A Simple Orthodontic Approach to Regain Incisal Guidance after Occlusal Elevation of the Collapsed Vertical Dimmention Case and Edge-to-edge Occlusion Case

Abstract

Regaining appropriate vertical dimension and clearance is necessary to reconstruct occlusion with acute occlusal plane when treating dental compression syndrome. Thus, patients with decreased vertical dimension should be treated by elevating the occlusion to restore the vertical dimension.
However, since occlusal elevation inevitably causes open bite in the anterior region, we have to face an important question of how to restore anterior guidance when correcting disocclusion in the posterior region.
In patients with edge-to-edge occlusion who have no diastema in the anterior region in the upper and lower arch, which makes it hard to insert orthodontic appliances, occlusion may be elevated first to move the mandible backward so as to allow space for elongation of the anterior teeth.
We have attempted various methods including the conventional methods. We herein report a case treated by a simple method.
A comparative study of panoramic radiographs taken before and after treatment by doubling them revealed a 7.5 mm increase of the vertical dimension between the alveolar bones in the third molar region on the right side. However, there was no depression in the molar region, indicating that the anterior overbite was restored by elongation of the anterior teeth.
It was suggested from our study that infraocclusion can be treated not only by the conventional methods using a multibracket technique, but also by some simple methods. by employing these simple methods, we can elevate occlusion before regaining anterior guidance while meeting patients' demands. The prognosis was also found to be stable.