Section 08 Articulators II



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Section 08 - Articulators II
Handout

Abstracts

001. Weinberg, L. A. An evaluation of basic articulators and their concepts. Part II: Arbitrary, positional, semiadjustable articulators. J Prosthet Dent 13:645-663, 1963.

002. Hobo, S., Shillingburg, H. T. and Whitsett, L. D. Articulator selection for restorative dentistry. J Prosthet Dent 36:35-43, 1976.

003. Bellati, N. D. The significance of articulator capabilities. a. Part I: Adjustable vs. semiadjustable articulators. J Prosthet Dent 29:269-275, 1973. b. Part II: The prevalence of immediate side shift. J Prosthet Dent 42:255-256, 1979.

004. Hanau, R. L. Articulation defined, analyzed, and formulated. JADA 13:1694-1709, 1926.

005. Weinberg, L. A. Arcon principle in the mechanism of adjustable articulation. J Prosthet Dent 13:263-268, 1963.

006. Wagner, G.A. The effect of the articulator settings on the cusp inclines as measured by a coordinate measuring machine. J Prosthod 2:19-23, 1993.

007. Javid, N. S. and Porter, M. R. The importance of the Hanau formula in construction of complete dentures. J Prosthet Dent 34:397-404, 1975.

008. Lauciello, F. R. and Appelbaum, M. Anatomic comparison to arbitrary reference notch on Hanau articulators. J Prosthet Dent 40:676-681, 1978.

009. Taylor, T. D., Huber, L. R. and Aquilino, S. A. Analysis of the lateral condylar adjustments of nonarcon semiadjustable articulators. J Prosthet Dent 54:140-143, 1985.

010. Wachtel, H. C. and Curtis, D. A. Limitations of semiadjustable articulators. Part I: Straight line articulators without setting for immediate side shift.   J Prosthet Dent 58:438-442, 1987.

011. Curtis, D. A. and Wachtel, H. C. Limitations of semiadjustable articulators. Part II: Straight line articulators with provision for immediate side shift. J Prosthet Dent 58:569-573, 1987.

012. Beck, H. 0. and Morrison, W. E. Investigation of an arcon articulator. J Prosthet Dent 6:359-372, 1956.

Section 08: Articulators II – SemiAdjustable


(Handout)


Semiadjustable articulator: an articulator that allows adjustment to replicate average mandibular movements-called also Class III articulator (GPT-6)

A Class III articulator, an instrument that simulates condylar pathways by using averages or mechanical equivalents for all or part of the motion. These instruments allow for orientation of the cast relative to the joints and may be arcon or nonarcon instruments. (GPT-6)

The semiadjustable articulator has evolved to become the "workhorse" articulator in prosthodontics. In the first articulators seminar, history was reviewed and it was shown how sophisticated and complex articulators such as the Hanau Model M Kinoscope and the Stuarts articulator were simplified into the Hanau Model H110 series and Whip Mix articulators in common use today.

To briefly review, Rihani developed a modern system based on adjustment capabilities of the articulators, and this has simplified the process. 

Table I Classification of articulators:

ARCON and NON ARCON articulators

Bergstrom coined the term arcon from articulating condyle, this articulator has the condylar elements on the lower member of the articulator and the condylar path elements on the upper member. The non arcon or condylar articulator has the reverse sequence with the condylar element on the upper member of the articulator.

The angle between the condylar inclination and the occlusal plane is fixed on the arcon, this is not so with the nonarcon articulator.

What clinical implication does this difference have?

What is Weinberg’s view about fabricating restorations on these articulators?

In his investigations, what did Beck have to say about the advantages of the arcon articulator?

In his classic article, Weinberg reviewed the use and mathematical study of the Hanau Model H

Hanau stated the less realeff, the more the instrument would simulate mandibular movements.

Use of the Model H (designed primarily for complete dentures)

Orientation of the maxillary cast: anatomic average for the hinge axis, anterior point of reference can be orbital pointer, or lining up the incisal edges of teeth, or the wax rim to the notch on the incisal pin

Centric relation record:"Gysi Gothic arch" tracing, interocclusal wax records acceptable

Protrusive record: records condylar inclination (Christensen's method)

Balancing condylar motion: motion is downward, forward and medial (medial or Bennett angle is determined by H/8 +12

Working condylar motion: the Hanau Model H has no individual accommodation, the intercondylar rod passes laterally through the working condylar ball. This produces an upward, backward and lateral motion. The Bennett movement varies only in amount rather than direction

Mathematical study of the Model H:

The most significant error is produced by the lack of working condylar motion. Overall, many errors tended to cancel each other out.

When comparing usage for complete dentures versus fixed prostheses, the negative error is due to the lack of working condylar guidance, which produce flatter posterior cusps.

Compensation for this negative error can be done by decreasing the Bennett angle of the opposite balancing condylar guidance, which produces more rotation and less lateral shift of the working condyle in question, thus increasing the working cusp inclines.



As stated in Rihani’s table of capabilities of articulators above there are distinct differences in the semi and fully adjustable articulators.

Bellanti compared the capabilities of the semi and fully adjustable articulators.

He stated the semiadjustable articulator (Whip-Mix) guides only the lateral component of the rotating condylar element, whereas the fully adjustable articulator (Denar 4A) may be set to simulate all components of mandibular movement.

What were his criteria/findings and what is needed to reproduce the effects of mandibular movements with reasonable accuracy?

From Bellanti’s first article it was noted that an immediate side shift (ISS) produced a large difference in the cusp pathways of the opposing dentition. If this ISS occurs in patients, an excessive amount of intraoral adjustment may be needed due to occlusal interferences..

What percentage of the subjects in this study demonstrated an immediate side shift?

IMMEDIATE SIDE SHIFT: defined as a mandibular side shift in which the orbiting condyle moves essentially straight medially as it leaves centric relation (Guichet)

The ISS occurs at the beginning of lateral jaw movement, since the teeth are not, or only slightly separated when this movement occurs, the presence and degree of immediate side shift affects the shape of the occlusal surfaces of the teeth. (Aull) This must be considered, movement in all three planes along with the timing (4th dimension), when selecting an articulator, in recontouring the existing occlusal surfaces and developing the morphology of dental restorations.



