GOTHIC

ARCH

TRACING

HONORATO VILLA A., D.D.S.

Mexico, D. F.
HE GOTHIC ARCH TRACING has been accepted by many as a means of locating the centric maxillomandibular relation. It is also invaluable for reproducing the working and balancing lateral paths. Several kinds of appliances are used to register the Gothic arch tracing. The tracer is located in a vertical position in some procedures, while in others it is at variable inclinations. The lateral cusp height is introduced when making the interocclusal record in some techniques, while in others it is introduced after the casts with the occlusion rims have been placed on the articulator. The purpose of this investigation was to determine which method produces the best results.

GYSI TECHNIQUE

In the original Gysil technique the occlusal plane is determined by locating the correct height of the upper occlusion rim. Then the lower occlusion rim is adapted to the upper rim at the correct vertical dimension of occlusion. The Gothic arch tracer is fixed to the occlusion rims with the tracing table parallel to, or continuous with, the plane of occlusion. The central bearing point is not used. No mention is made of the inclination of the tracing point. No cusp height is introduced when the Gothic arch tracing is registered. This means that even contact of the occlusion rims is lost when the patient makes forward or lateral excursions of the mandible because of the forward and downward movement of the condyles. For accurate tracings to be made, the baseplates must be positioned correctly on the residual ridges at all times during the movements of the mandible. This may be accomplished only with the use of a central bearing point. Therefore, the first requisite to correctly develop a Gothic arch tracing is the use of a central bearing point and stabilized baseplates. The tracing point must be adaptable to the different inclinations necessary for each patient.
METHODS AND PROCEDURES

A registering table was fixed to a lower occlusion rim, and a tracing point was attached to the upper rim (Fig. 1). An adjustable tracing point that could be inclined or moved forward and backward was used. A tracing was made with the tracing point perpendicular to the tracing table. The condylar guidances were set at 30 degrees, and the incisal guide was horizontal.
This is the fifth of a series of articles lators, tooth forms, and occlusion. Received for publication June 19, 1958. dealing 624 with problems of jaw movements, articu-

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GOTHIC

ARCH

TRACING

62.5

Then the incisal guide was rotated to a 30-degree inclination without changing the Gothic arch tracer, and a new tracing was made. A small difference in the tracing was noted (Fig. 2). This difference is more noticeable when the Gathic arch tracin;l is nearer 100 degrees.
Fig. 1. Fig. 2.

Fig. 3.

Fig. 4.

Fig. I.-The tracing point is attached to tihe upper occlusion rim, and the tracing plate ix attached to the lower rim. Fig. 2.-Tracings are made with different angulations of the in&al guide. The tracing point was perpendicular to the tracing plate. Note the difference in the tracings. Fig. 3.-The tracing point is adjusted so that it is perpendicular to a line from the open ing axis to the point of contact on the tracing plate. This is the correct inclination of the stylus. Fig. 4.-When the cusp height is introduced, two tracings are developed by an intraoral tracing device. A correctly inclined extraoral tracing stylus develops only one tracing.

The tracing point was adjusted so that it was perpendicular to a line from the condylar axis to the point where the tracing point touches the tracing table (Fig. 3) A tracing was made with a horizontal incisal guide. The incisal guide was again

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J. Pros. Den. July-August, 1959

placed at an inclination of 30 degrees, and the tracing was repeated. No difference in the tracings was observed because the tracing point was inclined as a tangent to a circle drawn from the condylar axis. When the Gothic arch was closed to 100 degrees and two tracings were made, there was no difference in these tracings. An intraoral Gothic arch tracer was used, and the cusp height was introduced by raising the central bearing point. Two different intraoral tracings were developed, one at the vertical dimension of occlusion and one with the cusp height introduced for making lateral and protrusive interocclusal records. The extraoral tracer inclined perpendicular to a line from the tip of the tracer to the condyle (or hinge axis) gave only one tracing for both positions (Fig. 4). This is the correct tracing.

Fig. 5. Fig. 5.YWhen the Gothic arch working side will coincide on both Fig. B.-When the Gothic arch the working side will not coincide on DISCUSSION

Fig. 6. tracing has been developed correctly, the occlusion on the the articulator and in the mouth. tracing has not been obtained correctly, the occlusion on the articulator and in the patients mouth.

When the Gothic arch tracing is correctly obtained, the occlusion on the working side will be the same in the mouth as it is on the articulator (Fig. 5). However, when the Gothic arch tracing is not correctly obtained, the centric relation will be correct, but the occlusion on the working side as seen on the articulator will not be the same when the dentures are placed in the patients mouth (Fig. 6). The correct Gothic arch tracing is one that will be the same whether it is made with or without cusp height. This kind of tracing may be obtained only when the tracing point is placed perpendicular to a line from the condyle to the point of the tracer. Also, the tracing point inclination is variable according to the size of the face and the anteroposterior width of the face. The longer the face and the narrower the face, the more inclination to the tracing point (Fig. 7). Therefore, a tracing point with fixed inclination should not be used, and the inclination of the

GOTHIC

ARCH

TRACING

tracing point should be determined by means of a square on the patients face. This is one more reason that the hinge axis of the opening movement of the mandibk should be located.

Fig. 7.-The tracings will have different angulations according to the length and width of the face. RP, The relation plane for: 2, short; 3, medium; and 4, long faces. 1, The angulation is greater for a narrow face.

It has been recommended that lateral interocclusal records should be made along the tracings made with the cusp height introduced. Since there is no way of seeing an intraoral tracing when it is in the mouth, different points may be used and different results obtained (Fig. 8). Therefore, an extraoral tracer at the correct inclination is indicated.

++yg Cl
Fig. S.-Intraoral tracings used as a guide to reproduce the Gothic arch tracing will produce incorrect results. C, Centric relation at the vertical dimension of occlusion. Cl, Centric relation after vertical increase for cusp height. 2, The tracing at the vertical dimension of occlusion. 3, The tracing allowing for cusp height. 4 and 5, The incorrect paths obtained when using the two intraoral tracings as a guide. SUMMARY

A study of Gothic arch tracings made by intraoral and extraoral made. Different inclinations of the extraoral tracer were used.

methods was

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J. Pros. Den. July-August, 1959

To obtain correct Gothic arch tracings, stabilized baseplates and a central bearing point must be used. The extraoral stylus must be used, and it must be perpendicular to the condylar hinge axis of the mandible.
REFERENCE

1. Gysi, A.: Practical Conclusions From Scientific Research in Denture Construction, New York, 1929,Dentists Supply Co. of New York. BOLIVAR 21, DESP. 307
EDIFICIO MEXICO SAN FRANCISCO

1, D. F.