Orientation Of Occlusal Plane Research Articles

Evaluation of Two Facebow/Semi-adjustable Articulator Systems for Orienting Maxillary Cast on Articulators: A Pilot Study.

The present study was aimed to assess the transferability of occlusal plane (OP) orientation from the patient to the articulators with the help of two different facebow systems and evaluated with a gold standard. Twenty dentate patients were selected for the study. Two semi-adjustable arcon articulators that are Hanau Wide(®) Vue using SpringBow and Whip Mix(®) using quick-mount facebow were used in the study. Mean angle between OP to horizontal reference plane obtained from Hanau Wide Vue articulator system (SpringBow using Orbitale as anterior reference point) and Whip Mix articulator system (quickmount facebow using nasion as anterior reference point) was tabulated. These values obtained were further compared with each other and evaluated against cephalometric evidence, which was considered as the gold standard for the study. Descriptive statistics, analysis of variance, Scheffe post hoc analysis for group comparison, and level of significance (P) was calculated using Statistical Package for the Social Sciences version 16 (IBM, New York, USA) software program. Intragroup comparison of mean angle OP values showed highly significant difference (p = 0.000). Comparison between Hanau Wide Vue articulator system and Whip Mix articulator system showed statistically highly significant with a mean difference of 10.51° with Hanau system values being lower than Whip Mix system. Difference between Hanau system and cephalometric values were statistically significant with a mean difference of 2.835° and Hanau system consistently recording lower values than cephalometric values. Difference between Whip Mix system and cephalometric values was also statistically significant with a mean difference of 7.680° with group 2 values were on average 7.680° higher than group 3. Within the limitations of this study, the Hanau system and Whip Mix system showed significant difference in reproduction of angle between OP and horizontal reference plane. Hanau articulator system showed closer values to that of cephalometric values in comparison with Whip Mix articulator system. Orientation of the maxillary cast in an articulator is a crucial part of several techniques used in dentistry. Orientation of maxillary cast in the articulator acts as a baseline from which further steps for occlusal rehabilitation of the patients are carried out. Recording and transferring of the occlusal cant to articulators require facebow.

In vitro comparison of the maxillary occlusal plane orientation obtained with five facebow systems

Statement of problemThe sagittal and coronal orientation of the maxillary occlusal plane plays an important role in the esthetic and functional outcome of dental prostheses. The accuracy of contemporary facebow transfer systems in transferring this orientation to semiadjustable articulators has not been quantified. PurposeThe purpose of this in vitro investigation was to analyze the sagittal and coronal orientation of the occlusal plane with 5 different facebow transfer systems. Material and methodsA phantom head containing a maxillary typodont (control) was oriented so that the Frankfort horizontal plane was horizontal. The angle between the occlusal plane of the maxillary arch of the phantom head and the Frankfort horizontal plane was measured along the sagittal and coronal planes with a digital protractor. Fifteen facebow records using each of 5 facebow transfer systems (test groups) were made on the phantom head containing the maxillary typodont. Diagnostic casts of the maxillary typodont were mounted on semi-adjustable arcon articulators from the facebow records. The same angles measured on the control were measured on the test groups. These angles were compared with the same angle measured on the maxillary arch of the phantom head (control). All measurements were made by 2 operators. ResultsSignificant differences in the sagittal and coronal orientation of the occlusal plane were noted. Compared with the control, the Denar system had the least significant difference in the coronal orientation of the occlusal plane, while the Pana-Mount system had the least significant difference in the sagittal orientation of the occlusal plane. An intergroup comparison of the test groups showed significant differences among the groups. The Kois system showed the greatest difference in the coronal plane orientation, while the Denar system showed the greatest difference in the sagittal plane orientation. ConclusionsNone of the tested facebow systems exactly replicated the sagittal and coronal orientation of the maxillary occlusal plane. Significant differences in the sagittal and coronal orientation of the occlusal plane were observed between the test groups and the control. Intergroup comparisons revealed significant differences in the sagittal and coronal orientation of the occlusal plane.

