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Journal of Oral Rehabilitation,

1988, V o l u m e 15, pages 367-371

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The value of the Gothic arch tracing in the


positioning of denture teeth
>
A. S. EL-GHERIANI and R. B. WINSTANLEY
Dentistry, University of Sheffield

M':

Department of Restorative

Summary

Twenty-five subjects of three nationalities carried out Gothic arch tracings.


Measurements between the side arms were compared with the upper intercuspid
distances measured in the same subjects. A relationship was found which may be of
value in the setting up of anterior maxillary denture teeth.
;
Introduction

The correct positioning of the upper and lower six anterior teeth for satisfactory
aesthetics, phonetics and function during the construction of dental prostheses has
concerned many workers (Lang & Kelsey, 1973; Heartwell & Rahn, 1974; Boucher,
Hickey & Zarb, 1975). Many attempts have been made to make use of anatomical
landmarks as a guide for setting artificial teeth. The relationship of the incisive
papilla to the position of the upper central incisor and canine teeth anteroposteriorly
is well documented (Harper, 1948; Schiffman, 1964; Ellinger, 1968; Watt &
MacGregor, 1976). Martone (1963) stated: "By employing this artifice of nature, we
can minimize the artificiality of the denture appearance".
This paper presents a relationship between the Gothic arch tracing and the
distance between the upper canine teeth mediolaterally. This finding, if used in
combination with the incisive papilla guide, may give a more accurate indication of
the positions to be occupied by upper anterior denture teeth.
Method and materials

Twenty-five dentate multiracial subjects were involved in this study: twenty male
and five female. The first group (1-9) were Arabic, the second group (10-16) were
Caucasian, and the third group (17-25) were Malaysian. All were healthy adults and
had no dental or orofacial disease present. None of the subjects had artificial crowns
on any of the upper anterior teeth and had not undergone orthodontic treatment.
The age group ranged between 21-43 years.
The Gothic arch (arrow point) tracing, first introduced to the dental profession
by Gysi in 1910 for recording centric jaw relation, was used in the present study.
Upper and lower alginate impressions of each subject were taken in metal stock
trays. On the casts intraoral Gothic arch tracing plates were constructed. A stylus
t mbedded in cold-cure acrylic resin was formed for the upper on a line passing
! etween the first and second premolars on each side (Fig. 1) and a tracing plate
c mbedded in cold-acrylic was formed for the lower (Fig. 2). The plates were adjusted
C >rrespondence: R. B. Winstanley, Department of Restorative Dentistry, University of Sheffield,
S hool of Clinical Dentistry, Wellesiey Road, Sheffield SIO 2SZ, U.K.
,
:
:. .
367

368

A. S. El-Gheriani and R. B. Winstanley

Fig. 1. Upper tracing plate with stylus.

in the mouth by means of the screw adjustment on the stylus to eliminate occlusal
contacts between the upper and lower natural teeth during lateral and protrusive
movements, but with minimal tooth separation. Instructions on the procedure to be
followed were given to each subject. Movement of the mandible started from a
retruded position forward into protrusion and then back again. This was repeated a

Fig. 2. Lower tracing plate.

Value of Gothic arch tracing

369

Fig. 3. A number of completed Gothic arch tracings on the waxed lower plates.

number of times and lateral movements were introduced. A wax crayon was used on
the lower plate so that the stylus gave a tracing on it (Fig. 3). The subjects were asked
to make the movements as 'extreme' as possible in all directions. When each
recording was completed the following measurements were made:
(i) The distance between the ends of the right and left Gothic arch tracing arms,
points C and D, as shown in the diagram (Fig. 4).
(ii) On the casts, the distance between the hngual inclines of the tips of the cusps
of the upper natural canine teeth. In cases with cusp wear, measurement was

{!g. 4. Diagrammatic representation of a typical Gothic arch tracing. AC, AD are the side arms and AB
i se protrusive path. CD is the distance (d) between the side arms.

370

A. S. El-Gheriani and R. B. Winstanley

Table 1. The measurements and percentage ratio between side arm points C and
D(d) of the Gothic arch and the upper intercuspid width 3l3

'

'

'

'.

Subjects

18-5
19-0
14-0
18-0
19-0
17-0
16-5
19-0
16-5

10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

1
'

;v '
Distance d
between Gothic
arch arms
(C/D)mm

3
4
5
6
7

'

'

Distance D
between
3^(mm)

'

36-2

Percentage
(d/DxlOO=%)

35-7
35-2

51-10 \
54-44
46-05
49-31
53-82
50-74 *
45-20
53-22
46-87.

