SRM University Journal of Dental Sciences

Volume 2, Issue 1, January

- March 2011

Review

Face bow a caliper - Review article
N Kalavathy\

A Ananthra]', K Premanth', C Santhosh Kumar'

1Department of Prosthodontics, 'Departmeni of Pedodontics, DAPMRV Dental College, Bangalore Address for correspondence Dr. N. Kalavathy M.D.S., Professor and Head of the Department Department of Prosthodontics DAPMRV Dental College, Bangalore Abstract To fabricate any restoration, on an articulator mandibular movements have to be simulated on it. To simulate the mandibular movements on an articulator various jaw relations have to be recorded and transferred to it. The face bow transfer forms an indispensable part of jaw relation recording procedures. Face bow transfer helps, transferring the spatial relationships of jaw relation to various reference points. The restoration fabricated with face bow transfer require less chair side correction and also patients are more comfortable as the occlusion relation of the restorations are in harmony with the stomatognathic system ofthe patient. Keywords: Face bow, orientationjaw relations, Hinge axis

Introduction
Recording of jaw relations is one of the most important steps in the complete denture treatment. The temporomandibular joint has a significant role in this procedure. Unlike the other joints of the body, the TMJ is peculiar in that it is lined by a fibro cartilage. The disc of the joint divides the TMJ into two synovial cavities. The relationship of maxilla to mandible is not the same in all the persons, the anatomy of maxilla and TMJ varies from person to person. The opening movement to bring the jaw from occlusal to rest position is purely a hinge movement. The mandible moves on an arc of the circle with a definite radius from the temporomandibular joint. This path of the condyle is determined by the curvature of the condylar head of the curvature of the mandibular fossa. Definitions: - It is a caliper like device that is used to record the relationship of the jaws to the opening axis of the jaws and to orient the casts in this same relationship to the opening axis of the articulator', - It is a caliper like device 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 another selected anterior point'. - Face bow is a caliper like device used to record the 3 relationship of the maxilla to the TMJ • Classification offace bows:

1) Arbitrary face bow a) Faciatype; Eg: Hanau 132-25m and Hanau 132-2c b) Earpiece type - Ex: Hanau 164-2 twirl bow and 153,Self centering or quick mount; Ex: Whipmix, Bergstorm, SAM 2) Kinematic facebow (Records true hinge axis)

Anterior points of reference': 1) Orbitale: In the skull, Orbitale is the lowest point of the infraorbital margin. On the patient it can be palpated through the overlying tissue and skin. One orbitale and two posterior points determine the horizontal axis of rotation will determine the axis-orbital plane. Orbital and the two posterior landmarks are transferred from the patient to the articulator with the facebow. The articulator must have the orbital indicator guide that is in the same plane as the hinge of the articulator.

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Augsberger concluded in a review of literature that the occlusal plane parallels this line with minor variations in different facial types. Gozalez pointed out that this posterior tissue landmark on the patient in average lies 7mm superior to the horizontal axis. the dentist can transfer Campers line from the patient to the articulator by marking the right or the left alae on the patient. setting an anterior reference point to it and with the facebow transferring the ala anteriorly and the hinge axis posteriorly from the patient to the articulator. on this line is used as the arbitrary hinge axis point. another skull landmark. Weinberg's point: This is a point 11-13mm anterior to the reference line drawn from the middle and the posterior border of the tragus of ear to the comer of eye. When the facebow is positioned anteriorly to the Nasion guide the cross bar will be in the approximate region of Orbitale. Teteruck and Lundeen's point: 13mm from the base of the tragus to the canthus. the nasion can be approximately located in the head as the deepest part of the midline depression just below the level of the eyebrows. Swenson: Described arbitrary location of the condyles as 11mm anterior to the meatus of ear on reference line from top of the meatus to the comer of eye. 2011 . A point 13mm anterior to Richey condylar marker to this line is used as the arbitrary reference point.Review article N Kalavathy et al 2) Orbitale minus 7 mm: The Frankfort horizontal plane passes through both the poria and one orbital point. The facebow cross bar and not the nasion guide is the actual anterior reference point locator. Sicher recommends using the midpoint of the upper border of the external acoustic meatus as the posterior cranial landmark on the patient. The recommended compensation for this discrepancy is to work the anterior point of reference 7mm below Orbitale on the patient. A point about 13mm in front of the tensed anterior margin of the meatus. posterior reference points must be located and marked. In the condylar rods with graduation extending form main assembly which is 38 Streamdent. S) Incisal edge plus anterior midpoint to articulators axis: Horizontal plane distance: Guichet emphasized that a logical position of casts in the articulator would be the one which would position the plane of occlusion near the mid horizontal plane of the articulator. Beck's point: 10mm anterior to the center of the external auditory meatus and 7mm below the Frankfort plane. Schlosser's point: A line drawn from the upper margin of the external auditory meatus to the outer canthus of eye. this measured distance is measured onto the patients from the existing incisal edges of the planned occlusal plane and then the transfer is done. 2(1). Brandrup Wognsen point: On line extending from the tragus to the lateral angle of eye. Posterior points of reference'" 7: Prior to the aligning of the facebow on face. The Nasion guide or positioner of the quickmount facebow which is designed to be used with the Whipmix articulator fits into this depression. Lauritzen and Bodner's point: A point 13mm anterior to the tragus on the tragus-canthus line. 3) Nasion minus 7mm: According to Sicher. Pcraddock and Symmon's point: A point 1em anterior along a line drawn from the upper free margin of the tragus of ear to comer of eye. Prothero's point: A line drawn from top of Richey condylar marker (placed in the external auditory meatus) to the outer canthus of eye. The cross bar (U shaped frame) is located 23mm below the midpoint of the Nasion pointer. Knowing this. The mid horizontal distance to the axis condylar plane is measured. (Various arbitrary hinge axis points) Description of Facebow: The facebow consist of 'V' shaped frame which is wide enough to avoid contact with sides of the face. 4) Alae of the nose: A line from the alae of the nose to the centre of the auditory meatus is called the CAMPER'S LINE.Face bow a caliper . because porion is a skull landmark. They are located byA) Arbitrary method B) Kinematic method A) Arbitrary method: Most commonly used measurements and landmarks. Bergstorm's point: A point 10mm anterior to the center of the spherical insert for the external acoustic meatus and 7mm below the Frankfort horizontal plane. Beyorns point: A point 13mm anterior to the posterior margin of tragus of ear on a line drawn from the center of the tragus of tragus to the comer of the eye (Tragus canthus line) Gysi's point: A point 10mm in front of the tragus on the tragus-canthus line. a point is marked at about 12mm in front of posterior margin of the most prominent tragus. So this facebow employs an approximate Axis-orbital plane.

