Horizontal jaw relations/dental courses

HORIZONTALHORIZONTAL
JAW RELATIONSJAW RELATIONS
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.comwww.indiandentalacademy.com

INTRODUCTION.INTRODUCTION.
 Maxillomandibular relations and occlusion createsMaxillomandibular relations and occlusion creates
more controversy than other dental subjects.more controversy than other dental subjects.
 There are lot of concepts by their own. Each oneThere are lot of concepts by their own. Each one
has their own thought based on scientific grounds.has their own thought based on scientific grounds.
 There are reasons for the controversies.There are reasons for the controversies.

 Difference in the interpretation of definitions.Difference in the interpretation of definitions.
 Usage of terminology is not universally accepted.Usage of terminology is not universally accepted.
 Difference in the interpretation of clinical results.Difference in the interpretation of clinical results.
 There are different types of instruments1 to getThere are different types of instruments1 to get
exact results.exact results.
 Differences in the evaluation of jaw relations andDifferences in the evaluation of jaw relations and
occlusion of natural teeth and relating andocclusion of natural teeth and relating and
applying these findings to completely edentulousapplying these findings to completely edentulous
patient.patient.

 MANDIBULAR MOVEMENTSMANDIBULAR MOVEMENTS

1.Hinge1.Hinge like movement used in opening and closinglike movement used in opening and closing
the mouth for the introduction of food to a limitedthe mouth for the introduction of food to a limited
degree, crushing of brittle food.degree, crushing of brittle food.
2.2.ProtrusiveProtrusive movement used in grasping andmovement used in grasping and
incision of food.incision of food.
3.Right and left lateral movements3.Right and left lateral movements for use in thefor use in the
reduction of fibrous food as well as other types ofreduction of fibrous food as well as other types of
food.food.

1.Hinge1.Hinge like movementlike movement
used in opening andused in opening and
closing the mouth forclosing the mouth for
the introduction ofthe introduction of
food to a limitedfood to a limited
degree, crushing ofdegree, crushing of
brittle food.brittle food.

2.2.ProtrusiveProtrusive
movement usedmovement used
in grasping andin grasping and
incision of food.incision of food.

3.Right and left lateral3.Right and left lateral
movementsmovements for usefor use
in the reduction ofin the reduction of
fibrous food as wellfibrous food as well
as other types ofas other types of
food.food.

4.4. Bennett movement-Bennett movement- the bodily side shift ofthe bodily side shift of
mandible.mandible.

 CENTRIC RELATION.CENTRIC RELATION.
 CENTRIC OCCLUSION.CENTRIC OCCLUSION.
 TERMINAL HINGE AXISTERMINAL HINGE AXIS..
 CENTRIC RELATON:-CENTRIC RELATON:-IT IS MOST POSTERIORIT IS MOST POSTERIOR
RELATION OF MANDIBLE TO MAXILLAE ATRELATION OF MANDIBLE TO MAXILLAE AT
THE ESTABLISHED VERTICAL RELATION.THE ESTABLISHED VERTICAL RELATION.
 OROR
 IT IS DEFINED AS THE MOST POSTERIORIT IS DEFINED AS THE MOST POSTERIOR
RELATION OF THE MANDIBLE TO THERELATION OF THE MANDIBLE TO THE
MAXILLA WITH THE HEAD OF THE CONDYLE INMAXILLA WITH THE HEAD OF THE CONDYLE IN
UNSTRAINED AND NOST RETRUTED POSITIONUNSTRAINED AND NOST RETRUTED POSITION
IN GLENOID FOSSA.IN GLENOID FOSSA.