Wachtel and Curtis also addressed the immediate side shift in both their articles involving the limitations of semiadjustable articulators. The first did not provide for an ISS setting to the articulator, while the second article did so by providing patient lateral interocclusal records.

The article noted that most semiadjustable articulators lack adjustments for the ISS, surdetrusion of the superior wall, proretrusion of the posterior wall, and the intercondylar distance. Also there is no provision for motion along curved pathways.

What were the significant findings from these two articles?

HANAU’S FORMULA – In 1930 Hanau introduced his formula (L = H/8 + 12)

Used in the setting of the lateral condylar guidance, for Hanau and some other type of articulators. How accurate is this formula?

What did Javid and Porter recommend when precise restorative procedures were indicated?

In Taylors article how did he compensate for discrepancies when immediate shift was present? How did the intercondylar distance affect this?

(In Lundeen’s study with the plastic blocks and air turbine drills the average Bennett angle was found to be 7 ½ degrees)

FACEBOW TRANSFER (on the Hanau articulator)

To review, the facebow measures the glenomaxillary relationship in three planes, this is anteroposteriorly, laterally and vertically. The anteroposterior and lateral positions are anatomically determined by their relationship to the maxilla and glenoid fossa.

It is the vertical relationship, ie. the anterior reference point that is determined by several techniques. Weinberg stated that if the face-bow mounting is oriented 16mm too high on the articulator, a disclusion of 0.2mm will be noted on the balancing occlusal side.

What did Lauciello find as the most accurate method to orient the maxillary cast to the articulator?



HANAU‘S QUINT coordinates the ten main laws of articulation. It records the influence of one factor, governing the establishment of balanced articulation, one other factor, while the remaining factors remain unchanged. Each fifth of the quint represents a factor and the change is indicated with a heavily drawn arrow.

Dr. Thielmann’s formula helps to visualize the interrelationships of the "Quint". 

Thielmanns Formula:

    CG x IG = Balanced Occlusion
CH x CC x OP  

CONDYLAR GUIDANCE


INCISAL GUIDANCE
CUSP HEIGHT
COMPENSATING CURVE
OCCLUSAL PLANE

ARTICULATOR SELECTION FOR RESTORATIVE DENTISTRY (HOBO/SHILLINGBURG/WHITSETT)

Although the semiadjustable articulator has its limitations as noted above, it is very popular because of its stability, durability and ease of manipulation.

QUESTIONS TO CONSIDER

What are the problems with using a small hinge articulator? (shorter radius of movement, steeper are of closure)



How does the semiadjustable articulator decrease the errors noted above?

Define positive error and negative error (Which is more beneficial for fixed/removable?)

What are the sources of error when using a semi-adjustable articulator?

- Abstracts -

08-001. Weinberg, LA. An evaluation of basic articulators and their concepts. Part II: Arbitrary, positional, and semiadjustable articulators. J Prosthet Dent 13:645-663,1963.

- Only a summary of the semiadjustable is presented in this abstract.


- Weinberg discussed the use and a mathematical study of the errors of the Hanau

Use of the Model H.

- Orientation of the Maxillary cast: Anatomic average for the hinge axis. Anterior point of reference can be the orbital pointer or by aligning the incisal edges of the teeth or the wax rim to the notch on the incisal pin.
- Centric relation record: Hanau states the Gysi gothic arch tracing is the most admired method. Interocclusal wax records or other methods are acceptable.
- Protrusive record: The condylar inclination of the patient is recorded by a protrusive record.
- Balancing condylar motion: Is downward, forward, and mesial. The protrusive is used for the downward component. The medial or Bennett angle is determined by H/8 + 12.
- Working condylar motion: The intercondylar rod passes laterally through the working condylar ball. This produces an upward, backward, and lateral motion. The Bennett movement varies only in amount rather than in direction.

Mathematical study of the Hanau Model H

Approximate error at the second molar cusp height

Balancing Working

type of error

1. Anatomic average hinge axis                 0.2 0.2 anterior-posterior


2. Arbitrary anterior point of reference 0.2 0.0 Neg
3. Straight condylar path                         0.2 0.2 Pos
4. No Fischer angle                                 0.1 0.0 Pos
5. No individual working condylar motion 0.0 0.8 Neg

     The most significant error is produced by the lack of working condylar motion. Overall, most of the errors tend to cancel each other out rater than add up. The error produced is often negative and tends to produce flatter cusps. The error in the working condylar guidance affects posterior teeth more than anterior teeth. Decreasing the Bennett angle of the opposite balancing condylar guidance produces more rotation and less lateral shift of the working condyle and, therefore, increases posterior working cusp inclines.


Overall: The instrument is of practical value and within the accuracy of the records used for complete dentures.

08-002. Hobo, S., Shillingburg, H. T. and Whitsett, L. D. Articulator Selection for Restorative Dentistry. J Prosthet Dent 36:35-43, 1976.



