Section 07 - Articulators

Handout
Abstracts
Picture Gallery
001. Bonwill, W. G. A. The scientific articulation of the human teeth as founded on geometrical,
mathematical, and mechanical laws. Dent. tems of nterest, !!. "17-"#$, %cto&er 1'((. n )ol.
., *lassic +rosthodontic Articles. A.*.%.+., !!. 1-,'.
00,. Wein&erg, -. A. An e.aluation of &asic articulators and their conce!ts. a. +art / Basic
conce!ts. 0 +rosthet Dent 1$/",,-"##, 1("$. &. +art / Ar&itrar1, !ositional, semiad2usta&le
articulators. 0 +rosthet Dent 1$/"#3-""$, 1("$.
00$. *ele4a, 5. ). An anal1sis of articulators. D*6A ,$/$03-$,", 1(7(.
00#. 7all, 8. 9. An anal1sis of the de.elo!ment of the articulator. 0ADA 17/$-31, 1($0. n )ol.
, *lassic +rosthodontic Articles. A.*.%.+., 1(7', !!. 3$-101.
003. :itchell, D. -. and Wil;ie, 6. D. Articulators through the 1ears. a. +art / <! to 1(#0. 0
+rosthet Dent $(/$$0-$$', 1(7'. &. +art / 5rom 1(#0. 0 +rosthet Dent $(/#31-#3', 1(7'.
00". :ohamed, S. 9., Schmidt, 0. 8. and 7arrison, 0. D. Articulators in dental education and
!ractice. 0 +rosthet Dent $"/$1(-$,3, 1(7".
007. Smith, D. Does one articulator meet the needs of &oth fi=ed and remo.a&le !rosthodontics>
0 +rosthet Dent 3#/,("-$0,, 1('3.
00'. 8ittani, A. *lassification of articulators. 0 +rosthet Dent #$/$##-$#7, 1('0.
00(. :onson, G. S. %cclusion as a!!lied to crown and &ridge wor;. 0ADA 7/$((-#1$, 1(,0. n
)ol. , *lassic +rosthodontic Articles. A.*.%.+. 1(7', !!. 1-13.
010. G1si, A. +ractical a!!lication of research results in denture construction. 0ADA 1"/1((-,,$,
1(,(. n )ol. , *lassic +rosthodontic Articles, !!. ,7-31, A.*.%.+., 1(7'.
011. Schweit4er, 0. :. An e.aluation of 30 1ears of reconstructi.e dentistr1. +art /
9ffecti.eness. 0 +rosthet Dent #3/#(,-#(', 1('1.
01,. Bec;er, *.:. and ?aiser, D.A. 9.olution of occlusion and occlusal instruments. 0 +rosthod
,/$$-#$, 1(($.
Section 07: Articulators I - Overview
(Handout)
. Definition/ A mechanical instrument that re!resents the tem!oromandi&ular 2oint and 2aws, to
which ma=illar1 and mandi&ular cast ma1 &e attached to simulate some or all mandi&ular
mo.ements. @G+T-"A
. *lassification/
A. The Glossar1 of +rosthodontic Terms classifies articulators into four classes.
Class I. A sim!le holding instrument ca!a&le of acce!ting a single static registration. )ertical
motion is !ossi&le.
Class II. An instrument that !ermits hori4ontal as well as .ertical motion &ut does not orient the
motion to the tem!oromandi&ular 2oints.
Class III. An instrument that simulates cond1lar !athwa1s &1 using a.erages or mechanical
eBui.alents for all or !art of the motion.. These instruments allow for orientation of the cast
relati.e to the 2oints and ma1 &e arcon or nonarcon instruments. @Arcon articulator - An
articulator that maintains anatomic guidelines &1 the use of cond1lar analogs in the mandi&ular
element and fossa assem&lies in the ma=illar1 element.A
Class I. An instrument that will acce!t three dimensional d1namic registrations. These
instruments allow for orientation of the cast to the tem!oromandi&ular 2oints and re!lication of
all mandi&ular mo.ements. @G+T-"A
B. Awni 8ihani !u&lished an article in 0+D in 1('0 discussing the classification of
articulators that a!!ears to &e the acce!ted terminolog1 to date.
A nonad!ustable articulator can acce!t one or two of the following records/ 5ace &ow, centric
2aw relation or !rotrusi.e record.
A se"i ad!ustable articulator can acce!t all three of those records.
A #ully ad!ustable articulator can acce!t the following fi.e records/ 5ace &ow, centric 2aw
relation, !rotrusi.e, lateral records, and intercond1lar distance record.
A class articulator is a nonad2usta&le articulator.
A class or articulator is a semiad2usta&le articulator.
A class ) articulator is a full1 ad2usta&le articulator.
5or a re.iew of the !re.ious names for classif1ing articulators re.iew the 8ihani article at 0 +ros
Dent #$/ $##-$#7, 1('0.
. %cclusion and occlusal theories in addition to mechanical theories dro.e the de.elo!ment of
articulators. @0 +ros ,/$$-#$, 1(($A
A. %cclusion.
1. Bonwill 1'3' Triangular theor1 of occlusion
,. Bal;will 1'"" Translating 2aw mo.ed mediall1
$. )on S!ee 1'(0 %cclusal !lane of teeth follow a cur.e
#. Snow 1'(( 5ace&ow
3. *hristensen 1(01 %!ening of !osterior teeth in !rotrusion
". Bennett 1(0' mmediate side shift
7. G1si 1(10
Demonstrated use of incisal guide !in. %ne of the first to allow
for side shift
'. :onson 1(1" S!herical theor1 of occlusion
(. 7all 1(1' *onical theor1
10.7anau 1(,1 8oc;ing chair denture occlusion
11.Stan&ur1 1(,( +ositional records Tri!od.
