FACE BOW AND

TYPES

Presented by B. Annapoorani Guided by – DR Uma Maheshwari

DR Karthigeyan
1st year postgraduate
 CONTENTS
• INTRODUCTION

• DEFINITION

• THE EVOLUTION OF THE FACEBOW

• ADVANTAGES

• WHAT IF FACEBOW IS NOT USED

• CLASSIFICATION OF FACEBOW

• ANTERIOR REFERENCE POINT

• POSTERIOR REFERENCE POINT

• PARTS OF FACEBOW

• CONCLUSION
• Maxilla is a part of the cranium and is a fixed entity.

• When the teeth of both jaws come in contact,

maxilla becomes related to the mandible so that
entire craniomaxillary complex is articulated with a
moving bone, which is the mandible.
• The upper jaw in the human skull is positioned
uniquely to the lower jaw. This position is different
for every person.

• The relationship of the maxilla to the

temporomandibular joint is not the same in all persons
i.e., the anatomy of maxilla and the temporomandibular
joint varies from persons to persons.
• The opening movement to bring the jaw from occlusal to rest
position is almost a pure hinge movement.

• Here the mandible moves on an arc of a circle with a definite

radius from the temporomandibular joint. This path of the
condyle is determined by the curvature of the condylar head
and curvature of
glenoid fossa
 Since the radius is not constant for all the patients, it has
to be determined for every individual patient, i.e., the relation
of maxilla to the opening and closing axis has to be
determined.
 TRANSVERSE HORIZONTAL AXIS

In the masticatory system, rotation occurs when the mouth opens and
closes around a fixed point or axis within the condyles.
In other words, the teeth can be separated and then occluded with no
positional change of the condyles .

ROTATIONAL MOVEMENT
AROUND A FIXED POINT IN THE
CONDYLE
When the condyles are in their most superior position in the articular fossae and
the mouth is purely rotated open, the axis around which movement occurs is
called the TERMINAL HINGE AXIS.

• Rotational movement around the terminal hinge can be readily

demonstrated but rarely occurs during normal function.
• Maximun range of terminal hinge rotation is about 12 degree
• Interincisal opening is 18-25mm
TRANSVERSE HORIZONTAL AXIS IS ALSO KNOWN AS
HINGE AXIS OR HORIZONTAL AXIS OF THE MANDIBLE
 ORIENTATION JAW RELATION
• They are those that orient the mandible to the cranium in such a way
that, when the mandible is kept in its most posterior unstrained
position, the mandible can rotate in a sagittal plane around an
imaginary transverse axis passing through or near the condyles.
GPT -8
 DEFINITION - FACEBOW

• A caliper like 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. (GPT 9)
 THE EVOLUTION OF THE FACEBOW

• BONWILL – 1860

• The distance between the centre of the CONDYLE and the

MEDIAN INCISAL POINT - 10cm.
 BALKWILL – 1866

• The angle formed by the occlusal plane and the

line passing through the condyle to the incisal

line of the lower teeth 22 – 30 degrees

• Distance between the condyles and

‘the front of the gums.

 THE CALIPER
• HAYES - 1880

• No control of the proper orientation of the occlusal plane

 CLINOMETER
• WALKER – 1890
• Was used only for measurement of the
condylar
inclination
• He mounted his cases in accordance with
the
the Bonwill Method
 SNOW

• Snow constructed an instrument that

became the prototype for all facebows in
1899
• The instrument allowed positioning of the
plaster casts on the articulator so that all
points on the occlusal plane (OP) were
given their correct positions in relation to the
condyles. The instrument allowed correct
anatomic positioning of the plaster casts on
the articulator.
• After the development of the Snow facebow, attempts were made to give the

occlusal plane an individual position in the third dimension.

• Snow set the bite- fork in such a position that when the occlusion rim was

placed in the mouth, the handle was parallel with a plane extending from the

bottom of the glenoid fossa to the anterior nasal spine (upper part of the

tragus to the lower edge of the nostril). This is known as the Bromell or

Camper plane.
 GYSI
• GYSI – Towards the end of the 19Th Century

• Protetische Ebene - Corresponds to the Frankfurt Horizontal

Plane
 ADVANTAGES OF THE FACEBOW
• It permits a more accurate use of lateral rotation points for the
arrangement of teeth.

• It aids in securing the anteroposterior cast position with relation to

the condyles of the mandible.

• It registers the horizontal relationship of the casts quite accurately,

and thus assists in correctly locating the incisal plane.

