{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:37:44Z","timestamp":1794263864399,"version":"4.9.0"},"reference-count":51,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"College of Dentistry, University of Kentucky, Initial Manuscript Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Complete denture fabrication requires multiple clinical and laboratory steps. One of the most critical clinical steps is establishing an anatomical occlusal plane based on hard and soft tissue references. The aim of this study was to determine whether age or gender affects the level of the Ala-Tragus plane to establish which reference point on the Tragus should be used when fabricating the occlusal plane in edentulous patients. Clinical photographs and lateral cephalometric radiographs with complete dentitions were taken from 58 volunteers at the DMD clinic at the University of Kentucky. Each photograph was superimposed over its corresponding cephalometric image. An analysis was conducted to establish the angle of the occlusal plane relative to the Ala-Tragus landmarks; this data was then grouped according to age and gender. The analysis shows that age and gender did not significantly affect where the Camper\u2019s plane should be approximated for complete denture treatment. However, it was found that the most parallel line to the occlusal plane was Ala\u2019s inferior border to the \u2018Tragus\u2019s inferior border. It should be noted that the volunteers\u2019 skeletal classification was significantly related to a Cl III malocclusion tendency. Still, with this new information, functionality and esthetics can be more adequately addressed for patients undergoing complete denture treatment. Given our results, we suggest redefining the \u2018Camper\u2019s plane with a line extending from \u2018Ala\u2019s inferior border to the \u2018Tragus\u2019s inferior border instead of the superior border. Further consideration should be taken if the patient is a skeletal CL III malocclusion.<\/jats:p>","DOI":"10.3390\/dj11030081","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T06:36:36Z","timestamp":1678862196000},"page":"81","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Cephalometric Analysis Assessing the Validity of Camper\u2019s Plane to Establishing the Occlusal Plane in Edentulous Patients"],"prefix":"10.3390","volume":"11","author":[{"given":"Lina","family":"Sharab","sequence":"first","affiliation":[{"name":"Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1285-4436","authenticated-orcid":false,"given":"David","family":"Jensen","sequence":"additional","affiliation":[{"name":"Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-9965","authenticated-orcid":false,"given":"Gregory","family":"Hawk","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Kutkut","sequence":"additional","affiliation":[{"name":"Division of Prosthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0022-3913(85)80076-7","article-title":"A cephalometric method to determine the angulation of the occlusal plane in edentulous patients","volume":"54","author":"Monteith","year":"1985","journal-title":"J. Prosthet. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1111\/j.1365-2842.1995.tb01569.x","article-title":"A study of the occlusal plane orientation by intra-oral method (retromolar pad)","volume":"22","year":"1995","journal-title":"J. Oral Rehabil."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/j.1365-2842.1987.tb00735.x","article-title":"A study of the occlusal plane orientation in complete denture construction","volume":"14","author":"Karkazis","year":"1987","journal-title":"J. Oral Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0022-3913(75)80161-2","article-title":"A comparative study of the occlusal plane in dentulous and edentulous subjects","volume":"33","author":"Vig","year":"1975","journal-title":"J. Prosthet. Dent."},{"key":"ref_5","unstructured":"Boucher, C.O., Hickey, J.C., Zarb, G.A., and Bolender, C. (1985). Boucher\u2019s Prosthodontic Treatment for Edentulous Patients, CV Mosby. [9th ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/0022-3913(53)90059-6","article-title":"Occlusion in prosthodontics","volume":"3","author":"Boucher","year":"1953","journal-title":"J. Prosthet. Dent."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/0022-3913(70)90198-8","article-title":"Occlusal plane determination","volume":"23","author":"Lundquist","year":"1970","journal-title":"J. Prosthet. Dent."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S0022-3913(68)80017-4","article-title":"Position of the occlusal plane in natural and artificial teeth","volume":"20","author":"Ismail","year":"1968","journal-title":"J. Prosthet. Dent."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/0022-3913(61)90106-8","article-title":"The height of the occlusion rim and the interocclusal distance","volume":"11","author":"Yasaki","year":"1961","journal-title":"J. Prosthet. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s40510-014-0041-1","article-title":"Changes of occlusal plane inclination after orthodontic treatment in different dentoskeletal frames","volume":"15","author":"Li","year":"2014","journal-title":"Prog. Orthod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/ejo\/18.1.27","article-title":"Significance of the cant of the posterior occlusal plane in Class II division 1 malocclusions","volume":"18","author":"Fushima","year":"1996","journal-title":"Eur. J. Orthod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2147\/CCIDE.S248983","article-title":"The Occlusal Plane Inclination Analysis for Determining Skeletal Class III Malocclusion Diagnosis","volume":"12","author":"Ardani","year":"2020","journal-title":"Clin. Cosmet. Investig. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1018793","DOI":"10.1155\/2020\/1018793","article-title":"Influence of Vertical Facial Growth Pattern on Herbst Appliance Effects in Prepubertal Patients: A Retrospective Controlled Study","volume":"2020","author":"Giuca","year":"2020","journal-title":"Int. J. Dent."},{"key":"ref_14","unstructured":"Athanasiou, A.E. (1995). Orthodontic Cephalometry, Mosby International. [2nd ed.]."},{"key":"ref_15","unstructured":"Jacobson, A. (1992). Radiographic Cephalometry, Quintessence Publishing Co."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/0022-3913(53)90144-9","article-title":"Occlusal plane relation to facial type","volume":"3","author":"Augsburger","year":"1953","journal-title":"J. Prosthet. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1365-2842.1980.tb01460.x","article-title":"A simplified technique for determining the occlusal plane in full denture construction","volume":"7","author":"Spratley","year":"1980","journal-title":"J. Oral Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/0022-3913(85)90068-X","article-title":"The alatragus line in complete denture prosthodontics","volume":"53","author":"Miller","year":"1985","journal-title":"J. Prosthet. Dent."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e04244","DOI":"10.1002\/ccr3.4244","article-title":"Orthodontic treatment of an adolescent patient with Class II division 1 malocclusion with consideration of growth pattern and occlusal plane: A case report","volume":"9","author":"Hou","year":"2021","journal-title":"Clin. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/0022-3913(67)90124-2","article-title":"The occlusal plane in relation to facial types","volume":"17","author":"Hartono","year":"1967","journal-title":"J. Prosthet. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/0022-3913(86)90075-2","article-title":"Evaluation of a cephalometric method of occlusal plane orientation for complete dentures","volume":"55","author":"Monteith","year":"1986","journal-title":"J. Prosthet. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/S0022-3913(89)80051-4","article-title":"The relationships of upper facial proportions and the plane of occlusion to anatomic reference planes","volume":"61","author":"Ow","year":"1989","journal-title":"J. Prosthet. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0022-3913(96)90096-7","article-title":"A cephalometric study comparing the occlusal plane in dentulous and edentulous subjects in relation to the maxillomandibular space","volume":"75","author":"Bhargava","year":"1996","journal-title":"J. Prosthet. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/j.1532-849X.2008.00341.x","article-title":"Occlusal Plane Orientation: A Statistical and Clinical Analysis in Different Clinical Situations","volume":"17","author":"Jayachandran","year":"2008","journal-title":"J. Prosthodont."},{"key":"ref_25","unstructured":"Nairn, N. (1991). Complete Denture Prosthetics, Wright. [3rd ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1046\/j.1365-2842.2003.01044.x","article-title":"Relationship between occlusal plane determinants and craniofacial structures","volume":"30","author":"Nissan","year":"2003","journal-title":"J. Oral Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0022-3913(91)90172-S","article-title":"Cephalometrically predicted occlusal plane: Implications in removable prosthodontics","volume":"65","author":"Karkazis","year":"1991","journal-title":"J. Prosthet. Dent."},{"key":"ref_28","first-page":"16","article-title":"The morphology of Tragus. Part II: Reliability of tragus morphology and its ref-erence to established Camper\u2019s plane","volume":"11","author":"Solomon","year":"2000","journal-title":"J. Inf. Proc. Syst."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/0972-4052.17107","article-title":"Validity of soft tissue landmarks in determining the occlusal plane","volume":"5","author":"Shigli","year":"2005","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"(2017). Glossary of prosthodontic terms. J. Prosthet. Dent., 117, E1\u2013E105.","DOI":"10.1016\/j.prosdent.2016.12.001"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/j.1532-849X.2010.00643.x","article-title":"The Position of the Occlusal Plane in Natural and Artificial Dentitions as Related to Other Craniofacial Planes","volume":"19","author":"Hazzaa","year":"2010","journal-title":"J. Prosthodont."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4047\/jap.2013.5.1.58","article-title":"Cephalometrically assessing the validity of superior, middle and inferior tragus points on ala-tragus line while establishing the occlusal plane in edentulous patient","volume":"5","author":"Chaturvedi","year":"2013","journal-title":"J. Adv. Prosthodont."