7 Horizontal Jaw Relations
7 Horizontal Jaw Relations
7 Horizontal Jaw Relations
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Centric occlusion:
The occlusion of opposing teeth when the mandible is in centric relation. This
may or may not coincide with the maximal intercuspal position (it is bone to
bone relationship).
Maximal intercuspal position: is a maxillomandibular relationship
determined by tooth-to-tooth relationship independent on condylar position.
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The clinician must be able to manipulate the patient's mandible to the centric
relation position, as it is:
5. The non dominant hand is inverted and placed in the mouth so that the
soft tissue of the thumb and index fingers lies on the opposing buccal
surfaces of the maxillary and mandibular occlusion rims, between the
occlusal surfaces in the first molar region.
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6. The other hand is used to help guide the patient to centric relation
position. Care should be exercised to avoid displacing the mandibular
record base in the posterior direction.
9. It is advisable to instruct the patient to "let your jaw relax, close slowly.
2. Placing the tip of the tongue in the top and back of the mouth.
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3.Telling the patient to “Stick out the upper teeth"
4. Tipping the chair and patient back to allow gravity to help position the
mandible.
5. Using a mirror so that the patient can see the CR mandible position.
• The maxillary master cast has now been properly placed on the
articulator using a face-bow recording.
• because we must make the recording at the correct OVD, space must
now be created to allow room for the record material.
Once the maxillary cast is properly positioned, the occlusion rims are placed
on their respective casts, and the records are seated together. Observe the casts
for possible contact in the posterior areas. If they make contact, the cast must
be trimmed until there is no cast-to-cast contact.
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Methods of recording centric jaw relation:
1. Functional or chew-in methods
2. Graphic method
3. Tactile or inter occlusal check record method
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1-Functional methods
a-Needle-house technique:
In this method we used impression compound occlusion rims with four metal
stylus placed in the maxillary rim in premolar and molar regions. When the
patient moves his mandible, the stylus on the maxillary rim will create a
marking on the mandibular rim, after all mandibular movements are made,
and a diamond-shaped pattern is formed. The anterior most point of this
diamond pattern indicates the centric jaw relation.
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b-Patterson’s technique
In this method wax occlusion rims are used. A trench is made along the length
of mandibular rim. A 1:1 mixture of pumice and dental plaster is loaded into
the trench. When the patient moves his mandible, compensating curves on the
mixture will produced, and the height of the mixture is also reduced. The
patient is asked to continue these movements till a predetermined vertical
dimension is obtained. Finally, the patient is asked to retruded his jaw and the
occlusal rims are fixed in this position with metal staples.
c-Swallowing technique:
In this method, soft cones of wax are placed on the lower record base. The
wax cones contact the upper occlusion rim when the patient swallows. This
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procedure is supposed to establish both proper vertical and horizontal relation
of the mandible to maxilla.
2-Graphic methods
These methods are called so because they use graphs or tracing to record the
centric relation. The general concept of this technique is that a pen-like pointer
is attached to one occlusal rim and a recording plate is placed on the other rim,
the plate coated with carbon or wax on which the needle point can make the
tracing, when the mandible moves in horizontal plane, the pointer draws
characteristic patterns on the recording plate.
The characteristic patterns created on the recording plate is called arrow point
tracing, also known as Gothic arch tracing. The apex of the arrow point
tracing gives the centric relation, with the two sides of the tracing originating
at that point being the limits of the lateral movements. The apex of the arrow
head should be sharp else the tracing is incorrect.
The graphic methods are either intraoral or extraoral depending upon the
placement of the recording device. The extraoral is preferable to the intraoral
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tracing, because the extraoral is more accurate, more visible, and larger in
comparing with the intraoral tracing.
3- Tactile or inter occlusal check record method
In this method the centric relation is recorded by placing a record medium
between the record bases when the jaws positioned at centric relation. The
patient closes into the recording medium with the lower jaw in its most
retruded unstrained position and stops the closure at predetermined vertical
dimension. This method is simple, because mechanical devices are not used
in the patient mouth and are not attached to the occlusion rims. It has
advantage of causing minimal displacement of the recording bases in relation
to the supporting bone. It is essential in making an accurate record, the visual
acuity and the sense of touch of the dentist also inter in making of centric
relation record, this phase is developed with experience and it is difficult to
teach to another individual.
Indications of the Interocclusal check record:
1-Abnormally related jaws.
2-Displaceable, flabby tissues.
3-Large tongue.
4-Uncontrollable mandibular movements.
5-It can also be done for patient already using a complete denture.
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5-Technique employed in making the record.
6-The ability of the dentist.
Eccentric jaw relation
It is defined as any relation-ship of the mandible to the maxilla other than the
centric relation. It includes protrusive and lateral relations. The main reason
in making an eccentric jaw relation record is to adjust the horizontal and
lateral condylar inclination in the adjustable articulator, and to establish the
balanced occlusion.
The protrusive and left and right lateral movements records are made in the
same manner as for centric relation record and these include:
1-Functional or chew in methods.
2-Graphic methods.
3-Physiological methods (tactile or inter-occlusal check record
method).
The Interocclusal eccentric records may be made either on the occlusion rim
before the teeth are set up or on the posterior teeth at the try-in appointment.
When the protrusive eccentric record is made on Hanau articulator, the
following formula is used to obtain an acceptable lateral inclination.
H
L= --------- + 12
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H: Is the horizontal condylar inclination in degrees as established by the
protrusive relation record.
L: lateral inclination in degrees as obtained from the formula.
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2- The condyles do not travel in straight lines during eccentric mandibular jaw
movements.
3- Semi-adjustable articulators in which the condyles travel on a flat path
cannot be used to reproduced eccentric movements exactly.
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