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An in vivo study of voluntary mandibular lateral translation concerning its

existence, magnitude, and timing


Seung Cheon Son, DDS,a F. Michael Gardner, DDS, MA,b Merle Harry Parker, MS, DDS,c and
Kent L. Knoernschild, DMD, MSd
Medical College of Georgia, Augusta, Ga.; US Army Dental Activity, Fort Gordon, Ga.; and
University of Illinois, Chicago, Chicago, Ill.
Statement of problem. The existence of mandibular lateral translation and the approaches to its mea-
surement and interpretation by using a pantograph are controversial.
Purpose. This study evaluated the validity of using a pantograph to measure mandibular lateral translation
and analyzed human pantographic tracings to determine whether they exhibited mandibular lateral transla-
tion.
Material and methods. A pantograph was modified by adding 2 posterior horizontal recording tables
and styli at the transverse horizontal axis. Pantographic tracings of 25 human subjects were compared with
the corresponding theoretically determined values for tracings that exhibited only rotation with no transla-
tion. Differences in the tracings at 2 pantographic recording table locations, relative to the transverse hori-
zontal axis, were also compared.
Results. The character of the lateral component of 100 pantographic tracings all differed from the lateral
component of theoretically determined values for pure rotation. In 64% of tracings, over 50% of the total
mandibular lateral translation occurred by the first 1 mm of forward movement of the nonworking side
condyle. In 94% of tracings, more than 50% of the translation had occurred in the first 3 mm of forward
movement. For the pantographic system used, the amount of mandibular translation represented in the trac-
ing was not changed by altering the posterior horizontal recording table position in the anterior-posterior
direction, relative to the transverse horizontal axis.
Conclusion. All subjects showed evidence of mandibular lateral translation. New definitions for timing of
mandibular lateral translation are proposed. Of the tracings, 64% were classified as exhibiting early transla-
tion, 30% as intermediate, and 4% as late mandibular lateral translation. (J Prosthet Dent 1998;80:672-9.)

CLINICAL IMPLICATIONS
On the basis of the evidence that mandibular lateral translation existed in all tested
subjects, articulators and occlusal schemes that accommodate this movement should be
used.

T he existence of mandibular lateral translation


(MLT) and the approaches to its measurement and
Norman G. Bennett,22 a British dental surgeon,
published “[A] Contribution to the Study of the Move-
interpretation with a pantograph remain controversial. ments of the Mandible” in 1908. The main objective of
The pantograph is a device that has been widely used in this article was to show that “no single fixed center
the study of MLT.1-21 However, the validity for its use exists, but that the center of rotation is constantly shift-
for this purpose has been questioned by several investi- ing.” Bennett22 described that the working side
gators.15-17 condyle moved in an almost direct lateral line with
“extreme opening combined with extreme movement
From a thesis submitted in partial fulfillment of the requirements for to the right.” Later, this lateral translational-like move-
MS degree in Oral Biology, Medical College of Georgia, School ment of the working side condyle was termed, “Ben-
of Graduate Studies. nett’s movement.”
This project was partially supported by a research grant from The L.
D. Pankey Institute, Key Biscayne, Fla.
Many studies have used various types of tracing
aGraduate Student, School of Graduate Studies, Medical College of devices that demonstrated an apparent nonrotational or
Georgia. translatory component to lateral border move-
bDirector, Postgraduate Prosthodontics, School of Dentistry, Med-
ments.18-21 However, there are several studies that ques-
ical College of Georgia. tion the existence of immediate MLT or MLT. For
cDirector, Postgraduate Prosthodontics, US Army Dental Activity, Ft

Gordon.
example, Landa23,24 questioned the validity of MLT
dCo-Director, Postgraduate Prosthodontics, School of Dentistry, based on his study of skulls and cadavers and in vivo
University of Illinois. studies using roentgenographic, cinefluorographic, and

