CLINICAL RESEARCH

A craniometry-based predictive model to determine occlusal

vertical dimension
Claudio Morata, DDS,a Andrea Pizarro, DDS,b Hector Gonzalez, DDS,c and
Raúl Frugone-Zambra, DDS, MHSc, DHScd

The occlusal vertical dimension ABSTRACT

(OVD) is the distance between 2
Statement of problem. Craniometry is a method of determining the occlusal vertical dimension
selected pointsdusually on the (OVD); the current prediction models do not consider factors such as facial type and sex or
chin and the tip of the nosed normalizing the OVD by using 1 main variable.
with the teeth in maximum
Purpose. The purpose of this clinical study was to determine whether sex, facial type, and age can
intercuspation.1 Determining
influence the creation of a predictive model by using the right or left eye-to-ear distance to
the correct OVD is important determine the OVD in dentate and edentate individuals.
when restoring dentitions in
which loss or change of poste- Material and methods. Healthy individuals (N=385) (238 women, 147 men) aged between 18 and 50
years were classified according to sex, age, and facial type. A single operator recorded all distances in
rior dental support has occurred.
millimeters between the anatomic landmarks proposed by Knebleman (nose-to-chin and right and
In such situations, restoring left eye-to-ear distances) by using a computer numerical control (CNC) machined aluminum
the OVD is essential given its anatomic gauge. Measurements were converted into z-scores to determine abnormal values
effect on esthetics, neuro- (±3 standard deviations criteria). The Pearson correlation coefficient was calculated for each facial
musculature, and biomechan- type and for the entire sample between nose-to-chin and the right and left eye-to-ear distances.
ical behavior.2-5 Moreno-Hay Multiple regression analysis was performed to establish the dependence of the measured variables
and Okeson6 pointed out that on the OVD and the development of a further predictive model (a=.05).
scientific evidence that alter- Results. According to the z-scores of the measured distances, 4 participants were discarded, leaving
ations in OVD cause temporo- a final sample of 381 participants (237 women, 144 men; 115 leptoprosopic, 164 mesoprosopic, 102
mandibular disorders in the euryprosopic). The left eye-to-ear distance showed a better correlation with the nose-to-chin
long term is lacking. distance (leptoprosopic r=0.54, mesoprosopic r=0.60, euryprosopic r=0.55, total sample=0.56)
than the right eye-to-ear distance (leptoprosopic r=0.48, mesoprosopic r=0.56, euryprosopic
However, they suggested that r=0.54, total sample=0.51). Multiple regression analysis revealed that age was not a predictive
any changes in the OVD should variable (P=.57), that OVD depended on sex (P<.001) and facial type (P<.01), and that women
be minimal.6 had shorter OVD than men, as well as more euryprosopic faces than leptoprosopic faces. Using
Different techniques to these relationships, the following equation to determine OVD was constructed as a model:
determine OVD have been OVD=42.17+(0.46×left eye-to-ear distance)+sex (women=−3.38, men=0)+facial type
described, including mandib- (leptoprosopic=0, mesoprosopic=−1.19, euryprosopic=−2.19).
ular physiologic rest position,7 Conclusions. OVD depends on facial type and sex, both of which are craniometric variables. This
esthetics,8 phonetics,9 and study proposed a baseline method of determining OVD by using the left eye-to-ear distance as
deglutition.10 These tech- an initial reference that involves a straightforward mathematical calculation. (J Prosthet Dent
niques rely on the clinical 2019;-:---)

a
Professor, Faculty of Dentistry, Pedro de Valdivia Univerisity, Santiago, Chile.
b
Professor, Faculty of Dentistry, University of Chile, Santiago, Chile.
c
Professor, Faculty of Dentistry, San Sebastián University, Santiago, Chile.
d
Professor, Dental School, Institute of Multidisciplinary Research in Science and Technology, University of La Serena, La Serena, Chile.

