The Effect of Skeletal Pattern on Determining Articulator Settings for Prosthodontic Rehabilitation: An In Vivo Study

Purpose: During extensive prosthodontic treatment, the use of an accurately adjusted articulator is recommended to simulate mandibular movements. This clinical study was undertaken to assess any possible effect of the underlying skeletal pattern on programming articulator settings. Materials and Methods: Subjects (n = 73, mean age: 22.8 ± 6.8 years) were recruited from a dental school and two regional specialist orthodontic units. Subjects were allocated into groups based on their underlying sagittal (I, II, or III) and vertical (reduced, average, or increased) skeletal patterns by three orthodontists and three prosthodontists who examined their profile photographs. Electronic pantographic recordings were made of each subject using the Cadiax Compact system to record the sagittal condylar inclination (SCI), progressive mandibular lateral translation (PMLT), and immediate mandibular lateral translation (IMLT). Results: Agreement between assessors for sagittal skeletal pattern classification was excellent (97% for total or good agreement); agreement for vertical skeletal pattern was high, but at a lower level than that for sagittal relationships (70% for total or good agreement). SCI settings for sagittal II subjects were significantly higher than those for sagittal I (P .05) and sagittal III (P .001) subjects. Differences were statistically significant, with mean SCI differences of 4 and 7 degrees, respectively. No statistical difference could be observed between SCI values in the sagittal I and III groups. Subjects with an average vertical skeletal pattern had SCI values lower than those with a reduced vertical skeletal pattern (P = .058) and an increased vertical skeletal pattern (P .01, statistically significant). No patterns could be determined for PMLT or IMLT between the study groups. Conclusion: During prosthodontic treatment of patients with a noticeable skeletal discrepancy, appropriate consideration should be given to customizing SCI values.