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SON ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

electromyographic techniques that failed to suggest the


existence of MLT. Brotman25 suggested that Bennett
may have misinterpreted the results of scientific experi-
ments. Dawson16 advocated that what appears to be
immediate MLT before working side rotation occurs is
instead the result of improper manipulation by the oper-
ator. If the nonworking side condyle starts its move-
ments from the superior position, it will not move medi-
ally.16 Also, what appears to be immediate MLT is due
to the “downward movement” of the recording table as
the nonworking side condyle travels down the steepest
part of the eminence.16 As the recording table moves
down, it rotates in a curve around the working side
condyle, but the stylus extends straight down to the
recording table to draw a lateral line that can be misin-
terpreted as immediate MLT.16 Levinson26 also suggest-
ed that immediate MLT does not occur when the Fig. 1. Modified Denar pantograph assembled on subject.
condyles are fully braced against the articular eminences. Two additional horizontal recording tables and styli were
LePera17 pointed out through an apparatus capable of positioned at transverse horizontal axis. Occlusal vertical
simulating the mandibular movements that the geomet- dimension was minimally increased by central bearing
ric relationships of the recording elements (stylus and screw.
table) to the transverse horizontal axis could affect the
graphic tracings. Similarly, Clayton et al.3 showed that
the orientation of the styli in relation to the transverse A Denar pantograph (Teledyne Water Pik, Fort
horizontal axis could affect the graphic tracings. Crad- Collins, Colo.) was modified so that 2 additional pos-
dock et al.15 demonstrated that pure rotation can mimic terior horizontal recording tables and styli were
immediate MLT depending on the recording table loca- attached and could be located at the transverse hori-
tion and axis of rotation by analyzing rotational and zontal axis (Fig. 1). As a result, this modified panto-
translational tracings made at 9 different locations (supe- graph could trace MLT at 4 posterior horizontal loca-
rior-anterior, superior-middle, superior-posterior, mid- tions (2 on each side) simultaneously. One table was at
dle-anterior, middle-middle, middle-posterior, inferior- the transverse horizontal axis (posterior horizontal
anterior, inferior-middle, and inferior-posterior) with recording table), while the other one was anterior to
respect to the transverse horizontal axis. They suggested the transverse horizontal axis (anterior horizontal
that “by placing the plate and stylus on the transverse recording table). The distance between the 2 ipsilateral
horizontal axis, immediate mandibular translation can be posterior vertical styli was approximately 45 mm in an
differentiated from rotational movements.” The Denar anteroposterior direction. Of the 4 posterior vertical
pantograph, as manufactured, locates the posterior hor- styli, the 2 anterior styli were more laterally positioned
izontal styli approximately 20 mm anterior to the trans- than the 2 posterior styli. This distance between the 2
verse horizontal axis, and the Stuart pantograph locates ipsilateral posterior vertical styli was approximately
the styli approximately 5 to 10 mm anterior and approx- 11 mm in a medial-lateral direction. This modified pan-
imately 20 mm below the axis. tograph was used to pantograph each subject.
The purpose of this study was to evaluate the validi- A transverse horizontal axis locator (Almore Inter-
ty of using a pantograph to measure MLT and to ana- national, Inc., Portland, Ore.) was used to locate a
lyze human pantographic tracings to determine repeatable transverse horizontal axis with accuracy of
whether subjects exhibit MLT. ±0.5 mm. Clutches were fabricated with orthodontic
resin (L.D. Caulk Co. Milford, Del.) according to the
MATERIAL AND METHODS
manufacturer’s recommendations.27 Clutches were
Twenty-five subjects (17 men and 8 women, mean made as thin as possible by having the patient penetrate
age of 33.5 years, ranging from 23 to 56 years) were the clutch material through to the clutch former. The
selected. Ethnicity of the subject population consisted central bearing screw was then opened until the clutch-
of 15 white subjects, 5 Asian subjects, 3 black subjects, es cleared in all excursive movements. Each subject was
and 2 Hispanic subjects. No subject in this study exhib- instructed to voluntarily manipulate his or her
ited any contraindication for pantographing such as mandible. If the instructions could not be followed, the
acute temporomandibular disorders (TMDs), neuro- subject was guided by the operator until he or she
muscular disorders, and/or limited range of mandibu- could voluntarily make the necessary movements. After
lar motion. practicing making the voluntary border movements for

