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DENTAL INSTRUMENTATION

The History of Articulators: A Critical


History of Articulators Based on Geometric
Theories of Mandibular Movement: Part I
Edgar N. Starcke, DDS
S
INCE AS early as the 1860s, dental scientists
and inventors investigated the nature of man-
dibular movement for the purpose of reproducing
these movements in an articulator. Simple hinge
articulators became commonplace, but by the turn
of the 20
th
century, the natural variability of the
condylar paths, both between individuals and
from side to side in the same individual, had be-
gun to be recognized and appreciated as impor-
tant determinants of mandibular movement. Un-
doubtedly, the investigators interpretations of
what they observed varied greatly. This is demon-
strable in the features of their articulators. From
the inspired to the near-genius and from the ridic-
ulous to the sublime, these articulators simply
reected what was perceived to be the anatomic
and kinesthetic characteristics of mandibular
movement. Despite differences in investigators
perception and application of mandibular move-
ment, the complexity of articulators began to evolve
as a result of the important work of such scientists
as W.E. Walker, Alfred Gysi, and George Snow. By
1910, most inventors had become more systematic
in their attempts to reproduce the individual natu-
ral movements of the mandible.
1
The Condylar (or Anatomic) School
of Articulator Design
In a broad sense, the school of articulator design
that emphasizes condylar guidance and rotation
centers can be called the condylar, or anatomic,
school. During the early 20
th
century, articulators
with adjustable condylar guides were becoming
more popular; or at least so it seemed on the
surface. However, undercurrents brought about by
intense competition in the marketplace and den-
tists demands for simplicity, generated a trend
toward average value instruments.
1
The most
noteworthy example is the Gysi Simplex articula-
tor,
2
which, incidentally, caused quite a reaction
from Gysis critics when introduced in 1912
(Fig 1).
3
*
The Geometric (or Nonanatomic)
School of Articulator Design
By about 1900, a second major school of articulator
design, the geometric, or nonanatomic, school,
was emerging. This approach embodied principles
contrary to the condylar school and proved to be
both trend-setting and a source of controversy.

The geometric school denied the existence of con-


dylar axes and disregarded the condylar paths as
inuences on occlusion, instead contending that the
articulation of the teeth guides the mandible dur-
ing mastication. The condylar paths need only be in
accord with the plane of occlusion. Critics of the
geometric school believed that this view was invalid
for 2 primary reasons: (1) It did not take into
Correspondence to: Edgar N. Starcke, DDS, Clinical Professor, De-
partment of Prosthodontics, The University of Texas Health Science Center
at Houston Dental Branch, 6516 M.D. Anderson Boulevard, P.O. Box
20068, Houston, TX 77225. E-mail: estarcke@mail.db.uth.tmc.edu
Copyright 2002 by The American College of Prosthodontists
1059-941X/02/1102-0012$35.00/0
doi:10.1053/jpro.2002.124356
*Gysi was tireless in his resolve to promote his Sim-
plex articulator, of course, with a little help from his
friends. A booklet titled The Happy Average Way was
published for practitioners of general dentistry in about
1912. It was endorsed by George Wood Clapp, the editor
of Dental Digest, and promoted Gysis average complete
denture technique, which included his Simplex articula-
tor.

By 1918, several theories of occlusion existed along


with articulators designed to promote them. According to
James E. House, since the principles of these theories
varied so widely, it was decided that in the best interest
of the profession, a study club would be created, limited
to 50 men dedicated to testing their ideas on each other
in a workshop setting. Their goal was to narrow the eld
of articulator design to one acceptable articulator for the
improvement of prosthodontics. This was one of the
primary reasons that, in August 1919, the National Soci-
ety of Denture Prosthetics was organized.
4
134 Journal of Prosthodontics, Vol 11, No 2 ( June), 2002: pp 134-146
consideration individual variations (i.e., there was
the notion that one size ts all), and (2) no
provision was made for the BalkwillBennett move-
ment.
Articulators designed to reect geometric theo-
ries feature some type of mechanism that allows
the mandible to move around a single central
radial axis generally located above and/or posterior
to the occlusal plane. Traditionally, these devices
have been called arbitrary and single rotation
center articulators. These terms are not ade-
quately descriptive, however, because they are sim-
ply too vague and ambiguous. For example, to
stretch a point, the simple hinge articulators might
also be considered single rotation center articu-
lators,
4
and they certainly can be considered arbi-
trary. (Incidentally, it appears that over the years,
the popularity of simple hinge devices has never
waned.)
The inventors most frequently associated with
the geometric school of mandibular movement and
articulator design are George S. Monson (for his
spherical theory) and Rupert E. Hall (for his
conical theory). It was earlier investigators, how-
ever, who laid the basic foundations on which the
principles of the various geometric theories were
built.
William G.A. Bonwill and Francis H. Balkwill,
who were contemporaries although oceans apart,
were perhaps the earliest investigators to apply
geometric principles to articulation, mandibular
movement, and the design of articulators. In 1864,
Bonwill introduced his equilateral triangle the-
ory, establishing the size of the mandible as 10 cm
from condyle to condyle and from each condyle to
the incisor point. Bonwill believed that articulation
of the teeth guides the mandible during function,
but that the centers of the condyles are also the
centers of lateral rotation for the mandibles open-
ing and closing movements.
5
Balkwill presented his observations on mandib-
ular movement in 1866. When describing the open-
ing motion, he theorized that
the articulating posterior outline of the condyle of the lower
jaw appears formed of parts of two circles, the inner and
larger forming part of an independent smaller circle. The
condyle articulates with the glenoid cavity so as to allow a
single hinge-like motion and a forward and backward
motion. While there is only a slight lateral motion, both
sides move on the radii of the same circle. The combined
motion of both circles will give the [rotating] side nearly a
simple lateral action, while the [orbiting] side will move
forward and downward.
6
In 1890, anatomist Ferdinand Graf von Spee of
Kiel, Germany (Fig 2) called attention to the
relationship between the curved arrangements of
the occlusal planes of natural teeth and the corre-
sponding curves of the condylar paths.
7
As re-
ported by Gysi, von Spee described the forward
movement of the mandible (as viewed in the sagit-
tal plane) in this manner:
Figure 1. The rst and fac-
ing pages of The Happy Aver-
age Way. Probably published
by the Dental Digest in about
1912, this booklet was in-
tended to enable the general
practitioner to provide ef-
cient denture service with-
out the need for scientic
equipment. The Gysi Adapt-
able articulator (left) would
be the ideal instrument, but
the Simplex would sufce in
80% of the cases. The booklet
advertised the services of the
I.J. Dresch Laboratories of
Toledo, OH, and the illustra-
tions were provided by the
Dental Digest, G.W. Clapp, ed-
itor. It was not copyrighted.
135
The total visible contact of the molar masticatory surfaces
lies on the same arc of a circle. The posterior continuation
of this arc touches the most anterior point of the condyle.
Accordingly, the points of the mandible that glide in contact
along the upper part of the skull are lying on the same
cylindrical surface. The location of the axis of that cylin-
ders curvature is at the level of the horizontal mid-orbital
plane. The steeper the path of the condyles, the more
pronounced the tooth curve would be, because both have the
same radius.
8
This was later to be known as the curve of Spee.
The Spherical Theory: Should the
Credit Go to Christensen or
Monson?
There was never a raging controversy over who
originated the spherical theory. On the contrary,
most authors have traditionally awarded that dis-
tinction to George Monson. However, there were
some early discussions on this issue, and even into
the late 1940s, there was some question as to who
actually originated the spherical theory of mandib-
