A comparison of lateral interocclusal records to pantographic tracings

Many techniques exist to record patients' lateral jaw movements, but they have not been thoroughly investigated. This study compared recordings of immediate sideshift by using a pantograph and two intraoral registration materials. Pantographs were completed on 20 healthy participants by using chinpoint guidance and a kinematic hinge axis. Three lateral interocclusal records were completed on each participant and averaged for right and left sides. The average immediate sideshift recorded by a pantograph (0.54 mm) was less than that recorded by the two intraoral registration materials. The standard deviations were similar for all materials. An analysis of variance test identified significant statistical differences between a pantograph and one of the intraoral registration materials, but not between the pantograph and the other registration material. Immediate sideshift recorded with one material compared favorably with a pantograph recording when three records using the chinpoint guidance were averaged.     

Effect of interocclusal records on the condylar path of the articulator

Although there are studies on materials used for interocclusal records, there are no scientific data how the condylar path is influenced by the positional interocclusal records. The purpose of this in vitro study was to determine the effects of different interocclusal mediums on condylar inclination of the articulator. The materials selected for this experiment were: two addition type silicone pastes, two silicone putty materials and two waxes. The samples of protrusive records were performed on a Quick-Master semiadjustable articulator (FAG Dentaire). The same pre-established eminentia angles were used during the experiment for each type of materials. To improve the control of the condylar angles a protractor was mounted to the upper member of the articulator at right angels to each condylar fossa housing. A stylus moving simultaneously with the condylar fossa marked the eminentia angle on the protractor. 108 interocclusal records were performed and in 24 hours they were returned to the articulator. Then the articulator was adjusted and the settings of the eminentia angle were recorded. Numerical deviations between the pre-established and the adjusted settings in degrees were subjected to statistical analysis. The results indicated that these deviations for addition type silicones were significantly smaller than that of the other materials. The two waxes proved to be the least accurate materials. It is concluded that the condylar inclination is influenced by the properties of the registration materials, which may increase the shortcomings of the protrusive bite records.     

Reproducibility of lateral excursive tooth contact in a semi-adjustable articulator depending on the type of lateral guidance

The purposes of this study were (i) to compare the reproducibility of lateral tooth contacts of casts mounted in a semi-adjustable articulator when condylar guidance was set by different methods and (ii) to assess the margin of error of the variations of condylar guidance without changing lateral tooth contacts, depending on the type of lateral guidance. In subjects with different types of lateral guidance, intraoral lateral tooth contacts identified with occlusal registration strips were compared with those identified by use of a semi-adjustable articulator, setting the condylar guidance in four different ways: using protrusive wax wafers, by axiography and by adding and subtracting 5 degrees from the value of condylar guidance obtained by protrusive wax wafers. Tolerance to variations of condylar guidance without changing lateral tooth contacts was determined by increasing and decreasing the value of condylar guidance until lateral tooth contacts changed. Different ways of setting condylar guidance on a semi-adjustable articulator give rise to different values of condylar guidance in the same subject. The occlusal repercussions of these variations of condylar guidance values depend on the type of lateral guidance. Canine protection had the greatest tolerance to variations in the setting of condylar guidance without changing lateral occlusal contacts.     

Comparison of condylar guidance setting obtained from a wax record versus an extraoral tracing: a pilot study

