It is defined as Any relation of the mandible to the maxilla

Types: 1. Orientation jaw relation

2. Vertical jaw relation
3. Horizontal jaw relation

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RECORD BASES AND OCCLUSAL RIMS

They simulate teeth and help in establishing vertical dimension and

centric relation
Record bases should be retentive
For making phonetics test and for accurate jaw relation record

If slightly loose, denture adhesive can be used

If pronounced looseness final impression has to be remade

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The record base will simulate the proper position of the teeth and
establish the occlusal plane when contoured correctly

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CAUSES FOR POOR RETENTION
OF RECORD BASE
Poor adaptation of resin to cast
Over or under extension of borders
Excessive blockout for undercuts while fabricating record base

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ORIENTATION JAW RELATIONS

The wax rims are arbitrarily adjusted prior to actual adjustment on

the patient for the orientation jaw relation
a. Maxillary occlusal rim anterior height 22 mm

b. Mandibular occlusal rim anterior height 18mm

c. Maxillary rim slightly facial to ridge to compensate for residual ridge

resorption to support upper lip

d. Posteriorly the mandibular occlusal rim is kept up to 2/3 of retromolar pad.

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 CLINICAL STEPS IN ADJUSTING THE
MAXILLARY WAX RIM
2 objectives when adjusting upper rim:
1. Establish the correct orientation and level of the
occlusal plane

2. Produce the correct shape for the labial, buccal and

palatal surfaces

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ESTABLISHING CORRECT ORIENTATION AND
LEVEL OF OCCLUSAL PLANE OF UPPER WAX
RIM
Use a Foxs plane guide to evaluate the occlusal plane of the upper
rim

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ADJUST THE UPPER RIM TO CONFORM TO THE FOLLOWING:
1. Incisal level of the upper rim is about 1 2 mm below the upper
lip when it is at rest

Exceptions:
In older patients, less of the incisal level shows below the upper lip
Patients with a long upper lip may show very little of the upper teeth
while those with a short upper lip may show more of the teeth
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PHONETIC EVALUATION OF UPPER RIM

Evaluate the incisal length

of the upper rim by having
the patient pronounce f
and v sounds (Count
from 50 to 60)
Wet-dry line of the lower
lip should gently contact
the labial edges of the
anterior wax rim
th sound contact of the
tongue with lingual
surfaces of the anterior
part of the rim

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2. Occlusal plane is parallel to the interpupillary line or at right angles
to the long axis of the patients face

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3. The antero-posterior orientation of the occlusal plane should be
parallel to the Campers line (ala-tragus line)

*Ala-tragus line imaginary line joining the lower border of the ala of the nose
with the midpoint of the tragus of the ear

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SHAPING OF THE LABIAL, BUCCAL & PALATAL
SURFACES OF THE UPPER WAX RIM

The labial surface of the upper wax rim is contoured to provide

proper lip support affects resting length of the upper lip
The rims should support the lips and normal amount of vermillion
border should be visible
Face should have a relaxed appearance

A increased lip support; B insufficient lip support; C normal lip support

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 A insufficient lip support
B adequate lip support

Naso labial angle should be at 90 degree

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ADJUSTING THE OCCLUSAL PLANE OF
THE LOWER WAX RIM
For mandibular occlusal rim
Anteriorly the occlusal plane should be at the corner of the mouth

Posteriorly the occlusal rim should be at 2/3 of the retromolar pad

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The upper and lower wax rims should meet evenly

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VERTICAL JAW RELATION

Relation of the mandible to the maxilla in a vertical plane

The Vertical Jaw Relations can be recorded in 2 positions:-

1. Vertical Dimension at Rest position (VDR)
2. Vertical Dimension at Occlusion (VDO)

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 Vertical dimension vertical measurement of the face between any two
arbitrarily selected points which are located one above and one below
the mouth in the midline
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VDR vertical dimension of face when the jaws are in rest position
VDO vertical dimension of face when the teeth or wax rims are in contact in
centric occlusion
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VERTICAL DIMENSION AT REST
(VDR)
Vertical dimension of the face when the mandible is in the
physiologic rest position.

Rest position theoretically a balance of muscles when the head is

in a normal upright position

The vertical dimension of rest is a measurable distance, a

repeatable reference within an acceptable range & a useful
reference when establishing the vertical dimension of
occlusion.(VDO)

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PHYSIOLOGIC REST POSITION

When mandible is at rest position and teeth are not in

contact
a. Tissues which support the denture are not loaded
b. No strain on TMJ
c. No strain on the elevator and depressor muscles of
the mandible

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MEASURING THE VDR (Niswongers
Method)
Mark two points One at tip of nose and one at tip of chin.

Make patient sit upright comfortable position in dental chair with head
unsupported.

