Dental Considerations in the Adjustment of Lost Occlusal Vertical Dimension: A Clinical Report

The purpose of this clinical report is to discuss the clinical considerations related to increasing the occlusal vertical dimension (OVD) when restoring a patient’s dentition. Extra-oral and intraoral evaluations are mandatory to assess the suitability of increasing OVD. In the literature, multiple techniques have been proposed to quantify OVD loss. However, the techniques lack consistency and reliability, which in turn affects the decision of whether to increase the OVD. Therefore, increasing OVD should be determined on the basis of the dental restorative needs and aesthetic demands. In general, a minimal increase in OVD should be applied, through a 5 mm maximum increase in OVD can be justified to provide adequate occlusal space for the restorative material and to improve anterior teeth aesthetics. The literature reflects the safety of increasing the OVD permanently, and although signs and symptoms may develop, these are usually of an interim nature. The exception to this is for patients with Temporo-mandibular joint disorder (TMD), where increasing the OVD should still be achieved using removable appliances to control TMDassociated symptoms before considering any form of irreversible procedures.