STATEMENT OF PROBLEM: Protrusive condylar angles can be determined by use of wax protrusive records (WPR), pantographic tracings (PT), and occlusal wear facets. These methods generate different angles in the same patient. PURPOSE: The purpose of this study was to compare the condylar inclination angles found by use of the WPR in a Hanau articulator with those found by use of the Whip-Mix PT quick-set recorder. The occlusal wear facet method was not part of this study. MATERIAL AND METHODS: Ten subjects were chosen at random from a dental school patient population. All subjects had a majority of maxillary and mandibular teeth present and according to the examination criteria used in the school's Division of Occlusion, they were healthy with no signs/symptoms of temporomandibular disorders. The WPR was accepted when it was evident that the patient had protruded straight forward at least 6 mm anterior to centric relation, as shown on the Hanau articulator by the condylar spheres having moved anteriorly an equal distance of 6 mm on both sides. The condylar inclination on the articulator was adjusted accordingly. The PT was used according to the manufacturer's directions, which included the use of an intraoral clutch adapted to the mandibular arch, connected to an extraoral facebow with bilateral inscribing pointers. A holder frame was adapted to the face with bilateral flags where the inscribing pointers traced the protrusive movement of the jaw. All the readings were in degrees. No control was used in this project. To test whether there was a significant difference between the 2 independent samples, a Mann-Whitney U test was performed (P=.01). RESULTS: The mean results for the WPR were as follow: right side (28.1 degrees, SD 8.94); left side (31.50 degrees, SD 9.73). For the PT, results were: right side (41.10 degrees, SD 7.53); left side (35.5 degrees, SD 6.43). When right and left side protrusive condylar angles were combined, the values were: WPR (29.80 degrees, SD 9.25); PT (38.30 degrees, SD 6.98). The differences on the right condylar values were significant (P=.01). There was no statistical difference on the left side. CONCLUSIONS: Within the limitations of this study, it was concluded that the PT technique yielded greater values for the protrusive condylar inclination than the WPR.     

Comparative evaluation of sagittal condylar guidance obtained from a clinical method and with cone beam computed tomography in dentate individuals

Statement of problemProgramming semiadjustable and fully adjustable articulators involves time-consuming clinical steps which can be avoided if an accurate radiographic method can accurately determine the condylar guidance angles.PurposeThe purpose of this clinical study was to compare the sagittal condylar guidance in dentate individuals as determined by a clinical method, protrusive interocclusal record, and a radiographic method, cone beam computed tomography. If the methods show a correlation, then cone beam computed tomography can be used as a time-saving method of programming an articulator for patients requiring a cone beam computed tomography scan.Material and methodsA total of 40 participants (20 men and 20 women) within the 20 to 40 years age group were enrolled according to the inclusion and exclusion criteria. Cone beam computed tomography scans were obtained, and by using an appropriate software program, the sagittal condylar guidance was measured for both sides. A protrusive interocclusal record was obtained by using polyvinyl siloxane material. The maxillary cast of each participant was mounted on a semiadjustable articulator with a facebow transfer, and the mandibular cast was mounted with a maximum intercuspal record. The protrusive record was then transferred to the articulator for programming.ResultsThe right and left sagittal condylar guidance values obtained from both the protrusive interocclusal record and cone beam computed tomography method were comparable, with no significant differences (P>.05). The difference in condylar inclination values for both sexes obtained from both methods for both sides were not statistically different (P>.05). With increasing age, condylar inclination values obtained from both methods tended to decrease. The values for sagittal condylar guidance obtained from both methods (protrusive interocclusal record and cone beam computed tomography) were comparable and correlated.ConclusionsCone beam computed tomography measurement involves stable bony landmarks and can be standardized, whereas clinical methods are time consuming and can provide inaccurate results because of the instability of the materials used to register the maxillomandibular relationship. Thus, cone beam computed tomography can be used to obtain the sagittal horizontal guidance for programming semiadjustable and fully adjustable articulators for patients requiring a cone beam computed tomography scan.     

Graphic tracings of condylar paths and measurements of condylar angles

A study was carried out to determine the accuracy of different methods of measuring condylar inclination from graphical recordings of condylar paths. Thirty subjects made protrusive mandibular movements while condylar inclination was recorded on a graph paper card. A mandibular facebow and intraoral central bearing plate facilitated the procedure. The first method proved to be too variable to be of value in measuring condylar angles. The spline curve fitting technique was shown to be accurate, but its use clinically may prove complex. The mathematical method was more practical and overcame the variability of the tangent method. Other conclusions regarding condylar inclination are outlined.     

Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study

Purpose: The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. Materials and Methods: Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p < 0.05. Results: The radiographic values were on average 4° greater than the values obtained by protrusive interocclusal record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method ( p= 0.071 and p= 0.057, respectively) were not statistically significant. Conclusion : Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi‐adjustable articulators.     

