# Bite-raising / VDO checklist

> Enter your measurements. The checklist compares them with the guide values Dr Hajtó teaches in his bite-raising course and shows the source for each value.

Source: https://hajto.de/en/tools/bite-raising-vdo-checklist  
Last updated: 2026-10-19T13:39:52Z  
German version: https://hajto.de/bisshebung-planer.md

Planning aid, not a diagnosis or treatment recommendation. Does not replace functional analysis, model analysis or clinical judgement.

## Criteria

### Anterior length: the Shimbashi rule

Guide value: 19 ± 1 mm (18–20 mm) from the CEJ of the upper central incisor to the CEJ of the lower central incisor, measured in occlusion.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisshebung Anhaltspunkte” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Upper incisal display at rest

Guide value: 0.5–3.5 mm upper incisal display with the lips relaxed.

Depends on age, sex, lip length, degree of wear and skeletal base.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisshebung Anhaltspunkte” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Lower incisal edge

Guide value: lower incisal edge 1–1.5 mm above the lip line.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisshebung Anhaltspunkte” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Posterior clinical crown length (premolar/first molar)

Guide value: 6–7 mm clinical crown length of premolar/first molar.

Caution: secondary eruption and soft-tissue changes.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisshebung Anhaltspunkte” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Planned incisal raise: the 5 mm limit

Raising up to 5 mm (incisal) is considered safe; the system adapts. Mild transient symptoms are possible, mostly self-limiting.

Conversion on the lateral ceph (taught by Dr Hajtó): 1 mm at the anterior teeth ≈ 1° rotation; 2 mm at the incisal pin ≈ 1° rotation.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisshebung Anhaltspunkte” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))
- Literature: [Abduo J. Safety of increasing vertical dimension of occlusion: a systematic review. Quintessence Int. 2012;43(5):369-80.](https://pubmed.ncbi.nlm.nih.gov/22536588/) (PMID 22536588) – Systematic review: a permanent increase is safe and predictable when indicated; negative signs are self-limiting.
- Literature: [Abduo J, Lyons K. Clinical considerations for increasing occlusal vertical dimension: a review. Aust Dent J. 2012;57(1):2-10.](https://pubmed.ncbi.nlm.nih.gov/22369551/) (PMID 22369551) – Abstract: a maximum increase of 5 mm can be justified; a minimal increase is preferred.
- Literature: [Moreno-Hay I, Okeson JP. Does altering the occlusal vertical dimension produce temporomandibular disorders? A literature review. J Oral Rehabil. 2015;42(11):875-82.](https://pubmed.ncbi.nlm.nih.gov/26140528/) (PMID 26140528) – Adaptation to moderate changes of the vertical dimension; mild transient symptoms; no long-lasting TMD.
- Literature: [Pissiotis AL et al. EPA Consensus Project Paper: The Vertical Dimension of Occlusion. How to Determine and How to Alter? A Systematic Review. Eur J Prosthodont Restor Dent. 2023.](https://pubmed.ncbi.nlm.nih.gov/37265247/) (PMID 37265247) – Increases studied 1.8–8 mm; adaptation successful for 1.8–6.0 mm.
- Literature: [Lassmann Ł, Calamita MA, Manfredini D. Myths surrounding vertical dimension of occlusion in restorative dentistry: A scoping review. J Esthet Restor Dent. 2025;37(1):94-105.](https://pubmed.ncbi.nlm.nih.gov/39189329/) (PMID 39189329) – No causal link between a change of the vertical dimension and TMD found.

