Author: Dr. Krishna Prasad, Dr. B. Rajendra Prasad, Dr. Divya Mehra.

Nitte University, Deralakatte, Mangalore 575018 Abstract: An articulator can be called as a guide of the dental professionals. It gives the provision for adjusting the maxillary and the mandibular cast in three planes of space relative to the hinge axis of the patient and the instrument. It can be undoubtedly said that no other instrument has influenced the Science of Prosthodontics as much as the articulator. In the past patients were forced towards an ideal bite set on the articulator. However, there has been constant increasing refinement of the instrument.The articulators that dental surgeons use today are based on the principles that have evolved over the devices 200-year history. This article illustrates the evolution of the articulators through the years and recent advances of the same. Introduction: In the fabrication of indirect dental prosthesis, a mechanical device called an articulator is used, which relates the maxillary and the mandibular casts. To define, an articulator is aA mechanical instrument that represents the temporomandibular joints and jaws, to which maxillary and mandibular casts may be attached to simulate some or all mandibular movements. Articulator being the mechanical analogue of the temporomandibular joint and the maxillary and the mandibular arches, its primary function is to serve as a patient in the absence of the patient. Although it is often said that the patients mouth is the best articulator, it is not practical and convenient to work exclusively in the patients mouth at all times, thus, articulators have been designed to enable the dental surgeon and technician to study the patients dentition and construct the prosthesis without the continued presence of the patient. Hence the advent of the articulators is a boon and the Science of Prosthodontics and the total oral rehabilitation is incomplete without it. The Evolutionof Articulators: The PlasterArticulators: Since 1900, the honour of having invented the articulator has been given to two eminent European dentists of the 18th and 19th centuries, Phillip Pfaff and Jean Baptiste Gariot. The articulator that was first to be described was the Plaster Articulator. In 1756, Phillip Pfaff first described the method of making Plaster casts after making the impression with sealing wax.1It has been assumed that he used a device to preserve the relationship of the casts. Hence it is believed that he was the first to use a dental articulator. However, it was only in 1805, when Jean Baptiste Gariot described the method of extending the plaster casts posteriorly and grooved them to provide an indexing mechanism, which helped in preserving the relationship of the casts. This was called as the Plaster articulator, which later came to be known as the Oiled Board Articulator. An early variation of the Gariot design was called the Slab Articulator. MechanicalHingeArticulators: By 1830s, emerged the Mechanical Hinge Articulators. They consisted of two wooden/metal blocks hinged together with a simple hinge. They are now commonly referred to as the BARN

DOOR HINGE.1 Thomas W. Evans was probably the first to discuss one of the Earliest Mechanical Hinge articulators in some detail in 1848-1849. FixedCondylarGuideArticulators: The mechanical Hinge articulators were capable of functioning only in a Hinge movement. Hence, a need to invent articulators that could imitate the mandibular movement arose. Daniel T. Evens devised one such device which he named as the Dentists Guide as he believed this articulator simulated the motions of the human mandible.2However, it was believed to be very inconvenient and difficult to use. The most well known and accepted articulator amongst all that were proposed was the Bonwills Articulator in 18582 that were based on his theories on articulation and Anatomic occlusion. Next important advancement in the articulator was made by Richmond S. Hayes in 1889.3 He incorporated a Fixed descending Condylar path in his articulator, as a downward movement of the mandible was observed during mandibular excursions. Gritman, Gysi and Stephan also introduced articulators with the similar feature. The Gritman Articulator,18993featured descending condylar path of 15, an average determined by measurements taken from a large number of patients. Alfred Gysi, in 1912, introduced the Simplex Articulator that had the condylar path of 33 and the lateral paths of 16. 3It was probably the first articulator to have an incisal pin and guide assembly. The Appearanceof Facebows: In 1889, Richmond H. Hayes introduced the first example of a functional facebow-like device for locating the position of the casts correctly in the articulator. He named this device the articulating calliper.4This device however did not enable a three dimensional orientation of the casts to the articulator and did not meet the essential requirements of a facebow. George B. Snow of Buffalo, NY, in 1899, introduced the first instrument and technique for recording the anatomic relationship of the maxilla to the condylar axis and transferring this relationship to the articulator. The Snow facebow was patented and introduced with the Gritmans articulator in 1899.4The Wordsworth T attachment facebow4 provided a Third Point of reference indicator to determine vertical position of the occlusal plane. Another facebow which used a third point of reference is the Infra-orbital pointer which appeared in the late 1920s. It is the Hanau CM Facebow.4 The Conceptof AdjustableCondylarGuidance: An important breakthrough in articulator design occurred in 1896, when William E. Walker, introduced his articulators with adjustable condylar guide and named them as Walkers physiological articulators.5 In 1901, Christensen reported his observations of the space that existed between the maxilla and mandible during protrusion and suggested the use of a protrusive interocclusal wax record to measure the angle of the condylar paths. Based on this principle he introduced an articulator with adjustable condylar guides and used the wax interocclusal records to set the condylar controls on this articulator.5 By 1907, came the New Century Articulator, by George B. Snow, which was an improved version of the Gritmans Articulator. It had adjustable condylar guides. A tension spring was added which allowed a greater range of movement without compromising the stability of the frame. He also described the use of the Christensens procedure in this articulator. However, a common but a very significant error in these designs was the absence of calibration

