Overview

The restorative needs for the prosthodontic patient frequently require an increase in occlusal vertical dimension (OVD). This may be due to loss of tooth structure and concomitant loss of OVD, supereruption of opposing teeth into edentulous spaces, or for esthetic reasons. It is often difficult to assess whether OVD has truly been lost. Therefore, it may be prudent to focus on whether alteration in OVD is restoratively acceptable. Another consideration for the alteration in OVD is changes in soft tissue profile. In addition to the correct proportions of the teeth, the relationship of the teeth to the lips and gingiva is also an important factor for an esthetic smile. During a normal smile, the upper lip should rest at the level of the mid-facial gingival margins of the maxillary anterior teeth.4 Furthermore, the gingival outline of the maxillary anterior teeth should follow the upper lip line. The incisal edges of the maxillary anterior teeth should follow the curvature of the lower lip. As the vertical dimension of occlusion increases, the distance between the maxilla and the mandible is increased.

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