Re-Establishment of an Occlusal Vertical Dimension: A Case Report

Submit Manuscript | http://medcraveonline.com to excessive occlusal wear [4]. Excessive wear of anterior dental elements is a fact of high influence on the smile’s esthetics and harmony [3-5]. As cases become more complex, aspects related to the patient’s occlusion re-establishment must be observed, including the recovery of the occlusal vertical dimension (OVD), which is defined as the vertical distance between two points, one in maxilla and one in mandible, when the occlusal surfaces are in contact [6-8]. One of the most important aspects in facial appearance involves the Occlusal Vertical Dimension, as the esthetics of the face is affected by facial form and facial height [9]. When a patient presents decreased OVD, because of advanced tooth abrasion, attrition, or tooth loss, its facial appearance is aged due to the decrease of the lower third of the face, lips intrusion, drop of the nose and can also bring phonetic and masticatory disorders and possible involvement of the temporomandibular joint (TMJ) and mastication muscles [5-9]. In general, in a situation that there was loss of dental elements or excessive wear of them, the OVD must be recovered before any definitive restorative procedure is executed, it must be done gradually at the beginning of treatment. Temporary acrylic resin crowns, fixed prosthesis or even interim removable prosthesis should be used for initial adaptation, particularly in determining a stable and functional occlusal vertical dimension [5,10]. After the creation of an optimum maxillomandibular relationship and the restitution of a restorative space the treatment plan can evolve into a definitive rehabilitation [11]. This paper describes the treatment of a 72-year-old patient who presented decrease in OVD. The treatment consisted in an OVD re-establishment by means of using a provisional device (occlusal overlay bilateral splints) made in acrylic resin. The final restoration occurred after a 60-day follow-up and was made with ceramic crowns in posterior teeth and direct restorations in anterior teeth.