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Published on: January 28, 2020
Guided and unguided mandibular reference positions in asymptomatic individuals
A Celar1, J Freudenthaler, A Crismani
1Orthodontic Division, Bernhard Gottlieb Dental Clinic, Medical University of Vienna, Vienna, Austria. ales.celar@meduniwien.ac.at
Orthodontics & Craniofacial Research
|January 15, 2013
Summary
Guided mandibular positioning showed a statistically significant, though not clinically relevant, difference compared to unguided methods in articulator simulations. Repeatability varied between techniques, with individual differences being the largest source of variance.
Area of Science:
- Dental occlusion and biomechanics.
- Orthodontic treatment planning and assessment.
Background:
- Accurate determination of mandibular reference positions is crucial for diagnosing and treating occlusal disorders.
- Articulator simulation is a common method for evaluating jaw relationships.
Purpose of the Study:
- To compare condylar positions obtained through guided versus unguided mandibular reference positioning using articulator simulation.
- To assess the repeatability and variability of these two methods.
Main Methods:
- Three examiners performed bimanual guided and unguided stationary hinging on 37 participants (19 male, 18 female) without temporomandibular disorders.
- Occlusal wax recordings were made, and condylar positions were measured using a 3D electronic condylar position indicator on an articulator.
- Measurements were repeated after 8 and 17 days.
Main Results:
- Bimanual guidance resulted in condylar positions that were, on average, 0.1 mm more right and 0.6 mm more posterior and superior than unguided hinging (p < 0.04).
- Repeatability was generally better with bimanual guidance (SD 0.19-0.4 mm) compared to unguided hinging (SD 0.41-0.76 mm).
- Individual variation contributed most to the total variance, followed by days, then intra- and inter-operator variability.
Conclusions:
- A statistically significant difference exists between guided and unguided mandibular positioning methods in articulator simulations.
- This difference is not considered clinically relevant, suggesting both methods may be acceptable within study limitations.
- Individual variability plays a substantial role in condylar position measurements.
