Orientation Of Occlusal Plane Research Articles

The 3D-printed shell complete denture technique: Simplifying prosthodontic diagnosis prior to implant planning.

Traditionally, artificial teeth arrangements or the definitive complete dentures are used to establish important prosthodontic parameters such as the occlusal plane orientation, vertical dimension, and the incisal edge position. The relationship of these elements with the underlying bony structures is commonly evaluated using advanced planning protocols such as the dual scan technique. This technique article presents an uncomplicated alternative approach to establish these parameters intraorally using a 3D-printed shell complete denture generated from a 3D scan of the patient's existing complete denture.

Relación entre el plano oclusal y tres niveles diferentes de la línea ala-trago en una muestra de adultos sudaneses

Aim: Correct orientation of the occlusal plane plays a vital role in achieving the perfect occlusal balance and function of complete dentures. This study aimed to evaluate the most reliable posterior reference point of the ala-tragus line (ATL) concerning occlusal plane (OP) in a sample of the dentate Sudanese population. Materials and Methods: A total of 150 subjects with healthy and well-aligned permanent teeth were randomly selected. Right lateral profile photographs were taken with subjects having a fox plane placed intra-orally, contacting the occlusal plane. Reference points corresponding to inferior, middle, and superior borders of the tragus and inferior border of the ala of the nose were marked on photographs. The angles between the lines were measured using the Auto-CAD software program, and the most parallel relationship was determined. Descriptive statistics in terms of means and standard deviations were presented. Independent t-test and one-way ANOVA tests were used to compare as appropriate. A p-value < 0.05 was considered significant. Results: The mean angle formed by the OP and ATL was 8.5±3.69º for the superior level, 4.68±3.13º for the middle line, and 2.89±2.57º for the inferior line. A significant difference was found between the means of the three angles (p< 0.001), while no significant difference (p> 0.05) was found between both genders regarding the measured angles. Conclusions: The line joining the inferior border of the ala of the nose with the inferior border of the tragus of the ear was the most reliable line in terms of parallelism to determine the occlusal plane orientation. Keywords: Occlusal plane; Denture, complete; Prosthodontics; Anatomic landmarks; Cephalometry; Sudan.

Assessment of Most Definite Reference Point on Tragus to Mark the Ala Tragus Line for Orientation of Occlusal Plane: A Systematic Review and Meta Analysis

Objective: This systematic review and meta-analysis aimed to establish the most appropriate posterior reference point on the tragus of the ear for orienting the occlusal plane in complete denture prosthesis, addressing the existing confusion regarding this crucial anatomical landmark. Methods: A comprehensive literature search identified 20 relevant articles, with 12 meeting the inclusion criteria as original clinical experimental studies. Statistical analysis was performed to assess the preferred location on the tragus for aligning with the Fox plane. Results: Among the reviewed studies, 72.72% favored the inferior or lower border of the tragus as the optimal posterior reference point for aligning with the Fox plane. This choice was in contrast to the tip or middle point (18.18%) and the superior border (9.09%) of the tragus, which showed less tendency to parallel with the occlusal plane. Conclusion: Based on the findings of this systematic review and meta-analysis, it is concluded that the inferior border of the tragus is the most definitive posterior reference point for establishing the Ala-Tragus line during complete denture prosthesis. This consensus can guide clinicians in achieving accurate occlusal plane orientation and enhance the quality of complete denture prostheses. Update Dent. Coll. j: 2023; 13(2): 38-41

Evaluating the relation of posterior occlusal plane to ala-tragal line according to age and sex.

Occlusal plane orientation affects the esthetic, function, and success of removable or fixed prostheses. The most prevalent index for determination of this plane is the ala-tragus line while there are controversies in the exact location of tragus reference point.