## Notes (shown for the entries made)

### Functional findings: analysis and splint first

Functional findings: functional analysis and splint pretreatment before any change of the bite position.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisslageveränderung Zusammenfassung” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Screen first

Screen first: every patient is checked for functional problems before a bite raise.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisslageveränderung Zusammenfassung” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Dahl principle: more than 2 mm planned at once

Dr Hajtó teaches: with the Dahl principle, do not raise too much at once, not more than 2 mm; otherwise the tongue may interpose.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “DAHL Methode” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

### Dahl principle: notes

Dr Hajtó teaches on the Dahl principle:

- not with TMJ problems
- the younger the patient, the faster
- temporary lisping
- not too much at once (> 2 mm, risk of tongue interposition)
- not with tongue dysfunction
- no dorsal vector
- check the posterior proximal contacts
- the plateaus stay permanently

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “DAHL Methode” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))
- Literature: [Dahl BL, Krogstad O. Long-term observations of an increased occlusal face height obtained by a combined orthodontic/prosthetic approach. J Oral Rehabil. 1985;12(2):173-6.](https://pubmed.ncbi.nlm.nih.gov/3857319/) (PMID 3857319) – 20 individuals, mean increase 1.9 mm, mean observation 67 months (5.5 years); no reversal to baseline; 12 of 19 practically stable from 6 to 67 months.
- Literature: [Dahl BL, Krogstad O. The effect of a partial bite raising splint on the occlusal face height. Acta Odontol Scand. 1982;40(1):17-24.](https://pubmed.ncbi.nlm.nih.gov/6950642/) (PMID 6950642) – More eruption than intrusion in the youngest groups; lisping was the most serious complaint; no dysfunction symptoms.

### Printed occlusal build-ups: durability

Durability of printed occlusal build-ups: in place no longer than 6–12 months.

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Okklusalaufbauten LZP” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))
- Literature: [Doumit M et al. Wear behavior of 3D printed, minimally invasive restorations: Clinical data after 24 months in function. J Prosthet Dent. 2025;134(3):662-669.](https://pubmed.ncbi.nlm.nih.gov/40253233/) (PMID 40253233) – 28 patients, 352 printed restorations: mean maximum occlusal height loss at molars 0.76 mm at 12 and 1.25 mm at 24 months; at 24 months 35 % had wear over 0.5 mm (classified as fractured); the material appears suitable only for interim restorations.

## The common thread: changing the bite position in 7 steps

1. Screen every patient to identify possible functional problems.
2. If a changed bite position (shifted, collapsed) is suspected: functional analysis and pretreatment with an occlusal splint.
3. Model analysis: identify and mark the direction in which the teeth are to be changed.
4. End of the splint phase: when the patient shows reproducibly stable identical contacts on the splint at 2 or 3 check-ups, is more relaxed muscularly and feels comfortable, the therapeutic bite position has been reached.
5. Registering the new bite position: the patient comes in the morning with the splint in place; check the contacts again.
   - a) No raise needed: register as close as possible to the current vertical dimension, either the patient holds the position at first contact, or open as little as possible with a leaf gauge or anterior jig. Record with Luxabite, possibly a control record; current scans or impressions.
6. Occlusal build-ups: made in the laboratory and bonded in the mouth; occlusal checks and fine-tuning on the build-ups, T-Scan. They may be slightly higher than the final vertical dimension so that some adjustment remains possible.
7. Prosthetic restoration: the patient can now be treated like a habitual patient. There are several options:
   - by quadrant
   - by side
   - posterior teeth first, then anterior teeth (or the other way round)
   - 4 molars (upper/lower), 4 PM, 4 M, 4 PM
   - whole upper arch, whole lower arch (record with an anterior jig on the upper/lower central incisors)
   - all teeth together (sequential registration)

- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Bisslageveränderung Zusammenfassung” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

## Time planning

- Splint: 2–3 months
- Occlusal build-ups: 2–3 months

Printed occlusal build-ups: no longer than 6–12 months in place (applies to printed build-ups).

- Taught by Dr Hajtó: prosthodontics course 2026 (German), chapter “Planung” ([In-person course on prosthetic dentistry with Dr Hajtó](https://hajto.de/en/courses/in-person/prosthetic-dentistry-gauting))
- Taught by Dr Hajtó: bite-raising course 2026 (German), chapter “Okklusalaufbauten LZP” ([In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes))

## How the checklist works

Each criterion is compared on its own with its guide value and shown as “within range”, “below”, “above” or “not entered”. A value exactly on a limit (for example 0.5 or 3.5 mm) counts as within range; a planned raise of exactly 5 mm does not trigger the warning.

