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Technique
Intraoral Gothic arch tracers provide all the advantages of their
early extraoral counterparts, but do so with far greater simplicity.
The technique for using both old style and newer Gothic arch trac-
Figure 3. Looking nut tightened on stylus positioned on maxillary occlusion rim. ers is the same and utilizes four very basic parts (Figure 2). First,
the maxillary occlusion rim is contoured for: a. facial; b. incisai
length; and c. occlusal plane. A metal plate holding an adjustable
stylus is then secured to the maxillary wax occlusion rim and
record base and a flat metal plate is attached to the mandibular
occlusion rim and record base. The point of the tracing stylus
should be at the intersection of the maxillary midline and an
imaginary line passing through the distal surface of the first bicus-
pids. The aluminum tracing plate is attached to the mandibular
record base and wax rim, so that it is parallel to the maxillary plate
and perpendicular to the tracing stylus.
The record bases are returned to the mouth and the stylus is
adjusted to allow a VDO position that feels comfortable to the
patient and appears esthetically and physiologically correct to the
Figure 4. Gothic arch tracing on aluminum plate positioned on mandibular dentist. A locking nut is used to secure the height of the stylus when
occlusion rim. the VDO is acceptable (Figure 3). The patient is instructed to
retrude the jaw and then advance the mandible into a protrusive
position. These paths of retrusion and protrusion are repeated sev-
eral times to ensure they are marked on the lower tracing plate
(Figure 4). Air abrasion of the tracing plate to give a matte finish or
coating with wax may make the tracing marks easier to see. The
patient is then instructed to carry his or her mandible into its most
lateral movements; these movements are similarly marked on the
lower tracing plate.
After a discernable Gothic arch tracing has been marked on
the aluminum plate, a small hole or divot is made with a #6 round
burr at the apex, which is used to position the patient for a static
record (Figure 5). The record bases are returned to the mouth and
the patient is asked to close his or her mouth and move to a
Figure 5. Divot or hole is placed at apex ot tracing to mark centric position. retruded mandibular position so that the stylus falls into the divot
Conclusion
The use of an intraoral Gothic arch tracing device is a simple, effi- Figure 6. Quick-set plaster used to secure plates in centric relation position.
cient and relatively consistent technique to determine both VDO
and record a repeatable retruded jaw relationship when fabricating
complete dentures.'"' It is a tried and tested technique that is not
new to dentistry, but may be especially useful for the younger den-
tal practitioner or dentist with limited experience in treating com-
pletely edentulous patients. •
REFERENCES
1. Rubel B. A Clinical (îuide to Complete Denture Prosthodontics. Jackson, MS: Art Figure 7. Try-in after tooth set-up to confirm correctness of VDO and centric rela-
tion occlusion.
Bookblndery. 2008.
2. Boos RH. Intermaxillary relation established by biting power. J Am Dent Assoc
l94ü;27:1192-99.
3. McGee G. Use of facial measurements in determining vertical dimension. ) Am Dent
4.
Assoc 1947;35(5):342-50.
.Silverman MM. Determination of vertical dimension by phonetics. J Pros Dent JACOBSON GOLDBERG & KULB, LLP
1956;6(4):465-71.
5. Ismail Y, Arthur G. The consistency of the swallowing technique in determining vertical
Attorneys and Counselors at Law
dimension in edentulous patients. 1 Pros Dent l968;19(3):230-36.
6. Lytle RB. Vertical dimension of occlusion by the patient's neuromuscular perception. ) 585 Stewart Avenue
Pros Dent 1964;14(1):12-2I.
7. The glossary of prosthodontic terms. J Pros Dent 2005:94( 1 ); 10-92. Garden City, New York 11530
8. Beresin VE, Schiesser FJ. The neutral zone in complete dentures. ) Pros Dent
1976;.16(4):356-67. (516) 222-2330
9. Balkwill FH. The best form and arrangement of artificial teeth tor mastication. Br ) Dent
Sei 1866;9:278. Serving The Legal Needs Of The
10. Hardy IR. Technique for use of nonanatomic acrylic posterior teeth. Dent Dig
1942;48:562. Dental Profession For 50 Years
II el-Gheriani AS, Winstanley RB. The value of the Gothic arch tracing in the positioning of
denture teeth. | Oral Rehabil 1988;15(4):367-71. • Office of Professional Discipline
12 Phillips GP. Fundamentals in the reproduction of mandibular movements in edentulous
mouths. I Am Dent Assoc 1927;14:409-15. Purchase and Sale of Practices
1.3. Kapur KK, Yurkstas AA. An evaluation of centric relation records obtained by various Partnership. Employee, independent
techniques. | Pros Den 1957;7(6):770-86.
14. Myers M, Dziejma R, Goldberg |, Ross R, Sharry ). Relation of Gothic arch apex to den-
Contractor Agreements
tist-assisted cenlric relation. J Prosthet Dent 1980;44(l):78-81. Business Transactions
15. McCord IF, Grant AA. Registration: Stage II - intermaxillary relations. Br Dent J
2000;188(11):601-606.
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