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Original Article

Effect of Direct and Indirect Face-Bow Transfer on the

Horizontal Condylar Guidance Values: A Pilot Study
Aditi Mishra, Jayant Palaskar
Department of Prosthodontics and Crown and Bridge, Sinhgad Dental College and Hospital, Pune, Maharashtra, India

Abstract
Aims and Objectives: This study aimed to evaluate the effect of direct and indirect face-bow transfer on the horizontal condylar guidance
(HCG) values obtained on the semi-adjustable articulator. Materials and Methods: A total of 15 subjects of age 20-30 years, of either sex were
selected. Two sets of maxillary and mandibular casts were obtained. A single arbitrary face-bow record was used for mounting the maxillary
casts by direct and indirect transfer for each subject. The mandibular casts were mounted using maximum intercuspation record. Protrusive
records were made in Alu wax and used to program the directly and indirectly transferred casts. HCG values obtained from cephalometric
records were taken as control. The data was subjected to ANOVA and Bonferroni post hoc test. Results: Mean values of HCG obtained in
direct face-bow transfer were 24.93, indirect transfer 27.66, and cephalometric analysis 32.73. One-way ANOVA test indicated that there
was a significant difference between all the groups (P < 0.05). Tukeys test with Bonferronis correction (P < 0.01) was significant for direct
and indirect transfer (P = 0.008), and direct transfer and cephalometric readings (P = 0.0046). A nonsignificant difference was found between
indirect transfer and cephalometric readings (P = 0.047). Conclusion: There is a statistically significant difference in HCG values obtained
from direct and indirect face-bow transfer records. Lateral cephalograms gave higher mean HCG values than those obtained from protrusive
records. Mean HCG values obtained from indirect face-bow transfers are significantly more than those obtained from direct transfers and are
also closer to the values obtained from the lateral cephalograms.
Key words: Condylar guidance, facebow transfer, interocclusal records

Introduction
Condylar guidance by definition (GPT-8)[1] is the mandibular
guidance generated by the condyle and articular disc
traversing the contour of the glenoid fossa. Success
of complex prosthodontic procedures is enhanced by
accurate simulation of the condylar path of the patient
on an articulator. It enables the clinician to estimate the
correlation between the path traced by the condyle during
mandibular movements and the morphology of the occlusal
surfaces which in turn aids in restoring the occlusion without
interferences.[2]
Many studies have been done on the comparative accuracy of
clinical as well as radiographic methods of determining the
horizontal condylar guidance (HCG). The condylar guidance
inclination in semi-adjustable articulators is set either by
protrusive or lateral interocclusal registrations recorded in
a suitable recording medium. The same can be determined
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DOI:
10.4103/2277-4696.156518

radiographically by tomographs,[2] lateral cephalograms,[3]

and pantomographs.[4]
It has been shown by many studies that methods and materials
used to make the arbitrary face-bow records and protrusive
records for programming the articulators play a significant
role in determining the HCG. However, as claimed by the
manufacturer, there is no effect of the type of face-bow transfer,
that is, direct and indirect, on the values of HCG.
Direct mounting means that after face-bow registration has
been obtained, and the ear-bow halves have been removed
from the subject, the face-bow is transferred directly on to the
articulator to mount the maxillary cast. With indirect mounting,
once the face-bow registration has been obtained, the transfer
assembly is removed from the spring-bow and placed on to
the articulator using the transfer jig and mounting platform for
mounting the maxillary cast.[5]
The aim of this study was to evaluate the effect of the type
of face-bow transfer on the HCG values obtained on the
articulator and their comparison with values obtained from a
Address for correspondence: Dr. Aditi Mishra,
Department of Prosthodontics and Crown and Bridge, Sinhgad Dental
College and Hospital, Sinhgad Institutes, Off Sinhgad Road,
Pune - 411 041, Maharashtra, India.
Email: draditimishra89@gmail.com

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Mishra and Palaskar: Effect of facebow transfer on condylar guidance value

lateral cephalogram of the subject. This study was based on

the null hypothesis that type of transfer of arbitrary face-bow
has no effect on HCG values obtained on the semi-adjustable
articulator.

Materials and Methods

casts [Figure 4]. The HCG values obtained from the direct and
indirect transfers were noted for each subject [Figures 5 and 6].

Radiographic method
Lateral cephalograms of the subjects were obtained
(Planmeca EC Proline Ceph, Helsinky, Finland; 77 kV

A total of 15 subjects (dental students at Sinhgad Dental

College and Hospital, Pune) within the age group of 20-30
years, of either sex were selected. Inclusion criteria included
having a full complement of teeth, class I molar relation and
2-4 mm of overjet. Exclusion criteria included subjects with
temporomandibular disorders, any progressive periodontal
disease, major restorations, gross attritions, poor general
health and lack of adequate neuromuscular control of jaw
movements.
Two sets of irreversible hydrocolloid impressions were made
for each subject and poured using Dental stone (Kaldent,
Kalabhai, India). Split casts were prepared for all maxillary
casts. Face-bow record (HANAU Spring Bow, Whip Mix
Corporation, USA) was made for each subject.

Articulator preparation

Figure 1: Magnified condylar guidance

The semi-adjustable articulator (HANAU Wide-Vue

Articulator, Whip Mix Corporation, USA) has a condylar
guidance which is graduated at 5 intervals. In order to obtain
more accurate readings, a sectioned modified protractor,
graduated at per degree interval, was attached onto the inner
side of the graduated markings on the condylar element, in
alignment with the markings. An L-shaped extender made from
23 gauge orthodontic wire was attached onto the reference
zero line [Figure 1]. The articulator was zeroed according to
the Hanau manual.[5]

Direct face-bow transfer

After making the face-bow record, the ear pieces of the springbow were used for suspending the bow over the condylar shaft
ends of the Hanau Wide-Vue articulator. The anterior elevator
was adjusted so as to position the top of orbitale pointer on
the spring-bow to the underside of the orbitale indicator on
the articulator and then was secured by the thumbscrew. The
bitefork index was checked to be adequately supported by
cast support before placement of the maxillary cast and plaster
mounting to the articulator [Figure 2].

Figure 2: Direct face-bow transfer

Indirect face-bow transfer

After the direct transfer had been completed, the spring-bow

was unscrewed from the transfer assembly. The mounting
platform was secured on the lower member by the cast support.
The transfer assembly was secured onto the mounting platform,
and the cast support was raised to support the bitefork index
following which the maxillary cast was mounted [Figure 3].
The mandibular casts were then mounted using maximum
intercuspation Alu wax record for both direct and indirect
transfers. A single protrusive record for each subject was made
in Alu wax to program the directly and indirectly transferred

Figure 3: Indirect face-bow transfer

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Mishra and Palaskar: Effect of facebow transfer on condylar guidance value

and 10 mA.). The outline of the condyle, glenoid fossa

and articular eminence (AE) was traced. The Frankfort
horizontal plane (FHP) was traced by joining the porion
and orbitale. Another line along the posterior slope of AE
was drawn, extending from the most antero-superior point
on the glenoid fossa to the most convex point on the apex
of AE. The angle between FHP and posterior slope of AE
was measured to obtain condylar inclination angle as seen
in [Figure 7]. HCG values obtained from cephalometric
records were taken as control. The data was subjected to
ANOVA and Bonferroni post hoc test.
Table 1: Mean HCG values from different groups
Method

Mean

SE

SD

Sample
variance

Direct
24.93
1.52
5.92
35.06
Indirect
28
1.62
6.29
39.6
Cephalometric
32.73
1.52
5.92
35.06
HCG: Horizontal condylar guidance, SE: Standard error, SD: Standard
deviation

Results
All the statistical analyses were done using Microsoft
Excel 2013. Out of the 15 subjects who participated in the
study, 8 were males, and 7 were females. Mean values of
HCG obtained in direct face-bow transfer were 24.93,
indirect transfer 27.66 and cephalometric analysis-32.73
[Table 1]. One-way ANOVA test indicated that there was
a significant difference between all the groups (P < 0.05).
Tukeys test with Bonferronis correction (P < 0.01) was
significant for direct and indirect transfer (P = 0.008), and
direct transfer and cephalometric readings (P = 0.0046). A
nonsignificant difference was found between indirect transfer
and cephalometric readings (P = 0.047) [Table 2].

Discussion
There have been previous studies that compare the accuracy
of different clinical methods of recording the HCG and their
comparison with readings obtained radiographically. Occlusal
interferences may result during mandibular movements if

Figure 4: Programming the articulator using protrusive record

Figure 5: Horizontal condylar guidance readings from direct face-bow

transfer

Figure 6: Horizontal condylar guidance readings from indirect face-bow

transfer

Figure 7: Horizontal condylar guidance readings from cephalometric

tracing

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Mishra and Palaskar: Effect of facebow transfer on condylar guidance value

Table 2: One-way ANOVA and Bonferronis post hoc test of HCG values obtained from different groups
Source of variation

SS

df

MS

P (ANOVA)

Post hoc test

P value of
Bonferronis test

Between groups
463.24
2
231.62
6.33
0.039*
Direct and indirect transfer
0.008**
Within groups
1535.86
42
36.56
Indirect transfer and cephalometric tracing
0.047
Total
1999.11
44
Direct transfer and cephalometric tracing
0.0046**
For ANOVA: *Statistically significant (P < 0.05). For Bonferronis test: **Statistically significant (P < 0.01). SS: Sum of squares, df: Degree of freedom,
MS: Mean sum of squares, HCG: Horizontal condylar guidance

condylar guidance is not taken into account. Clinically, this

might lead to an increased chairside adjustment time and
arbitrary trimming which can be frustrating for both the patient,
as well as the dentist.
Gracis[6] advocated setting the condylar inclination at lower
than average values to ensure disocclusion of the posterior teeth
during excursions. Gilboa et al.[4] contradicted this by stating
that if the individual inclination of the eminence is very steep
or flat, guidance obtained from average value settings may
differ sufficiently to cause problems in achieving particular
clinical objectives, such as posterior disocclusionor balanced
occlusion.
Several extraoral and intra oral methods are used to clinically
record condylar guidance. Extra oral methods are mainly used
in edentulous patients. Interocclusal protrusive wax records,
jigs, and intra oral tracers are the most commonly used intra
oral methods.
Donegan and Christensen[7] have stated that one important
reason for the inconsistency of intra oral methods may be
that, regardless of the material used, horizontal condylar angle
changes with the degree of protrusion, and the intra-oral record
represents only one point along the condylar path.
Ratzmann et al.[8] have stated that intra oral methods of
recording condylar guidance angle have lower levels of
reproducibility and are subject to variations of the operator,
instrument, and occlusal records.
Radiographs provide an alternative method of ascertaining
HCG values. Compared to clinical methods, radiographic
measurement has the advantage of using stable bony landmarks
and ability of being standardized and repeatable. Studies
comparing radiographic and clinical methods like protrusive
wax records have also been abundant.
Goyal and Goyal[9] compared sagittal condylar values of arcon
and nonarcon articulators with cephalometric readings and
determined the amount of discrepancy in sagittal condylar
guidance values between arcon and nonarcon articulators
using same protrusive record. The authors concluded that the
mean difference in sagittal condylar guidance values obtained
from nonarcon and arcon articulators was highly significant
indicating a low level of reproducibility.
Tannamala et al.[10] compared the sagittal condylar angles
set in the Hanau articulator by use of an intraoral protrusive
record to those angles found using a panoramic radiographic

image. The radiographic values were found to be on average

4 greater than the values obtained by protrusive interocclusal
record method. The authors concluded that protrusive condylar
guidance angles obtained by panoramic radiograph may be
used in programming semi-adjustable articulators.
Shreshta et al.[2] compared condylar guidance measurements
made using computed tomography (CT) scans, interocclusal
wax records, interocclusal jigs, and intraoral tracer in
healthy adults. The results showed that CT scan showed
higher HCG values than the clinical methods and among the
clinical methods, values obtained from all the methods were
comparable.
After a literature search on HCG, it was found that while all
possible variations of recording, may it be of instruments,
methods of recording, interocclusal records, intra- and interoperator variability had been studied, the one variable that had
been consistently ignored was the effect of type of face-bow
transfer, that is, direct and indirect, on the values of HCG.
The Hanau Spring Bow manual considers both direct and
indirect transfer similar and describes indirect as an alternative
to the direct type of transfer. The manual further mentions that
indirect transfer offers increased stability when mounting,
greater access to the cast, and parallel orientation of the upper
and lower members of the articulator.[5]
In order to have more accuracy regarding the HCG values,
the Hanau Wide Vue articulator was innovatively modified
by adding a sectioned protractor to measure the angle to per
degree as compared to the original 5 mark. Furthermore, an
L-shaped extender made from 23 gauge orthodontic wire was
attached onto the reference zero line so as to extend it.
Alu wax was used to make protrusive interocclusal records
which were then used to program the articulators. Same
protrusive record was used to program both mountings for
a subject. Another factor that added to the objectivity and
reduced error was the use of split cast which allowed the
observer to accurately ascertain that there was indeed no
gap between the two rigid surfaces while programming the
articulator.
Lateral cephalograms (Planmeca EC Proline Ceph, Helsinky,
Finland) were made for all 15 subjects. Cephalometric tracings
were done, and values of HCG were determined by measuring
the angle between Frankfurts horizontal plane and posterior
slope of AE. The values obtained were consistently higher than

