• Measure vertical and take pictures of vertical measurement with a caliper.
• Mark tip of nose and chin, and measure vertical dimension at physiologic rest position.

Handmade Software, Inc. Image Alchemy v1.13

2. Measure the lip closure line

• The lip closure line is one of the most important pieces of information, in particular for the length of the anterior teeth. The Papillameter is the ideal instrument for measuring the length of the upper lip and the lip closure line. The Papillameter is made of a sterilizable and disinfectable resin.

• Duplicating the denture is a first appointment way to capture, occlusion, bite record, VDO, Midline, and also used as a custom tray-capture final impression.

• Duplicate denture(s) in a denture duplicating flask. (Lang dental)

1. Lubricate denture with vasoline or similar.
2. Using alginate, fill one side of the flask and submerge occlusal side of denture into the impression material up to the peripheral roll.
3. After impression sets up, lubricate intaglio of denture and impression material.
4. Fill the empty side of the flask, close, and fasten set screw.
5. After the impression is set, open flask and carefully remove denture.
6. Fill both sides of the impression with a cold cure acrylic, and place in pressure pot with warm water at 30 psi. for about 10 minutes.

   

7. Remove duplicate denture, inspect, and compare to make sure it is an accurate duplicate.

1. Using duplicate denture as a custom tray, paint inside with tray adhesive.
Make a border impression with putty. Cover the peripheral roll and extend into the vestibule.

2. Make sure that borders are extended into the vestibule, but do not impinge on muscle attachment landmarks. Have the patient go through motions and sucking actions to capture muscle attachment positions.

• Extend impression to the retro-molar pads on the mandibular, and post-dam area, and Hamular Notch on maxillary.

• After putty impression, take a medium body and wash impression and repeat motions and sucking action. 

3. Before the final wash impression, remove any areas where the tray kisses through the body impression. (Relieve 1-2 mm )

• Check vertical with relined final impression duplicate denture(s).
• With relined duplicate denture inserted, evaluate the facial dimensions and appearance.
• Measure the same 2 dots on the nose and chin again to assist in evaluating vertical.

If vertical is satisfactory proceed as follows:

• Take a face bow record using Kois Facial Analyzer. Be sure to record facial midline with the vertical rod positioned. We highly recommend using the Kois Facial Analyzer to record the horizontal smile line and facial midline of the old denture(s).

• Take a bite with PVS bite registration material.

• Mark facial midline on denture

If you need to increase vertical:

• Add slices of pink base-plate wax to occlusal until vertical is satisfactory.
• Follow steps above with pink wax in place as bite record.

• Close-up or smile
• Full face smile
• Repose of lip at rest

Communicate to dental lab all changes from current denture, especially incisal edge positions in the smile. Include both incisal edge position vertically to the lip and anterior-posterior shift changes.