ular movement.
9
Rupert Halls historical review of the work of
various investigators on mandibular movement led
him to believe that Carl Christensen had developed
Figure 2. Ferdinand Graf von Spee (18551937). (Re-
printed by permission of ADA Publishing, a division of
ADA Business Enterprises, Inc. Copyright 1980, Amer-
ican Dental Association.)
Figure 3. Sagittal view of the mandible. The concentric
arcs demonstrate the nature of the protrusive movement
of the mandible. The short black line represents the
joint path. Christensen believed that the path of the
condyle never differs much from a straight line. (Re-
printed from Christensen.
11
)
Figure 4. A lateral view of the skull with a schematic
drawing of dentures in centric occlusion and in protru-
sion. This illustrates the intraoral method for recording
the condylar inclination, or Christensens phenomenon.
Christensens Rational articulator is based on this prin-
ciple. (Reprinted from Christensen.
11
)
136
the spherical theory.
10
Christensens claim to fame,
of course, was his practical technique for register-
ing positional relations of the mandible. He was the
rst to describe an intraoral method for recording a
static protrusive record to determine the condylar
inclination, and he produced an adjustable condylar
guide articulator, the Rational articulator, to pro-
mote this technique.
11,12
Fromhis description of the
technique came what Ulf Posselt coined Chris-
tensens phenomenon, or the posterior separation
of the occlusion rims that occurs when the mandi-
ble moves from a centric to a protrusive position.
13
In the late 1890s, Christensen discovered what was,
until then, the largely unknown work of von Spee
on the displacement path of the jaw.
7
He believed
that Spee should be credited with pointing out the
importantand simpletruth that the path of the
condyle during the bite movement must be in
conformity with the bite-path.
12
Christensen de-
veloped his method of recording the condylar incli-
nations for his Rational articulator as an exten-
sion of Spees principle, that is, harmonizing the
articulation of the teeth with the movements of the
condyles.
14
Christensen was well aware that in Spees
view, the nature of the temporomandibular joint
during movement was of more a mechanical than
an anatomic character and that his observations
may not hold true in all cases. He pointed out
that Spee himself admitted that there seemed to
be a discrepancy between his hypothesis and the
accepted conception of anatomic conditions. But
Christensen proposed that during movement of
the mandible in individuals with natural teeth,
while the teeth remain in sliding contact, the
condyles can only move downward and forward 4
to 5 mm, with a maximum distance of 12 mm.
Therefore, he believed that the small distance
and direction that the condyles traveled while the
teeth remained in contact was of utmost impor-
tance for dentures to function properly. Chris-
tensen believed that, as von Spee indicated, if the
articulation-path and the joint-path were
similar, then whether the articulation-path is
straight or curved, the joint-path must be par-
allel to it (Fig 3).
11
In this gure, both paths are
shown to conform to concentric arcs with a com-
mon center. Christensen considered the condy-
lar path curves to have innite radii and, for
all practical purposes for setting denture teeth,
to be a straight line. His articulator was based on
this principle (Fig 4).
11
Figure 5. Christensens Rational articulator with plaster
casts and wax occlusion rims mounted in the centric
position. The plaster blocks, mounted for the simulated
functional generated path procedure, would look similar
to this. (Reprinted from Christensen.
11
)
Figure 6. (A) Christensens Rational articulator with
the condylar guides set at a high inclination. The maxil-
lary and mandibular plaster blocks have been manually
ground in and the surfaces have obtained spherical
shapes. (Reprinted from Christensen.
12
) (B) Vulcanite
rubber stints with wax occlusion rims on casts of badly
worn natural teeth. The spherical contours of the rims
were formed as a result of the subject moving his man-
dible freely and as far as capable while maintaining
contact of the rims with moderate pressure. (Reprinted
from Christensen.
12
)
137
Christensens Spherical Theory
Carl Christensen pursued Spees ideas further but
adopted different concepts of the nature of man-
dibular movement. By the early 1900s, he had stud-
ied the work of other investigators and had made
his own observations on mandibular movement and
occlusal wear patterns of natural teeth.
Christensens new spherical hypothesis was based
on the conclusions that he had reached regarding the
factors that determine the nature of the occlusal
plane and the relationship betweenthe occlusal plane,
tooth articulation, and condylar paths. Preferring to
use the root word bite rather than the terms artic-
ulation and occlusion, Christensen claimed that
the only way to prove that his theories were correct
was to observe the bite-movement (articulation)
phenomenon itself.

But, he explained, it must be


remembered that the minute details of [these move-
ments]. . .in the living individual. . .are still a closed
book to us, and. . .are hardly suitable as the real basis
for [debate].
12
Christensen held that it is the ideal
jaw-path during bite movement of the edentulous
mouth (related to the construction of complete den-
tures) that should be determined, not the accidental,
more or less normal bite-path of the mouth with
natural teeth.
12
Christensen did not fully understand the nature
of the lateral movements of the mandible, but he
concluded that the mandible must make lateral
movements similar to the forward movements and
that only a spherical surface arrangement of the
occlusal plane would allow continuous tooth contact
during all excursions of the mandible. These spher-
ical surfaces differ for each individual, ranging from
an almost-plane surface with an innite radius to a
highly curved surface with a radius of 4 to 5 inches.
Christensen offered 2 of his several practical
experiments to conrm that the principles of his
spherical theory were correct. The rst experiment,
a laboratory demonstration, used his Rational
articulator to manually simulate functionally gen-
erated path occluding surfaces on maxillary and
mandibular rims. To simulate occlusion rims,
Christensen mounted plaster blocks in his articula-
tor (Fig 5). He then set the condylar guides at an
especially high oblique position. Maintaining rm
hand pressure on both bows of the articulator and
using the guiding mechanism of the instrument, he
functionally articulated the blocks to grind them
in to balancing surfaces in all directions of the
moving bite. The worn surfaces now showed per-
fect contact through all movements and obtained
the shape of spherical surfaces, the mandibular
surface concave upward and the maxillary surface
convex downward (Fig 6A).
12
Christensen claimed to conrm this indirect
proof by another experiment that he carried out
with a living subject, a man whose natural teeth
were severely abraded. The subjects plane of occlu-
sion was slightly curved but was not smooth. Chris-
tensen constructed vulcanite rubber stints to cover
the teeth, and over the stints he placed wax occlu-
sion rims of a few millimeters thickness. After
lubricating the rims with soap, the subject was
asked to move his mandible in all possible direc-
tions, holding the rims together with moderate
pressure. Although not as dramatic, the outcome
was the samethe occlusal surfaces of the wax
rims obtained a spherical shape (Fig 6B and C).
12
A Frank-ly Discouraging Word
In 1908, Bernard Frank of Amsterdam, took aim at
von Spee and Christensen, harshly criticizing their
work on mandibular movement and admonishing
any inventors who had claimed that their so-called
anatomic articulators could imitate the joint
mechanism.
15
Frank conducted experiments that
he believed produced conclusive evidence that
Spees ndings were inaccurate. He said that von
Spee had stated emphatically that the sagittal oc-
clusion curve of man has a radius of 6 to 7 cm, and
claimed that his own experiments showed that this
was the case in only 27% of the measurements.
15
Frank also contended that Christensen did not
prove the validity of his Rational articulator. Us-
ing cross-sections of dentulous mandibular casts,
Frank demonstrated that there were vast differ-
ences among individuals in the curvatures of the
occlusal planes. Moreover, by cutting cross-sections
of each cast at the positions of the premolars and