• It is an aid in the vertical positioning of the casts on the articulator.

 WHAT IF FACEBOW IS NOT USED ???

• If the maxillary cast is positioned without the correct

maxillae-hinge axis relationship, arcs of movement in the
articulator will occur which differ from those of the patient.
Moreover, the authentication of the mandibular cast spatial
position by using interocclusal records made at increased
vertical dimensions of occlusion will not be easy unless
subsequent records are the same thickness.
• An occlusion that is restored to an incorrect arc of closure or
opening axis may have interceptive and deflective tooth
contacts in the hinge-closing movement if there are
subsequent changes in the vertical dimension of occlusion.
Deflective contacts also may be present in functional and
parafunctional lateral movements from the time the restoration
is initially inserted.

• Such contacts are undesirable in either natural or artificial

occlusions and can contribute to periodontal trauma, muscle
spasm and TMJ pain.
 CLASSIFICATION OF FACEBOWS

FACE
BOW
ARBITRARY
KINEMATIC

FASCIA TYPE EAR PIECE TYPE

WITH NASAL RELATOR

WITH ORBITAL
INDICATOR
 THE PLANE OF ORIENTATION

• A horizontal plane established on the face of the patient by one anterior

reference point and two posterior reference points from which measurements
of the posterior anatomic determinants of occlusion and mandibular motions
are made. (GPT-9)

• Two points are located posterior to the maxillae and one point located
anterior to it.
• The posterior points are referred to as the posterior points of reference and
the anterior one is known as the anterior
Anterior reference Posterior reference
points points

• Orbitale • Bergstrom point

• Orbitale minus 7 • Beyrons point
mm • Gysi’s point
• Nasion minus 23 • Brandrup-Wognsen
mm point
• Alae of the nose • Lauritzen and
Bodner’s point
 ORBITALE
Orbitale is the lowest point of the
infraorbital rim of skull which can be
palpated on the patient through the
overlying tissues and the skin. One
orbitale and the two posterior points
that determine the horizontal axis of
rotation will define the axis - orbital
plane
 ORBITALE MINUS 7MM

The Frankfort horizontal plane passes through

both the porion and one orbital point. Because
porion is a skeletal landmark,
Sicher recommended to use the midpoint of the
upper border of the external auditory meatus as the
posterior cranial landmark on a patient. Most
articulators do not have a reference point for this
landmark.
Gonzalez pointed out that this posterior tissue
landmark on the average lies 7 mm superior to the
horizontal axis
 NASION MINUS 23MM

• This reference point is widely used by

Whip Mix articulator.

• Nasion guide is designed to fit into this

depression which can move in and out but
not up and down.

• Distance from realtor to anterior crossbar

is 23mm
 ALAE OF THE NOSE

• In most of the conventional

complete denture techniques it is
imperative to make tentative or
the actual occlusal plane parallel
with the horizontal plane.
 BERGSTROM POINT
• 10 mm anterior to the center of
the spherical insert for the
external auditory meatus and
7mm below the Frankfort plane.
Beyrons point

• 13 mm anterior to the posterior

margin of the tragus of the ear
on a line from the center of
tragus extending to the corner of
the eye.
 GYSI’S POINT

Gysi placed it 11–13 mm anterior to

the upper third of the tragus of the
ear on a line extending from the
upper margin of the external
auditory meatus to the outer
canthus of the eye.
Brandrup-Wognsen point

On line extending from the tragus to the lateral angle of eye, a point is
marked at about 12mm in front of posterior margin of most prominent
tragus.

• Lauritzen and Bodner’s point

A point 13mm anterior to the tragus on tragus-canthus line.

 Arbitrary Face bow

• The hinge axis is approximately located in this type of face

bow.

• It is commonly used for complete denture construction.

• This type of face bows generally locate the true Hinge axis
within a range of 5 mm.

• As the located hinge axis is

arbitrary, occlusal discrepancies
produced in the dentures should be
corrected by minor occlusal
adjustments during insertion.
 ARBITARY FACEBOW - EAR PIECE

• The External Auditory meatus is 6 – 6.5mm Posterior and 2.5mm

superior to the actual hinge axis point .

