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Original Research

Revising Average Condylar Inclinations Using Electronic

Pantograph Assessment: A Cross-Sectional Study
Safoura Ghodsi, Sasan Rasaeipour
Department of Prosthodontics, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

Abstract
Introduction: Condylar inclinations produce a frame for the occlusal morphology of dental restorations. Applying arbitrary average values
for the articulator settings has brought about more practicality to the prosthesis fabrication procedures. The present study aimed at determining
the average sagittal condylar inclination (SCI) and Bennett angle (BA) using electronic pantograph and comparing the inclination quantities
obtained from different methods to proposed average measurements. Materials and Methods: Using Cadiax Compact II, condylar
inclinations were recorded in 50 participants, generally healthy without any signs of joint problems. The recorded average values were
compared with proposed mean values using one sample t-test. The level of significance was set at P < 0.05. The available articles were also
searched using electronic databases. Results: A statistically significant difference was observed in the mean SCI (41.66°) and the proposed
average value (33°) (P < 0.05). The difference between BA mean value (10.10) and arbitrary proposed value (15) was even more pronounced
(P < 0.05). Pantographic records show different values compared to average propositions for condylar inclinations. Conclusion: Ongoing
controversies concerning the average values for articulator settings proposed a revision in traditionally used arbitrary settings as well as Hanau
formulation on the sagittal and lateral inclination interrelationships.

Keywords: Anatomy, jaw biomechanics, jaw relation record/methods, occlusion

INTRODUCTION afterwards. With regard to the formula, L = H/8 + 12, in

Mandibular movements are naturally dictated by the
anatomic structure of the bony components in mandibular
joints, the thickness and shape of the medial portion of the
articular disc, the ligaments, and the masticatory muscles.[1]
Whatever introduced to the mouth (including dental
prostheses) is required to coordinate with this
predetermined system to prevent future complications.
Condylar inclination is a critical determinant of
mandibular movements that plays a pivotal role in
fabrication of different types of prostheses.[2,3]
Although various procedures have been proposed to register
condylar inclination, some authors suggest using average
values for the majority of restorative procedures.[4-9]
Average condylar inclinations have been suggested many
years ago by measuring values resulted from intraoral
records; their application was proposed to simplify the
prostheses fabrication. According to sagittal condylar
inclination (SCI), Hanau in 1930 introduced a formula for
Bennett angle (BA) determination that became very popular
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which L is BA and H represents SCI. As the proposed average
SCI was 33°, the resulted average BA was 15°. These mean
values have been routinely used in prosthetic treatments for
years.[10]
Average settings are able to satisfy the demands of treatment
and are reliably applicable in a variety of situations. Factors like
gender, nationality, and even age are the roots of extensive
controversies on the amounts of average values.[11-16] Different
quantities have been reported as average SCIs using different
methods.[5,7,9,11,13,17-43] Following the introduction of the new
recording instruments, the condylar guidance adjustments were
reevaluated.[19,30,33-37] The mechanism of inclination
registration is the main difference between traditional
Address for correspondence: Dr. Sasan Rasaeipour, Department of
Prosthodontics, Dental Research Center, Dentistry Research Institute, School
of Dentistry, Tehran University of Medical Sciences, North Kargar St, Tehran,
14399-55991, Iran.
E-mail: drrasaeipour@yahoo.com
This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as
appropriate credit is given and the new creations are licensed under the identical
terms.

For reprints contact: reprints@medknow.com

DOI: How to cite this article: Ghodsi S, Rasaeipour S. Revising Average

10.4103/denthyp.denthyp_20_17 Condylar Inclinations Using Electronic Pantograph Assessment: A
Cross-Sectional Study. Dent Hypotheses 2018;9:84-9.