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eye-to-ear distance, depending on the variables of sex,

Clinical Implications age, and facial type.
Determining OVD by sex and facial type is possible
by using a straightforward mathematical equation MATERIAL AND METHODS
with the left eye-to-ear distance. OVD in women is
shorter than in men and in euryprosopic faces. Participants aged between 18 and 50 years were volun-
There is a maximum difference of 5.5 mm for the tarily recruited from patients and employees of the IN-
same eye-to-ear distance but with different DISA Clinic (Santiago, Chile) to participate in this clinical
combinations of sex and face type. Therefore, the study between May 2016 and August 2016; 238 women
craniometric model for determining the OVD should (average age ±standard deviation 32.5 ±7.52 years) and
be a valid, objective, and specific baseline method, 147 men (average age 32.1 ±7.54 years). This study was
requiring relatively little clinical time. approved by the ethics committee (East Metropolitan
Healthcare Service). All participants gave their informed
written consent to take part in this research in accordance
with the Declaration of Helsinki.
criteria of the clinician and the cooperation of the patient, The participants were enrolled by a single researcher
which leads to variability.11 (C.M.) by using a questionnaire and visual inspection to
More objective techniques have been described based ensure the following inclusion and exclusion criteria were
on craniometrics,12,13 cephalometric studies,14-17 facial fulfilled. The inclusion criteria are as follows: healthy,
proportions,18,19 and preextraction methods.20-22 As fully, or partially dentate (with no more than 2 missing
these techniques are based on the analysis of morpho- teeth, apart from third molars) adults with stable
logic relationships, which can be observed and quanti- maximum intercuspal position and bilateral posterior
fied, their variability should be lower. support and without any temporomandibular skel-
Knebelman23 described a craniometric method and etomuscular symptoms. The exclusion criteria are as
proposed a proportional relationship between the dis- follows: developmental maxillofacial anomalies; tooth
tance from the anterior wall of the external auditory wear with dentin exposure; facial features precluding
meatus to the medial aspect of the lateral wall of the correctly locating anatomic landmarks and making ac-
right orbit (eye-to-ear distance) and the distance from curate measurements; dense beards; parafunction;
the lower surface of the anterior nasal spine to the most ongoing or past orthodontic treatment; acute ear condi-
anterior and inferior point of the mandible with the tions; skeletal class III malocclusion; and edentulism.
teeth in occlusion (nose-to-chin distance). The patent23 After the participants had been selected, they were
indicated that such relationship is adjusted to a factor classified according to sex, age, and facial type, and their
dependent on cranial size, for each millimeter incre- craniometric measurements were recorded. This was
ment of the eye-to-ear measurement (made between 60 performed by the same single researcher (C.M.). The
and 80 mm), a deduction of 0.1 mm is made, starting overall morphological facial index26 (FI) was used to
with −5 mm when the eye-to-ear measurement is 60 determine the facial type. The FI was calculated by using
mm to a low of −3.0 mm when the eye-to-ear mea- the following formula: FI=100×(FH/FW), where facial
surement is 80 mm. The technique has been described height (FH) is the distance between the glabella (the
as a straightforward, inexpensive, and noninvasive point situated on the midline between the supraorbital
method that can be used for determining OVD.12,24 arches) and the gnathion (the most antero-inferior point
However, the predictability of the method varies of the mandibular symphysis) and facial width (FW) is
depending on sex, side of the face measured, and the bizygomatic distance (zygion to zygion).
ethnicity.12,24 In addition, Manns et al25 reported that, Digital calipers (Ubermann) were used to measure all
given the possible differences in muscular pattern dis- distances. The participants were seated on a chair with
played by different biotypes, facial biotype should be their backs upright against the back of the chair, with
considered when the OVD is restored. their heads unsupported and looking straight ahead and
The Knebelman method of predicting OVD takes only with the plane of Camper parallel to the floor. The
1 variable into account. The purpose of this clinical study operator sat on a rolling stool at the same height as each
was to determine whether the variables of sex, facial type, participant and recorded all measurements to calculate
and age can influence the determination of the OVD by the FI. Having calculated the FI, participants were
using the right or left eye-to-ear distance as an indicator divided into euryprosopic (FI<97), mesoprosopic (FI 97-
to predict the OVD in dentate and edentate individuals. 104), and leptoprosopic (FI>104). Their facial type, sex,
The research hypothesis of this clinical study was and age were recorded on a spreadsheet (Excel; Micro-
that a correlation would be found between OVD and the soft Corp).

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Figure 1. Calipers used to record eye-to-ear distance A, Lateral view. B,

Front view showing part of calipers used to record nose-to-chin distance.

