Is it possible to detect a true rotation axis of the temporomandibular joint with common pantographic methods? A fundamental kinematic analysis

The location of the terminal hinge axis of the temporomandibular joint is still a very wide-spread procedure in dentistry in order to replicate the movement in various articulator devices. Especially pantographic methods are claimed to provide accurate measurements and, additionally, are seen to be able to separate a pure rotation of the joint from a movement with an arbitrary combined shift and rotation. In the latter application, these methods were used in a lot of studies as a reference standard. The aim of this study was to analyze, whether common pantographic methods in general are able to distinguish between a pure rotation and a movement with rotational and translational portions. The mathematical proof of this analysis was done with theoretical kinematic considerations and compared with computer simulations. The results show for the first time that there exist combinations of rotational and translational movements of the temporomandibular joint which cannot be separated from pure rotational movements using actual pantographic methods. Even more, the consequence is a shifted location of the (combined) finite center (axis) of rotation in comparison to the true center (axis) of rotation: in case of a translational portion of only 1 mm, this is a displacement of around ±6 mm and, in case of 2 mm translation, a displacement of ±12 mm. This finding necessitates a critical reinterpretation of former studies using pantographic methods as a reference standard. Further, under some circumstances it may also affect the applicability of articulator concepts and the interpretation of functional signs.