Question

The question composed from two parts the first is how to diagnose the reduced vertical dimension in Dentulous patients while the second part is about how to increase the reduced vertical dimension with mentioning four diagnoses and four methods of treatment. Thank you!

Answer 1

1. Take the distance between the corner of the eye and the same corner of lips . In older people the measurement should be done a little more mesial , closer to the nose to avoid that down pointing tip . And using a ruler apply it between the center bottom of the nose that rises from the upper lip and lower tip over the mandible center.  
2. In general in minimal increase in ovd should be applied through a 5 mm maximum increase in ovd can be justified to provide adequate occlussion space for the restorative material and to improve an anterior teeth asthetics. the literature reflux the safty of increasing the ovd permanantly , and although signs and symptoms may devolop these are unusually of an interim nature. whenever indicated the increase in ovd should be achieved with restoration rather than are movable applience , due to the preditable patient adaptation.