ARTICULATION DEFINED, ANALYZED AND

FORMULATED *
By RU DO LPH L. H A N A U , Buffalo, N ew York

I do not like the obscure thought. I like to Endless is the number of criticisms
see the p lain tru th b ro u g h t directly o u t upon
that have been applied to the situation,
the page, devoid o f a ll th a t cam ouflage
w hich m any poets use. So I, w ho have no which is worse than we care to admit.
wish to m ystify, w ill alw ays call a spade a Numerous are the remedies suggested
spade. T h ere are no tricks about m y trade. for eliminating the evil of malarticu-
I am a poet whose appeal is m ade direct. I ’ll
not conceal m y thoughts beneath some pretty
lated dentures.
phrase th at can be read in different ways. A fter all, there is only one course
I ’ll n o t dress up the things I say to suit the which promises success. I t leads via the
fashion o f the day. A nd so, unless you’re desire to experience, learn, analyze,
satisfied w ith simple tru th , then cast aside this
little book, because in it you’ll surely find
understand and apply. I f the cycle is
some verse to fit the th o u g h t th a t y o u r pet repeated many times, we will realize
idol m ay, like a ll the rest, have feet o f clay— that still more is to be learned.
Owen White. I have no simple appearing analysis
F several hundred prosthetic den­ of articulation to offer you. I know
O tures checked up during the past
three years, about 95 per cent
were judged unsatisfactory by their
o f none that is simple and correct. I
know of many that are said to be both,
but are neither. I have knowledge of
own makers or brother dentists, after a few that are logical and correct in
being tested and checked. O f the 95 part. T he proven facts of my precur­
per cent unsatisfactory dentures, more sors, not their claims, are the premises
than half were dismal failures, if bal­ of this presentation.
anced articulation was the object. I T he establishment o f balanced artic­
shall repeat similar tests in a clinic ulation is a mere matter of recognizing
scheduled for this convention. the conditions and of applying mental
Figures 1 and 2 also make us realize and physical adroitness, in order to
that the situation is serious. Natural, reach a known goal. Incidentally, we
accidental and habitual causes account also need proper tools, instruments and
for anatomic deficiencies, the condition materials with which to work.
o f the individual being more or less T he anatomic masticatory apparatus
responsible. T his does not apply to is intended to triturate foods without
afflictions due to the ill-fitting dentures trauma. Technically, we may say, the
tested. Figure 3 gives us an idea o f the masticatory surfaces should operate
bewildering complications invited by smoothly, without interference. Smooth
“ missing the bite.” operation is secured by giving the
numerous co-acting surface fragments
♦ R ead before the Section on F u ll D enture
Prosthesis a t the Sixty-Seventh A nnual Ses­
o f the masticatory surfaces suitable dis­
sion o f the A m erican D ental Association, tribution, suitable diameters and suitable
L ouisville, K y., Sept. 24, 192J. directions, so that a balanced contact is
Jour. A . D .A ., December, 1926 1694
 H anau— Articulation Defined, Analyzed and Formulated 1695

maintained during function. T he tures. I f the balanced articulation is

maintenance of balanced contact of the confined to the initial part of articula­
masticatory surfaces (balanced occlusion tion from centric occlusion of a natural
during function) is designated as bal­ denture, then, with our present under­
anced articulation. standing of anatomic articulation, it
should not be defined as malarticulation.
ARTICULATION D EFIN ED It seems more appropriate to describe the
Articulation is the change from one unbalanced continuation o f articulation
occlusion to another occlusion while the in the incisal region of natural dentures
masticatory surfaces maintain contact. with overarticulation. Mixed articula­
N atural articulation is articulation of tion is malarticulation for prosthetic
natural or prosthetic dentures conform ­ dentures.
ing to accepted physiologic requirements Balanced articulation is the change
for com fort and efficacy. from one balanced occlusion to another
Unnatural articulation is an articula­ while the masticatory surfaces remain
tion o f natural or prosthetic dentures not in balanced contact. Balanced articu­
conforming to accepted physiologic re­ lation complies with accepted laws of
quirements or to individual requirements balanced articulation.
of a case, because of limitations or ab­ Unbalanced articulation is the change
normalities. from one occlusion to another while
Anatomic articulation infers the the masticatory surfaces maintain con­
articulation of natural dentures in the tact, but balance is interrupted or lack­
mouth. ing. Unbalanced articulation does not
Prosthetic articulation infers the ar­ comply with accepted laws of balanced
ticulation of prosthetic dentures in the articulation. Unbalanced articulation
mouth, individual occlusions being induces a patient to perform malarticu­
associated with analogous jaw relations. lation, if he accepts it at all. It invari­
Semiprosthetic articulation infers the ably forces the patient, if he tolerates it,
articulation of prosthetic dentures in to acquire the habit o f performing
the mouth, individual occlusions not unnatural articulation and to seek for
always being associated with like jaw rest positions along the lines of least
relations. resistance and least discomfort.
Ordinary articulation is an articula­ Strained articulation is function
tion complying with accepted laws of while forces act, namely, when pressure
articulation. Ordinary articulation is is applied.
always balanced within admitted resi­ Unstrained articulation is function
lient limits. when no forces act; namely, when pres­
Malarticulation is articulation not sure is not applied.
complying with accepted laws of articu­ Balanced anatomic articulation is a
lation. Malarticulation lacks balance, change of natural dentures from one
in toto or in part, of function. balanced occlusion associated with an
Mixed articulation infers balanced analogous jaw relation to other corre­
articulation to and from centric occlu­ sponding associations, while the masti­
sion during part of the masticatory catory surfaces remain in contact.
stroke only. Rather frequently, mixed I t has been claimed by some that a
articulation is found in natural den­ natural denture, balanced throughout
1696 The Journal of the American Dental Association

