ORIGINAL ARTICLE Year : 2023  |  Volume : 22  |  Issue : 3  |  Page : 316-320  

Comparison of accuracy of protrusive condylar guidance registration by two interocclusal recording materials in edentulous patients

C Dhinesh Kumar1, Sunantha Selvaraj2, Jayashree Mohan2, Ramesh Raju2
1 Department of Prosthodontics and Crown and Bridge, JKKN Dental College, Namakkal, Tamil Nadu, India
2 Department of Prosthodontics and Crown and Bridge, Vinayaka Mission's Sankarachariyar Dental College, Vinyaka Mission's Research Foundation-DU, Salem, Tamil Nadu, India

Date of Submission22-Apr-2022Date of Decision12-May-2022Date of Acceptance20-Jun-2022Date of Web Publication4-Jul-2023

Correspondence Address:
Sunantha Selvaraj
Department of Prosthodontics and Crown and Bridge, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation-DU, Salem, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/aam.aam_70_22

   Abstract 

Background and Purpose: During complete denture fabrication making Interocclusal records plays an integral role to obtain the condylar guidance value. The study was conducted to compare the protrusive condylar guidance registration by two interocclusal recording materials-Quick setting plaster and Luxabite®(bisacrylic composite) in semi adjustable articulator for completely edentulous patients. Methodology: Maxillary and Mandibular casts of the completely edentulous patients were mounted in Hanau®Wide Vue articulator. The Quick setting plaster and Luxabite®(bisacrylic composite) was used as interocclusal recording materials to program the protrusive condylar guidance angles in the articulators. Results: The protrusive condylar guidance values registered in the articulator for the different interocclusal records were tabulated and statistically analyzed.. The mean protrusive condylar guidance values registered in the articulator was compared with two parameters obtained from the radiographic tracings -- the protrusive condylar path angle obtained with Quick setting plaster and Luxabite with the inclination of articular eminence to the Frankfort horizontal plane. Conclusion: From the study it was concluded that the Luxabite®(bisacrylic composite) material demonstrated better reproducibility of protrusive condylar guidance registration.than the Quick setting plaster.

   Abstract in French 

Résumé
Contexte et objectif: Pendant la fabrication complète de la prothèse de prothèse, la fabrication des enregistrements d'interoccluse joue un rôle essentiel pour obtenir la valeur de guidage condylien. L'étude a été réalisée pour comparer l'enregistrement de guidage condylien en saillie par deux matériaux d'enregistrement interocclusal - Platter en plâtre et Luxabite® (composite bisacrylique) dans un articulateur semi-réglable pour les patients complètement édentés. Méthodologie: Les moulages maxillaires et mandibulaires des patients complètement édentés ont été montés dans l'articulateur de Hanau® à large de Vue. Le plâtre à réglage rapide et Luxabite® (composite bisacrylique) ont été utilisés comme matériel d'enregistrement interocclusal pour programmer les angles de guidage condyliennes en saillie dans les articulateurs. Résultats: Les valeurs de guidage condylien en saillie enregistrées dans l'articulateur pour les différents enregistrements interocclusaux ont été tabulées et analysées statistiquement. Les valeurs de guidage condyliennes en protruments moyennes enregistrées dans l'articulateur ont été comparées à deux paramètres obtenus à partir des tracages radiographiques - le protruments de l'angle de trajectoire condylien obtenu avec un plâtre rapide et luxabite avec l'inclinaison d'une éminence articulaire au plan horizontal de Frankfort. Conclusion: D'après l'étude, il a été conclu que le matériau Luxabite® (composite bisacrylique) avait démontré une meilleure reproductibilité de l'enregistrement de guidage condylien en saillie que le plâtre de réglage rapide.
Mots-clés: Guidage condylien, édenté, facebow, plan horizontal de Frankfort, dossier interocclusal, radiographie céphalométrique latérale, guidage condylien en saillie, articulateur semi-réglable

Keywords: Condylar guidance, edentulous, facebow, Frankfort horizontal plane, interocclusal record, lateral cephalometric radiograph, protrusive condylar guidance, semiadjustable articulator

