Fixed partial dentures

The significance of articulator capablities.

Part I. Adiustable vs. semiadjustable articulators

Neal D. Bellanti, D.D.S., M.A.*

University of Kentucky, College of Dentistry, Lexington, Ky.

-Lh e c 1”mica 1 significance of the semiadjustable vs. the fully adjustable articulator
is the subject of continuing controversy in fixed prosthodontics. In mandibular border
movements, the orbiting condyle moves medially, anteriorly, and inferiorly. The
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.l 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 prostheses.
The semiadjustable articulator? guides only the lateral component of the
rotating condylar movement, whereas the fully adjustable articulatorf may be set to
simulate all components of mandibular movement. The purpose of this study was to
measure the discrepancies that may exist in articulator capability due to incomplete
movement simulation. The effects on cusp positions produced by variations of inter-
condylar width, the shape of the condylar housing, and the timing and direction of
the side shift were ascertained.

INTERCONDYLAR WIDTH
Methods and materials. Dental stone casts of the maxillary and mandibular
dental arches with all posterior teeth removed were used. Styli were positioned at the
location of, and at the same height as, the mesiolingual cusp of maxillary first
molars. On the mandibular cast, recording tables were added parallel to the OC-
clusal plane and at the level of the central pit of the first molars. The casts were
mounted on the fully adjustable articulator (Fig. 1, A and B) .
To preclude the necessity of transferring the casts from one articulator to the
other, only the fully adjustable articulator was used. The capabilities of the semi-

*Assistant Professor, Department of Restorative Dentistry.

TWhip-Mix Articulator.
$Denar D4A Articulator.
269
 J. Prosthet. Dent.
270 Bellanti March, 1973

Fig. 1, A and B. Casts, with recording tables, styli, and grids, mounted on the Denar D4A
Articulator.

adjustable articulator were used as control, while the capabilities of the fully
adjustable articulator were used as experimental. Control simulations were ac-
complished by setting only the intercondylar width, angle of the articular eminences,
and angle of the progressive side shift on the fully adjustable articulator. This
configuration represents the maximum adjustment capability of the semiadjustable
articulator. Experimental data were obtained by adding adjustments that only the
fully adjustable articulator can make.
A photographic method was used to measure the position of the styli. The
articulator was placed in a marked, reproducible position. Grids were attached to
the lingual surfaces of the mandibular recording tables near the stylus position. The
camera was positioned on a mounting board at a right angle to the buccal surfaces
of the posterior teeth. A shim, 3.3 mm. thick, was placed behind the orbiting condyle,
producing a constant mediotrusion. This position was chosen because it placed the
working side canines in an end-to-end relationship. Photographs were taken with the
articulator in control and experimental configurations and measurements were made
from the projected slides, determining the mesiodistal as well as the vertical displace-
ment of the stylus tips (Fig. 2).
The semiadjustable articulator is capable of three intercondylar width settings,
with a 7 mm. interval between each two (48, 55, and 62 mm. measured from the
midline). To determine the efficacy of the 7 mm. interval, 48 mm. was compared
with one half of the interval to the next larger setting, or 51.5 mm. Also, the largest
possible setting, 62 mm., was compared with the maximum patient width of 70 mm.
reported by Aull.* The articulator eminence angle was 35O, the progressive side shift
was 20°, and these were constant in both experimental and control procedures.
Results. The variance in mesiodistal cusp tip position between the 48 mm. and
the 51.5 mm. widths was 0.2 mm. on the working side and 0.2 mm. on the nonwork-
ing side. The difference between the 62 mm. and the 70 mm. widths was 0.2 mm.
on the working side and 0.5 mm. on the nonworking side.
Conclusions. The results indicate that the 7 mm. interval between the settings
is adequate to provide clinical accuracy within a correctable range. However, the
62 mm., or large, width is too narrow to accommodate all patients at a correctable
discrepancy.
Volume 29 Significance of articulator capabilities 271
Number3

Fig. 2. The casts were placed with the canines in an end-to-end relationship, with the stylus
superimposed over the grid.

TIMING OF THE PROGRESSIVE SIDE SHIFT

Methods and materials. 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.* The articular eminence angle
was 35’, the progressive side shift was 20 O, the intercondylar width was 56 mm., and
these were all constant in both experimental and control procedures.
Results. The effect of the early progressive side shift on the mesiodistal CUSP tip
position was 0.1 mm. on the working side and 0.5 mm. on the nonworking side.
Conclusions. The variation is beyond the range of clinical acceptability for the
nonworking side.

SHAPE OF THE CONDYLAR HOUSING

Methods and materials. 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 s/s inch radius convex curvature insert$ as experi-
mental. The articular eminence angle was 35 O, the progressive side shift was 20”,
the intercondylar width was 56 mm., and these were all constant in both experi-
mental and control procedures.
Results. The variance produced by a curved superior wall was a 0.1 mm. longer
cusp on the working side and a 0.2 mm. shorter cusp on the nonworking side.
Conclusions. The effects of the superior wall shape are within a clinically cor-
rectable range.