Criteria: the Shimbashi distance from CEJ to CEJ in occlusion (18–20 mm), upper incisal display at rest (0.5–3.5 mm), the lower incisal edge above the lip line (1–1.5 mm), clinical crown length of premolar/first molar (6–7 mm) and the planned raise at the incisors (warning above 5 mm). For the Shimbashi distance the checklist shows the raise this criterion suggests; for the planned raise, the approximate rotation after Dr Hajtó's rule of thumb.

The checklist adds nothing up: it does not compute a combined “ideal” raise, and it does not convert the crown length missing at a posterior tooth into a value at the incisors.

## Where the values come from

The guide values are taken from Dr Jan Hajtó's courses (marked “Taught by Dr Hajtó”, with the course chapter). Where the literature gives other values, Dr Hajtó's value is shown. Papers whose abstract agrees are listed with their PMID.

Your entries stay in your browser. They are not saved or sent anywhere.

## FAQ

### What does the bite-raising checklist check?

Five measurements: the Shimbashi distance from CEJ to CEJ (19 ± 1 mm), upper incisal display with the lips relaxed (0.5–3.5 mm), the lower incisal edge above the lip line (1–1.5 mm), the clinical crown length of premolar/first molar (6–7 mm) and the planned raise at the incisors (warning above 5 mm). It adds notes on functional findings, the Dahl principle and printed occlusal build-ups, the seven steps and the time planning.

### How is the Shimbashi suggestion calculated?

Dr Hajtó teaches 19 ± 1 mm from the CEJ of the upper central incisor to the CEJ of the lower central incisor in occlusion. For a measured distance x the checklist shows a raise of (18 − x) to (20 − x) mm, never below 0. At 20 mm or more this criterion suggests no raise. It is one criterion among several (18–20 mm), not an ideal value.

### What does the 5 mm limit mean?

Dr Hajtó teaches that a raise of up to 5 mm at the incisors is considered safe. Abduo and Lyons (2012) state in their abstract that a maximum increase of 5 mm can be justified. Above 5 mm the checklist shows a warning.

### How many degrees of rotation is a raise?

Dr Hajtó's rule of thumb on the lateral ceph: 1 mm at the anterior teeth ≈ 1° rotation, 2 mm at the incisal pin ≈ 1° rotation. For a planned incisal raise the checklist shows the approximate degrees.

### Why does the checklist not show an ideal raise?

The criteria describe different things: the anterior length, the incisal edges, the posterior crowns and a safety limit. Each one is shown on its own; the decision stays with the clinical planning, including functional and model analysis.

### How long do splint and build-up phases take?

Dr Hajtó plans 2–3 months for the splint and 2–3 months for the occlusal build-ups. Printed build-ups should stay in place no longer than 6–12 months; Doumit et al. (2025) followed 352 printed restorations and found wear over 0.5 mm in 35 % after 24 months.

### What applies to the Dahl principle?

Dr Hajtó teaches not to raise more than 2 mm at once with the Dahl principle (risk of tongue interposition), not to use it with TMJ problems or tongue dysfunction, and that it works faster the younger the patient. Above 2 mm with the Dahl method the checklist shows a warning.

### Does the checklist replace a diagnosis?

No. Planning aid, not a diagnosis or treatment recommendation. Does not replace functional analysis, model analysis or clinical judgement.

[In-person course on bite raising and bite position changes with Dr Hajtó](https://hajto.de/en/courses/in-person/bite-raising-bite-position-changes) · [Article: the vertical dimension of occlusion](https://hajto.de/en/blog/vertical-dimension-of-occlusion)

Dataset as of 2026-10-19. Publisher: Munich Dental Academy