Discussion: Maximum intercuspation is a static position and would require only a simple hinge articulator. The mandible, however, is not a simple hinge and can rotate about axes in three planes. There are four types of occlusal interferences: centric occlusion interference, working occlusal interference, nonworking occlusal interference, and protrusive occlusal interference. Centric occlusal interference is an occlusal prematurity which causes the mandible to deflect forward and/or laterally and may lead to bruxism. Working occlusal interference occurs during a lateral mandibular movement on the side corresponding to the direction in which is moving. A nonworking occlusal interference occurs on the side opposite to the direction the mandible is moving. This is the most damaging interference and can disrupt normal function. The protrusive occlusal interference can prevent posterior teeth from being disoccluded by the incisors.
     Errors in occlusal restorations can be classified into two categories - positive and negative. A positive error on the occlusal surface occurs when the articulator undercompensates for the mandibular movement causing a cusp tip or ridge that is too high. A negative error occurs when the articulator overcompensates for the mandibular movement and grooves are wider or cusp are more narrow. If contacts are maintained in centric relation, negative errors will result in a slightly flatter occlusal surface and can still be acceptable
     A facebow transfers the distance between the hinge axis and the tooth being restored from the patient to the articulator. If the hinge axis is not kinematically located (arbitrary), the interocclusal record must be made at the correct vertical dimension of occlusion. A small hinge articulator has a shorter radius of movement when closing in centric position. A tooth will travel a steeper arc of closure on a small articulator than in the mouth. A slight positive error occurs on the mesial incline of maxillary teeth and the distal incline of mandibular teeth on casts mounted on a small articulator and no increase in VDO. If the intercondylar distance of the articulator is greater than the mandible, the paths of movement will be distal to the ones in the mouth. If the condylar inclination on the articulator is set at a steeper angle than the patient, the restoration will have a positive error on the protrusive or nonworking side. A negative error occurs when the angle is less steep than the patient and will give greater clearance in excursive movements. A negative error is acceptable as long as centric occlusal contacts are maintained.
     A nonadjustable articulator with a fixed condylar path is acceptable for single restorations. A shallow 20 fixed condylar inclination is desirable because the error will usually be a negative error. Multiple restorations or FPD’s can be fabricated on a semiadjustable articulator. A facebow transfer will minimize tooth hinge axis errors. The fully adjustable articulator is indicated for extensive treatment of the occlusion, significant side shift movements, and restoring lost vertical dimension of occlusion. 

 

08-002. Hobo, S., Shillingburg, H. T. and Whitsett, L. D. Articulator Selection for Restorative Dentistry. J Prosthet Dent 36:35-43, 1976.

This is a review article on selecting an articulator for restorative dentistry. The article looks at various aspects of using the various classes of articulators. The highlights include:
Occlusal Interferences: There are four types of occlusal interferences: (1) in centric (2) in working (3) in nonworking and (4) in protrusive. The centric occlusal interference will cause the mandible to be deflected forward or laterally from the optimum mandibular position. A working side interference will occur on the facial aspect of the maxillary lingual cusps and on the lingual aspect of the mandible facial cusps. A nonworking side interference will occur on the lingual aspect of the maxillary facial cusps and the facial aspect of the mandibular lingual cusps. Protrusive occlusal interferences occur on the mesial aspect of mandibular centric holding cusps and on the distal aspect of the maxillary holding cusps.
Positive vs. Negative Errors: By definition a positive error is one that occurs on the occlusal surface when the articulator undercompensates for the mandibular movement. What one will see on the restoration is a positive feature on the restoration where that feature should be smaller or nonexistent.
     A negative error is when the articulator overcompensates for a mandibular movement. One will see a fossa or groove that is wider than ideal or a ridge or cusp that is narrower than normal.

If contacts are maintained in CR, negative errors may be acceptable.

Condylar Inclination and Occlusal Morphology: The steeper the condylar inclination the steeper the cuspal inclines and the occlusal morphology can be; the reverse is true with a flatter condylar inclination.



Effect of Intercondylar Distance:

- When the intercondylar distance on the articulator is greater than that of the mouth, the paths of movement on the articulator are slightly distal to the paths traced in the mouth.


- When the intercondylar distance on the articulator is less than that of the mouth, the cusp paths traveled on the articulator will be slightly mesial to the paths traced in the mouth.

Summary: A fully adjustable articulator should be utilized in the following situations: extensive treatment in which opposing quadrants are being restored, for reconstruction of the entire mouth and patients with considerable side shift during lateral movement.

08-003a. Neal D. Bellanti, DDS, MA. The significance of articulator capabilities Part I. Adjustable vs. semiadjustable articulators. JPD, Mar 1973.

Orbiting condyle - moves medially, anteriorly, and inferiorly.
Rotating condyle - moves laterally within the confines of a cone whose apex is at the terminal hinge position and whose axis lies on the terminal hinge axis. The direction of movement of the condyle within this cone is determined by the contours of the glenoid fossa. This movement in turn determines the cusp height, fossa depth, and ridge and groove direction on the occlusal surfaces of the prostheses.
     The semiadjustable articulator guides only the lateral component of the rotating condylar movement, whereas the fully adjustable articulator may be set to simulate all components of mandibular movement.
Purpose: measure the discrepancies that may exist in articulator capability due to incomplete movement simulation. The effects on cusp positions produced by variations of intercondylar width, the shape of the condylar housing, and the timing and direction of the side shift were ascertained.

* Intercondylar Width:   The semiadjustable articulator is capable of three intercondylar width settings, with a 7mm interval between each two (48, 55, and 62mm. measured from the midline).


     To determine the efficacy of the 7mm. interval, 48mm. was compared with one half of the interval to the next larger setting, or 51.5mm. Also, the largest possible setting, 62mm., was compared with the maximum patient width of 70mm. reported by Aull.
Results - The variance in mesiodistal cusp tip position between the
1) 48mm. and the 51.5mm. widths was:
     .2mm on the working side
     .2mm on the nonworking side

   62mm. and the 70mm. widths was:


     .2mm. on the working side
     .5mm. on the nonworking side
Conclusions - The 7mm. interval between the settings is adequate to provide clinical accuracy within a correctable range. However, the 62mm. or large, width is to narrow to accommodate all patients at a correctable discrepancy.
The error incorporated at the wide extreme would require more than minimal intraoral adjustment at insertion.

* Timing Of The Progressive Side Shift: To study the effect of the timing of the mediotrusion on the mesiodistal cusp position, the flat medial wall of the condylar fossa, the control, was compared with a maximum early side shift insert. Results - effect of the early progressive side shift on the mesiodistal cusp tip position was:


     .1mm on the working side
     .5mm on the nonworking side
Conclusions - The variation is beyond the range of clinical acceptability for the nonworking side.
The semiadjustable articulator is incapable of reproducing any variation in the timing of mediotrusion. The variation of the progressive mediotrusion timing would require substantial occlusal adjustment at insertion.
Shape Of The Condylar Housing: The effect of the shape of the superior wall of the condylar housing on the vertical cusp tip position was studied with the use of the flat insert as control and the 3/8 inch radius convex curvature insert as experimental.
Results - The variance produced by a curved superior wall was
a .1mm. longer cusp on the working side and
a .2mm. shorter cusp on the nonworking side.
Conclusions - The effects of the superior wall shape are within a clinically correctable range.