Influence of occlusal plane orientation on sound production and masticatory performance in implant retained mandibular overdenture

Influence of occlusal plane orientation on sound production and masticatory performance in implant retained mandibular overdenture

Influence of Occlusal Plane Orientation on Sound Production and Electromyographic Activity in Complete Denture Wearers

Influence of Occlusal Plane Orientation on Sound Production and Electromyographic Activity in Complete Denture Wearers

Control of the occlusal plane in orthognathic surgery

• Diagnostic considerations of occlusal plane can make a treatment plan for better results. • Presurgical control of occlusal plane can contribute in reducing the need for double-jaw surgery. • Functional occlusal plane should be controlled to improve stability with better esthetics. • Adequate planning of occlusal plane orientation is of high significance in orthognathic surgery. The orientation of the occlusal plane (OP) influences the functional and esthetic balance of the face. We report on two patients for which the careful consideration of OP angulation from diagnosis to treatment planning aided in achieving a superior esthetic correction and improved stability. In both surgical patients, adequate presurgical control of the OP facilitated the surgical correction with a rotation of the OP. The results showed a better esthetic outcome and improved orientation of the musculoskeletal relation. Therefore, in severe mandibular prognathism or retrognathism, adequate planning of the OP orientation is of high significance.

OCCLUSAL PLANE ORIENTATION IN PATIENTS WITH DENTOFACIAL ANOMALIES BASED ON MORPHOMETRIC CRANIO-FACIAL MEASUREMENT

Based on 79 lateral projection head teleroentgenograms obtained from relatively young patients (median age, 37.4±4.3), we have developed a method for the occlusal plane orientation in view of cranio-facial anatomical reference points. As stable anthropometric reference points, we employed the gnathic angle shaped by the spinal and mandibular planes, as well as the interalveolar angle, where the subspinal Downs point and the supramental point were employed as retention elements. When reconstructing the occlusal plane in patients with dentoalveolar anomalies, the construction of the bisector of the interalveolar angle was explained as a key reference point, which allows diagnosing occlusion anomalies in the vertical direction (symmetrical and asymmetric) not only in the lateral, yet also in the frontal segment of the dental arches. The method developed for constructing the occlusal plane does not depend on the position of the incisors and the second permanent molars, which can be used to identify the vertical deformation of the dental arches.

Determination of the Occlusal Plane in Complete Denture: About the Paterson Technic

The rehabilitation by complete removable denture is commonly used for edentulous patients. The respect of operating procedures represents the main condition for therapeutic success.Among these procedures, the determination and the orientation of occlusal plane remain an important step to respect minutelyIndeed, it is one of the most stages for obtaining an optimal smile esthetic, a facial harmony and improve the oral functions.Various technics were reported by many authors: anatomical, radiographic, and physiologic methods such as piezography and Paterson technic.This later consists on the determination of the individualized occlusal plane according to the registration of physiological movements.In this context, we will describe Paterson method via a case report and discuss its feasibility, clinical effectiveness as well as its advantages compared to others technics.

Evaluation of deviation of the occlusal plane to three different points of the ala-tragus line among different age group in south Indian population

The aim of the study is to evaluate the deviation of the occlusal plane to three different points of the ala-tragus line among different age group in South Indian population. Incomplete denture prosthetics, there are four basic criteria that every satisfactory denture should achieve. They are aesthetics, phonetics, mastication and comfort. These requirements are attained by adopting proper techniques in complete denture construction. Thus, the exact determinations of the artificial occlusal plane in the upper occlusal rim while jaw registration procedures play an important role in attaining this objective. Considering the importance of the occlusal plane orientation in complete denture prostheses, planes which are steeper or inclined to the occlusal plane can be unaesthetic or cause difficulty in establishing balanced occlusion or centric occlusion, a study is done to evaluate the deviation of the occlusal plane to three different points of ala-tragus line among 15-20 years,20-30 years, 30-40 years age group individuals. Comparison of OP angle measurements with CP1, CP2 and CP3 within the four age groups. In the 15-20 years & 30-40 years age group, CP1 measurement was closest to OP followed by CP2. In the 20-30 year age groups, CP2 measurement was closest to OP followed by CP1. In the 40-50 year age groups, CP2 measurement was closest to OP followed by CP3. This study indicates or younger individual who is less than 40 years when the complete denture is constructed a superior point of external auditory meatus has to be taken as reference point & in an individual who is above 40 middlemost points of external auditory should be taken as reference point.

