R E S T O R A T I V ER EDS ETNO TR IASTTI RV YE
Occlusion: 3.Articulators and
Related Instruments
Abstract: Dental articulators are instruments that reproduce jaw movements to
varying degrees of accuracy. This article aims to give an overview of the various types of
articulator and describe their applications and limitations.
Dent Update 2003; 30: 511–515
Clinical Relevance: An understanding of the use of articulators is central to the
successful provision of indirect restorations.
A rticulators can be classified as in
Table 1. A further division relates to
whether or not the condyle is attached to
the upper arm of the articulator: if it is, the
articular is ARCON – anatomically
articulated condyle, e.g. Denar, Whipmix.
When the condylar ball is on the lower
arm, the articulator is NON-ARCON (non-
anatomically articulated condyle), e.g.
Dentatus. The ARCON articulator
reproduces mandibular movement more
accurately.
HINGE ARTICULATOR
The hinge articulator is NOT an
articulator! At best it is a cast holder. The
only movement is an inaccurate opening
and closing. The shorter radius from the
centre of rotation to the lower incisors on
the hinge articulator, compared to the
patient, results in a more curved arc or
pathway for the incisor. After the casts are
mounted in ICP using an interocclusal
record, the record is discarded and the
Alex Milosevic, PhD, BDS, FDS RCS, DRD
RCS(Edin.), Consultant and Honorary Senior
Lecturer in Restorative Dentistry, Liverpool
University Dental Hospital, Pembroke Place,
Liverpool L3 5PS.
Dental Update – November 2003
D E N T I S T RY
ALEX MILOSEVIC
surfaces so that the FGP record can be
located on the working cast. Once the
crown is waxed up on the working die, the
FGP record is fully seated on it and any
interferences that show up on the wax can
be removed prior to casting.
PLANE LINE AND AVERAGE
VALUE
The average value instrument tends to be
casts are closed through the thickness of
the record. Because of the more curved
(shorter) pathway taken by the incisors,
larger than the plane line and
consequently better equipped to
reproduce jaw movement. Both
these meet prematurely with a wedge- articulators have limited lateral and
shaped space manifest between the teeth, protrusive movement, usually set at 30o
the greatest gap occurring posteriorly for condylar guidance angle, 15o for
(Figure 1). The consequent ‘high spot’ on
the restoration needs grinding down, more
so the further posterior the restoration. Hinge
Thinner records are preferable.1 Providing Plane line
there are sufficient teeth to gain ICP Average value
manually, it may be better not to take any
Semi-adjustable (Arcon or Non-arcon)
interocclusal record but relate the casts by
Fully-adjustable
visual and tactile methods.2 There is no
possibility of lateral or protrusive Fossa-moulded/stereographic
movement on this ‘articulator’. Therefore,
Table 1. Classification of dental articulators.
its applications are limited to the
manufacture of a single crown in an
otherwise fully dentate arch. It has no
place in diagnostic assessment. The risk
of introducing interferences on any
restoration can be reduced if the hinge is
used in conjunction with a Functionally
Generated Pathway. The FGP is obtained
by asking the patient to carry out
excursions on soft wax held within a
copper ring tightly placed on the Figure 1. The shorter radius from the ‘articulator’
centre of rotation to the incisor results in a more
preparation (Figure 2). The cuspal paths
curved arc of closure. Removal of a wax
carved into the wax (-ve impression) are interocclusal ICP record and closure through the
copied in impression plaster (+ve cast) thickness of wax leads to initial contact at the
with inclusion of the adjacent occlusal incisors and a wedge-shaped gap, widest posteriorly.
511
© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 131.172.036.029 on September 30, 2017.
Use for licensed purposes only. No other uses without permission. All rights reserved.
R E S T O R AT I V E
a b
c d
Figure 2. (a) Functionally generated path in soft wax retained within copper ring on prepared 6/
(46). (b) Plaster positive of FGP held in silicone putty (another case). (c) FGP placed on waxed up
crown. (d) Single waxed up crown on hinge ‘articulator’ with harmonious occlusal anatomy.
incisal guidance and 110 mm for inter-
condylar distance. For a couple of
posterior crowns or a short span
posterior bridge (max 3 units), an average
value can be used in preference to a
plane line, although for complete denture
construction this distinction may be less
important. Some intra-oral adjustment
may well be necessary, particularly RCP–
a
b respectively. For all diagnostic
Figure 3. (a) Dentatus semi-adjustable
articulator. (b) Dentatus with facebow
attached to condylar ball (Non-arcon) and
related to orbital pointer.
512
D E N T I S T RY
compensation allows other systems to
use an earbow placed into the external
auditory meatus, which is arguably more
user-friendly. The true position of the
terminal hinge axis can only be
determined dynamically using a kinematic
bow which is attached to mandibular
teeth. Pure rotation of the side arm
pointers indicates the place to mark the
skin for placement of the separate
maxillary bow and thus accurately relate
the maxillary cast to the hinge axis on the
articulator. Facebows correctly position
the maxillary cast spatially in 3-D by way
of the third reference point (usually the
orbital pointer) and thus give the
technician an aesthetic perspective.
