Alteration of the Occlusal Vertical Dimension for Prosthetic Restoration Using a Target Tracking System

Clinicians and researchers have used various methods to reproduce the maxillomandibular relationship and mandibular movement of individual patients using an articulator, with efforts being made to reduce errors associated with the conventional technique. When a change to a vertical dimension is required during the conventional prosthesis construction process, the maxillary and mandibular casts are mounted on the mechanical articulator using a facebow and bite registration and the elevation of the anterior guide pin of the articulator is used. However, this can inevitably cause errors due to differences between the articulator hinge movement and the actual trajectory of the patient. There has recently been increasing interest in tracking the trajectory of jaw motion of a patient, and this paper presents a new technique for altering the vertical dimension based on the measured trajectory. Target materials for performing tracking are attached to the maxillary and mandibular anterior teeth to record opening and closing movements of the patient’s mouth in real time and align the patient’s scanned intraoral data or cast data. The movements of the targets are replaced with the movement of the patient’s oral scan data. Additionally, then the occlusal vertical dimension is set to a new position based on the obtained trajectory. After determining the optimal vertical dimension with consideration of the space required for restoration, maxillary and mandibular STL files are exported and the designed cast is created using a 3D printer. The printed cast is mounted on an articulator for subsequent procedures. This approach maintains the patient’s actual maxillomandibular relationship at various vertical heights and can also reduce the chair time required when adjusting for errors.