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BackgroundThe determination of the maxillary occlusal plane presents a significant clinical challenge in the treatment of edentulous patients as well as it is critical for complex full‐mouth reconstructions in dentate patients, including those with implant‐supported rehabilitations. While the use of a Fox plane plate is standard in edentulous cases, its application in dentate patients lacks thorough documentation in existing literature.PurposeThis clinical study assessed the sagittal position of the maxillary dentition in relation to facial landmarks using a digital three‐dimensional analysis and evaluated the suitability and reliability of applying a simulated Fox plane plate, also known as an occlusal plane guide, in dentate patients.Materials and MethodsEighty‐one subjects were recruited at the Department of Prosthetic Dentistry of Goethe University Frankfurt, Germany, according to specific inclusion criteria. Intraoral and facial scans were obtained and analyzed using GOM Inspect Pro software (GOM, Braunschweig, Germany). The angles between the maxillary occlusal plane and three variations each of Camper's plane and ala‐tragus line, relating to superior, middle, and inferior tragus points, were measured. These modified planes were then compared to a plane established by a simulated digital Fox plane plate, which was adapted to the maxillary anterior teeth and the lowest point of the posterior teeth in both quadrants.ResultsA total of 81 subjects (58 female and 23 male) with a mean age of 23.9 years were evaluated in this study. No significant angular difference was found between the angles of the maxillary occlusal plane compared with superior Camper's plane, middle Camper's plane, or superior ala‐tragus line (p >0.05). The smallest angle occurred between superior Camper's plane and the maxillary occlusal plane on both the right (3.443°) and left (3.535°) sides. The application of a Fox plane plate resulted in two different occlusal planes in 70% of patients, significantly deviating from the digitally determined plane (p <0.05).ConclusionSuperior and middle Camper's planes, along with superior ala‐tragus line, can be considered approximately parallel reference planes and are suitable for routine determining of the maxillary occlusal plane in restorative treatments. However, in contrast to digital evaluation methods, the application of a Fox plane plate in dentate patients showed high variability, indicating its low reproducibility due to its ambiguous positioning on the maxillary dentition.Clinical trial registration site: https://drks.de/search/de/trial/DRKS00030166.
BackgroundThe determination of the maxillary occlusal plane presents a significant clinical challenge in the treatment of edentulous patients as well as it is critical for complex full‐mouth reconstructions in dentate patients, including those with implant‐supported rehabilitations. While the use of a Fox plane plate is standard in edentulous cases, its application in dentate patients lacks thorough documentation in existing literature.PurposeThis clinical study assessed the sagittal position of the maxillary dentition in relation to facial landmarks using a digital three‐dimensional analysis and evaluated the suitability and reliability of applying a simulated Fox plane plate, also known as an occlusal plane guide, in dentate patients.Materials and MethodsEighty‐one subjects were recruited at the Department of Prosthetic Dentistry of Goethe University Frankfurt, Germany, according to specific inclusion criteria. Intraoral and facial scans were obtained and analyzed using GOM Inspect Pro software (GOM, Braunschweig, Germany). The angles between the maxillary occlusal plane and three variations each of Camper's plane and ala‐tragus line, relating to superior, middle, and inferior tragus points, were measured. These modified planes were then compared to a plane established by a simulated digital Fox plane plate, which was adapted to the maxillary anterior teeth and the lowest point of the posterior teeth in both quadrants.ResultsA total of 81 subjects (58 female and 23 male) with a mean age of 23.9 years were evaluated in this study. No significant angular difference was found between the angles of the maxillary occlusal plane compared with superior Camper's plane, middle Camper's plane, or superior ala‐tragus line (p >0.05). The smallest angle occurred between superior Camper's plane and the maxillary occlusal plane on both the right (3.443°) and left (3.535°) sides. The application of a Fox plane plate resulted in two different occlusal planes in 70% of patients, significantly deviating from the digitally determined plane (p <0.05).ConclusionSuperior and middle Camper's planes, along with superior ala‐tragus line, can be considered approximately parallel reference planes and are suitable for routine determining of the maxillary occlusal plane in restorative treatments. However, in contrast to digital evaluation methods, the application of a Fox plane plate in dentate patients showed high variability, indicating its low reproducibility due to its ambiguous positioning on the maxillary dentition.Clinical trial registration site: https://drks.de/search/de/trial/DRKS00030166.