1,.:e1er $0Cs *hew in techniBue
1$.A.er1 Brothers 1($0 Anti-:onson 8e.erse cur.e of Wilson
1#.+leasure 1($0 Anti-:onson e=ce!t ,
nd
molars in &alance
13.+:S ,0Cs 9liminate &alance, ncisal guidance im!ortant, -ong centric
1".Gnatholog1 ,0Cs +antogra!h, need to re!roduce mandi&ular mo.ements
17.+age 1(30 Transogra!hics. +age is dead and so is Transogra!hics.
1'.Gel& 1(70
*ranial %rtho!edics. The cond1les assume a certain sha!e &ased
on mandi&ular mo.ements.
). Basic anatomic !rinci!les and mo.ements that need to &e a!!lied to articulators were
discussed &1 Wein&erg in 1("$. 7e also discussed an outdated classification s1stem.
A. The h1!othetical !atient.
+rotrusi.e cond1lar inclination of #00
The ,
nd
molars located 30mm from the hinge a=is in the hori4ontal !lane and $,mm
&elow it.
The incisal edge of the mandi&ular incisors is located 100mm from the hinge a=is on the
hori4ontal !lane and $,mm &elow it.
B. The &asic elements of mandi&ular motion
+rotrusion
ncisal guidance
Balancing cond1lar !ath
Balancing cus! inclines
Wor;ing cond1lar motion -- Basic t1!es of wor;ing cond1lar motion
*. Tooth contact dominates mandi&ular motion.
D. Two essential ste!s in a face &ow mounting.
1. 7inge a=is
,. Anterior !oint of orientation
9. 9ffects of raising or lower the occlusal !lane and changing the cond1lar inclination ha.e on
tooth mor!holog1.
). *ontri&utions of s!ecific indi.iduals
A. Bonwill
+hiloso!h1 of mastication
Anatom1 of the human 2aws
The Bonwill articulator
The method of using BonwillCs articulator
Significance of the eBuilateral triangle.
B. G1si
G1si used the gothic arch tracing and a tracing of the sagittal inclination of the cond1lar !ath.
The a.erage angle of the gothic arch is 1,0
0
and the a.erage sagittal inclination of the cond1le is
$0
0
.
The two cond1le and incisor !oint determine interdigitation.
n the edentulous !atient the mo.ement from incisi.e to !rotrusi.e is com!letel1 lost.
G1si does not regard lateral mo.ements of the mandi&le im!ortant e=ce!t in unusual cases and
suggest an a.erage cond1lar !ath of 13
0
.
The following four features are reBuired of an articulator/
centric relation of the mandi&le
control of lateral incisor !oint mo.ements
sagittal inclinations of the cond1lar !ath
incisor !ath
5our methods of ada!ting the articulator
The intra-oral chec;&ite method with !lastic material
The intra-oral chec;&ite method with !laster
The e=tra-oral gra!hic method with the face-&ow @G1si !refersA
The intra-oral dentogra!hic method
A fault1 cus!id relation is a freBuent cause of denture dis!lacement.
The lateral incisor !aths are more im!ortant than the cond1lar !aths &ecause the teeth lie closer
to the incisor !oint and the lateral !aths of the cond1les are more difficult to re!roduce.
<se of a face&ow is necessar1 to accuratel1 !lace the cast on the articulator es!eciall1 when the
sagittal cond1lar !ath differs from the incisor !ath.
Denture teeth should &e !laced o.er the ridge to insure sta&ilit1 and guard against ti!!ing or
dislodging of the dentures.
Teeth should &e set to conform to the al.eolar ridge.
*. :onson The .arious !hases of occlusion of the teeth in
The de.elo!ing 2aws
The &ones ad2acent to the ma=illar1 &ones forming the masticating organs of man
The segments or teeth mounted in this mechanism, forming the masticating mem&ers
The normal construction of the human 2aw
Anatomical malformations of the mandi&ular mechanism
The construction of crowns and &ridge wor;
D. 7all
7is role in the de.elo!ment of articulators
7is lo.e for G1si
). n toda1Cs dental schools we ha.e different articulators for fi=ed .. remo.a&le restorations.
What a&out in the Dreal worldD.
n dental school, the Whi!-:i= and Denar are the most commonl1 used articulators used
for fi=ed restorations while a 7anau model is more commonl1 used for remo.a&le.
@Smith 0+D 3#/,("-$0,, 1('3A
:ohamed @0+D $"/$1(-$,3, 1(7"A found that "#E of !racticing dentist used a hinge or
sim!le articulator, ,"E used a semi-ad2usta&le, and 10E used a full1 ad2usta&le
articulator.
Schweit4er found that he had eBual amounts of success using different articulators. @0+D
#3/#(,-#(', 1('1A
$oard %uestions
Alfred G1si was the first to !roduce an articulator which could re!roduce downward and forward
mo.ements.
The first articulator to record downward and forward motion at the cond1les was the Bal;will
articulator.
William Wal;er de.elo!ed an ad2usta&le articulator for indi.idual mandi&ular mo.ements,
ma;ing registrations of the inclinations of indi.idual cond1lar !aths e=traorall1.
