Comparative evaluation of sagittal condylar guidance obtained from a clinical method and with cone beam computed tomography in dentate individuals

doi:10.1016/j.prosdent.2020.02.033

The Journal of Prosthetic Dentistry

Volume 125, Issue 5, May 2021, Pages 753-757

https://doi.org/10.1016/j.prosdent.2020.02.033 Get rights and content

Abstract

Statement of problem

Programming semiadjustable and fully adjustable articulators involves time-consuming clinical steps which can be avoided if an accurate radiographic method can accurately determine the condylar guidance angles.

Purpose

The purpose of this clinical study was to compare the sagittal condylar guidance in dentate individuals as determined by a clinical method, protrusive interocclusal record, and a radiographic method, cone beam computed tomography. If the methods show a correlation, then cone beam computed tomography can be used as a time-saving method of programming an articulator for patients requiring a cone beam computed tomography scan.

Material and methods

A total of 40 participants (20 men and 20 women) within the 20 to 40 years age group were enrolled according to the inclusion and exclusion criteria. Cone beam computed tomography scans were obtained, and by using an appropriate software program, the sagittal condylar guidance was measured for both sides. A protrusive interocclusal record was obtained by using polyvinyl siloxane material. The maxillary cast of each participant was mounted on a semiadjustable articulator with a facebow transfer, and the mandibular cast was mounted with a maximum intercuspal record. The protrusive record was then transferred to the articulator for programming.

Results

The right and left sagittal condylar guidance values obtained from both the protrusive interocclusal record and cone beam computed tomography method were comparable, with no significant differences (P>.05). The difference in condylar inclination values for both sexes obtained from both methods for both sides were not statistically different (P>.05). With increasing age, condylar inclination values obtained from both methods tended to decrease. The values for sagittal condylar guidance obtained from both methods (protrusive interocclusal record and cone beam computed tomography) were comparable and correlated.

Conclusions

Cone beam computed tomography measurement involves stable bony landmarks and can be standardized, whereas clinical methods are time consuming and can provide inaccurate results because of the instability of the materials used to register the maxillomandibular relationship. Thus, cone beam computed tomography can be used to obtain the sagittal horizontal guidance for programming semiadjustable and fully adjustable articulators for patients requiring a cone beam computed tomography scan.

Section snippets

Material and methods

An ethical clearance certificate for the study was obtained from the institutional review board (IRB No: MRADC&H/ECIRB/0827/2016-17). The authors are unaware of previous studies that compared SCG angles obtained by clinical methods and from CBCT scans. Hence, an appropriate sample size (N=40) was calculated from a pilot study with 5 participants. Forty participants (20 men and 20 women) between 20 and 40 years were enrolled from among the patients who reported to the Outpatient Department of

Results

Condylar guidance angle obtained for both the right and left sides by using both the clinical (PIR) and CBCT techniques for all the participants are presented in Table 1. No significant differences were found between the condylar inclination obtained for both the sides with the CBCT (P=.440) or PIR method (P=.680) (Table 2). Figure 2 shows the correlation between the condylar inclination angle values obtained from the CBCT and PIR method on the right and left sides. Table 3 and Table 4 show

Discussion

Based on the results of this clinical study, the null hypothesis was accepted. The difference between the left and right condylar inclination values obtained from the clinical and radiographic method were not statistically different, results consistent with Shreshta et al.¹⁷ However, El Gheriani and Winstanley¹⁹ and Zamacona et al¹ reported significant differences between the left and right condylar guidance values.¹⁹ The difference with Zamacona et al's results may be attributed to the

Conclusions

Based on the findings of this clinical study, the following conclusions were drawn:

1.
The right and left SCG angle values obtained from both the PIR and CBCT methods were comparable with no significant difference (P>.05).
2.
There was no significant difference between the right and left side SCG angle values for both sexes obtained from CBCT and PIR methods.
3.
With increasing age, SCG angle values obtained from both the methods tend to decrease.
4.
CBCT scans, with advantages over other radiographic and