84 © 2019 Dental Hypotheses | Published by Wolters Kluwer - Medknow

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Rasaeipour and Ghodsi: Average condylar inclinations
methods of condylar guidance recording (by interocclusal
materials) and the pantographic method. Interocclusal
materials record just two points of condylar path: the centric
relation (CR) point and the last point of mandibular excursive
movement. However, condyle does not move in a straight line.
The double ogee curve of the glenoid fossa will cause the
apparent path of the condyle to be different with varying values
of mandibular protrusion.[3] This rang the bell for a revision of
what normally considered as the average arbitrary settings.
Relying on an electronic pantograph (Cadiax Compact II,
Whip Mix Corp, GAMMA Medizinisch-wissenschaftliche
Fortbildungs-GmbH, Klosterneuburg, Austria), the present
study aimed at determining the average SCI and BA among a
group of participants. Furthermore, reviewing the available
articles, the present study tried to evaluate the condylar
inclination quantities resulted from different measuring
procedures. The null hypothesis was that the average
values for SCI and BA obtained from different measuring
methods would have no significant difference compared to
routinely accepted average quantities.
MATERIALS AND METHODS
All procedures were in accordance with the ethical standards
of the institutional research committee and the 1964 Helsinki
declaration. All persons gave their informed consent prior to
their inclusion in the study. The study was authorized to use
human participants by the university human research ethics
committee (ethical approval code: 139).
The inclusion criteria were as follows: The absence of any
symptoms of temporomandibular joint diseases, myofascial
pain, and intra/extracapsular disorders, normal or near
normal overjet and overbite (2–4 mm), and the capability
to move the mandibular jaw at least 6 mm in all excursive
movements.
Based on the requirements of the study, the exclusion criteria
consisted of these conditions: physical or psychological
illnesses preventing the attachment of a facebow for
registration purposes, the lack of capability to follow or
carry out the attending dentist’s instructions correctly, and
dental or periodontal diseases.
According to inclusion/exclusion criteria, 50 healthy cases
were selected. The cases came in both genders (17 females
and 33 males) with an average age of 26 years; the
participants had all their teeth to support the clutch. They
were selected from the under/postgraduate students of
Table 1: Detailed average condylar inclinations
Condylar inclination N Min. Max.
SCI Right SCI 50 32.6512 53.1305
Left SCI 50 33.0138 51.8410
BA Right BA 50 5.2418 17.0958
Left BA 50 6.0503 16.1608
BA = Bennett angle, SCI = sagittal condylar inclination. a All results had significant difference compared with average inclinations.
Dental Hypotheses ¦ Volume 9 ¦ Issue 4 ¦ October-December 2018
dentistry who were familiar with the requested jaw
movements. This, indeed, minimized the errors resulted
from movements’ inaccuracy. All the measurements were
performed by the same operator (the first author).
Pantographic records were made using Cadiax Compact II.
The patients were guided to centric position, and all
movements (forward and lateral movements, and open/
close) were recorded three times. Before each, the system
was calibrated. Cadiax Compact recorded the average SCI
and BA values. The results were compared with routinely
used mean values (33° for SCI, and 15° for BA) using Epicalc
2000 software (Brixton Health, http://www.brixtonhealth.
com/epicalc.html) by one sample t-test.
The search for available literature up to the year 2016 was
performed through electronic databases (PubMed, Google
Scholar, Medline, and Cochrane) applying each or
combinations of following keywords: condylar inclinations,
horizontal condylar angle, BA, average inclination, condylar
guidance, interocclusal records, Pantographic records,
radiographic evaluation, jaw relation records, and Hanau’s
formula. After reviewing the abstracts of more than 230
articles, the most relevant literatures were selected, their full
texts were obtained, and the results of condylar guidance
recording were extracted. The predetermined inclusion
criteria were any English language article published in a peer-
reviewed journal containing any of the search terms; the
articles published between 1959 and 2016; and any article
that evaluated and measured the condylar inclinations using
any of the different methods. The articles that did not measure
or report the posterior guidance angulations were excluded.
RESULTS
Assessing the included participants, who were apparently healthy
without any symptom of temporomandibular, occlusal, dental,
and periodontal problems, the following results were obtained.
The average values for SCI obtained by Cadiax Compact (41.66)
were considerably higher than what proposed as the mean value
(33°) (P < 0.05). The mean (standard deviation) SCI was 42.15
(5.35) for right the temporomandibular joints (TMJ), and 41.18
(5.74) for left side.
The average values for BA recorded by Cadiax (10.10) were
much less than what is obtainable using Hanau formula (15°)
(P < 0.05). The mean (standard deviation) BA quantity was
10.19 (3.49) for right side, and 10.02 (5.11) for left TMJ. All
the differences between recorded values and routinely used
Mean Std. deviation Mean std. error Pa
42.1536 5.35089 1.14081 <0.001
41.1811 5.74795 1.22547 <0.001
10.1919 3.49056 0.74419 <0.001
10.0218 5.11280 1.09005 <0.001
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Rasaeipour and Ghodsi: Average condylar inclinations