The 5ournet and 7ageman articulators are e=am!les utili4ing the s!herical theor1.
nstruments that encom!ass the Dterminal or&ital functionD are the Gnathosco!e, the Wadsworth
articulator, the Transogra!h, the Denar D-3A, and the Stuart
Gnatholator, Denar, and Stuart are full1 ad2usta&le articulators
7anau, Whi!-:i=, and Dentatus articulators are semi ad2usta&le.
The Whi!-:i=, 7anau <ni.ersit1, and Stuart are e=am!les of articulators with ad2usta&le
intercond1lar distance.
Wal;er first recorded mandi&ular mo.ement
- Abstracts -
07-00&' $onwill( )'G'A' *+e Scienti#ic Articulation o# t+e Hu"an *eet+ as ,ounded on
Geo"etrical( -at+e"atical( and -ec+anical .aws' /ent' Ite"s o# Interest( 00' 1&7-123(
October &455' In ol' I'( Classic Prost+odontic Articles' A'C'O'P'( 00' &-64'
*+eory o# -astication: %nl1 one side of the 2aw can function at a time. 7e relates how
millstones are groo.ed to the left from the center of the stone and the u!!er stone is re.ol.ed to
the right to allow clearing of the grain to the outside. 7e recommends using articulation rather
than occlusion &ecause it was a word of action.
Anato"y o# t+e Hu"an 7aw: (3E of cases will ha.e the u!!er teeth !ro2ect o.er the lower,
and the de!th of o.er&ite .aries as the de!th of the cus!s of the &icus!ids are dee! or shallow.
The ramus will &e found to come u!ward and &ac;ward in relati.e !ro!ortion to the length of the
cus!s and the o.er&ite.
Tri!od arrangement of the lower 2aw forming an eBuilateral triangle from the center of one
cond1loid !rocess to the other, four inches is a.erage. 5rom the cond1loid !rocess to the inferior
centrals touch at the cutting edge is also four inches. t .aries slightl1, &ut not more than F of an
inch.
%rdinar1 &rass articulators are 2oined as if the 2aw was 2ointed at the !har1n=. The cus!ids to
molars are in a straight line to ena&le them to ;ee! the largest !ro!ortion of surface !resented for
mastication.
%.er&ite or under&ite will &e in !ro!ortion to their de!th and to the length of the cus!s of the
cus!ids, &icus!ids and molars. The length of the cus!s on &icus!ids will ne.er &e more than 1G'
inch off.
$onwill Articulator: As of 1'3', the Bonwill Articulator corres!onds to the sha!e and
mo.ements of the mechanism of the 2aw. The &ase with its mo.ements forms one !art and the
two &ows another. t is made of 1G' inch diameter &rass wire.
-et+od o# 8sin9 t+e Articulator: Alwa1s model the u!!er wa= @record &aseA first, 2udging the
length of incisors and trial !lacement of anterior teeth for shade, sha!e, length and width. To
articulate the lower cast, use a !air of di.iders four inches a!art with the center of the lower teeth
at the median line 2ust four inches from the cond1les on either side. The first &icus!id should
onl1 ha.e one cus!. A groo.e in the u!!er teeth should &e !laced nearer the &uccal side, and for
the lower on the lingual.
+ro!oses D&ilateral &alanceD to eBuali4e the !ressure and action of the muscles on &oth sides
or !arts of the dental arches. The incisors ne.er touch when the 2aws are in lateral mo.ement.
%ne side of the mouth can &e used at the same instant, lea.ing the other free to &alance the other
side at wor;.
Si9ni#icance o# t+e :;uilateral *rian9le: The center of each cond1le &eing the center of
motion, rotating on one cond1le onl1, the other descri&ing the arc of a circle &1 mo.ing in the
glenoid ca.it1. Bonwill claims to ha.e e=amined #,000 dead 2aws and at least ",000 li.ing 2aws.
The si4e of the lower 2aw must &e 1G1, of the main circle drawn around the eBuilateral
triangular 2aw. The si= incisors mean diameter, in line, measure the same as the two &icus!ids
and two molars on either side forming an eBuilateral triangle.
07-006a' )einber9 .' A' An evaluation o# basic articulators and t+eir conce0ts' Part I'
$asic conce0ts' 7 Prost+et /ent &3( 166-122( &513'
9.aluation and associated conce!ts of articulators com!ared to that of a h1!othetical !atient and
the clinical im!lications. The ma=illar1 arch is the fi=ed &ase from which mandi&ular motion is
recorded. The im!ortance of face&ow transfer and *8 records to the starting !osition of
mandi&ular motion is em!hasi4ed. The cond1les and incisors are the three !oints used to stud1
mandi&ular motion. ncisal guidance is the dominant determinant of mandi&ular motion due to
itCs mechanical le.erage. Transfer of a ;inematic a=is reBuires the rods of the articulator are
mo.ed to meet the !ins of the face&ow for accurac1. Bennett Angle, 5ischer Angle and Bennett
mo.ement are discussed.
07-006b' )einber9 .' A' An evaluation o# basic articulators and t+eir conce0ts' Part II'
Arbitrary( Positional( Se"iad!ustable Articulators' 7 Prost+et /ent &3( 122-113( &513'
Ar&itrar1/ :onsonCs s!herical Theor1 and the 'D s!here do not consider indi.idual .ariations &ut
has .alue in esta&lishing a general cur.e of the occlusal !lane.
+ositional/ Stans&ur1 Tri!od of limited use, an1 change in )D% reBuires new records.
Semiad2usta&le/ 7anau :odel 7.
