RESEARCH AND EDUCATION

Three-dimensional analysis of the interchangeability of a

semiadjustable articulator system in service over time
Vern Chien Lee, BDS, MDS,a Ming Yi Tan, BDS, MDS,b Sophia Hui Xin Yee, BDS, MDS,c
Kuan Yee Wong, BDS, MDS,d Frank Kong Fei Lee, BDS, MDS,e and Keson Beng Choon Tan, BDS, MSDf

ABSTRACT
Statement of problem. Some contemporary articulator systems claim to be highly precise in their interchangeability, with tolerances below
10 mm in vertical error; however, the claims have not been independently verified.
Purpose. The purpose of this study was to investigate the interchangeability of calibrated semiadjustable articulators in service over time.
Material and methods. A calibrated mounting articulator served as the master articulator, while the test groups were used articulators with a
minimum of 1-year use by predoctoral dental students (n=10); used articulators with a minimum of 1-year use by prosthodontic residents
(n=10); and new articulators (n=10). One set of mounted maxillary and mandibular master models was positioned in the master and test
articulators. High-precision reference markers on the master models were used to determine interarch 3D distance distortions (dRR, dRC,
and dRL), interocclusal 3D distance distortion (dRM), interocclusal 2D distance distortions (dxM, dyM, and dzM), and interocclusal angular
distortion (dqM) relative to the master articulator. All measurements were conducted three times using a coordinate measuring machine
and then averaged to derive the final data set.
Results. For interarch 3D distance distortion, the mean dRR ranged from 4.6 ±21.6 mm for new articulators to 56.3 ±47.6 mm for articulators
used by prosthodontic residents; mean dRC ranged from 65 ±48.6 mm for new articulators to 119.0 ±58.8 mm for articulators used by
prosthodontic residents; and mean dRL ranged from 12.7 ±39.7 mm for articulators used by prosthodontic residents to 62.8 ±75.2 mm for
new articulators. For interocclusal 3D distance distortion, the mean dRM ranged from 21.5 ±49.8 mm for new articulators to 68.6 ±64.9 mm
for articulators used by predoctoral dental students. For the 2D distance distortions, the mean dxM ranged from −17.9 ±43.4 mm for
articulators used by predoctoral dental students to −61.9 ±48.3 mm for articulators used by prosthodontic residents; mean dyM ranged
from 18.1 ±59.4 mm for new articulators to 69.3 ±115.1 mm for articulators used by prosthodontic residents; and mean dzM ranged from
29.5 ±20.2 mm for new articulators to 70.1 ±37.8 mm for articulators used by prosthodontic residents. Mean dqM ranged from −0.018
±0.289 degree for new articulators to 0.141 ±0.267 degree for articulators used by prosthodontic residents. One-way ANOVA by
articulator type revealed statistically significant differences among the test groups for dRR (P=.007) and dzM (P=.011) only, where
articulators used by prosthodontic residents fared significantly poorer than the other test groups.
Conclusions. The new and used articulators tested did not fulfill the manufacturer’s claim of accuracy of up to 10 mm in the vertical
dimension. Up to 1 year of time in service, none of the investigated test groups fulfilled the criterion for articulator interchangeability,
even if the more lenient threshold of 166 mm were accepted. (J Prosthet Dent 2024;132:1028-37)

The dental articulator reproduces maxillomandibular re- fabrication of dental prostheses. Digital or virtual articu-
lationships and some or all mandibular movements, lators may overcome the limitations of analog articula-
thereby aiding diagnosis, treatment planning, and the tors, with the key advantage that dynamic movements

Supported by the National University of Singapore, Master of Dental Surgery (MDS) Research Grant.
a
Graduate student, Department of Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore.
b
Lecturer, Department of Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore.
c
Registrar, Department of Dentistry, Khoo Teck Puat Hospital, Singapore.
d
Registrar, Department of Dentistry, Khoo Teck Puat Hospital, Singapore.
e
Senior Lecturer, Department of Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore.
f
Associate Professor, Department of Prosthodontics, Faculty of Dentistry, National University of Singapore, Singapore.

