Development of the vertical dimension: Nature and nuture

The relevance of analyzing the development of the vertical dimension to clinical practice is first to determine if there is a vertical dimension component to the malocclusion, then ascertain what factors are having the greatest influence on the vertical dimension problem. Unfortunately, studies on the genetic and environmental factors that influence the development of vertical dimension are representative of the samples, not necessarily of any particular individual. In addition, the extent that a particular trait is influenced by genetic factors may have little if any effect on success of environmental (treatment) intervention. Genetic factors that influenced a trait may also influence the response to intervention to alter that trait, or other genetic factors may be involved in the response. Therefore, the possibility for altering the environment to gain a more favorable dimension is theoretically possible, even in individuals with a relatively high genetic influence on the vertical dimension. However, the question of how environmental and genetic factors interact (a question that essentially cannot be answered in estimates of heritability), is most relevant to clinical practice because it may explain why a particular alteration of the environment (treatment) in one compliant patient may be successful and not in another.