Setting the sagittal condylar inclination on a virtual articulator by using a facial and intraoral scan of the protrusive interocclusal position: A dental technique

Setting the condylar inclination of a dental articulator enables the delivery of prostheses without occlusal interferences. This technique article describes obtaining the sagittal condylar inclination (SCI) by using a facial and an intraoral scan of the protrusive interocclusal position. The SCI can be used on a virtual articulator in dental computer-aided design (CAD) software programs, which can facilitate the fabrication of functional prostheses without occlusal interferences.     

Changes in condylar path inclination during maximum protrusion between the ages of 6 and 12 years

The purpose of this study is to quantify the changes in sagittal condylar path inclination during mandibular protrusion between the ages of 6 and 12 years. A total of 172 children (82 males and 90 females) ranging in age from 6.5 to 12.9 years were divided according to their chronological age into five subgroups with mean ages of 7.1, 8, 9, 10 and 11.4 years respectively. The control group consisted of 41 adults with a mean age of 28 years. All subjects had a normal temporomandibular joint function and neutral occlusion. Five maximum protrusion-retrusion movements were recorded with six degrees of freedom in each subject using an ultrasound (JMA) jaw-tracking system. Initially, condylar path inclination angle (CPIA) was calculated stepwise for each millimetre distance, for the first 10 mm of protrusive tracing path on both sides. A single mean value was then assigned for the entire protrusive path. One-way analysis of variance proved to be significant among the five subgroups of children. Linear regression analysis showed that condylar path had a tendency to become steeper with age, although it was statistically weak. The data indicated that the mean CPIA is 43 degrees -44 degrees at the age of seven, increases annually by 1.2 degrees -1.3 degrees and reaches an average of 49 degrees -50 degrees by the age of 12 at which time it attains around 83-85% of its adult level. In subgroup V, the female population had significantly steeper condylar path on the left-hand side than the male population. Condylar path inclinations indicated a symmetrical growth pattern of the articular eminence.     

A Comparative Evaluation of Static and Functional Methods for Recording Centric Relation and Condylar Guidance: A Clinical Study

To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using “Woelfel subjective evaluation criteria”. Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P > 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.     

Recording sagittal condylar angles using a mandibular facebow

summary The aim of this study was to determine the average sagittal condylar inclination angles of dentate subjects using a mandibular facebow with pencil tracing styli, to relate these angles to values assigned to articulators, and to assess the repeatability accuracy of drawing a tangent to a traced curve. The right and left sagittal condylar inclination angles of 103 subjects were recorded using a mandibular facebow with pencil tracing styli which marked a graph card during protrusive excursions. Tangents to the tracings were measured with a protractor allowing assessment of reproducibility. The mean left and right sagittal condylar inclination angles were 32° and 31.5°, respectively, with no significant differences ( P =0.609). Individual right and left measurements within each group showed significant differences ( P = 0.0000). The mean of the tangents drawn through three sagittal condylar angle tracings by 10 operators was 33.3°, and the mean of 10 tangents drawn through the same three tracings by one of the authors was 32.9°, with no significant difference ( P = 0.634). The average sagittal condylar inclination angles found in this study are in agreement with those reported in the literature. In fixed sagittal condylar angle articulators 30° appear to be an appropriate setting. The reproducibility of this method of recording sagittal condylar inclination angles was found to be accurate for the individual operator and between operators.     

The effect of custom tray material type and fabrication technique on tensile bond strength of impression material adhesive systems

The purpose of this investigation was to evaluate the tensile bond strengths of two impression material systems (polysulphide and polyvinyl siloxane) to two custom tray materials [autopolymerizing and visible light-cured (VLC) acrylic resin]. The effect of polymerizing the tray materials directly against wax spacer and tin foil was evaluated for each material. Polymerizing tray materials against tin foil significantly increased the bond strengths of polysulphide and polyvinyl siloxane impression materials to VLC and autopolymerizing acrylic resin tray materials. Polyvinyl siloxane VLC cured against tin foil combination produced the strongest bond. The VLC resin tray material generated greater bond strength than autopolymerizing acrylic resin when polymerized against tin foil.     

A comparative study to measure the condylar guidance by the radiographic and clinical methods

PURPOSE

The study was conducted to compare the radiographic and clinical methods of measuring the horizontal condylar guidance (HCG) values.