1028 THE JOURNAL OF PROSTHETIC DENTISTRY

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interchangeable. Chung et al4 investigated Hanau Wide-

Clinical Implications Vue semiadjustable articulators (Whip Mix Corp) and
Cumulative errors from interchanging mounting reported significantly worse error in articulators in use for
30 months than in new and 18-month-old articulators.
and working articulators or between working
Artex CR articulators (Amann Girrbach AG) claim to
articulators are expected to be of clinical
be highly precise in their interchangeability, with toler-
significance, particularly in the fabrication of
ances below 10 mm in vertical error.9 Tan et al10 reported
implant-supported prostheses.
the 2D repositioning accuracy of casts on to the Artex CP
with black magnetic mounting plates to be below 9 mm.
However, this 2D distortion value did not consider both
may be more easily and accurately captured. Nonethe- the upper and lower members and was also limited to
less, the shift toward virtual articulators requires invest- one articulator. Interchangeability across articulators re-
ment in an appropriate scanner system and mains unknown.
accompanying software program for jaw motion ana- The purpose of the present study was to investigate
lyses. Recently introduced digital workflows also require the interchangeability of calibrated Artex CR articulators
substantial optimization to attain a reasonable level of in service over time. The null hypotheses were that no
clinical utility. These barriers remain significant to many significant difference would be found in the repositioning
end-users. Therefore, analog articulators remain impor- accuracy of mounted casts across articulators in service
tant in many practices, and manufacturers have recently over time and that operator designation would not
introduced interchangeable analog articulator systems. significantly affect the repositioning accuracy of mounted
These offer numerous advantages, including fewer ar- casts across articulators.
ticulators being needed to accommodate multiple
ongoing treatments; reduced damage to articulators as
MATERIAL AND METHODS
transportation is minimized; improved ease of commu-
nication with the dental laboratory technician; and A set of dentate maxillary and mandibular master
reduced transmission of infectious agents between the models with a missing maxillary right first molar and a
dental office and dental laboratory.1-5 missing mandibular right first molar were fabricated with
The definition of articulator interchangeability re- heat-polymerized pink (Lucitone 199 Denture Base
mains imprecise because of the lack of standardization Resin; Dentsply Sirona) and tooth-colored (Dentalon
and established criteria. The present authors propose that Plus; Kulzer GmbH) polymethyl-methacrylate (PMMA).
articulator interchangeability be defined as the ability of Wide-neck solid abutment analogs (048.165; Institut
the dental cast to be transferred from one articulator to Straumann AG) simulated crown preparations at the
another with repositionable accuracy. The articulators positions of the missing maxillary and mandibular right
should be calibrated with the same gauge to maintain first molars. Six Ø8.0-mm grade 5 silicon nitride refer-
their operability and reliability in service over time. ence spheres (Ceramic Balls Si3N4: 8.0 mm G5, refer-
The validity of articulator interchangeability has been ence 8 057 222; Tsubaki Nakashima Co, Ltd) with a
examined,1-8 but heterogeneous methodologies have led manufacturer-specified sphericity of 0.13 mm were
to inconsistent and conflicting findings. Most of these embedded in the master model at the sites of the
earlier studies were restricted by limitations in the maxillary right second molar, between the maxillary
measuring instruments, which tended to have brand- central incisors, maxillary left second molar, mandibular
specific calibration or check systems, and data were right second molar, between the mandibular central
largely limited to 2-dimensional (2D) measurement. incisors and the mandibular left second molar (Fig. 1).
Many of these studies on interchangeability were also The solid abutment analogs and silicon nitride spheres
conducted on new articulators, but time in service is a were incorporated into the master models because their
crucial criterion that was not generally investigated. precisely manufactured geometric features allowed for
However, Price and Mansfield2 assessed 46 Whip Mix accurate measurement via coordinate metrology.
#2240 (Whip Mix Corp) articulators in use for between 1 The Artex CR semiadjustable articulator system has
and 6 years using the Whip Mix #2245 check system and been selected for use in the National University Center
reported that 83% were interchangeable within a 94-mm for Oral Health Singapore (NUCOHS), which is a na-
tolerance level in the horizontal dimension, while 93.5% tional specialty center and base for the Faculty of
were interchangeable within a 52-mm tolerance level in Dentistry. Because of the interchangeability feature of
the vertical dimension. Price et al3 evaluated the inter- Artex CR articulators, all newly introduced articulators
changeability of 109 new Whip Mix #2240 and #3040 had been calibrated using a strict protocol with a single
articulators using the same measuring protocol, calibration key (Splitex Key, Artex C-Version; Amann
concluding that 93% of these new articulators were Girrbach AG) and verified by a trained technician from