Orientation of the Maxillary Cast
Anatomic a.erage for hinge a=is. Anterior !oint of reference can &e the or&ital !ointer or
&1 aligning the incisal edges of the teeth or the wa= rim to the notch on the incisal !in.
CR record, the G1si Gothic arch tracing is the most desira&le. nterocclusal wa= records
or other records are acce!ta&le.
Protrusive record gi.es cond1lar inclination
Balancing Condylar motion- downward, mesial and forward. The !rotrusi.e is used for
the downward com!onent . Bennett mo.ement is determined &1 formula @ hG' H1,A.
:athematical stud1 of the 7anau :odel 7
A!!ro=imate 9rror at the second molar cus!
height
BalancingWor;ingT1!e of error
1. Anatomic a.erage hinge a=is ., ., antG!ost
,. Ar&itrar1 anterior !oint of reference ., .0 neg
$. Straight cond1lar !ath ., ., !os
#. 6o 5ischer angle .1 0.0 !os
3. 6o indi.idual wor;ing cond1lar motion .0 .' neg
Ar&itrar1 hinge a=is
*8 record, Gothic arch desira&le, wa= records acce!ta&le
+rotrusi.e record gi.es cond1lar indication and Bennett Angle
Bennett mo.ement of wor;ing cond1le gi.es u!, &ac; and out mo.ement onl1, can onl1
.ar1 amount
*ond1lar indication changed &1 ar&itrar1 third !oint of reference
5ischer angle unaccounted for
-ac; of ad2ustment of wor;ing cond1le could cause negati.e error of.'mm
The most significant error is !roduced &1 the lac; of wor;ing cond1lar motion. %.erall, most
of the errors tend to cancel each other out rather than com!ound.. The error !roduced is often
negati.e and tends to !roduce flatter cus!s. The error in the wor;ing cond1lar guidance effects
!osterior teeth more than anterior teeth. Decreasing the Bennett angle of the o!!osite &alancing
cond1lar guidance !roduces more rotation and less lateral shift of the wor;ing cond1le and ,
therefore increases !osterior wor;ing cus! inclines.
07-003' Cele<a( ,' ' An analysis o# articulators' /C=A 63: 30>-361( &575'
+ur!ose/ 8edefine the articulator.
Discussion/ An articulator is defined as a Dmechanical de.ice which re!resents the
tem!oromandi&ular 2oints and 2aw mem&ers, to which ma=illar1 and mandi&ular casts ma1 &e
attachedD. :an1 de.ices that are called articulators do not satisf1 this definition. Some of these
de.ices ma;e no attem!t to re!resent the T:0 @ face&ow transferA or their !aths of motion
@eccentric registrationsA.
6oneccentric mo.ement articulators differ in the a!!roach to the occlusal !osition.
The mandi&ular !athwa1s are all cur.ed and onl1 one of these !athwa1s can &e registered.
9ccentric mo.ement articulators must all &e oriented to the T:0 and therefore, reBuire
registrations of centric relation as a starting or reference !osition. The reason for using an
instrument that allows eccentric mo.ement is to minimi4e ad2ustments and !reser.e anatomical
detail. The more ad2ustments reBuired, the greater the loss of anatomical form, since all
ad2ustments are su&tractions onl1.
When selecting an articulator for !rosthodontic use, first determine what t1!e of occlusal
scheme is most desira&le. f centric occlusion is to &e used as the !osition of :+, then onl1 a
registration of that !osition with the remaining teeth in contact should &e ta;en. The wor;ing
casts cannot &e 2oint oriented &ecause centric occlusion is not a &order !osition. Therefore, the
!recise end !oint of centric occlusion must &e maintained &1 the articulator.
f centric occlusion is going to &e used as the !osition of :+, it would &e most ad.antageous
to use a 2oint-oriented techniBue such as the face-&ow transfer. n this wa1 the end!oint @centric
relationA can &e !reser.ed on the articulator with slight changes in .ertical dimension. 9ccentric
!athwa1s can &e d1namicall1 registered either gra!hicall1 @!antogra!hic methodA or
stereogra!hicall1 @engra.ing methodA, !ositionall1 registered @chec;&ite methodA, determined &1
the articulator @mechanical eBui.alentsA, or ad2usted entirel1 on the !atient.
*lassification of cast relators/
1. Class I - sim!le holding instruments ca!a&le of acce!ting a single static registration. The
eccentric mo.ements !ermitted offer no ad.antage &ecause the1 are not registered and are
therefore inaccurate. The e=ce!tion to this is the Su&di.ision * instrument. *lass instruments
are suita&le for crown and &ridge, and o!erati.e instruments. m!ortant features are !ositi.e
sto!s and loc;s at the mounted !osition.
Subdivision A: .ertical motion is !ossi&le. 9=/ *orelator, )enticulator.
Subdivision B: .ertical motion is 2oint related. 9=/ *entric 8elator.
Class II - instruments that !ermit hori4ontal as well as .ertical motion &ut do not orient the
motion to the T:0.
Subdivision A: eccentric motion is unrelated to !atient motion. 9=/ G1si Sim!le=.
Subdivision B: eccentric motion !ermitted is &ased on theories of ar&itrar1 motion. 9= /
Shofu 7and1 .
Subdivision C: eccentric motion !ermitted is determined &1 the !atient &1 using
engra.ing methods. 9=/ Gnathic 8elator.
Class III: instruments that simulate cond1lar !athwa1s &1 using a.erages or eBui.alents for all
or !art of the motion. The1 allow for 2oint orientation of the casts and ma1 &e arcon or nonarcon
instruments. All the e=am!les are arcon instruments, acce!t face&ows, and ha.e mounting !lates
for unlimited case load.