MATERIALS AND METHODS

The condylar guidance was measured using the radiographic (CT scan) and three clinical methods i.e. the wax protrusive records, Lucia jig record and intraoral central bearing device in 12 patients aged between 20-40 years irrespective of sex. The records were taken and transferred on the semi-adjustable articulator to record the HCG values. The CT scan was taken for 3D reconstruction of the mid facial region. Frankfort horizontal plane (FHP) and a line extending from the superior anterior most point on the glenoid fossa to the most convex point on the apex of articular eminence (AE) was marked on the CT scan. An angle between these two lines was measured on both right and left sides to obtain condylar inclination angle. Three interocclusal protrusive wax and jig records were taken and transferred to the semi adjustable articulator. Three readings were recorded on each side. Similarly the records were taken and transferred to the same articulator using the intra oral central bearing device to record the readings.

RESULTS

The statistical analysis showed insignificant differences in the HCG values between the right and left sides [(P=.589 (CT), P=.928 (wax), P=.625 (jig), P=.886 (tracer)]. The clinical methods provided low Pearsons correlation values [(R = 0.423 (wax), R = 0.354 (jig), R = 0.265 (tracer)] for the right as well as the left sides when compared with the CT values. Among the clinical methods, jig and wax method showed strong level of association which is statistically significant while the intra-oral tracer showed weak association with the other two methods.

CONCLUSION

The right and left HCG values were almost similar. The CT scan showed higher HCG values than the clinical methods and among the clinical methods, values obtained from all the methods were comparable.     

The horizontal condylar inclination: clinical comparison of different recording methods

Various types of semi-adjustable articulators (arcon and nonarcon), in combination with different interocclusal recording materials (wax and polyether), have been proposed as an easier alternative to extraoral tracing devices or axiographs. There is no consensus as to which combination is the nearest to the recognized standard extraoral tracing devices. This trial measured differences in performance among four combinations of interocclusal recordings in calculating the horizontal condylar inclination (HCl). The mean HCI measurement obtained by axiograph was 50.3 degrees (SD = 10.2) for the right condyle and 52.5 degrees (SD = 9.3) for the left. Of the four tested combinations, the arcon Whip Mix with wax was most likely to reproduce HCI values obtained using the axiograph.     

Comparison of condylar control settings using three methods: a bench study.

Articulators that program eccentric condylar pathways minimize occlusal adjustments of dental prostheses. This bench study compared three groups of methods for recording the immediate Bennett shift and the protrusive condylar path of the mandible. The experimental design restricted the variable associated with these methods. The various methods for recording protrusive excursions from best to worst were: (1) electronic pantography (Denar); (2) mechanical pantography (Denar); and (3) simplified mandibular motion analyzers (Whip-Mix and Denar). The methods of recording immediate side shift from best to worst were: (1) electronic pantograph; (2) polyether interocclusal records; (3) mechanical pantography (Denar) and simplified mandibular motion analyzer (Panadent); (4) simplified mandibular motion analyzer (Whip-Mix and Denar); and (5) zinc oxide interocclusal records.     

Evaluation of vertical accuracy of interocclusal records

PURPOSE: The aim of this study was to evaluate four recording materials (polyether, polyvinyl siloxane, acrylic resin, and wax) for their ability to accurately record, maintain, and reproduce the vertical interocclusal relationship. MATERIALS AND METHODS: A metallic apparatus was used to represent the opposing arches; its epoxy resin duplicate represented the working casts. The vertical discrepancies produced because of the presence of the records were measured both after repositioning them on the metal apparatus and after transferring them onto the casts. Two-way ANOVA was performed. RESULTS: Closure through the interocclusal recording materials produced small vertical discrepancies ranging from 24 to 74 microm. When repositioned on the apparatus, the vertical discrepancies were greater. The lowest discrepancy was displayed by polyvinyl siloxane (101 microm) and polyether (107 microm), and the greatest was displayed by wax (168 microm). When records were transferred onto casts, the discrepancies were approximately 0.5 mm, without significant differences among materials. CONCLUSION: Closure through interocclusal recording materials and removal and repositioning of the records on the apparatus produced small vertical discrepancies with clinically insignificant differences between the materials tested. When records of all materials tested were transferred onto casts, vertical discrepancies of approximately 0.5 mm were found, which is of clinical concern.     