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THE JOURNAL OF PROSTHETIC DENTISTRY SON ET AL

Fig. 2. Theoretical tracings of rotation without translation on


anterior and posterior horizontal recording tables. Theoreti-
cal tracings of rotation without translation of mandible go
from b to a on anterior table and from b´ to a´ on posterior
table. Center of rotation c remains constant due to rotation
without translation. These 2 tracings represent same
mandibular movement though they look different. D and D´,
lateral component of movement due to rotation without
translation, are in opposite directions, differ in magnitude,
and do not represent mandibular lateral translation. They Fig. 3. Theoretical tracing of rotation without translation.
look different because of different table position and nature This diagram represents theoretical tracings of patient’s left
of rotational movement. Hypothetical tracings of mandible lateral movement on patient’s right nonworking side, and it
that rotates and translates simultaneously, go from b to t on is assumed that patient’s left lateral movement is pure rota-
anterior table and from b´ to t´ on posterior table. To deter- tion (no translation). Point c is working side condyle or cen-
mine mandibular lateral translation from actual pantograph- ter of rotation. Point b´ is centric relation point on recording
ic tracing, the lateral component (D or D´) due to pure rota- table at transverse horizontal axis (CRTHA) while b is centric
tion must be subtracted from lateral component of tracing. relation point on recording table that is anterior to transverse
horizontal axis (CRA). Arcs b´a´ and ba represent tracing of
patient’s left lateral movement. Lines b´f´ and bf represent
sagittal plane reference line. P and P´ represent correspond-
each lateral movement, 2 pantographic tracings were ing protrusive movements along sagittal plane reference
obtained simultaneously, 1 at the transverse horizontal line. D is length of ad, distance from point a to line bf (ad
axis and 1 at an anterior position. Z bf). This represents lateral component of movement due to
The secured maxillary and mandibular pantograph rotation without translation at anterior horizontal recording
bows were mounted to the Denar articulator (D4-A, table. D´ is length of a´d´, distance from point a´ to b´f´
Teledyne Water Pik) with GC pattern resin (GC Corp., (a´d´Z b´f´), and represents lateral component of movement
Tokyo, Japan) to confirm the estimated intercondylar due to rotation without translation at posterior horizontal
distance using tracings on the front (anterior) record- recording table.
ing tables.
Determining mandibular lateral translation
Figures 2 and 3 depict theoretical tracings of rota-
In a manner similar to the Cartesian coordinate sys- tion without translation. P and P´ are the posterior
tem in which the x and y components can be evaluated components of movement projected on the anteri-
separately, the lateral component and anterior/posteri- or/posterior line (sagittal plane reference line) (Fig. 3).
or component of lateral mandibular movement can be Lines D and D´ denote the lateral component of move-
evaluated separately. Mandibular lateral translation can ment due to rotation without translation. Primed (´)
be seen as a lateral scribing on all plates.15 However, all symbols represent posterior tables and unprimed sym-
lateral movements seen on a scribing are not necessari- bols the anterior tables. Theoretical values of D and D´
ly MLT. As illustrated in Figures 2 and 3, D and D´ are for rotation are designated as DTH and D´TH, whereas
lateral components of movement due to rotation and the measured values for actual patient tracings are des-
there is no MLT present. To evaluate a patient’s MLT, ignated as DM and D´M. The lateral movement mea-
it is necessary to subtract the lateral component of sured on the patients scribing, DM and D´M, may be
movement caused by rotation. caused by both rotation and MLT. The difference

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SON ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