These instruments can fulfill the reBuirements for com!lete denture construction.
Desira&le features would &e good centric loc;, !rogressi.e and immediate side shift controls,
!rotrusi.e inclination, intercenter distance ad2ustment, a sim!le mounting !rocedure, a good
sturd1 design, and an arcon arrangement.
Subdivision A: acce!t static !rotrusi.e registrations. 9=/ 7anau Arcon .
Subdivision B: acce!t static lateral !rotrusi.e registrations. 9=/ Denar :ar; , Whi!
:i=, *ase Articulator Simulator, +anadent model +, 7anau :odel 1$0-,,, T:0
:echanical 5ossa nstrument.
Class IV: instruments that will acce!t three dimensional d1namic registrations.
These instruments allow for 2oint orientation of casts. These articulators are the instruments of
choice for com!lete reconstructions. These instruments should hold ad2ustments, contain good
centric loc;ing mechanism, .ersatile incisal guide ta&les, and sta&le mounting features, and &e
!recision engineered.
Subdivision A: the cams re!resenting the cond1lar !aths are formed &1 registrations
engra.ed &1 the !atient. 9=/ T:0.
Subdivision B: instruments that ha.e cond1lar !aths that can &e angled and customi4ed.
9=/ Stuart Gnathological *om!uter, Denar :odel 3A, Denar :odel S9.
07-002' Hall( ?' :' An analysis o# t+e develo0"ent o# t+e articulator' 7A/A &7:3->&( &530'
In ol II( Classic Prost+odontic Articles A'C'O'P'( &574( 00' >3-&0&'
+ur!ose/ To increase ;nowledge and understanding of the de.elo!ment of the articulator in an
effort to end the contro.ers1 o.er ,D @gothic archA .s $D @anatomicA articulators.
Discussion/
AA. 8e.iew histor1 of de.elo!ment/
-Gariot @1'03A/ original in.entionI sim!le hinge
-Snow/ face&ow@1st e.idence of $D relationsA
-7a1es/ articulating cali!er
-Broomell/ !lanes of orientation to !lane of occlusion, ala-tragal
-9.ans@1'#0A/ gi.en credit for the ,nd articulator
-*ameron/ the real ,nd contri&utorI 1D o!ening J closing mo.ement
-Bonwill @1'3'A/ father of anatomicG&alanced occlusion, eBuilateral triangle
-Wal;er @1'("A/ real !ioneer &ut G1si too; credit, .aried a=es of lateral mo.ement, cond1le !ath
and rotation !oint theor1 ad2usta&le cond1lar guidance, incisal guidance and Bal;will-Bennett
mo.ement were, onl1 real changes !rior to $D
-7a1es @1'((A/ downward mo.ement of the cond1le
--uce @1(11A/ incisal !in and su!!ort guideI $D &ut !lastic
-G1si @1(10A/ Bal;will-Bennett mo.ementI incisal guidance and !in
-7all/ ad2usta&le $D anatomic articulatorI uni.ersal mandi&ular mo.ements, ad2usta&le incisal
guide
-G1si Tru&1te and Wadsworth/ com!onents of all !re.ious articulators
-7anau @1(,0A/ engineerI ,D
BA. Warring cam!s of G1si@,DA and 7all@$DA
,D/ gothic arch tracingI cannot re!roduce arcuate mo.ement of the mandi&le and accuratel1
chec; $D &ites
$D/ wor;ing cond1le mo.es in all directions, no restraining hinge 2ointI automatic
*A. %ther nota&le credits/
Da.is J -euchenring/ intercond1lar width ad2ustment
:onson/ di.ider for determining &asic cur.es dis; locating center for !ro2ecting cur.es
07-00>a' /onald .' -itc+ell( //S( -S( and =oel /' )il@ie( //S' Articulators t+rou9+ t+e
years' Part I' 80 to &520' 7 Prost+et /ent 35:330-334( &574'
A !ictorial histor1 of the articulators at the 6ational 6a.al Dental *enter is !resented. All
articulators in the article will &e listed with a uniBue attri&ute noted.
*+e Plaster Articulator' +laster e=tensions off the distal !ortions of the cast articulated the cast
together. *redited to +hili! +faff of Berlin who was the dentist of 5rederic; the Great.
*+e $arn /oor Hin9e' 7ea.1 dut1 hinge modified &1 &ending each arm (0 degrees to form a
--sha!ed u!!er and lower mem&er.
*+e Ada0table $arn /oor Hin9e' 7as an anterior .ertical sto!. <suall1 a machine &olt.
*+e Aerr Articulator' 7inge is on the same !lane as the occlusal !lane. 5i=ed !rotrusi.e and
lateral mo.ement.
*+e =ew Century Articulators' Snow in 1(0". 8otational centers !laced # inches a!art.
*+e Ac"e Articulator' 9la&oration of the 6ew *entur1 articulators. Three different models to
allow for three ranges of intercond1lar distance.
*+e Gysi Ada0table and Si"0leB' The ada!ta&le was introduced in 1(0" &ut was too technical
and cost too much so the sim!le= was introduced in 1(1#. The cond1lar guidance was fi=ed at
$$
0
and has a S-sha!ed cur.e in !rofile.
