Dr. DiTolla’s Clinical Tips – Leaf Gauge
Chairside Magazine: Volume 9, Issue 1
The humble leaf gauge is one of the most cost-effective tools we have. I prefer the one from Great Lakes Orthodontics, which can be autoclaved without causing any damage. For a centric-relation bite, I use about one-third of the leaves, and place them behind the maxillary centrals and have the patient close. Have patients slide into protrusive on the leaves, then go all the way back, then instruct them to squeeze. Typically, if they don’t have any pain in the joint or muscle tension in this position, they will be in CR. Make sure to use enough leaves so that when they squeeze together, there is about 2 mm of space between the posterior teeth so that your VPS bite registrations have adequate thickness and won’t fall apart when the lab goes to use them. It’s also great for occlusal equilibrations: Remove one leaf at a time until you have the first tooth contact and adjust that contact. Remove another leaf, check again and adjust any contacts. Continue until the canines contact when the patient closes.