Distances between those anatomic landmarks

considered to be predictive in determining the OVD ac-
cording to the craniometric method of Knebelman were
subsequently recorded for all participants: right and left
eye-to-ear distance (the distance between the medial
aspect of the lateral wall of the orbit and the anterior wall
of the external auditory meatus) and OVD (the distance Figure 2. A, Range and location of zero mark of calipers. B, C, Surfaces
between the lower surface of the anterior nasal spine and that contact anatomic structures when recording eye-to-ear distance (3,
the most anterior and inferior point of the mandible with 2) and nose-to-chin distance (1, 2).
the teeth in occlusion).
The researcher, trained according to the protocol
created by Knebelman, performed and recorded all cra- scales, the zero mark was located on the surface of the
niometric measurements by using a computer numerical calipers that would contact the corresponding anatomic
control (CNC) machined anodized aluminum anatomic landmarks for measuring the eye-to-ear and nose-to-
measuring device calibrated in millimeters with laser- chin distances in turn (Fig. 2).
engraved graduations. The device was designed by using Using the protocol of Knebelman,23 measurements
software (Rhinoceros 3D; Robert McNeel & Associates) were recorded with both participant and operator in the
with a scale on the front surface to measure the nose-to- setting described previously to classify facial type. The tip
chin distance and a scale on the lateral surface to mea- of the lower arm of the device was placed onto the
sure the eye-to-ear distance (Fig. 1). For each of the 2 anterior wall of the right external auditory meatus,

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bring their posterior teeth together without occluding

hard to achieve maximum intercuspation. The nose-to-
chin distance (OVD) was then recorded, with the upper
side of the upper arm of the calipers placed against the
lower surface of the anterior nasal spine. In turn, the
upper side of the lower arm of the device was positioned
on the most anterior and inferior surface of the mandible
(Fig. 3C). The fixing screw was then tightened, and the
reading displayed on the device was recorded in milli-
meters. All measurements were recorded on the
spreadsheet (Excel; Microsoft Corp).
Qualitative variables were described as frequencies and
percentages. Continuous variables were analyzed by using
quartiles, averages, and standard deviations. Distance
measurements were converted into standard scores
(z-scores) with the purpose of identifying measurements
outside a normal range. The distance criteria for this were ±3
standard deviations from the arithmetic mean of recorded
distances. This was done for each facial type according to
their FI. The Pearson correlation coefficient was calculated
between the nose-to-chin distance and the right and left
eye-to-ear distances for each facial type and for the entire
sample. Subsequently, a possible dependence between the
nose-to-chin distance and the eye-to-ear distance by sex,
age, and facial type was calculated by using multiple
regression analysis (a=.05). The data were analyzed by using
statistical software (STATA 14.0; StataCorp LLC).

RESULTS
The overall sample was 385 participants between 18 and
50 years of age: 238 women (average ±standard deviation
age 32.5 ±7.52 years) and 147 men (32.1 ±7.54 years).
Face types were classified as 30.9% leptoprosopic (16.1%
women and 14.3% men); 42.9% mesoprosopic (28.8%
women and 14.1% men); and 26.7% euryprosopic
(16.9% women and 9.8% men).
According to the z-scores for distances measured in
this study, 4 participants were discarded from the sample
because their measurements lay outside ±3 standard
deviations; all other participants were considered valid.
Figure 3. Recording distances. A, Right eye-to-ear distance. B, Left eye- Although there were 10 outliers in the final data sample,
to-ear distance. C, Nose-to-chin distance. they were included as they were within the ±3 standard
deviations criteria and did not show great differences
overall (Fig. 4). Further, these 10 outliers met the inclu-
perpendicular to the sagittal plane of the cranium; the sion and exclusion criteria. Thus, the final sample for this
end of the upper arm of the device was placed against the study was 381 participants; 237 women (32.53 ±7.52
medial aspect of the lateral wall of the right orbit years), 144 men (32.01 ±7.52 years); 30.2% leptoprosopic
(Fig. 3A). Measurements were made with minimal (16.3% women, 13.9% men); 43.0% mesoprosopic
pressure to avoid excessive compression of anatomic (28.9% women, 14.2% men); 26.8% euryprosopic (17.1%
structures and discomfort. The fixing screw was tight- women, 9.7% men). A descriptive analysis for the nose-
ened, and the reading (in millimeters) on the device for to-chin distances and right and left eye-to-ear mea-
eye-to-ear distance was recorded. The same procedure surements for all face types is shown in Table 1.
was performed for the left-hand side of the cranium For all facial types, the left eye-to-ear distance
(Fig. 3B). Subsequently, the participants were asked to showed a better correlation with the nose-to-chin

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Men Women
3

1
(mm)

–1

–2

1 2 3 1 2 3
Facial Type
Nose-chin distance 1=Leptoprosopic
Right eye-ear distance 2=Mesoprosopic
Left eye-ear distance 3=Euryprosopic

Figure 4. Z-scores for average distances (mm) according to sex and facial type.