Face bow a caliper . static and dynamic occlusal records for articulator programming and diagnostic set-ups. It also helps in achieving the exact anterioposterior or vertical Figure 3: Hanau Face Bow Streamdent. I would like to say that studies have proved that the masticatory performance was influenced by plane of orientation. an articulator which can't receive face bow transfer. The cluth or the frok on the mandible in case of edentulous patient is stabilized using a chin clamp. The rea re certain situations where in face bow transfer is not required. The fork is attached to the main frame of there is a pointer for the third point of reference like orbital pointer or nasion relator.Review article N Kalavathy et al placed over the posterior reference points. Eg: Hanau I32-25m andHanau I32-2c 4) 5) Kavo Arcus Facebow: A fully functional 3-dimensional computerized pantographic registration system to capture both. face bow record helps in securing anteroposterior positioning of cast in relation to condyles. There are attachments where the grids with graph paper are attached to frame which are either attached to maxilla. 2) 3) The facebow transfer record is an integral part in analyzing and studying the occlusion of the natural teeth. In case of a Kinematic type of facebow. insteated of a fork attached to maxilla. Accuracy and repeatability are unsurpassed. Once the facebow is adjusted. positioning of cast in relation to condyles. Figure 1: Facia type. 2011 39 . A facebow record is used to transfer these relationships. with all records permanently archived Clinical Advantages: D D D D D Full mouth Reconstruction .Cosmetic and Implant Diagnostic Wax-ups that are gnathologically correct Articulator programming functional disorders Splinttherapy set-up Orthognathic surgical treatment planning for TMJ derangements and Figure 2: Denar slidematic Earbow Conclusion The value of face bow has been a topic of considerable discussion and controversy in prosthetic dentistry for many years. Thus we are able to get a fine representative of the patient and biological restoration is possible. This helps to position the 'V' shaped frame at the center of the face. for example when monoplane teeth are being used. The true hinge axis is recorded when kinematic facebow is used. The better the cast on an articulator duplicate the distances to the condylar rotation centers. It records the intercondylar distance. The part of the assembly that is attached to the wax rim is called bitefork. Hence and hinge axis should be accurately captured and transfered to the articulator whenever required. it is attached to the mandible. teeth of held by head straps or worn as spectacles. Significance of a facebow usage": 1) The theoretical advantage of using a facebow includes the anatomical similarity of the resulting relationship between the teeth and the Condyles. there are locknuts that are tightened. and also hinge axis is an important component of mandibular movement which can't be disgraded. 2(1). the less the potential for articulator produced errors of motion. However.

2011 .Review article N Kalavathy et al Figure 10: Gysi's point Figure 11: Bergstorm's Point Figure 4: Whipmix quick mount bow Figure 12: BrandrupWognsen point Figure 13: Lauritzen and Bodner's point Figure 5: Kinematic facebow (Records true hinge axis) Figure 6: Orbitale Figure 7: Nasion Figure 14: Recent advances in face bow References l. 8. 94: 10-92 Hartwell CM. Syllabus of complete dentures. Elsevier. 2. 2(1). Glossary of Prosthodontic terms no. Figure 8: Alae of the nose Figure 9: Beyorns point 3. Zard-Bolender.Face bow a caliper . Rahn AO. 40 Streamdent. J Prosthet Dent 2005. Complete dentures and implant supported prosthesis. 4th edition Varshese publishing house. 12th edition Mosby.

2(1). J Prosthet Dent 1979. Streamdent.Review article N Kalavathy et al 4. 488-95 Schillingburg 3rd Prosthodontics. J Prosthet Dent. 2011 41 . 1980. 1953.Face bow a caliper . Wilkie ND. its significance application. 224-29.3. Bonder GR.43. Variations in location of arbitrary and true hinge axis position. J Prosthet Dent.11. 5. edition fundamentals of fixed Lauritzen AG. Walker PM. Wognsen TB. 279-85. 41. 8. Discrepancies between arbitrary and true hinge axis. 6. The facebow. 1961. J Prosthet Dent. The anterior point of reference. 618-28 and 7.

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