Face Bow

FACE BOW
Asha C S
Post Graduate Student
CONTENTS
 INTRODUCTION
 DEFINITION
 CLASSIFICATION OF FACEBOW
 ANTERIOR REFERENCE POINT
 POSTERIOR REFERENCE POINT
 PARTS OF FACEBOW
 ADVANTAGES
 CONCLUSION
INTRODUCTION
• Maxilla is a part of the cranium and is fixed

entity
• The anatomy of maxilla and the

temporomandibular joint varies from person to
person.
• The relationship of maxilla to the

temporomandibular joint is not same in all the
patients
TERMINAL HINGE AXIS
• When mandible opens and closes, rotation

occurs around transverse axis which is
more commonly called hinge axis, also
termed as terminal hinge axis
• Maximum range of terminal hinge rotation is
about 12 degree
• Interincisal opening is 18-25mm.
Orientation Jaw Relation
They are those that orient the mandible to the

cranium in such a way that, when the mandible is
kept in its most posterior unstrained position, the
mandible can rotate in a sagittal plane around an
imaginary transverse axis passing through or near
the condyles.
DEFINITION OF FACEBOW
A caliper like instrument used to record the spatial relationship of the

maxillary arch to some anatomic reference point or points and then transfer
this relationship to an articulator; it orients the dental cast in the same
relationship to the opening axis of the articulator; customarily the anatomic
references are the mandibular transverse horizontal axis and one other
selected anterior reference point. (GPT 9)
GEORGE.
B.SNOW
• Snow constructed an instrument that became
the prototype for all facebows in 1899

• The instrument allowed correct anatomic
positioning of the plaster casts on the
articulator.
CAMPER PLANE
 SNOW set the bite- fork in such a position

that when the occlusion rim was placed in the
mouth, the handle was parallel with a plane
extending from the bottom of the glenoid fossa
to the anterior nasal spine (upper part of the
tragus to the lower edge of the nostril). This is
known as the Bromell or Camper plane.
GYSI
The Plane of orientation
 A horizontal plane established on the face of the patient by one anterior

reference point and two posterior reference points from which
measurements of the posterior anatomic determinants of occlusion and
mandibular motions are made. (GPT-9)
 Two points are located posterior to the maxillae and one point located
anterior to it.
ANTERIOR REFERENCE POSTERIOR REFERENCE
POINTS POINTS
• Orbitale • Bergstrom point

• Orbitale minus 7 mm • Beyrons point
• Nasion minus 23 mm • Gysi’s point
• Alae of the nose • Brandrup- Wognsen point
• Lauritzen and Bodner’s
point
ORBITALE
Orbitale is the lowest point of the infraorbital
rim of skull which can be palpated on the patient
through the overlying tissues and the skin.
One orbitale and the two posterior points that
determine the horizontal axis of rotation will
define the axis - orbital plane.Used in Hanau
spring face bow.
Orbitale minus 7mm
 Sicher recommended to use the midpoint of the
upper border of the external auditory meatus as the
posterior cranial landmark on a patient. Most
articulators do not have a reference point for this
landmark.
 Since we use auditory meatus as posterior reference
points these discrepancies are compensated by
placing the anterior reference point 7mm below the
orbitale.
Nasion minus 23mm
This reference point is widely used by Whip Mix

articulator.
Nasion guide is designed to fit into this

depression which can move in and out but not up
and down, from its attachment to the face‑bow
crossbar. The crossbar is located 23 mm below
the midpoint of the nasion positioner
Kumar P, Kumar A, Goel R, Khattar A. Anterior point of reference: Current knowledge and perspectives in prosthodontics. Journal of Orofacial
Bergstrom point
• 10 mm anterior to the center of the spherical

insert for the external auditory meatus and
7mm below the Frankfort plane.
BEYRON POINT
• 13 mm anterior to the posterior margin of the
tragus of the ear on a line from the center of
tragus extending to the corner of the eye.
M, SunShafiullah RS, Ravichandran dar MK, Kamakshi V. Posterior Reference