 THE MAXILLOMANDIBULARTHE MAXILLOMANDIBULAR
RELATIONSHIP IN WHICH THERELATIONSHIP IN WHICH THE
CONDYLES ARTICULATE WITH THECONDYLES ARTICULATE WITH THE
THINNEST AVASCULAR PORTION OFTHINNEST AVASCULAR PORTION OF
THEIR RESPECTIVE DISKS WITH THETHEIR RESPECTIVE DISKS WITH THE
COMPLEX IN THE ANTERIOR-COMPLEX IN THE ANTERIOR-
POSTERIOR POSITION AGAINST THEPOSTERIOR POSITION AGAINST THE
SHAPES OF THE ARTICULARSHAPES OF THE ARTICULAR
EMINENCIES.EMINENCIES.

 CENTRIC OCCLUSION:- IT IS DEFINED ASCENTRIC OCCLUSION:- IT IS DEFINED AS
TOOTH TO TOOTH RELATION.TOOTH TO TOOTH RELATION.
 OROR
 CENTERD CONTACT POSITION OF THECENTERD CONTACT POSITION OF THE
OCCLUSAL SURFACE OF THEOCCLUSAL SURFACE OF THE
MANDIBULAR TEEH AGAINST THEMANDIBULAR TEEH AGAINST THE
OCCLUSAL SURFACE OF THEOCCLUSAL SURFACE OF THE
MAXILLARY TOOTH.MAXILLARY TOOTH.

 TEMINAL HINGE AXIS:-TEMINAL HINGE AXIS:-It is an imaginary lineIt is an imaginary line
/ axis which passes horizontally through the/ axis which passes horizontally through the
rotation centers of the right and left condylesrotation centers of the right and left condyles
when they are in their most distal / retruded,when they are in their most distal / retruded,
unstrained positions in their respective articular /unstrained positions in their respective articular /
glenoid fossa.glenoid fossa.

 TERMINAL HINGE POSITION:-TERMINAL HINGE POSITION:-
 THE POSITION OF MANDIBLE INTHE POSITION OF MANDIBLE IN
RELATION TO MAXILLA FROM WHICHRELATION TO MAXILLA FROM WHICH
AXIS MOVEMENT CAN BEAXIS MOVEMENT CAN BE
ACCOMPLISHED.ACCOMPLISHED.

IMPORTANCE OF CENTRICIMPORTANCE OF CENTRIC
RELATIONRELATION
 IT HELPS IN BETTER RETENTION ANDIT HELPS IN BETTER RETENTION AND
STABILITY.STABILITY.
 IN EDENTULOUS PATIENT THE CENTRICIN EDENTULOUS PATIENT THE CENTRIC
RELATION SHOULD BE RECORDED TORELATION SHOULD BE RECORDED TO
GET MASTICATORY & SWALLOWINGGET MASTICATORY & SWALLOWING
EFFICIENCY.EFFICIENCY.
 HELPS IN ADJUSTING THE ARTICULATRO.HELPS IN ADJUSTING THE ARTICULATRO.

 IT HELPS IN MOUNTING MAXILLARYIT HELPS IN MOUNTING MAXILLARY
CAST TO THE ARTICULATOR.CAST TO THE ARTICULATOR.
 IT MAINTAINS THE HEALTH OF THE TMJ.IT MAINTAINS THE HEALTH OF THE TMJ.
 IT IS THE STARTING POINT OF TEETHIT IS THE STARTING POINT OF TEETH
SETTING AND ADJUSTMENT OFSETTING AND ADJUSTMENT OF
ARTICULATORS.ARTICULATORS.

 Centric relation record is most difficult record toCentric relation record is most difficult record to
make and the most important maxillomandibularmake and the most important maxillomandibular
relation.relation.
 A maxillomandibular relation record that must beA maxillomandibular relation record that must be
repeated appears to be more difficult to make.repeated appears to be more difficult to make.
 Relaxation of muscle attached to the mandible isRelaxation of muscle attached to the mandible is
essential in the procedure.essential in the procedure.
 Psychic or emotional tensions, pain or discomfortPsychic or emotional tensions, pain or discomfort
in any part of stomatognathic system leads toin any part of stomatognathic system leads to
problem in recording centric relation.problem in recording centric relation.www.indiandentalacademy.comwww.indiandentalacademy.com