Validity of intraoral soft tissue landmarks as reference points for orientation of occlusal plane in natural dentition: A clinical study

Introduction: Occlusal plane is the average plane established by incisal and occlusal surfaces of teeth. Various anatomic landmarks are used to determine this missing component of occlusion which is lost with the loss of teeth. However, variation has been observed in the orientation of occlusal plane determined clinically with different anatomical landmarks as references. Objective: This study was undertaken to determine the relation of intraoral anatomic soft tissue landmarks, namely, retromolar pad and parotid papilla with occlusal plane in natural dentition. Materials and Methods: Irreversible hydrocolloid impressions of 100 edentulous individuals (50 males and 50 females) were made to get the models. A 16 gauge wire was extended from mandibular occlusion plane posteriorly up to retromolar pad to establish their relationship. Furthermore, vertical distance of apex of parotid papilla to maxillary molar cusp tip it opposed (distobuccal cusp of maxillary first molar or mesiobuccal cusp of maxillary second molar), and mandibular molar cusp tip (to which parotid papilla apposed) was measured when the teeth were in maximal intercuspal position. Results: This study determined that the natural occlusal plane is oriented posteriorly at the level corresponding with the lower third of retromolar pad. Mean distance of parotid papilla above the corresponding maxillary cusp tip (while in occlusion) was 5.048 mm, and mean distance of Parotid papilla above the corresponding mandibular molar cusp tip (while in occlusion) was determined to be 3.602 mm. The difference in observed means between males and females or between right and left side was not statistically significant.

Systematic assessment of the various controversies, difficulties, and current trends in the reestablishment of lost occlusal planes in edentulous patients.

Accurate occlusal plane orientation is an essential factor in the fabrication of complete denture prosthesis. Over the years, it has received a number of methodologies by several researchers utilizing various anatomical landmarks however none of them is considered as perfect that could orient ideal occlusal plane. The presented literature review is an attempt to enlighten historical perspectives, pioneer researches, different controversies, difficulties and current trends for re-establishment of lost occlusal plane in edentulous patients. An extensive literature search was performed using Medline/PubMed interface and other scholarly research bibliographic databases using Medical Subject Headings. Studies describing research studies, case series and assorted clinical reports were retrieved and evaluated from 1963 to 2013. Most of the studies have suggest and evidence to consider Camper's plane for artificial orientation of occlusal plane however there is a substantial lack of genuine long term studies and authentic data that could recommend a single reliable landmark for perfect occlusal plane reorientation in a variety of cases.

Simplified Method for Occlusal Plane Orientation in Fabrication of the Complete Dental Prosthesis

The objective of this letter is to present the fabrication and use of a device in combination with a commercially manufactured occlusal plane guide as an aid in determining occlusal plane orientation in complete dental prosthesis treatment.

Occlusal plane location in edentulous patients: a review.

Occlusal plane orientation is an important factor in the construction of a complete denture. Occlusal plane could be oriented using landmarks in the mandibular arch as well as in the maxillary arch. In the mandibular arch there are few landmarks which could be used to orient the occlusal plane like the retromolar pad, corner of the lips (lower lip length) whereas the maxillary arch has a number of landmarks, of which the ala-tragal line is the most commonly used and the same being the most controversial. In the following article different landmarks and its accuracy for orientating the occlusal plane in an edentulous subject as studied by various authors has been discussed.

Esthetic smile preferences and the orientation of the maxillary occlusal plane

The anteroposterior orientation of the maxillary occlusal plane has an important role in the creation, assessment, and perception of an esthetic smile. However, the effect of the angle at which this plane is visualized (the viewing angle) in a broad smile has not been quantified. The purpose of this study was to assess the esthetic preferences of dental professionals and nondentists by using 3 viewing angles of the anteroposterior orientation of the maxillary occlusal plane. After Institutional Review Board approval, standardized digital photographic images of the smiles of 100 participants were recorded by simultaneously triggering 3 cameras set at different viewing angles. The top camera was positioned 10 degrees above the occlusal plane (camera #1, Top view); the center camera was positioned at the level of the occlusal plane (camera #2, Center view); and the bottom camera was located 10 degrees below the occlusal plane (camera #3, Bottom view). Forty-two dental professionals and 31 nondentists (persons from the general population) independently evaluated digital images of each participant's smile captured from the Top view, Center view, and Bottom view. The 73 evaluators were asked individually through a questionnaire to rank the 3 photographic images of each patient as 'most pleasing,' 'somewhat pleasing,' or 'least pleasing,' with most pleasing being the most esthetic view and the preferred orientation of the occlusal plane. The resulting esthetic preferences were statistically analyzed by using the Friedman test. In addition, the participants were asked to rank their own images from the 3 viewing angles as 'most pleasing,' 'somewhat pleasing,' and 'least pleasing.' The 73 evaluators found statistically significant differences in the esthetic preferences between the Top and Bottom views and between the Center and Bottom views (P<.001). No significant differences were found between the Top and Center views. The Top position was marginally preferred over the Center, and both were significantly preferred over the Bottom position. When the participants evaluated their own smiles, a significantly greater number (P< .001) preferred the Top view over the Center or the Bottom views. No significant differences were found in preferences based on the demographics of the evaluators when comparing age, education, gender, profession, and race. The esthetic preference for the maxillary occlusal plane was influenced by the viewing angle with the higher (Top) and center views preferred by both dental and nondental evaluators. The participants themselves preferred the higher view of their smile significantly more often than the center or lower angle views (P<.001).