between DM and DTH is the actual MLT for the ante-


rior table. Similarly, D´M – D´TH equals the MLT seen
on the posterior table. Evaluating scribings on the pos-
terior plate at the transverse horizontal axis (THA)
enables a valid determination of MLT.15 If MLT deter-
mined from the anterior plate equals this posterior plate
value, then it validates the use of the anterior plate
for determining MLT. Although DM and D´M are
not equal, and DTH differs from D´TH, one would
expect to find that the calculated MLTs are equal or
(DM – DTH) equals (D´M – D´TH). Clinically, it is time-
consuming to perform the calculations necessary to
determine the lateral component for rotation, which is
subtracted from DM to find MLT. Because the lateral
Fig. 4. Measuring D and D´ using customized template in
component due to rotation at the THA, D´TH, should CorelDRAW.
be minimal, we expected to find that D´M is a good
approximation of MLT, (D´M – D´TH), without need
for the calculations.
following equations were derived from Figure 3 to
Measured variables
determine P, DTH, and D´TH values:
To determine measured lateral component of move-
α = [arcsin(P´/R´)]/2 (1)
ment DM and D´M on the pantographic tracings, a
sagittal plane reference line, which was perpendicular to
D´TH = P´tan(α) (2)
the transverse horizontal axis, was drawn on each
recorded tracing. This was used rather than a protrusive
ab = 2ae = 2Rsin(α) (3)
tracing because, in many instances, the protrusive line
was not perpendicular to the transverse horizontal axis.
β = 90° – θ + α (4)
The obtained tracings with the reference lines were
scanned by the ScanMaker III (Microtek, Redondo
P = (ab)sin(β) = 2Rsin(α)sin(β) (5)
Beach, Calif.) with a resolution of 400 dpi. A software
program (CorelDraw 6, Corel Corp., Farmingdale,
DTH = (ab)cos(β) = 2Rsin(α)cos(β) (6)
N.Y.) was used to measure the actual distances DM and
D´M on the scanned pantographic tracings up to A software program (Son’s Length Calculation, Ivi-
0.1 mm (Fig. 4). sion Corp., Berkeley, Calif.) was developed to calculate
The following measurements were made from the P, DTH, and D´TH values. After the input of the mea-
articulator and the pantograph with a ruler (Crown 30 sured variables of R, R´, and θ, the computer program
mm stainless steel ruler, Tokyo, Japan), triangular automatically calculated D´TH and DTH values by using
rulers (SK 360-8 8 inch, Alvin & Co., Windsor, the preceding equations.
Conn.), a protractor (P476, Alvin & Co.), and a com- Values of MLT obtained from the posterior hori-
pass (Drafting Kit 608K, Alvin & Co.) with accuracy of zontal recording table (D´M – D´TH) and the anterior
±0.25 mm for lengths and ±0.25 degrees for angles. horizontal recording table (DM – DTH) were compared
1. Distance (R´) from the working side condyle (the by calculating their difference. No difference between
center of rotation) to centric relation point on the pos- the 2 values ([DM – DTH] – [D´M – D´TH]) within the
terior horizontal recording table. limit of measurement would indicate that the MLT
2. Distance (R) from the working side condyle to predicted by the pantographic tracings at the 2 posi-
centric relation point on the anterior horizontal record- tions were equivalent. If (DM – DTH) – (D´M – D´TH)
ing table. was unequal to 0, it may indicate that the tracing
3. Angle (θ) formed by the transverse horizontal axis obtained from the anterior recording table incorporat-
and the line connecting the working side condyle and ed some error or artifact.
centric relation point on the anterior horizontal record-
Statistical analysis
ing table.
The mean mandibular lateral translation value and
Calculated variables
standard deviation were calculated from the 25 tracings
Values for P´ were arbitrarily assigned as 0, 1, 2, 3, for each side for each of the 6 P´ positions (1, 2, 3, 4,
4, 5, and 6 mm, and the corresponding P value for each 5, and 6 mm). For each subject’s lateral movements, a
assigned P´ value was calculated with a computer. The percentage of the total MLT at each P´ value (1, 2, 3,