markings on the condylar controls. Hence the setting could not be preserved. Articulatorswith an Incisal-pin and GuideAssembly: Some form of "vertical stop" was commonly seen even in the mechanical articulators of the 18th century. The importance of preserving the vertical relationship of the casts in the articulator was recognized by some early inventors. However, Bonwill was of the opinion that a vertical stop if provided in an articulator would impair the accurate functioning of the articulator as it would interfere with the lateral movements. Alfred Gysi was the first to recognize the importance of the incisal pin and guide. He had incorporated a fixed incisal table of 45 in his articulator the Adaptable and suggested that the slope of Simplex incisal table could also be altered with a metal plate and modelling plastic.6 Then came the articulators called the Alligators. These were the first articulators with an adjustable incisal guide table with fixed lateral wings. These were introduced in November, 1916 by Rupert E. Hall.6A successor of this by Hall called as the Dental Occluding frame had a horizontal incisal table with adjustable lateral wings and a triangular guiding edge on each lateral wing that could be set to follow a "gothic arch" tracing. It had the The First Patented "Gothic Arch" Incisal Guide Table.6 The Trubyte Articulator by Gysi in 1928, 6also had an incisal table with guiding lateral edges that could be set to follow the Gothic Arch Tracings. It had 10lateral wings called as FISCHER ANGLE.The incisal table included a provision for adjusting the inclination of the protrusive path. A contribution by House was the innovation of the Offset incisal pin. The lower section of the pin was set at an angle of 55 tangent to the arch of closure of the articulator to facilitate a smooth movement of the pin. Articulatorsbasedon Geometrictheoriesof Mandibularmovements: There were two schools of thought Anatomic and Non Anatomic The Geometric (Non anatomic) school of thought denied the existence of condylar axes and believed that the condylar paths had no influence on the occlusion. It was the articulation of the teeth that guides the mandible during mastication.7The Condylar (Anatomic) school of thought emphasized the influence of condylar paths on occlusion. The articulators based on the geometric theory are called as Arbitrary or Single Rotation Centre articulators.William Bonwill and Francis Balkwill were the first investigators to apply geometric principles to mandibular movement and occlusion. Bonwills articulator in 1858 is based on his theory of Equilateral triangle. He believed that the mandibular movement during function was guided by the articulation of the teeth guide, however the centres of the condyles are also the centres of lateral rotation for the mandibles opening and closing movements.7 Other inventors most frequently associated with the geometric school of mandibular movement and articulator design are George S. Monson (for his spherical theory) and Rupert E. Hall (for his conical theory).The Hall Articulator also known as The Alligator as well as the Automatic Anatomic Articulator by Rupert E. Hall in 1919 are based on his conical theory.7,8 In the first decade of the 20th century, Carl Christensen and George Monson independently described their applications of the spherical theory of mandibular movement and articulator design. According to the theory, the mandibular teeth move over the maxillary teeth as over the surface of a sphere that has an average radius of 4 inches, but the Monson articulator had set screws that could vary the instruments radius. Although Monsons articulator is no longer used, parts of the Spherical Theory are still in use today.7,8 Monson based on his Spherical Theory, devised the Mandibulomaxillary instrument in 1918.1,8

