MMR
MMR
MMR
Dr Mandakini Mohan
Dr.Omar H. Bayati
to uderstand the theory of the face-bow transfer , it‘s indication & clinical
application procedure.
Part 1
MMR is The clinical stage following the visit where
Definitive (final impressions) are recorded.
extend dental floss from the inner canthus of the eye, via
the lateral border of the alar cartilage (with the patient
smiling) onto the incisal edge of the upper rim
use a photograph of the patient
when the patient was dentate.
Using the pupils as stable
reference points, the clinician
may determine the relative
position of the upper canine
teeth using the ratio
Using the canine tips as a
reference point, the buccal
form of the upper rim may
be moulded by reducing the
inferior borders of the
posterior rims by 3° to 5°.
Canine points.
Centre line
Recording of intermaxillary relations:
JAW RELATIONSHIPS:
Vertical Relationships
Horizontal Relationships
Orientation of the occlusal plane in
relation to the condyler axis.
Vertical Relation
Important terms
Vertical dimension of rest: (RVD)
also known as Physiologic rest
position
Interocclusal Distance
Formerly known as ― freeway
space‖
Vertical Dimension of Occlusion:
The position of the jaws when
the natural teeth are in maximum
intercuspation.
May become ―less‖ (nose closer to
chin) if posterior support is lost or
natural teeth wear quickly.
With complete dentures
VDO ―lost‖ as denture teeth wear
and ridges resorbs.
Vertical Dimension of Rest Position
of jaws when ―All muscles that open and close the jaw are in a state
of minimal tonic contraction‖.
• VDO is usually about 2-4mm less than VDR
• Difference (VDR-VDO) is the interocclusal distance (free way
space)
• This space between the teeth is necessary for comfort
• This is the best starting point in establishing the correct VDO for
a new set of dentures
Vertical Relation
RVD OVD
Increase in OVD
―patient mouth is opened excessively‖
Loss of interocclusal distance
Denture teeth in contact at rest
Soreness of mucosa over ridges
Potential for accelerated resorption
Soreness of facial muscles : ―Tired face‖
Soreness of TMJ
Difficulty with eating and speech
Clicking dentures, no room to chew
Decrease in OVD
―patient‘s mouth has over closure‖
Collapsed Appearance - chin too close to
the nose or protruding jaw
Fatigue when chewing
Sore muscles or joints
Establishing
Occlusal Vertical Dimension
1. Measure difference between RVD & OVD
2. Tactile sense and patient-perceived comfort.
3. Phonetics tests “Closest Speaking Space”
Train the patient to bite into retruded contact position prior to registration.
Draw a check marks on the occlusal rims to ensure reproducibility of the
mandibular closure pattern.
Registration of the centric relation: