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Journal of Oral Rehabilitation 1997 24; 303309

The influence of anterior guidance and condylar guidance on
mandibular protrusive movement
T . O G AWA , K . K O YA N O , & T . S U E T S U G U Department of Prosthetic Dentistry II, Faculty of Dentistry, Kyushu
University, Fukuoka, Japan
SUMMARY This study reveals the influence of the incisal and
condylar guidance on mandibular protrusive movement. The
protrusive movements were measured on 54 young adults (27
females, 27 males) using a three-dimensional mandibular
movement analysing system. The inclinations of the sagittal
paths on the incisor, canine, 1st molar, 2nd molar and condylar
points were calculated, and multiple regression analysis was
performed to evaluate the influence of the incisal and condylar
paths on the path of each tooth quantitatively. The influence of
the incisal path on any tooth path was
consistently greater than that of the condylar path. The
condylar path had a greater influence on the paths of
posterior teeth than on the paths of anterior teeth, especially
in the female subjects. The influence of the condylar path on
the molar paths was twice as great in the female than that in
the male subjects. It was concluded that the influence of the
incisal and condylar guidance on the protrusive movement
path varies according to the kind of tooth and the gender of
the subject. These guiding system characteristics were
confirmed by morphological analysis.
Introduction
Mandibular movements depend upon anterior guidance and
posterior guidance. Limited to natural dentition, the
protrusive movements of the normal mandible are governed
by incisal and condylar guidance (Lee, 1982; Rugh &
J ohnson, 1988).
Hanau's quint (Hanau, 1926) is a determinant of occlusion
(which includes the two guidances mentioned above, the
plane of occlusion, compensating curve and the cusp height)
that has been described as a method of creating a balanced
occlusion for complete dentures. This theory is based on the
assumption that the incisal and condylar guidance regulate
mandibular movements without inter-individual variation.
However, there are other morphological factors that could
have effects on mandibular protrusive movements, such as
the size of the mandible and the location of the dentition. It
should be considered that the movement path of each point
on the mandible is determined according to its location
relative to the two guiding factors.
Men have a wider and larger mandible than women
(Sakamoto, 1959; Broadbent, Broadbent & Golden, 1975),
and the dentition in women is located, both horizontally and
vertically, nearer to the condyle than that in men (Ogawa,
Koyano & Suetsugu, 1992). Little information, however, has
been available concerning the relationship between the sex
difference in these morphological factors and actual
mandibular protrusive movements. This lack of information
may be due to insufficient data from the kinesiological as
well as morphological standpoint, although some
mathematical or geometrical analyses have been attempted
(Villa, 1959; Katona, 1991). Analysis of the movement paths
of canines and molars, in relation to the incisal and condylar
paths, is the only way to clarify the mechanism of anterior
and condylar guidances.
The purpose of this study was to investigate the
1997 Blackwell Science Ltd 303
304 T . O G AWA et al.
influence of the incisal and condylar paths on the protrusive
movement path of canines and molars and to evaluate the
null hypothesis that the difference in the guidance system
exists between the sexes, by means of actual measurements
of mandibular movements and dentofacial morphology.
Materials and methods
Subjects
Fifty-four young adults including 27 males and 27 females
(age range from 19 to 28 years, with a mean age of 219
years) were randomly selected from among the students and
staff of Kyushu University. Before their entry into the study,
a clinical examination was performed on each candidate. All
had (a) a complete natural dentition excepting third molars
and (b) Angle's class I occlusion without noticeable
abnormalities in the upper and lower dentitions, and/or in
their relationship. There was no history of orthodontic
therapy and no symptoms indicative of temporomandibular
disorders. Their anterior guidances were examined with
metal strips (occlusal registration strips)*. All their
protrusive movements had smooth guidances by contacts of
anterior teeth only, and there were no contacts between the
upper and lower molars during the movements. The subjects
chosen for the present study were volunteers who were fully
informed about the nature of this investigation.
Mandibular movement measuring apparatus
The three-dimensional mandibular movement analysing
system (Figs 1 & 2) was used for the measurement of
mandibular movements. This original instrument was
developed in our laboratory and has the ability to record
movements in six degrees of freedom. A frame with three
light-emitting diode (LEDs) ( HLP-60RB)

targets was
attached to the labial surfaces of the lower incisors using a
cast clutch with cyanoacrylate adhesive. Another one with
three LED targets was attached to the upper incisors as well,
in order for cancelling head movements. The clutches were
designed and attached to the teeth so as not to disturb
masticatory movements or lip seal as much as possible. Two
cameras, including position sensitive
*The Artus Corp., Englewood, New J ersey, U.S.A.

Hitachi Ltd, Tokyo, J apan.

Fig. 1. (a) The three-dimensional mandibular movement analyzing
systemwhich can analyse the movements of any point on the mandible.
(b) LED target frames attached to the labial surfaces of the upper and
lower incisors.
detectors (PSDs)

, detected the positions of the six LEDs.

The basic principle of the sensing system is the same as
Karlsson (1977) reported. The data were recorded in a data
recorder and analysed with a personal computer

. Because
there is no requirement to stabilize the head, and that the
total measuring apparatus attached to the lower incisors
weighs only 15 g, it is possible to record the natural and
physiological movements of a subject. The maximum error
of the system was 100 m within 30 mm from the
intercuspal position (ICP), and the resolution of the system
was 50 m. The details of the system were described in a
previous study (Koyano, 1987).
Measurement of mandibular movements
Each subject was requested to sit upright in a portable dental
chair. The maximal protrusive movements from

S-1880, Hamamatsu Photonics Co., Inc., Hamamatsu, J apan.

PC-9801,
NEC Corp., Tokyo, J apan.
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
G U I D A N C E S Y S T E M D U R I N G P R O T R U S I O N 305
Fig. 2. A block diagramof the three-dimensional mandibular movement
analysing system.
Fig. 3. Computerized measurement of the inclination of the sagittal
path. The 2 mmanterior position fromthe ICP (d) which the incisor
moved was defined as the protruded position (j). This figure shows the
explanatory diagramfor calculating the inclination of the incisal path.
The inclination of the line from the ICP to the protruded position
relative to the horizontal reference plane was calculated as the
inclination of the incisal path. The inclination of the line connecting
these two positions at each analysis point was also calculated for each
inclination of the movement path.
the ICP with the teeth in light contact were recorded four
times using the measuring apparatus mentioned above.
Standard co-ordinates
Camper's plane was used for the horizontal reference plane,
which included bilateral arbitrary hinge points and an
inferior border point on the left wing of the nose. The
arbitrary hinge points were located at a position 5mm
vertically inferior to the point 13mm anterior to the posterior
border of the tragus on the canthus-tragus line.
Analysis of mandibular movements
The inclination of the sagittal path at each analysis point was
calculated as shown in Fig. 3. The analysis points were on
the line angle of the left central incisor, the tip of the cusp on
the left canine, the tip of the distobuccal cusp on the left 1st
and 2nd molars, and the morphological center of the left
condyle on the kinematic axis (Kohno & Ishiwara, 1971;
Kohno & Nakano, 1987). The averaged data for each subject
was used for the statistical analysis. The significance of
differences was determined at the 5% level by Student's t-
test. Multiple regression analysis was used to evaluate
Fig. 4. Variables for the morphological analysis. L, the antero-postero
distance fromthe line angle of the left central incisor to the tip of the
distobuccal cusp on the left 2nd molar. Vi, the distance fromthe line
angle of the left central incisor to the horizontal reference plane. Hi, the
antero-postero distance fromthe lineangle of the left central incisor to
the left arbitrary hinge point. V2m, the distance fromthe tip of the
distobuccal cusp on the left 2nd molar to the horizontal reference plane.
H2m, the antero-postero distance fromthe tip of the distobuccal cusp on
the left 2nd molar to the left arbitrary hinge point.
the influence of the incisal and condylar paths on the path of
each analysis point.
Morphological analysis
An analysis to evaluate the following morphological factors
was performed in the sagittal plane (Fig. 4): (a) the length of
the dentition (L); (b) the vertical and
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
306 T . O G AWA et al.
Table 1. Inclination of the sagittal path of the representative point on the mandible (degrees)
Incisor Canine 1st molar 2nd molar Condyle
Male 416 6 81* 414 677 406 665 401 658 363 653
Female 389 6 72 387 669 384 656 383 652 369 679
Sex difference n.s. n.s. n.s. n.s. n.s.
*Mean 6s.d. n.s., not significant.
horizontal position of the incisal point (Vi, Hi); and (c) the
vertical and horizontal position of the second molar point
(V2m, H2m). The positions of the points described in Fig.3
were obtained by translating the data, which were measured
on precision casts with a three-dimensional digitizer*, into
standard coordinates. A previous study (Ogawa et al., 1992)
described the measuring procedure of the digitizer.
Results
The inclination of the sagittal path at each analysis point is
presented in Table 1. All of the tooth path inclinations were
greater than the inclination of the condylar path, and they
tended to be greater for the anterior teeth than for the
posterior teeth, regardless of sex. There was no significant
difference in the inclinations between the male and female
subjects.
The results of the multiple regression analysis are
presented in Table 2. No significant correlation was found
between the inclinations of the incisal and condylar paths.
Therefore, the inclinations of the paths at these two points
could be defined as explanation variables(Xi and Xc,
respectively). The inclinations of the canine, 1st molar and
2nd molar paths were defined as criterion variables (Yca,
Y1m and Y2m, respectively). The inclination of each tooth
path was represented by means of separate multiple
regression equations with a considerably higher coefficient
of determination.
The standard partial regression coefficients (i, c)
showed the respective contribution of the incisal and
condylar paths to each tooth path quantitatively. The ratio of
c to i was also calculated to evaluate the effect of the kind
of teeth and gender of the subject on the guidance system.
There was a tendency that the incisal path had a greater
influence on the anterior tooth path, whereas the condylar
path was more influential on the posterior
*MXF203, Mitsutoyo Mfg Co., Ltd, Tokyo, J apan.
tooth path. The canine path especially depended almost
wholly upon the incisal path regardless of sex, and the
influence of the condylar path on the canine path could be
ignored. It should be noted that the influence of the incisal
path on any tooth path was consistently greater than that of
the condylar path. Even the influence of the condylar path on
the second molar path was one-third of the influence of the
incisal path in male subjects, and two-thirds in female
subjects. It was shown that the influence of the condylar path
on the 1st and 2nd molar paths was twice as great in female
than that in male subjects.
Table 3 shows the data for male and female subjects
obtained by the morphological analysis. There was no
significant difference in the length of the dentition (L)
between male and female subjects. On the other hand, the
dentition in women was located 70 mm horizontally and 38
vertically nearer to the condyle than that in men with a
significant difference, as seen in data for H2m and V2m. The
analysis of L, Vi, V2m, Hi, and H2m revealed that even the
2nd molar in the female was nearer, both vertically and
horizontally, to the incisor than to the condyle.
Discussion
When anterior and posterior guidances govern mandibular
movements, the movement path of any point on the
mandible is determined by its location relative to these two
guiding factors. In order to evaluate the mechanism of the
guiding system, it is necessary to simultaneously analyse the
mandibular movements and the dentofacial morphology and
to measure the movement path of any tooth and the condyle.
However, it has been very dificult to obtain the
kinesiological and morphlogical data in common coordinates
due to the lack of the technique to establish the standard
coordinates by which these two data can be superimposed. A
measuring apparatus, such as the
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
G U I D A N C E S Y S T E M D U R I N G P R O T R U S I O N 307
Table 2. Results of the multiple regression analysis
Male
Tooth kind Multiple regression equation Coefficient of Standard partial regression c/i
determination coefficient
r
2
i c
Canine Yca 5095 Xi 1005 Xc 1001 099

100 003 003

1st molar Y1m5 079 Xi 1 024 Xc 097 098

098 020 020

2nd molar Y2m5 068 Xi 1 032 Xc 010 098

095 029 031

Female
Tooth kind Multiple regression equation Coefficient of Standard partial regression c/i
determination coefficient
r
2
i c
Canine Yca 5096 Xi 1007 Xc 1130 099

100 008 008

1st molar Y1m5 077 Xi 1 026 Xc 115 098

097 037 038

2nd molar Y2m5 062 Xi 1 036 Xc 1095 098

087 055 064

P , 0001.
Table 3. Means for measurement of morphological variables (mm)
L Vi Hi V2m H2m
Male 399 6 17* 244 648 874 646 268 634 476 648
Female 397 6 19 225 635 803 645 230 626 406 642
Sex difference n.s. n.s.
*Mean 6s.d. n.s., not significant.

P , 001;

P , 0001.
Sirognathograph, has no ability to specify a definite
reference plane and to analyse the movement at any point on
the mandible. In the present study, the three-dimensional
reference plane was defined, and the movement data were
recorded in six degrees of freedom. The design of the present
study, therefore, made it possible to realize the precise
measurements of the movement path at any point of the
mandible including the condylar point and the dentofacial
morphology in common coordinates, and showed the
definite influence of the incisal and condylar guidances on
the movement path of the canine and molars.
The length of the dentition showed little variability
between the subjects, and there was no significant difference
between the male and female subjects as shown in the
results, which led to the following finding. In the sagittal
plane, the longer the mandible the further the dentition was
located from the condyle. The present results demonstrated
that male subjects had a longer
mandible in the sagittal plane than the female subjects and,
as mentioned above, the dentition in female subjects was
located, horizontally and vertically, nearer to the condyle
than that in the male subjects. It is geometrically understood
that the condylar guidance effect in females is greater than
that in males due to the morphological difference between
them. The difference in the horizontal location was
especially great, and it may have a dominant contribution to
the functional difference between males and females. Even
the 2nd molar in male subjects was located at the middle
point between the incisal and condylar points horizontally. It
could be a reason for the dominance of the incisal path
effect, compared to the condylar path effect, on any tooth
path.
No previous study has reported the ratio of the incisal
guidance effect to the condylar guidance effect, and the
results of this study may contribute to prosthodontic theory.
Unfortunately, current articulators have an
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
308 T . O G AWA et al.
immutable relationship between the incisal table and the
bilateral condyles, and the influence of the two guidances
appears to be far from being thoroughly considered.
Although the present study showed no data obtained from
the articulator, the present results suggest the important role
of the face-bow transfer so as to minimize the error of the
guiding systeminduced by the inter-individual variation of
the dentocranial mophology. Further studies should be
conducted to reflect these findings on the guidance system
and the functional difference between male and female
subjects, to actual work in the clinical field.
Condylar guidance appears to vary with variations of the
morphology of the temporomandibular joint, such as
remodelling in relation to the long-term changes in dentition
(Mongini, 1980). On the other hand, Ingervall (1972)
reported that no correlation existed between the incisal and
condylar paths during protrusive movements. Previous
studies (Pelletier & Campbell, 1990; Alsawaf, &
Garlapo,1992) indicated no consensus correlating the
condylar movements with the anterior guidance. Considering
reconstructive work in the clinical situation, it is commonly
accepted that condylar guidance is individual and
immutable, and that only the anterior guidance, but not the
posterior guidance, can be changed to improve masticatory
function. We have, therefore, acquired the standard to
change the inclinations of the molar movement path by
altering the anterior guidance through this study. For
example, according to the multiple regression equation
presented, as the inclination of the incisal path increases 10,
the inclination of the 2nd molar path increases 64 in men
and 46 in women, respectively. Considerably higher
coefficients of determination have confirmed that the path of
any tooth mostly depends upon the two incisal and condylar
guidances. It seems, therefore, that the major determinants of
each tooth path in protrusive movements were the two
guiding factors, anterior and condylar guidance, and gender.
The inclination of the sagittal path can be changed by
altering the definition of the protruded position. In the
present study, the amount of the incisal movement from the
ICP to the edge-to edge position, which we measured on 35
of the 50 subjects, was 348 6 105 mm. In all of the
subjects, furthermore, the incisal edges of the lower anterior
teeth were held in contact with the lingual surfaces of the