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Figure 1. Maxillary and mandibular master model with silicon nitride spheres at regions buccal to maxillary right second molar, maxillary central
incisors, maxillary left second molar, mandibular right second molar, mandibular central incisors, and mandibular left second molars. Implant solid
abutment analogs placed at positions of missing maxillary and mandibular right first molars.

the manufacturer.11 The manufacturer has not specified test articulators were stored in a dry room maintained at
any schedule for recalibration. Therefore, the current 25  C and away from cleaning agents, water, or heat.
arrangement is for articulators to be recalibrated at the The master models were mounted using magnetic
discretion of the operator. mounting plates (Magnetic Mounting Plates-Black;
The test groups, each with a sample size of 10, Amann Girrbach AG) onto the master mounting artic-
comprised used articulators with a minimum of 1- ulator with gypsum (Plaster of Paris; Asia Plaster Co,
year use by predoctoral dental students, used articulators Ltd) mixed with an antiexpansion solution formulated
with a minimum of 1-year use by prosthodontic resi- with 6% potassium sulfate and 0.6% borax in water.
dents, and unused articulators. A total of 410 articulators, These were stored in a room maintained at 20  C and
comprising 228 predoctoral, 24 resident, and 158 unused left undisturbed for 96 hours to allow for complete
articulators, were available for testing. The maximum age setting of the mounting plaster.12 Occlusal equilibration
of used articulators was 2 years. The test articulators were was performed to ensure that bilateral simultaneous
selected by using a random number generator applied to contacts were present on the canines, premolars, and
the three pools of articulators. The recruited test articu- molars. This was verified with the use of 8-mm-thick
lators were inspected based on a checklist of criteria and shim stock (Arti-Fol; Dr Jean Bausch GmbH & Co KG)
were excluded if a history of significant damage or mis- (Fig. 3). Thereafter, randomization was conducted to
handling had been recorded or if visible damage (such determine the sequence of measurements of the test
as dents, bent components, or damage to the centric articulators. The same set of mounted maxillary and
latch or central axis) had been noted upon inspection. mandibular master models was removed from the
Articulators were also excluded if, on manual inspection, master articulator and repositioned in the test articula-
the two semiaxes of the centric lock mechanism could not tors for measurement.
engage the receptacles of the respective condyle analogs The master and test articulators were firmly secured
with sufficient precision (Fig. 2). The random selection to the granite table of a coordinate measuring machine
was repeated for the predoctoral pool after excluding two (CMM) (Global Silver Performance 7.10.7; Brown &
articulators. Sharpe) with a reported measuring precision of 1 mm.
A mounting articulator (Splitex Mounting Articulator All measurements were performed with the articulators
116mm; reference 216 020; Amann Girrbach AG) served in the upright position, with the incisal pin removed to
as the master articulator. This had been newly cali- improve accessibility of the CMM probe, and using
brated with the same calibration key immediately before direct computer control (DCC) mode. Two types of
the study started. Throughout the study, the master and centroid positions were derived in this study. The

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Figure 2. Articulator demonstrating precise engagement between centric lock mechanism’s semiaxis and receptacle of corresponding condyle analog.

Figure 3. Right lateral and frontal views of mounted master models on master articulator.