DIRECTION OF THE SIDE SHIFT

Methods and materials. The effects of the directional components of the side
shift on both vertical and mesiodistal cusp positions were studied with only the

*Denar D43 Af2 medial wall insert.

tDenar D44 NO superior wall insert.
$.DenarD44 A3 superior wall insert.
 J, Prosthet. Dent.
272 Bellanti March, 1973

Table I. Cusp position variance (in millimeters) due to the direction of the side shift,
compared with a simple laterotrusion. Only the working-side condylar housing
was adjusted

Working side cusp Nonworking side ctlsfi

Direction Mesiodistal Length Mesiodistal Length

Lateral-up 0 0.1 L* 0.2 M 0.2 s
Lateral-down 0.1 M 0.1 s 0.1 M 0
Lateral-forward 0.4 D 0.1 s 0.1 M 0.1 s
Lateral-backward 0.5 M 0 0.2 M 0.1 s
Lateral-forward-up 0.6 D 0 0 0.2 s
Lateral-forward-down 0.4 D 0.2 s 0 0.1 s
Lateral-backward-up 0.5 M 0.2 L 0.1 M 0.2 s
Lateral-backward-down 0.6 M 0.1 s 0.1 M 0
*M, More mesial; D, more distal; L, longer; S, shorter.

Table II. Cusp position variance (in millimeters) due to the direction of the side
shift, compared with a simple laterotrusion. Both the condylar housings
were adjusted

Working side cusp Nonworking side CUSP

Direction Mesiodistal Length Mesiodistal Length
Lateral-up 0 0.1 L 0.2 M 0.3 s
Lateral-down 0.1 M 0.1 s 0.1 M 0.1 L
Lateral-forward 0.4 D 0.1 s 0.1 M 0.1 s
Lateral-backward 0.5 M 0 0.4 D 0.1 s
Lateral-forward-up 0.5 D 0.1 L 0.2 M 0.3 s
Lateral-forward-down 0.3 D 0.2 s 0.1 M 0
Lateral-backward-up 0.4 M 0.2 L 0.2 D 0.4 s
Lateral-backward-down 0.6 M 0.1 s 0.4 D 0.1 L

working side adjusted and again with both condylar housings adjusted. Control was
a simple laterotrusion. Experimental data were obtained on shifts of lateral and:
(1) up 25O, (2) down 25O, (3) forward 25O, (4) backward 25’, (5) forward 25O
and up 25O, (6) f orward 25O and down 25’, (7) backward 25’ and up 25’, and (8)
backward 25’ and down 25O. The articulator eminence angle was 35’, the progres-
sive side shift was 20°, the intercondylar width was 56 mm., and these were all
constant in both experimental and control procedures.
Results. The variations produced by altering the direction of the side shift are
presented in Tables I and II. They varied from 0 to 0.6 mm. change, with ranges
of 1.2 mm. mesiodistally and 0.5 mm. vertically.
Conclusions. The variance of the total of possible combinations at the settings
measured is greater than could be controlled clinically.

IMMEDIATE SIDE SHIFT

Methods and materials. The procedures performed under “Direction of the side
shift” were repeated with a 2 mm. immediate side shift added.
Volume 29 Significance of articulator capabilities 273
Numbrr 3

Table III. Cusp position variance (in millimeters) due to the direction of the side
shift, compared with a simple laterotrusion. Only the working side condylar
housing was adjusted. A 2 mm. immediate side shift was added

Working side cusp Nonworking side cusp a

Direction Me&distal 1 Length / Mesiodistal 1 Length
Lateral-up o..i M 0.1 I, 0.6 D 0
I,ateral-down 0.9 M 0.7 s 0.5 D 0.3 L
Lateral-forward 0.5 D 0.4 s 0.6 M 0
Lateral-backward 1.8 M 0.2 s 0.5 D 0.2 L
Lateral-forward-up 1.0 D 0 0.7 1) 0.1 s
Lateral-forward-down 0.4 D 0.8 S 0.6 D 0
Lateral-backward-up 1.5 M 0.1 D 0.3 D 0.1 I,
Lateral-backward-down 1.9 M 0.6 S 0.5 D 0.2 L

Table IV. Cusp position variance (in millimeters) due to the direction of the side
shift, compared with a simple laterotrusion. Both the condylar housings were
adjusted. A 2 mm. immediate side shift was added

Working side cusp Nonworking side cusp

Direction 1 Mesiodistal 1 Length 1 Mesiodistal 1 Length
Lateral-up 0.4 M 0.1 L 0.2 D 0.4 s
Lateral-down 0.8 M 0.6 S 0.6 D 0.8 L
Lateral-forward 0.4 D 0.3 L 0.2 M 0.2 L
Lateral-backward 1.8 M 0.9 s 2.0 D 0.1 s
Lateral-forward-up 0.7 D 0 0.4 M 0.4 s
Lateral-forward-down 0.3 D 0.6 S 0.1 D 0.7 I,
Lateral-backward-up 1.4 M 0.4 s 1.5 D 0.9 s
Lateral-backward-down 1.8 M 1.1 s 2.4 M 0.6 L

Results. The variations produced by adding the immediate side shift are presented
in Tables III and IV. The figures show changes ranging from 0 to 2.4 mm., with
ranges of 4.4 mm. mesiodistally and 1.7 mm. vertically.
Conclusions. The variance of the total of possible combinations at the settings
measured is greater than could be controlled clinically.