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THE JOURNAL OF PROSTHETIC DENTISTRY SON ET AL

Fig. 6. Graph of mean difference between mandibular later-


al transplantations calculated from anterior and posterior
tables for right and left side and for each P’ value. All mean
differences are less than 0.1 mm, limit of measurement
Fig. 5. Mean MLT with respect to P´ value (protrusive move- accuracy of equipment so both plate positions provide same
ment of nonworking condyle along the sagittal plane refer- value for MLT as long as lateral component due to rotation
ence line, 0, 1, 2, 3, 4, 5, and 6 mm) for 25 subjects. Max. is subracted.
MLT = Maximum value of mandibular lateral translation in
the study; Mean MLT = mean mandibular lateral translation;
pure rotation = mandibular lateral translation value for pure
rotation that is always zero; SD = standard deviation. 0.48(0.29) mm, 0.57(0.32) mm, 0.61(0.36) mm, and
0.62(0.40) mm (Fig. 5).
For MLT timing, in 64% of the tracings, more than
4, 5, and 6 mm) was calculated and categorized into 50% of the total MLT occurred in the first 1 mm of for-
each 10% interval (0%-9%; 10%-19%; 20%-29%; ward movement of the nonworking side condyle from
30%-39%; 40%-49%; 50%-59%; 60%-69%; 70%-79%; the centric relation position. In 94% of the tracings, at
80%-89%; 90%-100%) to demonstrate the frequency least 50% of the total MLT occurred during the first
distribution of MLT timing. 3 mm of forward movement of the nonworking side
The mean and standard deviation values were deter- condyle from the centric relation position. In 4% of the
mined for ([DM – DTH] – [D´M – D´TH]) for the right tracings, more than 50% of the total MLT occurred
and left sides at each of the 6 positions on the sagittal after the first 3 mm of forward movement of the non-
plane reference line (P´ = 1, 2, 3, 4, 5 and 6 mm). A working side condyle from the centric relation position.
2-way analysis of variance (ANOVA) was used to deter- Two percent of the tracings (one subject’s left side)
mine the significance of any differences, with side and exhibited a negative value of MLT. This could have
P´, the independent variables. Clinical relevance was been an artifact or recording error.
evaluated by comparing these values to the limit of In evaluating the difference in the MLTs calculated
measurement accuracy, 0.1 mm. at the anterior and posterior plates, the distribution of
the 300 calculated differences included 226 “0” values,
RESULTS
24 “–0.1”, 49 “+0.1”, and 1 “0.2”. Only 1 difference
All subjects showed evidence of MLT. The lateral (0.2 mm) of the 300 values exceeded the limit of mea-
component of all human pantographic tracings differed surement accuracy of 0.1 mm. The 2-way ANOVA
from the corresponding lateral component of theoreti- revealed a significant difference for both independent
cally determined values for rotation without transla- variables with a P value of .023 for the side (right or
tion. The mean MLT and standard deviation values left) and a P value of .002 for the variable P´ (Table I).
were calculated for the 25 right side tracings for each of The Tukey-HSD test with significance level 0.05
the 6 P´ positions (1, 2, 3, 4, 5, and 6 mm). Mean showed the group on the right side at P´ equal to 4 to
values (and SD) were 0.31(0.19) mm, 0.44(0.24) mm, be significantly different from 9 of the other 13 groups.
0.51(0.27) mm, 0.62(0.28) mm, 0.65(0.31) mm, Of the average differences between the MLTs calculat-
and 0.66(0.36) mm. The corresponding left side ed at the anterior and posterior tables, the largest was
values were 0.33(0.17) mm, 0.42(0.26) mm, found for this group with a value of 0.052 mm (Fig. 6).
0.45(0.32) mm, 0.52(0.35) mm, 0.57(0.41) mm, and
DISCUSSION
0.58(0.43) mm. Values for the right and left side
combined were 0.32(0.18) mm, 0.43(0.24) mm, Whether a tracing should be obtained from an

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SON ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

Table I. Two-way ANOVA for the difference between the MLT determined from the anterior and posterior plates
Source of variation DF Sum of squares Mean square F Prob*

Main effects 6 0.058 0.010 4.178 0.0005


Side 1 0.012 0.012 5.207 0.023
P´ 5 0.046 0.009 3.972 0.002
Interactions 5 0.022 0.004 1.918 0.091
Side/P´ 5 0.022 0.004 1.198 0.091
Explained 11 0.080 0.007 3.151 0.0005
Residual 288 0.666 0.002
Total 299 0.746 0.002
*A significant difference exists at P=.05.