Background To establish the occlusal plane, the conventional methods for facial analysis to gain accurate alignment of the occlusal plane are inadequate, while 3D technologies are an ideal diagnostic tool. The aims of this research are to compare the difference accuracy of anatomic landmarks on the occlusal plane and ala-tragus line between the conventional clinical method and 3D image method in both non-orthodontic and orthodontic treatment volunteers. Methods A total of 44 volunteers (22 non-orthodontic and 22 orthodontic treatment volunteers) with normal occlusion were selected. All volunteers received 2 operative methods for occlusal plane determination. In conventional method, the occlusal plane was defined by the fox plane line. The ala-tragus line was defined by the radio-opaque markers. In the 3D image method, the volunteers were recorded intraoral images, 3D facial images and CBCT images. A 3D virtual picture was created using EXOCAD® software. The occlusal plane was generated by the incisal and occlusal surfaces of the teeth. Both methods, the angles and distances between the occlusal plane and ala-tragus line were measured and compared statistically on both sides of each volunteer. Results Both volunteers’ group, the mean angles and distances between the occlusal plane-ala tragus line in the conventional method were reported to be significantly greater than the 3D method (P < 0.05). The percentage difference of angles in conventional method were reported to be significantly higher by 13.61–21.58% (p < 0.05) compared to the 3D method. The percentage difference of distances in the conventional method were reported to be significantly greater than the 3D method by 4.73–7.51% (p < 0.05). Conclusions Within the limitation of the study, it can be concluded that both conventional and digital methods for establishing the occlusal plane are not parallel to the occlusal plane. The occlusal plane and ala-tragus line in the conventional method and the 3D method were significantly different in terms of angles and distances in both non-orthodontic and orthodontic treatment volunteers. However, the deviation angle of both methods is approximately 13–20 degrees, which is clinically acceptable for occlusal plane establishment. The accuracy of both methods is still within the using in clinical implementation.
Background The available literature lacks comprehensive guidance on constructing the occlusal plane within the broader facial and skeletal context. This study aims to accurately determine the occlusal plane (OP) within the normal population through three-dimensional data analysis using cone-beam computed tomography (CBCT) and specific feature points alignment. Material and methods One hundred patients underwent both clinical evaluation and CBCT imaging examination. A digital model was constructed based on the imaging data, delineating a virtual occlusal plane (V-OP), a virtual Frankfort plane (V-FP), and a virtual plane formed by two camper lines (V-CL) using specific feature points. Two angles, formed by V-OP and V-FP, as well as V-OP and V-CL, were computed using the angle measurement function in Geomagic Control X. The angular relationship between V-OP and the angular bisector plane (ABP) of V-FP and V-CL was determined through calculations using the aforementioned data. Ordinary two-way ANOVA with post hoc Sidak’s multiple comparisons was performed (p < 0.05). Results The mean ± standard deviation of the angle between V-FP and V-OP is 8.94° ± 4.22°, and it is 4.82° ± 3.07° between V-CL and V-OP. In comparison, the mean ± standard deviation of the angle between ABP and the occlusal plane was 3.12° ± 1.78°, lower than that of the former two groups. Conclusions The ABP and OP are nearly parallel, suggesting stability across different patients, making it a reliable reference for digital dental alignment. Trial registration This study was registered in the Chinese Clinical Trial Registry as “Exploring the Method of Determining the Occlusion Plane in 3D Data Analysis: A Retrospective Study” (No. ChiCTR2300077289) on November 3rd, 2023 (https://www.chictr.org.cn/searchproj.html?regno=ChiCTR2300077289).
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