its effective masticatory range, is the from a perpendicular to the sagittal

normal, if centric occlusion of the mas­ plane.
ticatory surfaces is associated with pro­ B. Tooth Alinem ent.— T he out­
trusive relation of the jaws. T h at may standing features of tooth alinement
be so. I t has not been convincingly are the arch form, the compensating
demonstrated to me, though it is con­ curve and the buccolingual inclination
ceded that the mandible is able to carry of the posterior teeth. T he importance
the masticatory surfaces into a retruded of the labiolingual inclination of the
position under strain. anterior teeth is amply recognized by
Balanced prosthetic articulation is a their special consideration as an incisal
change of prosthetic dentures from one guidance.
balanced occlusion associated with an A tooth alinement is characterized as
analogous jaw relation into other cor­ horizontal, vertical and frontal projec­
responding associations, while the mas­ tion. T he same applies to sections of
ticatory surfaces maintain contact. alinement and to individual teeth. T he
Balanced semiprosthetic articulation accepted anatomic terms, such as bucco­
is a change of prosthetic dentures from lingual, mesiodistal and their reverse,
one balanced occlusion not always asso­ are equivalents.
ciated with analogous jaw relation to C. Incisal Guidance.— This in­
other corresponding associations, while cludes a consideration o f ( 1) labiolingual
the masticatory surfaces maintain con­ inclination (protrusive, horizontal or
tact. anteroposterior guidance), and (2 )
sagittal inclination (lateral guidance).
FACTORS GOVERNING ARTICULATION
T he mandibular incisors, including the
A. Condyle Guidance.— This in­ cuspids, may be considered one large
cludes (1 ) anteroposterior guidance cusp having a curved ridge. T he labial
(horizontal inclination); (2 ) lateral and lingual surfaces are o f no particu­
guidance (sagittal inclination), and lar interest mechanically. Analo­
(3 ) lateral aberration. All movements gously, we will accept the maxillary
of the condyle heads are accepted as incisors, including the cuspids, as a large
starting in the socket and returning to sulcus, of which the lingual surface
it. T hree distinct excursions o f the becomes a guiding wall (posterosuperior
condyle head in the condylar fossa are surface of the bicuspoid), and the incisal
of particular interest: (1 ) the forward edge surface itself, a guiding surface
and downward directed excursion along (anterosuperior surface of the bicus­
the protrusive guidance, the inclination poid). W ith this simile in mind, the
of which is expressed by the angle to a incisal guidance is reduced to the sim­
horizontal plane (horizontal inclina­ plicity of an ordinary cusp guidance
tio n ); (2 ) the forward, downward with its protrusive and bilateral guiding
and inward directed excursion on the surfaces.
balancing side along the lateral guid­ D. Relative C usf H eight.— This
ance, the inclination of which is re­ subject includes (1 ) the cusp guidance
ferred to the sagittal plane (saggital incline for the protrusive bite; (2 ) cusp
inclination), and (3 ) the lateral excur­ guidance incline for the lateral on the
sion on the working side, the lateral working side, and (3 ) cusp guidance
aberration which deviated slightly incline for the lateral on the balancing
 Hanau— Articulation Defined, Analyzed and Formulated 1697

side. T h e cusp height is only relative, tions of the second molar buccal grooves.
if we compare it with its “ basal radius,” These three points are the three corners
which is the projection on the cusp base of the triangle of orientation through
of the movement of a point directed which we may lay a plane of orienta­
along the incline from the base to the tion. No distinction is made between
cusp summit. Strictly, we should in
the maxillary and the mandibular tri­
each case speak of the inclination and
angle of orientation. T he angle
magnitude of a guiding path or line and
refer dimensions and projections to the beween the two ordinarily is compara­
planes of one accepted coordinate sys­ tively small.
tem. T here are quite a number of
Cusp height is the conventional term additional factors governing the estab­
and, being descriptive, will be adhered lishment of articulation of the teeth.
to in expressing the laws of articulation. Some of these factors are of vital
T he laws of articulation express the importance to the classification and
modification of the cusp height by one standardization of tooth molds.
factor at a time. A change of cusp
ARTICULATION
height, without modification of cusp
base, is the object of grinding a chosen W e must know the laws of articula­
tooth. It is the customary operation re­ tion, in order to understand the
quired. T he selection of a larger or intricacies of articulation, and if we
smaller tooth will ordinarily change the have the desire to apply and discuss
base. T he consequences are readily them scientifically. Some of these laws
traceable by the application of elemen­ are of such fundamental significance
tary geometry. that those who confine themselves to
W ith the foregoing in mind, we may setting up of teeth only should know
without detriment to succinctness, them for their own convenience.
speak of a “ relative cusp height” and Articulation is a purely mechanical
apply our deductions also to the guiding function and as such must be investi­
cusp incline under consideration. gated and explained by geometry, cine­
E. Position o f Triangle o f Orienta­ matics and mechanics. A correctly
tion ( Denture Position) . — This includes adjusted articulator is a secure indirect
a consideration of (1 ) the distance guide to show the skilled operator when
of the central incisal contact point he is right or wrong. T hen he will
from the condyle line; (2 ) the distance reason rather than apply unnecessary
of the central incisal contact point from time to experiments.
the sagittal plane, and (3 ) the rotation T he laws of articulation express the
of the triangle of orientation about its reciprocal influence of the factors gov­
axes through the central incisal contact erning articulation. T he character of
point: ( a) the horizontal lateral axis; these factors does not permit the setting
(b) the horizontal anteroposterior axis, up of a succinct collective formula as
and (c) the vertical axis. is done, for instance, in hydrodyamics
T he triangle of orientation is ac­ and electrotechnics.
cepted in the plane of orientation, which I shall therefore foljow the line of
is a plane through the central incisal least resistance by relating only two
contact point and the occlusal termina­ factors at a time, accepting that, while
1698 The Journal of the American Dental Association

