One of the challenges faced by practitioners is communicating the neuromuscularly correct bite to the laboratory after the orthotic is placed and adjusted. This adjusted bite must be transferred accurately so that a diagnostic wax-up can be produced to the identical position achieved over the course of orthotic treatment. The following technique has proven to be invaluable in achieving this objective.

1. Patient is wearing the adjusted orthotic and is in a comfortable neuromuscular position. (Figure 1)
   
2. Take green occlusal wax and lay it on top of each quadrant of the orthotic. Have the patient bite into centric occlusion firmly. Leave upper arch model mounted on the Acculiner. Take lower arch model and knock off the mounting plate. (Figure 2)
   
3. Take orthotic with green occlusal wax and hand mount to upper arch in centric. Use wax or hot glue to stick the models together. (Figure 3)
   
4. With quick stone, remount lower arch model and mounting plate to Acculiner. (Figure 4A and Figure 4B).
   
5. Remove orthotic, dispose of green wax and replace orthotic in patient’s mouth.
   
6. Take bite registration material and place between the mounted upper and lower arches. (Figure 5)
   
7. Once set, remove the arches and bite from Acculiner and return models and bite to laboratory.
   
8. The technician can now wax the upper and lower arches to the patient’s corrected vertical and anterior/posterior position.

Photographs courtesy of Dr. Buddy Wheeler, Sugarland, Texas