A Review on Occlusal Plane Analysis in Edentulous Patients

Aim: The Purpose of the present review was to determine the occlusal plane in edentulous patients.Objective : Occlusal plane orientation is an important factor in the construction of a complete denture.Occlusal plane could be oriented using landmarks in the maxillary arch as well as the mandibular arch .Many methods have been used to establish the occlusal plane in complete dentures , but no method seemsto be fully acceptable. So it is always challenging for the prosthodontist to restore the existing occlusalcondition with a suitable prosthesis.Materials and Methods : : An electronic search engine without time/ language restrictions was taken fromGoogle Scholar .Conclusion: This article reviews different techniques to determine and correct occlusal plane. HIP wasparallel to the occlusal plane , Ala-tragal line passing through lower part of the ala of the nose to inferiorposition of the tragus was relatively parallel to maxillary residual ridge. Therefore, this may be a viablereference in complete denture prosthodontics.

Fundamentals for orientation of occlusal plane in completely edentulous patients – A review

In order to restore the occlusal contact to the original condition and for harmonious stomatognathic system in Conventional Prosthodontic Rehabilitation, the establishment of occlusal plane is very important. The ideal position of artificial teeth in complete denture in the same position of natural teeth will be achieved by the orientation of occlusal plane similar to the natural location of occlusal plane. This review highlights the significance of occlusal plane orientation, basic concepts, various landmarks associated with occlusal plane to achieve the functional, mechanical and esthetic rehabilitation of completely edentulous patients.

The differences in parallelism between ala-tragus line and occlusal plane of down syndrome and normal individuals

People with down syndrome have a different craniofacial structure compared to normal individuals. Commonly, down syndrome patients have abnormal ear morphology with smaller size, and lower ear position compared to that of normalsubjects. These patients also have smaller nose, shorter maxilla structure and facial height. Other disorders are anomalies in tooth shape, numbers and size. The ala-tragus line is one of the anatomical landmarks to determine the occlusal plane orientation. Abnormalities in the anatomical structure of people with down syndrome can affect the parallelism between the ala-tragus line and the occlusal plane. The purpose of this research was to determine the differences in parallelism between the ala-tragus line and the occlusal plane of people with down syndrome and normal individuals. The sample in this study were people with down syndrome and normal individuals. The sample was photographed using a digital camera with a fox plane attached to the oral cavity. Parallelism of the ala-tragus line and the occlusal plane was analyzed by tracing these photographs. Photo tracing was done using the Autocad 2013 software. The mean value of angle on people with down syndrome (5.852° ± 5.367°) was greater than that of normal individuals (2.169° ± 2.557°). Based on the research, it was concluded that the parallelism of the ala-tragus line to the occlusal plane in people with down syndrome was different from that in normal individuals. The ala-tragus inferior line in normal individuals was more parallel to the occlusal plane compared to that in people with down syndrome.

Layperson’s Preference Regarding Orientation of Transverse Occlusal Plane from the Frontal Perspective in Fabrication of a Complete Denture: A Cross-sectional Study

Background and aim: Assessment of dentofacial asymmetries and other discrepancies that can affect the horizontal reference lines should be considered initially as a part of the esthetic diagnosis. Some variations of facial asymmetry are not considered an esthetic liability. So the aim of the present study is to determine a layperson’s preference regarding transverse occlusal plane (TOP) orientation in fabrication of a complete denture.Materials and methods: A total of 100 subjects who are edentulous and have enrolled for complete denture fabrication were selected. Photograph of the patient’s face was obtained from the frontal perspective on the day of try-in. The image obtained was edited to orient the occlusal plane in three different cants, zero degree, two degrees, and four degrees to the inter-pupillary line (IL) and presented to the patient. The obtained results were statistically analyzed.Results: The observed data was analyzed using Friedman’s test and Wilcoxon test was used for comparing ordinal data between groups. There was a statistically significant difference in acceptance depending on angulation, χ2(2) = 183.2, p = 0.0001.Conclusion: A cant of two degrees is not perceived by the subject but some subjects’ preference of occlusal plane may be altered according to the commissural canting which cannot be incorporated in complete denture fabrication.

