JAW RELATION INTRODUCTION AND

ORIENTATION RELATION

PRESENTED BY:
DR. AMRIT ASSI
DEPT. OF PROSTHODONTICS, CROWN,
BRIDGE & IMPLANTOLOGY
 INTRODUCTION:

• The relationship of the mandible to the maxilla and their orientation to the cranium is a
very important consideration in prosthodontics, specially in completely edentulous
individuals where there are no teeth to provide any reference.

• The maxillomandibular relationship is recorded following the fabrication and contouring

of occlusal rims.

• The recorded jaw relations are then transferred to an articulator which can simulate these
movements and assist in arranging the artificial teeth accordingly.

• The constructed complete denture should function in harmony with the various
mandibular movements. This will ensure a great deal of comfort and confidence to the
denture wearer.
 MAXILLOMANDIBULAR RELATIONS AND RECORDS:

• Maxillomandibular relationship: Any spatial relationship of the maxillae to the

mandible; any one of the infinite relationships of the mandible to the maxillae (GPT8)

• Maxillomandibular relationship record: A registration of any positional relationship

of the mandible relative to the maxillae (GPT8).

• Maxillomandibular relations can be classified as:

1. Orientation relations
2. Vertical relations
a) Vertical relation (dimension) at rest
b) Vertical relation (dimension) in occlusion (occlusal vertical dimension)
3. Horizontal relations
a) CR
b) Protrusive
c) Lateral
ORIENTAL JAW RELATION:

• This is the first jaw relation to be recorded.

• It establishes the relationship of the maxilla

to the base of the skull or cranium.

• Basically, it establishes the angle or tilt of

the maxilla in the three reference planes.

• The mandible moves against a fixed

maxilla and to accurately reproduce
mandibular movements, it is necessary to
establish and record the tilt of the maxilla
• To record the angulation of the maxilla, a plane should be formed with at least two
posterior references and one anterior reference.

View of a head from top – to record the inclination of maxilla, a plane should be formed with two
posterior (centre of both condyles A and B) and one anterior point – here infraorbital notch C is used as
anterior reference point
• As the mouth opens and closes in CR, the movement of the condyles in the initial stages
(up to about 12 mm) of opening and final stages of closing is a rotational movement in the
horizontal axis, following an arc of a circle.

• The axis of the rotation or arc passes through the centre of both the condyles.

• The condyles are centred in the glenoid fossa during this rotational movement.

• If the centre of condylar rotation can be determined, it will correspond to the two
posterior reference points necessary to form a plane for the maxilla, as the glenoid fossa is
located just above the center.

• A third reference point located anteriorly in the maxilla – infraorbital notch or nasion –
will complete the plane
Facebow is used to determine the inclination
of maxilla by forming a plane (a–c) using the
centre of the two condyles (a and c) as
posterior references and infraorbital notch
(b) as anterior reference.

Hence, the center of condylar rotation is also

determined and the same is transferred to the
articulator
 THE INSTRUMENT THAT IS USED TO RECORD THE
CENTRE OF CONDYLAR ROTATION ALONG WITH A
THIRD REFERENCE POINT, THEREBY FORMING A
PLANE TO RECORD THE ORIENTATION RELATIONSHIP
OF THE MAXILLA TO THE CRANIUM, IS CALLED
FACEBOW
FACEBOW:

AN INSTRUMENT USED TO RECORD THE SPATIAL RELATIONSHIP

OF THE MAXILLARY ARCH TO SOME ANATOMIC REFERENCE
POINT OR POINTS AND THEN TRANSFER THIS RELATIONSHIP TO
AN ARTICULATOR; IT ORIENTS THE DENTAL CAST IN THE SAME
RELATIONSHIP TO THE OPENING AXIS OF THE ARTICULATOR;
CUSTOMARILY THE ANATOMIC REFERENCES ARE THE
MANDIBULAR TRANSVERSE HORIZONTAL AXIS AND ONE OTHER
SELECTED ANTERIOR REFERENCE POINT.
INDICATIONS OF FACEBOW:

• The need to use a facebow in complete dentures has been debated with many dentists
preferring not to use the same.

• It is seen that not using the facebow only leads to minor errors in occlusion, which can be
corrected intraorally during the delivery of the denture.