The BalancerDesigns: The term balancer was coined by Harry Hagman in the 1920s for devices that include a rotational center located above the occlusion plane.9 Maurice Babb was the first to receive a patent for an articulator but Hagman line of balancer articulators became more famous. HanausArticulators-Returnof the Era of Articulatorswith AdjustableCondylarGuide: Rudolph L. Hanau, an engineer believed that the Hall and Monson theories were misinterpretations of masticatory movements as applied to articulators and believed that it was absolutely necessary to adjust an articulator to comply with given individual requirements. The Hanau articulators were popular with dental professionals for their ease of use and durability. Hanau in 1921 developed a research model called the Hanau - Model C Articulator.1Later in 1923, he devised the Kinoscope1 which he claimed to provide exact measurement of mandibular movements. HanaumodelH-110 (1926): Evolved from model H115 in 1926, the Hanau Model H110 incorporated individual condylar guidance adjustments in both the sagittal and horizontal planes. Rather than using lateral positional records, the lateral setting was calculated by dividing the condylar inclination by eight and adding 12.1 L=H/8+12 HanaumodelH-110 modified(1927):Similar to H110 except that it had an incisal guide table instead of incisal guide cup.1 HanaumodelH2 series(1958): It was a non-arcon, semi adjustable articulator. Principal feature was an increased distance between upper and lower members from 95mm to 110mm. It had a fixed intercondylar distance of 110 mm and accepted facebow transfer. Horizontal condylar inclinations were simulated by means of a protrusive interocclusal record. Bennett movement was calculated from horizontal condylar inclinations by the formula L= H/8+12. The mechanical incisal guide table was adjustable both in sagittal and frontal planes. HanauWideVue(Models183 & 184): The Hanau Wide VUE I and Hanau Wide VUE II are the newest articulators. They are Arcon with fixed intercondylar distance of 110mm. The difference is that Hanau wide VUE I has a closed condylar track and Hanau wide VUE II has an open condylar track which allows upper member to be removed.Wide VUE II has condylar retainers to avoid accidental separation of upper member. A micrometer protrusive - retrusive condylar adjustment is available which is accurate to 0.05. Horizontal condylar angle is adjustable from -20 to 60 and side shift angle adjustment is from 0 to 30 (same as H2). The straight incisal guidepin or with adjustable foot is available. The straight pin has dual ends chisel and spherical which extends above the upper member to act as a third point stability when inverting the articulator for mandibular cast mounting. Three incisal guide tables are available: mechanical, flat and pantacrylictable. The WhipmixArticulator: The whip mix articulator and quick mount face bow were introduced by Dr. Charles Stuart in

