The aim of this study was to compare two methods used to orientate the occlusal plane (OP) and to determine the vertical dimension of occlusion (VDO). In method A the VDO was established by means of the rest position, the minimal speaking distance, and the patient's profile. Method B used a newly developed registration pin assembly. The VDO was registered using a silicone occlusion rim and the swallowing technique. The results were compared to the values of the new dentures. Three standardized lateral radiographs were taken at the VDO obtained with methods A, B, and at that of the final dentures. On each radiograph the orientation of the OP to the Camper plane and the VDO were measured by two investigators independently. The results indicated no statistically significant differences between the mean VDO with method A and B compared with the new dentures (P greater than 0.05). With both methods it was not possible to orientate the OP parallel to the Camper plane. None of the occlusal planes of the new dentures were parallel either. Their OP diverged on average by 7 degrees dorso-caudally. The time spent with method B to orient the OP and to determine the VDO was significantly lower than with method A (17-50 min).

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Background: Anterior shoulder instability can be successfully treated using Latarjet procedures, although a small proportion of patients report unexplained pain. Purpose/Hypothesis: The purpose was to report the prevalence and characteristics of patients with unexplained pain without recurrent instability after open Latarjet procedures and to determine whether screw removal can alleviate pain. The hypothesis was that unexplained pain without recurrent instability might be due to soft tissue impingements against the screw heads and that the removal of screws would alleviate or reduce pain. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed the clinical and radiographic records of 461 consecutive shoulders treated by open Latarjet procedures for anterior instability between 2002 and 2014. Unexplained anterior pain was present in 21 shoulders (4.6%) and treated by screw removal at 29 ± 37 months (mean ± SD). Postoperative assessment at >12 months after screw removal included complications, visual analog scale for pain (pVAS), subjective shoulder value, Rowe score, Walch-Duplay score, and ranges of motion. The study cohort comprised the shoulders of 20 patients (9 women, 11 men) aged 25 ± 6 years (median, 25 years; range, 16-34 years) at screw removal and involved the dominant arm in 13 (62%) shoulders. Results: Screw removal alleviated pain completely in 14 shoulders (67%; pVAS improvement, 6.4 ± 1.8; median, 6; range, 3-8) and reduced pain in the remaining 7 (33%; pVAS improvement, 2.4 ± 1.4; median, 2; range, 1-5). At 38 ± 23 months after screw removal, 2 recurrences of instability unrelated to screw removal occurred. The subjective shoulder value was 79% ± 22% (median, 90%; range, 0%-95%); Rowe score, 85 ± 20 (median, 95; range, 30-100); and Walch-Duplay score, 82 ± 19 (median, 85; range, 25-100). Mobility improved in active forward elevation (171°± 14°), external rotation with the elbow at the side (61°± 12°), and external rotation with the arm at 90° of abduction (67°± 13°) and especially in internal rotation, with only 2 shoulders (10%) limited to T12 spine segment. Conclusion: The present findings confirm that unexplained anterior pain after Latarjet procedures can be related to the screws used to fix bone blocks, which can safely be alleviated or reduced by screw removal.