average values were statistically significant (P < 0.05).
Table 1 shows the detailed results.
Table 2 demonstrates the separated data extracted from
articles reviewed. Pantograph recordings showed more SCI
quantities compared to intraoral records, and mean BA
recorded by pantograph was less than what proposed using
intraoral records or Bennett formulation.
DISCUSSION
For dental restorations to be durable and cause no long-
term discomfort for the patients, harmony with individual
jaw movements is crucial. Complicated dental
reconstructions call for accurate condylar guidance
recording. However, in routine prosthetic procedures,
average value could simplify the process while fulfilling
the treatment purposes.
SCI, by definition, is the angle of condylar guidance
inclination to Frankfort horizontal plane. Condyle moves
through a rather steeper incline in the first 3 mm.[38,39]
Two points recording will not register this steeper part
[Figure 1], whereas pantographs record the whole condylar
pathway, and show the mean measurement according to the
amount of condylar Travers. Therefore, it will be apparent
that SCI recorded by intraoral bite registration materials
would be less than pantographic average. This is in
agreement to several studies.[7,11,13,15,18,19,24,26,30,32,40-43]
BA is the angle formed by the sagittal plane and the path of
the advancing condyle during lateral mandibular movement
as viewed in the horizontal plane. According to Boulos
et al.,[31] intraoral records do not depict the immediate
mandibular lateral translation that is expressed in a 10th of
a millimeter. Therefore, the recorded BA using conventional
two points registration method, or Hanau formula (which was

Table 2: Different articles recorded dissimilar average condylar inclination values

Authors Method of measurement Average SCI (degrees) Average BA (degrees)
Shillingburg et al.[5] Intraoral records 30.4
Anderson[9] Intraoral records 33 15
Isaacson[17] Intraoral records 35.56 12.3
Ecker et al.[18] Intraoral records—wax 32.41
Torabi et al.[19] Intraoral records—wax 39.04 15.99
Prasad et al.[20] Intraoral records—wax 34.85
Shahidi et al.[21] Intraoral records—additional silicone 29.80
Goyal and Goyal[22] Intraoral records—additional silicone 33.75
Vankateshwaran et al.[23] Intraoral records—additional silicone 25.47
Prasad et al.[41] Intraoral records—wax 33.25
Galagali et al.[42] Intraoral records—wax 34.16
Bhawsar et al.[43] Intraoral records—plaster/Bennett formula 15.07
Prasad et al.[20] Radiographic—panoramic 37.43
Goyal and Goyal[22] Radiographic—lateral cephalogram 36.05
Vankateshwaran et al.[23] Radiographic—TMJ tomogram 30.47
Shreshta et al.[24] Radiographic—CT 43.12
Galagali et al.[42] Radiographic—panoramic 35.26
Galagali et al.[42] Radiographic—lateral cephalogram 34.59
Lundeen and Wirth[7] Pantograph 45 10
Payne[11] Electronic pantograph 42.7 6.22
Hernandez et al.[13] Electronic pantograph 48.85 8.2
Alshali et al.[15] Electronic pantograph 41.9
Ecker et al.[18] Electronic pantograph 37.38
Torabi et al.[19] Electronic pantograph 41.63 10.63
Preti et al.[25] Mechanical pantograph 33
Zamacona et al.[26] Mechanical pantograph 36.15
El-Gheriani and Winstanley[27] Pantograph 25.88
Curtis[28] Pantograph 29.5 10.2
Theusner et al.[29] Modified SAM axiograph 7.8
Beard et al.[30] Electronic pantograph 36.7 5.15
Boulos et al.[31] Electronic pantograph 11.1
Aull[32] Stuart pantograph 37.15
Prasad et al.[41] Axiograph (Axioquick system) 42.13
Bhawsar et al.[43] Computerized K7 jaw tracking device 19.53
Present study Electronic pantograph 41.66 10.10
SCI recorded by pantograph is generally more than what recorded using intraoral procedures, but the main difference is in BA values. TMJ, temporomandibular joints.