induced or a voluntary mandibular lateral movement line interpretation (Fig. 4) of the smooth scribing line
remains controversial. Tupac28 advocated that scanned for computer analysis. The mean difference
mandibular movements should be induced if the objec- (0.052 mm) at that point is still half of the measure-
tive of a pantographic survey is to record “the complete ment accuracy of 0.1 mm. This is not considered a clin-
capacity of the mandibular movements.” Lundeen and ically significant difference.
Wirth21 found that recordings made with firm lateral From the results of these 2 studies, it can be con-
guidance on the body of the mandible showed lateral cluded that for the Denar pantograph system, the
border pathways that were reproducible and that the amount of mandibular translation calculated from the
maximum attainable immediate MLT could be repeat- tracing was not changed by altering the posterior hori-
ed. However, it has not been proven that one’s func- zontal recording table position in the anterior-posteri-
tional and/or habitual mandibular movements corre- or direction, when the lateral component of the tracing
spond to “the complete capacity” of the mandibular due to rotation was subtracted (Fig. 2). However, if a
movements or “the maximum attainable immediate pantograph system is modified so that the posterior-
mandibular lateral translation.” Also, the mandible and horizontal recording styli and tables can be positioned
its surrounding soft tissues can be compressed or at the transverse horizontal axis, as the posterior tables
stretched by excessive external forces used to induce and styli on our experimental pantograph were, the
mandibular movements. It is difficult to determine an tracings made by the modified pantograph can be easi-
adequate amount of force to induce mandibular move- ly and readily interpreted for any MLT. This is because
ments for each person in a scientifically controlled man- tracings made at the transverse horizontal axis incorpo-
ner. Clayton et al.3 suggested that border tracings rate only a minimal lateral component of movement
should be guided when the teeth are in contact, or a due to rotation so that any lateral components seen on
central bearing surface should be used because tooth the tracings are almost true representations of MLT. All
interferences and muscles may deflect the movements 300 differences between this estimate of MLT and
away from the border position. In recording MLT, it is MLT were 0.1 mm or less. From a clinical viewpoint
our opinion that voluntary mandibular movements that this provides a good estimate of the actual MLT.
use clutches to prevent interferences seem to be more Therefore it is desirable to have such a pantograph sys-
clinically relevant and justifiable than induced tem, whose posterior styli are located at the transverse
mandibular movements. Therefore all pantographic horizontal axis.
tracings in this study were obtained from the subjects’ Two subjects, who were currently asymptomatic,
voluntary mandibular lateral movements. had a history of TMD and received occlusal splint ther-
Craddock et al.15 reported that, if the horizontal apy. One of them showed a negative MLT value in her
recording table in a pantograph is even with the trans- left nonworking side tracing. This might be a true rep-
verse horizontal axis in a superior-inferior direction, resentation of what actually occurred but was probably
rotational movements of the mandible do not produce a result of operator error. The other subject did not
tracings that mimic immediate MLT. The results of our show any abnormality in her tracings or present any
study confirmed the finding of Craddock et al.15 In our problem during the procedure.
study, the values of MLT obtained from the 2 record- The definitions of 3 subcategories of mandibular
ing table positions with the modified Denar panto- translation (immediate, early, and progressive) in the
graph were equivalent within the accuracy of measure- Glossary of Prosthodontic Terms29 are not precise. For
ment. The significant difference observed for the mean example, in the Glossary, “early mandibular transla-
difference at one point may be due to the computer tion” is defined as “the translatory portion of lateral
measuring on different sides of the steps in the broken movement in which the greatest portion occurs early in

