Its a debate since several years in the field of complete denture Prosthodontics regarding the use of face bow transfer in fabrication a complete denture. Even though literature does not favour the use , but if we see recent services , its been mentioned that use of facebow has increased in dental colleges.
Good question you asked dr.
In my opinion, it is a must to have a facebow record when making complete dentures.
This practice may seem plausible and it is also traditionally deeply entrenched in dentistry. (Pick up any +80 year old book on restorative dentistry (i.e. Schweizer) and you'll see illustrations of face bows of sorts...). However, there is no evidence to support its usefulness. Jens Türp and others did interesting work in this exact area (i.e. the use of face bows for full/full dentures) and found it had no effect on occlusal adjustment time. A good read on this topic (and others) is "Dogmas in Dentistry" by Gunar Carlson.
Despite gnathology is around us for years, its "utility versus futility" still controversial. Probably you have read publication of Prakash P, Singh K, Bahri R, Bhandari SK. Utility versus futility of facebow in the fabrication of complete dentures: A systematic review. J Indian Prosthodont Soc. 2020 Jul-Sep;20(3):237-243. doi: 10.4103/jips.jips_402_19. Epub 2020 Jul 17. PMID: 33223693; PMCID: PMC7654196, where take home message is - we still don't know the truth. If you want to measure utility of method, you should know where to measure, when to measure, what to measure, how precise to measure , what clinical acceptance of measurement is and ect. I am in agreement with authors" ...Variations in assessment criteria, non uniform distribution of sample size amongst different clinical trials and subjective questionnaire based criteria are the weaker links in the review. Extensive research and long term standardised studies with objective criteria for assessment are required for comprehensive and conclusive results to establish the need for change in clinical practice... In my opinion, using an arbitrary face bow is not at all time and expenses consuming. These are not the issues to abandon face bow. Using the face bow without Christensen's phenomenon record (values) gives a very little benefit if not at all. Christensen's phenomenon record (values) will enable your dental technician to construct the best possible occlusal schema desired (indicated) for specific individual patient to achieve. Should be noted, face bow does not applies for esthetics (meaning - model position will be related to arbitrary hinge axis, but not to patients esthetic horizon) resulting in dental technology should to imply methods of interchangeable model setup in articulator for esthetics one and function another. That's, in may opinion, not too much time consuming and expensive also. In medicine we are using an optimal combination of evidence based (what quality of evidence we have in this case) and best or good practice knowledge. If you say, that you are treating your patient by his individual needs and anatomy (production of individual denture), today will be more ethical to use face bow, than to abandon. And yes, we see patients wearing unbelievable awful complete dentures being very satisfied and others - having correct (right) dentures constantly complaining on them. What you, dear colleagues ,think? Regards.
In the end of the day it's a game of "pick & choose". If one feels better using a facebow there's certainly no harm in doing so but this practice is by no means a hallmark for "proper" dentistry.
Sascha Hein Thanks. In general agree with you and regularly checking current literature on that topic. But I am saying for my patient: my dear, there is no solid evidence on complete dentures and face bow; it won't cost you and it will take extra 10 min chair side time; you and me, as a team, will give max available info for another team member - the dental technician - to produce most individual dentures, specifically for you.
Good question,I am agree with you to use of face bow in complete denture fabrication
If we see the literature, there are many clinical trail who conclude that facebow is not improve the ease of performance .
In dentistry, a lot of procedures are operator-dependent, making it hard to check the scientific evidence of their effectiveness in clinical trials. If you use the facebow twice a year, it will take about a decade to see its benefits, if even. If you use it twice a week, you and your technician, in a couple of months, will see that the benefits are clear. IMHO.
I personally prefer giving conventional dentures with facebow record and Christensen's Values noted as pointed out by Rolandas Pletkus Many articles involving systematic reviews and meta analysis have come up regarding utility of facebows like:1. Khan FR, Ali R, Sheikh A. Utility of facebow in the fabrication of complete dentures, occlusal splints and full arch fixed dental prostheses: A sytematic review. Indian J Dent Res 2018;29:364-9.
In this research, it was inferred that facebow transfer does not yield a superior prosthesis (complete denture or occlusal splint). There are no clinical trials available for the utility of facebow transfer in full arch crown and bridge work. Similarly in the study by Prakash P, Singh K, Bahri R, Bhandari SK. Utility versus futility of facebow in the fabrication of complete dentures: A systematic review. J Indian Prosthodont Soc. 2020 Jul-Sep;20(3):237-43, it was found that similar results were obtained in dentures with and without facebow. Also, it was felt that extensive research and long term standardised studies with objective criteria for assessment are required for comprehensive and conclusive results to establish the need for change in clinical practice.
Putting all the data available aside, in my personal opinion, giving a denture with facebow record gives us a customised denture with the correct occlusal scheme for that particular patient alone and the results are amazing both for the patient and the Prosthodontist.
It is an interesting question. The literature shows that the two options of use, with or without face bow registration, for complete denture fabrication are effective. In Brazilian graduation instituitions, if you don't use the face bow, the "Camper table" can be used to mount the superior cast in ASA. This device simulate the standart mean of Camper's plan that range about 15º.
Ramesh Chowdhary is there any mention in the literature about the use of face-bow in the fabrication of complete dentures in Private Dental Practice! though there is a general consensus amongst the prosthodontists on its usefulness.
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