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Page 1
Introduction
Jaw relations are defined as any one of
the many relations of the mandible to the
maxillae
Maxillomandibular relationship is
defined as any spatial relationship of the
maxillae to the mandible; any one of the
infinite relationships of the mandible to the
maxilla.
Page 2
Jaw relation/maxillomandibular
relation
 Types:
1. Orientation relation
2. Vertical relation
3. Horizontal relation
centric relation
eccentric relation—protrusive records
---lateral records.
Page 3
Clinical significance of jaw relation
• To re-establish the functional position of the

mandible.
• Comfort
• Esthetics
• Phonetics
• Functional efficiency
• Structural balance.
Page 4
TRIMMING THE UPPER RECORD BLOCK
When trimming the rim there are four main

considerations and they must be taken in the order
given.
Labial fullness: The lip is normally supported by the

alveolar process and teeth which, at this stage, are
represented by the base and rim of the record block.
Therefore, the labial surface must be cut back or
added to until a natural and pleasing position of the
upper lip is obtained.
Page 5
2. The height of occlusal rim: It should be trimmed
vertically until it represents the amount of anterior teeth
intended to show below the lip at rest. The average adult
shows approximately 3mm of upper central incisors when
the lips are just parted, but there are many variations from
this amount which should be accepted as a guide rather
than a rule
A greater length of tooth than normal may be shown if the

patient has:
A short upper lip
a. Superior protrusion
b. An Angle’s Class II malocclusion of natural teeth
And less will be shown:

a. With a long upper lip
b. In most old people, owing to attrition of natural
teeth and some loss of tone of the orbicularis oris muscle
Page 6
3. Anterior plane: Generally the plane to
which the anterior teeth should be set, and
to which the rim must be trimmed, is
parallel to an imaginary line joining the
pupils of the eyes or a line at right angles
to the midsagittal plane of the face.
Page 7
4. The anteroposterior plane: This plane indicates the
position of occlusal surfaces of the posterior teeth and
is obtained in conjunction with the anterior plane.
The rim is trimmed parallel to Ala-tragus line (an
imaginary line running from the external auditary
meatus or tragus of the ear to the lower border of ala of
the nose).
Thus when the rim has been trimmed to these
planes it indicates the place of orientation for setting
the artificial teeth.
Page 8
GUIDELINES
1. The centre line or midline

In the normal natural dentition, the upper central
incisors have their mesial surfaces in contact with an
imaginary vertical line which bisects the face and, for
esthetic reasons, it is desirable that the artificial
substitutes should occupy the same position.
The following aids are suggested as a help in
deciding where to mark a vertical line on the labial
surface of the upper rim
• Where it is crossed by an imaginary line from the centre
of the brows to the centre of the chin.
• Immediately below the centre of the philtrum
• Immediately below Powerpoint
the centre of the labial tubercle
Templates
Page 9
2. High lip line
This is a line just in contact with the lower
border of the upper lip when it is raised as high as
possible unaided, as in smiling or laughing. It is
marked on the labial surface of the rim and indicates
the amount of denture which may be seen under
normal conditions, and thus assists in determining
the length of tooth needed.
3. Canine lines
These mark the corners of the mouth when
the lips are relaxed and are supposed to coincide
with the tips of the upper canine teeth but are only
accurate to within 3 or 4 mm. These lines give some
indication of the width to be taken up by the six
anterior teeth from tip to tip Templates
Powerpoint of the canines. Page 10
TRIMMING THE LOWER RECORD
BLOCK
Trim the lower block so that it occludes
evenly with the upper, the mandible will be
separated from the maxilla by the same distance
that it was when the natural teeth were in occlusion.
The location of the occlusal plane posteriorly
will ultimately be determined by the height of the
mandibular anterior teeth and anterior 2/3 rd of
retromolar pads. After recording the tentative
occlusal vertical relation and the centric relation
position, the maxillary occlusion rims are oriented
to the opening axis of the jaws with the help of the
face bow. Powerpoint Templates
Page 11
ORIENTATION RELATIONS
Orientation relations are those that orient the
mandible to the cranium in such a way that when the
mandible is kept in its most posterior unstrained
position, the mandible can rotate in the sagittal plane
around an imaginary transverse axis passing
through or near the condyles
Page 12
THE FACE BOW
A caliper like instrument used to record the spatial
relationship of the maxillary arch to some anatomic
reference point or points and then transfer this
relationship to an articulator; it orients the dental cast
in the same relationship to the opening axis of the
articulator.
Types of Face bow:
There are two types of face bows.
1. KINEMATIC face bow
2. ARBITRARY face bow -Facial type
-Earpiece type
Page 13
KINEMATIC FACE BOW
The Kinematic face bow is initially used to accurately locate the

