occurs, this greatly increases the risk for caries and mucosal infections [ 10 , 11 ]. The loosening of vertical dimension due to the age, the presence of bruxism or other oral parafunction that are very common in the elderly population can cause the patients to have a bad masticatory function, low quality of life and the risk of losing other teeth; it is also worth mentioning the high comorbidity index of elderly patients with numerous comorbidities such as coronary artery disease, neurological disease, diabetes mellitus that impact oral health [ 12 , 13 , 14 ].…”

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“…También Aronson (s/a) nos indica que el retrognatismo mandibular, su incremento de la altura facial, también la mordida abierta anterior o la mordida cruzada puede deberse a factores ambientales crónicos, como la obstrucción de vías aéreas, y el tratamiento va dirigido a las modificaciones ambientales sobre la ubicación de la mandíbula y su oclusión dental (Barragán et al, 2020& Goldstein et al, 2021.…”

“…Variados estudios científicos publicados en resistas científicas regionales nos indican que la dimensión vertical es aquella medida que es coherente con las relaciones fisiológicas de ambos maxilares, para obtenerla se debe pasar por un proceso metódico en donde se presentan efectos craneofaciales cuando logra de manera errónea, los diferentes conceptos individuales deben ser cambiados e interiorizados de forma colectiva; esto se debe a la complejidad de la dinámica de la masticación. La dimensión vertical y la parte funcional/disfuncional del complejo craneofacial es innegable y está más allá de la relación dental (Barragán et al, 2020& Goldstein et al, 2021. Los diferentes trabajos consultados coinciden en que para una adecuada dimensión vertical se debe evitar la alteración y reducción de los márgenes fisiológicos, los cuales pueden repercutir de manera correcta en la biomecánica de la articulación temporomandibular.…”

“…Esta condición hace que la piel alrededor del área de la boca se pliegue y arrugue. La presencia de pliegues y arrugas acomodará la saliva en la que la presencia de C. albicans y otros contaminantes provoca una infección bacteriana o viral, como la queilitis angular (Goldstein et al, 2021& Silveira et al, 2022. Por esa razón el objetivo de este capítulo es describir lesiones bucales consecuentes de alteración de la dimensión vertical.…”

Complete morphofunctional oral rehabilitation by physiological increase of occlusal vertical dimension according to computerized mandibular scanner

“…The computerized mandibular scanner (CMS) together with transcutaneous electrical nerve stimulation (TENS) and surface electromyography (sEMG) is a method by which the muscular balance can be restored, and therefore the OVD corresponding to the functional rest position can be determined. Oral rehabilitation relies on the clinical application of the available evidence regarding interocclusal distance (IOD), the steadiness of RVD, and the consequences of altering the patient's OVD [2].…”