EC Dental Science

The evaluation of the vertical dimension of occlusion (VDO) continues to be a diagnostic challenge in restorative dentistry and oral rehabilitation. Traditional methods based on phonetics, swallowing, free functional space and cephalometry have limitations in terms of reproducibility and objectivity. This article proposes an objective clinical technique, the interincisal anatomical assessment of VDO (IAA_ VDO), based on the anatomical measurement of the distance between the gingival zeniths of the upper and lower central incisors in maximal intercuspal position precisely of the enamel-cementum junction (UCA), considering the anatomical length of both crowns and the functional overbite. This technique, which is simple to apply, can be used in cases with structurally altered anterior dentition and provides an additional tool to validate the stability or alteration of the VDO.

 Keywords: Vertical Dimension of Occlusion (VDO); Incisal Anatomical Assessment of VDO (IAA_VDO); Enamel-Cementum junction (UCA)

1. Turner LC and Fox L. “Establishing the vertical dimension in full denture construction”. Journal of the American Dental Association 15 (1928): 181-187.
2. Willis FM. “Features of the face involved in full denture prosthesis”. Dental Cosmos 72 (1930): 123-130.
3. Niswonger ME. “The rest position of the mandible and the centric relation”. Journal of the American Dental Association 9 (1934): 1572-1582.
4. Pound E. “Esthetic dentures and their phonetic values”. Journal of Prosthetic Dentistry 1-2 (1951): 98-111.
5. Silverman MM. “The speaking method in measuring vertical dimension”. Journal of Prosthetic Dentistry 2 (1953): 193-199.
6. Atwood DA. “A cephalometric study of the clinical rest position of the mandible”. Journal of Prosthetic Dentistry 4 (1956): 504-519.
7. Shanahan TEJ. “Physiologic vertical dimension and centric relation”. Journal of Prosthetic Dentistry 6 (1956): 741-747.
8. Carlsson GE., et al. “Effect of increasing vertical dimension on masticatory system in subjects with natural dentition”. Journal of Oral Rehabilitation 6 (1979): 303-314.
9. Dahl BL and Krogstad O. “The effect of a partial chrome-cobalt splint on the occlusal vertical dimension”. Acta Odontologica Scandinavica 43 (1985): 283-289.
10. Gaspard M. “Vertical dimension: myths and realities”. Revue de Stomatologie et de Chirurgie Maxillo-faciale 86 (1985): 125-132.
11. Rivera-Morales WC and Mohl ND. “Relationship of occlusal vertical dimension to the health of the masticatory system”. Journal of Prosthetic Dentistry 4 (1991): 547-553.
12. Tallgren A. “Changes in adult face height due to aging, wear and loss of teeth and prosthetic treatment”. Acta Odontologica Scandinavica 30 (1972): 1-120.
13. Orthlieb JD., et al. “Cephalometric estimation of vertical dimension of occlusion”. Journal of Oral Rehabilitation 9 (2000): 802-807.
14. Harper RP. “Clinical indications for altering vertical dimension of occlusion”. Quintessence International 4 (2000): 275-289.
15. Dawson PE. “Functional occlusion: from TMJ to smile design”. St. Louis: Mosby (2007).
16. Okeson JP. “Management of temporomandibular disorders and occlusion”. 7^th St. Louis: Elsevier (2013).
17. Slavicek R. “The masticatory organ: functions and dysfunctions”. Klosterneuburg: Gamma (2006).
18. Kois JC. “Altering occlusal vertical dimension: clinical concepts and risk assessment”. Compendium of Continuing Education in Dentistry 25 (2004): 32-40.
19. Abduo J. “Safety of increasing vertical dimension of occlusion: A systematic review”. Quintessence International 5 (2012): 369-380.
20. Abduo J and Lyons K. “Clinical considerations for increasing occlusal vertical dimension: A review”. Australian Dental Journal 1 (2012): 2-10.
21. Moreno-Hay I and Okeson JP. “Does altering the occlusal vertical dimension produce temporomandibular disorders?” Journal of Oral Rehabilitation 11 (2015): 875-882.
22. Fabbri G., et al. “Increasing the vertical dimension of occlusion: A multicenter retrospective study”. International Journal of Periodontics and Restorative Dentistry 3 (2018): 323-335.
23. Goldstein G., et al. “Occlusal vertical dimension: Best evidence consensus statement”. Journal of Prosthodontics S1 (2021): 12-19.
24. Lassmann Ł., et al. “Myths surrounding vertical dimension of occlusion in restorative dentistry: A scoping review”. Journal of Esthetic and Restorative Dentistry 1 (2025): 94-105.
25. Discacciati JAC., et al. “Increased vertical dimension of occlusion: Signs, symptoms, diagnosis and treatment”. Journal of Contemporary Dental Practice 1 (2013): 123-128.
26. Joy TE., et al. “Evaluation of vertical facial height reduction and TMJ disorders using Shimbashi number”. Cranio (2019).
27. Makarova OM., et al. “Characteristics of interalveolar height using the Shimbashi index”. Ukrainian Dental Almanac 1 (2020): 69-73.
28. Sutter BA., et al. “What is the clinical significance of the Shimbashi measurement?” Advanced Dental Technology (2025): 1-7.
29. Bassett J and Kois JC. “Creating a hybrid smile design workflow: The analog brain drives digital technology”. Journal of Esthetic and Restorative Dentistry 5 (2023): 773-786.
30. Manfredini D., et al. “Occlusal features and temporomandibular disorders: An evidence-based approach”. Journal of Oral Rehabilitation 44 (2017): 448-456.
31. Sierpinska T., et al. “Effects of increasing vertical dimension on cephalometric and EMG parameters”. Acta Odontologica Scandinavica 72 (2014): 1-7.
32. Moss C. “Laboratory observations on incisal CEJ-to-CEJ distance in TMD patients”. Unpublished data 1980s.
33. Shimbashi H. “Lectures on vertical dimension and neuromuscular occlusion”. Drayton Valley, Alberta 1980-1990.