* Direction Of The Side Shift:  The effects of the directional components of the side shift on both vertical and mesiodistal cusp positions were studied with only the working side adjusted and again with both condylar housings adjusted. Control was simple laterotrusion


Results - variations produced by altering the direction of the side shift are varied from 0 - .6mm change, with ranges of 1.2mm. mesiodistally and .5mm vertically.
Conclusions - the variance of the total possible combinations at the settings measured is greater than could be controlled clinically.
     The semiadjustable articulator is capable of only a simple laterotrusion.
     In those patients with a backward or upward component in laterotrusion, the eccentric error would represent the variance proportional to the amount of backward or upward movement in the laterotrusion.
     In those patients with a forward or downward component in laterotrusion, the error would represent the variance shown, proportional to the amount of forward or downward movement in laterotrusion.

Occlusal adjustments cannot be considered minimal.



* Immediate Side Shift:
Results - Figures show changes ranging from 0 - 2.4mm, with ranges of 4.4mm mesiodistally and 1.7mm. vertically.
Conclusions - The variance of the total possible combinations at the settings measured is greater than could be controlled clinically.
Summary: An articulator with a wide range of intercondylar width adjustment and with adjustable posterior, medial, and superior fossa walls is needed to reproduce the effects of mandibular side shift with reasonable accuracy.

08-003a. Neal D. Bellanti, DDS, MA. The significance of articulator capabilities Part I. Adjustable vs. semiadjustable articulators. J Prosthet Dent Mar 1973.

Purpose: To compare the capabilities of adjustable and semiadjustable articulators.
Subject: Comparisons were made between a Whip-mix semiadjustable and a Denar D4A fully adjustable articulators
Methods and materials: Dental casts were articulated on the fully adjustable Denar, all posterior teeth were removed, styli were placed in the position of the mesiolingual cusp tip of the maxillary first molars, and recording tables parallel to the occlusal plane at the level of the central pit of the mandibular first molars. The adjustments of the semiadjustable articulator were simulated on the fully adjustable articulator by making only the adjustments available on the semiadjustable articulator. Examined were the intercondylar width, timing of the progressive side shift, shape of the condylar housing, direction of the side shift, and immediate side shift.
Results/Conclusions: Intercondylar width: The semiadjustable articulator is capable of three settings: 48, 55, and 62mm measured from the midline. (A maximum patient width of 70mm was reported by Aull). For widths between 48 and 62mm, discrepancies of .2mm were measured on the working and non working side, which was considered a correctable discrepancy. However at the maximum of 70mm, a .5mm discrepancy was measured on the nonworking side, considered to be in excess of a correctable discrepancy.
Timing of the progressive side shift: an early progressive side shift produced an error of .5mm on the nonworking side, considered to be beyond the range of acceptability.
Shape of the condylar housing: A curved superior wall produced a .1mm longer working cusp and a .2mm shorter nonworking cusp, considered clinically acceptable.
Direction of the side shift: Variations produced by altering the direction of side shift varied from 0 to .6mm, with a range of 1.2mm mesiodistally and .5mm vertically. This variance was considered to be greater than could be controlled clinically.
Immediate side shift: Changes ranged from 0 to 2.4mm, with ranges of 4.4mm mesiodistally and 1.7mm vertically. (Note that these measurements were recorded with a setting of 2mm side shift added.)
Conclusion: The error produced by the use of a semiadjustable articulator may result in a need for more than minimal eccentric occlusal adjustment or uncontrolled amounts of disocclusion of fixed prostheses. An articulator with a wide range of intercondylar width adjustment and with adjustable posterior medial and superior fossa walls is needed to reproduce the effects of mandibular side shift with reasonable accuracy.

08-003b. Neal D. Bellanti, DDS, MA. The significance of articulator capability. Part II: The prevalence of immediate side shift. Sep 1979, Vol 42, Num 3, pp255-256.



Purpose: To determine the prevalence and extent of immediate side shift of the mandible in a sample population.
Results: 24 of 80 (30%), demonstrated an immediate side shift with a mean length of .3mm. Six subjects presented immediate side shifts bilaterally and eighteen subjects unilaterally.
The presence of immediate side shift of the mandible increases the potential for working and nonworking side tooth contacts. Although the mean length of the immediate side shift was found to be .3mm, only 13% demonstrated an immediate side shift greater than .2mm. With such a low prevalence, it is possible that intraoral adjustment could eliminate the undesirable occlusal contacts more easily than use of a more complex articulator system. Observing for the presence of these interferences immediately adjacent to the centric relation contacts is especially important.
Conclusion: the prevalence and degree of immediate side shift do not indicate that a fully adjustable articulator is required for all patients.

08-003b. Neal D. Bellanti, DDS, MA. The significance of articulator capability. Part II: The prevalence of immediate side shift. Sep 1979, Vol 42, Num 3, pp255-256.

Purpose: In Part I, 1973, it was asserted that a semi adjustable.
articulator may produce a significant error when used to fabricate fixed prostheses for a patient with immediate side shift. This article addresses the prevalence of immediate side shift in a sample population.
Subject: Eighty subjects evenly divided into four groups: men 15-30, men over 30, women 15-30, women over 30
Methods and materials: Acrylic resin clutches fabricated, hinge axis located, a pantographic tracing made and verified by repetition for each patient.
Results: 24 of 80 (30%) demonstrated an immediate side shift with a mean length of 0.3mm. Six subjects presented immediate side shift bilaterally and eighteen subjects unilaterally.
Conclusion: The prevalence and degree of immediate side shift do not indicate that a fully adjustable articulator is required for all patients. The decision to use or not use a fully adjustable articulator must remain an individual one, based on a careful analysis of the patient's movements.