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centroid positions of the reference spheres were derived distortion or damage to the master models throughout
through eight probe hits on the external surface of each the study.
reference sphere. The centroid positions of the solid A statistical software program (IBM SPSS Statistics,
abutment analogs placed at the positions of the missing v27.0; IBM Corp) was used for all statistical calculations.
maxillary and mandibular right first molars were derived The data were initially submitted to the Shapiro-Wilk test
via the intersection (or pierce point) between the to check for the assumption of normality, and it was not
respective central axes and flat planes of the solid rejected. One-way analysis of variance (ANOVA) and the
abutment analogs; 4 probe hits were conducted on each Tukey honestly significant difference (HSD) test were
coronal platform plane, while 12 probe hits spread over used for the comparison of the three articulator groups.
3 parallel planes were conducted on each external cone. Within each test group, Pearson correlation coefficients
The optimal number of probe hits for each measured were computed to assess the linear relationships between
feature had been determined during the pilot phase of the sample and distortion parameters (a=.05).
the study.
For each articulator, three independent sets of the
RESULTS
following measurements were computed in the CMM
metrology software program (PC-DMIS CAD++ Version Interarch 3D distance distortion values between the
2021.1 Build #210 MR1; Wilcox Associates Inc): 3D dis- centroids of the paired reference spheres are shown in
tances between centroids of paired right, central, and left Figure 5. For the right paired reference spheres, the
reference spheres (RR, RC, and RL); 3D distance between magnitude of mean dRR ranged from 4.6 ±21.6 mm for
centroids of the 2 solid abutment analogs placed at the new articulators to 56.3 ±47.6 mm for articulators used by
positions of the missing maxillary and mandibular right prosthodontic residents. For the center paired reference
first molars (RM); 2D distance between centroids of the 2 spheres, the magnitude of mean dRC ranged from 65.0
solid abutment analogs placed at the positions of the ±48.6 mm for new articulators to 119.0 ±58.8 mm for ar-
missing maxillary and mandibular right first molars in the ticulators used by prosthodontic residents. For the left
buccolingual, anteroposterior, and supero-inferior di- paired reference spheres, the magnitude of mean dRL
rections (xM, yM, and zM); and 3D angle between the ranged from 12.7 ±39.7 mm for articulators used by
central axes of the two solid abutment analogs placed at prosthodontic residents to 62.8 ±75.2 mm for new
the positions of the missing maxillary and mandibular articulators.
right first molars (qM). Verification checks using CMM Interocclusal distortions between centroids of the 2
software program tolerance criterion functions ensured solid abutment analogs placed at the positions of the
data veracity. The tolerance value for each measured missing maxillary and mandibular right first molars are
physical geometric feature was set at 6 mm. For the shown in Figures 6-8. Mean dRM ranged from 21.5
approved data set, calculations using two or more ±49.8 mm for new articulators to 68.6 ±64.9 mm for ar-
measured features did not exceed their respective ticulators used by predoctoral dental students. For the
thresholds of 10 mm (RR, RC, and RL) or 20 mm (xM, yM, 2D distance distortions, the greatest distortions were
zM, and RM) when the 3 independent measurements consistently found in the articulators used by prostho-
were compared. These stipulated tolerance values dontic residents. The negative values in this segment
ensured that errors in individual measurement sets were represent the direction of distortion based on the local
sieved out and eliminated. The three independent mea- coordinate system. Mean dxM ranged from −17.9 ±43.4
surement sets, if consistent with one another, were then mm for the articulators used by predoctoral dental stu-
averaged to derive the final data set. This further reduced dents to −61.9 ±48.3 mm for articulators used by pros-
the magnitude of any unavoidable random errors. The thodontic residents. Mean dyM ranged from 18.1 ±59.4
dependent variables were derived by subtracting master mm for new articulators to 69.3 ±115.1 mm for articula-
measurements from test measurements. Three interarch tors used by prosthodontic residents. Mean dzM ranged
distortions (dRR, dRC, and dRL) were derived from the from 29.5 ±20.2 mm for new articulators to 70.1 ±37.8
measurement of the reference spheres, while five inter- mm for articulators used by prosthodontic residents. For
occlusal distortions were obtained through measurement interocclusal angular distortions between the central
of the implant solid abutment analogs placed at the axes of the two solid abutment analogs placed at the
positions of the missing maxillary and mandibular right positions of the missing maxillary and mandibular right
first molars (dRM, dxM, dyM, dzM, and dqM) (Fig. 4). first molars, mean dqM ranged from −0.018 ±0.289 de-
Measurements on the master articulator were con- grees for new articulators to 0.141 ±0.267 degrees for
ducted at the start of the study and repeated at the end. articulators used by prosthodontic residents.
The investigated 3D distances on the master articulator One-way ANOVA by articulator group revealed
at these two time points differed less than a preset statistically significant differences among the test groups
threshold of 10 mm, implying negligible PMMA for dRR (P=.007) and dzM (P=.011) only. In both

