When O.V.D is Wrong in Complete Dentures


Dental News Volume XXII, Number IV, December, 2015


By Dr. Jamila Jaouadi







Introduction

Why O.V.D should be correctly determined?
• To establish and maintain a harmonious relationship with all oral structures and to provide a masticatory apparatus that is efficient and esthetically acceptable.
• To ensure that all the effects of occlusal loading be distributed as evenly as possible to all supporting structures capable of receiving the force.
• To best control the undesirable effects of rotational or torquing forces on the prosthesis.
• To prevent any deflective contacts of the teeth during centric or eccentric closures as these can produce pathological changes in the supportive structures or in the neuromuscular mechanism that controls mandibular movement. 

Definitions
• Rest Vertical Dimension (RVD)
Is the distance measured when the mandible is in the rest position .
• Occlusal  Vertical Dimension (OVD)

Is the distance measured when the occluding rims or teeth are in contact.




Case one

A 46 year-old man patient; cardiopathic; works as a doctor, consulted us for diseases at the masseter at the right side.






At the beginning; his first pre-occupation is to have implants, thinking that this will resolve diseases.

At the examination; he presents a complete edentulism at the maxillary; a clII Kennedy-Appelgathe; and a unilateral mastication.




We did some modifications  on the old upper prostheses to ameliorate stabilization and retention; we also equilibrated occlusion because O.V.D was overestimated.

Meanwhile some extractions were performed on some roots of: 35, 36 and 37.

We examinated the situation more than one time; since ache has regressed; upper prostheses was redone by taking on the new O.V.D.
And eventually; the lower one was remade to keep once again the correct O.V.D.

For this case; the treatment lasted one year, to finally let the patient use his new prostheses for implant treatment as a surgical guide.


Case two

A 54 year old male nurse consulted our service at the Dental-clinic of Monastir for a habitual prosthetic treatment by complete dentures.

He complained of a local pain at the lower left side when palpating by the index finger.

Radiographic exam; didn’t show any abnormalities except a well- built-up ridge.
It was proved that the patient masticates on his ridges and has never got a prosthetic treatment.








His treatment was clearly to regain O.V.D. by a well-done temporary prosthese by making a roll of occlusion strengthened with metal.




And this temporary treatment will be used as a reference for the final restoration when disease regresses.








Conclusion

Various aspects presented by the dysfunctions of the masticatory system helped search the different factors that come into play in their etiologies. Probably age is one factor  but it is not the only. Clinical aspect of the condition in its various aspects is by far the most important. It concerns the majority of the stages of construction and operation of a complete prosthetic rehabilitation. This treatment is proposed for a pain relief and optimized function but does not mean healing.


References

1. Batolloni R, Christensen LC. 
L’esthétique en prothèse complète. 
Art & Technique Dentaires 1998;6:311-7.

2. Berteretche MV, Hüe O. 
Visage, esthétique et symétrie (Première partie). 
Cah Proth 1996;93:16-24.

3. Burchett PJ, Christensen LC. 
Estimating age and sex by using color, form and alignment of anterior teeth. 
J Prosthet Dent 1988;59:175-179

4. Jaudoin P, Coutarel-Fond C, Millet C. 
Aspects psychologiques de l’édentation totale. 
Encycl Med Chir (Elsevier, Paris), Stomatologie, Odontologie, 23-325-B-
08, 1996, 4 p.

5. Lejoyeux J. 
Prothèse complète. Tome II: diagnostic et traitement (3ème
 édition). 
Paris: Maloine, 1976.

6. Morchio S. 
La prothèse complète: principes esthétiques et fonctions. 
Art & Technique Dentaires 2002;1:23-9.

7. Rignon-Bret C, Rignon-Bret JM. 
Prothèse amovible complète, prothèse immédiate, prothèses  supraradiculaire 
et implantaire. 
Paris: CdP, 2002






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