08-004. Hanau RL. Articulation Defined, Analyzed and Formulated. JADA 13:1694-1709, 1926.



Purpose: To discuss Hanau’s theoretical basis for the laws that govern balanced articulation in the fabrication of satisfactory dentures, and the concept of Hanau’s Quint.
Discussion: Articulation is the change from one occlusion to another occlusion while the masticatory surfaces maintain contact. The maintenance of balanced contact of the masticatory surfaces is designated as balanced articulation.
     Hanau further defines variations on the original definition of articulation to explain the many combinations of interarch relationships and denture designs, namely:
Natural- is physiologic
Unnatural- is not conforming to accepted physiologic requirements
Anatomic- infers the articulation of natural dentures in the mouth
Prosthetic- infers the articulation of prosthetic dentures in the mouth individual occlusions being associated with analogous jaw relations
Semiprosthetic- is not always associated with like jaw relations
Ordinary- is always balanced within admitted resilient limits
Malarticulation- lacks balance
Mixed- balanced only during part of masticatory stroke
Unbalanced- balanced is interrupted or lacking
Strained- function while pressure is applied
Unstrained- function while pressure is not applied
Balanced anatomic- natural dentures in changing balanced occlusion associated to analogous jaw relations to other corresponding associations
Balanced prosthetic- prosthetic dentures in changing balanced occlusion associated to analogous jaw relations to other corresponding associations

Balanced Semiprosthetic- prosthetic dentures in changing balanced occlusion not always associated with analogous jaw relation to other corresponding associations, while the masticatory surfaces maintain contact.

HANAU’S QUINT

Each fifth represents one of the five factors governing articulation. They are:

Condylar Guidance

- anteroposterior guidance – horizontal inclination – forward and downward excursion along protrusive guidance.


- lateral guidance – sagittal inclination – forward, downward and inward excursion on the balancing side
- lateral aberration – the lateral excursion on the working side

Compensating Curve

- Tooth alignment is characterized as a horizontal, vertical, and frontal projection.

Incisal Guidance

     The mandibular incisors (including cuspids) may be considered as one large cusp having a curved ridge, and the maxillary incisors (including cuspids) considered as a large sulcus. Simplified, it is an ordinary cusp guidance with its protrusive and bilateral guiding surfaces.

Relative Cusp Height

Includes the cusp guidance inclines for protrusive, lateral and balancing sides. The cusp height is only relative if it is compared with its "basal radius" which is the projection on the cusp base of the movement of a point directed along the incline from the base to the cusp summit.

Position of Triangle of Orientation (Denture Position)

The triangle of orientation is a plane through the central incisal contact point and the occlusal terminations of the second molar buccal grooves. These three points are the corners of the triangle of orientation, through there may be a plane of orientation.

THE LAWS OF BALANCED ARTICULATION

Articulation is a purely mechanical function and must be explained by geometry, cinematics and mechanics. The Quint gives a combination of the most essential laws of articulation in convenient form. Each fifth represents a factor undergoing a change. The changes indicated are accompanied by heavy arrows. The light arrows in each fifth refer to the other factors. The direction of the light arrows indicates the sense in which to read the influence of a respective factor on the factor they identify.



08-005. Weinberg, L. A. Arcon Principle in the Mechanism of Adjustable Articulation. J Prosthet Dent 13:263-268,1963.

Purpose: To evaluate the condylar articulator with the Arcon articulator. An Arcon articulator has the condylar fixed to the upper member and the ball attached to the lower member. The condylar articulator (non-Arcon) has the condylar slot that keeps changing angulation to the upper member. The Arcon articulator has the condylar slot in a constant angulation to the maxillary dental arch.
Methods and Materials: The protrusive and lateral records were placed on both types of instruments and readings were calculated mathematically. The non-Arcon (condylar type) articulator has a constant angulation of the condylar slot to the lower member. In protrusive movements, the angulation changes between the upper member and the condylar slot of the articulator. In the Arcon articulator, the upper member remains constant in relation to the condylar slot. In a protrusive movement, the angulation of the condylar slot changes to the lower member.
Results: In protrusive position, both instruments measured the same. The balancing condylar positions were identical on both articulators. Bennett angle readings were different on the two instruments due to the mechanical method of producing the motion. The position of the balancing condyle and motion were identical on each instrument.
Conclusion: Both the Arcon and non-Arcon articulators produce the same motion because condylar guidance is the result of the interaction of a condylar ball on an inclined plane. Reversing the relationship does not change the guidance produced. Only the numbers used to record the inclination are changed. Mathematical evidence proves that neither instrument has any specific advantage over the other.

08-005. Weinberg, L. A. Arcon Principle in the Mechanism of Adjustable Articulation. J Prosthet Dent 13:263-268,1963.

Purpose: To evaluate the condylar articulator with the Arcon articulator. An Arcon articulator has the condylar fixed to the upper member and the ball attached to the lower member. The condylar articulator (non-Arcon) has the condylar slot that keeps changing angulation to the upper member. The Arcon articulator has the condylar slot in a constant angulation to the maxillary dental arch.
Methods & Materials: The protrusive and lateral records were placed on both types of instruments and readings were calculated mathematically. The non-Arcon (condylar type) articulator has a constant angulation of the condylar slot to the lower member. In protrusive movements, the angulation changes between the upper member and the condylar slot of the articulator. In the Arcon articulator, the upper member remains constant in relation to the condylar slot. In a protrusive movement, the angulation of the condylar slot changes to the lower member.
Results: In protrusive position, both instruments measured the same. The balancing condylar positions were identical on both articulators. Bennett angle readings were different on the two instruments due to the mechanical method of producing the motion. The position of the balancing condyle and motion were identical on each instrument.
Conclusion: Both the Arcon and non-Arcon articulators produce the same motion because condylar guidance is the result of the interaction of a condylar ball on an inclined plane. Reversing the relationship does not change the guidance produced. Only the numbers used to record the inclination are changed. Mathematical evidence proves that neither instrument has any specific advantage over the other.