Table 1. Descriptive analysis in millimeters for the right and left eye-to-
type (P<.01); age was dismissed as a predictive variable
ear and nose-to-chin distances according to facial type as it was not statistically significant (P=.57) (Table 3).
Facial Type N Min p25 p50 p75 Max Mean SD Thus, a model was obtained (Table 4) from which
Leptoprosopic the following equation was derived: OVD=42.17+(0.46×
Nose-to-chin distance 115 61 69 72 75 81 72.14 4.27 left eye-to-ear distance)+sex (women=−3.38, men=0)+
Right ear-to-eye distance 115 61 66 68 71 77 68.55 3.58 facial type (leptoprosopic=0, mesoprosopic=−1.19,
Left eye-to-ear distance 115 60 66 68 71 77 68.50 3.55 euryprosopic=−2.19).
Mesoprosopic
Nose-to-chin distance 164 62 67 70 73 83 70.49 4.28 DISCUSSION
Right ear-to-eye distance 164 62 66 69 71 79 68.71 3.38
Left eye-to-ear distance 164 60 66 68 71 79 68.48 3.44 According to the provided results, the research hypoth-
Euryprosopic esis of this clinical study was partially accepted. A positive
Nose-to-chin distance 102 60 66 70 73 78 69.55 4.30 correlation was found between OVD and the left eye-ear
Right ear-to-eye distance 102 61 66 69 71 80 68.74 3.45 distance (r=0.56), and it was dependent on sex (P<.001)
Left eye-to-ear distance 102 61 65 69 71 76 68.37 3.50 and facial type (P<.01). However, age was not a variable
Total on which the OVD depended (P=.57).
Nose-to-chin distance 381 60 67 70 73 83 70.74 4.39 The results of this clinical study are consistent with
Right ear-to-eye distance 381 61 66 69 71 79 68.67 3.45 the findings of Chou et al.12 To predict the nose-to-chin
Left eye-to-ear distance 381 60 66 68 71 79 68.45 3.48 distance, the left eye-to-ear distance should be used by
Max, maximum; min, minimum; SD, standard deviation. measuring between the anterior wall of the left external
auditory meatus and the medial aspect of the lateral wall
distance (leptoprosopic r=0.54, mesoprosopic r=0.60, of the left orbit for all the different facial types (lep-
euryprosopic r=0.55, total sample=0.56) than the right toprosopic r=0.54, mesoprosopic r=0.60, euryprosopic
eye-to-ear distance (leptoprosopic r=0.48, mesoprosopic r=0.55).
r=0.56, euryprosopic r=0.54, total sample=0.51), with a Sex is a factor related with various functional and
positive correlation between the variables (Table 2). anatomic aspects. Compared with women, the crania of
Multiple regression analysis revealed that the nose- men are larger and heavier, with more prominent muscle
to-chin distance depended on sex (P<.001) and facial insertions due to greater muscle development, greater

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Table 2. Pearson correlation coefficients for the right and left eye-to-ear Table 3. Multiple regression coefficients for nose-to-chin distance
distances and nose-to-chin distance according to facial type and for total prediction including all variables
sample 95% Confidence
Nose-to-Chin Right Eye-to-Ear Left Eye-to-Ear Variables Coefficient Std Err P Interval
Facial Type Distance Distance Distance Left eye-to-ear distance 0.460 0.0552 <.001 0.3518053 to 0.570172
Leptoprosopic Women -3.403 0.4002 <.001 -4.190263 to -2.616123
Nose-to-chin 1.0000 Age 0.012 0.0221 .577 -0.031226 to 0.056028
distance Facial type
Right eye-to-ear 0.4809 1.0000
Mesoprosopic -1.202 0.3964 .003 -1.982590 to -0.423405
distance
Euryprosopic -2.203 0.4405 <.001 -3.070761 to -1.335978
Left eye-to-ear 0.5409 0.9389 1.0000
distance Cons 42.007 3.9199 <.001 34.29953 to 49.71532
Mesoprosopic Std Err, standard error.
Nose-to-chin 1.0000
distance
Table 4. Multiple regression coefficients for nose-to-chin distance
Right eye-to-ear 0.5638 1.0000
distance
prediction excluding age variable
Left eye-to-ear 0.6053 0.9454 1.0000 95% Confidence
distance Variables Coefficient Std Err P Interval