I do so, all other factors remain un­ compensating curve on the same
changed. side and to a small degree also on
It is assumed that guidances have the the other side.
required magnitude and that esthetics 1:3 decreases the steepness of the pro­
and phonetics are taken care of inde­ trusive incisal guidance.
pendently. 1:4 tends to incline the plane of ori­
T he key chart shown in the accom­ entation upward toward the
panying table will serve to facilitate posterior (anatomic limitation).
finding a law of articulation relating 1:5 increases the buccolingual incli­
any two single factors. T he intersec­ nation of the tooth axes progres­
tion of a vertical and horizontal column sively toward the posterior on the
contains the key numbers that precede same side and decreases them in a
the particular law. lesser degree on the other side.
T H E LAWS OF BALANCED 1:6 is an existing anatomic relation
ARTICULATION1 to the sagittal condyle inclination
All laws of articulation may be ( L ° = ( A s 0 plus 12°) plus or
transformed as shown by examples minus 3° for the Hanau articu­
given in the key to the quint. Certain lator, Model H ).
laws referred to the anatomy become 1:7 decreases the steepness of the
misleading, if not applied with discre­ sagittal incisal guidance on the
tion, because we accept the fact that we other side.
articulate teeth to conform to anatomic 1:8 tends to modify the upper tooth
conditions, transferred, measured and alinement toward the square type
established. T he change of a factor and the lower toward the taper­
from the real to the ideal calls for mod­ ing type.
ifications of accepted dental conceptions. 1:9 increases the relative cusp height
T he resultant modifications are inter­ progressively toward the posterior
esting from a mathematical point of on the same side and in a small
view only; but they are about as unim­ degree also on the other side.
portant to practitioners as are the square 2. An increase of the prominence
roots of minus values to physicians. of the compensating curve on one side:
T h e influence of one factor on an­ 2:3 increases the steepness of the pro­
other, assuming that all other factors trusive incisal guidance.
remained unchanged, is: 2:4 tends to decline the plane of
1. An increase in steepness of the orientation toward the posterior
horizontal condyle inclination on one on the same side and in a lesser
side: degree on the other side.
1:2 increases the prominence of the 2:5 decreases the buccolingual incli­
1. T hese law s were fo rm u la ted w ithout
nations of the tooth axes toward
experim ental data on hand. T h e y should be the posterior on the same side and
c arefu lly rechecked by investigators. T h e increases them in a lesser degree
o riginal d ra ft o f these law s was modified on the other side.
a fte r consulting w ith Drs. A . E. Boyce, 2 :6 is the consequence of a decrease
C. J. R. E ngstrom , F. W . F ra h m , R. R. Gil-
lis, A lfre d Gysi, A. A. Nelson, R. O. Schlos- of the sagittal condyle inclination
ser, V ictor H . Sears and W . H . W rig h t. on either side.
 Hanau— Articulation Defined, Analyzed and Formulated 1699

2-:7 increases the steepness of the 3:7 increases the steepness o f the
sagittal incisal guidance on the inclination of the sagittal incisal
other side. guidance.
2:8 tends to modify the upper tooth 3:8 tends to modify the upper tooth
alinement toward the tapering alinement toward the tapering
type and the lower toward the type and the lower toward the
square type. square type.
2:9 decreases the relative cusp height 3 :9 increases the relative cusp heights
progressively toward the posterior progressively to the anterior.

K ey C h a r t to L a w s o f A r t ic u l a t io n

Plane of orienta­
K EY *
Protrusive incisal

alignm ent
dyle inclination

Sagittal condyle
Horizontal con­

*To find the law of ar­

inclination of

Sagittal incisal
Com pensating

ticulation which relates

Relative cusp
Buccolingual
two single factors see

inclination
tooth axes
paragraph corresponding
guidance

guidance
to the num bers given in

height
th e in te rs e c tio n of re­
curve

spective factor columns.

Tooth
tion

The reversals are listed

in parenthesis.
H orizontal condyle
inclination 1:2 1:3 1:4 1:5 1:6 1:7 1:8 1:9
Com pensating curve (2:1) 2:3 2:4 2:5 2:6 2:7 2:8 2:9
Protrusive incisal
guidance (3:1) (3:2) 3:4 3:5 3:6 3:7 3:8 3:9
Plane of o rientation (4:1) (4:2) (4:3) 4:5 4:6 4:7 4:8 4:9
Buccolingual incli­
nation of tooth axes (5:1) (5:2) (5:3) (5:4) 5:6 5:7 5:8 5:9
Sagittal condyle
inclination (6:1) (6:2) (6:3) (6:4) (6:5) 6:7 6:8 6:9
Sagittal incisal
guidance (7:1) (7:2) (7:3) (7:4) (7:5) (7:0) 7:8 7:9
Tooth alignm ent (8:1) (8:2) (8:3) (8:4) (8:5) (8-d) (8:7) 8:9
Relative cusp height (9:1) (9:2) (9:3) (9:4) (9:5) (9:6) (9:7) (9:8)

T he consideration of a ten th factor adds nine new laws of articulation. T he nth factor adds
n (n —1)
(n— l) laws. T he to ta l num ber of laws for “ n ” factors e q u a l s : ------------
2

on the same side and in a lesser 4. An increase of the inclination of

degree on the other side. the plane of orientation toward the
3. An increase of the steepness of posterior:
the protrusive incisal guidance: 4:5 increases the steepness of the buc­
3 :4 tends to increase the steepness of colingual inclinations of the tooth
the inclination of the plane of axes.
orientation toward the posterior. 4:6 is the consequence of decreas­
3 :5 increases the buccolingual incli­ ing sagittal condyle inclination.
nations of the tooth axes toward 4:7 increases the steepness o f the sag­
the posterior. ittal incisal guidance.
3 :6 is a consequence of an increase of 4:8 tends to modify the upper tooth
the sagittal condyle inclination. alinement toward the tapering
1700 The Journal of the American Dental Association

type and the lower toward the T he widespread opinion that differ­
square type. ent fundamental principles of mechanics
4:9 decreases the relative cusp heights apply to the generation o f the mastica­
equally (or nearly so). tory surfaces in order that they may
5. An increase of the buccolingual conform to accepted modes of articula­
inclination of the tooth axes toward the tion is erroneous. T he fundamental
posterior on one side: laws involved are practically alike for
5 :6 is the consequence of a decrease orthodontic, periodontic, crown, bridge,
of the sagittal condyle inclination partial and full denture work, though
on the same side or of an increase the manipulations in their application
of the sagittal condyle inclination differ. T he range of application of
on the other side. these laws covers more than ordinary
5 :7 increases- the steepness o f the sag­ needs.
ittal incisal guidance on the other W hile we are concerned in. this paper
side. primarily with the correct application
5 :8 tends to modify the upper tooth of mechanics, it is important that the
alinement toward the square type mechanics be in compliance with physi­
and the lower toward the taper­ ologic requirements, and I wish to
ing type. emphasize the necessity of coordinating
5 :9 decreases the relative cusp heights the mechanical and physiologic require­
of the teeth inclined. ments. They are of equal importance.
6. An increase of the sagittal con­ T he scientific value of these laws of
articulation is made readily appreciable
dyle inclination on one side:
by use of the articulation quint, which
6:7 increases the steepness of the sag­
greatly facilitates their practical appli­
ittal incisal guidance on the other
cation. T he quint gives a combination
side.
of the most essential laws of articula­
6:8 tends to modify the tooth aline-
tion in convenient form. Each fifth
ments toward the tapering type.
represents a factor undergoing a change.
6:9 decreases the relative cusp heights
T he changes indicated are accompanied
on both sides progressively to the
by heavy arrows. T he light arrows in
posterior.
each fifth refer to the other factors.
7. An increase of the steepness of T he directions of the light arrows indi­
the sagittal incisal guidance: cate the sense in which to read the in­
7 :8 tends to modify the upper tooth fluence of a respective factor on the
alinement toward the square type factor they identify. (Fig. 4.)
and the lower toward the tapering T he solution of the problem of estab­
type. lishing articulation in the mouth and its
7 :9 increases the relative cusp heights explanation had been sought in the past,
on both sides progressively toward by the following means: (1 ) the de­
the anterior. velopment of devices which resembled
8. A modification o f the upper and the anatomic apparatus in form only;
lower tooth alinements toward the tap­ (2 ) the building of arbitrary mecha­
ering type: nisms with arbitrarily accepted dimen-
8:9 decreases the relative cusp heights mensions and functions; (3 ) the
progressively toward the anterior. introduction of instruments for accepted
 H anau— Articulation Defined, Analyzed and Formulated 1701