hinge axis.
It is attached to a clutch, which in turn attaches to the mandibular teeth.
As the mandible makes opening and closing movements the condylar styli
move in an arc.
Their position is adjusted until they exhibit pure rotation and not translation,
when the mandible is opened and closed.
The points of rotation are marked on the skin and this determines the true
hinge axis.
The mandibular clutch is removed and the face bow is attached to the
maxillary arch.
The true rotation points are again used to orient the tips of the condylar
styli . Page 14
ARBITRARY FACE BOW
The arbitrary type of face bow is so called because it uses arbitrarily
located marks on the skin at the condyle points as the hinge axis
position.
1. Facia type:
In the facia type the condyle rods
are positioned on a line extending from
the outer canthus of the eye to the
superior inferior center of the tragus
and approximately 13mm anterior to
the distal edge of the tragus of the ear.
This locates the condyle rods

within 5mm. of the true center of the
Page 15
2. Ear piece type:
The earpiece face bow is designed to fit into the external auditory
meatuses. Here also the fork is attached to the maxillary occlusion rim.
Page 16
Vertical jaw relation
• Amount of separation b/w maxilla & mandible.

• Acc GPT –8.
– Distance b/w two selected points one on a fixed and
one on a movable member
or
– The vertical dimension of face b/w any two arbitrary
selected points located one above and one below the
mouth,usually in the midline.
Page 17
Classification
1) Vertical dimension of occlusion
2) Vertical dimension of rest
3) Vertical dimension in the other positions.
 Vertical dimension of occlusion: (GPT-8)

The distance b/w two points when the occluding
members are in contact. OR
It is the relation of the mandible to the maxilla
when the occlusal stops are provided by the
teeth/occlusion.
 Vertical dimension of rest:
The distance b/w two selected point measured
when the mandible is in the physiologic rest
position.
Page 18
INTEROCCLUSAL DISTANCE /INTEROCCLUSAL REST
SPACE.
• Difference b/w the resting
vertical dimension and vertical
dimension of occlusion.
• First studied by Dr.M E
Niswonger
• 2-4mm.
• Verticentric : involves the

simultaneous recording of
vertical dimension of occlusion
with the jaws in centric
relation.
• Vertical dimension of speech:
the distance measured b/w
two selected points –occluding
members-closest proximity
during speech. Page 19
Common factors to consider while recording vertical jaw relation
Position of mandible – influenced by gravity

Patient should be calm, cool, & relaxed
Difficult in neuromuscular disturbances
No one method –accepted.
Page 20
Methods for recording vertical jaw relation
1) Mechanical methods:
i. Ridge relation:
a) distance of incisive papilla from mandibular incisors
b) parallelism of ridges
ii. Measurement of former dentures
iii. Pre-extraction records-
 Profile radiographs
 Profile photographs
 Casts of teeth in occlusion
 Facial measurements
2) Physiologic methods
Physiologic rest position
Phonetics & esthetics as guide
Swallowing threshold
Tactile sense
Page 21
Methods for determining VDO
• Niswonger’s method:
(1934)
– interocclusal distance : 2-
4mm at first premolar
region.
• Two marks-
– Base of nose
– Chin
• Disadvantages;
– Marks on skin – move –
difficult – constant
measurement.
– Lack of permanentPowerpoint Templates
reference points. Page 22
Effect of increased vertical dimension
1) Increased risk of trauma-
clenching of teeth.
2) Discomfort to patient
3) Teeth are liable to contact –
causing clicking during
speech
4) Trauma & pain – basal seat
areas of denture
5) Loss of freeway space-
muscular fatigue
6) Clicking sound
7) Elongated appearance of
face
8) Bone resorption
9) Loss of retension & stability
of dentures
10) Generalised hyperemia.Powerpoint Templates
Page 23
Effect of decreased vertical
dimension
1) Reduced masticatory efficiency
2) Poor esthetics
3) Cheek biting/ tongue biting/ lip
biting
4) Denture look
5) Angular chelitis
6) Pain in TMJ
7) Coston’s syndrome
8) prognathism
Page 24
Tests to aid in confirming correct vertical relation
Judgement of facial
support
Visual observation
of space b/w rims
Observation –
sibiliant words.
Page 25
Horizontal jaw relations
Eccentric relation
Centric relation
Protrusive record Lateral record
Centric relation: -- GPT -8