• Studies comparing the patient response to complete dentures with or without facebow
transfer failed to show any significant clinical advantage with facebow use.

• facebow may be indicated when:

1. Balanced occlusion is desired

2. Vertical dimension is subject to change

HANAU FACEBOW
PARTS OF A FACEBOW:

• U-SHAPED FRAME.

• CONDYLAR RODS.

• BITE FORK.

• LOCKING DEVICE.

• ORBITAL POINTER WITH CLAMP

1. U-SHAPED FRAME. 1

2. CONDYLAR RODS.

3. BITE FORK. 5
4. LOCKING DEVICE. 3
2

5. ORBITAL POINTER
WITH CLAMP 4
U SHAPED FRAME:

• METALLIC BAR THAT FORMS THE MAIN FRAME OF THE FACE-BOW.

• ALL OTHER COMPONENTS ARE ATTACHED TO THE FRAME WITH THE

HELP OF CLAMPS.

• THIS ASSEMBLY IS LARGE ENOUGH TO EXTEND FROM THE REGION OF

THE TMJ TO AT LEAST 2-3 INCHES ANTERIOR TO THE FACE AND WIDE
ENOUGH TO AVOID CONTACT WITH THE SIDES OF THE FACE.

• THIS RECORDS THE PLANE OF THE CRANIUM

CONDYLAR RODS:

• THESE ARE TWO SMALL METALLIC RODS ON EITHER SIDE OF THE FREE
END OF THE U SHAPED FRAME THAT CONTACTS THE SKIN OVER THE
TMJ.

• THEY HELP TO LOCATE THE HINGE AXIS OR THE OPENING AXIS OF THE
TEMPOROMANDIBULAR JOINT.

• THEY TRANSFER THE HINGE AXIS OF THE TMJ BY ATTACHING TO THE

CONDYLAR SHAFT IN THE ARTICULATOR.

• CERTAIN FACE-BOWS DO NOT HAVE A CONDYLAR ROD.

• INSTEAD THEY HAVE AN EARPIECE WHICH FITS INTO THE EXTERNAL

AUDITORY MEATUS
BITE FORK:

• THIS IS A U-SHAPED PLATE, WHICH IS ATTACHED TO THE OCCLUSAL

RIMS WHILE RECORDING THE ORIENTATION RELATION.

• IT IS ATTACHED TO THE FRAME WITH THE HELP OF A ROD CALLED THE

STEM.

• THE BITE FORK SHOULD BE INSERTED ABOUT 3 MM BELOW THE

OCCLUSAL SURFACE WITHIN THE OCCLUSAL RIM.

• SOME SUGGEST THAT THE BITE FORK CAN BE INSERTED IN ANY DEPTH.

• SOMETIMES THE BITE FORK IS ATTACHED TO THE OCCLUSAL SURFACE

OF THE OCCLUSAL RIM USING IMPRESSION COMPOUND IN ORDER TO
PRESERVE THE OCCLUSAL RIM
LOCKING DEVICE:

• THIS PART OF THE FACEBOW HELPS TO ATTACH THE BITE FORK TO THE
"U"-SHAPED FRAME.

• THIS ALSO SUPPORTS THE FACE-BOW, OCCLUSAL RIMS AND THE CASTS
DURING ARTICULATION.

• IT CONSISTS OF A TRANSFER ROD AND A TRANSVERSE ROD.

• THE "U"-SHAPED FRAME IS ATTACHED TO THE VERTICAL TRANSFER

ROD.

• THE POSITION OF THIS TRANSFER ROD CAN BE LOCKED WITH A THUMB

SCREW.
• THE HORIZONTAL TRANSVERSE ROD CONNECTS THE TRANSFER ROD
WITH THE STEM OF THE BITE FORK.

• AFTER POSITIONING THE "U"-SHAPED FRAME AND THE BITE FORK,

THE HORIZONTAL TRANSVERSE ROD SHOULD BE POSITIONED.

• IT CAN BE POSITIONED AUTOMATICALLY BY ATTACHING IT TO THE

TRANSFER ROD AND THE BITE FORK AND TAPPING IT.