averages and ideals o f dimensions and w ith relations in function. A rticulation

functions; (4 ) the developing of is n a tu ra l o r u n n atu ral, and, in addition,
methods for measuring and recording is anatom ic, prosthetic o r sem iprosthetic.
D epending on the properties, balanced, m ixed
anatomic dimensions and transferring or unbalanced, we have them classified as
them to adjustable instruments. ord in ary articulation and m alarticulation.
W ith the development of instru­ Such cross-classification perm its very fine d if­
ferentiation.
ments, the function of the anatomic
In F igure 1, the upper h a lf o f the c h art is
apparatus became more clearly under­ so a rran g ed th at the shortest circuit, using the
stood. I t led to the articulator of dashed line on the side w here we start as the
W alker, to Christensen’s wax bite tech­ return, determines a ll the properties o f an a r­
nic and to the articulator technic and ticulation. F o r instance, anatom ic a rticu la ­
tion, as here understood, becomes un n atu ral if
analysis of articulation by Gysi. T heir
unbalanced, because unbalanced anatom ic artic­
pioneer work incorporates many basic ulation is m ala rtic u la tio n ;’ fro m w hich it
principles which I accept with simple w ill be noted in the chart th a t a dashed line
modifications. leads back to articulation. Likewise, unnatural
Closely following Gysi, various a rticulation cannot be balanced anatom ic
articulation because we w ould have to return
efforts were again made to explain ar­ via ord in ary articulation on the dashed line
ticulation by peculiar and novel theories on the le ft, which is located opposite to un­
and mechanisms. These efforts evi­ n a tu ra l articulation. On the other hand, it
denced the fact that the interpretation w ill be noted th a t any articulation w hich is
balanced becomes an o rdinary articulation,
of articulation was lacking, rather than
etc.
a novel mechanism to establish it. T h e low er h a lf o f the chart analyzes
W e now have concise methods of o rd in ary articulation w ith consideration o f
measuring, and accurate instruments, the association o f occlusions and ja w rela­
which permit consideration not only of tions, and finally contracts the eight possi­
bilities into fo u r groups.
the dimensions but also of functional
F ig u re 2 is an analysis o f articulation fro m
peculiarities, due to the resilient effect a point o f view different fro m th at o f F ig u re
of the supporting tissues. 1. Occlusion and jaw relations were analyzed
W e also have an understanding of sim ilarly on a previous occasion.
desirable occlusions, jaw relations, and W ithin the square are accepted all kinds o f
articulations we m ay possibly think o f, and
articulation and means for establishing o f these the ordinary relations are confined
them accurately. w ithin the circle. T h e area outside the circle,
I am fully aware that the most thor­ but w ithin the square, represents the area f o r
ough understanding and the most m alarticulation. Each o f the fo u r horseshoe­
perfect application of my present like figures present properties o f a rticu la tio n ;
namely, balanced, unbalanced, strained and
recommendations are not all that makes unstrained. In addition, we find the p roperty
a good denture restoration. These two “m ixed” shown by a Z-shaped area. T he
items1are only links in a long chain of balanced, unbalanced and m ixed areas are so
requirements, but they are strong links. arran g ed th at they p a rtly overlap the ord i­
nary articulation and m alarticulation as well
T he situation today is a happy one. as the strained and unstrained areas. A ll areas
T he problem of establishing balanced are so a rran g ed th a t their single or m ultiple
articulation in the mouth is no more a overlaps designate hypothetical, but not neces­
mystery beclouded by questionable the­ sarily acceptable, combinations.
W e m ay derive the fo llo w in g triple com ­
ories. I t has been analyzed and solved.
binations:
Subject to the given definitions, a rticu la­ (1 ) balanced unstrained ordinary a rticu la ­
tion, generally speaking, is occlusion associated tio n ; ( 2 ) unbalanced unstrained o rdinary
1702 The Journal of the American Dental Association

a rticu la tio n ; ( 3 ) m ixed unstrained ordinary (7 ) balanced strained o rdinary a rticu la tio n ;
a rticu la tio n ; (4 ) balanced strained m alarticu- (8 ) unbalanced strained o rdinary articula-
latio n ; (5 ) unbalanced strained m alarticula- tio n ; (9 ) m ixed strained ordinary
tio n ; ( 6 ) m ixed strained m ala rtic u la tio n ; a rticu la tio n ; (1 0 ) balanced unstrained m al-

|OCCLUSIONS plus RELATIO NS plU* FUNCTION

r-—— I /IRTICULflTION I---------------

r a - < H m m m i]

A N ft T O M IC flL 1 PROSTHETIC^ I ISENI-PROSTHETiCl

~~X— Ï J. 1— I ± 1 J_ I X J
B li U B M U B M U

• _____ I I I I_
M O R D I N A R Y / IR n c W flT iO W

B^tfNCED Efl LANCED

ANMOMIML ARTICULATION PROSTHETIC 5EMI-PR0StHCtIC
0,+ R, o + r , °,+r2 0Í+ Rz 01+ R 1 02.+ R 1 O1 + R«1
lO z+ R z
IDEAL COITION f^R E FrCQUEHT IDEiL mmm OCCASIONAL

I iFreqtntjy the unavoidable result' o f corrections

IMostly caused by interfering forces

- . P * accepted ordinary conditions

RLHan a v
IE* accepted, ideal slaaJarti.^
A U 6 .1 9 Z S

B * BO UNCED M -M IXED U —U N B ^ l ^ N C E O
O , = B a la n ce d ordinary occlu sio n s I R O r d i n a r y a n ilo g o u a relations
0 2 = B a la n c e d m alocclusion 's , | R 4= Ord.non-analtKjoua relatio n s

F ig . 1.— A rticulation analyzed.