A Cephalometric Study on the Relationship Between the Occlusal Plane, Ala-Tragus and Camper's Lines in Subjects with Angle's Class I, Class II and Class III Occlusion.

Considering the importance of the occlusal plane orientation in complete denture prostheses, a study was conducted on the relationship between this plane with ala-tragus and Camper's lines in soft tissue among individuals with class I, class II and class III occlusion. The aim of the present study was to define the best soft tissue index by which the location and inclination of the occlusal plane in complete dentures could be established. A total of 60 subjects were selected for the study. Lateral cephalograms of these subjects were obtained. Tracings and analysis was done to confirm to the skeletal relationship of subjects to be class I (normal), class II (prognathic maxilla) and class III (retrognathic maxilla). 20 Subjects of each group were screened for further analysis. Radiopaque markers were attached to the intended points on soft tissue and then standard lateral cephalograms were obtained from each subject. The angles between the following lines were measured: Occlusal line, Camper's line (ala-porion), AT1 (ala-superior border of tragus), AT2 (ala-mid-tragus) and AT3 (ala-inferior border of tragus). The mean values and standard deviations were calculated for all the groups. The mean values calculated were subjected to repeated ANOVA test and significance was evaluated. Comparison of the results by the ANOVA test exhibited a significant difference. In class I subjects, it was evaluated that in 75% individuals, the posterior reference point was found to be the mid-tragus; of class II subjects, in 60% individuals, the posterior reference point was found to be the mid-tragus; and of class III subjects, in 75% individuals, the posterior reference point was found to be the inferior border of tragus.

Midline correction by asymmetric reciprocal torque: a pilot study

Can we correct dental midline discrepancies by systematic torque bends on all canines and premolars without extraction and mesiodistal tooth movement? Eight orthodontic patients (4 males, 4 emales, mean age 31 years) presented a dental midline discrepancy of 2-4 mm, moderate deviation of the chin, no skeletal asymmetry, and a horizontal orientation of the occlusal plane in the frontal aspect. On the side where the mandible was shifted medially, asymmetric torque bends moved the antagonist canine and both premolar crowns buccally, while palatal crown torque was used on the maxillary canine and premolars on the other side. Lingual crown torque corrected the medially shifted canine and premolars in the mandibular dental arch, and buccal crown torque the laterally shifted lower canine and premolars. On average, torque effects altered the canine guidance by 6.5 ± 4.7°, the first premolar guidance by 7 ± 4.1°, and the second premolar guidance by 6.3 ± 3.7°. Correction of the dental midline shift averaged 1.6 ± 0.8 mm after the torque, and eliminated the midline discrepancy completely (n = 2) or partly (n = 6). In this pilot study, asymmetric reciprocal torque represented a treatment option for midline corrections of approximately 2-4 mm and improvement in the chin position without mesiodistal tooth movement or extraction.

Reference guide for prosthetic occlusal plane orientation: An obscured dilemma

Reference guide for prosthetic occlusal plane orientation: An obscured dilemma

“Occlusal Plane Orientor”: An Innovative and Efficient Device for Occlusal Plane Orientation

Correct occlusal plane orientation is a prerequisite in Prosthodontic reconstructive treatment therapy as it helps in achieving esthetics and phonetics anteriorly and forms a milling surface posteriorly where tongue and buccinator muscle position the food bolus during mastication. Activity of Muscles during clenching will be least, when the occlusal plane is made parallel to plane of lost natural teeth. Conventionally the ala-tragus line (Camper's plane) is used as a guide for assessment of the occlusal plane and fox plane is used to check the parallelism between the two. Occlusal plane orientor is a new device developed to mark occlusal plane parallel to ala-tragus line on maxillary occlusion rim, thereby saving clinician's time and increasing efficiency. Additionally, it is a useful tool for occlusal plane orientation in patients with facial deformity, absence of an eye or an ear.

