Purpose: To test the accuracies of different methods of digital vertical dimension augmentation (VDA) by comparison with a clinical situation.
Materials and methods: Bite registrations with approximately 5 mm of VDA were made in the incisor regions of 10 subjects (mean VDA 4.5 mm). The conventional maxillary and mandibular stone casts in maximum intercuspation (MICP) and VDA bite registrations were digitized for all subjects using a laboratory scanner (control group). Lateral portraits were taken of all subjects to locate the position of the condylar axis. Four different digital VDA methods were compared to the control group: 100% rotation of the mandible referring to the lateral picture (100RL); 85% rotation and 15% translation referring to the lateral picture (85R15TL); 100% rotation in normal mounting mode of the Trios virtual articulator (100R); and jaw-motion analysis (JMA) equipment. The amount of VDA for each experimental group was compared to the control group. The augmented distances between the central incisors and the second molars were measured using 3D analyzing software. The ratio of the augmented distances between the posterior and anterior regions (P/A ratio) was calculated. One-way analysis of variance and multiple comparisons via least significant difference test were carried out to determine statistical significance.
Results: The P/A ratio of each group was as follows: Control = 0.61; 100RL = 0.55; 85R15TL = 0.61; 100R = 0.53; JMA = 0.52. Significant differences were observed for control vs JMA and for 85R15TL vs JMA (P < .05). The addition of translational movement was the primary factor for increasing the accuracy of digital VDA, with the lateral picture being a secondary factor.
Conclusion: VDA using a virtual articulator with 100% rotation induces an error when compared to the clinical situation. When a clinician performs digital VDA, the setting of 85% rotation and 15% translation produces results closer to the real clinical condition.