Comparative analysis of the effectiveness of virtual and mechanical articulators in the functional diagnosis of temporomandibular joint disorders

INTRODUCTION. The study presents the results of a comparative evaluation of the effectiveness of mechanical and virtual articulators in the functional diagnosis of patients with temporomandibular joint (TMJ) disorders.

AIM. To assess the advantages and limitations of using mechanical and virtual articulators for analyzing dynamic occlusion in patients with internal TMJ pathology.

MATERIALS AND METHODS. A total of 52 patients (45 women and 7 men), aged 25 to 42 years, with occlusal disturbances caused by internal TMJ disorders, were examined. All patients underwent cone-beam computed tomography (CBCT) for TMJ assessment and axiographic recording (optical axiograph Dentograf Prosystom). The patients were divided into two groups: Group 1 (n = 26) was analyzed using a mechanical articulator, and Group 2 (n = 26) using a virtual articulator. CBCT and axiography data, as well as the results of dynamic occlusion evaluation (tooth contact in closure and opening, protrusion, and laterotrusion), were analyzed in both articulator types.

RESULTS. Mechanical articulators enabled the evaluation of dynamic occlusion with an effectiveness of 73.1%. Limitations were associated with their inability to accurately account for individual anatomical characteristics of the TMJs. Virtual articulators demonstrated higher effectiveness (92.3%) due to the integration of CBCT and axiography data, allowing detailed modeling of individual mandibular movements.

CONCLUSIONS. Virtual articulators show significant advantages over mechanical ones in assessing dynamic occlusion in patients with TMJ disorders, providing greater accuracy and personalization of the diagnostic process. Mechanical articulators demonstrated limited effectiveness and a considerable margin of error related to their non-individualized approach.

1. Astanov O.M., Ruzieva M.I. Prevalence, Risk Factors, and Pathogenetic Mechanisms of Temporomandibular Joint Dysfunction. International Journal of Studies in Natural and Medical Sciences. 2023;2(5):164–171. Available at: https://scholarsdigest.org/index.php/ijsnms/article/view/228 (accessed: 15.07.2025).

2. Guluyev A.V. Methods of diagnosis of diseases of the temporomandibular joint. Scientific Review. Medical Sciences. 2017;(2):14–18. (In Russ.) Available at: https://science-medicine.ru/ru/article/view?id=965 (accessed: 15.07.2025).

3. Gazhva S.I., Zyzov D.M., Bolotnova T.V., Seninа-Volzhskaya I.V., Demin Y.D., Astvatsatryan L.E. et al. Comparison of additional methods of diagnosis dysfunction of the temporomandibular joint. International Research Journal. 2017;(1-1):98–101. (In Russ.) https://doi.org/10.23670/IRJ.2017.55.130

4. Ronsivalle V., Ruiz F., Lo Giudice A., Carli E., Venezia P., Isola G. et al. From reverse engineering software to CAD-CAM systems: How digital environment has influenced the clinical applications in modern dentistry and orthodontics. Appl Sci. 2023;13(8):4986. https://doi.org/10.3390/app13084986

5. Avelino M.E.L., Neves B.R., Ribeiro A.K.C., Carreiro A.F.P., Costa R.T.F., Moraes S.L.D. Virtual facebow techniques: A scoping review. J Prosthet Dent. 2025;134(1):85–90. https://doi.org/10.1016/j.prosdent.2023.08.032

6. Jairaj A., Agroya P., Tiwari R.V.C., Alqahtani N.M., Salkar M., Sagar Y.P. Evolution of Articulators – Research and Review. Ann Rom Soc Cell Biol. 2021;25(4):10665–10681. Available at: http://www.annalsofrscb.ro/index.php/journal/article/view/3832 (accessed: 15.07.2025).

7. Vinayahalingam S., Berends B., Baan F., Moin D.A., Luijn R., Bergé S., Xi T. Deep learning for automated segmentation of the temporomandibular joint. Journal of Dentistry. 2023;132:104475. https://doi.org/10.1016/j.jdent.2023.104475

8. Yau H.T., Liao S.W., Chang C.H. Modeling of digital dental articulator and its accuracy verification using optical measurement. Comput Methods Programs Biomed. 2020;196:105646. https://doi.org/10.1016/j.cmpb.2020.105646

9. Chou T.-H., Liao S.-W., Huang J.-X., Huang H.-Y., Vu-Dinh H., Yau H.-T. Virtual dental articulation using computed tomography data and motion tracking. Bioengineering. 2023;10(11):1248. https://doi.org/10.3390/bioengineering10111248

