A three-dimensional morphometric study on the position of temporomandibular joints

Objectives: To address the controversy, in which indications average value articulation is suitable or to what extent individual registrations, especially using the facebow, should be applied, a quantification of the variability of relevant anatomical landmarks is necessary. The goal of this study was to investigate the mean and natural bandwidth of the parameters describing articulation. Methods: Significant landmarks were measured on three-dimensional (3D) cone beam computed tomography (CBCT) scans of 120 arbitrarily selected individuals. The bandwidth and mean values of the anatomical relations were calculated. Results: The mean arm length of the Bonwill triangle was 103.3 mm, with a range of 90.2 mm (minimum) to 117.9 mm (maximum), and a mean base length of 99.6 mm, with a range of 85.2 mm to 112.6 mm. There was a high correlation between the length of the left and right arms, but not between the arms and the base. The mean height of the Bonwill triangle, measured between the condyles and the occlusal plane, resulted in 34.3 mm, with a range of 21.0 mm to 47.2 mm. The mean value of the Balkwill angle was 20.4 degrees, with a range of 9.0 degrees to 27.6 degrees. The angle between the Camper's line and the occlusal plane averaged around 7 degrees. Conclusions: This study presents the bandwidth of anatomical relations necessary for articulation systems. The results are specific for males and females. The relevant parameters offer a high symmetry between the right and left sides. Additionally, the results show that the Bonwill triangle is more likely to be isosceles than equilateral. Clinical significance: The knowledge of the anatomical bandwidth of temporomandibular joint (TMJ) positions in relation to the dentition allows the simulation of software- controlled virtual articulators and the substitution of facebows. Keywords: Bonwill triangle, anatomical landmarks, Camper's plane, articulator, occlusal plane