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Vertical dimension of occlusion: the keys to decision

During an extensive prosthetic reconstruction, the choice of the vertical dimension of occlusion (VDO) is frequently presented as the main point to obtain a success of treatment. Probably, it is a sensible opinion to think that there is an optimal adaptive space concerning the vertical dimension (VD) rather than a magic point. The practitioner may play with the VD, if a strict rotation around the hinge axis is utilized, if the facial type is not worsened and if lip closure is kept in a natural position. In case of temporomandibular osteoarthritis, non progressive large changes of VD have to be avoided. The decision making will be described in relation to different factors, such as overjet, overbite, prosthetic space, mandibular morphology, profile, vertical and horizontal skeletal type. A decision-making table is proposed to visualize the trend of these different factors.

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