10. Saini R.S., Alshoail H.H., Kanji M.A., Vaddamanu S.K., Mosaddad S.A., Heboyan A. Virtual articulator software: Accuracy, usability, and clinical applicability: A systematic review. Int Dent J. 2025;75(3):1691–1704. https://doi.org/10.1016/j.identj.2025.03.005

11. Fadeev R.A., Ovsiannikov K.A. Radiological methods for diagnosing temporomandibular joint diseases. Herald of North-Western State Medical University named after I.I. Mechnikov. 2024;16(1):13–24. (In Russ.) https://doi.org/10.17816/mechnikov625521

12. Tekucheva S.V., Bazikyan E.A., Afanasyeva Ya.I., Postnikov M.A. Copyright Research Protocol for Comprehensive Assessment of the Dento-Alveolar Complex in Patients with Temporomandibular Joint Disorders: Clinical Cases. Kuban Scientific Medical Bulletin. 2023;30(4):110–136. (In Russ.) https://doi.org/10.25207/1608-6228-2023-30-4-110-136

13. Ogura I., Kaneda T., Mori S., Sakayanagi M., Kato M. Magnetic resonance characteristics of temporomandibular joint disc displacement in elderly patients. Dentomaxillofac Radiol. 2012;41(2):122–125. https://doi.org/10.1259/dmfr/1286942

14. Kamel Z.S.A.S.A., El-Shafey M.H.R., Hassanien O.A., Nagy H.A. Can dynamic magnetic resonance imaging replace static magnetic resonance sequences in evaluation of temporomandibular joint dysfunction? Egypt J Radiol Nucl Med. 2021;52:19. https://doi.org/10.1186/s43055-020-00396-8

15. Talmaceanu D., Bolog N., Leucuta D., Tig I.A., Buduru S. Diagnostic use of computerized axiography in TMJ disc displacements. Exp Ther Med. 2022;23(3):213. https://doi.org/10.3892/etm.2022.11137

16. Lepidi L., Galli M., Mastrangelo F., Venezia P., Joda T., Wang H.L., Li J. Virtual Articulators and virtual mounting procedures: Where do we stand? J Prosthodont. 2021;30(1):24–35. https://doi.org/10.1111/jopr.13240

17. Hong S.J., Noh K. Setting the sagittal condylar inclination on a virtual articulator by using a facial and intraoral scan of the protrusive interocclusal position: A dental technique. J Prosthet Dent. 2021;125(3):392–395. https://doi.org/10.1016/j.prosdent.2020.01.031

18. Szyszka-Sommerfeld L., Machoy M., Lipski M., Woźniak K. Electromyography as a means of assessing masticatory muscle activity in patients with pain-related temporomandibular disorders. Pain Research and Management. 2020:9750915. https://doi.org/10.1155/2020/9750915

19. Erturk A.F., Kendirci M.Y., Ozcan I., Rohlig B.G. Use of ultrasonography in the diagnosis of temporomandibular disorders: a prospective clinical study. Oral Radiol. 2023;39(2):282–291. https://doi.org/10.1007/s11282-022-00635-w

20. Park J.H., Lee G.-H., Moon D.-N., Kim J.-C., Park M., Lee K.-M. A A digital approach to the evaluation of mandibular position by using a virtual articulator. J Prosthet Dent. 2021;125(6):849–853. https://doi.org/10.1016/j.prosdent.2020.04.002

21. Goldstein G., Goodacre C. Selecting a virtual articulator: An analysis of the factors available with mechanical articulators and their potential need for inclusion with virtual articulators. J Prosthodont. 2023;32(1):10–17. https://doi.org/10.1111/jopr.13517

22. Padmaja B.I., Madan B., Himabindu G., Manasa C. Virtual articulators in dentistry: a review. Int J Med Appl Sci. 2015;4(2):109–114.

23. Shetty S. Virtual articulators and virtual facebow transfers: Digital prosthodontics!!! J Indian Prosthodont Soc. 2015;15(4):291. https://doi.org/10.4103/0972-4052.171825

24. Solaberrieta E., Etxaniz O., Minguez R., Gorozika J., Barrenetxea L., Sierra E. Virtual production of dental prostheses using a dental virtual articulator. Int J Interact Des Manuf. 2015;9(1):19–30. https://doi.org/10.1007/s12008-013-0203-2

25. Maltauro M., Vargiu E., Tozzi F., Ciocca L., Meneghello R. A semi-automated tool for digital and mechanical articulators comparative analysis of condylar path elements. Comput Biol Med. 2025;186:109724. https://doi.org/10.1016/j.compbiomed.2025.109724