Vertical Dimension in Prosthodontics Theory and Practice (Part II): A Comprehensive Review of Vertical Dimension Determination in Prosthodontics From Classical Methods to Digital Innovation.

The determination of vertical dimension of occlusion (VDO) represents one of the most challenging and critical aspects of prosthodontic treatment, particularly in edentulous patients. Accurate establishment of VDO is essential for optimal function, esthetics, and patient comfort in prosthetic rehabilitation. This comprehensive literature review aims to analyze the current evidence regarding various methods for determining vertical dimension (VD) in prosthodontic practice, examining their reliability, clinical applicability, and evolution from traditional to modern digital approaches. A search was conducted across multiple databases, including PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library. The search strategy included terms related to VD, prosthodontics, complete dentures, and measurement techniques. A total of 1,259 articles were initially identified, with 903 remaining after duplicates were removed. Following screening and quality assessment, 79 high-quality studies were included in this comprehensive review. The analysis identified two main categories of VDO determination: (a) pre-extraction record methods and (b) post-extraction assessment methods, the latter encompassing anthropometric/biometric approaches, physiological and functional techniques, mechanical methods, measurement devices, radiographic or imaging modalities, and esthetic evaluations. While traditional techniques hold historical value, their reliability and reproducibility remain limited. In contrast, contemporary digital methods offer greater precision and patient comfort, though their use demands advanced equipment and practitioner training. While no single method has emerged as universally superior, the integration of multiple assessment techniques with digital technology offers enhanced accuracy and reproducibility. Contemporary evidence supports a multifactorial approach combining traditional clinical judgment with digital precision and novel radiographic formulas for optimal VDO determination.