08-006. Wagner,AG, and Rennels, KE. The effect of the articulator settings on the cusp inclines as measured by a coordinate measuring machine. J Prosthodon 2: 19-23,1993.



Purpose: To learn the effect of various articulator settings on cusp inclines during working, nonworking and protrusive movements.
Materials and Methods: a reference point of the maxillary first molar (mesiolingual cusp) was fixed to the upper member of the 96H2 Hanau articulator. A coordinate measuring machine (CMM) recorded the position of the reference point in centric relation, working, nonworking and protrusive. Articulator setting were changed (ie the condylar angles and anterior guide angles) for a total of 432 different cusp angles were measured at the first molar by the coordinate measuring machine.

Results: The data collected was used to produce formulas, three formulas were produced, the working angle, nonworking angle and protrusive angle.
     These formulas were used to calculate the working, nonworking and protrusive cusp angles produced as a result of 72 different articulator settings.
Discussion&Conclusion: The Numerex coordinate measuring machine is useful in taking measurement of articulator movements. Further research is needed to determine the cusp angles of manufactured teeth, as then coordination could be made with the cusp angles of the teeth and the cusp inclines found from the articulator. In the future comparisons can also be made between articulators (ie arcon vs non-arcon)

08-007. Javid, N.S. and Porter, M.R. The importance of the Hanau formula in construction of complete dentures. J Prosthet Dent 34:397-404,1975.



Purpose: To determine the accuracy of the Hanau formula for use in the construction of complete dentures.
Materials and Methods: Six articulators (two Denar D4-A, two Whipmix and two Hanau model 130-28) were used. Maxillary and mandibular alginate impressions were made and duplicated for five patients. The Denar hinge axis facebow kit was used to transfer the upper cast of all patients to the articulators. The mandibular casts were articulated in maximum intercuspation. Protrusive and lateral interocclusal records were made for each patient. The horizontal and lateral condylar inclinations were adjusted on all articulators using the protrusive and lateral records. The adjustments were repeated twenty times for each articulator. The actual recording were compared to the values obtained by using Hanau’s formula.
Discussion: In studying the five patients, the difference of the means of the protrusive condylar guidance inclinations between the two Hanau articulators was 3 degrees on the right side (30.4 – 27.4 = 3) and 2.8 degrees on the left side (30.6 – 33.4 = 2.8). The range of means of the 20 readings of the protrusive condylar guidance of the Hanau articulator No. 1 for five patients was from 18 to 42 degrees on the right side and 22 to 42 degrees on the left side. This range for the Hanau articulator No. 2 was 22 to 36 degrees on the right side and 20 to 39 degrees on the left side. The range of the means in the five patients with the protrusive condylar guidance of the same articulators adjusted by lateral interocclusal records varied (1) from 22 to 32 degrees on the right side and from 26 to 41 degrees on the left side with the Hanau articulator No. 1 and (2) from 22 to 36 degrees on the right side and 20 to 39 degrees on the left side with the Hanau articulator No. 2. Significant differences in the means of condylar guidance readings existed in the Hanau articulators, when adjusted with the use of the records and the Hanau formula, in the readings of the right and left sides of the Hanau articulator No. 1 and in the left side of the Hanau articulator No. 2. Further study of the lateral condylar guidance of the same patients in the other articulators clearly indicated that the range of the lateral condylar guidance in different articulators varied from 0 to 50 degrees and the means of the five patients varied from 1 to 34 degrees. The range of means of lateral condylar guidances of the Hanau articulators adjusted by using the Hanau formula was only from 14 to 17 degrees. This small possibility of variation in the lateral condylar guidances will affect the balanced occlusion of the complete dentures when the are placed in the patient’s mouth, assuming a wider variation existed in the mouth.
Conclusion: The range of means of lateral condylar guidances of Hanau articulators using the Hanau formula was small. This small possibility of variation in the lateral condylar guidance would suggest the use of lateral interocclusal records when precise restorative procedures are necessary

08-008. Laucello, F.R. Anatomic comparison to arbitrary reference notch on Hanau articulators. J Prosthet Dent 40:676-681, 1978.



Purpose: to determine the average orbitale-maxillary incisal edge distance and to compare this measurement to the incisal reference notch of the Hanau articulators.
     The facebow registers the glenomaxillary relationship in three planes(anteroposteriorly, laterally, and vertically). The anteropostererior and lateral positions are determined by the anatomic relationship between the maxilla and the glenoid fossa. The vertical position , i.e., the anterior reference point, has been determined various techniques.
     One recommended method of locating vertical position when using Hanau articulators is to elevate the maxillary cast while the facebow is still attached to the articulator until the maxillary incisal edges are aligned to the level of a groove on the incisal guide pin. This groove is 30 mm below the horizontal condylar plane ( a plane described by the center of the condylar spheres and the infraorbital indicator) and is called the "incisal reference notch". Unfortunately the location of this groove bears no relation to the anatomic anterior reference point (orbital). In other words, the 30 mm measurement is not calibrated to approximate the average distance between the orbital and the maxillary incisal edges.

