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BASIC PRINCIPLES OF
M A X I L L 0 - M A N DIB U L A R R E L AT 1 0 N S
LUBNA ELDIDI
BDS 2006, M SC 2011, PHD 2018

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1. INTRODUCTION v.v.v

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I WHAT IS MAXILLO-MANOTBULAR RELATION wmm
2. SIGNIFICANCE OF RECORDING JAW RELATION
2. ORIENTATION RELATIONS
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I. OCCLUSAL PLANE
2. FACEBOW RECORD
3. VERTICAL JAW RELATIONS
.
I VERTICAL DIMENSION OF REST AND OCCLUSION.
,
2. FREEWAY SPACE.
3. METHODS OF ESTABLISHING VERTICAL DIMENSION.
4. HORIZONTAL JAW RELATIONS
1. CENTRIC RELATION.
2. ECCENTRIC RELATION.
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Clinical
1. Examination & Diagnosis

2. Primary impression Study cast

Laboratory
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■ Special tray

3. Final impression ■ Boxing and pouring master cast

■ Occlusion blocks

4aCÿaw relation registration ■ Mounting on articiNlor

4b Selection of artificial teeth ■ Setting of artificial teetlr
waxing up

5. Try m Processing

6, Insertion

7. Post insertion care

 REC

What is a maxillo-mandibular
relation?
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It is defined as: f
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“Any spatial relationship of the

maxilla to the mandible”
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What is a maxillo-mandibular • ••

relation?
It is a 3-dimcnsional relation of 3 components
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 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

> Accurate and repeatable recording of the patient's jaw relationships
are essential for all types of oral rehabilitation.

> They provide essential clinical documentation that enables dentists and
technicians to create the occlusal relationships necessary to meet the
patient's functional and esthetic needs.
 REC

SIGNIFICANCE OF RECORDING JAW RELATION

Function: *
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1. All mandibular movements start and end with the
condyle in its position in the Glenoid fossa, an incorrect
jaw relation will lead to disharmony between
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mandibular movement and the TMJ. c
MASTICATION SPEECH SWALLOWING
 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

Function:
2. Proper jaw relation is essential for maintaining the health of the remaining
structures.

RESIDUAL OTHER
TMJ STRUCTURES
RIDGE

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 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

Function:

TMJ
The presence of condyle in an
incorrect position leads to pain
and discomfort in the TMJ.
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 REC

SIGNIFICANCE OF RECORDING JAW RELATION

Function:
RESIDUAL
RIDGE

In cases with poor jaw relations,

dentures will move during
function damaging the residual
ridges.
 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

Function:
OTHER
STRUCTURES

For example, angular ehelitis is a fungal m

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infection that occurs at the comers of the 4

mouth with low vertical dimensions. «1

 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

Function:
OTHER
STRUCTURES

Check and tongue biting is

another common problem in ••• / • •i
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 REC

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SIGNIFICANCE OF RECORDING JAW RELATION

Function:
3. Proper jaw relations are important for phonetics.

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 REC

SIGNIFICANCE OF RECORDING JAW RELATION

Normal facial
contours restored
with dentures

Esthetics:
Jaw relation guides facial tissue r
support as well as proportions of the
face. fa
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 REC

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JAW RELATIONS CONSIST OF 3 STEPS:

I. ORIENTATION RELATION. 2. VERTICAL RELATION.

3. HORIZONTAL RELATION

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 REC

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“It is the relation that orients the maxilla to
the cranium in such a way, that, when
mandible is kept in its most posterior Jr*
position, the mandible can rotate in sagittal
plane around an imaginary terminal hinge
axis passing through or near the condyles.” \

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IN OTHER WORDS, IT ORIENTS THE OCCLUSAL PLANE TO THE
BASE OF THE SKULL AND THE CONDYLES.
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 REC

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1. Occlusal plane

2. Cranio-maxillary Orientation
 REC

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Occlusal plane
It is the average plane established by the incisal and
occlusal surfaces of the teeth

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Occlusal plane
In jaw relations of completely edentulous patient it is W&
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The maxillary wax rim should be 1-2

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Occlusal plane
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Level mmm
□ Greater length may he shown in cases of
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□ Decreased length may be shown with

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o Long upper lip
o Old patients muscle tone decreases as a result
lower lip sags and upper lip drops
o Attrition of the natural teeth. • -

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 REC

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Occlusal plane

The mandibular wax rim should be below the

level of the lower lip and angle of the moth
anteriorly and 2 thirds the level of the Rctromolar

pad posteriorly.
 REC

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Occlusal plane
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Orientation • •4