Age Changes in Horizontal Condylar Angle: A Clinical and Cephalometric Study

Determination of condylar inclination is important when restoring the occlusal surfaces of teeth. It is important to know the changing trends in horizontal condylar inclination with age so as to have an idea about the cuspal morphology. Aims and objectives: a) to determine the effect of age changes in horizontal condylar inclination using articulator method and radiographic method (cephalometry) b) to compare the values of horizontal condylar inclination obtained using articulator method with that of cephalometric method c) to ascertain the symmetry of horizontal condylar angle on both right and left side on an articulator. 40 dentulous individuals with Angle’s class I occlusion were selected for the study. They were divided into four groups Group I: 20–29 years, Group II: 30–39 years, Group III: 40–49 years, Group IV: 50–59 years. Horizontal condylar inclination was determined on right and left side for each individual using protrusive interocclusal record in a Dentatus (ARL) semiadjustable articulator. Cephalometric recording was carried out twice on the left side, once in centric occlusion position and then in protrusive position. The two radiographs were superimposed to draw a line connecting the shifting position of condylion on an acetate tracing paper. This line when joined with Frankfurt horizontal plane gives the horizontal condylar inclination. Analysis of variance (ANOVA) revealed that there was a significant difference in horizontal condylar angle values in all the four groups which were statistically significant. There is a decrease in horizontal condylar angle values from Group I to Group IV. Horizontal condylar values obtained by articulator method and cephalometric method showed no significant difference for all the four groups tested. When horizontal condylar values obtained on right and left sides of Dentatus articulator were compared there was not much of a significant difference. Horizontal condylar values showed a decreasing trend with increasing age, i.e, as age advances there is a flattening of condylar head. Both articulator and cephalometric method yielded no significantly different values and hence both the methods can be used for determining condylar inclination. The difference in values of horizontal condylar angle on right and left sides were insignificant.     

The effect of three different recording materials on the reproducibility of condylar guidance registrations in three semi‐adjustable articulators

Sagittal condylar guide settings of three semi‐adjustable articulators: WhipMix^®, Hanau 158^® and Denar Mark II^® were compared using registrations of base plate wax, copper wax and self‐curing acrylic resin in two subjects. Four‐way ANOVA showed differences between instruments ( P < 0·0001), materials ( P < 0·0001), registrations ( P < 0·0001), and no difference between operators. Mean differences between materials were 3°and 6° within the range of registration and articulator variability. Denar Mark II^® gave the highest values, Hanau 158^® the lowest with pantronic values generally lower than articulator settings. Neither acrylic nor copper wax were superior to base plate wax. This and previous studies show low reproducibility and variability between instruments, occlusal records and registration material.     

Influence of choice of reference point on the condylar movement paths during mandibular movements

summary Series of four open-close, protrusive and lateral movements were recorded by the six degrees of freedom jaw movement recording system OKAS- 3D in 20 healthy subjects. Consequently the movement paths of nine condylar points, the palpated lateral pole and eight points located on a square parallel to the sagittal plane with an edge of 10 mm and centred around the lateral pole were calculated. For all movements except the protrusive movements, the 3-D excursions of the condylar points strongly depended upon the choice condylar reference point (ANOVA, P < 0 001). During laterotrusive movements the Bennett angle and the Bennett shift also varied significantly according the position of the reference point (ANOVA, P < 0 001). The results of this study underline that comparison of condylar movements between different studies only possible when the same condylar reference point is used. General consensus on the choice condylar reference point is thus needed.     

Effects of changes in articulator settings on generated occlusal tracings. Part I: Condylar inclination and progressive side shift settings

An occlusal scribing device attached to a fully adjustable articulator was used to generate occlusal tracings. The tracings were analyzed to determine the effect changes in progressive side shift and condylar inclination settings had on molar occlusal morphology. The progressive side shift adjustment affected the cusp height and ridge and groove position, primarily in the nonworking excursion. The condylar inclination adjustment affected the cusp heights in the protrusive and nonworking excursion without affecting the working excursion.