17-0
16-5
13-5
19-0
17-0
20-5
14-5

31-6
31-4
31-7
35-8
32-7
35-9
30-6

53-79 \
52-54
42-58
53-07 1
51-98
57-10
47-38/

16-0
16-0
15-5
13-0
16-0
14-5
15-0
17-0
13-5

33-4
34-6
32-2
31-5
33-4
34-1
30-2
37-6
33-4

47-90 \
46-24
48-13
41-26
47-90
42-52
49-66
45-21
40-41/

.;

'

34-9

'

30-4

-. .

36-5
35-3
33-5

36-5

Average
en nc
JU-UO

.
Average
jl-Zl

Average
45-47

made from the middle of that area if it was large, or its lingual margin if it was
small.
The Gothic arch measurements were made using a divider and ruler, a magnifying lens being employed to ensure accuracy. An M 3000 Electronic Digital Caliper
Range* was utilized to measure the distances between the upper canine teeth on the
casts.
Results
These are shown in Table 1. It can be seen that the distance between the arms of the
Gothic arch tracing (C-D) is approximately half the distance between the upper
canines in all three groups (50-08% in the first group of subjects (1 to 9), 51-21% in
the second group of subjects (10 to 16) and 45-47% in the third group of subjects (17
to 25).
Discussion
The problems associated with the correct positioning of artificial teeth and imitating
nature can be overcome by reference to anatomical landmarks and their relationship
*Moore and Wright, Sheffield, U.K.

./

Value of Gothic arch tracing

371

to the natural teeth. The greater the number of these relationships that are available
the less guesswork is involved in denture tooth positioning.
The present paper describes a relationship between the Gothic arch tracing and
the upper canine intercuspal width. Although it is not suggested that the arrow point
tracing technique be used solely for the cuspid positioning of upper denture teeth, it
is suggested that where it has already been used for recording maxillo-mandibular
relationships it can also be used in this manner to provide a further guide. It has been
reported for instance that 40% of the dental schools in the U.S.A. use intra or
extraoral Gothic arch tracings for recording centric jaw relation (Jaggers, Javid &
Collaizzi, 1985).
The first and second group, subjects 1 to 16, in this study gave similar results. The
third group gave a small difference, presumably due to their different skeletal
pattern. Some caution should therefore be exercised when making use of anatomical
relationships for the positioning of denture teeth according to the ethnic origin of the
patients. For subjects 1 to 16 it can be seen from the table that on average the
difference between the distance (C-D) in the Gothic arch tracing and the intercanine
distance is just above 50%.
Approximately doubling the Gothic arch tracing measurement (C-D) for subjects 1-16 will give the upper intercuspid width. With the third group of subjects (1725) this relationship is 45-47%. It is, therefore, necessary to increase the Gothic arch
tracing distance approximately 2-2 times to get the intercuspid distance. These
findings draw attention to the need for more research into the relationship between
the buccal cusps of posterior teeth and the Gothic arch tracing in order to give further
guidance in the positioning of denture teeth.
References
C O . , HICKEY, J . C , ZARB, G.A. (1975) Prosthodontic Treatment for Edentulous Patients, 7th
edn. The C V. Mosby Co., St Louis.
ELLINGER, C W . (1968) Radiographic study of oral structures and their relation to anterior tooth position.
Journal of Prosthetic Dentistry, 19, 36.
GYSI, A . (1910) The problem of articulation. The Dental Cosmos, L l l , 1.
HARPER, R . N . (1948) The incisive papilla. The basis of a technique to reproduce the positions of key teeth
in prosthodontia. Journal of Dental Research, 27, 661.
HEARTWELL, C M . & RAHN, A . O . (1974). Syllabus of Complete Dentures, 2nd edn. Lea and Febiger,
Philadelphia.
JAGGERS, J.H., JAVID, N.S. & COLLAIZZI, F.A. (1985) Complete denture curriculum survey of dental
schools in the United States. Journal of Prosthetic Dentistry, 53, 736.
LANG, B . R . & KELSEY, C.C. (1973) International Prosthodontic Workshop on Complete Denture Occlusion. The University of Michigan, School of Dentistry, Ann Arbor, Michigan.
MARTONE, A.L. (1963) Clinical apphcations of concepts of functional anatomy and speech science to
complete denture prosthodontics. Part VIIL The final phase of denture construction. Journal of
Prosthetic Dentistry, 13, 204.
ScHiFFMAN, p. (1964) Relation of the maxillary canines to the incisive papilla. Journal of Prosthetic
Dentistry, 14, 469.
WATT, D.M., MACGREGOR, A.R. (1976) Designing Complete Dentures, pp. 30-56. W. B. Saunders Co.,
Philadelphia.
BOUCHER,

Vlanuscript accepted 1 May 1987

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