Evaluation of the Treatment Complexity with Single Complete Removable Denture: A Cross-sectional Study in Tunisia

The aim of this study is to determine the complaints of patients wearing single complete removable dentures (SCRDs), to evaluate their satisfaction degree, and to identify the main construction faults committed. One hundred patients with SCRDs were included. A questionnaire was prepared to investigate the patients' complaints and satisfaction. This questionnaire was supplemented by a professional examination of dentures. Loss of retention and chewing difficulties were the most common complaints of the patients. Examination of the complete dentures by a professional in removable prosthodontics has shown prosthetic instability, lack of retention, and poor adaptation of the prosthetic bases in 49%, 42%, and 38% of the cases, respectively. Occlusal errors related to balanced occlusion, occlusal plane orientation, and occlusal vertical dimension were found successively in 41%, 37%, and 27% of the examined dentures, respectively. Sixty-three percent of the patients were overall dissatisfied with their dentures. This dissatisfaction was correlated to the quality of the denture (p < 10-3). The complaints expressed by the patients with their dentures are mostly justified. The design of a single removable denture does not seem to be mastered by many practitioners.

Reliable Ala-Tragus Line for the Orientation of Occlusal Plane by Cephalometry

Introduction: The aim of the study was to determine the most reliable ala-tragus line for the orientation of the occlusal plane in edentulous patients during complete denture fabrication by cephalometry.&#x0D; Materials and Methods: Lateral cephalometric radiographs of 37 dentate subjects were taken at maximum intercuspation. Steel balls were used as radio opaque markers which were adhered to superior border, middle point, and inferior border of tragus as well as the inferior border of ala of nose. Lead foil was cemented to cover the mesio-palatal cusp of maxillary first molar. Tracings of cephalogram were done. Angle between ala-tragus superior, ala-tragus middle and ala-tragus inferior in relation to occlusal plane were measured. Variables were determined and data were analyzed using SPSS version 17 (SPSS, Inc. Chicago, III).&#x0D; Results: The angle formed between occlusal plane and ala tragus middle had lowest mean value of 2.39°. The highest was measured with ala tragus superior 5.18°, while the angle formed with ala tragus inferior was 3.60°. The differences between the three planes in relation to the occlusal plane were significantly different in total subjects as well as in both males and females (p &lt; 0.001).&#x0D; Conclusion: Statistical analysis showed that the middle point of the tragus with the inferior border of the ala of the nose was most accurate in orienting the occlusal plane.

An in vitro evaluation of the maxillary occlusal plane orientation obtained with an electronic application: A preliminary investigation

Statement of problemIn the evaluation and fabrication of dental prostheses, maxillary occlusal plane orientation in the sagittal and coronal planes may affect functional and esthetic outcomes. The accuracy of a recently developed electronic application in transferring this orientation to a semiadjustable articulator has not been evaluated. PurposeThe purpose of this in vitro study was to evaluate the coronal and sagittal orientation of the occlusal plane on maxillary casts mounted with an electronic application facebow system onto a corresponding semiadjustable arcon articulator. Material and methodsA maxillary typodont was placed into a phantom head (control) oriented with the Frankfort horizontal plane parallel to the horizon. A digital protractor was used to measure the angle between the occlusal plane of the maxillary arch of the phantom head and the Frankfort horizontal plane along the sagittal and coronal planes. The commercial system (test group) was used to make 15 facebow records of the maxillary typodont within the phantom head. The system records were used to mount diagnostic casts of the maxillary typodont onto a semiadjustable arcon articulator. The same measurements were made on the mounted diagnostic casts and were compared with the control. Statistical differences between the occlusal plane of the control and the occlusal plane of the mounted maxillary casts were determined using the 1-sample t test (α=.05). ResultsThe coronal orientation of the occlusal plane was significantly different (P<.001) between test group and control. No significant differences (P>.05) were found in the sagittal orientation of the occlusal plane. ConclusionsWithin the limitations of this study, variations in the coronal plane orientation were observed with the system. Variations in this plane may lead to adverse evaluation and clinical outcomes.