• Accurate relationship for most diagnostic and restorative

procedures

• .Eg : Whipmix, Slidematic etc

ADVANTAGES
• Simple to use.
• Do not require measurements
on face
• As accurate as other face
bows.
• It provides an average
anatomic dimension between
the external auditory meatus
and horizontal axis of
mandible
DISADVANTAGES
• Regardless of which arbitrary
position is chosen an error of
0.2 mm from the axis can be
expected.
• When coupled with the use of
a thick inter occlusal
record
made at an increased vertical
dimension. This factor can
lead to considerable
inaccuracy .
 ARBITRARY FACEBOW – FASCIA TYPE

FACIA TYPE
The approximate on the skin over TMJ region are used as
posterior reference point and the condyle rods of face bow placed over it .
 DISADVANTAGE
• As the face bow is placed on the skin which is movable there is a tendency
for the condylar rods to displace .

•Also requires an assistant to hold the face bow in place.

 KINEMATIC FACEBOW
• Facebow is attach to the lower jaw by
means of clunch
• Graph of grid paper is placed near TMJ
to detect stylus movement
 PRINCIPLE OF KINEMATIC
FACEBOW

When we consider rotation of any circular object , only the central points
rotates, any other point within the circle will show translatory movement .
 USES
• Kinematic facebows are indicated when it is crucial to precisely reproduce
the exact opening and closing movements of the patient on the articulator. ie
: full mouth rehabilitation

• For instance , to alter the occlusal vertical dimension during the

fabrication of the fixed prosthesis , a kinematic facebow record and centric
interocclusal record is needed ,Which in turn minimizes occlusal errors .
 HANAU FACEBOW – SPRING BOW

o In the Hanau Articlulator, a groove indicated the position of the occlusal

plane

o At this plane, The occlusal plane will be 3.5cm below

the intercondylar shaft

o Balkwills old average value position

o 13mm Anterior to the External Acoustic Meatus

o Infraorital Notch - Anterior reference point

 WHIPMIX FACEBOW

o Built in hinge axis locator

o First ear piece facebow used

o Special nasion relator assembly or infra orbital pointer can

also be added to the facebow ( Nasion – Orbitale Axis)

o Anterior reference point – A (Nasion) minus 23mm

 DENAR / SLIDEMATIC FACEBOW

• Can be modified into ear piece or facia bow

• Built in Pointer aligns the facebow with the horizontal

reference plane

• Anterior reference point – The point 43mm above the incisal

edge of the right central or lateral incisor / lower border

of the upper lip .

 PARTS OF FACEBOW

• U Shape frame work

• Condylar rods

• Bite fork

• Locking device

• Orbital pointer with clamp

 U SHAPE FRAME
• It forms the main frame of the face
bow.
• All other components are attached to
this frame.
• It extends from the region of TMJ on
one side to other side without
contacting .
• Two small metallic rods on either side of
the free end of the U shaped frame that
contact the skin over the TMJ.
• They are used to locate the hinge
axis and transfer it to the articulator.
• Some face bows have ear piece that fit
into the external auditory meatus
 “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.
 LOCKING DEVICE

This part of the face bow helps to fix

the bite fork to the U-shaped frame
firmly after recording the orientation
jaw relation.
 REFERENCE POINTER

Third reference point is used to

orient the face bow assembly to
a anatomical reference point on
the face along with the two
condylar reference points.
VIRTUAL FACEBOW
 Conclusion

• Failure to use the face bow leads to error in occlusion.

• Hinge axis is a componenet of every masticatory
movement of mandible and therefore cannot be
disregarded and this hinge axis should accurately
captured and transferred to the articulator ,comfort for
patient and biologically acceptable restoration is
possible.
 REFERENCES
• Syllabus for edentulous patient – heartwell

• Essentials of complete denture – wrinkle

• Prosthodontic treatment for edentulous patient – Boucher

• Face-bow transfer in prosthodontics: a systematic review of the literature

• A. Farias-neto, a. H. M. Dias, b. F. S. De miranda & a. R. De oliveira Health

School, Potiguar University – Laureate International Universities, Natal, Brazil
• Wilkie ND. The anterior point of reference. J Prosthet Dent 1979;41:488-96.

• Comparison of cast positions by using four face-bows

J. R. Goska, D.D.S.,* and L. V. Christensen, D.D.S.** Marquette

University, School of Dentistry, Milwaukee, Wis.

• In vitro comparison of the maxillary occlusal plane orientation

obtained with five facebow systems

Thomas C. Maveli, DDS,a Montry S. Suprono, DDS, MSD,b Mathew
T. Kattadiyil, BDS, MDS, MS,c

Charles J. Goodacre, DDS, MSD,d and Khaled Bahjri, MD, MPHe

 This part of the face bow helps to fix the bite fork to
the U-shaped frame firmly after recording the
orientation jaw relation.