Using Double Occlusion Checking System and Bi-digital O-Ring Test to Determine the Vertical Dimension of Occlusion for Maxillofacial Prosthodontics for Patients with Long-Term Pathophysiological Condition

Common practice of establishing occlusal vertical dimension by adopting traditional method for patients with long-term pathological conditions has left the results much less than desired, since the degree of pathological condition for each patient varies from one patient to another, and traditional methods to determine vertical dimension are mostly intended for normal patients. Ideally, the occlusal vertical dimension should be dictated by, and conformed to patient's comfort range for the physiological accommodation to each patient's condition. This article describes a method of a double checking system for occlusion determination by increasing vertical dimension of occlusion (VDO) by ½ mm each week to find the most comfort zone and beyond for patient, and then to gradually decrease ½ mm of the VDO each week to the original VDO to double check the comfort zone for the patient. During the process, Bi-Digital O-Ring Test was employed to corroborate, to determine, and to individualize the occlusal vertical dimension for patients with pathological abnormalities. Traditional methods of vertical dimension determination were merely used as a guiding reference in our treatment of those patients. Patient's comfort and discomfort were carefully recorded, compared and studied before the denture prosthesis was fabricated.