A digital approach to the evaluation of mandibular position by using a virtual articulator

The purpose of this technique report was to describe a fully digital technique to evaluate the mandibular position both in centric relation occlusion (CRO) and maximal intercuspation position (MIP). The procedure transfers data relative to the position of the maxillary and mandibular dentition to a virtual articulator based on a single cone beam computed tomography (CBCT) image. A CBCT scan of the patient was obtained in CRO, and the maxillary and mandibular casts were scanned both in CRO and MIP with an intraoral scanner. The model CRO scan data were registered on the dental part of the CBCT image by using a virtual articulator program, and a virtual facebow transfer process and mounting was performed. The virtual articulator was positioned in the right and left condyle medial pole and right orbitale. The mandibular position was evaluated in CRO and MIP by superimposing the data of the mandible position in both CRO and MIP. A quantitative 3D measurement was obtained by using the grid function. Based on this protocol, it is possible to use a fully digital approach to transfer the position of a patient's maxillary dentition to a virtual articulator based on the data from a single CBCT scan and intraoral scans. This technique eliminates the traditional facebow transfer and mounting process and complicated laboratory procedures for evaluating mandibular positional changes in CRO and MIP.