 Hanau— Articulation Defined, Analyzed and Formulated 1703

a rticu la tio n ; ( 11 ) unbalanced unstrained “ o, a, b, c, d, e” or “ o, I, I I , III, IV, V” or

m alarticulation, and ( 12) m ixed unstrained “ o, A , B, C, D , E .” One, tw o o r m ore
m alarticulation. series o f indices are used to differentiate the
Com binations 2, 4, 8 and 10 are contra­ consequences o f possible lin ear strokes devi­
dictory to the proposed definition and there­ a tin g in direction fro m the startin g position,
fo re elim inated. Com binations S, 6, 11 and o r o f possibilities created by various m agni­
12 are redundant superlatives o f the a rticu ­ tudes o f “ m issing-the-bite.”
lations we should a t a ll times avoid, 6 and 12 T h e starting position, the direction and the
being in addition m isleading expressions. m agnitude (o r either) o f a m andibular ex­
Com binations 3 and 9 are unsettled issues. cursion m ay enlarge, lim it the num ber o f oc­
T h u s balanced unstrained articulation ( 1) clusions passed th ro u g h or be responsible fo r
and balanced strained articulation (7 ) rem ain. an entirely different a rra y o f occlusions.
These tw o com binations only, -at this time, E x a m fle 1.: Ao presents centric occlusion
are here recom m ended as the ideal standards, associated w ith centric relation. A t appears
w hich acceptable conditions m ust approach.
In F ig u re 3, unstrained centric relation is
accepted as the n a tu ra l startin g position o f all
m andibular excursions. R etruded relations are
accepted to occur under application o f biting
force accom panied by displacem ent o r pos­
sibly compression o f tissues, inviting undue
tissue changes, if carried beyond physiologic
toleration. R etruded relations o f colum ns
2, 8 and 9 are equivalent to strained relations
o f colum ns 1, 4 and 5, respectively.
It shall be agreed to re fe r a ll “ bites” to
the existing occlusion associated w ith centric
relation as a startin g position.
E x a m fle : “ Retrusive occlusion associated
w ith centric ja w relation” and not “ protruded
ja w relation associated w ith centric oc­
clusion,” though the expressions are synony­
mous. T h e first mode o f expression perm its
succinct tabulation and makes investigation
clearer. Likewise, we say, “ le ft late ra l oc­
clusion associated w ith centric ja w relatio n ,”
etc. Various occlusions associated with centric
ja w relation are differentiated by capitals. at the intersections o f the vertical (o r re­
T h e index “ o ” in Ao, Bo, Co, Do, etc., in­ latio n ) and like horizontal (o r occlusion)
dicates the startin g association o f an occlusion colum ns. No indices besides “ o” and “ 1” are
w ith a jaw relation and as such is considered attached to “ A .” T h is m eans th at occlusions
(irrespective o f the m agnitude o f “ missing- are associated w ith like relations.
the-bite” ) in the horizontal column. E x a m fle 2.: Bo represents retrusive oc­
T h e index “ 1” in A i, B i, C i, D i, etc., in a clusions (horizontal colum n) associated w ith
vertical colum n, denotes the occlusion into centric relation (v ertical c o lu m n ), the sta rt­
w hich the m asticatory surfaces are b rought ing association. As soon as the m andible p ro ­
im m ediately a fte r leaving the startin g posi­ trudes fro m centric relation, the occlusions
tions Ao, Bo, Co, Do, etc., d u rin g the stroke change fro m retrusive occlusion, the startin g
into the relation designated by the respective occlusion Bo, to a less retru d ed occlusion B i,
vertical relation colum n. T h e complete stroke than to centric occlusion B 2, a n d finally to p ro ­
into the respective relation is alw ays accepted trusive occlusion B3. Sim ilarly, we m ay f o l ­
to carry a ll points alo n g straight lines. T h e low up all relations into w hich the mandible
m asticatory surfaces m ay be carried th ro u g h is brought, when moved fro m any other
various occlusions. These occlusions, in se­ starting association. W e w ill find the conse­
quence fro m their starting positions, are quent occlusion or occlusions into which the
indicated by the indices “ 0, 1, 2, 3, 4, 5” or m asticatory surfaces are b ro u g h t, in the
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F ig . 3.— C hart Show ing Associations o f Occlusions and Relations.