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Master Articulator Test Articulators

(n=10 for 3 test groups)

Mounting of master Average of 3 repetitions Mounting of master Average of 3

casts onto master in direct computer casts onto test repetitions in
articulator control (DCC) mode articulator DCC mode

Measurement set 1 Measurement set A

Opening of articulator, Average of 3 Opening of articulator, Average of 3
repositioning of master casts, repetitions in repositioning of master casts, repetitions in
closing of articulator DCC mode closing of articulator DCC mode

Measurement set 2 Measurement set B

Opening of articulator, Average of 3 Opening of articulator, Average of 3
repositioning of master casts, repetitions in repositioning of master casts, repetitions in
closing of articulator DCC mode closing of articulator DCC mode

Measurement set 3 Measurement set C

Average of Average of
measurement measurement
sets 1, 2, 3 sets A, B, C

Final measurement set Final measurement set

for master articulator for test articulator

(Final measurement set for Test articulator) - (Final measurement set for Master articulator)

Dependent variables: 3 interarch distortions, 5 interocclusal distortions

Figure 4. Measurement process for deriving dependent variables (dRR, dRC, dRL, dRM, dxM, dyM, dzM, and dqM) for each test articulator.

Interarch: 3D Distortion Between Paired Reference Spheres (dRR, dRC, dRL), mm

0.20000

0.15000

0.10000

0.05000

0.00000

–0.05000

–0.10000

–0.15000
dRR dRC dRL

Articulators used by predoctoral dental students

Articulators used by prosthodontic residents
New articulators

Figure 5. Mean 3D distance interarch distortions between centroids of paired reference spheres (dRR, dRC, and dRL). Error bars indicate standard
deviation.

instances, the distortion for the articulators used by by predoctoral dental students, which were not different
prosthodontic residents was found to be significantly from each other. Table 1 summarizes the results of the 1-
larger than that of new articulators and articulators used way ANOVA and Tukey HSD procedures performed.

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Interocclusal: 3D Distance Distortion Between the 2 Solid Abutment Analogs Placed at

the Positions of the Missing Maxillary and Mandibular Right First Molars (dRM), mm
0.20000

0.15000

0.10000

0.05000

0.00000

–0.05000

–0.10000

–0.15000
Articulators used by Articulators used by New articulators
predoctoral dental students prosthodontic residents
Figure 6. Mean 3D distance interocclusal distortions between centroids of two solid abutment analogs placed at positions of the missing maxillary and
mandibular right first molars (dRM). Error bars indicate standard deviation.

Interocclusal: 2D Distance Distortion Between the 2 Solid Abutment Analogs Placed at

the Positions of the Missing Maxillary and Mandibular Right First Molars (dxM, dyM, dzM), mm
0.20000

0.15000

0.10000

0.05000

0.00000

–0.05000

–0.10000

–0.15000
dxM dyM dzM

Articulators used by predoctoral dental students

Articulators used by prosthodontic residents
New articulators

Figure 7. Mean 2D distance interocclusal distortions between centroids of two solid abutment analogs placed at positions of missing maxillary and
mandibular right first molars (dxM, dyM, and dzM). Error bars indicate standard deviation.

The Pearson correlation coefficients computed to assess accuracy while maintaining this operability and reliability
the linear relationships between the sample and in service over time. The goal of this study was to quantify
respective distortion parameters revealed no statistical articulator interchangeability through the investigation of
significance (Table 2). three interarch and five interocclusal dependent variables.
Distortions were calculated relative to the master articu-
DISCUSSION
lator. The Pearson correlation coefficients computed to
The null hypotheses for this study were rejected. Articu- assess the linear relationships between the sample and
lator interchangeability refers to the ability to transfer respective distortion parameters revealed a lack of corre-
mounted dental casts across articulators with repositioning lation between intragroup samples and the reported

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Interocclusal: 3D Angle Distortion Between Central Axes of the 2 Solid Abutment Analogs
Placed at the Positions of the Missing Maxillary and Mandibular Right First Molars (dθM), Degree
0.50000

0.40000

0.30000

0.20000

0.10000

0.00000

–0.10000

–0.20000

–0.30000

–0.40000
Articulators used by Articulators used by New articulators
predoctoral dental students prosthodontic residents
Figure 8. Mean 3D angular distortions between central axes of the 2 solid abutment analogs placed at positions of missing maxillary and mandibular
right first molars (dqM). Error bars indicate standard deviation.