Euryprosopic Left eye-to-ear distance 0.464 0.0551 <.001 0.355707 to 0.572699

Nose-to-chin 1.0000 Women -3.385 0.3986 <.001 -4.169577 to -2.601731

distance Facial type
Right eye-to-ear 0.5464 1.0000 Mesoprosopic -1.197 0.3960 .003 -1.976521 to -0.419194
distance
Euryprosopic -2.195 0.4405 <.001 -3.061766 to -1.329445
Left eye-to-ear 0.5568 0.9372 1.0000
Cons 42.173 3.9051 <.001 34.494470 to 49.8519
distance
Total sample (n=381) Std Err, standard error.

Nose-to-chin 1.0000
distance
Right eye-to-ear 0.5139 1.0000 experience loss of OVD because of compensatory mecha-
distance nisms, mostly at the expense of the occlusal plane.29,30
Left eye-to-ear 0.5602 0.9405 1.0000
distance
Therefore, according to the results from this study
and the supporting evidence of previous morphometric
studies, the variables of sex and facial type must be consid-
ered when the left eye-to-ear distance is used as a predictor
facial heights and facial indices, and anatomic differences in restoring the OVD. A maximum eye-to-ear difference of
in the region of the external auditory meatus.27 The re- 5.5 mm between the combined variables (leptoprosopic men
sults were consistent with the work of Chou et al12 in that versus euryprosopic women). According to Abduo and
the craniometric method differs depending on sex. Lyons,31 5 mm is the limit for increasing the OVD.
Therefore, statistically significant differences were ex- This study proposes a variation of the Knebelman
pected between sexes (P<.001) when the craniometric technique for determining the OVD, by using an equation
method of predicting OVD was used. with the left eye-to-ear distance, sex, and facial type and
Regarding facial type, the vertical craniofacial using anatomic calipers. The equation can be solved in
morphology pattern of the patient should be considered different ways, including with a mobile application or a
(P<.01), mainly because of growth vectors and muscular spreadsheet with the formula entered. However, the
patterns that represent the different facial types.25 The proposed method relies on soft tissue landmarks, which
craniometric method uses the eye-to-ear distance as its could introduce errors if too much pressure is applied
predictive distance, relying on measurements recorded when measuring distances. This problem has been re-
from the neurocranium, which, unlike the viscer- ported in other studies that have used anatomic land-
ocranium, undergoes rapid growth during the prenatal marks.7,12,18,19 The proposed technique should be used as
period. The latter develops at a later stage and is largely a baseline because it is straightforward and requires little
influenced by functional factors such as breathing, time, but it needs to be used together with other methods
phonation, mastication, and muscle development.28 The to completely determine the OVD.
results of this study concur with these observations, and
this is why facial type must be considered when pre- CONCLUSIONS
dicting the nose-to-chin distance.
Based on the findings of this clinical study, the following
Another important aspect arising from this clinical study
conclusions were drawn:
is the fact that the OVD is not affected by age (P=.57) despite
a participant age range between 18 and 50 years. Older 1. Occlusal vertical dimension depends on facial type
people who may experience tooth wear do not necessarily and sex, both of which are craniometric variables.