The occlusal plane is adjusted to be parallel to 2 \i

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important extra-oral planes, these are;

1. Intcrpupillary line.
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 REC

Occlusal plane

The occlusal plane is adjusted to be parallel to 2

important extra-oral planes, these are;
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2. Alatragal line (Campers plane)
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C ran io- maxi1lary Orientation • ••
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Facebow Record
The l'acebow is a caliper like device which
relates the occlusal plane to the condylar
elements in an articulator similar to how it is
related to the patient’s actual tenninal hinge axis.
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Cranio- maxillary Orientation |

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Cranio- maxillary Orientation 1
Is if essential?
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Whether or not this step of essential depends on:

• How closely articulator movements need to simulate the actual mandibular
movements.
• The complexity of the dental restoration.
• The occlusal scheme of the dental restoration.
 REC

KJTOOMimrON
JAW RELATIONS CONSIST OF 3 STEPS:

1. ORIENTATION RELATION. 2. VERTICAL RELATION.

3. HORIZONTAL RELATION

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‘it is the relation of mandible to the maxilla in a vertical plane.”

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VERTICAL VERTICAL DIMENSION
DIMENSION OF REST OF OCCLUSION

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Hie vertical dimension at the llic vertical dimension when

physiologic rest position. patient is occluding.
 REC

Free way space

• It is the interdental space when the patient

is at rest. \\
• It is the difference between VDR and

VDO.
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• It ranges between 2-4mm. Freeway space
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 REC

Free way space (

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 REC

Correct determination of occlusal vertical dimension is important for :

• Proper mastication.
• Proper speech and articulation of sounds.
• Normal facial appearance.
• Tissue preservation.
 REC

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Methods of establishing vertical dimension
□ Measurement of former dentures
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Methods of establishing vertical dimension ••

□ Prc-cxtraction records:
a. Profile radiograph
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Methods of establishing vertical dimension

□ Prc-cxtraction records:
b. Profile photograph ilk

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 REC

Methods of establishing vertical dimension

□ Prc-cxtraction records:
c. Articulated casts I
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 REC

Methods of establishing vertical dimension

□ Post-extraction methods:
a) Niswonger’s method »v4

• Most commonly used method.

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■ • Patient sits upright for measurements.

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 REC

Methods of establishing vertical dimension

□ Post-extraction methods:
b) Willi's method
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 REC

Methods of establishing vertical dimension

□ Post-extraction methods:
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c) Equal thirds
Upper third

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tablishing vertical dimension
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The occlusal rims are placed in the

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mouth and the height is adjusted until a
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the patient pronounces the letter “s.”
 REC

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Methods of establishing vertical dimension

□ Physiologic methods:
a. Physiologic rest position.
b. Esthetics.
c. Phonetics.
d. Swallowing.
c. Tactile sense.
 REC

JAW RELATIONS CONSIST OF 3 STEPS:

I. ORIENTATION RELATION. 2. VERTICAL RELATION.

3. HORIZONTAL RELATION

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Canine paamon
 REC

It is the relation of mandible to the maxilla in a horizontal plane. It involves

recording centric and eccentric relations.
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Relations
relations

Eccentric
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Lateral records

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 REC

CENTRIC RELATION It is a bone to bone relation

Occlusion of opposing teeth when

CENTRIC OCCLUSION
mandible is in centric relation

Complete interdigitation of
MAXIMUM
INTERCUSP AT ION opposing teeth regardless of
condylar position.
 REC

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In natural dentition, centric relation, occlusion and maximum

intercuspation do not coincide.

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Lubna Eldidi's screen

 REC

In complete dentures, centric relation, occlusion and maximum

intcrcuspation should coincide.

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 REC

How TO RECORD THE CENTRIC RELATION

After the occlusal rims arc adjusted at the desired vertical dimension:
1. Reference lines arc placed on the wax rim including:
■■ nnc
1. Midlinc.
2. Canine lines.
3. High lip line
4. Low lip line
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 REC

How TO RECORD THE CENTRIC RELATION

2. 4 V-shapcd grooves are cut on the maxillary wax rims.

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 REC

How TO RECORD THE CENTRIC RELATION

3. An interocclusal recording material is placed on the lower and the
patient is guided to bite on the wax rims with the mandible in the
most retruded unstrained position.
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 REC

How TO RECORD THE CENTRIC RELATION

3. An interocclusal recording material is placed on the lower and the
patient is guided to bite on the wax rims with the mandible in the

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most retruded unstrained position.

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