• THIS TYPE OF ASSEMBLY WHERE THE TRANSVERSE ROD GETS

AUTOMATICALLY POSITIONED WHEN TAPPED IS CALLED AN AUTO-
ADJUSTING OR SELF-CENTERING ASSEMBLY
ORBITAL POINTER:

• IT IS DESIGNED TO MARK THE ANTERIOR REFERENCE POINT

(INFRAORBITAL NOTCH) AND CAN BE LOCKED IN POSITION WITH A
CLAMP.

• PRESENT ONLY IN THE ARBITRARY FACE-BOW

TYPES OF FACE-BOWS:

ARBITRARY FACE-BOW KINEMATIC OR HINGE BOW

• MOST COMMONLY USED FACE-BOW IN • GENERALLY USED FOR THE FABRICATION

COMPLETE DENTURE CONSTRUCTION. OF FIXED PARTIAL DENTURE AND FULL-
MOUTH REHABILITATION.
• HINGE AXIS IS APPROXIMATELY LOCATED.
• TRUE HINGE AXIS SHOULD BE LOCATED
• CONDYLAR RODS ARE POSITIONED AND MARKED
APPROXIMATELY 13 MM ANTERIOR TO THE • BEFORE USING THE FACE-BOW.
AUDITORY MEATUS ON A LINE RUNNING
FROM THE OUTER CANTHUS OF THE EYE TO • LOCATION OF THE HINGE AXIS IS THEN
THE TOP OF THE TRAGUS ALSO CALLED THE TRANSFERRED TO THE ARTICULATOR WITH
CANTHOTRAGAL LINE. THE FACE-BOW.

• AS THIS IS AN ARBITRARY HINGE AXIS, • REQUIRES A FULLY ADJUSTABLE

ERRORS IN JAW RELATION MAY PRODUCE ARTICULATOR TO ACCEPT THE TRUE HINGE
OCCLUSAL DISCREPANCIES WHICH SHOULD AXIS (THA).
BE CORRECTED BY MINOR OCCLUSAL
ADJUSTMENTS DURING INSERTION
 THE DENAR
SLIDEMATIC FACEBOW
WHIP MIX QUICK MOUNT FACEBOW
 POSTERIOR REFERENCE POINTS:

1. BEYRON’S POINT: 13 mm anterior to posterior margin of tragus of outer canthus of

eye

2. GYSI’S POINT: 13 mm anterior to anterior margin of external auditory meatus (EAM)

3. SNOW’S POINT: 11-13 mm anterior to tragus

4. DENAR’S POINT: 12 mm anterior to posterior border of tragus and 5 mm inferior to

line from (EAM) and outer canthus

5. BERGSTROM’S POINT: 10 mm anterior to the EAM and 7 mm below the Frankfort’s

horizontal plane)
POSTERIOR REFERENCE POINTS
TYPES OF ARBITRARY FACEBOW:

FACIA TYPE:

• UTILIZES APPROXIMATE POINTS ON THE

SKIN OVER THE TMJ REGION.

• THE HINGE AXIS OR THE POSTERIOR

REFERENCE POINT IS 13 MM ANTERIOR TO
THE EXTERNAL AUDITORY MEATUS AND THE
ANTERIOR REFERENCE POINT IS THE
ORBITALE (MIDPOINT OF THE LOWER
BORDER OF THE ORBIT).

• FACE-BOW HAS A POINTER THAT CAN BE

POSITIONED TO THE POSTERIOR REFERENCE
POINT
EARPIECE TYPE:

• THE POSTERIOR REFERENCE POINT IS

THE EXTERNAL AUDITORY MEATUS
AND THE ANTERIOR REFERENCE
POINT IS THE ORBITALE.

• THE EARPIECES ENGAGE INTO THE

POSTERIOR REFERENCE POINTS (THE
EXTERNAL AUDITORY MEATUS).
ORBITALE:
HANAU SPING BOW:

• THE MOST COMMONLY USED FACE-BOW.

• IS AN EARPIECE-TYPE FACEBOW, USED TO CAPTURE AND RECORD THE PATIENT'S

MAXILLARY ARCH AND ITS RELATIONSHIP TO THE EXTERNAL AUDITORY MEATUS
SLIDEMATIC TYPE (DENAR):
• HAS AN ELECTRONIC DEVICE, WHICH GIVES THE READING THAT CAN BE SEEN IN
THE ANTERIOR REGION.