DECEMBER 1998 677


THE JOURNAL OF PROSTHETIC DENTISTRY SON ET AL

the first 4 mm of forward movement of the nonwork- the centric relation position 1, 2, 3, 4, 5, and 6 mm,
ing condyle as it leaves centric relation,” but it does not respectively.
clarify what “the greatest portion” and “early in the 3. For mandibular lateral translation timing, in 64% of
first 4 mm” mean. Also, the Glossary defined “pro- the tracings, more than 50% of the total mandibular lat-
gressive mandibular translation” as “the greatest rate of eral translation occurred during the first 1 mm of for-
motion is distributed throughout the first 4 mm of for- ward movement of the nonworking side condyle from
ward movement of the nonworking condyle as it leaves the centric relation position. The differences DM – DTH
centric relation.” However, it does not specify what and D´M – D´TH, which represent true mandibular later-
“the greatest rate of motion” is in a quantitative way al translation, were calculated. If a subject’s mandible
(for example, percentage). “Immediate mandibular moves in a pure rotation, D´M – D´TH = 0. However, if
translation” is defined in the Glossary as “the translato- any difference existed, then this indicated that the
ry portion of lateral movement in which the non-work- mandible translated. In 94% of the tracings, at least 50%
ing condyle moves essentially straight and medially as it of the total mandibular lateral translation had occurred
leaves the centric relation position.” The meaning of within the first 3 mm of forward movement of the non-
the clause, “as it leaves the centric relation position,” is working side condyle from the centric relation position.
not clear. It would seem to be better if the clause meant In only 4% of the tracings did 50% of the total mandibu-
a range of time or a range of distance on the sagittal lar lateral translation occur after the first 3 mm of
plane reference line rather than a practically undefin- forward movement of the nonworking side condyle
able instantaneous moment. Also, the definition does from the centric relation position.
not specify how much the nonworking side condyle 4. For the Denar pantograph system, the amount of
should move essentially straight and medially as it mandibular translation represented in the tracing was
leaves the centric relation position. For example, if a not changed by altering the posterior horizontal
nonworking side condyle moves medially straight only recording table position in the anterior-posterior direc-
for 0.1 mm out of its total 2 mm mandibular lateral tion, relative to the transverse horizontal axis, when the
translation in its range of motion, it may not be appro- lateral component of the tracing due to rotation was
priate to classify this movement as “immediate accordingly subtracted.
mandibular translation.” 5. Tracings on the posterior horizontal recording
The following are the proposed definitions for tim- table at the transverse horizontal axis were easier to
ing of mandibular lateral translation: interpret because the lateral component of the tracing
1. Early mandibular lateral translation: When more due to rotation was negligible and did not need to be
than 50% of the total lateral movement occurs in the considered.
first 1 mm of forward movement of the nonworking 6. Results of this study suggest that current termi-
side condyle from the centric relation position. nology related to mandibular lateral translation should
2. Intermediate mandibular lateral translation: When
be revised.
at least 50% of the total lateral movement occurs with-
in the first 3 mm of forward movement of the non-
REFERENCES
working side condyle from the centric relation position.
1. Winstanley RB. Observations on the use of the Denar pantograph and
3. Late mandibular lateral translation: When less
articulator. J Prosthet Dent 1977;38:660-72.
than 50% of the total lateral movement occurs in the 2. Chance DA, Williams EO, Huff TL, Andrews DH. Determination of
first 3 mm of forward movement of the nonworking chronology of mandibular border movements by optical pantography. J
side condyle from the centric relation position. Prosthet Dent 1984;51:559-63.
3. Clayton JA, Kotowicz WE, Myers GE. Graphic recordings of mandibular
CONCLUSIONS movements: research criteria. J Prosthet Dent 1971;25:287-98.
4. Anderson GC, Schulte JK, Arnold TG. An in vitro study of an electronic
Within the limits of this study, the following conclu- pantograph. J Prosthet Dent 1987;57:577-80.
5. Dupas PH, Picart B, Graux F, Lefevre C. Effect of clutch surface changes
sions were drawn. on the computerized pantographic reproducibility index and the Fischer
1. The value of the lateral component of 100 human angle. J Prosthet Dent 1987;57:625-30.
pantographic tracings from 25 subjects differed from 6. Gross MD, Nemcovsky CE. Investigation of the effects of a variable later-
al guidance incline on the pantronic registration of mandibular border
the lateral component of theoretically determined val- movement: part II. J Prosthet Dent 1993;70:336-44.
ues for rotation without translation. The difference 7. Clayton JA, Kotowicz WE, Zahler JM. Pantographic tracings of mandibu-
supports the presence of mandibular lateral translation lar movements and occlusion. J Prosthet Dent 1971;25:389-96.
8. Clayton JA. A pantographic reproducibility index for use in diagnosing
in these subjects.
temporomandibular joint dysfunction: a report on research. J Prosthet
2. The mean mandibular lateral translation values Dent 1985;54:827-31.
(SD) of the right and left side combined were 9. Crispin BJ, Myers GE, Clayton JA. Effects of occlusal therapy on panto-
0.32(0.18) mm, 0.43(0.24) mm, 0.48(0.29) mm, graphic reproducibility of mandibular border movements. J Prosthet Dent
1978;40:29-34.
0.57(0.32) mm, 0.61(0.36) mm, and 0.62(0.40) mm 10. Jackson MJ. The reproducibility of pantographic tracings on medicated
when the nonworking condyle moved forward from and nonmedicated subjects. J Prosthet Dent 1979;41:566-75.