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Preliminary clinical study of the accuracy of a digital axiographic recording system for the assessment of sagittal condylar inclination
2023, Journal of Dentistry
The aim of this study was to clinically evaluate the accuracy of a digital axiographic recording system in tracing the sagittal condylar inclination.
An axiographic examination that records the sagittal condylar path during protrusive/retrusive movement was performed on ten patients. Each subject was registered five different times by two different systems: 1) the Cadiax Gamma Diagnostic 4 computerized system as the control; 2) the Zebris Jaw Motion Analyser+ Optic System as the tested digital axiographic recording system. The records obtained allow to calculate the kinematic terminal transverse horizontal axis and the sagittal condylar inclination (SCI) at 3 and 5 mm along the pro-retrusive path. A linear mixed model was used to analyze if there was a statistically significant difference between the two systems.
The mean left SCI value recorded by Zebris system were 49.81 ± 10.64° at 3 mm, 48.10 ± 11.04° at 5 mm, while the values recorded by Gamma system were 55.16° at 3 mm, 52.18° at 5 mm. The mean right SCI value recorded by Zebris system were 54.53 ± 10.26° at 3 mm, 51.85 ± 8.55° at 5 mm, while the values recorded by Gamma system were 49.68° at 3 mm, 48.23° at 5 mm. Linear mixed model showed no significant statistical difference between the two systems.
Based on preliminary results, the Zebris Jaw Motion Analyzer+ Optic System demonstrates comparable accuracy to the Cadiax Gamma Diagnostic 4 when measuring sagittal condylar inclination.
The digital axiographic recording system enables to evaluate sagittal condylar inclination and to adjust virtual articulators in a digital workflow.
Sagittal condylar guidance angle measurement methods: A systematic review
2023, Journal of Prosthetic Dentistry
Precise assessment of the condylar guidance angle can aid successful prosthodontic treatment. However, the reliability and accuracy of current methods remain unclear.
The purpose of this systematic review was to evaluate the reliability and accuracy of current methods of determining the sagittal condylar guidance angle, including protrusive interocclusal records, axiography, cone beam computed tomography (CBCT), and panoramic and cephalometric radiographs.
A literature search was conducted using BASE, Embase, PubMed, and Web of Science databases up to June 2022. Inclusion criteria involved studies that compared protrusive interocclusal records against other methods of sagittal condylar guidance angle assessment in adult dentate and edentulous patients. Studies that did not provide the values for the right and left joint separately were excluded. The methodological quality of the included studies was assessed by using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data were tabulated and analyzed for correlations and their significance.
A total of 24 articles qualified for the analysis. The differences between protrusive interocclusal records and panoramic radiograph sagittal condylar guidance angle values were up to 9 degrees. Lateral cephalometric radiographs revealed greater condylar guidance values than facebow transfers or the Bonwill methods. Correlations between average sagittal condylar guidance angle values obtained from CBCT and protrusive interocclusal records differed depending on the method of registration. For protrusive interocclusal records, axiographic or pantographic measurement variance analysis showed that the condylar inclination values recorded with wax were statistically lower than those recorded with a pantograph (P<.05).
Although CBCT appears to be the most suitable method of evaluating the sagittal condylar guidance angle, the limitations and discrepancies among methods, including protrusive interocclusal records and panoramic and cephalometric radiographs, should be acknowledged. Digital axiography, with its potential to capture comprehensive functional data, may surpass other techniques. The use of mean values for articulators may be a practical solution for some patients. Further research is needed to refine sagittal condylar guidance angle assessment methods and to develop more reproducible and reliable approaches for the future.
A systematic review and meta-analysis of accuracy between protrusive interocclusal record and horizontal condylar guidance angle recording methods in dentulous patients
2024, Journal of Indian Prosthodontic Society
Evaluation of the accuracy of a fully digital method of measuring sagittal condylar inclination
2024, Hua Xi Kou Qiang Yi Xue Za Zhi / West China Journal of Stomatology
Evaluation and Comparison of Conventional Techniques with the Advanced Axiographic Technique in Recording Condylar Guidance
2023, World Journal of Dentistry
Comparison of the performance of various virtual articulator mounting procedures: a self-controlled clinical study
2023, Clinical Oral Investigations

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Clinical ResearchComparative evaluation of sagittal condylar guidance obtained from a clinical method and with cone beam computed tomography in dentate individuals

Abstract

Statement of problem

Purpose

Material and methods

Results

Conclusions

Section snippets

Material and methods

Results

Discussion

Conclusions

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

J Prosthet Dent

The glossary of prosthodontic terms. Ninth edition

J Prosthet Dent

Condylar determinants in a patient population: electronic pantograph assessment

J Oral Rehabil

Physiology of occlusion and rehabilitation

A textbook of occlusion

Prosthodontic treatment for edentulous patients: complete dentures and implant-supported prostheses

Clinical Research
Comparative evaluation of sagittal condylar guidance obtained from a clinical method and with cone beam computed tomography in dentate individuals