JODRDMIMS 176 REVIEW Dr. Rewa Kawade 1 , Dr. Seema Sathe (Kambala) 2 , Dr. Anjali Bhoyar (Borle) 3 , Dr. Mithilesh Dhamande 4 Vol 6 No 4 A CONSPECTUS ON THE ANTERIOR REFERENCE POINTS ABSTRACT : The use of anterior point of reference is obligatory to orient the casts on an arculator. This especially plays an important role while fabricaon of a prosthesis. Facebow is used to orient the maxilla to the base of the skull and transfer the same to an ar - culator. Arculator and their respecve compable facebows use different anatomic points for this purpose. There have been various suggesons by authors so as to which anatomical point should be used. This arcle concisely briefs on the various refer - ence points used, their modus operandi and jusficaons. KEYWORDS : Third point of reference, Anterior reference point, Orbitale, Nasion. INTRODUCTION : Orientaon of the maxillary casts on the semi- adjustable arculator is the most common pracce in Prosthodoncs. The manipulaon and programming of the semi-adjustable arculator is done based on the face bow records of the paent. The most commonly used facebows use two posterior points for reference. However, for determining the plane of orientaon of maxilla, another ‘third’ point is needed apart from these posterior points. The use of third point orients the maxillary cast three dimensionally to the arculator. The arc of closure of mandible in the paent to maxilla/plane of occlusion is replicated by the arculator accurately based on this plane. IMPORTANCE OF THIRD POINT OF REFERENCE : It was pointed out by Gonzalez et al in 1968(1) that the plane in which the maxillary casts are oriented, will determine the appearance of anterior teeth in the paent’s mouth. In literature, the anterior reference point has been extensively invesgated in an aempt to establish the plane of occlusion same as that in the paent. Invesgators have proposed various points that could be used as a guide. 1. Orbitale 2. Orbitale minus 7mm 3. Nasion minus 23mm 4. 43mm from lower border of upper lip/ lateral incisor 5. Ala of nose 6. Incisal edge plus arculator midpoint to arculator axis. Orbitale : Radiographically, orbitale is the lowest point on the infraorbital rim that can be palpated clinically inferior to the eye ball. Orbitale along with the posterior reference points will define the axis- orbital plane. The Hanau semi-adjustable arculator can receive the records of the posion of orbitale with the orbital indicator that needs to be oriented according to the orbital pointer in the spring bow. The method of recording this is that we first orient the U-shaped frame of the spring bow parallel to the axis orbital plane of the paent while the bite fork is secured firmly in the maxillary occlusal rim. Orbitale minus 7mm : The Frankfort horizontal plane has been referred to being parallel to the occlusal plane. This consists of Porion, which is a radiological landmark, to infraorbital notch on the inferior orbital rim. The facebow that we use ulizes the external auditory meatus as the posterior point of orientaon instead of porion. The disparity in which is 7mm as the external auditory meatus is situated 7mm below the poria. This is compensated in the Hanau as the orbital Post Graduate Student, Department of Prosthodoncs and Crown & Bridge, Sharad Pawar Dental College, Daa Meghe Instute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India DOI:10.54054/jodr.2022642