Statement of problem
In complete mouth reconstructive dentistry, the occlusal vertical dimension may be
increased to provide adequate restorative space or to improve esthetics. The effect
of increasing the occlusal vertical dimension on the smile is not well understood.
Purpose
The purpose of this study was to evaluate the effect of increasing the occlusal vertical
dimension on the dimensions of the smile.
Material and methods
Thirty dental students, 12 men and 18 women between the ages of 21 and 30 years old,
participated in this study. Polyvinyl siloxane occlusal registrations 2, 4, 6, and
8 mm in thickness were fabricated from articulated stone casts. Posed smile images
at occlusal vertical dimension +0, +2, +4, +6, and +8 mm were made with a digital
single lens reflex camera mounted on a tripod. A wall-mounted head-positioning device,
modified from a cephalometric unit, was used to stabilize the head position. Interlabial
gap height, intercommissural width, incisal edge to upper lip, and incisal edge–to–lower
lip measurements were made with computer software. The smile index was obtained by
dividing width by height. The display zone area was measured by using computer software
tracing. One-way repeated measures ANOVA (α=.05) was used for statistical analysis.
Results
With an increase in the occlusal vertical dimension, the interlabial gap height, incisal
edge to lower lip distance, and display zone area increased significantly (P<.001), whereas the smile index decreased significantly (P<.001). No significant changes were observed in the intercommissural width and incisal
edge to upper lip distance.
Conclusions
The interlabial gap height, incisal edge–to–lower lip distance, and display zone area
increase with increased occlusal vertical dimension. The smile index decreases with
increased occlusal vertical dimension. However, the width of the smile and the length
of the upper lip tend to remain unchanged.
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Article info
Publication history
Published online: May 14, 2014
Footnotes
Supported by an American Academy of Fixed Prosthodontics Stanley D. Tylman Research Grant, and the Marquette University School of Dentistry Student Research Fund.
Third Place Winner, 2014 American Academy of Fixed Prosthodontics Tylman Research Award.
Identification
Copyright
© 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
