Use of a patients old complete denture to determine vertical dimension of occlusion

Majid Bissasu, DDS, PhDa Faculty of Dentistry, Al Baahth University, Homs, Syria

The vertical dimension of occlusion (VDO) is the distance measured between 2 points when the occluding members are in contact.1 Determination of the correct VDO for an edentulous patient is generally agreed to be one of the most important steps in making a complete denture. Many methods have been used to determine the VDO in edentulous patients,2-13 but this task can be difficult. The patients old complete denture, if available, can be useful.11,12 A simple method for determining the VDO and occlusal plane by using the patients existing complete denture is presented.

PROCEDURE
This procedure may be adopted only if the existing VDO and occlusal plane of the existing denture are within normal limits. If changes are indicated, this method provides a reliable starting point. 1. Make maxillary and mandibular preliminary impressions in the usual manner. 2. Make maxillary and mandibular record bases and wax occlusion rims. 3. Place the patients denture in his/her mouth, and examine the horizontal and vertical relationships. If necessary, stabilize the denture by relining it with zinc oxideeugenol or elastomeric materials. 4. Measure the vertical height between the tip of the maxillary lingual cusp of the first premolar and second molar and the tissue side of the patients denture base, on both sides of the arch, with a modified boley gauge (Fig. 1). 5. Mark with a pencil where the guage touches the tissue side of the maxillary and the mandibular denture base. Put similar marks on the tissue side of the record bases. 6. Measure the vertical height between the seats of the maxillary first premolar and second molar cusp tips and the tissue side of the mandibular denture base. 7. Adjust the vertical height of the maxillary and mandibular wax occlusion rims to correspond to the measurements made on the patients denture (Fig. 2). 8. Try the wax occlusion rims in the patients mouth, making minor adjustments if necessary. 9. Try-in and finish the denture in the conventional manner.
aAssociate

Fig. 1. Measurement of vertical height between cusp tip and tissue side of denture base.

Fig. 2. Adjusted vertical height of wax occlusion rim.

SUMMARY
This procedure is a simple and accurate method for determining the VDO and occlusal plane of an edentulous patient with the use of his/her existing denture. When the measurements of the patients old denture are sent to the dental technician with the final impression, the proper vertical height of the wax occlusion rims can be made in the laboratory. Thus, the time required for recording the jaw relationships is significantly reduced.
REFERENCES

Professor, Department of Removable Prosthodontics. J Prosthet Dent 2001;85:413-4. APRIL 2001

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2. Turner LC. The profile tracer: method for obtaining accurate pre-extraction records. J Prosthet Dent 1969;21:364-70. 3. Smith DE. The reliability of pre-extraction records for complete dentures. J Prosthet Dent 1971;25:592-608. 4. Thompson JR. The rest position of the mandible and its significance to dental science. J Am Dent Assoc 1964;33:151-80. 5. Silverman MM. The speaking method in measuring vertical dimension. J Prosthet Dent 1953;3:193-9. 6. Shanahan TE. Physiologic vertical dimension and centric relation. J Prosthet Dent 1956;6:741-7. 7. Boos RH. Intermaxillary relation established by biting power. J Am Dent Assoc 1940;27:1129-9. 8. Lytle RB. Vertical relation of occlusion by the patients neuromuscular perception. J Prosthet Dent 1964;14:12-21. 9. McGee GF. Use of facial measurements in determining vertical dimension. J Am Dent Assoc 1947;35:342-50. 10. Wills FM. Features of the face involved in full denture prosthesis. Dent Cosmos 1935;77:851-4.

11. Winkler S. Essentials of complete denture prosthodontics. Philadelphia, PA: WB Saunders; 1979. p. 706-7. 12. Hickey JC, Zarb GA, Bolender CL. Bouchers prosthodontic treatment for edentulous patients. 9th ed. St. Louis, MO: CV Mosby; 1985. p. 267-67. 13. Fayz F, Eslami A. Determination of occlusal vertical dimension: a literature review. J Prosthet Dent 1988;59:321-3. Reprint requests to: DR MAJID BISSASU PO BOX 768 HOMS SYRIA FAX: (963)31-462-345 Copyright 2001 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2001/$35.00 + 0. 10/4/114279 doi:10.1067/mpr.2001.114279

Noteworthy Abstracts of the Current Literature

The size of occlusal rest seats prepared for removable partial dentures Culwick PF, Howell PG, Faigenblum MJ. Br Dent J 2000;189:318-22.

Purpose. This aim of this study was to determine whether rest seats prepared for a removable partial denture (RPD) by a group of general dentists would differ in size and shape when compared with seats prepared by either a group of postgraduate students or their academic instructors. Material and methods. The occlusal surfaces of many plastic teeth were scanned by a laser profilometer (Proscan 1000, Scantron Industrial Products Ltd, Taunton, UK). Each tooth then was placed in a set of phantom head articulated dental arches. Thirty dental practitioners, 16 postgraduate students, and 11 academic teachers were asked to prepare rest seats in the mesial marginal ridge area suitable for the fabrication of a cast RPD. After preparation, each tooth was removed from the dental arch and rescanned; the data were converted to gray level images for measurements of the width, length, and area of each rest seat preparation. Depth of preparation was calculated as the difference between the preparation and postpreparation scanned profiles. Statistical analyses were performed by the commercial computer software program Minitab (Minitab Inc, State College, Pa.). Results. There was wide variation in the size of individual rest seat preparations among the 57 dentists. There were no statistically significant differences in the measured parameters of rest seats prepared by postgraduate students and academics, so the data for these 2 groups were combined. The length, width, and area of the rest seats prepared by the postgraduate/academic combined group were significantly greater than those prepared by the dental practitioner group. However, there was no significant difference in depth of preparation measurements between the 2 groups. The outline form of rest seats prepared by the dental practitioner group was more rounded, with sharply defined margins; in contrast, the postgraduate/academic group prepared rest seats that were triangular and smooth. Conclusion. The authors conclude that a refresher course on tooth preparation modifications for RPDs for general dentists would improve the long-term success of these types of prostheses. 31 References. RP Renner

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