 Three primary requiremetns of making centricThree primary requiremetns of making centric
relation are:relation are:
 To record the correct horizontal relation of theTo record the correct horizontal relation of the
mandible to maxillae.mandible to maxillae.
 To exert equalized vertical pressure.To exert equalized vertical pressure.
 To retain the record in an undistorted conditionTo retain the record in an undistorted condition
until the casts have been accurately mounted onuntil the casts have been accurately mounted on
the articulator or until a previous record can bethe articulator or until a previous record can be
verified.verified.

METHODS OF RECORDINGMETHODS OF RECORDING
CENTRIC RELATION.CENTRIC RELATION.
 PRIMARY REQUIREMENTS:PRIMARY REQUIREMENTS:
 TO RECORD THE CORRECT HORIZONTALTO RECORD THE CORRECT HORIZONTAL
RELATION TO MANDIBLE TO MAXILLA.RELATION TO MANDIBLE TO MAXILLA.
 TO EXERT EQUALIZED VERTICALTO EXERT EQUALIZED VERTICAL
PRESSURE.PRESSURE.
 TO RETAIN THE RECORD IN ANTO RETAIN THE RECORD IN AN
UNDISTURBED CONDITION UNTIL THEUNDISTURBED CONDITION UNTIL THE
CASTS HAVE BEEN ACCURATELYCASTS HAVE BEEN ACCURATELY
MOUNTED ON THE ARTICULATOR.MOUNTED ON THE ARTICULATOR.

METODS OF RECORDINGMETODS OF RECORDING
 FUNCTIONAL/DYNAMIC METHOD.FUNCTIONAL/DYNAMIC METHOD.
 GRAPHIC METHOD.GRAPHIC METHOD.
 TACTILE SENSE.TACTILE SENSE.

FUNCTIONAL/DYNAMICFUNCTIONAL/DYNAMIC
METHOD.METHOD.
 The possible movements of mandible are:The possible movements of mandible are:
 Left eccentric.Left eccentric.
 Right eccentric.Right eccentric.
 Protrusion.Protrusion.
 Retrusion.Retrusion.

 Examples of recording centric relation record are:Examples of recording centric relation record are:
 1.Patterson technique.1.Patterson technique.
 2. Needle house technique.2. Needle house technique.

NEEDLE HOUSE TECHNIQUENEEDLE HOUSE TECHNIQUE
 Occlusal rims are modifiedOcclusal rims are modified
for this method.for this method.
 Four metal styli are insertedFour metal styli are inserted
in either upper/lowerin either upper/lower
occlusal rim. Preferablyocclusal rim. Preferably
they are inserted in thethey are inserted in the
upper occlusal rim.upper occlusal rim.
 When mandible movesWhen mandible moves
against the styli present inagainst the styli present in
the maxillary occlusal rim,the maxillary occlusal rim,
styli cut four diamondstyli cut four diamond
shaped tracings.shaped tracings.

PATTERSON TECHNIQUE:PATTERSON TECHNIQUE:
 Wax is used in thisWax is used in this
method.method.
 Trench is made in theTrench is made in the
mandibular rim and amandibular rim and a
mixture or plaster andmixture or plaster and
carborundum paste iscarborundum paste is
placed in the trench.placed in the trench.

 The mandibular movements generateThe mandibular movements generate
compensating curves in the plaster andcompensating curves in the plaster and
carborundum.carborundum.
 For both methods tentative vertical relation isFor both methods tentative vertical relation is
necessary.necessary.
 Functional method of recording centric relationFunctional method of recording centric relation
require very stable record bases.require very stable record bases.
 Forces which can dislodge the record bases occurForces which can dislodge the record bases occur
in any method that requires the mandibularin any method that requires the mandibular
movements may can create error.movements may can create error.

Horizontal jaw relations/dental courses

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Horizontal jaw relations/dental courses