*+e $iBby Attac+"ent' A forerunner of the face&ow in attem!ted to regulate the antero!osterior
!osition of the cast on the articulator. @1'(#A
*+e -aBillo"andibular Instru"ent' Designed &1 :onson in 1(1' &ased on the s!herical
theor1. A.erage radius of the s!here was # inches &ut could &e changed.
*+e Ste0+an Articulator' De.elo!ed in 1(,1. 7as a fi=ed cond1lar inclination and allows for an
ar&itrar1 lateral mo.ement.
*+e Hanau -odel - Ainosco0e' 9arl1 1(,1. 5our !ost. The Bennett angle is ad2usted &1
changing the eccentric cone on the out&oard !ost.
*+e Ho"er ?elator' De.elo!ed in 1(,$ &1 0ose!h 7omer. T:0 uses a similar !rinci!le in
relating cast.
*+e )adswort+ Articulator' 5lag feature and an ad2usta&le intercond1lar distance.
*+e Hanau -odel H&&0' Designed to encom!ass mechanical a.erages.
.C HD4 E &6
*+e Hanau -odel H&&0 -odi#ied' ntroduced the incisal guide ta&le.
*+e Ha9e"an $alancer' 1(,0Cs. Based on the s!herical theor1 of occlusion. :andi&ular teeth
constructed first.
*+e P+illi0s Student Articulator (-odel C)' De.elo!ed around 1(,(. tCs de.elo!er claimed it
could follow an1 gra!hic record.
*+e Stanbery *ri0od Instru"ent' 8e!roduces !ositions not mo.ements.
*+e House Articulator' De.elo!ed in the 1(,0Cs. 8otar1 milling de.ice.
*+e Precision Coordinator' De.elo!ed in the earl1 1($0Cs &1 Terrell. *ur.ilinear cond1lar
guides.
*+e Hanau Crown and brid9e Articulator' Small articulator that can simulate wor;ing and
&alancing side e=cursions of 13
0
and !rotrusi.e of $0
0
.
*+e P+illi0s Occlusosco0e' +hilli!s &elie.ed in onl1 two @cond1larA determinants of occlusion
therefore the incisal !in rested on a flat !lane.

07-00>b' /onald .' -itc+ell( //S( -S( and =oel /' )il@ie( //S' Articulators t+rou9+ t+e
years' Part II' ,ro" &520' 7 Prost+et /ent 35:2>&-2>4( &574'
A !ictorial histor1 of the articulators at the 6ational 6a.al Dental *enter is !resented. All
articulators in the article will &e listed with a uniBue attri&ute noted.
*+e Ste0+an Articulator (-odi#ied)' 1(#0. Sim!le hinge 2oint with longer u!!er and lower
mem&ers than the 1(,1 model and a fi=ed cond1lar !ath of $0
0
.
*+e Ste0+an Articulator -odel P' An incisal !in and fi=ed 10
0
incisal guidance.
*+e ,ournet Articulator' 6o lateral mo.ement.
*+e 7o+nson - O9lesby and -oyer Articulators' The 0ohnson - %gles&1 instrument is a small,
nonad2usta&le, fle=i&le articulator de.elo!ed around 1(30. The u!!er mem&er of the :o1er has a
&all and soc;et ad2ustment. t is a mean .alue articulator.
*+e Coble Articulator' A hinge articulator that maintains .ertical dimension and centric relation
&ut does not allow for functional mo.ements.
*+e Galetti Articulator' The cast are held mechanicall1 without !laster.
*+e Pan@y--ann Articulator' %cclusal !lane of the mandi&ular teeth are &ased on the
S!herical theor1.
*+e Stuart Articulator' The settings are !rogrammed &1 using !antogra!hic tracings from the
!atient.
*+e Hanau -odel H6 Series' ncreased the distance &etween the u!!er and lower mem&er from
(3mm to 110mm and added an or&ital indicator to the u!!er mem&er.
*+e /entatus A?. Articulator' Allows for the transfer of cast from one articulator to another
while the same relationshi! is maintained.
*+e I"0roved =ew Si"0leB Articulator' A.erage mo.ements. *ond1lar inclination of $0
0
.
Bennett mo.ement of 7.3
0
. The incisal guide ta&le ad2ust from 0
0
to $0
0
.
*+e erticulator' De.elo!ed to &e used with the functionall1 generated !ath techniBue and
Buadrant tra1s.
*+e =ey Articulator' 6o loc;ing de.ice &etween u!!er and lower mem&ers. )ar1ing
intercond1lar distances. *an use custom ground !lastic inserts in the cond1lar elements.
*+e Hanau -odel &30-6& Articulator' %ne of the 7anau uni.ersit1 series. ntroduced in 1("$.
*+e )+i0--iB Articulator' A sim!lified .ersion of StuartCs full1 ad2usta&le articulator. *an not
&e set to all !ositional records.
*+e Si"ulator' A full1 ad2usta&le articulator that can &e set from !antogra!hic tracings,
!ositional records, and other tracings.
*+e /enar /2A Articulator' A full1 ad2usta&le articulator. +rogrammed from tracings made
with a !neumaticall1 controlled !antogra!h.
*+e /entatus A?O Articulator' A mo.ea&le arm that holds the mandi&ular cast allows for
re!ositioning the mandi&ular cast without remounting.
07-001' -o+a"ed( S':'( Sc+"idt( 7'?' and Harrison( 7'/' Articulators in /ental :ducation
and Practice' 7 Prost+et /ent 31:3&5-36>( &571
Discussion/ Sur.e1 sent to $03 la&s in the 9ast *oast and in llinois. The1 recei.ed a res!onse
from 10" la&oratories. The sur.e1 results were inter!reted to identif1 dentistKs use of articulators
after training. %nl1 a small !ercentage of students continued to use or !rescri&e articulators.
