Determining articulation parameters using the Avantis 3D software, considering the individual hinge axis position
- Authors: Kovgan D.S.1, Erokhin V.A.2, Trunin D.A.2, Antonik P.M.3, Antonik M.M.3, Parunov V.A.1, Ryakhovsky A.N.4
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Affiliations:
- Peoples' Friendship University of Russia named after Patrice Lumumba
- Samara State Medical University
- Russian University of Medicine
- Central Research Institute of Dentistry and Maxillofacial Surgery
- Issue: Vol 28, No 6 (2024)
- Pages: 642-652
- Section: Digital Dentistry
- Submitted: 10.08.2024
- Accepted: 19.09.2024
- Published: 22.12.2024
- URL: https://rjdentistry.com/1728-2802/article/view/634855
- DOI: https://doi.org/10.17816/dent634855
- ID: 634855
Cite item
Abstract
BACKGROUND: Axiography (condylography) is used to assess the temporomandibular joints (TMJ) function and obtain individual articulator settings. Creating a virtual patient with TMJ dysfunction and determining its individual articulation parameters considerably simplify the procedure and accelerate the diagnosis for further rehabilitation.
AIM: To assess the potential of a virtual articulation system using the Avantis 3D software for determining angular parameters of mandibular movement, considering the individual hinge axis position.
MATERIALS AND METHODS: The clinical phase of the study included 25 volunteers aged 18–30 years, without complaints of TMJ dysfunction, previous orthodontic treatment, and malocclusion.
All volunteers underwent electronic condylography (axiography) using the CADIAX Diagnostic device; the movement of mandible heads during protrusion and mediotrusion was analyzed. The individual values of sagittal condylar inclination (SCI) and Bennett angle on the left and right were obtained. The individual hinge axis was determined, and special radiopaque markers were placed on the skin in the projection of its rotation. Additional markers were placed on the lower edge of the left orbital cavity.
Using these markers, cone beam computed tomography (CBCT) was performed in all volunteers, with a 17.5×20.0 matrix size, to create a 3D project, compare CBCT findings with virtual dental models, and generate a reference plane.
Virtual occlusion measurements were obtained in terminal positions (protrusion and laterotrusion) using the Trios 3 Basic Pod intraoral scanner. The Avantis 3D software was then used to create 3D scenes based on the obtained measurements and CBCT of the skull. The mean length of each path registered for virtual articulator settings in the Avantis 3D software was approximately 3 mm. The interarticular distance used for the analysis was recalculated using the Avantis 3D software to be equal to the standard intercondylar distance of the articulator, which is 110 mm. Individual SCI and Bennett angle values were obtained for all study subjects.
The experimental phase involved phantom models installed in a fully adjustable articulator Reference SL. CBCT was performed with an installed articulator and a maxillary cast, in a zero position, with closed center locks, which was matched to the maxilla present in the CT scan, and a 3D scene was created to measure SCI and Bennett angle values. After detecting the articulator’s hinge axis, electronic measurements of movement were taken, with a predefined SCI of 20–60° (increment 5°) and Bennett angle increments of 6, 12, and 20°. The results were assessed for a path of 3 mm.
RESULTS: The mean difference between the compared determination methods of angular parameters obtained during the experimental phase of the study was 3.20±7.22° for the left SCI; 2.09±9.75° for the right SCI; 5.50±11.26° for the left Bennett angle, and 6.40±6.29° for the right Bennett angle.
The mean difference between the compared determination methods of angular parameters obtained during the clinical phase of the study was 11.80±6.86° for the left SCI; 12.10±6.08° for the right SCI; 13.0±9.89° for the left Bennett angle, and 10.70±11.48° for the right Bennett angle.
CONCLUSION: Both approaches for determining angular parameters can be recommended for use in real-world dental practice. When sophisticated, expensive equipment is not available, a virtual articulation system in the Avantis 3D software can be used as a more simple and affordable technique of measuring angular parameters.
Full Text

About the authors
Dmitry S. Kovgan
Peoples' Friendship University of Russia named after Patrice Lumumba
Email: megaspayn@mail.ru
ORCID iD: 0009-0000-2390-0413
SPIN-code: 3243-8270
Russian Federation, Moscow
Vladislav A. Erokhin
Samara State Medical University
Author for correspondence.
