Determining Vertical Dimension in Edentulous Patients Through Cephalometric Evaluation: A Cross-Sectional Study

Area of Science:

• Dentistry
• Prosthodontics
• Radiography

Background:

• Accurate occlusal vertical dimension (OVD) is crucial for complete denture success, impacting esthetics, phonetics, comfort, and function.
• Traditional OVD assessment methods lack standardization and consistency, especially in edentulous patients.
• Cephalometric analysis presents a radiographic alternative using stable craniofacial landmarks.

Purpose of the Study:

• To evaluate the reliability of cephalometric landmarks (hard and soft tissue), angular parameters, and mandibular length in determining OVD in edentulous patients.
• To compare cephalometric measurements with and without dentures.
• To assess the correlation between cephalometric OVD determination and conventional methods.

Main Methods:

• A cross-sectional in vivo study involving 40 completely edentulous individuals.
• Standardized digital lateral cephalograms were taken without dentures (physiologic rest) and with dentures (centric occlusion).
• Five cephalometric parameters (ANS-Me, Sn-Me, N-Fc-A, ANS-Xi-Pm, Co-Gn) and conventional methods (Niswonger, Silverman) were assessed; statistical analysis included paired t-tests and Pearson's correlation.

Main Results:

• Strong positive correlations were observed between measurements with and without dentures for soft tissue proportion (r=0.928), middle third facial angle (r=0.923), and hard tissue proportion (r=0.870).
• No statistically significant differences were found between measurements with and without dentures (p>0.05).
• Interocclusal clearance remained consistent across all assessed methods.

Conclusions:

• Cephalometric analysis is a reliable, objective, and reproducible adjunct for determining OVD in edentulous patients.
• Integrating cephalometric analysis into digital prosthodontics can improve accuracy and efficiency in denture fabrication.
• This method is particularly beneficial for complex or compromised clinical cases requiring precise OVD.