Comparison of Maxillary Occlusal Plane with Various Craniofacial Reference Lines in Nepalese and Indian Young Adults

Orientation of occlusal plane for complete dentures play a vital role as it affects all the basic requirements of complete dentures. Depending on soft tissue landmarks for orienting occlusal plane seems to be unreliable. Cephalometrics were introduced in Prosthodontics to orient the occlusal plane in the same position as it was with the lost natural teeth.&#x0D; In the present study, 60 lateral cephalometric radiographs of a group of male and female dentulous subjects of Indian and Nepali origin (30 subjects in each group) were obtained and tracings were made. All the subjects selected were in the age group of 20-30 years in whom the facial growth was completed. Angular measurements were made between FH (Frankfort Horizontal plane)- CP (Camper's Plane), FH-OP (Occlusal Plane) and CP-OP and subjected to statistical analysis to determine the degree of separation between these planes in Indian and Nepalese ethnic groups.&#x0D; The absolute parallelism between the natural occlusal plane and Camper's plane were not proven in both Indian and Nepalese subjects involved in this study. This significantly reduces the reference values of these planes in Prosthodontics.

A study of parallelism of the occlusal plane and ala-tragus line.

Background and aims Orientation of the occlusal plane is one of the most important clinical procedures in prostho-dontic rehabilitation of edentulous patients. The aim of this study was to define the best posterior reference point of ala-tragus line for orientation of occlusal plane for complete denture fabrication. Materials and methods Fifty-three dental students (27 females and 26 males) with complete natural dentition and Angel’s Class I occlusal relationship were selected. The subjects were photographed in natural head position while clenching on a Fox plane. After tracing the photographs, the angles between the following lines were measured: the occlusal plane (Fox plane) and the superior border of ala-tragus, the occlusal plane (Fox plane) and the middle of ala-tragus as well as the occlusal plane (Fox plane) and the inferior border of ala-tragus. Descriptive statistics, one sample t-test and independent t-test were used. P value less than 0.05 was considered significant. Results There was no parallelism between the occlusal plane and ala-tragus line with three different posterior ends and one sample t-test showed that the angles between them were significantly different from zero (p<0.05). However, the supe-rior border of ala-tragus line had the lowest mean angle, 1.80° (3.12) and was almost parallel to the occlusal plane. Conclusion The superior border of the tragus is suggested as the posterior reference for ala-tragus line.

Occlusal plane orientation: A statistical and clinical analysis in different clinical situations

Purpose: Orientation of the occlusal plane is important in a number of clinical situations. Using the reported soft and hard tissue landmarks is difficult and requires experience, as the landmarks are located on the face or by use of a cephalometric radiograph. Improper use of these landmarks may compromise the functional and esthetic result of prosthetic restorations. This study evaluated the reliability of the hamular notch/incisive papilla plane (HIP) in establishing the occlusal plane. Materials and Methods: Ninety healthy, Indian adults (60 dentate, 30 edentulous) participated in this study. The occlusal plane of the subjects was compared with their HIPs. In dentate subjects, the maxillary stone cast was mounted on the Wills surveyor with HIP, which was made parallel to the horizontal plane using the tripoding method. The vertical distance between the occlusal plane and floor of the surveyor was measured at four points. When the measured values were equal, the two planes were confirmed to be parallel for that situation. In turn, this relation confirmed the parallelism between the occlusal plane and HIP. In the edentulous subjects, the occlusal plane, established clinically using the ala tragal line, was compared with the HIP radiographically using lateral cephalograms. Paired t-test was used to test the equality of the mean differences at a 0.05 significance level. Results: The mean differences from the right canine were: 0.055 cm at the left canine, 0.05 cm at the right molar, and 0.065 cm at the left molar in dentate subjects and 0.001 cm between the incisive papilla and hamular notch in edentulous subjects. The HIP appeared parallel to the occlusal plane as the paired t-test showed no statistically significant difference (p > 0.05). Conclusion: In the population tested, the HIP was parallel to the occlusal plane. Therefore, this may be a viable reference in complete denture prosthodontics.

