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

Introduction Accurate determination of occlusal vertical dimension (OVD) is essential for the success of complete denture prostheses, as it influences esthetics, phonetics, comfort, and function. Traditional methods for assessing OVD often lack standardization and can be inconsistent, particularly in completely edentulous patients. Cephalometric analysis offers a radiographic alternative based on stable craniofacial landmarks. This study aimed to evaluate the reliability of cephalometric landmarks, both hard and soft tissue, angular parameters, and mandibular length, in determining vertical dimension in edentulous patients with and without dentures. Methods A cross-sectional in vivo study was conducted on 40 completely edentulous individuals. Standardized digital lateral cephalograms were recorded in two stages: without dentures (WOD) at physiologic rest and with dentures (WD) in centric occlusion. Five cephalometric parameters were assessed using digital cephalometric analysis software: Anterior Nasal Spine-Menton (ANS-Me) representing hard tissue, Subnasale-Menton (Sn-Me) representing soft tissue, Nasion-Facial Centre-A-point (N-Fc-A) representing the middle third facial angle, Anterior Nasal Spine-Xi-Suprapogonion (ANS-Xi-Pm) representing the lower third facial angle, and Condylion-Gnathion (Co-Gn) representing mandibular length. Conventional vertical dimension was recorded using Niswonger's method and Silverman's closest speaking space technique. Statistical analysis was performed using paired t-tests and Pearson's correlation coefficient with SPSS software, version 25.0 (IBM Corp., Armonk, NY, USA). Results Cephalometric values demonstrated strong positive correlations between without dentures (WOD) and with dentures (WD) conditions, particularly for soft tissue proportion (r = 0.928), middle third facial angle (r = 0.923), and hard tissue proportion (r = 0.870), with no statistically significant differences (p > 0.05). Interocclusal clearance remained consistent across all methods. Conclusion Cephalometric analysis provides a reliable, objective, and reproducible adjunct for occlusal vertical dimension (OVD) determination in edentulous patients. Its integration into digital prosthodontics may enhance accuracy and streamline denture fabrication, especially in complex or compromised clinical cases.