66 S TEER clear,” you are told by many clinicians, ‘(of the patient who brings to your office an assortment of dentures he cannot wear.” Now let’s be honest. Would you wear any of those dentures yourself if you had that patient’s mouth ? If you make a thorough examination before answering, I believe you will agree that in most cases your answer would be “NO.” In a large percentage of these problem patients, you will find. “The Case of the Retrusive Mandible.” The complaints are many and varied, but prominent on the list of complaints is lack of esthetics. Inaccurate centric and accompanying symptoms are common. Balanced occlusion is rarely found, even though the patient brings forth a seemingly endless supply of dentures. If the occlusion is balanced, it is frequently done at the expense of other considerations. Normal speech has not usually been considered. The patient always has a true centric (seemingly retrusive) but sometimes has an acquired centric further forward. He often has an abnormally great anteroposterior range of jaw movements, sometimes being nearly an inch. This type of patient can be induced to bite back into centric position, but during speech and for many normal (for that individual) jaw movements, the mandible is brought forward to such an extent that upper and lower anterior teeth appear to have nearly an end-to-end relationship. “How then,” you may ask, “can this individual with such conditions be properly handled ?” Before starting the case, it seems advisable to explain to the patient his peculiarities through the use of office models and the patient’s own study models. Discuss also (without getting technical) the method of attempting to solve the problem. In this way, we can expect the utmost in patient cooperation. By this means. we justify our fee for the case and give the patient something to brag about. He is different from the ordinary and is, in his language, “difficult to fit.“ Since many phases of the procedure resemble those of any careful denture construction, only variations will be stressed. Developing impressions, casts, and baseplates with wax bite rims are normal procedures. The light “F” sound is the most suitable guide for establishing the length and position of the upper anterior teeth. The upper bite rim is adjusted so that the lower lip lightly contacts the incisal edge on the “F” sound. In this retrusive mandible type of case, it is well to establish the incisal edge as far posteriorly and as high as normal speech will allow. WC thereby gain as much space as possible for latet’ setting the anterior teeth, without disregarding other factors.