The loss of the initial vertical dimension of occlusion (VDO) as it is due to wear-related loss of tooth structure, e.g. attrition (mechanical abrasion through direct tooth-to-tooth contact, bruxism/clenching), abrasion (wear through foreign substances), erosion (exogenous or endogenous acids without bacterial involvement), tooth and jaw misalignment, non-attachment of teeth (hypodontia, oligodontics), the tooth loss in the posterior dentition, the inadequate prosthetic restoration after loss of the supporting zone, etc., can also have adverse health effects apart from general aesthetic, dental aesthetic and functional impairments.

 

Worn teeth sometimes cause the teeth to sink by several millimeters and consequently the lip to collapse, thus the loss of vertical dimension of occlusion (VDO) can no longer support the lips adequately. As a result, the lips and vermilion are narrow and drawn in and the upper lip becomes wrinkled. The lost vertical dimension of occlusion (VDO) of the face leads to drooping commissures around the mouth and deepened naso-labial folds, along with a tense looking face. A functional dental restoration raises the lip volume, facial expressions and smile relax and rejuvenate.

 

The reconstruction of a too low vertical jaw relation, in patients with a largely full dentition, by a rise of the vertical dimension of occlusion (VDO), is one of the most demanding treatments in the spectrum of restorative-prosthetic dentistry and is usually associated with high technical, time and financial effort.

Consistent diagnostics and pre-treatment, which includes cariological, endodontic, periodontal and functional aspects are important for the successful implementation of a rise of the vertical dimension.

 

Restoration the original vertical relation with the help of prosthetic or restorative measures usually requires a comprehensive individual treatment plan, as all teeth and their different therapy needs must be taken into account during the planning.

In the actual restorative-reconstructive phase, it can be helpful to carry out the rehabilitation systematically in individual stages in order to make the treatment less stressful.

Rehabilitation treatment of reduced vertical dimension of occlusion (VDO) is not designed to increase the vertical dimension beyond normal, but is intended to restore the amount of VDO that has been lost.

 

Careful treatment planning and prior testing of the newly defined bite height are of particular importance. If the vertical dimension (VDO) was significantly raised, the bite elevation should be tested over a period of time using bite splints or long-term temporary restaurations. They are primarily used to clinically test a newly defined bite position in static and dynamic occlusion. In most cases, this functional evaluation is preceded by an aesthetic evaluation derived from the wax-up.

Before starting the definitive therapy, there should be a symptom-free interval of about half a year.

 

Occasional complaints:

• Sensitivity of abraded teeth to sweets or cold

• Jaw joint problems / craniomandibular dysfunction (TMD) due to the altered load on the jaw joints, which can lead to pressure feelings, joint pain and tension in the head, neck and shoulder area

Aesthetic features:

• Pronounced naso-labial fold

• Shortened lower third of the face

Remedy:

• Lifting of the support zones in all 4 quadrants there is the possibility of reconstruction the vertical dimension (VD) and thus raising the sunken lower third of the face.

• Eliminating the hypersensitivity of the teeth by building up the lost tooth structure.

• Fix the aesthetics and functionality.

• Permanent prosthetic restoration care with: composite fillings, ceramic fillings (inlays. /onlays), dental crowns, dental bridges, veneers, table tops.

• Aftercare with night guard (Michigan guard) to protect against renewed wear and / or damage of the restauration(s).

• A re-evaluation (clinical & radiological) takes place approx. 12 months after the start of treatment.

A good end result requires the contribution of good patient compliance.

 

Indications of occlusal rehabilitation:

• Aesthetic and functional recovery of the abrasive dentition.

• Restore compromised occlusal function: by rebuilding your teeth in such a way that avoids future misloading with new damage or other pain.

• Preserve the longevity of the remaining teeth.

• To protect of your new beautiful teeth against teeth grinding (bruxism) or nocturnal pressing (clenching), you will receive a grinding splint (Michigan splint)

 

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