The Art of Complete Denture Therapy for the General Practitioner by Kevin Huff & Douglas Benting

Author:Kevin Huff & Douglas Benting
Language: eng
Format: epub
Publisher: Quintessence Publishing

FIG 5-16 Reference marks are made on the chin and tip of the nose in pencil and transferred to a tongue depressor for relative evaluation of the VDO for the patient’s original denture, the new VDO established with the record bases, and the VDR at the physiologic rest position.

EXISTING VDO AS A STARTING POINT

If a patient presents in the terminal dentition stage or has acceptable—the key word here is acceptable—existing complete dentures, the teeth or existing dentures can be used as a starting point for determining an appropriate VDO for new prostheses. While the esthetic and phonetic method helps us establish an ideal VDO, many patients do not want to change their esthetic appearance in the way that a new VDO might. Unless there is a substantial functional need to alter the VDO for muscular health or the health of the TMJs, it is often optimal to attempt to remain within approximately 2 mm of the existing VDO. Fortunately, most patients desire to appear younger and more vibrant and welcome positive changes in their appearance.

If you are attempting to maintain an existing VDO that is significantly reduced, we must accept the fact that the functional scheme of the occlusion may likely require careful planning if optimal facially generated esthetics are desired. For example, we may likely need to consider a pseudo-prognathic situation with incisor function that mimics a skeletal Class III scenario, and mandibular cusp angulation must be kept shallow with a flat occlusal plane to maximize stability of the denture.

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