How to cite this article:
Kumar C D, Selvaraj S, Mohan J, Raju R. Comparison of accuracy of protrusive condylar guidance registration by two interocclusal recording materials in edentulous patients. Ann Afr Med 2023;22:316-20
How to cite this URL:
Kumar C D, Selvaraj S, Mohan J, Raju R. Comparison of accuracy of protrusive condylar guidance registration by two interocclusal recording materials in edentulous patients. Ann Afr Med [serial online] 2023 [cited 2023 Jul 5];22:316-20. Available from: https://www.annalsafrmed.org/text.asp?2023/22/3/316/380162    Introduction 

The ideal combination of material and technique for making interocclusal records along with a proper selection of articulators would allow the fabrication of complete dentures for edentulous patients with minimum occlusal interferences and coordinated mandibular movements. Interocclusal recording materials such as dental plaster, base plate wax, zinc oxide eugenol, polyvinyl siloxane, and bis-acryl composite materials have been tested for reproducibility of the interocclusal recording of existing occlusion. According to the glossary of prosthodontic terms, the interocclusal record is defined as, “A registration of the positional relationship of the opposing teeth or arches or a record of the teeth or jaws to each other.” The semiadjustable articulators need either protrusive or lateral interocclusal records to program their condylar guidance values.[1],[2]

The purpose of this study is to evaluate the efficiency of quick-setting plaster, and LuxaBite bis-acryl composite materials to reproduce the horizontal condylar guidance angles when used with Hanau® Wide-Vue, semiadjustable articulator in a completely edentulous patient. The horizontal condylar guidance angles obtained with these two materials in a semiadjustable articulator are compared with the radiographically determined angle of slope of articular eminence to Frankfort horizontal plane for determination of correlation of horizontal condylar angle setting in semiadjustable articulator to anatomic angle of inclination of the articular eminence.[3],[4]

Objectives of the study

To compare the accuracy of two interocclusal recording materials, namely quick-setting plaster and bis-acrylic composite (LuxaBite) on the reproducibility of protrusive condylar guidance recordsTo compare the radiographic protrusive condylar guidance values obtained from quick-setting plaster and LuxaBite records with the angle of inclination of the articular eminence in the lateral cephalogram.    Methodology 

The present study was conducted in the department of prosthodontics, four edentulous patients of age 55–60 years with ideal Class I ridge relation, adequate vertical dimension, with no underlying temporomandibular joint disorders and tissue abnormalities were selected for the study. Informed consent from the patient was obtained before the study.

After completing the tentative jaw relation, the maxillary cast was transferred to the Hanau® Wide-Vue, semiadjustable articulator using Hanau® Earpiece Facebow. The mandibular cast was articulated using tentative centric relation. The extraoral Gothic arch tracers are attached to the maxillary and mandibular occlusal rims to obtain the tracing of mandibular movements. The interocclusal recording materials used in this study to obtain protrusive records are Bis-acrylic bite registration resin-LuxaBite (DMG, Germany), and quick-setting plaster[5][Figure 1]. Six interocclusal records were made using both materials for every four patients and a total of 48 records were used to program the Hanau semiadjustable articulator [Figure 2] to obtain the horizontal condylar guidance values. Two operators performed the articulator settings for all the protrusive interocclusal records to prevent operator bias. The horizontal condylar guidance angles recorded in each articulator for each of the protrusive interocclusal records were noted and tabulated.

Lateral cephalometric radiographs of the edentulous patients were made with Gothic arch tracers in centric and protrusive positions using interocclusal recording materials quick-setting plaster and LuxaBite (DMG, Germany) for both right and left sides of the patient.[6] The tracings of the radiographs were done. The tracings of the protrusive condylar positions were overlapped onto the tracing of centric positions for both right and left sides to obtain the radiographically determined protrusive condylar path angle with reference to Frankfort horizontal plane.