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Mishra and Palaskar: Effect of facebow transfer on condylar guidance value

those obtained from both directly and indirectly transferred

casts which is in agreement with Christensen and Slabbert,[11]
Shreshta et al.[2] and Tannamala et al.[10] who found that
radiographically determined angle always showed a greater
mean value than that determined by intra-oral records.
However, there can be other variables which might have played
a role. As this was designed to be a pilot study, the sample size
was just 15. A larger sample size would be able to give us more
reliable and insightful conclusions.

Conclusion
It was the aim of this study to analyze whether there is any
difference in mountings obtained by direct and indirect transfer
of the same face-bow record as the indirect type of transfer
does not directly utilize the anterior point of reference. Within
the limitations of this pilot study, it was proved that these two
procedures are indeed not exactly similar or an alternative to
each other as is stated by the Hanau Spring-bow manual.
Within the limitations of this study, the following conclusions
were derived.
There is a statistically significant difference in HCG values
obtained from direct and indirect face-bow transfer records.
Lateral cephalograms gave higher mean HCG values than those
obtained from protrusive records. Mean HCG values obtained
from indirect face-bow transfers are invariably more than
those obtained from direct transfers and are also closer to the
values obtained from the lateral cephalograms. More studies
need to be done with increased sample sizes so as to have a
more detailed insight into the role of the type of transfer on the
accuracy of semi-adjustable articulator mountings.

References
1. The glossary of prosthodontic terms. J Prosthet Dent 2005;94:10-92.
2. Shreshta P, Jain V, Bhalla A, Pruthi G. A comparative study to measure
the condylar guidance by the radiographic and clinical methods. J Adv
Prosthodont 2012;4:153-7.
3. Brewka RE. Pantographic evaluation of cephalometric hinge axis. Am J
Orthod 1981;79:1-19.
4. Gilboa I, Cardash HS, Kaffe I, Gross MD. Condylar guidance:
Correlation between articular morphology and panoramic radiographic
images in dry human skulls. J Prosthet Dent 2008;99:477-82.
5. Whipmix Corporation. Illustrated Instruction Manual for Hanau
Articulators. Waterpik Technologies, Fort Collins; 2008.
6. Gracis S. Clinical considerations and rationale for the use of simplified
instrumentation in occlusal rehabilitation. Part 2: Setting of the
articulator and occlusal optimization. Int J Periodontics Restorative
Dent 2003;23:139-45.
7. Donegan SJ, Christensen LV. Sagittal condylar guidance as determined
by protrusion records and wear facets of teeth. Int J Prosthodont
1991;4:469-72.
8. Ratzmann A, Mundt T, Schwahn C, Langforth G, Hutzen D, GedrangeT,
et al. Comparative clinical investigation of horizontal condylar
inclination using the JMA electronic recording system and a protrusive
wax record for setting articulators. Int J Comput Dent 2007;10:265-84.
9. Goyal MK, Goyal S. A comparative study to evaluate the discrepancy
in condylar guidance values between two commercially available
arcon and non-arcon articulators: A clinical study. Indian J Dent Res
2011;22:880.
10. Tannamala PK, Pulagam M, Pottem SR, Swapna B. Condylar guidance:
Correlation between protrusive interocclusal record and panoramic
radiographic image: A pilot study. J Prosthodont 2012;21:181-4.
11. Christensen LV, Slabbert JC. The concept of the sagittal condylar
guidance: Biological fact or fallacy? J Oral Rehabil 1978;5:1-7.
How to cite this article: Mishra A, Palaskar J. Effect of direct and indirect
face-bow transfer on the horizontal condylar guidance values: A pilot study.
J Dent Allied Sci 2014;3:8-12.
Source of Support: Nil. Conflict of Interest: None declared.

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