Patient is to asked to swallow and relax and drop his shoulders.

Let the lips touch gently or have the patient maintain a prolonged
mmm humming sound

Once the jaws are relaxed, measure distance between the 2 points

Usually 2 or 3 readings are taken the average is taken as reading. This

prevents error during taking measurements.

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Measuring the 2 dots using a caliper

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 Divider
Willis gauge

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VERTICAL DIMENSION AT OCCLUSION
(VDO)
Now.. The mandibular wa rim is inserted and patient is asked to bite
on the rims.
With patient in this occluding position, readings at same two points
marked earlier is made.
This measurement is vertical at occlusion.
Usually the VDO should be 2-4 mm less than VDR.

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The difference between the occlusal vertical dimension & the rest
vertical dimension is the INTEROCCLUSAL DISTANCE referred to as
the FREEWAY SPACE.

VD at occlusion = VD at rest - Freeway Space

.

VDO is the distance

measured between two
points when the occluding
members are in contact.

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Interocclusal Distance (free way space): the distance or gap
existing between the upper & lower teeth when the mandible is in
the physiological rest position. It is usually 2-4mm when observed
in the 1st premolar region.

If the interocclusal space is

greater then 4mm, the
occlusal vertical dimension
may be considered too
small.

If less then 2mm, the

dimension is considered to
be too great.

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1. The resting vertical dimension (A) is established and marked on a tongue blade.
The determination is made between two marks, one on the nose and another on
the chin.
2. The rims are contoured to make even contact at 23 mm less than the resting
vertical dimension. This 23 mm is the interocclusal distance and the resulting
position (B) is the occlusal vertical dimension.
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OTHER AIDS IN ESTABLISHING CORRECT
VERTICAL DIMENSION
1. Judgement of the overall facial support
2. Visual observation of the space between the wax rims when the
mandible is at rest
3. Phonetics
4. Examination of old dentures
5. Pre-extraction records

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ASSESSMENT OF FACIAL PROPORTION

With the patient wearing the wax rims, assess the facial proportion
If lower third of face appears too long excessive VDO
If lower third of face appears too short reduced VDO
Check for presence of creases at the corners of the mouth, loss of red
margin of the lips, incompetence of the lips and degree of
mandibular protrusion

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PHONETICS

Phonetic tests for correct vertical dimension includes observing the

relationships of teeth or rims during speech

Production of ch, s and j sounds brings the anterior teeth close

together but not touch

Observe if there is 1 2mm space between upper and lower wax

rims when making s sounds

If the distance is too large, increase the VDO

If the distance is too small, decrease the VDO

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OTHER METHODS IN RECORDING
OCCLUSION:-
1) Pre-extraction Records:-
a) Profile Photographs:-
- Profile photographs are made & enlarged to a life size of the patient.
- Measurements of anatomic landmarks on the photographs are compared
with measurements using the same anatomic landmarks on the patients
face.
-These measurements can be compared when the records are made &
again when the artificial teeth are tried in.
- The photographs should be made with the teeth in maximum occlusion, as
this position can be maintained accurately for photographic purposes.

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b) Profile Silhouettes:-
- The word silhouette means outline.
- Any further information like name, address, date,
colour & shape of the teeth can be entered on the
template & kept for future reference.

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 SIGNIFICANCE OF VERTICAL RELATION
Correct recording, transferring & incorporating the vertical
relations in the prosthesis, determines the success of the
prosthesis. Failure to do so may compromise the success of the
prosthesis.

Vertical dimension may be excessive or insufficient

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EFFECTS OF EXCESSIVELY INCREASED
VERTICAL DIMENSION
1. Discomfort teeth come into contact sooner than expected.
2. Trauma caused by constant pressure on the mucous
membrane.
3. Loss of freeway space
4. Clicking of teeth teeth are raised & the opposing cusps
frequently meet each other during speech & mastication.
5. Appearance over opening may cause elongation of the face &
at rest the lips are parted.
6. Residual ridge undergoes rapid resorption
7. TMJ pain

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EFFECT OF EXCESSIVELY DECREASED
VERTICAL DIMENSION
1) Inefficiency the force exerted with the teeth in contact decrease
considerably with over closure.

2) Cheek biting the flabby cheek tend to become trapped between the
teeth & bitten during mastication.

3) Appearance Closer approximation of nose to chin, soft tissue sag &

fall in, & the lines on the face are deepened

4) Soreness at the corner of the mouth (Angular cheilitis) falling in of

the corner of the mouth beyond the vermilion border & the deep fold
thus formed become bathed in saliva. This area becomes infected &
sore.

5) Pain in TMJ caused due to strain of the joint & associated ligaments.

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(to be continued with Horizontal Jaw Relations)

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