Correction of horizontal mandibular position in an edentulous patient accustomed to mandibular protrusion and deviation using the Gothic arch tracer

Objective: Due to the patient long-term habitual mandibular protrusion and deviation, the use of the bilateral manipulation to guide the patient to the centric relation (CR) failed. A technique to obtain the CR by mounting the Gothic arch tracer to an existing complete denture is described in the present report. Methods: A 51-year-old man who had an unsatisfactory complete denture for approximately five years presented to our hospital to make a better complete denture. He complained about poor stability and retention, frequent ulcers and the unaesthetic appearance. The maxillomandibular relationship record (MMRR) was obtained through the conventional bimanual manipulation method. In the customary manner, a new complete denture was finished. After one week of insertion, the patient complained about a sense of suffocation when chewing for a long time. When the patient was told to relax, the anterior artificial teeth were horizontally overlapped by approximately 2 mm. We hypothesized that the previous MMRR may be inappropriate. A Gothic arch tracer was mounted to the existing complete denture to obtain the new MMRR in the CR, and the mandibular artificial teeth were rearranged. Results: The patient did not report any discomfort or a sense of suffocation with the new complete denture. Conclusions: The Gothic arch tracer mounted to the existing complete denture can be used to successfully correct erroneous MMRR and precisely obtain the accurate CR.