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2. A baseline method was proposed to determine the 18. Willis FM. Esthetics of full denture construction. J Am Dent Assoc 1930;17:
636-42.
OVD by using the left eye-to-ear distance as an 19. Ladda R, Kasat VO, Bhandari AJ. A new technique to determine vertical
initial reference and consisting of a straightforward dimension of occlusion from anthropometric measurements of fingers. Indian
J Dent Res 2013;24:316-20.
mathematical calculation. 20. Aboul-Ela LM, Razek MK. Pre-extraction records of the occlusal plane and
vertical dimension. J Prosthet Dent 1977;38:490-3.
21. Smith DE. The reliability of pre-extraction records for complete dentures.
J Prosthet Dent 1971;25:592-608.
REFERENCES 22. Bissasu M. Pre-extraction records for complete denture fabrication: a litera-
ture review. J Prosthet Dent 2004;91:55-8.
1. The glossary of prosthodontic terms. Ninth edition. J Prosthet Dent 23. Knebelman S. Method for determining vertical dimension. US patent
2017;117(5S):e1-105. 4718805 Jan 12, 1988.
2. Schuyler C. Problems associated with opening the bite which would 24. Delic Z, Simunovic-Soskic M, Perinic-Grzic R, Vukovojac S, Rajic Z, Kuna T,
contraindicate it as a common procedure. J Am Dent Assoc 1939;26:734-40. et al. Evaluation of craniometrics methods for determination of vertical
3. Monteith B. The role of the free-way space in the generation of muscle pain dimension of occlusion. Coll Antropol 2000;1:31-5.
among denture-wearers. J Oral Rehabil 1984;11:483-98. 25. Manns A, Valdivieso C, Rojas V, Valdés C, Ramirez V. Comparison of clinical
4. Gattozzi JG, Nicol BR, Somes GW, Ellinger CW. Variations in mandibular rest and electromyographic rest vertical dimensions in dolichofacial and brachy-
positions with and without dentures in place. J Prosthet Dent 1976;36:159-63. facial young adults: A cross-sectional study. J Prosthet Dent 2018;120:513-9.
5. Tench R. Dangers in reconstructing involving increase of the vertical dimension 26. Companioni A, Torralbas A, Sánchez C. Relation between the aureal pro-
of the lower third of the human face. J Am Dent Assoc 1938;25:566-70. portion and the facial index in students of Stomatology of La Habana. Rev
6. Moreno-Hay I, Okeson JP. Does altering the occlusal vertical dimension Cubana Estomatol 2010;47:50-61.
produce temporomandibular disorders? A literature review. J Oral Rehabil 27. Keen JA. A study of the differences between male and female skulls. Am J
2015;42:875-82. Phys Anthropol 1950;8:65-80.
7. Niswonger M. The rest position of the mandible and the centric relation. 28. Sonnesen L, Bakke M. Molar bite force in relation to occlusion, craniofacial
J Am Dent Assoc 1943;21:1572-82. dimensions, and head posture in pre-orthodontic children. Eur J Orthod
8. Orenstein NP, Bidra AS, Agar JR, Taylor TD, Uribe F, Litt MD. Changes in 2005;27:58-63.
lower facial height and facial esthetics with incremental increases in occlusal 29. Berry DC, Poole DF. Attrition: possible mechanisms of compensation. J Oral
vertical dimension in dentate subjects. Int J Prosthodont 2015;28:363-70. Rehabil 1976;3:201-6.
9. Silverman MM. The speaking method in measuring vertical dimension. 1952. 30. Johansson A, Johansson AK, Omar R, Carlsson GE. Rehabilitation of the
J Prosthet Dent 2001;85:427-31. worn dentition. J Oral Rehabil 2008;35:548-66.
10. Shanahan TE. Physiologic vertical dimension and centric relation. 1956. 31. Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical
J Prosthet Dent 2004;91:206-9. dimension: a review. Aust Dent J 2012;57:2-10.
11. Alhajj MN, Khalifa N, Abduo J, Amran AG, Ismail IA. Determination of
occlusal vertical dimension for complete dentures patients: an updated re-
view. J Oral Rehabil 2017;44:896-907. Corresponding author:
12. Chou TM, Moore DJ, Young L Jr, Glaros AG. A diagnostic craniometrics method Dr Claudio Morata
for determining occlusal vertical dimension. J Prosthet Dent 1994;71:568-74. Faculty of Dentistry
13. Boyanov B. Determining vertical dimension of occlusion and centric relation. Pedro de Valdivia University
J Prosthet Dent 1970;24:18-24. Avda Vicuña Mackena #44, Santiago
14. Orthlieb JD, Laurent M, Laplanche O. Cephalometric estimation of vertical CHILE
dimension of occlusion. J Oral Rehabil 2000;27:802-7. Email: Claudiomoratag@hotmail.com
15. Hull CA, Junghans JA. A cephalometric approach to establishing the facial
vertical dimension. J Prosthet Dent 1968;20:37-42. Acknowledgments
16. Qamar K, Munir U, Naeem S. Role of cephalometry in evaluation of vertical The authors thank Dr Diego Jazanovich for his translation and revisions of the
dimension. Pak Oral Dental J 2013;33:183-6. article.
17. Edwards CL, Richards MW, Billy EJ, Neilans LC. Using computerized
cephalometrics to analyze the vertical dimension of occlusion. Int J Pros- Copyright © 2019 by the Editorial Council for The Journal of Prosthetic Dentistry.
thodont 1993;6:371-6. https://doi.org/10.1016/j.prosdent.2019.05.009

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