Opening the vertical dimension of occlusion in an implant case

I would like to respond to a question regarding opening the vertical dimension of occlusion in an implant case. First of all, the VDO is determined by the repeated contracted muscle length of the masseter muscles. In the war between muscle and bone, muscle wins. Cephalometric studies illustrate that an increased VDO will return to this length determined by the muscles. (Let me know if you want the studies) Therefore, you are correct. It is a significant dilemma to place implants in a full mouth rehab case.

The great thing is that through our adaptive processes, the bone returns to the original VDO, typically within one year. It is recommended that you complete your full mouth rehab in phases. Place implants one year post-increase of the VDO. This way potential overloading of implants is avoided. Cases where implants/crowns were done simultaneously, you must plan to adjust the occlusion often to prevent overloading and failure of the implants.

Posted on Thursday, February 22, 2007 by Shannon Johnson, DMD filed under

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7 comments (Add your own)

1. Mark Gladnick wrote:: I would appreciate a couple of the studies to share with our study club. Also, if you have an article that shows how to lift the posterior occlusion to permit more esthetic anterior restorations (ie: lab-composite bite "pads"), that would be great. Thanks as always for your insights! Mark
March 22, 2007 @ 2:31 PM
2. Shannon Johnson, DMD wrote:: Let me work on the literature part for you and I will get back to you!
April 9, 2007 @ 9:11 PM
3. rodarte flores adrian wrote:: ok
May 12, 2007 @ 5:26 PM
4. shanai wrote:: its nice work but is the implante will be able to hold great occlusion pressure
March 8, 2008 @ 6:07 AM
5. jyothi p.a wrote:: maintaining vertical dimension for full mouth rehabilitation cases
April 9, 2008 @ 7:49 AM
6. jyothi p.a wrote:: how much to open vetical dimension in severe bite collapse case when and how
April 9, 2008 @ 7:51 AM
7. parsa Atashrazm wrote:: Ther is challange when implant is placed by oral surgeon or periodotist without consultatin with prosthodontist.Now I treat a patient with posterior bite collapse and implants were placed in bilateral posterior region of mandible( three in right side which was free end and two in left side which was tooth bonded edentulous space.There is contact of maxillary right first and second molars with opposing healing abutments.
My plan is first restore vertical dimension with provisional fixed restoration on implants and correct occlusal plane. also I increased vertial dimension 2 milimeters in posterior region.However I started this procedure after four months of implant placement and osseointegration of implant.For simultaneous and bilateral load distribution, occlusal load are shared by all posterior and antrior teeth.Also I discluded provisional restoration (immediate disclusion) on implant in excursion.
Now we are in phase that evaluate patient response to this amount of increased vertical dimension and check the osseointegration of implants.
October 21, 2008 @ 1:34 PM

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