 Hanau— Articulation Defined, Analyzed and Formulated 1705

vertical colum n designating the relation into A reversed a rro w is a request to reverse the
w hich the m andible is to be brought. change.
E xa m p le 3.: Do presents le f t late ra l oc­ E x a m fle : “ Increasing prom inence o f the
clusion associated w ith centric relation. T h e com pensating curve,” w hich is read in the
m andible is to m ake a pro tru d ed le ft lateral upper rig h t fifth . T h e reverse is a “ decreas­
excursion. Do is fo u n d a t the intersection o f in g prom inence o f the com pensating curve.”
le f t late ra l occlusion a n d p ro tru d ed le ft T h e heavy, centric arrow s are topped by a
capital letter. R e ferrin g to the fifth m en­
late ra l relation m erely to recall the startin g
tioned, we find “ C” attached to the centric
position; D i is fo u n d in the horizontal colum n a rro w . On each side o f every centric arro w ,
f o r p ro tru d ed le ft lateral occlusion. N o f u r ­ we find tw o less conspicuous arrow s, indi­
ther “ D ” being fo u n d in the vertical colum n, vid u ally identified by capital letters o f the
sig n ify in g the relation into w hich the stroke rem aining fifths. T h e m eaning o f the a r­
is executed, we deduct: A denture in which rangem ent m ay be in ferred fro m the fo llo w ­
le ft la te ra l occlusion is associated w ith centric ing tw o problem s:
relation is carried into pro tru d ed le ft lateral 1. W h at is the influence o f the incisal
occlusion, w hen the m andible makes a p ro ­ guidance on the com pensating curve, a ll other
truded le ft late ra l excursion. N ow , we m ay factors rem aining unchanged?
also wish to know w h at happens to Do in a Solution-. Incisal guidance (lo w er le ft
rig h t lateral excursion. W e find in the fifth corner) ; D -a rro w , p o in tin g c entrifugally,
vertical c o lu m n : Do, D i, D 2, D 3, w hich is to stands f o r “ increasing horizo n tal inclination
be re ad : T h e occlusions change fro m the o f the incisal guidance.” T h e fifth fo r the
sta rtin g occlusion, w hich is le ft late ra l, to com pensating curve (u p p e r rig h t) is identi­
pro tru d ed le ft lateral, to protrusion and fied by “ C.” R e tu rn in g to the D -fifths, we
finally to pro tru d ed rig h t late ra l occlusion. find the sm all a rro w m arked “ C ” also point­
E x a m fle 4 .: Still m ore interesting be­ ing c en trifu g a lly . F o r such direction o f the
comes an investigation o f the association arro w , w e read “ C” : “ increasing prom inence
“ H ” , w hen the m andible moves into the o f the com pensating curve.” M e rg in g the tw o
pro tru d ed rig h t late ra l (v ertical colum n 7 ) . findings into a sentence, we re a d : A n increas­
H ere, we find Ho sym bolic f o r sta rtin g posi­ ing horizontal inclination o f the incisal
tions w ith various m agnitudes o f missing- guidance (D ) increases the prom inence o f the
the-bite. T h e fo llo w in g results are recorded: com pensating curve ( C ) .
2. W hat influence does the condylar g uid­
Ho, H i, H 2 , H s ; Ho, H a, H b, H c; H o, H i,
ance exert on the relative cusp height (a ll
H „ , fill,, H iv, H v; Ho, H a, H b, H e, H d, H e.
other factors rem aining unchanged) ?
Each series presents a sequence o f occlusions Solution; C ondylar guidance “A ” ; relative
the dentures have to pass th ro u g h . N ot only cusp height “ E .” W e note th a t the sm all
the startin g position, but also the m agnitudes a rro w “ E ” in the A -fifth points centripetally,
and directions o f the excursions are respon­ which means th a t “ E ” should be read in the
sible f o r the variance. reverse in connection w ith “ A .” Instead o f
A care fu l study o f the table is recom ­ “decreasing o f the relative cusp height,” we
m ended as a m ost profitable step in coping m ust now read : “ increasing o f the relative
w ith m andibular problem s. T h e deductions cusp height.” Hence the la w : A n increase o f
fro m this table apply to a ll branches o f den­ the horizontal inclination o f the condylar
tal specialization. guidance increases the relative cusp heig h t;
F ig u re 4 is the articulation quint, coordi­ progressively to the posterior, we add, to be
n a tin g the ten m ain law s o f articulation. It concise.
records the influence o f one fa cto r, govern­ F o r the purpose o f fa c ilita tin g the study
in g the establishm ent o f balanced articulation, and ultim ate practical application o f the quint,
one other fa cto r, w hile the rem aining factors the law s o f a rticulation w hich it embraces are
rem ain unchanged. E ach fifth o f the quint herew ith recorded. T h e ir transform ations
represents a f a c to r; the change is indicated on are se lf evident fro m the exam ple fo llo w in g
the centric, heavily draw n a rro w . I t shall be later. A. An increase o f the h o rizontal in­
understood th a t the direction o f each in d i­ clination o f the condylar guidance: A :B tips
vidual heavy a rro w characterizes the change down the plane o f orientation to the pos­
o f the fa c to r indicated in the respective fifth . te rio r; A :C increases the prom inence o f the
1706 The Journal of the American Denial Association

com pensating curve; A :D decreases the h o ri­ height progressively to the a n te rio r and their
zontal inclination o f the incisal guidance; transform ations.
A :E increases the relative cusp heights to the E xam ple show ing transform ations o f C :D :
posterior. B. T h e tip p in g down to the pos­ C :D (positive) : A n increase o f the prom ­
terio r o f the plane o f orientation: B :C in­ inence o f the com pensating curve increases the

F ig. 4.— A rticulation quint.

creases the prom inence o f the com pensating h orizontal inclination o f the incisal guidance.
c u rv e ; B :D decreases the horizontal inclina­ C :D (n eg ativ e) : A decrease o f the prom ­
tion o f the incisal guidance; B :E increases inence o f the com pensating curve decreases
the relative cusp height equally (o r nearly the horizontal inclination o f the incisal
so ). C. A n increase o f the prom inence o f guidance. D :C (positive) : An increase o f
the com pensating curve: C :D increases the the horizontal inclination o f the incisal g uid­
h o rizo n tal inclination o f the incisal guidance; ance increases the prom inence o f the com­
C :E decreases the relative cusp height p ro ­ pensating curve. D :C (n eg ativ e) : A decrease
gressively to the posterior. D . A n increase o f the horizontal inclination o f the incisal
o f the h o rizontal inclination o f the incisal guidance decreases the prom inence o f the
guidance: D :E increases the relative cusp com pensating curve. C :D (p o sitiv e ), C :D
 Hanau— Articulation Defined, Analyzed and Formulated 1707