In his 1905 paper, Christensen chose to avoid the use


of the terms articulation and occlusion, but instead,
chose the word bite as a general term meaning all the
forms of contact in which both rows of teeth may meet.
He went into detail dening his bite-related terms and
his arguments for preferring their use; but his basic
reason was simply because experience has taught me
that neither articulation nor occlusion [are under-
stood by] the great majority of dentists when a thorough
explanation of the subject is attempted.
11
138
molars, he showed that the radius of each of the 5
pairs of teeth would be different (Fig 7).
Using Christensens Rational articulator, Frank
repeated his simulated functionally generated path
experiment using blocks made of a pumicestone
mixture (Fig 8). The curved occlusal surfaces gener-
ated on Franks blocks were remarkably more compli-
cated than the spherical surface reported by Chris-
tensen. Furthermore, Frank suggested that it was
evident that the directions of the natural masticating
surfaces differ so greatly from those obtained by re-
peating the experiment of Christensen that this ex-
periment entirely fails to prove the correctness of the
[Christensen] articulator.
15
Bernard Franks rhetoric was that of a man with
a mission: to let the world know that it is utterly
impossible to solve the problems of articulation by
means of articulators. In the milieu of this early-
20th century dentist, it is doubtful that he found
many colleagues to argue with that statement. In-
deed, there are those today who would wholeheart-
edly agree with him.
Clearly, Frank expressed some legitimate con-
cerns. He understood the concepts of the facebow,
Figure 7. Cross-sections of mandibular dentulous casts of different individuals demonstrating how Frank calculated the
differences betweenthe lateral occlusal plane curvature variations (as viewed inthe frontal plane.) Lines were drawntouching
the highest points of the respective pairs of teeth. Points a and b identify the midpoint of the occlusal surfaces. The lines
intersect at point c. Frank identied points a, b,and c as the inter-occlusal surface angle. At points a and b, perpendicular lines
were drawn that intersected at point d, representing the common center of rotation of each pair of teeth. Frank noted that
each tooth had a circle of occlusal contact, 1 with radius r and 1 with radius r. None of the radii constructed for the occlusal
circles of each tooth pair ever appeared to be equal. (Reprinted from Turner.
14
)
Figure 8. Cross-sections of
the mandibular casts of oc-
clusal rims that Frank gener-
ated by repeating Christen-
sens simulated functionally
generated path experiment.
Frank made 5 transverse sec-
tions at the proper posi-
tions of the posterior teeth.
He noted 10 different slop-
ing surfaces, 5 for each side,
and pointed out numerous
discrepancies between Chris-
tensens ndings and his. (Re-
printed with permission.
15
)
139
the third point of reference, and the variability of
the intercondylar distance. Christensen had not
addressed these issues in his work. On the other
hand, Franks choice of analysis to challenge Chris-
tensens theories could be described as comparing
apples and oranges. Even though the spherical
theory implies multidirectional movement, Chris-
tensen primarily studied the movement of the man-
dible in the anteroposterior direction (as observed
in the sagittal plane) after the work of Spee,
whereas Franks observations were in the frontal
plane. Christensen also made it quite clear that the
Figure 9. George S. Monson, DDS (18691933). (Re-
printed by permission of ADA Publishing, a division of
ADA Business Enterprises, Inc.
16
Copyright 1933,
American Dental Association.)
Figure 10. George Monson
demonstrated his spherical
theory for the rst time on
this Bonwill articulator.
The casts were mounted in
the articulator according
to Bonwills equilateral tri-
angle and with the spheri-
cal occlusion guide. (Re-
printed from Washburn.
17
)
Figure 11. Dr. Monson making measurements on a
human mandible to demonstrate that from the 4-inch
common center, the divider touches the incisal edges and
the condyles. (Reprinted from Washburn.
17
)
140
ideal occlusal curve would be considered only for
the edentulous mouth in the context of construct-
ing complete dentures.
12
So what did Frank conclude from his own exper-
iments with curves of occlusion and from his obser-
vations of the known articulators of his day? What
he said was this: An anatomical articulator is good
for nothing. Life cannot be imitated. It would seem
then, that we must give up forever any idea of being
able to construct a mechanical joint articulator that
will enable us to construct a physiologically articu-
lating denture for each individual case.
15
Clearly,
he was ahead of his time.
Monsons Spherical Theory
and Articulator
Conducting experiments on mandibular movement
during the same period as Carl Christensen was
George Monson, of St. Paul, MN(Fig 9).
16
H.B. Wash-
burn (also of St. Paul, MN), writing on the history of
occlusal concepts, reported that Monson had con-
ceived the spherical theory. Washburnalso considered
it signicant that Christensen and Monson, so close in
ideas, knew nothing of each others work.
17
Washburn reported that in 1898, speaking to a
group at Mankato, MN, Monson presented for the
rst time a method for setting denture teeth, using
Bonwills equilateral triangle conforming to the
surface of a sphere. Monson had been a student and
close friend of Bonwill for many years, but the time
came when he could no longer strictly follow all of
