Patients with reduced vertical dimension present a challenge to the clinician, especially in extreme situations where the facial esthetics is affected. Additionally, a deep overbite is often present in these subjects resulting in collapsed occlusal patterns which are difficult to treat. Specific objectives of treatment in these patients should be focused in determining an adequate vertical position of the maxillary incisors, followed by determination of a proper occlusal plane and overbite. Knowledge of biomechanics allows to plan for the most cost-effective alternatives in restoring a functional occlusion and smile esthetics in these patients. Specific strategies will be discussed in order to achieve predictable outcomes. One couple systems, endosseous dental implants, TADs, orthognathic surgery and surgical/prosthetic multidisciplinary approaches will be presented.
Objectives
1. Describe the treatment planning process in patients with reduced vertical dimension and deep overbite.
2. Illustrate the different force systems that can be delivered through endosseous dental implants, one couple systems, and TADs in the treatment of deep overbite malocclusions.
3. Describe the importance of following a proper sequence in the mechanics plan to allow proper vertical control.
3. Discuss the role of orthognathic surgery, specifically of surgery first, in the treatment of patients with reduced vertical dimension.