Email: vladalex.171097@mail.ru
ORCID iD: 0000-0003-1096-7568
SPIN-code: 4724-5883
MD
Russian Federation, 89 Chapaevskaja street, 443099 SamaraDmitry A. Trunin
Samara State Medical University
Email: trunin-027933@yandex.ru
ORCID iD: 0000-0002-7221-7976
SPIN-code: 5951-4659
MD, Dr. Sci. (Medicine), Professor
Russian Federation, 89 Chapaevskaja street, 443099 SamaraPavel M. Antonik
Russian University of Medicine
Email: wow-oop@yandex.ru
ORCID iD: 0000-0001-5262-6679
SPIN-code: 7892-3432
Russian Federation, Moscow
Michail M. Antonik
Russian University of Medicine
Email: wow-oop@yandex.ru
ORCID iD: 0000-0001-7902-1215
SPIN-code: 8713-4695
MD, Dr. Sci. (Medicine), Professor
Russian Federation, MoscowVitaly A. Parunov
Peoples' Friendship University of Russia named after Patrice Lumumba
Email: vparunov@mail.ru
ORCID iD: 0000-0003-2885-3657
SPIN-code: 8797-6513
MD, Dr. Sci. (Medicine), Professor
Russian Federation, MoscowAAleksandr N. Ryakhovsky
Central Research Institute of Dentistry and Maxillofacial Surgery
Email: avantis2006@mail.ru
ORCID iD: 0000-0002-0308-126X
SPIN-code: 5774-4493
MD, Dr. Sci. (Medicine), Professor
Russian Federation, MoscowReferences
- Utyuzh AS, Zekij AO, Lushkov RM, et al. Restoring the integrity of the dentoalveolar apparatus in the absence of a fixed interalveolar height using the immediate implant loading technique. The Dental Institute. 2021;(1):65–67. EDN: VEMCZS
- Dubova LV, Prisyazhnyh SS, Romankova NV, Malahov DV. Analysis of functional methods for determining the optimal position of the mandible. Parodontologiya. 2020;25(1):22–25. EDN: GFYMVU doi: 10.33925/1683-3759-2020-25-1-22-25
- Zhang XX, Liu JZ, Zou W, Wang M. Diagnostic testing using pterygomaxillary notches and retromolar pads on casts to check horizontal jaw relation. Chin J Dent Res. 2021;24(1):61–66. doi: 10.3290/j.cjdr.b1105885
- Kattadiyil MT, Alzaid AA, Campbell SD. What materials and reproducible techniques may be used in recording centric relation? Best evidence consensus statement. J Prosthodont. 2021;30(S1):34–42. doi: 10.1111/jopr.13321
- Postnikov MA, Nesterov AM, Trunin DA, et al. Possibilities of diagnostics and complex treatment of patients with tmj disfunctions. Clinical Dentistry (Russia). 2020;(1):60–63. EDN: JNDLGX doi: 10.37988/1811-153X_2020_1_60
- Kordaß B, Behrendt C, Ruge S. Computerized occlusal analysis — innovative approaches for a practice-oriented procedure. Int J Comput Dent. 2020;23(4):363–375.
- Shagibalov RR, Lushkov RM, Utyuzh AS, Zekij AO. Restoring the integrity of the dentoalveolar apparatus in the absence of a fixed interalveolar height using the immediate implant loading technique. Stomatolog. Minsk. 2020;(4):24–29. EDN: XHYFDY doi: 10.32993/dentist.2020.4(39).10
- Mamedov AdA, Kharke VV, Morozova NS, et al. Diagnostic methods selection in patients with temporomandibular joint dysfunction. The Dental Institute. 2019;(2):74–77. EDN: HTVSSH
- Kolk A, Scheunemann LM, Grill F, et al. Prognostic factors for long-term results after condylar head fractures: A comparative study of non-surgical treatment versus open reduction and osteosynthesis. J Craniomaxillofac Surg. 2020;48(12):1138–1145. doi: 10.1016/j.jcms.2020.10.001
- Doroshenko SI, Fedorova AV, Irha SV, et al. Optimization prosthetic treatment of patients with defects in teeth and dentitions, completed by the secondary dento-jaw deformations. Vestnik stomatologii. 2019;32(2):38–42. EDN: VVFALM
- Carossa M, Cavagnetto D, Ceruti P, et al. Individual mandibular movement registration and reproduction using an optoeletronic jaw movement analyzer and a dedicated robot: a dental technique. BMC Oral Health. 2020;20(1):271. doi: 10.1186/s12903-020-01257-6
- Postnikov MA, Trunin DA, Gabdrafikov RR, et al. Diagnosis of tmj dysfunction and planning of complex dental treatment on a clinical example. The Dental Institute. 2018;(3):78–81. EDN: XZONOH
- Ohlendorf D, Fay V, Avaniadi I, et al. Association between constitution, axiography, analysis of dental casts, and postural control in women aged between 41 and 50 years. Clin Oral Investig. 2021;25(5):2595–2607. doi: 10.1007/s00784-020-03571-3
- Najdanova IS, Pisarevskij YuL, Shapovalov AG, Pisarevskij IYu. The potential of current technologies in diagnostics of temporomandibular joint dysfunction (literature review). Actual Problems in Dentistry. 2018;14(4):6–13. EDN: VRJMEL doi: 10.18481/2077-7566-2018-14-4-6-13
- Park JH, Lee K, Kim JC, et al. Evaluation of mandibular position for splint therapy using a virtual articulator. J Clin Orthod. 2020;54(8):466–472.
- Lee H, Burkhardt F, Fehmer V, Sailer I. Accuracy of vertical dimension augmentation using different digital methods compared to a clinical situation — a pilot study. Int J Prosthodont. 2020;33(4):380–385. doi: 10.11607/ijp.6402
- Das A, Muddugangadhar BC, Mawani DP, Mukhopadhyay A. Comparative evaluation of sagittal condylar guidance obtained from a clinical method and with cone beam computed tomography in dentate individuals. J Prosthet Dent. 2021;125(5):753–757. doi: 10.1016/j.prosdent.2020.02.033
- Parreiras Ferreira R, Isaias Seraidarian P, Santos Silveira G, et al. How a discrepancy between centric relation and maximum intercuspation alters cephalometric and condylar measurements. Compend Contin Educ Dent. 2020;41(4):e1–e6.
- Cassi D, De Biase C, Tonni I, et al. Natural position of the head: review of two-dimensional and three-dimensional methods of recording. Br J Oral Maxillofac Surg. 2016;54(3):233–240. doi: 10.1016/j.bjoms.2016.01.025
- Lundström F, Lundström A. Natural head position as a basis for cephalometric analysis. Am J Orthod Dentofacial Orthop. 1992;101(3):244–247. doi: 10.1016/0889-5406(92)70093-P
- Christensen C. The problem of the bite. Dent Cosmos. 1905;47:1184–1195.
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