Points: A Simplified Classification. Dent. 2019;9(1):9-12.
Gysi's point
Gysi placed it 11–13 mm anterior to the upper

third of the tragus of the ear on a line
extending from the upper margin of the
external auditory meatus to the outer canthus
of the eye.
Lauritzen and Bodner’s point
A point 13mm anterior to the tragus on
tragus-canthus line.
 Brandrup- Wognsen point
On a line extending from the tragus to the

lateral angle of eye, a point is marked at about
12mm in front of posterior margin of most
prominent tragus.
CLASSIFICATION OF FACE BOW
ARBITARY FACE BOW
• The hinge axis is approximately located in this
type of face bow.
• It is commonly used for complete denture

construction.
• This type of face bows generally locate the

true Hinge axis within a range of 5mm, what
can lead to 0.2mm error at the second molar
area (REALEFF EFFECT)
ARBITARY FACEBOW - EAR PIECE
• The External Auditory meatus is 6 – 6.5mm

posterior and 2.5mm superior to the actual hinge
axis point .
• Accurate relationship for most diagnostic and

restorative procedures
• Eg : Whip mix, Slidematic etc

ADVANTAGES DISADVANTAGES
• Simple to use.
• Do not require
measurements on face
• Regardless of which
• As accurate as other face arbitrary position is
bows. chosen an error of 0.2
mm from the axis can be
• It provides an average expected.
anatomic dimension
between the external
auditory meatus and
horizontal axis of
mandible
ARBITRARY FACEBOW – FASCIA TYPE
FACIA TYPE
The approximate on the skin
over TMJ region are used as posterior
reference point and the condyle rods of
face bow placed over it .
Eg: Hanau facia type,Denar facia face
bow
Disadvantage
As the face bow is placed on the skin which is movable

there is a tendency for the condylar rods to displace .
Also requires an assistant to hold the face bow in place.

KINEMATIC FACEBOW
• Facebow is attach to the lower jaw by means of a clutch affixed to the

mandibular teeth.
• Left and right styli are attached via a facebow to the clutch
• Graph of grid paper is placed near TMJ to detect stylus movement .
PRINCIPLE OF KINEMATIC FACEBOW
When we consider rotation of any circular

object , only the central points rotates, any
other point within the circle will show
translatory movement .
Uses
 Kinematic facebows are indicated when it is crucial to precisely reproduce

the exact opening and closing movements of the patient on the articulator. ie :
full mouth rehabilitation
 For instance, to alter the occlusal vertical dimension during the fabrication of
the fixed prosthesis , a kinematic facebow record and centric interocclusal
record is needed ,which in turn minimizes occlusal errors .
PARTS OF FACEBOW
U Shape frame work

 Condylar rods
 Bite fork
 Locking device
 Orbital pointer with clamp
U SHAPE FRAME
• It forms the main frame of the face bow.

• It extends from the region of TMJ on one side
to other side without contacting .
• Two small metallic rods on either side of the
free end of the U shaped frame that contact the
skin over the TMJ.
• They are used to locate the hinge axis and
transfer it to the articulator.
• Some face bows have ear piece that fit into
the external auditory meatus
BITE FORK
“U” shaped plate, which is attached

to the occlusal rims, while recording
the orientation relation. It is attached
to the frame with the help of a rod
called the stem.
LOCKING DEVICE
This part of the face bow helps to fix

the bite fork to the U-shaped frame
firmly after recording the orientation
jaw relation.
REFERENCE POINTER
• Third reference point is used to

orient the face bow assembly to
a anatomical reference point on
the face along with the two
condylar reference points.
• HANAU FACEBOW – SPRING
BOW –infraorbital notch.
• WHIPMIX FACEBOW-Nasion
minus 23mm
HANAU FACEBOW – SPRING BOW
o In the Hanau Articulator, a groove indicated the position of the

occlusal plane
o Posterior reference point-13mm Anterior to the External

Acoustic Meatus
o Infraorbital Notch - Anterior reference point

WHIPMIX FACEBOW
o Built in hinge axis locator
o First ear piece facebow used
o Special nasion relator assembly or infra orbital pointer can

also be added to the facebow
( Nasion – Orbitale Axis)
o Anterior reference point – A (Nasion) minus 23mm

DENAR / SLIDEMATIC FACEBOW
 Can be modified into ear piece or facia bow
 Built in Pointer aligns the facebow with the horizontal

reference plane
 Anterior reference point – The point 43mm above the incisal

edge of the right central or lateral
incisor / lower border of the
upper lip .
ADVANTAGES OF THE FACEBOW
 It permits a more accurate use of lateral rotation points for the

arrangement of teeth.
 It aids in securing the anteroposterior cast position with relation to

the condyles of the mandible.
 It registers the horizontal relationship of the casts quite accurately,

and thus assists in correctly locating the incisal plane.
 It is an aid in the vertical positioning of the casts on the articulator.

