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Brooklyn, N.Y.
Read before the Greater New York Academy of Prosthodontics, New
York City, Dec. 3, 1955.
Reprinted with permission from Prosthet Dent 1956;6:741-7.
J Prosthet Dent 2004;91:206-9
SHANAHAN
SHANAHAN
occlusal adjustments were minor. If extensive adjustments were made, it is advisable to wait until the
neuromusculature system adjusts to the new conditions.
The method for testing the natural or physiologic
vertical dimension and centric relation is virtually the
same for all occlusal restorations and replacements at all
ages. Procedures may vary somewhat, depending upon
whether the patient is dentulous, partially edentulous,
or completely edentulous.
To test the complete natural dentition, drape a small
ball of very soft (Trubyte Equalizing) wax, 8 to 10 mm in
diameter, over the occlusal surface of the lower first
bicuspid on each side (Fig. 1). With the patient relaxed
and in a comfortable position, have him swallow several
times. Upon examining the wax, if there is evidence that
the lower teeth made contact with the upper teeth, then
you can be certain that the natural vertical dimension has
been retained, and no need exists for increasing it. On
the other hand, if it is obvious that the teeth did not
make contact during the swallowing function, it indicates that the teeth did not occlude at the physiologic
vertical dimension and that the vertical dimension may
be increased, regardless of the extent of the interocclusal
distance. However, several tests should be made before
the final decision is reached.
To test the physiologic vertical dimension in a partially edentulous mouth, drape a small amount of very
soft wax over the occluding surfaces of the lower first
bicuspids (Fig. 2). Cause the patient to relax in a normal
sitting posture. Give him a small piece of candy to suck
on, with instructions to swallow the saliva for five
minutes. If upon examination of the wax, it is found that
considerable wax remains between the upper and lower
teeth, it indicates that the teeth do not occlude at the
natural vertical dimension, and that treatment may be
safely instituted after several tests are made.
If, upon examining the wax, it is obvious that the
lower teeth have contacted the upper teeth, it indicates
that the natural vertical dimension has been retained. If
the interocclusal distance should be in excess of the 2 to
208
SHANAHAN
MARCH 2004
SUMMARY
Prior to the introduction of dental physiology to
prosthodontics, the vertical dimension and the centric
relation were determined by mathematical and mechanical means.
Today, the basic science of dental physiology is not
only being applied as a diagnostic aid, but it is also being
applied in determining the physiologic vertical dimension and centric relation.
A method has been described for determining the
vertical dimension and the centric relation by physiologic means.4
REFERENCES
1. Kurth LE. Mandibular movements in mastication. JADA 1942;29:1769.
2. Boswell JV. Practical occlusion in relation to complete dentures. J Pros Dent
1951;1:307.
3. Jankelson B, Hoffman GM, Hendron JA. The physiology of the stomatognathic system. JADA 1953;46:375.
4. Shpuntoff H, Shpuntoff W. Study of physiologic rest position and centric
position by electromyography. J Pros Dent 1956;6:621.
5. Silverman MM. Pre-extraction records to avoid premature aging of the
denture patient. J Pros Dent 1955;5:465.
0022-3913/$30.00
Copyright 2004 by the Editorial Council of The Journal of Prosthetic
Dentistry
doi:10.1016/j.prosdent.2003.09.002
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