THE MASTICATORY EFFICIENCY OF COMPLETE DENTURE WEARERS WITH OCCLUSAL PLANE ORIENTATION USING CAMPER’S LINE WITH DIFFERENT LEVELS OF THE TRAGUS

Peter Camper described ala-tragus line for orientation of antro-posterior occlusal plane and defined it as a line running from the lower border of the ala of the nose to the tragus of the ear. Camper never mentioned exact point of reference for this line of the tragus of the ear; superior, inferior or middle. The aim of this study was to evaluate the effect of changing the posterior reference point of ala-tragus line on masticatory efficiency of complete denture wearers.Subjects and method : Ten completely edentulous patients were selected. For each patient new complete denture was constructed. The denture anterior teeth were set to meet the esthetic needs with minimal incisal guidance as much as possible. Posterior anatomic form teeth were arranged in balanced articulation with the posterior occlusal plane follow the ala tragus line at the middle point of tragus. Then, the denture posterior segments were exchanged twice to orient occlusal plane parallel to the ala tragus line at the superior and the inferior points of tragus, respectively. After three months of each new and modified denture use, masticatory efficiency test was carried out.Results: There were no significant differences of all masticatory efficiency parameters (when patients were chewing apple, peanut and carrot) with the occlusal plane oriented parallel to the Camper’s line using the three levels of the tragus.Conclusion: According to the results of the present study, the use of any posterior point of tragus for occlusal plane orientation is acceptable at the point of masticatory efficiency.

Layperson’s preference regarding orientation of the transverse occlusal plane and commissure line from the frontal perspective

Statement of problemFacial asymmetries in features such as lip commissure and interpupillary plane canting have been described as common conditions affecting smile esthetics. When presented with these asymmetries, the clinician must choose the reference line with which to orient the transverse occlusal plane of the planned dental restorations. PurposeThe purpose of the online survey described in this study was to determine lay preferences regarding the transverse occlusal plane orientation in faces that display a cant of the commissure line viewed from the frontal perspective. Material and methodsFrom a digitally created symmetrical facial model with the transverse occlusal plane and commissure line parallel to the interpupillary line (horizontal) and a model constructed in a previous study (control), a new facial model was created with 3 degrees of cant of the commissure line. Three digital tooth mountings were designed with different transverse occlusal plane orientations: parallel to the interpupillary line (A), parallel to the commissure line (B), and the mean angulation plane formed between the interpupillary and commissure line (C), resulting in a total of 4 images. All images, including the control, were organized into 6 pairs and evaluated by 247 selected laypersons through an online Web site survey. Each participant was asked to choose the more attractive face from each of the 6 pairs of images. ResultsThe control image was preferred by 72.9% to 74.5% of the participants compared with the other 3 images, all of which represented a commissure line cant. Among the 3 pairs which represent a commissure line cant, 59.1% to 61.1% preferred a transverse plane of occlusion cant (B and C) compared with a plane of occlusion parallel to the interpupillary, line and 61.1% preferred a plane of occlusion parallel to the commissure line (B) compared with the mean angulation plane (C). ConclusionsLaypeople prefer faces with a commissure line and transverse occlusal plane parallel to the horizontal plane or horizon. When faces present a commissure line cant, laypeople prefer a transverse occlusal plane with a similar and coincident cant.

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.