1963.It is a simplified version of Stuarts fully adjustable articulator.1 It is a semi adjustable articulator of the arcon type with 3 intercondylar adjustments i.e. small, medium and large. They are selected by means of accompanying quick mount facebow. The condylar and Bennett guide paths are straight. There is no provision for timing the Bennett movement. Dentatus: It is an adjustable articulator designed in 1944 in Sweden. The condylar elements are attached to upper member and the condylar path is straight. Bennett angle is calibrated to 40. Inter condylar distance is fixed. This receives hinge axis face bow transfer. Its features are similar to Hanau Model H. ModifiedDentatusAro:With movable arms that holds the cast. The DenarD4Aarticulator(1968, by NilesGuichet): It is a fully adjustable articulator that used interchangeable condylar guidance. It is programmed from tracings made with a pneumatically controlled pantograph. It has a definite centric lock. The curved incisal pin assembly can rest on a mechanical or plastic incisal guide table. The invention of the pantograph in 1968 by Dr. Niles Guichet has also influenced fully adjustable articulation. With the pantograph, a dental surgeon could record the threedimensional border movements of the condylar rotational centers. But the pantograph could only be used with highly sophisticated, three-dimensional adjustable articulators that would accept and reproduce the measurements recorded by the pantograph. For example, the Denar D4A articulator. PanadentArticulators: Panadent system is based on the work of Lee and others.The Panadent articulator was introduced in 1978 by Robert Lee and current models were introduced in 1983. It is an arcon with fixed intercondylar distance 110mm. It utilizes interchangeable preformed curved analogue fossae for condylar pathway which were developed from research which demonstrated that the lateral condylar pathways were quite similar in curvature except for steepness of the horizontal condylar inclinations and the amount of immediate side shift. The ArtexSystem(Girrbach,Germany): Artex articulators have a history of 30 years. The design parameters of all Artex articulators are identical for certain limit values, whereas other parameter adjustments differ from model to model. Artex articulators are easily and economically calibrated to each other, providing cast transfer between multiple stations or between the laboratory and the dental office with occlusal deviations of less than 10 microns. Both the arcon and the non - arcon variants are available under the Artex System ranging from Average Value to Fully-Adjustable articulators. The system includes models with pre-set or adjustable condylar inclination, adjustable Bennett angles, immediate sideshift (I.S.S.) settings, protrusion and retrusion indicators. The Sam3Articulator: SAM3 Professional is an Arcon type fully adjustable articulator with the same lower to upper cast 3D relationships. A precision conical ball bearing centric locking mechanism assures the highest precision centric locking available with complete freedom when unlocked. Also, all inserts are independent of the centric locking mechanism. Condylar pathway and Bennett

Guidance can be exchanged easily. Special clear polycarbonate condylar element covers serve to keep upper and lower members together when so desired. Optional protrusion/retrusion screw assemblies are available. The Sam 3 articulator uses the Axioquick Facebow with AxiomaticTransfer Fork Assembly which features Single Toggle Lock. The single toggle locking mechanisms simplifies the process of facebow recording.This assembly is fast and easy to use. The anatomical simulation is exact. The transfer is flawless. Axiographs: Axiography is a measuring device for recording all mandibular movements. Electronic registration of mandibular movement is now a standard procedure in many dental practices. Axiographs allow bilateral, simultaneous, timed 3D registration of condylar movement. It is easy to determine a precise hinge axis and to also make a direct analysis of the recordings. Discussion: Although a wide variety of options are available to us today, their understanding and appliance in clinical dentistry varies with the complexity of each prosthesis in question. The large number of different designs of articulator available leave the dental surgeon quite confused as to which one to choose. The choice of the articulators should be made according to the best intercuspal position required for the patient. If occlusion contacts are to be perfected in centric relation only, then a simple hinge articulator can be selected. If denture teeth are to have cross arch and cross tooth balanced occlusion, then minimum requirement is semi adjustable articulator. If complete control of occlusion is desired, a completely adjustable, three dimensional articulator is selected. Besides, a proper selection amongst the Arcon and the nonArcon variant is also important. In an Arcon articulator the condylar housing is built in the upper member of the articulator and the condyles are fixed onto the lower member. The non-arcon variant is just the opposite of the arcon type. Although studies say that reversing the relationship does not change the guidance produced and that neither instrument has any specific advantage over the other, a proper selection specific to the type of case is important. If bilateral balanced occlusion is desired after obtaining condylar guidance record of the patient, then semiadjustable articulator-non arcon variant is sufficient. But if bilateral balanced occlusion is desired after obtaining protrusive and lateral records and if vertical dimension is to be altered, then semi-adjustable articulator-arcon variant is preferred. Summaryand Conclusion: After all the advancement that has occurred in the design of the articulators, a typical articulator consists of a hinge-type frame, mounting plates for casts, two adjustable condyles, an incisal guide pin and a facebow with a bite fork. It must be recognized that the person operating the instrument is more important than the instrument. If dental professionals understand articulators and their deficiencies, they can compensate for their inherent inadequacies. The rapid advancement of modern technology and the continued development has contributed to advanced and accurate articulators at our disposal. As always, these anticipated advancements promise to significantly increase abilities of the dental professionals to successfully serve the needs of their patients. References:

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