Occlusal Plane Orientation: A Statistical and Clinical Analysis in Different Clinical Situations

Orientation of the occlusal plane is important in a number of clinical situations. Using the reported soft and hard tissue landmarks is difficult and requires experience, as the landmarks are located on the face or by use of a cephalometric radiograph. Improper use of these landmarks may compromise the functional and esthetic result of prosthetic restorations. This study evaluated the reliability of the hamular notch/incisive papilla plane (HIP) in establishing the occlusal plane. Ninety healthy, Indian adults (60 dentate, 30 edentulous) participated in this study. The occlusal plane of the subjects was compared with their HIPs. In dentate subjects, the maxillary stone cast was mounted on the Wills surveyor with HIP, which was made parallel to the horizontal plane using the tripoding method. The vertical distance between the occlusal plane and floor of the surveyor was measured at four points. When the measured values were equal, the two planes were confirmed to be parallel for that situation. In turn, this relation confirmed the parallelism between the occlusal plane and HIP. In the edentulous subjects, the occlusal plane, established clinically using the ala tragal line, was compared with the HIP radiographically using lateral cephalograms. Paired t-test was used to test the equality of the mean differences at a 0.05 significance level. The mean differences from the right canine were: 0.055 cm at the left canine, 0.05 cm at the right molar, and 0.065 cm at the left molar in dentate subjects and 0.001 cm between the incisive papilla and hamular notch in edentulous subjects. The HIP appeared parallel to the occlusal plane as the paired t-test showed no statistically significant difference (p > 0.05). In the population tested, the HIP was parallel to the occlusal plane. Therefore, this may be a viable reference in complete denture prosthodontics.

Occlusal plane orientation in Klinefelter syndrome (47, XXY males)

summary Occlusal plane position was analysed cephalometrically in 35 Klinefelter adults (47, XXY) and compared with 60 eugnath control males (46, XY).The significantly smaller angles between the occlusal plane and the cranial base (NSL‐OLs) and between the occlusal plane and the Frankfort horizontal plane (Fr‐OLs) were obtained in 47, XXY males (P &lt; 0.0l), while the angles between the maxillary base and the occlusal plane (NL‐OLs) and between the Camper's line and the occlusal plane (Camp.‐OLs) were not significantly different (P &gt; 0.05) from the control group. Significantly smallelr angles between the occlusal plane and the cranial base (NSL‐OLs) and between the occlusal plane and the Frankfort horizontal plane (Fr‐OLs) in Klinefelter males are attributed to the hereditary influence of an extra X chromosome on the smaller growth of the cranial base and the greater growth of the lower border of the mandible. Although the maxilla was also shifted forward in XXY males in relation to the cranial base it was not enough to compensate for the hereditary influence, due to the greater growth of the lower border of the mandible and the smaller cranial base in 47, XXY males, on the inclination of the occlusal plane to the Frankfort horizontal plane and the cranial base. The forward shift of maxilla was sufficient to compensate for the inclination of the occlusal plane in 47, XXY males to the maxillary base and the Camper's line (P &gt; 0.05).

A study of the occlusal plane orientation by intra-oral method (retromolar pad).

Reliability of the intra-oral method which orientates the occlusal plane to terminate at the upper level of the retromolar pad was studied. Thirty individuals all with natural teeth and 34 complete denture wearers participated in the study. Stone casts were mounted in the S.A.M. 2 articulator by a quick mount face bow transfer. The angle between the occlusal plane and the articulator horizontal plane was measured in both groups. The angle was 9.42 degrees +/- 4.1 degrees in dentate individuals and 8.53 degrees +/- 2.8 degrees in complete denture wearers. No statistically significant difference was found between the groups (t = 0.72, P > 0.05). Therefore, the method can be advocated for a wide clinical use, as it is a simple method and places the artificial occlusal plane very close to the position of the natural plane of occlusion.

Evaluation of a cephalometric method of occlusal plane orientation for complete dentures

Evaluation of a cephalometric method of occlusal plane orientation for complete dentures

Cephalometrically programmed adjustable plane: A new concept in occlusal plane orientation for complete-denture patients

Cephalometrically programmed adjustable plane: A new concept in occlusal plane orientation for complete-denture patients

Occlusal plane orientation in complete denture construction

Guides to the orientation of the occlusal plane in complete denture construction are reviewed and the current opinions of some British dentists are reported.It is concluded that this element of complete denture construction owes less to the intelligent application of scientific principles than to a form of guesswork.