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Rasaeipour and Ghodsi: Average condylar inclinations

Figure 1: Condylar guidance anatomy and different inclinations recorded using different methods (a: the angle recorded by pantograph, b: the angle
recorded by intraoral record, AO: the pathway depicting first few millimeters of condylar movement with steeper incline, BO: the pathway recorded
using intraoral records that misses the most important part of the incline)
introduced using conventional method) will always be higher CONCLUSION
than what is recorded by pantographic device (which shows
the mean quantity of whole condylar lateral pathway) SCI measurement using electronic pantograph (Cadiax Compact
II) showed significantly higher values in comparison to routinely
[Figure 2]. This result is in agreement to Hernandez
et al.,[13] Torabi et al.,[19] and several other studies.[7,11,28-31] used average quantities (33°) (P < 0.05).

A review on available literature from 1959 up to now, showed
that what had been proposed as average condylar settings (and
were widely accepted and applied for years), are not supported
by the application of new equipment. Although there are
differences in average values according to age, sex, and
nationality, generally, average SCI reported by pantographs
and different types of pantronics is more than what could be
obtained using intraoral records, and mean BA recorded by new
devices is far less than what proposed using intraoral records
and Bennett formulation [see Table 2].[5,7,9,11,13,17-43] New
apparatus helped us to improve our scientific visions in
many aspects; it seems now is the time to revise our
assumption regarding condylar adjustment.
In the present article, mean SCI was 41.66, with scanty
difference between right (42.15) and left (41.18) sides. The
average BA was 10.10 (10.19 on right, and 10.02 on left). The
results rejected the null hypothesis. It seems Hanau formula
for BA is not applicable for relating these values, and BA
could be related to SCI by a revised formulation: BA =
horizontal condylar inclination (HCI)/8 + 5.
Electronic pantograph records significantly lower values for
BA compared to what has been proposed for arbitrary
articulator adjustment (15°) (P < 0.05).
The relationship between SCI and BA, obtained through the
application of pantographs and new recording devices, does
not follow Hanau formula for BA.
Authors’ contribution
All the authors substantially contributed in
(1) Concept and design of study or acquisition of data or
analysis and interpretation of data;
(2) Drafting the article or revising it critically for important
intellectual content; and
(3) Final approval of the version to be published.
Manuscript has been read and approved by all the authors.
Financial support and sponsorship
Nil.

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Rasaeipour and Ghodsi: Average condylar inclinations

Figure 2: Diagram shows the nonworking condyle pathway during excursive movements (a: the Bennett angle recorded by two-points intraoral record,
b: the angle recorded including immediate lateral side shift, OA: immediate lateral side shift, OB: nonworking condylar pathway in mediotrusion)

Conflicts of interest Zarb G, editor. Prosthodontic treatment for edentulous patients:

There are no conflicts of interest.
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