MAXILLO-MANDIBULAR

RELATIONSHIP
 JAW RELATIONS

Spatial relationship of the maxillae

to the mandible
Occlusal Rim Try In
 OCCLUSAL RIMS TRY IN
● Inspection of occlusal rims
● Establishing the labial form of the occlusal rims
● Establishing the occlusal plane
● Establishing the vertical jaw relations
● Facebow transfer/ Orientation relation record
● Establishing and recording of Horizontal/centric jaw
relations
OCCLUSAL RIMS TRY IN

● Inspection of occlusal rims

● Establishing the labial form of the occlusal rims
● Establishing the occlusal plane
● Establishing the vertical jaw relations
● Facebow transfer/ Orientation relation record
● Establishing and recording of centric jaw
relations
INSPECTION OF OCCLUSAL RIMS
● Record bases interferences
● Patients' comfort
OCCLUSAL RIMS TRY IN

● Inspection of occlusal rims

● Establishing the labial form of the occlusal rims
● Establishing the occlusal plane
● Establishing the vertical jaw relations
● Facebow transfer/ Orientation relation record
● Establishing and recording of centric jaw
relations
Establishing the labial form of
occlusal rims
Establishing the labial form of occlusal rim

● To establish the antero-posterior position of the

anterior teeth and esthetics of lips and face

● Following guides are used;

■ Facial esthetics as guide
■ Phonetics guidelines
Establishing the labial form of occlusal rim
Facial Aesthetics as guide
Check list

■ Fullness of upper lip

■ The philtrum
■ The naso-labial fold
■ Commissures of mouth
● Inadequate lip support
● Inadequate lip support

■ Upper lip looks flabby and unsupported

■ Deepening of nasolabial folds
■ Facial creases will appear deeper
■ Loss of prominence of philtrum
■ Drooping of the commissures of mouth

Correction is done by adding more

wax
● Excessive lip fullness:
● Excessive lip fullness:

■ Stretched face
■ Philtrum appears shallow
■ Nasolabial fold appear smooth and filled
■ Corners of mouth appears stretched

■ Correction is done by removing the wax

Facial Aesthetics as guide
Incisal visibility

● Establishing the height of the anterior portion of

the occlusal rims establishes the supero-inferior
position of the anterior teeth

● Governing factors are;

■ Age
■ Length of the upper lip
Establishing the labial form of occlusal rim
Phonetics as Guide
Edge of rim touches wet line of lower lip when
F and V sounds are made

Count 50-60
● Inspection of occlusal rims
● Establishing the labial form of the occlusal rims
● Establishing the occlusal plane
● Establishing the vertical jaw relations
● Facebow transfer/ Orientation relation record
● Establishing and recording of centric jaw
relations
OCCLUSAL PLANE

● An imaginary surface which is related anatomically

to the cranium and which theoretically touches the
incisal edges of the incisors and tips of the occluding
surfaces of the posterior teeth
The occlusal plane usually departs from a
straight line and assumes a curvature upward
posteriorly in the direction of glenoid fossa.
Establishing the Occlusal plane using
the Maxillary occlusal rim
● From one canine to the other canine, the region
is made parallel to the inter-pupillary line in the
anterior region.
● The plane is nearly parallel to the Camper’s plane
or Ala-Tragus line in the posterior region.
Fox’s Plane
Establishing the Occlusal plane using the
mandibular occlusal rim

● Anterior Height:
■ The anterior part is adjusted to the level of
corner of the mouth
■ 0.5 mm of anterior portion of the occlusal rim
can be visible when the jaws are at rest and
lips slightly parted
● Posterior Height;
○ Rim should end at the junction of upper 1/3
and lower 2/3 of retromolar pad

○ Once the lower rim is established, the upper

occlusal rim is adjusted so that there is an
inter-occlusal rest space of 2-4 mm
● Inspection of occlusal rims
● Establishing the labial form of the occlusal rims
● Establishing the occlusal plane
● Establishing the vertical jaw relations
● Facebow transfer/ Orientation relation record
● Establishing and recording of centric jaw
relations
TYPES of maxillomandibular relations

● Vertical jaw relation

● Orientation relation
● Horizontal jaw relation
VERTICAL RELATION
EFFECTS OF INCREASED VERTICAL DIMENSION
EFFECTS OF INCREASED VERTICAL DIMENSION

● Trauma to underlying mucosa

● Rapid resorption of alveolar bone
● Clicking of teeth
● Rapid wear of acrylic teeth
● Elongated face
● Strained appearance
● Discomfort and annoyance
● Inability to close the lips
● TMJ dysfunction syndrome
EFFECTS OF DECREASED VERTICAL DIMENSION
EFFECTS OF DECREASED VERTICAL DIMENSION