The ability to adjust condylar guidance
ICP and on lateral excursions. For
replacement anterior teeth, the semi-
adjustable articulator is the instrument of
choice.
Figure 4. Denar MKII semi-adjustable.
THE SEMI-ADJUSTABLE
ARTICULATOR
These instruments are the workhorses for
many restorative problems (Figures 3 and
4). Although several different
manufacturers make semi-adjustable
articulators (see Table 2), the principles of <ICD
record taking and programming are
>ICD
similar. They require a facebow to relate
the maxillary cast to the hinge axis
accurately, plus interocclusal records in Figure 5. The effect of varying inter-condylar
distance (ICD) on cuspal paths. Red line
protrusion and left/right lateral excursion indicates true path with ICD of 110 mm. If ICD is
to programme condylar guidance angle greater (blue path) or less than (green path)
and Bennett shift and/or angle, true ICD, paths followed by the teeth on the
articulator will differ.
procedures (e.g. orthognathic treatment
planning, occlusal analysis) an RCP
(tooth apart) record is required, whereas
for restorative procedures either an RCP
or ICP record is indicated. Once again,
the latter can be dispensed with if a
sufficient number of teeth allow accurate
visual manipulation into ICP.
The average position of the hinge axis
for placement of the condylar points of Figure 6. Illustration of both the horizontal and
the facebow is 13 mm anterior to the vertical centres of rotation and the radius to a
tragus on the trago-canthal line. In-built cusp tip.
Dental Update – November 2003
© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 131.172.036.029 on September 30, 2017.
Use for licensed purposes only. No other uses without permission. All rights reserved.
 R E S T O R AT I V E D E N T I S T RY

ARCON
angle. Examples of fully adjustable
Denar MKII (Water Pik Inc. supplier Prestige Dental) articulators are:
KaVo EWL (KaVo, POB 1320, Leutkirch, D-88293, Germany)
SAM (Prazisionstechnik, Munich, D-8000, Germany)
Whip Mix 3040 (Whip Mix Corp. POB 17183, Louisville, Kentucky, USA)
l Denar D5A (see Figure 9) and
l Stuart.
NON-ARCON
Dentatus ARL/ARH (Dentatus Int. AB, Hagersten, Sweden, 126-53)
Gerber (Condylator, Zurich 8028, Switzerland)
These articulators require
Hanau (Teledyne Hanau, Buffalo, NY, USA) pantographic tracings to set the
adjustments. Upper and lower bows are
Table 2. Types of semi-adjustable articulator.
attached to the teeth via clutches and
separated by an intra-oral central bearing
a b point. Styli record the paths on tracing
tables after which the bows are locked,
dismantled from the clutches and re-
assembled on the articulator. Apart from
recording mandibular border movements
accurately, the pantograph has also been
applied as a diagnostic and prognostic
tool in the management of TMJ
Figure 7. (a and b) Techniques to check reproducibility of dysfunction. The Pantographic
intra-oral records. These show the Lauritzen split cast with Reproducibility Index (PRI) was
two different RCP records for the same patient.The gap in developed to confirm dysfunction and to
(b) alerts the dentist to a discrepancy during record taking. monitor progress of treatment.6 However,
It’s best to take at least three records in each position.
technique sensitivity, equipment expense
and the time involved in clutch
construction, recording and programming
angle and Bennett shift will facilitate holds the appropriate position and have deterred many dentists from
occlusal harmony of restorations within silicone is injected around the teeth (see investing in such instrumentation.
any given stomato-gnathic system. If previous paper on the RCP record). None
incisal guidance is unknown, i.e. in cases of the current techniques or materials is
with an old partial denture replacing all ideal (see Table 3), although certain waxes
four upper incisors or four poorly distort less (Moyco Beauty Pink supplied
contoured pontics on an upper six-unit by Procare). Finally, the paths taken
bridge, then incisal guidance can be between two points are linear on the semi-
customized in acrylic and then adjusted on adjustable articulator but curved in the
the incisal guidance table of the articulator. human condyle. Pathways on fossa-
Some instruments allow limited moulded and fully adjustable instruments
adjustment of the inter-condylar distance. are curved and thus more accurately
The horizontal path taken by a molar cusp reproduced. Dynamic methods rather than
across the opposing tooth with either a static wax records are utilized by some Figure 8. Another technique to check RCP
greater or lesser inter-condylar width on semi-adjustable articulators, such as the record accuracy or consistency. The Denar
Vericheck or Centricheck uses a special upper
the articulator is illustrated in Figures 5 Gerber. In this instrument, condylar arm with flags and pointers. Note the silicone
and 6. For clarity, this illustration does not guidance angle is gained using a kinematic buccal index record and the custom-made
consider the effect of Bennett shift. Some bow and the gothic arch tracing relates the acrylic incisal guidance table.
semi-adjustable articulators facilitate the casts in RCP. Techniques to check the
waxing-in of RCP-ICP movement, freedom accuracy of an RCP record are shown in l Does not displace teeth during
in centric. Figures 7 and 8. intercuspation.