},{"key":"ref_33","first-page":"ZC39","article-title":"Relationship between Occlusal Plane and Three Levels of Ala Tragus line in Dentulous and Partially Dentulous Patients in Different Age Groups: A Pilot Study","volume":"9","author":"Shaikh","year":"2015","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4103\/2141-9248.133450","article-title":"Systematic assessment of the various controversies, difficulties, and current trends in the reestablishment of lost occlusal planes in edentulous patients","volume":"4","author":"Kumar","year":"2014","journal-title":"Ann. Med. Health Sci. Res."},{"key":"ref_35","first-page":"142","article-title":"Occlusal Plane Location in Edentulous Patients: A Review","volume":"13","author":"Shetty","year":"2013","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/jopr.12250","article-title":"Position of Occlusal Plane in Dentate Patients with Reference to the Ala-Tragal Line Using a Custom-Made Occlusal Plane Analyzer","volume":"24","author":"Shetty","year":"2015","journal-title":"J Prosthodont."},{"key":"ref_37","first-page":"413","article-title":"Relation of the reference planes for orientation of the prosthetic plane","volume":"34","author":"Seifert","year":"2000","journal-title":"Acta Stomatol. Croat"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/0022-3913(57)90073-2","article-title":"A scientific approach to the study of the temporomendibular joint and its relation to occlusal disharmonies","volume":"7","author":"Landa","year":"1957","journal-title":"J. Prosthet. Dent."},{"key":"ref_39","unstructured":"Lang, B., and Swartz, W. (1979). Clinical Dentistry, Harper and Row. [5th ed.]."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/ijos.2012.2","article-title":"The occlusal plane in the facial context: Inter-operator repeatability of a new three-dimensional method","volume":"4","author":"Rosati","year":"2012","journal-title":"Int. J. Oral Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/j.1365-2842.2001.00667.x","article-title":"Evaluation of the utility of cephalometric parameters in constructing complete denture. Part I: Placement of posterior teeth","volume":"28","author":"Bassi","year":"2001","journal-title":"J. Oral Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1111\/j.1365-2842.1992.tb01583.x","article-title":"A comparative study of two methods for the orientation of the occlusal plane and the determination of the vertical dimension of occlusion in edentulous patients","volume":"19","author":"Koller","year":"1992","journal-title":"J. Oral Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/jopr.12524","article-title":"An Evaluation of Benchmarks for Esthetic Orientation of the Occlusal Plane","volume":"26","author":"Priest","year":"2017","journal-title":"J. Prosthodont."},{"key":"ref_44","first-page":"243","article-title":"Use of digital photography in the reconstruction of the occlusal plane orientation","volume":"6","author":"Guberina","year":"2009","journal-title":"Med. Glas."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/0972-4052.57083","article-title":"Relationship of anatomic landmarks with occlusal plane","volume":"9","author":"Gupta","year":"2009","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4103\/0972-4052.206955","article-title":"Reliability of intra oral anatomical landmarks in establishing occlusal plane in edentulous subjects","volume":"9","author":"Shetty","year":"2009","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s12548-009-0023-y","article-title":"Mandibular rotation and occlusal development during facial growth","volume":"2","author":"Kim","year":"2009","journal-title":"Int. J. Stomatol. Occlusion Med."},{"key":"ref_48","first-page":"472","article-title":"Assessment of Occlusal Plane in Angle\u2019s Class I, II, III Malocclusion Patient and Relating the Result to Edentulous Patients: A Cephalometric Analysis","volume":"4","author":"Singh","year":"2019","journal-title":"Saudi J. Oral Dent. Res."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Valenti, C., Federici, M.I., Masciotti, F., Marinucci, L., Xhimitiku, I., Cianetti, S., and Pagano, S. (2022). Mechanical properties of 3D-printed prosthetic materials compared with milled and conventional processing: A systematic review and meta-analysis of in vitro studies. J. Prosthet. Dent., S0022-3913(22)00415-2.","DOI":"10.1016\/j.prosdent.2022.06.008"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/jips.jips_197_20","article-title":"Use of Facebow device in prosthodontics: A systematic review on randomized control trials","volume":"21","author":"Suman","year":"2021","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"364","DOI":"10.4103\/ijdr.IJDR_377_17","article-title":"Utility of facebow in the fabrication of complete dentures, occlusal splints and full arch fixed dental prostheses: A systematic review","volume":"29","author":"Khan","year":"2018","journal-title":"Indian J. Dent. Res."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/3\/81\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:55:28Z","timestamp":1760122528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/11\/3\/81"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["dj11030081"],"URL":"https:\/\/doi.org\/10.3390\/dj11030081","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,15]]}}}