1. Loosen lower turn screw and slide lower incisor clamp forward.
2. Center lower midline indicator over lower central incisors, cinch up lower incisor clamp, and tighten lower turn screw.
3. Remove from mouth and place bite fork into body of George Gauge. Use gray fork for 2mm between incisors or white for 5 mm.
4. Return George Gauge to mouth with lower incisor notch centered over lower incisors and instruct patient to close into upper incisor notch with upper midline indicator between upper incisors.
5. Use acrylic bur to modify upper incisor notch if upper incisors badly rotated.
6. Instruct patient to slide mandible first into centric relation, then into full protrusive as you observe these positions on millimeter scale.
7. From this protrusive range calculate amount of protrusion needed for the appliance you are constructing for this patient. Remove from mouth, and set marking end of bite fork over appropriate position on millimeter scale and tighten upper turn screw.
8. Place registration material (wax or silicone putty) on prongs of bite fork.
   1. Wax- cut two 3" x 1.5" pieces of base plate wax. Soften in water at 140 degrees F. Wrap one piece around each prong of bite fork.
   2. Silicone putty- Mix putty and hardener according to manufacturer's directions, roll into cigar shape, pinch in half, and impale on prongs of bite fork.
9. Return George Gauge to mouth with lower notch centered over lower incisors. Hand patient mirror, and instruct to close into upper incisor notch.
   
   If technique calls for maintaining a midline discrepancy, place mark on upper incisor to guide patient to proper transverse closure.
   
   
10. After registration material has sufficiently hardened remove from mouth. Send construction bite and bite fork along with models to lab.

Fig. 1	Fig. 2	Fig. 3
Fig. 4	Fig. 5	Fig. 6

Using the George Gauge with Polyvinylsiloxane

For the highest accuracy or when working with poorly coordinated patients who have difficulty correctly closing into the registration material, polyvinylsiloxane is the registration material of choice.

After step 7, properly position the notches of George Gauge on the incisors, and inject the polyvinylsiloxane on the teeth and bite fork through the occlusal space.

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