(n e g a tiv e ), D :C (p o sitiv e ), D :C (n eg ativ e) interpretation o f the latest developm ents in

are tantam ount law s. W hen one la w is the problem o f occlusions, relations and a r­
m entioned, it should alw ays be understood ticulation and their application to dental re­
th a t its transform ations also apply. quirem ents. F rom the men w ho are fa m ilia r
DISCUSSION w ith the w ork o f the noted pioneers o f in­
vestigation in this field w ill come the greatest
R . O. Schlosser, Chicago, III.: M r. H anau appreciation o f this paper. T h ey w ill know
begins his paper w ith a ra th e r broad state­ the bulw arks upon which the hard won
m ent, one which m any in a professional a u d i­ progress in this problem has been reared, and
ence such as is gathered here m ig h t readily have witnessed the sincere yet fu tile efforts
resent; yet a fte r a care fu l perusal o f the en­ o f those who have continually come to the
tire paper, and know ing M r. H anau quite fro n t, and have been fo u n d w anting a fte r
intim ately and being one o f m any w ho have scientific investigation and clinical observa­
subm itted cases to be tested and checked, I tion. T o those w ho have witnessed the long
am fo rce d to adm it th a t M r. H anau has but struggle in the hope th a t tangible results
to ld us the tru th . I f the tru th as he has w ould be produced to help them solve prob­
placed it before us has, so to speak, gotten lems in office practice, this w o rk should be an
under o u r hides and, because o f his persist­ inspiration to im prove and profit, fo r through
ence, we feel m ore o r less chafed, let me such efforts as this has come a better under­
assure you th a t our condition is as the p ro ­ standing and better equipm ent, both in theory
verbial “ bed o f roses” when com pared to the and technic, to render better service. W e w ill
m isery and to rtu re we have inflicted on our see here a t this m eeting clinics show ing the
unsuspecting patients by placing into their application o f m any o f H a n au ’s findings by
m ouths m aloccluded, m alrelated and m al- men o f outstanding m erit and distinction in
articulated dentures. Let us therefore re fra in the profession. T h a t men o f this caliber are
fro m any attem pt to recognize in this paper here g iv in g clinics in this w o rk should dispel
a n y th in g th a t could be construed as a per­ any reluctance on the p a rt o f those who
sonal affront to o u r professional dignity but question its m erit o r acceptance. It seems to
ra th e r let us accept it as a beneficial counter- me, a fte r care fu l study o f the w ork o f
irrita n t which shall stim ulate us to renew H anau, and a fte r checking up w ith previous
o u r efforts and im prove the service we render know ledge, that, in teaching and practice, it
our edentulous patients so th at it m ay become is essential to consider the m ost recent
tru ly professional in the f u ll acceptance of interpretation o f the subject. T h e technic in­
th at term . H aving accepted the co u n terirri­ corporates only a fe w items th a t were not p re ­
tant, we m ust concede th at M r. H anau has viously em ployed by the dental profession.
also proffered a remedy fo r some o f our ills, T h is means th at we do n o t have to cast aside
and though, as he suggests, we m ay not find the good we have gleaned fro m the past, but
it an easy one to take, it w ill require but a m erely revise the application o f w hat we
short treatm ent to convince us th at in it we already know . T h is know ledge is arranged,
shall find m uch alleviation. I quote “ the de­ coordinated, sim plified and im proved so that
sire to experience, learn, analyze, understand the results are a m arked advancem ent. T h ere
and a pply.” Let us study his definitions, is at present no need f o r fu rth e r search f o r a
check up his analysis and apply them con­ better instrum ent. O ur technic and results
scientiously alo n g w ith such a fu n d o f ac­ are not yet abreast w ith the possibilities o f
cum ulated know ledge as we possess, and I accom plishm ent w ith those we already have.
am confident th at we w ill come to appreciate Our attention should be turned to the technic
fu lly the service M r. H anau has rendered to and the acquirem ent o f sufficient know ledge
denture prosthesis by his introduction o f and so th a t we can intellig en tly ap p ly it. T h is
application o f the principles o f engineering, know ledge can be obtained by know ing the
especially in the field o f kinematics. T o those factors involved and their coordinated ap­
who are fa m ilia r w ith M r. H a n au ’s previous plication in establishing balanced articulation.
w orks, the caliber o f his paper was antici­ In his earlier w ork on the investigation o f
pated. It bears the characteristics o f clear, m andibular m ovem ents and th eir reproduction
logical thinking, and a sim plified and concise in the a rticu la to r mechanism , H anau says:
presentation o f the com plicated and involved “ No so-called anatom ic, autom atic o r a d ­
factors essential to an understanding and justable a rticu la to r w ill fill the gap w hich
1708 The Journal of the American Dental Association

has to be bridged by concentrated analytic pleasant o r otherw ise. Science is based upon
a n d constructive th in k in g .” T h a t is o nly too true statem ents o f facts and needs no other
true. It is quite evident to those w ho have supports. T r u th m ust conquer.
w orked w ith the Gysi adaptable, the H anau C. J . R . E ngstrom , Los A ngeles, C a lif.f :
H and the H anau kinescope th a t these in­ As m uch o f this valuable and im portant paper
strum ents are o f outstanding m erit, as clinical
is peculiarly technical, I give you m y in­
tests have adequately proved. P a rtic u larly
terpretation o f a few o f the points made.
w ith the la tte r tw o are we given an accurate
and practical technic. W hile the a rticu la to r O w ing to the lack o f scientific train in g , the
and technic supply the practical basis, M r. average dentist is inclined to accept the mystic
H a n au ’s paper supplies the theoretical basis, and fo llo w the line o f least resistance in try ­
w hich enables the com petent dentist to meet in g to solve his m any problem s. H e has been
w ith ease and precision the dem ands o f w aitin g fo r the standardization o f the hum an
occlusions, relations and articulation. G ener­ being and the autom atic device to cure the
ally speaking, the paper is p urely technical ills genus hom o is heir to. A perusal o f some
as m ust be expected in analyzing and inter­ o f the literatu re outside th at pertain in g to
p re tin g the com plex problem o f a rticulation dentistry w ill be h e lp fu l to the realization
and occlusion, w hich in itself is purely th at fundam ental law s m ust be obeyed in all
m echanical. T o m y know ledge, this paper successful procedures. A rticulation can only
can tru ly be classed as original, the outstand­ be sim plified by com prehending the law s th at
in g points being the enum eration o f the law s govern it. These law s a re now com piled fo r
o f articulation, the chart analyzing a rticu la ­ those w ho desire to ap p ly them . I t is true
tion and the articulation quint, the latter th at f o r thousands o f years the crooked stick
enabling the general practitioner to read and and m an pow er was the m eans f o r cultivating
ap p ly the law s o f articulation app ertain in g the soil. W e now have tractors and gang
to the five m ain factors w ithout expecting him plows but m any individuals still use the
to be a h ighly trained technical expert. T h is crooked stick. T h e teeth and supporting tis­
a rticulation quint is an invaluable contribu­ sues have several functions, th at o f m asti­
tion to w a rd the com prehension o f the law s cation being m ost im portant. T h e efficiency
o f articulation. Y our attention is also called o f m astication is in direct ratio to the co­
to the table g iving the m alassociations o f oc­ o rdination o f a ll factors involved; hence,
clusions and relation when “ m issing the bite.” changing one fa c to r modifies the efficiency.
T h is table presents the basis fo r the possi­ W hile it is true th at some o f these factors
bilities o f correcting trau m a and errors. M ay are beyond our control (as we are dealing
I offer a résum é o f w hat to me seem the high w ith hum an beings) that is no reason fo r not
spots in this essay: 1. D enture w o rk as know ing their relative value and counteract­
practiced by the m ajo rity o f o u r profession is in g any undesirable effect they w ould have.
w o e fu lly in w ant o f im provem ent. 2. M outh T o o m uch energy is w asted try in g to fit the
conditions the result o f n a tu ra l, accidental or patient to the creations o f the dentist. I f we
ha b itu a l causes being very difficult to treat study w ithout bias w hat has been presented
are seriously ag g rav ated and m ade much today, we shall find m uch o f the m ystery has
h a rd er to care f o r by slipshod practices. vanished. W e shall probably understand why
3. T o stem the tide o f the increasing p rob­ we m ade such a gran d success o f M rs. Sm ith’s
lems th at are daily co n fro n tin g us, we must case and fa iled on M r. Sm ith and a ll the
devote a g reat deal o f our tim e and energy as Jones fam ily.
individual practitioners to the study o f oc­
clusions and th eir association w ith ja w re­ A . A . N elson, D etroit, M ich .: I t was my
lations and articulation, as w ell as to the pleasure to learn this sum m er th a t D r. A lfred
k indred subjects p ertain in g to denture pros­ Gysi o f Z urich, Sw itzerland, was in this
thesis. +. We should fam iliarize ourselves country, and I im m ediately got in touch w ith
w ith the law s o f articulation as presented by and invited him to come to this m eeting and
M r. H anau and m ake a practical application m ake a presentation, o r a t least send us a
o f them daily in o u r denture w ork. paper to be read before the section. D r. Gysi
5. F in a lly , we should w ake up to the fa c t w ired me that, as he was sailing im m ediately
that, in the field o f scientific endeavor, there f o r E urope, he could n o t be present a t the
is no place fo r the injection o f personalities, tR e ad by r . M. H ight, H ouston, Texas.
 H anau— Articulation Defined, Analyzed and Formulated 1709