Literature review:
Snow - recommended that the occlusal plane be parallel to Campers plane(ala-tragus line) and oriented to the articulator so that it is parallel to the maxillary and mandibular bows of the articulator.
Gysi and Kohler - referred to "the prosthetic plane".
     Recent investigators noted that the Frankfort horizontal plane(porion to orbital) is usually parallel to the floor. It would seem logical to orient the maxillary cast to this plane so that the articulator would more accurately represent the patient. Clinically a maxillary cast is oriented to the Frankfort horizontal plane by using an infraorbital pointer that is attached to the facebow. The end of the pointer is placed at the lowest margin of the orbital rim. When transferred to the articulator, the end of the pointer is placed level with the condylar plane by utilizing the infraorbital indicator, thus orienting the maxillary cast to the (condylar) axis-orbital plane, which closely parallels the Frankfort horizontal plane. Thus the plane of occlusion, when viewed on the articulator, will be similar to that of the patient in an upright position.
Gonzalez and Kingery disputed this concept. They determined cephalometrically that the Frankfort horizontal plane was not parallel to the axis-orbital plane. The condylar axis was 7.1 mm below the cephalometrically determined porion. They suggested compensating for this error by adjusting the orbital pointer 7 mm above the orbital indicator or by placing the orbital pointer 7 mm below the orbitale of the patient during the facebow transfer. This has been compensated for in part by selecting the infraorbital foramen instead of the orbitale as the anterior reference point.
     An alternative to the use of the infraorbital pointer is the incisal reference notch on the Hanau incisal guide pin.
     The Hanau XP-51 has an incisal pin reference notch which measures 51 mm from the condylar plane. It was thought that this arbitrary measurement might better approximate the average orbitale-maxillary incisal edge distance.
Methods & Materials:
- 60 patients of different sex, race, and age with complete natural dentition
- Orbitale located by the point on the lower margin of the orbit which is directly below the pupil.
- A bar was positioned intraorally, recording the incisal edges of the teeth in compound.
- A Boley gauge was placed flush with the inferior surface of the bar, while the other arm was positioned level to the orbitale.
Results: The average orbitale-maxillary incisal edge distance determined from the representative population use in the study was 53.99 mm.
Discussion: According to Weinberg, if the facebow mounting is oriented 16 mm too high on the articulator, a disclusion of .2 mm will be noted on the balancing occlusal side. Manly states that complete denture patients can distinguish thicknesses down to.18 mm. Brill states complete denture patients can perceive objects at .6 mm.
Results: Results show a significant difference between the average orbitale-maxillary incisal edge distance and the 30 mm incisal reference notch measurement on the Hanau incisal guide pin. The average difference was 24 mm.
     Gonzalez and Kingery noted that the porion was 7.1 mm above the condylar axis point. Taking this information into consideration, the average determination of 54 mm was adjusted to 47 mm, thus more accurately paralleling the axis-orbital and Frankfort horizontal planes. Therefore if an incisal reference notch is to be used as a third point of orientation for the facebow, it should be calibrated 47 mm from the condylar plane. Therefore, it is suggested that using the orbital pointer when making the facebow transfer and adjusting the pointer 7 mm above the condylar plane of the articulator is the most accurate method of anatomically orienting the maxillary cast.
Conclusion:
1. The average orbitale-maxillary incisal edge distance for the representative population used in this study was found to be significantly greater than the 30 mm incisal reference notch on the incisal guide pins of the Hanau articulators.
     According to the present anatomic data, the incisal reference notch on Hanau articulators should be calibrated 47 mm below the condylar plane.
2. Due to the wide range of measurements recorded for the orbitale-maxillary incisal edge distance, it is suggested that the use of the orbital pointer when making the facebow transfer and adjusting the pointer 7 mm above the condylar plane of the articulator is the most accurate method of anatomically orienting the maxillary cast to the articulator.

08-009. Taylor T D et al. Analysis of the lateral condylar adjustments of nonarcon semiadjustable articulators. J Prosthet Dent 54:140-143,1985.



Purpose: A method to set the lateral condylar adjustment of the non arcon semiadjustable articulator to simulate border movements of the mandible more closely.
Materials and methods: A Denar D5A fully adjustable articular was used as the simulated patient. Pantographic tracings were done using only the anterior horizontal tables and transferred to the semiadjustable articulator.
Results: The semiadjustable articulator was able to duplicate the simulated patient tracings with a high degree of accuracy for the patient simulations without immediate side shift. It is suggested the semiadjustable articulator may be adjusted to simulate border movements more accurately by reducing the lateral condylar adjustment below the suggested range of 15-10 degrees. A single gothic arch tracing may be used to set the lateral adjustment or the articulator settings can be predicted by obtaining an intercondylar distance measurement with an arbitrary facebow. If ICD>=to 110 then lateral condylar adjustment should be set to 0 degrees. If<100 set to a slightly higher amount (8 degrees for ICD 100). If a more lateral cusp path is desired then set to 20-30 degrees.
Conclusions: Immediate side shift cannot be simulated by a slot rack semiadjustable articulator. Significant errors in cusp position and groove orientation may result. The results indicate that the Hanau formula or an arbitrary setting of 150-10 degrees does not provide the most accurate articulator setting possible.

08-010. Wachtel, HC and Curtis DA. Limitations of semiadjustable articulators. Part I: Straight line articulators without setting for immediate side shift. J Prosthet Dent 58:438-442,1987.



Purpose: To measure the amount and direction of error at the first molar when using a semiadjustable articulator.
Materials and methods: A Denar D5A articulator was used as a model for this study and programmed to simulate mandibular movements with the reported average values. Lateral and protrusive plaster records were made on the D5A and transferred to both the Hanau H2 and TMJ instruments and adjusted. A tracing was made on the D5A model articulator. The same tracing plate was transferred to one of the test articulators and a second line was scribed in the same plane. Tracings were completed in this manner for each of the tested articulators in each plane. The starting reference point of the tracings was the mesiolingual cusp tip of the upper first molar. Duplicate recordings were made with two different immediate side shift settings. The separation of lines in the recordings was measured 1 mm and 3 mm from the reference point in nonworking, working and protrusive movements.
Results: The Hanau H2 and TMJ articulators demonstrated positive error in the frontal plane. A comparison of tracings demonstrated that errors increased significantly when immediate side shift was increased. Errors were greater in the horizontal than in the frontal plane. Negative error was recorded in the sagittal plane.
Conclusion: The semiadjustable articulators adjusted with interocclusal records but without rear wall, top wall, and intercondylar distance settings demonstrated limitations in all three planes of measurement.
      To minimize the errors of straight line articulators in the horizontal plane, additional clearance should be made distal to the occlusal groove on mandibular teeth. For patients with less than 0.75mm of immediate side shift, chairside correction of the errors in the horizontal plane is possible. Errors in the sagittal plane were negative and small. The results demonstrated the need for incorporating immediate side shift into articular movements.

