VDO

[Brian8]

I had just received a call from one of my doctors requesting that I change the VDO 2 to 3 mm. less on a case that I had recently sent out. The patient loves the fit and the way they look she just can not eat with them.

My question is, what is the best and most accurate way to reduce the VDO on the denture and ensure it is the same as her old dentures.

Brian

[rob]

Hey Brian,


If the patient likes the esthetics and fit, I would do all of the reduction on the lower.
I would remount the case on a front pin articulator at the current centric relationship.Then I would eithier cut the lower teeth from the base(if you have room) or grind them off and use new teeth. Close the vertical 3mm and reset the teeth on the base for try-in.
How did you originally obtain this centric relationship? Used old dentures, made bite rims or some other technique?

Rob

[Brian8]

Hey Rob,

Thanks for the info. sadly I will be grinding on the occlusion of the lower and creating a 0 degree plane. I used the Ivoclar linguals on this case, upper and lower. Initially I made a bite rim to establish the centric relationship.

Brian

[Denturist]

What exactly do you mean ... She just can't eat with them?.... What happens when she tries? and how long has she had the new dentures?
Did the Dr. check for freeway space at the wax try in?
Did he/she check and balance occlusion after delivery?
How long has she been wearing dentures, how old is her previous set? and what kind of shape are her ridges in?
What degree of posterior tooth did you use? 0 degree, 10 degree, 20 degree, pilkington turner? (OK Ivo linguals )
Are the mandibular teeth set over the ridges?

Depending on the answers to the above questions you may be doing work that is unnecessary.

[JohnWilson]

Oh come on get a big bur and be done with it

Seriously, how the CR and VDO was recorded when you fabricated the dentures is in question. The truth is remounting on a standard hinge articulator and closing the bite down WILL NOT MATCH EXACTLY in the mouth. It will be close but absolutely not dead on. This is because of the ark of closure on the articulator rarly if ever matches dead on with the condyle.

As others have stated if the max denture has the proper smile line and the patients phonetics are accurate then I would leave it alone. If fixing this on the cheap is what the Dr is after he can take a face bow mount have you mount up the case on a semi or fully adjustable articulator. I would then reduce the pin and instead of removing teeth and resetting on a baseplate I would hog out the inside of the denture and tack it to the upper arch. After you get the pin down seal the borders and do a heat cured reline. Remount and adjust for processing errors and check lateral balance. Fast and accurate where the doc doesn't have to get the big acrylic bur out.

Another easy way if you are requested to remake the denture is to spot the bite in on a simple articulator and get the occlusion close. Send it to the Dr to do the final occlusial reduction in the mouth. Dismiss patient to see if he/she can function and is comfy at this bite. When patient is happy have them return and have the Dr take a VDO record then take reline impression, Very important to have the Dr check the VDO record after the reline imp is taken. Its very easy to open the bite with this impression. Pour/mount case and fab new denture for either try in or straight to finish. Simple easy and much easier for the GP to get a proper VDO CR than using a wax rim.

Ok good luck, let us know how you handle it, I bet on the big bur