upper anterior teeth within 2 mm of the ICP. Therefore, the 2
mm anterior position was defined as the protruded position,
and the
inclination of the sagittal path was calculated on each
analysis point as shown in Fig.3.
As for the inclinations of the incisal and condylar paths,
the present findings corresponded to the range of normal
data previously reported (Kang, Chung & Fricton, 1991;
Ferrario et al., 1992), except for a slight difference due to the
use of a different reference plane. Kohno & Nakano (1987)
proposed that the inclination of the incisal path should be
steeper than that of the condylar path when physiological
mandibular rotation around the condyles was taken into
account, based on the normal data actually measured. In
addition to this finding, this study showed that the
inclination on any tooth was greater than that of the condylar
path and that the inclination of any tooth path was closer to
that of incisal path than that of the condylar path.
This study revealed a relationship between the dentofacial
morphology and 3-D movements of the mandible, which
must be taken into consideration when restoration work is
carried out and stomatognathic function is examined. Further
research is required in order to develop a criteria for
establishing anterior guidance in clinical dentistry.
References
ALSAWAF, M.M. & GARLAPO, D.A. (1992) Influence of tooth contact on
the path of condylar movements. Journal of Prosthetic Dentistry, 67,
394.
BROADBENT, B.H. Sr, BROADBENT, B.H. Sr & GOLDEN, W.H. (1975)
Bolton Standard of Dentofacial Development Growth, p.1, C.V.
MosbyCompany, Saint Louis.
FERRARIO, V.F., SFORZA, C., MIANI, A. & SERRAO, G. (1992)
Kinesiographic three-dimensional evaluation of mandibular border
movements: A statistical study in a mormal young nonpatient group.
Journal of Prosthetic Dentistry, 68, 672.
HANAU, R.L. (1926) Articulation dened, analyzed, and formulated.
Journal of the American Dental Association, 8, 1694.
INGERVALL, B. (1972) Range of sagittal movement of the mandibular
condyles and inclination of the condyle path in children and adults.
Acta Odontologica Scandinavia, 30, 67.
KANG, J .H,. CHUNG, S.C. & FRICTON, J .R. (1991) Normal movements of
mandibule at the mandibular incisor. Journal of Prosthetic Dentistry,
66, 687.
KATONA, T.R. (1991) A mathematical Model of Mandibular Protrusion.
Journal of Prosthetic Dentistry, 66, 699.
KARLSSON, S. (1977) Recording of mandibular movements by intraorally
placed light emmiting diodes. Acta Odontologica Scandinavica, 33,
111.
KOHNO, S. & ISHIWARA, T. (1971) Analysis of movement of mandibular
condyle in sagittal plane. Bulletin of Tokyo Medical and Dental
University, 18, 233.
KOHNO, S. & NAKANO, M. (1987) The measurement and
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
G U I D A N C E S Y S T E M D U R I N G P R O T R U S I O N 309
development of anterior guidance. Journal of Prosthetic Dentistry,
57, 620.
KOYANO, K. (1987) A three dimensonal study of the retrusive movement
of the mandibule. Journal of Japanese Prosthodontic Society, 31,
5180.
LEE, R.L. (1982) Anteriro Guidance. In Advances in Occlusion (eds
Lundeen, H.C., Gibbs, C.H.). p. 51. J ohn Wright, Boston.
MONGINI, F. (1980) Relationship between the temporomandibular joint
and pantographic tracings of mandibular movements.
Journal of Prosthetic Dentistry, 43, 331.
OGAWA, T., KOYANO, K. & SUETSUGU, T. (1992) Three dimensional
analysis of the occlusal plane and the curve of spee in normal
subjects. Journal of Japanese Prosthodontic Society, 36, 602.
PELLETIER, L.B. & CAMPBELL, S.D. (1990) Evaluation of the relationship
between anterior anad posterior functionally
disclusive angles. Part I: Literature review, instumentation, and
reproducibility. Journal of Prosthetic Dentistry, 63, 395.
RUGH, J .D. & J OHNSON, R.W. (1988) Mandibular movements. In A
Textbook of Occlusion (eds Mohl, N.D., Zarb,G.A., Carlsson, G.E. &
Rugh, J.D), pp. 129141. Quintessence Publishing, Chicago.
SAKAMOTO, T. (1959) A study on the development changes of dentofacial
complex of J apanese with special reference to Sella Turcica.The
Journal of Japanese Orthodontic Society, 18, 1.
VILLA, H. (1959) Requirements of articulators for protrusive
movements. Journal of Prosthetic Dentistry, 9, 215.
Correspondence: Dr Takahiro Ogawa, Department of Prosthetic
Dentistry II, Faculty of Dentistry, Kyushu University, 3-1-1 Maidashi,
Higashi-ku, Fukuoka 81282, J apan.
1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24; 303309
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