Rethinking Occlusal Vertical Dimension: Clinical Decision-Making in Contemporary Restorative Dentistry
Occlusal vertical dimension (OVD) has historically been treated as a fixed value that must be identified or “restored.” However, contemporary evidence suggests that OVD should instead be understood as a dynamic parameter within a physiologic tolerance
range that can be modified when required to achieve functional and restorative goals.
In comprehensive rehabilitation, the decision to alter OVD is typically driven by three primary clinical needs: improving dentofacial esthetics, creating restorative space, and optimizing incisal and occlusal relationships. Because increasing
OVD reorganizes occlusion in three-dimensional space, careful integration of facial analysis, anterior tooth position, functional movements, and biomechanical principles is essential.
This lecture presents a pragmatic framework for evaluating when and how OVD should be modified in dentate patients. Particular emphasis will be placed on the role of maxillary incisal edge position in treatment planning, the relationship
between incisal lengthening and mandibular movement, and the importance of reversible clinical validation through mock-ups and provisional restorations.
Rather than attempting to restore a predetermined value, clinicians should aim to establish a vertical dimension that harmonizes esthetics, function, and restorative requirements with minimal biological risk.
- Explain why occlusal vertical dimension should be considered a dynamic clinical parameter rather than a fixed value.
- Identify the primary clinical indications for modifying OVD, including improvement of dentofacial esthetics, creation of restorative space, and optimization of occlusal relationships.
- Apply a structured decision-making approach to determine when and how OVD should be altered in dentate patients while minimizing biomechanical and functional risks.
Presenter
Marcelo Calamita, DDS, MS, PhD
Marcelo Calamita, DDS, MS, PhD graduated from the University of São Paulo in 1988, where he also completed his specialty training, master’s degree, and PhD in Prosthodontics. He currently serves as a Visiting Professor in the Department of Restorative
Dental Sciences at the University of Florida and previously held positions as Associate Professor of Prosthodontics at Braz Cubas University and the University of Guarulhos in São Paulo, Brazil.
Dr. Calamita is a former President of both the Brazilian Society of Esthetic Dentistry and the Brazilian Academy of Esthetic Dentistry. He served as Editor-in-Chief of the Dental Press Brazilian Journal of Esthetics and is currently a
member of the editorial board of the Journal of Esthetic and Restorative Dentistry.
He has lectured extensively in Brazil and internationally and has authored numerous scientific publications in the fields of esthetic and restorative dentistry. He is also the author of the book Esthetics in Function, which focuses on
treatment planning and occlusion.
Dr. Calamita maintains a private practice in São Paulo focused on comprehensive restorative and esthetic dentistry.