• THIS READING DENOTES ONE-HALF OF THE PATIENT'S INTERCONDYLAR

DISTANCE.

• THE POSTERIOR REFERENCE POINT FOR THIS INSTRUMENT IS THE EXTERNAL

AUDITORY MEATUS AND THE ANTERIOR REFERENCE POINT IS 43 MM SUPERIOR
TO THE INCISAL EDGE OF THE UPPER CENTRAL INCISOR FOR DENTULOUS
PATIENTS.

• IN AN EDENTULOUS PATIENT THE ANTERIOR REFERENCE POINT IS 43 MM

SUPERIOR TO THE LOWER BORDER OF THE UPPER LIP IN A RELAXED STATE.

• THE ANTERIOR REFERENCE POINT CAN BE MARKED USING A DENAR REFERENCE

PLANE LOCATOR
DENAR REFERENCE PLANE LOCATOR
TWIRL BOW:
• IT IS AN ARBITRARY TYPE OF FACE-BOW THAT DOES NOT REQUIRE ANY
PHYSICAL ATTACHMENT TO THE ARTICULATOR.

• IT IS NOT COMMONLY USED FOR CD CONSTRUCTION.

• IT RELATES THE MAXILLARY ARCH TO THE FRANKFURT'S HORIZONTAL

PLANE.

• A MOUNTING GUIDE IS USED TO MOUNT THE TRANSFER ROD TO THE

ARTICULATOR.

• IT IS EASY TO MANIPULATE BECAUSE THE FACE-BOW IS NOT NEEDED TO

MOUNT THE MAXILLARY CAST IN THE ARTICULATOR
KINEMATIC FACEBOW:
• USED FOR THE FABRICATION OF FIXED PARTIAL DENTURE AND FULL-MOUTH
REHABILITATION.

• NOT USED FOR COMPLETE DENTURE FABRICATION BECAUSE IT REQUIRES A

LONG AND COMPLEX PROCEDURE TO RECORD THE ORIENTATION JAW
RELATION.

• THE FACE-BOW HELPS TO ORIENT THE CAST IN THE PATIENT’S TERMINAL

HINGE AXIS.

• TRUE HINGE AXIS SHOULD BE LOCATED AND MARKED BEFORE USING THE
FACE-BOW, THE LOCATION OF THE HINGE AXIS IS THEN TRANSFERRED TO THE
ARTICULATOR WITH THE FACE-BOW.

• THIS FACE-BOW REQUIRES A FULLY ADJUSTABLE ARTICULATOR TO ACCEPT THE

TRUE HINGE AXIS (THA)
CLINICAL PROCEDURE FOR RECORDING ORIENTATION JAW RELATION
(USING FACIA TYPE):

• The maxillary occlusal rim is inserted into the patient’s mouth and contoured and all the
required guidelines are marked.
• A point 13 mm from tragus of the ear on the canthotragal line is marked on both sides.
• The bite fork is flamed and attached anteriorly to the maxillary occlusal rim, 3 mm above the
incisal plane and parallel to the occlusal plane.

The centre of the fork should coincide with the patient’s

midline
• The maxillary rim with the attached bite fork is inserted into the patient’s mouth.

• The parallelism and centring of the attached bite fork are verified
• The U-frame is supported by two fingers and gently rotated and inserted into the stem of the bite
fork in the patient’s mouth
• The condylar rods are unlocked and the condylar heads are then placed in the patient’s right and
left condylar centres on the previously marked points.
• The third point of reference (infraorbital notch) is palpated and the orbital pointer is set to the
third point of reference.

• The condylar rod readings are equalized on both sides and the locking screws are tightened.

• Following this, the orbital pointer is also tightened in position.

• The facebow record is removed from the patient by loosening only the condylar screws.

• The record is now ready to be mounted on the articulator.

• This completes the facebow transfer and then it is transferred to the articulator
MOUNTING ON THE ARTICULATOR:

• The facebow record is now mounted on the articulator as follows:

• The condylar rods are attached to the auditory pins.

• The bite fork is stabilized on the tilting support bar provided and the orbital pin is made
to coincide with the orbital axis plane indicator.

• The incisal pin is locked with its lock screw at zero on calibration and the incisal table is
set horizontally
END OF LECTURE
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