Table 1. Summary of 1-way ANOVA and Tukey HSD for distortion Table 2. Correlation between sample within test groups and distortion
parameters parameters
Test Group dRR dRC dRL dRM dxM dyM dzM dq M Pearson
Articulators used a a a a a a a a Test Group Variable Correlation P (2-Tailed)
by predoctoral Articulators used by dRR - .101 .780
dental students predoctoral dental dRC - .107 .768
Articulators used b a a a a a b a students
dRL d .151 .677
by prosthodontic
residents dRM - .203 .574
New articulators a a a a a a a a dxM d .354 .315
dyM - .211 .559
dzM - .317 .371
dqM - .480 .161
distortion parameters, indicating that inaccuracies were
Articulators used by dRR d .067 .854
widespread over all articulators rather than limited to only prosthodontic dRC - .537 .110
a few defective ones. residents
dRL .365 .300
Chung et al4 proposed that an error of 166 mm at the
d
dRM d .492 .148
occlusal level in the region of the second molar would dxM - .027 .941
neither result in prolonged chairside adjustment of the dyM d .348 .324
resultant prosthesis nor adversely affect morphology. An dzM - .108 .766
alternative way to justify thresholds for clinical accept- dqM - .261 .466
ability is to consider the physiologic movement permitted New articulators dRR - .405 .245
by healthy periodontal ligaments. One study reported dRC - .248 .489
that a 0.5-N buccolingual force resulted in 40 to 80 mm dRL d .513 .130

molar and 100 to 120 mm incisor movement.13 Therefore, dRM - .364 .302

a large range of 40 to 166 mm has been suggested to be dxM - .631 .051

dyM - .098 .788
acceptable. Seven distance distortion parameters (dRR,
dzM - .300 .399
dRC, dRL, dRM, dxM, dyM, and dzM) per test group were
dqM d .290 .416
available for analysis, giving a total of 210 distance
distortion measurements. For the distance distortion
measurements of the articulators used by predoctoral
dental students, 37/70 (52.9%) were less than 40 mm, 29/ measurements of the articulators used by prosthodontic
70 (41.4%) ranged from 40 to 166 mm, and 4/70 (5.7%) residents, 21/70 (30.0%) were less than 40 mm, 46/70
exceeded 166 mm. For the distance distortion (65.7%) ranged from 40 to 166 mm, and 3/70 (4.3%)

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B C C
A A B

A B
Figure 9. Frontal cross-section of right molars in intercuspal position. A, Negative dxM results in positive contact at point B. B, Positive dxM results in lack
of point B contact, increasing susceptibility to tipping of teeth.