8es!onses from (' la&s disclosed the t1!e of articulators dentists were su&mitted / "#E were
hinge or sim!le articulators, ,"E were semi-ad2usta&le articulators, and 10E were full1
ad2usta&le. The most common com!laints of the la& technicians were !oor registration records
and !oor im!ressions. The1 !referred that the dentist articulated the casts !rior to referring them
to the la&.
Authors thought it would &e &etter to !lace em!hasis on the selection of an articulator
de!endent u!on the difficult1 encountered with each !atient, rather than learning to use one
articulator - i.e. semi-ad2usta&le.
07-007' S"it+( /' /oes one articulator "eet t+e needs o# bot+ #iBed and re"ovable
0rost+odonticsF 7 Prost+et /ent >2:651-306( &54>'
+ur!ose/ Sur.e1 of dental schoolCs 5i=ed and 8emo.a&le de!artment as to the t1!e of
Articulatores reBuired of their students.
:ethods/ Sur.e1s were sent to each dental school and their res!ecti.e 5i=ed and 8emo.a&le
De!artments.
*onclusion/ 5i=ed De!artments !referred an articulator that allows se!aration of the ma=illar1
and mandi&ular mem&ers and in 8emo.a&le de!artments !refer those that do not.
07-004' Awni ?i+ani( //S( -Sc' Classi#ication o# articulator' 7 Prost+et /ent 23:322-327(
&540'
+ur!ose/ To discuss a classification s1stem for articulators.
Discussion/ Articulators ha.e &een classified in se.eral wa1s &1 se.eral different !eo!le. 8ihani
suggest classif1ing articulators as nonad2usta&le, semiad2usta&le, or full1 ad2usta&le. This is
&ased on the t1!e of records the1 can acce!t.
A nonad!ustable articulator can acce!t one or two of the following records/ 5ace &ow,
centric 2aw relation or !rotrusi.e record.
A se"i ad!ustable articulator can acce!t all three of those records.
A #ully ad!ustable articulator can acce!t the following fi.e records/ 5ace &ow, centric
2aw relation, !rotrusi.e, lateral records, and intercond1lar distance record.
07-005' -onson G' S' Occlusion as A00lied to Crown and $rid9e )or@' 7 =at /ent Assoc
7:355-2&3( &560' In ol II( Classic Prost+odontic Articles( A'C'O'P' 00' &-&>'
+ur!ose/ To achie.e well &alanced geometric !ro!ortions to the face and o!timum function, one
can relate all 2aws to a s!here whose radius is a!!ro=imatel1 four inches . The center is eBui-
distant from the occlusal surface of the teeth and the center of each cond1le.
Discussion/
5irst - The De.elo!ing 0aw
The function of mastication is essential in de.elo!ing the normal 2aw and the &ase of the
cranium. 5ood and function !la1 the ;e1 role in de.elo!ment and will create the ideal
masticator1 forces and facial form.
Second - The Bones Ad2acent to the :a=illar1 Bones 5orming the :asticating %rgans of :an
The total action of the muscles con.erge to a common center.
5unction of these muscles are the main factor in de.elo!ing well &alanced geometricall1
!ro!ortioned face.
Third - The segments or :issing teeth :ounted in This :echanism 5orming the :asticating
:em&ers
6o matter what !ositions the mandi&le ma1 ta;e, the masticator1 forces are directed down the
long a=is of the teeth. The center of the a!!lied forces con.erge to a common radial !oint a&out
four inches from the occlusal surfaces and the head of the cond1les. Tooth attrition is the greatest
distur&ance to this geometric &alance.
5ourth - The 6ormal *onstruction of the 0aw
The normall1 constructed 2aw will e=hi&it BonwillCs eBuilateral triangle. -ines from each corner
of the triangle are drawn u!ward to form a !1ramid. 5rom that common !oint, radii can &e drawn
to each occlusal surface forming a s!here of eight inches in diameter.
5ifth - Anatomical :alformations of the :andi&ular :echanism
:alformations are an1 de.iation from the eBuilateral triangle of four inches. These will lead to
im!ro!er function and !oor de.elo!ment as well as contri&ute to !ossi&le o&scure disorders
according to the author.
Si=th - The *onstruction of *rowns and Bridgewor; in Such a :anner As To Allow 5reedom of
8ange of %cclusion, +roducing the 7armonious Action and +ermanent 7ealth of the <nits
All !atients should &e restored in accordance with the s!herical !1ramid of which BonwillCs
triangle is the &ase
Summar1/ The dentist should !ro.ide more than 2ust !ro!er mastication with his restorations.
7is res!onsi&ilit1 is to see that the !ro!er facial and cranial dimensions are achie.ed.
07-0&0' Al#red Gysi( //S' Practical a00lication o# researc+ results in denture construction'
7A/A &1:&55-663( &565'
Se.eral to!ics are discussed. m!ortant &ullets are listed &elow.
G1si used the gothic arch tracing and a tracing of the sagittal inclination of the cond1lar
!ath .
The a.erage angle of the gothic arch is 1,0
0
and the a.erage sagittal inclination of the
cond1le is $0
0
.
The two cond1le and incisor !oint determine interdigitation.
n the edentulous !atient the mo.ement from incisi.e to !rotrusi.e is com!letel1 lost.
