Professional Documents
Culture Documents
F. Guide lines
The central line (midline) ( 1
2) The high lip line
3) The corner line (canine line)
B. Willis measurement
When the adjusted record blocks are in the
mouth, the distance from the base of the nose
to the lower edge of the mandible should be
equal to the distance from the outer canthus of
the eye to the parting line of the lips when the
.mandible is in rest position
C. Facial expression
A protruded mandible seen in profile may indicate excessive
interocclusal space. If the chin looks too close to the nose in full view;
there may be excessive interocclusal space.
Compressed lips, without strain, indicate overclosure. If the smooth
mucosa is overly exposed or if the chin is strained to allow lip contact, the jaws are being kept too far apart (high vertical
.dimension)
The mento-labial sulcus is obliterated when the jaws are too far
apart and deeply furrowed when they are too close together. The
nasolabial sulcus curves backwards excessively in overclosure and is
made excessively straight in over opening. When the patients facial
expression appears relaxed, request that the jaws be closed to contact.
If no closure is possible, no interocclusal distance exists. If closure is
possible, no interocclual distance exists . If closure is possible, some
. interocciusal distance does exist, and this can be measured
D. Other measurements
Paralleling posterior ridges: ( 1
The paralleling of the maxillary and mandibular ridges, plus
a 5 degree opening, in the posterior region, as suggested by
Sears, often gives a clue to the correct amount of Opening.
Parallelism between ridges is important because in this way
biting forces are vertical on the ridges and there is no
tendency for horizontal displacement of the dentures.
If the patient has lost the teeth at irregular intervals or has
suffered a great amount of bone loss due to periodontal
disease, the line of the ridges naturally is thrown out of
. parallelism
Phonetics: ( 2
Phonetics has been used by some to aid in obtaining the
correct vertical dimension, by having the patient use words
with the letters S and Ch (closest speaking space).
The theory seems to have limited value, because the
patient, after being edentulous for a long period of time,
would need time to accustom himself to the additional bulk
of the record blocks
3) The power point (Boos Bimeter):
The theory is that the patient registers the maximum
amount of biting force when the teeth first contact in
centric occlusion. This registration is done by means, of an
instrument called Bimeter. The Bimeter is attached to the
lower rim and a plate is attached to the upper. The patient is
asked to close with maximum biting force and the device is
locked. This technique was found to be clinically
. unreliable
E. Pre-extraction records:
When the dental surgeon is rendering a
patient edentulous he has the opportunity
for recording the vertical dimension and the
position and shape of the teeth before they
. are extracted
c) Articulated models
These will indicate the amount of overbite as
well as assisting in the selection of size,
shape and position of the teeth to be used for
the dentures.
d) Acrylic resin facemask:
Hydrocolloid or plaster of Paris is used as
facial impression materials. A transparent
acrylic resin from is then constructed on the
stone cast. This method was found to be
. impractical
A. Interocciusal registration of
centric relation
Always ask the patient to close never ask him to
bite. Bite conveys the impression of incising,
and to incise requires some protrusion of the
. jaw, which is reverse of what is required
b. Relaxation
If the patient can be persuaded to relax the muscles
of the jaw it will automatically assume the retruded
position and this will be greatly assisted by general
bodily relaxation. When general relaxation is
obtained the patient is asked to close the blocks and
the continuity of the vertical lines made during the
previous technique are checked. If the mandible is
now found to be more retruded, fresh lines are made
for further checking. If the lines coincide it may be
assumed that the position is correct, or further check
. as described below may be carried out as described
c. Swallowing
Ask the patient to swallow and conclude the act
with the blocks in contact. This is based on the fact
that with a natural dentition the teeth are brought
into centric occlusion during swallowing;
d. Fatigue
Ask the patient to protrude and retrude the mandible
continuously for as long as possible and to finish in
a retrusive position with the blocks in contact. The
objective is to tire the lateral pterygoid muscles so
that they will relax when the movement ceases, and
. so allow the condylar heads to be retruded
e. Head position
Having lowered the headrest, ask the patient to bend
the head backward as possible. This will produce
. some backward pull on the mandible
f. The temporalis muscle
The anterior fibers of the temporalis muscle only
contract on closure of the mandible if it is retruded.
Thus, if the fingers are placed on the temporalis and
the patient closes the rims firmly the contraction or
not of the anterior fibers of the temporalis may be
. used as an assessment of mandibular retrusion
The blocks are placed in the mouth while the added wax is soft
and the patient is guided to close in centric relation using any
of the previously mentioned techniques till the required
vertical dimension is obtained (vertical dimension of
occlusion). The blocks are then removed from the mouth and
chilled. After the wax has been chilled, the excess that oozed
out is trimmed away; this excess would act as guide planes to
reposition the mandible in the same relation as before, even
though it might be incorrect. In other words, it would not
permit a testing of the centric position . The centric relation is,
then, re-checked as described before.
Some -authors recommend the removal of wax only from the
posterior portion of the mandibular rim leaving the anterior
. portion to maintain the predetermined vertical dimension
Intra-oral tracings: . 1
a) Recording centric relation:
The intra-oral device consists of
a) a tracing plate.
b) a locking disc and
c) a carrier through the center of which is a
threaded a pointed stylus (tracing point)
. controlled by a locking nut
Extra-oral tracing. 2
The extra-oral tracing apparatus is similar to the intraoral except that the stylus and tracing plate are
outside the mouth, being attached to the record
blocks by rods, which pass between the lips. The
tracing plate is attached to the lower rim. The
technique is dependent on well-fitting, stable bases
and those of acrylic undoubtly give the most
successful results. Wax or compound rims-are used
in this technique
Occlusal plane should be parallel to the ala tragus line ( Campers line)
Fox plane
Alluwax
Must be dead soft