exceeded 166 mm. For the distance distortion measure- the patient’s left, reducing the point B contact and increasing
ments of the new articulators, 39/70 (55.7%) were less contacts on points A and C (Fig. 9B). Such undesired
than 40 mm, 30/70 (42.9%) ranged from 40 to 166 mm, occlusal loading can cause teeth to tip. When considering
and 1/70 (1.4%) exceeded 166 mm. These results suggest dental implants, horizontal movements are much more
that articulator interchangeability remains questionable. limited, at a maximum of 5 mm,15 compared with teeth with
All 3 test groups presented with some measurements normal periodontal ligaments.13 The results indicated that
exceeding the upper limit of 166 mm. In addition, only 97/ mean x-distortions at the interocclusal level exceeded the
210 (46%) of the measurements were found to be less limited horizontal leeway permissible in implant-supported
than the lower limit of 40 mm. prostheses, which may increase prosthetic complica-
The 3D distortions at the interarch level were found to tions.16,17 The largest mean angular distortion was found in
be greater in magnitude than the 3D distortions at the articulators used by prosthodontic residents, but no signifi-
interocclusal level. This finding of more prominent dis- cant difference was found among test groups.
tortions at the interarch level was similar to that reported This study revealed large standard deviations in the
by Yee et al.14 measured parameters, even for the new articulator group.
The 3D and 2D distance distortions derived from the Factors that may have contributed to this error included
investigation of the two solid abutment analogs placed at that articulator interchangeability depends on calibration
the positions of the missing maxillary and mandibular accuracy done using a specific gauge, where the Splitex
right first molars simulated the occlusal errors that would mandibular adjustment plate is held to the lower mem-
typically be present at the molar sites. In general, the ber of the articulator with an adhesive. This adhesive or
used articulator groups (articulators used by predoctoral the process of calibration could be the weak link affecting
dental students or prosthodontic residents) showed the accuracy of the whole system. Disturbances and
higher distortion values than the new articulators. Spe- discrepancies of the assembly before complete setting of
cific to dzM, the prosthodontic resident articulator test the adhesive may adversely affect calibration accuracy. In
group was found to be significantly worse than the other addition, that articulators used by prosthodontic resi-
two groups. This parameter relates to the need for dents displayed the highest distortions was consistent
occlusal adjustment in the supero-inferior direction and with the findings of Price at al and Chung et al.2-4
may lead to increased chair time, the alteration of Logically, these articulators underwent heavier usage
occlusal morphology, and a potential effect on material than articulators used by predoctoral dental students as a
thickness and strength. Mean dxM for all groups in this result of the greater volume and complexity of clinical
study were negative, resulting in the occlusal table patient procedures provided by postgraduate prostho-
shifting buccally and to the patient’s right side. Clinically, dontic residents. Poor handling of the articulators may
points A and C would be reduced while an increase in damage the condylar heads and tracks, and close prox-
contact at point B in maximum intercuspation occurs, imity to heat may also distort the adhesive. The accu-
creating a favorable situation (Fig. 9A). Yet, the reverse mulation of such errors can lead to the deterioration of
may also occur, whereby positive distortion seen on the articulator interchangeability. The magnetic plates are
right side of the patient shifts the occlusion laterally to not immune to wear, physical damage, and corrosion,

THE JOURNAL OF PROSTHETIC DENTISTRY Lee et al

November 2024 1037

which compromise the magnetic strength instrumental in 3. Price RB, Loney RW, Andreou P. Interchangeability of semiadjustable artic-
ulators after 2 to 7 years of use. J Prosthodont. 2000;9:142e147.
plate localization. The magnetic plates should be 4. Chung CC, Chai J, Jameson LM. Interchangeability of a semiadjustable
routinely examined to ensure continued operability. articulator. Int J Prosthodont. 2001;14:427e431.
5. Hatzi P, Millstein P, Maya A. Determining the accuracy of articulator
Limitations of this study included that the findings interchangeability and hinge axis reproducibility. J Prosthet Dent. 2001;85:
may not apply to other articulator systems that claim to 236e245.
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setting and hygroscopic linear expansion of three gypsum products used for
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duration may not have been sufficient to reveal clear static articulation accuracy of virtual models part I: system trueness and
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clusions were drawn: 2020;29:3e11.
17. Chochlidakis K, Fraser D, Lampraki E, et al. Prosthesis survival rates and
1. The new and used articulators tested did not fulfill prosthetic complications of implant-supported fixed dental prostheses in
the manufacturer’s claim of accuracy up to 10 mm in partially edentulous patients. J Prosthodont. 2020;29:479e488.

the vertical dimension. Corresponding author:

2. Up to 1 year of time in service, none of the inves- Dr Ming Yi Tan
Department of Prosthodontics
tigated test groups fulfilled the criterion for articu- Faculty of Dentistry
lator interchangeability, even if the more lenient National University of Singapore
threshold of 166 mm were accepted. 9 Lower Kent Ridge Road Singapore, 119085
SINGAPORE
Email: [email protected]
REFERENCES
Copyright © 2023 The Authors. Published by Elsevier Inc. on behalf of the
1. Kitzis GD, Millstein PL, Nathanson D. Determining the accuracy of articu- Editorial Council for The Journal of Prosthetic Dentistry. This is an open access
lator interchangeability. J Prosthet Dent. 1991;65:845e848. article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
2. Price RB, Mansfield WM. Long-term reliability of semiadjustable articulator nc-nd/4.0/).
interchangeability. J Prosthodont. 1999;8:235e239. https://doi.org/10.1016/j.prosdent.2023.04.009

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