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SON ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

11. Curtis DA, Sorensen JA. Errors incurred in programming a fully adjustable 26. Levinson E. The nature of the side-shift in lateral mandibular movement
articulator with a pantograph. J Prosthet Dent 1986;55:427-9. and its implications in clinical practice. J Prosthet Dent 1984;52:91-8.
12. Donaldson K, Clayton JA. Comparison of mandibular movements record- 27. Guichet NF. Procedures for occlusal treatment. A teaching atlas. Ana-
ed by two pantographs J Prosthet Dent 1986;55:52-8. heim: Denar Corp.; 1969. p. 55-9.
13. Beard CC, Donaldson K, Clayton JA. Comparison of an electronic and a 28. Tupac RG. Clinical importance of voluntary and induced Bennett move-
mechanical pantograph. Part I: consistency of an electronic computerized ment. J Prosthet Dent 1978;40:39-43.
pantograph to record articulator settings. J Prosthet Dent 1986;55:570-4. 29. The Academy of Prosthodontics. The glossary of prosthodontic terms. 6th
14. Pelletier LB, Campbell SD. Comparison of condylar control settings using ed. J Prosthet Dent 1994;71:41-112.
three methods: a bench study. J Prosthet Dent 1991;66:193-200.
15. Craddock MR, Parker MH, Cameron SM, Gardner FM. Artifacts in record- Reprint requests to:
ing immediate mandibular translation: a laboratory investigation. J Pros- DR F. MICHAEL GARDNER
thet Dent 1997;78:172-8. DEPARTMENT OF ORAL REHABILITATION
16. Dawson PE. Evaluation, diagnosis, and treatment of occlusal problems. SCHOOL OF DENTISTRY
2nd ed. St Louis: CV Mosby;1988. p. 221-3. MEDICAL COLLEGE OF GEORGIA
17. LePera F. Understanding graphic records of mandibular movements. J AUGUSTA, GA 30912-1260
Prosthet Dent 1967;18:417-24.
18. Aull AE. Condylar determinants of occlusal patterns. Part I. Statistical CONTRIBUTING AUTHORS:
report on condylar path variations. J Prosthet Dent 1965;15:826-46.
19. Lee RK. Jaw movements engraved in solid plastic for articulator controls. Wyatt F. Caughman, DMD, MEd, Professor and
Part I. Recording apparatus. J Prosthet Dent 1969;22:209-24. Chair, Department of Oral Rehabilitation, School of
20. Lundeen HC, Shryock EF, Gibbs CH. An evaluation of mandibular border
movements: their character and significance. J Prosthet Dent 1978;40:
Dentistry, Medical College of Georgia; Carol A.
442-52. Lefebvre, DDS, MS, Associate Professor, Department
21. Lundeen HC, Wirth CG. Condylar movement patterns engraved in plastic of Oral Rehabilitation, School of Dentistry, Medical
blocks. J Prosthet Dent 1973;30:866-75.
22. Bennett NG. A contribution to the study of the movements of the
College of Georgia; and Norris L. O’Dell, DMD,
mandible. J Prosthet Dent 1958;8:41-54 PhD, Professor, Department of Oral Biology, School
23. Landa JS. A critical analysis of the Bennett movement. Part I. J Prosthet of Dentistry, Medical College of Georgia.
Dent 1958;8:709-26.
24. Landa JS. A critical analysis of the Bennett movement. Part II. J Prosthet 10/1/93127
Dent 1958;8:865-79.
25. Brotman DN. Contemporary concepts of articulation. J Prosthet Dent
1960;10:221-30.

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