Aesthetics

/iːsˈθɛtɪks,ɛsˈθɛtɪks/

Lip line

Patients’ lip appearance and activity are a primary aesthetic determinant
Optimal aesthetic treatment outcomes require a harmonious reconciliation between lip morphology, teeth placement and design
Larger smiles with gingival exposure pose technical aesthetic challenges when managing anterior teeth restorations

Alveolar atrophy and insufficiency

Alveolar ridge reduction/resorption is influenced by local, systemic and genetic factors.

Teeth extractions are followed by a reduction of the bucco-lingual as well as the vertical dimension of the residual alveolar ridge. The ensuing resorption is progressive and even the basal jaw may become involved. In the lower jaw, the mandibular nerve can become located on top of the crest, causing pain to denture wearers.

Reduction of alveolar ridge height is far more frequently encountered in edentulous mandibles than in edentulous maxillae. Longevity of denture wearing, gender and a diminished Body Mass Index are associated with increased ridge resorption, while age does not appear to be relevant.

Vertical dimension

Vertical and horizontal jaw relations are integral components of the mandible’s centric relation (CR) position

Recording of patient-specific, vertical and horizontal jaw relations is a necessary starting point when planning for the occlusal rehabilitation

Aesthetic and phonetic assessments are considered optimal for the selection of the vertical dimension of occlusion (VDO)

Local history

Inspect facial structures for asymmetries, congenital anomalies, angiomata

Evaluate oral condition, especially history of existing periodontitis and/or temporo-mandibular dysfunction (TMD)

Treatment and control of existing periodontitis and TMD is critical

Non-implant based therapies may be indicated due to certain oro-maxillary conditions

Vertical Dimension of Occlusion (VDO)

he recording of patient-specific vertical and horizontal jaw relations is a necessary starting point when planning for the occlusal rehabilitation. They are integral components of the mandible’s centric relation (CR) position and develop as part of the normal process of jaw and teeth development and maturation. The preferred vertical relation for a patient reflects an informed decision based on a range of clinically-derived information, since VDO changes may result from untreated posterior teeth loss, severe dentition wear, inadequate prosthodontic treatment or long-term denture-wearing. Furthermore, mandibular rest position - with its 2-4 millimeter interocclusal rest space (IRS), or freeway space, between natural first premolars - is an unstable and unreliable determinant.

Aesthetic and phonetic assessments are considered essential and optimal for the selection of the VDO instead.

Information on this page and images credited to https://www.for.org/en

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