Bonwills teachings. Nevertheless, this rst demon-
stration of his spherical theory was performed with
a Bonwill articulator, and the casts were mounted
according to Bonwills instructions. However, the
teeth were set to conform to a wire spherical
occlusal guide constructed by Monson (Fig 10).
17
Through further studies, Monson concluded that
prenatally, mandibles ideally tend to develop as equi-
lateral triangles and, if the various interfering factors
can be controlled during development, that the teeth
also would conform to a sphere.
18
To verify this hy-
pothesis, Monson conducted experiments with both a
human mandible and with casts of the mandibular
dentition of highly developed individuals. By highly
Figure 12. L.A. Weinbergs schematic illustration of the 3-dimensional relationships of the components of Monsons theory.
Lines projected fromthe apices (A, B, and C) of Bonwills triangle intersect at point D, forming a spherical pyramid. Monsons
8-inch diameter sphere touches the apices of the triangle, and point D is the center of rotation or radius of the sphere.
Weinberg pointed out that a relationship betweenBonwills triangle and Balkwills angle. Monsons theory requires a condylar
inclination of close to 35 degrees and a Balkwill angle of 15.5 degrees. These angles do not correspond to those average angles
found by Gysi (30-degree condylar inclination) and by Balkwill (26-degree Balkwill angle) (Reprinted with permission.
22
)
141
developed, he meant a personwithanideal mandible
and dentition that had not been disturbed at some
point by disease, trauma, or developmental anomaly.
Monson afxed a metal rod to the center of the
occlusal surface of each posterior tooth, projecting the
rod upward and parallel to the long axis of the tooth.
These rods represented the radial lines of force of the
teeth. When all of the rods were in place, Monson
Figure 13. A frontal view of
the mandible illustrating the
relationship of the 8-inch-
diameter sphere with the
transverse plane of occlusion
that Monson claimed must
be the same as the antero-
posterior plane for balanced
occlusion to be achieved. The
radial lines of force of 4-inch
length converge forming the
radial point at the apex from
which the radius of occlusion
of each tooth is determined.
(Reprinted from Monson.
20
)
Figure 14. A posterior view
of the mandible, illustrating
the application of the radial
lines to the condyles. The
center of the condyles are
shown conforming to the sur-
face of the sphere, giving the
same radial dimensions from
the centers of the condyles to
the apex as from the occlusal
surfaces of the teeth. This
also illustrates Monsons
concept that this radial
center is the center for the
entire muscular action be-
cause the angles of the
mandible conform to lines
centering at apex A. (Re-
printed from Monson.
20
)
142
found that they intersected at a common point or
center. On the human mandible (Fig 11), he discov-
ered that when measuring from this common center,
a dividing caliper not only touched the incisal edges of
the anterior teeth and the buccal and lingual cusps of
the posterior teeth, but also bisected both of the
condyles.
This, then, was the origin of Monsons spherical
theory. It was based on the concept that the man-
dibular teeth move over the occlusal surfaces of the
maxillary teeth, as over the external surface of a
segment of an 8-inch sphere, and that the radius (or
common center) of the sphere is located in the
region of the crista galli. Because of the way in
which the mandible develops, Monson further be-
lieved that it would be logical to adapt Bonwills
4-inch equilateral triangle to the surface of the
8-inch sphere, because geometrically, such a spher-
ical-based triangle would also be a segment of the
8-inch sphere, and the apex of a pyramid erected on
Figure 15. Monsons Man-
dibulo-Maxillary instrument.
Point A is the radial center of
the instrument from which
the occlusal surfaces of the
teeth are determined. Point
B is the position of the con-
dylar hinge mechanism for
the instrument. The teeth
are arranged to conform to
the 8-inch sphere at C. Slot
D controls anteroposterior
movement. The slot is con-
centric with the outer surface
of the sphere. Jackscrews E
are used to adjust the posi-
tion of the lower cast to the
center if required. This in-
strument was manufactured
by M.F. Patterson Supply
Co., St Paul, MN. (Reprinted
from Campbell.
21
)
Figure 16. A sagittal view
demonstrating the relation-
ships of the 8-inch diameter
sphere to Monsons articula-
tor and to the anteroposte-
rior plane of occlusion. (Re-
printed from Monson.
20
)
143
the triangular base would be coincident with the
common center of rotation, that is, the 4-inch ra-
dius of the sphere (Figs 12, 13, and 14). Initially, the
spherical theory involved the articulation of natural
teeth in the highly developed individual and the
conviction that these principles apply to the eden-
tulous mandible with highly developed ridges.
18
Monson soon realized, however (and was quick to
point out), that most patients encountered are
not highly developed, because at some point in
life an unbalanced condition replaced an earlier
balance as a result of some disturbing inuence.
In these individuals, the radius of the sphere may
be greater or smaller than 4 inches and may not
always be in the same location. Thus Monson
provided a mechanism in his instrument and in
the method for mounting casts whereby the re-
lationship of the patients occlusal plane and
condyles to the patients center is the same on
the articulator as in the patient.
17
In 1923,