The mean protrusive condylar guidance values of both right and left sides obtained with two different interocclusal recording materials for all patients in Hanau® Wide-Vue articulator were compared with the protrusive condylar path angles of the right and left sides to Frankfort horizontal plane, obtained from radiographic tracings. The angle formed between the slope of the articular eminence and the Frankfort horizontal plane is called the angle of inclination of articular eminence[4][Figure 3] and [Figure 4]. This value was used to compare the condylar guidance values obtained from cephalometric tracing with two interocclusal recording materials quick-setting plaster, ad LuxaBite (DMG, Germany).[7],[8],[9]

Figure 4: Radiographic representation of angle of inclination of the articular eminence

Click here to view

Statistical analysis

Descriptive and comparative statistics are presented as mean, standard deviation, and coefficient of variance. Two-way ANOVA was also carried out to know possible interaction effect (interocclusal recording materials X articulator values) on protrusive condylar guidance angles.

Average deviations from the reference angles obtained from radiographic tracings of protrusive condylar path angle to the Frankfort horizontal plane were also presented for determining the articulator ability to simulate the patient's protrusive condylar guidance angle.

A P = 0.05 or less was considered for statistical significance.

The protrusive condylar guidance registrations obtained in all four edentulous patients with Hanau® Wide-Vue semiadjustable articulator with quick-setting plaster range from 35° to 42°, 35° to 45°, 40° to 45°, and 40° to 45°, respectively.

The protrusive condylar guidance registrations obtained in all four edentulous patients with Hanau® Wide-Vue semiadjustable articulator with LuxaBite material range from 30° to 40°, 35° to 40°, 32° to 38°, and 35° to 40°, respectively.

The results of two-way ANOVA for quick-setting plaster showed that a statistically significant difference was found between the patients P < 0.007 (significant difference = P < 0.01 and P < 0.05).

The results of two-way ANOVA for LuxaBite material showed that a statistically not significant difference was found between the patients P < 0.76 (not significant difference = P > 0.05) [Table 1] and [Table 2].

Table 1: Comparison of protrusive condylar guidance angles in four edentulous patients with two interocclusal recording materials to the reference condylar path angle to the Frankfort horizontal plane

Click here to view

Table 2: Comparison of the reference condylar path angle to the Frankfort horizontal plane, of two materials quick-setting plaster and LuxaBite to the radiographically determined angle of slope of the articular eminence

Click here to view

The radiographically determined protrusive condylar path angles obtained from quick-setting plaster record (41.5°) and LuxaBite material record (37°) were compared with the angle of inclination of articular eminence to Frankfort horizontal plane, i.e., (34°). The quick-setting plaster record showed a maximum percentage deviation of 22% and the LuxaBite material record showed a minimum percentage deviation of 9% [Figure 5].

Figure 5: Comparison with the angle of inclination of articular eminence to Frankfort horizontal plane

Click here to view

The protrusive condylar guidance angles with LuxaBite record in all four edentulous patients were also compared with radiographically determined angle of inclination of articular eminence to Frankfort horizontal plane, i.e., (34°). In Hanau® Wide-Vue articulator, it is 36.6° with a percentage deviation of 7.6% [Figure 6].

The protrusive condylar guidance angles with quick-setting plaster record in Hanau® Wide-Vue articulator is 41.8° with a percentage deviation of 23%, with reference to the radiographically determined angle of inclination of the articular eminence [Table 3] and [Table 4].

Table 3: Comparison of protrusive condylar guidance angles in four edentulous patients obtained with quick-setting plaster interocclusal records to the radiographically determined angle of slope of the articular eminence

Click here to view

Table 4: Comparison of protrusive condylar guidance angles in four edentulous patients obtained with LuxaBite interocclusal records to the radiographically determined angle of slope of the articular eminence

Click here to view

   Discussion 

The protrusive condylar inclination value is “the angle formed by the path of the moving condyle within the horizontal plane compared with the medial plane (anterior-posterior movement) and within the frontal plane when compared with the horizontal plane (superior-inferior movement) glossary of prosthodontic terminology (GPT)”.[9]

The protrusive interocclusal record is defined “as registration of the mandible in relation to the maxillae when both the condyles are advanced in temporal fossae”.[10]