 

08-010. Wachtel, H C and Curtis, D A. Limitations of semiadjustable articulators Part I: Straight line articulators without setting for immediate side shift. J Prosthet Dent 58:438-442,1987.



Purpose: Controversy exists concerning the complexity of the articulator to accurately simulate mandibular movements. This study measured the amount and direction of error at the first molar when using a semiadjustable articulator.
Methods: A Denar D-5A was used. A 37 degree condylar inclination, an immediate side shift of 0.75mm, progressive side shift of 7.5 degrees condylar insert was used and intercondylar distance of 110 mm was used. Lateral and protrusive interocclusal records were used on the semiadjustable articulator. Casts were mounted on TMJ and Hanau H for comparison.
Results:
Frontal plane:  Errors increased significantly when ISS was increased from 0.75 mm to2mm. The greatest errors were in nonworking direction where 1 mm of error was recorded 3mm from the reference position

Horizontal plane: Errors were greater in horizontal than frontal plane, again highest in the nonworking direction where 2,2 mm of error was recorded 3mm from the reference position.

Sagittal plane: Negative error in the sagittal plane was noted for the Hanau H-2 and TMJ articulators. Negative error measured 1mm from the reference position was 0.20 mm with Hanau and 0.30 mm with TMJ articulator.

Conclusion: the average arbitrarily adjusted settings of a straight-line articulator should have a condylar inclination of 45 degrees and a progressive side shift of more than 30 degrees.
- errors in the sagittal plane were negative and small
- in the frontal and horizontal planes errors increased significantly when ISS was elevated from 0.75 mm to 2 mm.
- the results demonstrated the need for incorporating ISS into articulator movements.

08-011. Curtis, D A and Wachtel H C. Limitations of semiadjustable articulators with provision for immediate side shift. Part II. JPD 58:569-573, 1987.



Purpose: This study determined the error when a semiadjustable articulator with a provision for setting ISS was used.
Methods: Same as previous study with Denar D5 A and TMJ articulators.
Conclusions:
- adding ISS settings to a semiadjustable articulator significantly improved accuracy in the horizontal plane compared with fully adjustable articulator model
- errors in the frontal plane emphasize the importance of the top wall setting.
- when ISS is less than 0.75 mm both TMJ and Mark II articulators provide a satisfactory mechanical equivalent to mandibular movement.xsu po

08-011. Curtis, DA and Wachtel, HC  Limitations of semiadjustable articulators with provision for immediate side shift.  J Prosthet Dent 58: 569-573, 1987.

Purpose: To determine the error when a semiadjustable articulator straight-line articulator with a provision for setting ISS (Immediate Side Shift) is used.
Materials&Methods: A Denar D-5A articulator programmed with average values was used to simulate mandibular movements. Values were condylar inclination 37 degrees, ISS 0.75 mm, progressive side shift 7.5 degrees, condylar insert ¾ inch, and intercondylar distance 110 mm. The Mark II and TMJ articulators were used as a comparison, with the intercondylar distance set at 110 mm and flat guiding surfaces to represent condylar inclination. Duplicate maxillary and mandibular typodont casts were prepared, and the maxillary cast was secured to the articulators with an average face-bow setting. Lateral and protrusive interocclusal records were made in an edge to edge relationship on the Denar-5A and transferred to the other articulators. Acrylic resin plates (transferable) were fabricated for tracings made in the frontal, horizontal and sagittal planes at the first molar. Two tracings were made in each plane, first on the Denar D-5A, then the tracing was transferred to the articulator tested, and another line was scribed in the same plane. Recordings were made with an ISS of 0.75 mm and also at 2 mm, measurements were taken at 1 mm and 3 mm from the reference points.
Results: In the frontal plane, both the Mark II and TMJ articulators showed a positive error (ie the articulator undercompensates resulting in positive adjustment when the restoration is transferred to the patient.) Errors increased appreciably when the sideshift was increased to 2 mm. In the horizontal and sagittal planes, both articulators showed minute error when compared with the model articulator.
Discussion: This research supports work done by Gibbs, in that a patient with average Bennett movement (<.75 mm) and an acceptable anterior guidance, can have restorations made on semi-adjustable articulators with minimal eccentric interferences.
     The addition of ISS provided greater accuracy in the horizontal plane on semiadjustable articulators, in the frontal plane, the error was due to the top wall (ie surtrusion-detrusion of the working condyle is not represented.)
Conclusions: When ISS settings are added to the semiadjustable articulator improved accuracy in the horizontal plane, errors in the frontal plane were due to the top wall setting not being represented. When ISS is less than 0.75 mm both TMJ and Mark II articulators are satisfactory for mandibular movement, but when the ISS is 2 mm or more these articulators are unreliable for movement in the frontal plane at the first molar.

08-012. Beck, H.O., and Morrison, W.E. Investigation of an Arcon Articulator. J Prosthet Dent 6:359-372,1956.



Purpose: To investigate the arcon articulator introduced by Bergstrom.
Discussion: The new features introduced which vary from most condylar articulators are: 1. A face-bow registration which employs the Frankfort horizontal. 2. The axis equivalent guide, which is adjustable from 0 to 90 degrees, is fixed to the upper member of the arcon instrument and has a convex curvature of 0.022mm. The Bennett angle is fixed at 15 degrees.
      The articulator is constructed so cases may be transferred from one articulator to another. The upper member is freed by locks so as not to distort the interocclusal record during setting the articulator. The centric position can be altered in a retrusive manner.
      The facebow registration uses Frankfort horizontal which is an orientation of the external auditory meatus to the left orbitale on the patient. Some limitations may be the location of orbitale on the patient and the fact that the external auditory meatus in relation to the condyles may vary greatly not only between patients, but in the same patient from right side to left.
     Since the axis guide is fixed to the upper member the occlusal plane will maintain its relationship to the adjusted arcon indication in any position of the upper bow of the instrument. This relationship does not exist in the condylar articulator. This fact, according to the authors, results in an articulator that may better reproduce mandibular movement. One important fact to remember is the intercondylar distance must be accurate to gain the benefit of the arcon design, especially in lateral motion.


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