● Chin appears close to nose

● Cheek biting
● Decreased chewing efficiency
● Angular cheilitis
● TMJ pain, Clicking sounds
● Reduced lower facial height
● Collapsed appearance
● Terminologies used while
recording Vertical Relations

1. Rest vertical dimension or RVD

Physiologic Rest Position

2. Occluded vertical dimension or OVD

3. Inter-occlusal dimension or Freeway

space or Rest space
 RESTING VERTICAL DIMENSION

● The postural position of the mandible when an

individual is resting comfortably in an upright
position and the associated muscles are in a state
of minimal contractual activity
OCCLUDED VERTICAL DIMENSION

● It is the distance measured when the

occluding members are in contact
 FREEWAY SPACE
● It is the difference between the RVD and OVD

● RVD- OVD = Freeway space

● In natural teeth, the space is 1-8 mm

● In complete dentures it should be between 2-4
mm
● And it is measured in the premolar region
Measuring Vertical dimension of Occlusion

● Two markings are made, one on the tip of the nose

and other on the prominent part of chin

● The patient is told to swallow and relax

● The distance between the marks is measured

● The difference between two selected points, one
on the maxilla and one on the mandible
Then the patient is asked to close with occlusal rims

Distance between the marks is again measured

This is the occlusal vertical dimension

It should be 2-4 mm less than resting vertical dimension

If not, then occlusal rims are adjusted accordingly by adding or

removing wax
METHODS TO DETERMINE
THE VERTICAL RELATIONS
Mechanical Methods

● Ridge Relations;
Distance from Incisive Papilla and
Parallelism of Ridges

● Measurements from Previous dentures

● Pre extraction records

Distance from Incisive Papilla
Distance from Incisive Papilla

● The distance of incisive papilla from

the incisal edges of mandibular
incisors is 4 mm

● The distance of incisive papilla from

the incisal edges of maxillary incisors
is 6 mm
Parallelism of Ridges
Measurement of Previous Dentures
● Pre-extraction Records
(a) Profile Radiographs
(b) Profile Photographs
(c) Articulated casts
(d) Face masks
(e) Facial measurements
(f) Lead wire silhouettes
(g) Resin framework
Physiologic Methods
● Physiologic rest position tests
- Parting the lips after swallowing
- Niswonger’s method
● Phonetics;
- Using the M sound
- Using the h , s & j sounds
- Sliverman’s closest speaking space
● Facial expressions and Esthetics as a guide
( Willi’s method)
● Tactile Sensation (Lytle’s method
- Boos bimeter )
● Electromyography
Parting the Lips After Swallowing
● Ask the patient to swallow and
relax

● The lips are parted gently after

instructing the patient to hold the
jaws still

● There should be 2-4 mm space

available between the rims in the
pre-molar region
 Niswonger’s Method
● Two markings are made, one on the tip of the nose
and other on the prominent part of chin

● The patient is told to swallow and relax

● The distance between the marks is measured

● Rims are adjusted until the distance at occlusion is

2-4mm less than restimg vertical dimension
Phonetics as Guide

● The patient is asked to pronounce certain

words and the relationship of the occlusal
rims to each other and the lips is observed
M sound

● Patient repeats letter M

● When the lips touches
● Jaw movement is stopped
● This is the resting position
● 2 mm space exists between rims at premolar
region
S sound
(Silverman Closest Speaking space)

● The occlusion rims are placed in the mouth and

the height is adjusted until a minimum space
exists when the patient pronounce the letter “S”
, Ch, J

● This space is 1-1.5mm

Facial esthetics as guide
Facial esthetics as guide
Facial esthetics as guide
● Different measurements from facial landmarks
should be equal to the distance between the
lower border of the septum of the nose and lower
border of the chin
●
TACTILE SENSATION
(Boos Bimeter)
Maximum biting force occurs at correct OVD

Device that measures bite force is attached to the mandibular record

base

Vertical relation is adjusted

Maximum power point is determined as correct VDO

TACTILE SENSATION
Lytle’s Method ( Neuromuscular perception)
Using central bearing plate , patient’s vertical relation is
increased beyond physiologic rest position.
Pin is lowered slightly and adjusted where patient signifies
that it is right and comfortable vertical height
Electro-myography
Minimal activity of muscles of mastication indicated rest
vertical dimension
Orientation Relation
Hinge Axis

Transverse Axis around which mandible rotates

Relation of Hinge Axiswith occlusal plane
For this we Use Facebow
● Facebow transfers are used to record
the anteroposterior and mediolateral
spatial positions of the maxillary occlusal
cusps in relation to the transverse
opening and closing axis (Hinge Axis) of
the patient's mandible.
Transfering orientation of hinge axis with
maxillary occlusal plane to the articulator
THANK YOU