What if facebow is not used ???
 If the maxillary cast is positioned without the correct

maxillae-hinge axis relationship, arcs of movement which
occur in the articulator will differ from those of the patient.
 An occlusion that is restored to an incorrect arc of closure

or opening axis may have interceptive and deflective tooth
contacts in the hinge-closing movement if there are
subsequent changes in the vertical dimension of occlusion
• Deflective contacts also may be present in functional and
parafunctional lateral movements from the time the restoration
is initially inserted.
• Such contacts are undesirable in either natural or artificial

occlusions and can contribute to periodontal trauma, muscle
spasm and TMJ pain.
Conclusion
• Failure to use the face bow leads to error in occlusion.
• Hinge axis is a component of every masticatory movement of

mandible and therefore cannot be disregarded and this hinge
axis should accurately captured and transferred to the articulator
• comfort for patient and biologically acceptable restoration

REFERENCES
 Essentials of complete denture – winkler
 Prosthodontic treatment for edentulous patient – Boucher
 Contemporary Fixed Prosthodontics-Rosenstiel
 Shafiullah RS, Ravichandran M, Sundar MK, Kamakshi V. Posterior Reference Points:

A Simplified Classification. Dent. 2019;9(1):9-12.
 Kumar P, Kumar A, Goel R, Khattar A. Anterior point of reference: Current knowledge

and perspectives in prosthodontics. Journal of Orofacial Sciences. 2012 Jul 1;4(2):96.

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FACE BOW

 ANTERIOR REFERENCE POINT

 POSTERIOR REFERENCE POINT

• Maxilla is a part of the cranium and is fixed

• The anatomy of maxilla and the

• The relationship of maxilla to the

• When mandible opens and closes, rotation

They are those that orient the mandible to the

A caliper like instrument used to record the spatial relationship of the

the prototype for all facebows in 1899

 SNOW set the bite- fork in such a position

 A horizontal plane established on the face of the patient by one anterior

• Orbitale • Bergstrom point

This reference point is widely used by Whip Mix

Nasion guide is designed to fit into this

• 10 mm anterior to the center of the spherical

M, SunShafiullah RS, Ravichandran dar MK, Kamakshi V. Posterior Reference

Gysi placed it 11–13 mm anterior to the upper

On a line extending from the tragus to the

• It is commonly used for complete denture

• This type of face bows generally locate the

• The External Auditory meatus is 6 – 6.5mm

• Accurate relationship for most diagnostic and

• Eg : Whip mix, Slidematic etc

As the face bow is placed on the skin which is movable

Also requires an assistant to hold the face bow in place.

• Facebow is attach to the lower jaw by means of a clutch affixed to the

When we consider rotation of any circular

 Kinematic facebows are indicated when it is crucial to precisely reproduce

U Shape frame work

• It forms the main frame of the face bow.

“U” shaped plate, which is attached

This part of the face bow helps to fix

• Third reference point is used to

o In the Hanau Articulator, a groove indicated the position of the

o Posterior reference point-13mm Anterior to the External

o Infraorbital Notch - Anterior reference point

o Built in hinge axis locator

o First ear piece facebow used

o Special nasion relator assembly or infra orbital pointer can

o Anterior reference point – A (Nasion) minus 23mm

 Can be modified into ear piece or facia bow

 Built in Pointer aligns the facebow with the horizontal

 Anterior reference point – The point 43mm above the incisal

 It permits a more accurate use of lateral rotation points for the

 It aids in securing the anteroposterior cast position with relation to

 It registers the horizontal relationship of the casts quite accurately,

 It is an aid in the vertical positioning of the casts on the articulator.

 If the maxillary cast is positioned without the correct

 An occlusion that is restored to an incorrect arc of closure

• Such contacts are undesirable in either natural or artificial

• Hinge axis is a component of every masticatory movement of

• comfort for patient and biologically acceptable restoration

 Essentials of complete denture – winkler

 Prosthodontic treatment for edentulous patient – Boucher

 Contemporary Fixed Prosthodontics-Rosenstiel

 Shafiullah RS, Ravichandran M, Sundar MK, Kamakshi V. Posterior Reference Points:

 Kumar P, Kumar A, Goel R, Khattar A. Anterior point of reference: Current knowledge