Monson was issued a patent for his


articulator.
19
The Mandibulo-Maxillary In-
strument, as Monson named it, was based on
his spherical theory (Figs 15 and 16). The
instrument had 2 rotational axes, spherical and
condylar. The condylar axis feature was, of
course, one of convenience but was also de-
signed for a facebow transfer method used for
the unbalanced [oral] conditions encoun-
tered in most patients. Both Washburn
17
and R.G. Keyworth
23
described their methods
for using Monsons articulator in complete
denture construction; both versions included
a similar facebow transfer technique (Figs 17
and 18).
In summarizing the principles of Monsons in-
strument, Washburn stated that it incorporated
Monsons spherical principle and combined the
Bonwill triangle with Walker and Gysis condyle
movements. In addition, the instrument included
Gysis idea that the forward and lateral movements
must be combined and that the plane of occlusion
conforms to the curve of Spee.
17
Returning to the Original Question
So, who should receive credit for the spherical the-
ory, Carl Christensen or George Monson? The an-
swer may never be denitely known, because the
exact date when and by whom the spherical idea
was conceived may be too close to call. Is this
answer important? Probably not. Because they were
working independently at about the same time,
either one of these men could have actually been
the rst. In any event, it is George Monson who
should and probably will be remembered for pro-
mulgating the spherical theory and for his convic-
tion that its principles were sound.