Despite these added features, most l Little or no dimensional change on setting.
interocclusal records taken in wax are l Accurate reproduction of occlusal/incisal
prone to distortion.3 On withdrawal from FULLY ADJUSTABLE surfaces.
the mouth, great care is needed to avoid ARTICULATORS l Remains rigid after setting.
bending the heels of the record inwards. As the name implies, these instruments l Offers minimal resistance during closure
Closure into wax with muscle force risks provide more adjustments and greater in order to reduce mandibular flexion or
tooth and/or mandibular displacement/ accuracy, particularly in respect of displacement.
flexion4,5 which can be avoided by using changes in vertical dimension, border Table 3. Ideal requirements of a material used
buccal indices taken whilst the patient movements, Bennett shift and Bennett for inter-occlusal records.

514 Dental Update – November 2003

© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 131.172.036.029 on September 30, 2017.
Use for licensed purposes only. No other uses without permission. All rights reserved.

a b
Figure 9. (a and b) The Denar D5A fully-adjustable articulator and close-up view of the
complex condylar assembly.
a b
c 1981; 46: 304–307.
Moreover, for most restorative treatment,
the semi-adjustable articulator should
prove perfectly acceptable. Recent
development of an electronic jaw-tracking
device significantly reduces chairside
time (Figure 10). The system facilitates
determination of condylar guidance angle
and Bennett shift by having ‘flags’ akin
to recording tables over each TMJ, with a
stylus or sensor on a mandibular bow
attached to the teeth via a clutch. The
movements are digitized by the table/
stylus assembly and subsequently
shown on a LCD or printed as a
permanent record for the patient’s file.
STEREOGRAPHIC OR
FOSSA-MOULDED
Stereographic techniques simplify
articulator programming by dispensing
with the pantograph and using intra-oral
clutches with studs which mould soft
acrylic during border movements. These
Dental Update – November 2003
R E S T O R AT I V E
Figure 10. (a) Denar Cadiax facebow in
position via mandibular clutch. (b) Close-up
of electronic digitizing table/sensor assembly.
(c) Monitor showing left and right condylar
path during protrusion.
dynamically carved, intra-oral 3D records
are then transferred to the articulated
casts (Figure 11). Cold cure acrylic is
placed in special fossa inserts and
articulator excursions are guided by the
intra-oral engravings. Whilst the
articulator arm is moved, the condylar
head on the instrument carves the acrylic
resin in the fossa insert, thus generating
permanent condylar moulds that
incorporate condylar inclination, Bennett
shift and angle at the correct inter-
condylar width. Other devices utilize pre-
moulded plastic fossa analogues with
fixed Bennett angle and various Bennett
shifts. Condylar Guidance angle can be
varied either by orienting the analogue or
some analogues also have pre-set
condylar inclines.
Such instruments include:
l TMJ Stereographic system;
l Denar Combi and Anamark;
l Panadent Corp. USA.
© MA Healthcare Ltd. Downloaded from magonlinelibrary.com by 131.172.036.029 on September 30, 2017.
Use for licensed purposes only. No other uses without permission. All rights reserved.
D E N T I S T RY
CONCLUSION
Occlusion is not an inherently
complicated subject. Understanding
occlusion is not easy because
explanation of condylar and mandibular
movement is difficult. This has more to
do with the author or teacher trying to
get a message across to his/her
audience. Hopefully, readers will have
their appetites whetted for further
study.
R EFERENCES
1. Adrien P, Schouver J. Methods for minimising the
errors in mandibular model mounting on an
articulator. J Oral Rehabil 1997; 24: 929–935.
2. Walls AWG, Wassell RW, Steele JG. A comparison
of two methods for locating the intercuspal
position (ICP) whilst mounting casts on an
articulator. J Oral Rehabil 1991; 18: 43–48.
3. Mullick SC, Stackhouse JA, Vincent GR. A study
of interocclusal record materials. J Prosthet Dent
4. Teo CS, Wise MD. Comparison of retruded axis
articular mountings with and without applied
muscular force. J Oral Rehabil 1981; 8: 363–376.
5. Omar R, Wise MD. Mandibular flexure associated
with muscle force applied in the retruded axis
position. J Oral Rehabil 1981; 8: 209–221.
6. Shields JM, Clayton JA, Sindledecker LD. Using
pantographic tracings to detect TMJ and muscle
dysfunction. J Prosthet Dent 1978; 39: 80–87.
F URTHER READING
Klineberg I. Occlusion: Principles and Assessment, 1st ed.
Oxford: Wright, 1991.
Warren K, Capp NJ. Occlusal accuracy in restorative
dentistry: the role of the clinician in controlling
clinical and laboratory procedures. Quintessence
Int 1991; 22: 695–702.
Winstanley RB. A retrospective analysis of the
treatment of occlusal disharmony by selective
grinding. J Oral Rehabil 1986; 13: 169–181.
Wise MD. A Clinical Guide to Occlusion, 1st ed. BDJ
Publications, 2002.
Figure 11. Upper intra-oral clutch for dynamic
stereographic reproduction of mandibular
movement. Note: the three acrylic engravings
with a gothic arch trace.
515