The degree of correlation between the patient and the articulator depends on many factors, including biological considerations, the mechanical properties of the materials used for recording and transfer of maxillomandibular relations, and programming the articulators with protrusive and lateral records. Therefore, the proper selection of the interocclusal recording material is an important factor to be considered during the transfer procedure.[11] Most of the interocclusal recording materials have shown varying degrees of reproducibility when used along with the different semiadjustable articulators.[12],[13]

Skurnik emphasized that the bis-acrylic resin is easy to handle and has reproductive accuracy and is rigid when it sets; making it a good bite registration material for fixed, removable, unilateral, and bilateral restorations.[14]

The LuxaBite material demonstrated better accuracy and reproducibility of protrusive condylar guidance registration in all four edentulous patients in relation to the radiographically determined protrusive condylar path angle and also showed reliable registration with less variations of protrusive condylar guidance angulations when compared to the radiographically determined angle of inclination of articular eminence to Frankfort horizontal plane.[13],[14],[15]

   Conclusion 

In this comparative evaluation among the two materials, the LuxaBite recording material gives the most reliable protrusive condylar guidance angle value in all four edentulous patients in relation to the radiographically determined protrusive condylar path angle and also to the radiographically determined angle of inclination of the articular eminence to Frankfort horizontal plane.

The Quick setting plaster material gives higher protrusive condylar guidance angle value with large variations in all edentulous patients with relation to radiographically determined protrusive condylar path angle and with radiographically determined angle of inclination of articular eminence to Frankforts horizontal plane.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

   References 
1.Yurkstas AA, Kapur KK. Factors influencing centric relation records in edentulous mouths. 1964. J Prosthet Dent 2005;93:305-10.  
    2.Lucia VO. Centric relation – Theory and practice a technique for recoding centric relation. J Prosthet Dent 1964;3:492-505.  
    3.Grasso JE, Sharry J. The duplicability of arrow point tracings in dentulous patients. J Prosthet Dent 1968;20:106-15.  
    4.Corbett NE, Huffer R. The relation of articular eminence to condylar path in mandibular protrusion. J Orthod 1971;41:286-92.  
    5.Mullick SC, Stackhouse JA Jr., Vincent GR. A study of interocclusal record materials. J Prosthet Dent 1981;46:304-7.  
    6.Millstein PL, Kronman JH, Clark RE. Determination of the accuracy of silicone-body and self-curing resin interocclusal registrations. J Prosthet Dent 1981;46:380-4.  
    7.Lassila V, McCabe JF. Properties of interocclusal registration materials. J Prosthet Dent 1985;53:100-4.  
    8.Freilich MA, Altieri JV, Wahle JJ. Principles for selecting interocclusal records for articulation of dentate and partially dentate casts. J Prosthet Dent 1992;68:361-7.  
    9.Rahn AO, Heartwell CM. Text Book of Complete Dentures. 5th ed. Pennsylvania: Lea & Febiger; 1993. p. 250-1, 298.  
    10.Zarb GA, Bolender CL, Carlson GE. Boucher's Prosthodontic Treatement for Edentulous Patients. 11th ed. St. Louis: Mosby; 1997. p. 218-26.  
    11.dos Santos J Jr., Nelson S, Nowlin T. Comparison of condylar guidance setting obtained from a wax record versus an extraoral tracing: A pilot study. J Prosthet Dent 2003;89:54-9.  
    12.Vergos VK, Tripodakis AP. Evaluation of vertical accuracy of interocclusal records. Int J Prosthodont 2003;16:365-8.  
    13.Gilboa I, Cardash HS, Kaffe I, Gross MD. Condylar guidance. Correlation between articular morphology and panoramic images in dry human skulls. J Prosthet Dent 2008;99:477-82.  
    14.Vivas JL, Sierraalata M. Interocclusal record fabricated with bis-acrylic composite resin ans vinyl polysiloxane registration material. J Prosthet Dent 2009;102:199-2008.  
    15.Zabarović D, Vojvodić D, Katanec D, Jerolimov V, Carek V, Vusić J. Comparative study of condylar inclination settings in two types of semiadjustable articulators. Coll Antropol 2009;33:431-5.  
    
  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
  [Table 1], [Table 2], [Table 3], [Table 4]