Occasionally, the interdisciplinary team (orthodontist, periodontist, restorative dentist, and oral and maxillofacial surgeon) is challenged to treat an adult patient with either overeruption of opposing teeth, extreme occlusal wear, or a combination of both of these vertical problems. In these situations, it would be beneficial, if the vertical dimension could be increased to provide space to restore either anterior or posterior teeth. In the past, the term "bite-opening" has often been used to describe the process of correcting these situations. However, this term is confusing and misleading. After all, the correction of decreased vertical dimension could involve tooth extrusion, tooth intrusion, maxillary osteotomy, mandibular osteotomy, or in extreme cases, a combination of all four modalities. How does the dental team diagnose various vertical problems and develop an appropriate treatment plan for each specific type of vertical malrelationship? This presentation will use many clinical examples to provide a systematic approach to diagnosing and treating patients with vertical malrelationships.
Analyze vertical dimension problems in adults;
Determine the appropriate solution for vertical dimension problems;
Identify when and how orthodontics can "open the vertical";
Describe the effect of opening vertical on the restorative possibilities.