Creation of a semi-adjustable virtual articulator by integrating intraoral, facial, and cone-beam computed tomography scans in freeware software: A proof of concept

Purpose: Open-source environments offer interesting opportunities to democratize digital workflows in dentistry, thereby reducing dependency on costly proprietary systems. This proof of concept aimed to demonstrate a method for creating a semi-adjustable virtual articulator by integrating intraoral, facial, and cone-beam computed tomography (CBCT) scans into freeware software. Methods: CBCT-derived mandibular segmentation was combined with intraoral and facial scans within Meshmixer (v. 3.5; Autodesk Inc, San Francisco, USA), with anatomical condylar pivots defining the hinge axis. Alignment was achieved using dental surfaces as common references. The workflow enabled simulation of mandibular opening, closure, protrusion, and lateral excursions based on patient-specific anatomy in a virtual semi-adjustable articulator. Conclusions: This proof of concept demonstrated how freeware environments can democratize access to virtual patient simulation, serving as a stepping-stone toward validated, cost-effective clinical workflows, fostering innovation beyond proprietary constraints and traditional facebows.