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PART I
The procedure
The physiologic concepts of jaw relations and
occlusion are based upon studies of dental and oral
physiology. The procedures involved are divided into
three parts: (1) jaw relations, (2) centric occlusion, and
(3) the removal of premature contacts from the paths
leading to centric occlusion.
The constant function of swallowing saliva is the basis
for establishing the mandibular positions and occlusion.
In swallowing saliva, the mandible rises to its habitual
closing terminal, then, as the saliva is forced backward
into the pharynx by the tongue, the mandible is retruded
to its physiologic centric relation (Fig. 1). These are the
mandibular movements that are used in determining the
vertical dimension and the centric relation for complete
dentures.
In practice, the vertical dimension is established by
first determining the length of the upper teeth on the
occlusion rim and then making a tentative vertical
dimension determination by using the free-way space
technique, or any of the usual methods, and mounting
the casts on an articulator.
To establish the physiologic vertical dimension, the
lower occlusion rim is reduced 3 mm, and a cone of very
soft wax is placed on top of the shortened occlusion rim
at the median line. The upper and lower occlusion rims
are placed in the mouth, and the patient is requested to
swallow several times. As the patient swallows, the soft
wax is reduced to the natural and physiologic vertical
dimension (Fig. 2).
MARCH 2004
Fig. 1. Mandibular pattern of movement during the swallowing of saliva. R, Physiologic rest position, PC, Physiologic
centric position: HCT, habitual closing terminal.
SHANAHAN
VOLUME 91 NUMBER 3
SHANAHAN
PART II
The rationale
Complete dentures are constructed to function in the
mouth as an integral part of the masticatory apparatus,
and, therefore, they should be designed to conform to
the patients physiologic jaw relations. The dentures
should also conform to the functional occlusal movements of swallowing, the nonfunctional lateral and the
protrusive movements of bruxism, and the deformation
of the dentures which occurs during swallowing.
Recently dental and oral physiology have been
applied in the maintenance, rehabilitation, and replacement of the natural dentition. The result is that
functional movements are used to replace the articulating machines and other mechanical devices that are
used for locating mandibular positions and for establishing occlusion in the treatment of the dental organ.
The function of swallowing saliva is the determinative
factor for obtaining the individuals natural vertical
dimension and centric relation because of its twentyfour-hour function. The constancy with which the
mandible is raised by the elevator muscles to the vertical
dimension and then retruded by the muscles of the
tongue to the centric relation makes the swallowing
function a reliable guide in recording the muscle
function of the masticatory apparatus.
One of the mechanical advantages in constructing
complete dentures to the jaw positions used in
swallowing is that a balanced centric occlusion under
light pressure may be obtained where the musculature
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