G1si does not regard lateral mo.ements of the mandi&le im!ortant e=ce!t in unusual
cases and suggest an a.erage cond1lar !ath of 13
0
.
The following four features are reBuired of an articulator/
1. centric relation of the mandi&le
,. control of lateral incisor !oint mo.ements
$. sagittal inclinations of the cond1lar !ath
#. incisor !ath
5our methods of ada!ting the articulator
1. The intra-oral chec;&ite method with !lastic material
,. The intra-oral chec;&ite method with !laster
$. The e=tra-oral gra!hic method with the face-&ow @G1si !refersA
#. The intra-oral dentogra!hic method
A fault1 cus!id relation is a freBuent cause of denture dis!lacement.
The lateral incisor !aths are more im!ortant than the cond1lar !aths &ecause the teeth lie closer
to the incisor !oint and the lateral !aths of the cond1les are more difficult to re!roduce.
<se of a face&ow is necessar1 to accuratel1 !lace the cast on the articulator es!eciall1 when the
sagittal cond1lar !ath differs from the incisor !ath.
Denture teeth should &e !laced o.er the ridge to insure sta&ilit1 and guard against ti!!ing or
dislodging of the dentures.
Teeth should &e set to conform to the al.eolar ridge.
07-0&&' Sc+weit<er( 7'-' An evaluation o# >0 years o# reconstructive dentistry' Part II:
:##ectiveness' 7 Prost+et /ent 2>: 256-254( &54&
+ur!ose/ 9.aluation of reconstructi.e thera!1 for !atients that were under o&ser.ation for at least
10 1ears.
Discussion/
A. Documentation
- %&ser.ations
- +atients must &e rece!ti.e to the !rogram.
- 8ecord ;ee!ing.
B. +rognosis
- 9=tent and t1!e of disease, which ma1 &e s1stemic, local, or emotional.
- 9tiolog1, which includes local en.ironmental factors, some which ma1 &e correcta&le or not.
- +h1sical health and ha&its of the !atient, the num&er and distri&ution of remaining teeth, and
the health of the !eriodontium.
- 8etention of Buestiona&le teeth, alteration in occlusal .ertical dimension, and alteration of
interocclusal distance.
- +ro&lems created &1 uncoo!erati.e !atients, inadeBuate home care, or failure to return for
!osto!erati.e e=amination and thera!1.
- Biological !ro&lems- !ostural changes induced &1 disease and aging which ma1 alter the
!osition of the mandi&le, malocclusion, growth anomal1, and s1stemic disease.
*. 8esults
- The goal of reconstructi.e thera!1 is to !ro.ide the !atient with an esthetic, functioning,
stomatognathic s1stem, in which the !rogress of degenerati.e disease is arrested or at least
retarded.
- A large ma2orit1 of the !atients with good !rognoses maintained good dental health.
- A lesser !ercentage of !atients with fair or !oor !rognoses im!ro.ed with time.
- Women held a slight ad.antage o.er men in maintaining good dental health.
- Age fa.ored !atients under 30 1ears when the !rognosis was good.
- ncreasing the .ertical dimension of occlusion did not consistentl1 influence the results.
- +rostheses in which wor;ing and &alancing occlusion were !roduced for ,7 !atients failed to
demonstrate su!erior results.
- 5or some !atients, &oth an increased .ertical dimension of occlusion and &alancing occlusion
was !ro.ided.
- The treatment !lan included increasing .ertical dimension of occlusion and esta&lishing
&alanced occlusion. This was attained with fi=ed tem!orar1 !rostheses, for a trial !eriod.
- The !atient ada!ted well to the increases .ertical dimension of occlusion, and the !ermanent
restorations were inserted ' months later. The increased .ertical dimension and &alanced
occlusion were included in the final restorations.
*onclusion/ Dental thera!1 must re2ect the conce!t of !ermanence. :utilated dentitions ma1 &e
restored to health and ser.e to create a non!athogenic stomatognathic s1stem for a satisfactor1
!eriod.
07-0&6' $ec@er C'-' and Aaiser /'A' :volution o# Occlusion and Occlusal Instru"ents' 7
Prost+od 6:33-23( &553'
+ur!ose/ To re.iew the historical origins and e.olution of occlusal conce!ts.
:aterials J :ethods/ 6one
8esults/ 6one
Discussion/ %cclusal conce!ts !ro!osed during the !eriod of 1'00 to 1($0 @age of occlusal
theoriesA were &asicall1 formulated for com!lete denture !atients stressing &ilateral &alance.
1(,0-1(#0Cs +an;e1, :ann, Schu1ler and Gnatholog1 were de.elo!ing. The conce!ts of
transogra!hics, cranial ortho!edics, and mandi&ular centricit1 @centric relationA are further
discussed. Biologic occlusion is a fle=i&le conce!t with the goal to achie.e an occlusion that
functions and maintains health. Goals/ 1. 6o interference &etween *8-:. ,. 6o &alancing
contacts. $. *us! to fossa occlusal scheme. #. A minimum of one contact !er tooth. 3. *us!id rise
or grou! function. ". 6o !osterior contacts with !rotrusi.e 2aw mo.ements. 7. 6o cross tooth
&alancing contacts. '. 9liminate all !ossi&le fremitus. (. %&tain and maintain a neurological
release.
*onclusion/ t is recommended to a.oid occlusal thera!1 for indi.iduals who a!!ear to &e
functioning in health, e.en if their occlusal scheme does not fit a conce!t of o!timum occlusion.
When thera!1 is una.oida&le it is suggested to treat within the guidelines of a &iologic occlusion.