James House states that Monson had applied for the


articulator patent in 1918 and had presented and defended
his spherical principles and his Mandibulo-Maxillary In-
strument surprisingly well before his peers at the annual
session of the National Society of Denture Prosthetists
about 2 years later. Monson was very much in the center of
the spirited dental controversy [over the various theories of
mandibular movement and articulator design] because his
idea of a single rotation center was an easy target.
4
Figure 17. A schematic
drawing illustrating the theo-
retical mechanics of transfer-
ring wax rims fromthe patient
to the instrument. (Reprinted
from Washburn.
17
)
144
Figure 18. (A) After a centric rela-
tion record is made, the rims are
fastened together and transferred
to the instrument with a facebow.
(B) After the occlusion rims are re-
lated to the condylar axis with the
facebow, the lower cast is adjusted
by placing one end of the open cal-
ipers in the radial center of the ar-
ticulator and touching the free end
of the calipers to the incisor point
on the lower wax rim. (C) A caliper
is used to project the spherical
curve to the occlusal surface of the
mandibular wax rim as a guide for
setting the teeth. (Reprinted by
permission of ADA Publishing, a di-
vision of ADA Business Enterprises,
Inc.
23
Copyright 1929, American
Dental Association.)
145
Carl Christensen was a practical clinician
who devised a useful intraoral procedure to
record the individual condylar paths for the
purpose of setting the adjustable condyle con-
trols of his articulator. Christensen was curious
about the nature of mandibular movement and,
through his experiments, recognized the spher-
ical curvature of the occlusal plane and its
relationship with the curvature of the condylar
paths. However, Christensen believed that be-
cause of the innite radius of the sphere, for all
practical purposes, the condyle paths would be
a straight line. He did not promote his spheri-
cal theory, but he will always be associated with
his method for making a protrusive intraoral
record and for Christensens phenomenon.
George Monson, on the other hand, believed
that his spherical principles produced the ideal
occlusion in the highest-developed type of indi-
vidual and accordingly, the best-balanced articial
dentures must conform to a spherical base.
20
Mon-
sons articulator and technique based on his spher-
ical theory attracted a number of devoted followers.
Even today, many of his principles persist as a part
of the dental landscape.
More on the history of articulators based on
geometric theories of occlusion will appear in the
next issue of The Journal of Prosthodontics.
References
1. Paraskis CS: Criteria for selecting an articulator to occlude
and articulate teeth for full denture construction. In Sharry
JJ (ed): Symposium on complete denture prosthesis, Dent
Clin North Am 1964; :629-663
2. Gysi A: Simplifying the correct articulation of articial
teeth. Dent Dig 1913;19:1-8
3. Starcke EN: The history of articulators: The appearance and
early use of the incisal-pin and guide. J Prosthodont 2001;
10:52-60
4. House JE: The design and use of dental articulators in the
United States from 18401970. Masters thesis, Indiana
School of Dentistry, Indianapolis, IN, 1970, pp 119-127
5. Bonwill WGA: Articulation and articulators. Trans AmDent
Assoc 1864; July 26:76-79
6. Balkwill FH: The best form and arrangement of articial
teeth for mastication. Trans Odont Soc Great Britain 1866;
5:133-158
7. von Spee FG: Die Verschiebrangsbahn des unterkiefers am
schadell. Arch Anat Physiol 1890;16:285-294. English trans-
lation, Niedenbach MA, Holtz M, Hitchcock HP: The gliding
path of the mandible along the skull. J Am Dent Assoc
1980;100:670-675
8. Gysi A: The problem of articulation (Part II). Dent Cosmos
1910;52:148-169
9. Lufkin AW (ed): A History of Dentistry (ed 2). Philadelphia.
PA, Lea and Febiger, 1948, p 292
10. Hall RE: An analysis of the work and ideas of investigators
and authors of relations and movements of the mandible.
J Amer Dent Assoc 1929;16:1642-1693
11. Christensen C: A rational articulator. Ashs Q Circular
1901;18:409-420
12. Christensen C: The problem of the bite. Dent Cosmos
1905;47:1184-1195
13. Posselt U (ed): Physiology of Occlusion and Rehabilitation.
Philadelphia, PA, Davis, 1962, pp 42-43
14. Turner CR (ed): The American Textbook of Prosthetic
Dentistry (ed 3). Philadelphia, PA, Lea Brothers, 1907,
p 414
15. Frank B: An investigation on articulation and experiments
with C. Christensens articulator. Brit Dent J 1908;29:289-
295
16. Cruttenden LM: Obituary of George S. Monson. J Am Dent
Assoc 1933;20:1285-1287
17. Washburn HB: History and evolution of the study of occlu-
sion. Dent Cosmos 1925;67:331-342
18. Washburn HB: The application of the Monson spherical
principle to full dentures. J Am Dent Assoc 1927;14:648-654
19. Monson GB: Dental Articulator. US Patent No. 1,457,385.
June 5, 1923
20. Monson GB: Occlusion as applied to crown and bridge-work.
J Nat Dent Assoc 1920;7:339-413
21. Campbell DD (ed): Full Denture Prosthesis. St. Louis, MO,
Mosby, 1924, p 355
22. Weinberg LA: An evaluation of basic articulators and their
concepts. Part II: Arbitrary, positional, semiadjustable ar-
ticulators. J Prosthet Dent 1963;13:645-663
23. Keyworth RG: Monson technic for full denture construction.
J Am Dent Assoc 1929; 16:130-162
146

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