Increased vertical dimension and speech articulation errors.

The correlation of gingivitis pocket depth and exudate from the gingival crevice. Correlation between sulcus fluid rate and clinical and histologic inflammation of the marginal gingiva. I ncreasing the vertical dimension of occlusion is frequently associated with complications and is held by some investigators to be a hazardous procedure in prosthetic treatment. i* 2 One of the neglected considerations of increasing vertical dimension is that of speech articulation. Current clinical and research emphasis is primarily of a masticatory nature. Because every person who wears dentures must adapt to changes, frequently in speech, additional descriptive clinical data are needed to assess the magnitude and relative significance of this occurrence. The aim of this study was to evaluate the effects on speech articulation of increasing the vertical dimension of occlusion. A technique illustrated by Christensen3 featured a clear acrylic resin splint temporarily cemented to the occlusal surfaces of teeth in the mandibular arch. The splints increased the vertical 401 dimension of occlusion 4 mm; and in conjunction with standardized speech articulation tests, the pattern of articulatory alterations and the degree of return to presplint proficiency were evaluated. Eight subjects 26 to 82 years of age voluntarily took part in the investigation (Table I). They were divided into three groups (A, B, and C) depending on the type of prosthesis worn. Patients in group A had no fixed or removable prosthetic restorations and had all their permanent teeth except third molars. The three patients in group B wore complete dentures, and the two group C subjects wore mandibular overdentures opposed by maxillary complete dentures. The sex ratio of the groups was not preestablished. Tape recordings for the articulation test were made of the patients' speech on three occasions: before splint fabrication, immediately following splint insertion, and 3 to 6 days thereafter prior to splint removal (Fig. 1). The recorded material consisted of 62 words arranged in couplets so that the sounds tested could be evaluated at the beginning and end of words as well as between