Condylar Position Analysis with a New Electronic Condylar Position Measuring Instrument E-CPM: Influence of Different Examiners and a Working Bite on Reproducibility

Purpose: Condylar position analysis facilitates a quantitative comparison of the condylar position with and without a bite record, different records and changed influencing factors. Handling by the examiner when positioning the model is a significant factor with regard to the accuracy of the examination. Measurement accuracy could be improved when positioning the models by using special working bites, hence the objective of the experiments described in this study consisted in examining the extent to which the measuring results are influenced by different examiners and by using working bites. Materials and Methods: In the first trial, one examiner performed ten measurements without and with an interposed working bite for five model pairs in each case. In the second trial, nine examiners (three specialized dentists, three dental assistants, three students) performed ten measurements in each case without and with an interposed working bite. The three-dimensional position was read digitally with the E-CPM (Gamma Dental, Klosterneuburg/Vienna, Austria), recorded by means of spreadsheet software (Microsoft Excel) and diagnostic software (CMDfact, CMD3D module, dentaConcept, Hamburg), and evaluated with graphing software (Sigma Plot, Systat Software, USA). Results: In the first trial, it was shown that the reproducibility of mounting was improved markedly (p 0.01) by using bite records in the form of working bites. In the second trial, it was shown that the mean error increased significantly (p 0.01) when several examiners performed the measurements compared with the results of one examiner alone. No significantly different results occurred (p 0.01) in the comparison of the different groups of examiners with different educational and training backgrounds. This applied for the mounting methods without and with working bite. On the other hand, the reproducibility of mounting improved distinctly (p0.01) in every group of examiners when working bites were used. Conclusions: Reproducibility of condylar position analysis was improved significantly by mounting the models with special working bites. This applied for operators of different professional background (dentists, dental assistants and dental students), while there were no significant differences between results of the three groups. Keywords: quantitative measurement of the jaw position, condylar position analysis, equalizing systems, electronic measuring instrument, centric records, influence of working bites on condylar position analysis