Centric relation is defined as a
maxillomandibular relationship in which the
condyles articulate with the thinnest avascular
portion of their respective disks with the
complex in the anterior superior position
against the shapes of articular eminences.
This position is independent of tooth contact.
This position is discernible when mandible is
directed superiorly and anteriorly and
restricted to a purely rotatary movement about
a transverse horizontal axis. Powerpoint Templates
Page 26
Methods of recording centric relation
Boucher's :
A) static methods-
Interocclusal record
Central bearing device
Tracing devices
B)functional methods—chew –
in technique
Needles technique
House technique
Essig technique
Patterson technique
Page 27
Static method
Causes minimal displacement of recording
bases
Intraoral interocclusal records- without
central bearing point –using plaster/wax.
Page 28
Preparing Occlusion Rims
– Place 3 widely separated lines between the rims
in the centric position
– CRITICAL! Check that record base heels/rims do
not touch
– Eliminate contact with record bases
Page 29
Registering Centric Relation
Max & Mand Occusion

Rims
– Two sharp “V”-shaped 1-2
mm
notches in the
molar/premolar area of
each sided wax
– Depth 1-2 mm
Page 30
Ensure Adequate Notch Depth
Too Shallow
- no undercuts
Page 31
– Rehearse making the record without

recording medium
– Place occlusion rims intraorally
– PVS registration material (Memoreg)
over entire occlusal rim
Page 32
Thin Layer of Material
Too Thick Good
Page 33
Thin Layer
• Want flat record, no

excess on sides of rims
• Excess material
recording of the sides
of the rim can cause
deflection when
checking record
Page 34
Making the Record
• Have patient close into record

• Ensure smooth arc of closure, no
horizontal deviations
• Use index fingers to stabilize lower
record base
Page 35
Patient opens, relaxes,

and slowly closes
Page 40
– Patient closes until rims are almost

touching (1 mm separation)
– Ask patient to stop as soon as this
position has been reached
– Some may not be able to tell when
they contact
Page 41
• Never instruct the patient to

bite firmly
• Causes translation or
inaccuracy in the record
Page 42
• Hold position until

set 1-2 min
• Remove both rims
together
• Separate
Page 43
Registration Should be Sharp,
Not Rounded
Page 44
Mounting the Mandibular Cast
• Ensure record is
repeatable
• Increase the height of
incisal pin 1 mm, invert
articulator
• Place wax rims together,
lute with sticky wax - 4
spots
Page 45
Eccentric relation record
Protrusive relation record Lateral relation record
Page 46
Methods for recording eccentric jaw relation
Functional method- needles- house & patterson technique
Graphic method
Tactile / direct check record methods
Page 47
Protrusive relation
Christensen’s phenomenon
Due to downward displacement
of the condlyes along the
articular slope.
Protrusive records are made of-

Direct protrusive check record
Graphic method
Functional procedures
Page 48
Lateral jaw relations
• Common methods:
– Graphic method
– With check bites of wax
– With positional records of stone/plaster
– Pantography
– Hanau’s formula:
– L = H/8 + 12 L=lateral condylar inclination
H=Horizontal condylar inclination
Page 49
Consequences of incorrect centric relation recording
Natural dentition– damage to

periodontal structure,
hypersensitivity, excessive
attrition, hypermobility of teeth.
Pain & dysfunction of masticatory
muscle, headache, neck& shoulder
pain.
Dentures- not in centric relation—
premature contact.
TMJ dysfunction— condyle press
upon peripheral vascular &
innervated part of articular disc.
Mucosal irritation & soreness.
Spasm of muscle of mastication
Resorption of residual alveolar
ridges.
Page 50
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• To re-establish the functional position of the

When trimming the rim there are four main

Labial fullness: The lip is normally supported by the

A greater length of tooth than normal may be shown if the

And less will be shown:

1. The centre line or midline

Orientation relations are those that orient the

mandible to the cranium in such a way that when the

mandible is kept in its most posterior unstrained

position, the mandible can rotate in the sagittal plane

around an imaginary transverse axis passing

through or near the condyles

The Kinematic face bow is initially used to accurately locate the

It is attached to a clutch, which in turn attaches to the mandibular teeth.

This locates the condyle rods

• Amount of separation b/w maxilla & mandible.

 Vertical dimension of occlusion: (GPT-8)

• Verticentric : involves the

Position of mandible – influenced by gravity

Centric relation: -- GPT -8

Max & Mand Occusion

– Rehearse making the record without

Too Thick Good

• Want flat record, no

• Have patient close into record

Patient opens, relaxes,

– Patient closes until rims are almost

• Never instruct the patient to

• Hold position until

Protrusive relation record Lateral relation record

Protrusive records are made of-

Natural dentition– damage to

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