DISCUSStON
The purpose of an articulator in fixed prosthodontics is to transfer the effective
mandibular movements of a patient to the laboratory bench. The accuracy of the
simulation of the jaw movement controls the accuracy of the fabricated prosthesis.
Greater accuracy of the prosthesis allows more accurate planning of the occlusal
relationships, thereby decreasing the number of changes of the occlusal surface at
insertion. The centric position may have no deflective or interceptive occlusal con-
tacts, but the eccentric positions may be uncontrolled. Lack of accuracy or incomplete
adjustment may result in periodontal insult”, 4 or may initiate parafunctional habits”
if not corrected.
274 Bellanti J. Prosthet. Dent.
March, 1973

Fig. 3. Upper casting viewed from the lingual in the working lateral excursion on the articu-
lator (left). Upper casting in the mouth viewed from the lingual in the working lateral ex-
cursion. Dotted line indicates occlusal adjustment needed. (Illustration by J. D. Walter.)

The semiadjustable articulator is capable of reproducing intercondylar width in

the small and medium range with only a small error. But the large adjustment did
not seem to allow adequately for the possible range of patient variation’ described
by Aull.* The error incorporated at the wide extreme would require more than
minimal intraoral adjustment of a prosthesis in eccentric positions.
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.
The variation measured as a result of increasing detrusion by changing the
configuration of the superior wall of the condylar fossa should be sufficiently small
to allow minimal intraoral adjustment.
The semiadjustable articulator is capable of only a simple laterotrusion. Aull*
reported that 84 per cent of the patients studied exhibited laterotrusions with vertical
or horizontal components. It has been assumed that, if the centric position and lateral
positions are accurately transferred to the articulator, the paths between these posi-
tions can be interpolated as a straight line and corrected in the mouth.6
However, in those patients with a backward or upward component in latero-
trnsion (lateral-up, lateral-backward, lateral-forward-up, lateral-backward-up,
lateral-backward-down), or 43 per cent in Aull’s study,2 the rotating articulator
condyle would contact the posterior wall or superior wall of the condylar fossa
before reaching its final position. The teeth of the cast would not reach full insertion
into the interocclusal relation record. If used in this position, the articulator would
duplicate correctly only the centric position. The eccentric error would represent the
variance shown in this study, proportional to the amount of backward or upward
movement in the laterotrusion.
Also, in those patients with a forward or downward component in laterotrusion
(lateral-down, lateral-forward, and lateral-forward-down), or 41 per cent of Aull’s
study,’ the rotating articulator condyle would be anterior and/or inferior from the
condylar fossa with the lateral interocclusal relation record in place. Upon removal
of the interocclusal relation record, the condylar fossa assumes the condylar control
and incorrect lateral pathways result. The error would represent the variance shown
 Significance of articulator capabilities 275

in this study, proportional to the amount of forward or downward movement in

laterotrusion.
Occlusal adjustments in the mouth of the magnitude involved cannot be con-
sidered minimal (Fig. 3). A technique accepting these adjustments would result in
extensive intraoral occlusal adjustment, occlusal discrepancies left unadjusted, or an
uncontrolled disocclusion.

SUMMARY AND CONCLUSIONS

A semiadjustable articulator was compared with a fully adjustable articulator to
determine the discrepancy of eccentric pathways of cusp motion. The effects of
intercondylar width, mediotrusion timing, superior wall shape, laterotrusion dirrc-
tion, and immediate side shift were measured. All produced a significant variation.
The error produced by use of the semiadjustable articulator may result in a need for
more than minimal eccentric occlusal adjustment or uncontrolled amounts of disoc-
elusion 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.
The author wishes to extend his appreciation to Drs. L. D. Whitsett and J. G. Burch and
Mr. J. S. Wiggs for advice and assistance.

References
1. Guichet, N. F.: Applied Gnathology: Why and How, Dent. Clin. North Am. 13: 687-700,
1969.
2. Aull, A. E.: Condylar Determinants of Occlusal Patterns, J, PROSTHET. DENT. 15: 826-846,
1965.
3. Glickman, I., and Smulow, J. B.: Further Observations on the Effects of Trauma from
Occlusion in Humans, J. Periodontol. 38: 280-293, 1967.
4. Glickman, I., and Smulow, J. B.: Adaptive Alterations in the Periodontium of the Rhesus
Monkey in Chronic Trauma from Occlusion, J. Periodontol. 39: 101-105, 1968.
5. Ramfjord, S.: Bruxism, J. Am. Dent. Assoc. 62: 21-44, 1961.
6. Hickey, J. C., Lundeen, H. C., and Bohannan, H. M.: A New Articulator for Use in Teach-
ing and General Practice, J. PROSTHET. DENT. 18: 425-437, 1967.

UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY

A. B. CHANDLER MEDICAL CENTER
LEXINGTON, KY. 40506