Some Hints

Residual ridges are (usually) parallel when the vertical is correct. (I know I said that before.)

If there is an old set of dentures, you can use them to get vertical. Have the patient speak and check to see the amount of speaking space. If you are happy with what you are seeing just measure the distance between your tape marks when the patient is in occlusion with the dentures. Make your wax rims to the same height.

Even an old maxillary denture that was made to an intact or restored mandibular arch can be used to get vertical. Since one arch remained, it was easier to get vertical.

Measure the denture from the mucobuccal fold to the occlusal surface of the teeth. Your new setup should have very similar dimensions.

A hypo vertical is better tolerated than a hyper vertical. Of course the correct vertical is best. If you have any doubts that the vertical is open, reduce it, thus increasing the free way space.

Try this on yourself. Bite and feel your temporalis muscle contracting. Then bite on a pencil and notice that your temporal muscle doesn't work properly. You are hyper and the muscle can't fire.

If you have to reduce the occlusion rim which one do you reduce? If the mandibular rim is above the dorsum of the tongue then I would reduce the mandibular.

Try to visualize the maxillary rim as teeth. Does the patient have a large toothy smile? Maybe you should reduce the maxillary rim.

The maxillary centrals should just touch the lower lip when you make the "f" sound. Does the wax rim just touch the lower lip with the "f" sound? Say 55, or count from 50 to 60.

You can also take a little off each rim.

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©1999 by Julius Rosen, D.D.S.