Introduction: Mandibular advancement and vertical correction with extrusion are two basic procedures that permit the skilled orthodontist to re-posture the mandible in Class II deep-bite occlusion with a disto-positioned mandible. Aim: To verify the entity and the possibility of mandibular advancement in a non growing deep-bite patient while improving vertical dimension. Methods: The diagnostic procedure is based on the use of (TENS) (Trans-cutaneous Electrical Nerve Stimulator) with application of the basic principles as described with the Neuromuscular Theory and technique. Treatment of a Class II occlusion on an adult patient without the use of mandibular tracking devices and without the aid of electromyography is described. Results: Mandibular advancement and increase in vertical dimension were achieved. Flaring of lower incisors and head extension improved overall aesthetics. Conclusions: The use of TENS is a valid diagnostic aid for predicting mandibular advancement in the adult patient.
Increasing the occlusal vertical dimension (OVD) is often indicated in complex oral rehabilitation to gain restorative space and improve the occlusal relationship and aesthetics. The effect of increasing the OVD on lower facial height and facial aesthetics is not well understood and evaluated. The authors present the philosophy of the neuromuscular concept and illustrate it through a case report of a 58-year-old female patient who presented severe deep bite, bruxism, and temporomandibular disorders (TMDs). After clinical evaluation, the extraoral examination showed a reduction of the lower facial height, protuberant lips, wrinkles, and over-closed commissures. In addition, intraoral examination showed a severe anterior deep bite articulation, and the upper incisors completely covering the lower incisors labial surfaces. Through the philosophy of the neuromuscular concept the diagnostic ability, the quality and stability of the treatment increases. A temporary long-term fixed prosthesis was made at the enlarged OVD to be used in the first stage of the rehabilitation. Compared to the initial situation, the new prosthesis was delivered at a vertical dimension (VD) higher with 7 mm. The purpose of the neuromuscular philosophy and methodology is to harmonize the facial profile, functional occlusion, the joint function, and neuromuscular control. Through the neuromuscular methodology, we can assess the patient's ability to manage a significant increase in VD and to restore a functional OVD by physiological measurements.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.