Complete morphofunctional oral rehabilitation by physiological increase of occlusal vertical dimension according to computerized mandibular scanner. 2022

Florin Eugen Constantinescu, and Fabio Savastano, and Paula Perlea, and Marian Vladimir Constantinescu
Doctoral School, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; AL399897@uji.es, florin-eugen.constantinescu@drd.umfcd.ro, Dr.florin.constantinescu@gmail.com, paula.perlea@gmail.com.

Increasing the occlusal vertical dimension (OVD) is often indicated in complex oral rehabilitation to gain restorative space and improve the occlusal relationship and aesthetics. The effect of increasing the OVD on lower facial height and facial aesthetics is not well understood and evaluated. The authors present the philosophy of the neuromuscular concept and illustrate it through a case report of a 58-year-old female patient who presented severe deep bite, bruxism, and temporomandibular disorders (TMDs). After clinical evaluation, the extraoral examination showed a reduction of the lower facial height, protuberant lips, wrinkles, and over-closed commissures. In addition, intraoral examination showed a severe anterior deep bite articulation, and the upper incisors completely covering the lower incisors labial surfaces. Through the philosophy of the neuromuscular concept the diagnostic ability, the quality and stability of the treatment increases. A temporary long-term fixed prosthesis was made at the enlarged OVD to be used in the first stage of the rehabilitation. Compared to the initial situation, the new prosthesis was delivered at a vertical dimension (VD) higher with 7 mm. The purpose of the neuromuscular philosophy and methodology is to harmonize the facial profile, functional occlusion, the joint function, and neuromuscular control. Through the neuromuscular methodology, we can assess the patient's ability to manage a significant increase in VD and to restore a functional OVD by physiological measurements.

UI MeSH Term Description Entries
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013705 Temporomandibular Joint Disorders A variety of conditions affecting the anatomic and functional characteristics of the temporomandibular joint. Factors contributing to the complexity of temporomandibular diseases are its relation to dentition and mastication and the symptomatic effects in other areas which account for referred pain to the joint and the difficulties in applying traditional diagnostic procedures to temporomandibular joint pathology where tissue is rarely obtained and x-rays are often inadequate or nonspecific. Common diseases are developmental abnormalities, trauma, subluxation, luxation, arthritis, and neoplasia. (From Thoma's Oral Pathology, 6th ed, pp577-600) TMJ Disorders,TMJ Diseases,Temporomandibular Disorders,Temporomandibular Joint Diseases,Disease, TMJ,Disease, Temporomandibular Joint,Diseases, TMJ,Diseases, Temporomandibular Joint,Disorder, TMJ,Disorder, Temporomandibular,Disorder, Temporomandibular Joint,Disorders, TMJ,Disorders, Temporomandibular,Disorders, Temporomandibular Joint,Joint Disease, Temporomandibular,Joint Diseases, Temporomandibular,Joint Disorder, Temporomandibular,Joint Disorders, Temporomandibular,TMJ Disease,TMJ Disorder,Temporomandibular Disorder,Temporomandibular Joint Disease,Temporomandibular Joint Disorder
D014070 Tooth One of a set of bone-like structures in the mouth used for biting and chewing. Teeth
D014716 Vertical Dimension The length of the face determined by the distance of separation of jaws. Occlusal vertical dimension (OVD or VDO) or contact vertical dimension is the lower face height with the teeth in centric occlusion. Rest vertical dimension (VDR) is the lower face height measured from a chin point to a point just below the nose, with the mandible in rest position. (From Jablonski, Dictionary of Dentistry, 1992, p250) Mandibular Rest Position,Rest Vertical Dimension,Vertical Dimension at Rest,Vertical Dimension of Occlusion,Dimension, Rest Vertical,Dimension, Vertical,Dimensions, Rest Vertical,Dimensions, Vertical,Mandibular Rest Positions,Occlusion Vertical Dimension,Occlusion Vertical Dimensions,Position, Mandibular Rest,Positions, Mandibular Rest,Rest Position, Mandibular,Rest Positions, Mandibular,Rest Vertical Dimensions,Vertical Dimension, Rest,Vertical Dimensions,Vertical Dimensions, Rest
D057887 Overbite A malocclusion in which maxillary incisor and canine teeth project over the mandibular teeth excessively. The overlap is measured perpendicular to the occlusal plane and is also called vertical overlap. When the overlap is measured parallel to the occlusal plane it is referred to as overjet. Deep Bite,Deep-Bite,Incisor Protrusion,Over Bite,Overjet, Dental,Deep Bites,Deep-Bites,Dental Overjet,Dental Overjets,Incisor Protrusions,Over Bites,Overbites,Protrusion, Incisor

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