Digital Determination and Recording of Edentulous Maxillomandibular Relationship Using a Jaw Movement Tracking System.

Abstract

To establish a direct digital method for determining and recording edentulous maxillomandibular relationship using a custom-made jaw movement tracking system and evaluate its accuracy. A novel jaw tracking system was used to record the trajectory of habitual opening-closing jaw movement, and mandibular rest position (MRP) in 10 edentulous patients. 3D surface scanning was performed on the conventional maxillomandibular impressions and facial structures of patients in MRP. The multisource data were registered using a custom-made recording tool. A plane parallel to the ala-tragus and horizontal lines was constructed 2 mm above the MRP, and its vertical position was used to determine the vertical relationship. The intersections of the trajectory passing through the plane were located, and their density distributions were analyzed. The coordinates of highest density, which presented the highest repeatability of jaw movement, were used to construct the digital maxillomandibular relationship (test group). The maxillomandibular relationship of the new complete dentures with artificial teeth in the intercuspal position was defined as the control group. The displacements of the anterior reference point and 3D deviations of the entire mandibular arch were measured and compared between the test and control groups using a Wilcoxon signed-ranks test and a one-sample t-test, respectively. With reference to the centric relationship position, the maximum displacements of the anterior reference points were in the horizontal anteroposterior direction for both groups, and there were no significant differences. Compared to the control group, the 3D deviations of the entire mandibular arch in the test group were significant (95% confidence interval: 0.76 mm to 1.35 mm, p < 0.001). By analyzing the individual trajectory features obtained by the in-house developed jaw tracking system, a digital method for determining and recording edentulous maxillomandibular relationships was established; however, the accuracy needs to be further improved.