m eeting, but he w ould be g lad to discuss one m ethods and contribute to the understanding
o f the papers. I le f t the selection o f the and proper application to such an extent th at
paper he wished to discuss to him , and he even the nonspecialists can take them up and
chose M r. H anau’s presentation. I am going find that, in the end, good scientific w ork is
to ask D r. Russell W . T ench, w ho \yas per­ m ore profitable than the use o f most o f the
present unscientific m ethods. As in other lines
sonally associated w ith D r. Gysi, to read his
o f hum an endeavor, m any false prophets have
discussion o f H an au ’s paper. cropped up and w ill crop up, adding con­
A lfr e d Gysi, ' Zurich, S w itzerland ^ : I fusion am ong us. As a group o f earnest
have read the paper th at R. H anau is g oing to workers, we should alread y have arrived at
read a t yo u r m eeting a t Louisville, and have an understanding o f the fundam ental p rin ­
ciples o f articulation and th eir application, if
fo und th at the conclusions he has arriv ed at
the hindrances o f a ll kinds had not been so
coincide very closely w ith those o f m y own
great.
personal investigations and those o f m y as­
sociates, a t the D ental College a t Zurich, J. W . Needles, Kansas C ity, M o .: M r.
H anau’s paper is entirely too long, unneces­
Sw itzerland. H anau and m y school have
sarily abstruse and com plicated. A lm ost every
w orked independently o f each other, and it phase touched in the paper is defined both in
should not be a surprise th at sim ilar thoughts the positive and then in the negative, w hich
are expressed in different term s. O nly the is unnecessary and unscientific. T h e next
careless reader m ay conclude th a t our findings criticism I have is th a t M r. H anau has a t­
differ in principles. I can assure you th at tem pted to relate m any conditions which are
w hile reading H anau’s p ap er a n d analyzing alm ost unrelated. T h is complicates the paper
it, I could find n o thing th at I w ould not ap ­ to such an extent th at it is alm ost incom pre­
prove o f a t present. In m any points, H anau hensible to the average m ind. T h ere are
has arrived at advanced results w hich to me m any good features in the paper and m any
appear quite logical. I expect th at, on closer truths are expressed but they could be m ade
investigation and checking, we, in Zurich, m uch m ore useful by leaving out the super­
shall be able to confirm his findings. Some fluous and sim plifying the rest.
o f m y personal w ork, still in the hands o f the F. W . F rahm , Los Angeles, C a lif.: T h e
publishers, and the recent investigations by m y definitions o f new term s should be c arefully
associates, w ill soon be published. B oth w ill studied and considered by a num ber o f q uali­
prove w hat I have just said. O u r under­ fied men before we can consider them w o rth ­
standing o f the problem o f a rticulation now w hile and acceptable to the profession o r the
is such th a t the dental profession can safely teaching staff o f our colleges. A rticulation
accept it, and by so doing, m ay obtain m ar­ is not a m ythical thing, but a real every day
velous results. O f course, we should not problem . I w ant to comm end M r. H anau
dream o f a panacea fo r a ll prosthetic ills; on the w hole paper in the abstract, because
yet it m ay be assumed that, in the present it has real m erit. T h e m ore we study this
status o f prosthetic know ledge, the dentist paper the better we w ill see the results as a
should be able to render better and safer w hole, and the m ore lig h t we w ill have on
service to a denture patient than a physician some o f our problem s. T h e surgeon w ho is
ord in arily can to a p atient suffering a not w illin g to get down to the base o f the
systematic disturbance. U nhappily, the con­ trouble, locate the causes and elim inate errors
tra ry is the case as regards the prosthetic w ill never get anyw here. N either should the
services rendered by the large m ajo rity o f dentist expect to obtain results fro m inac­
dentists. I sincerely hope th a t the N ational curate and slipshod m ethods. I w ould urge
Society o f D enture Prosthesis w ill assume the every m an to read and reread and study
leadership in advocating m odern prosthetic H an au ’s paper and m ake it a p a rt o f his
fR e ad by Russell W. Tench, New York City. practice.