T h e m o n o p la n e o c c lu sio n
N o doubt these teachers were influenced by
Philip M. Jones, DDS, MSD, Kansas City, Mo.
For many years, the manufacturers of artificial
teeth chose newly erupted premolars and molars
as their models for posterior teeth. Because of the
differences that exist between natural and arti­
ficial teeth, the zero degree posterior tooth forms
offer several advantages for complete dentures.
The most important of these is their ability to
better adapt to different occlusal relationships
that result from the gradual, but inevitable, re­
duction in the height of the supporting ridges.
In the early molds o f manufactured posterior
teeth for complete dentures, no attempt was
made to copy the anatomy o f natural teeth. Arti­
ficial teeth were ill-defined blocks o f porcelain
with few , if any, distinctions between right and
left, upper and lower, and premolar and molar.
A s manufacturing methods improved, artificial
posterior teeth became more natural in appear­
ance because the manufacturers chose as their
m odels newly erupted natural premolars and
molars. The models were desirable to repro­
duce the buccal surfaces, but they were an un­
fortunate choice for the occlusal surfaces.
Through the years, dental educators became
impressed with the importance of setting the
posterior teeth in positions so that the cusps
meshed. The generally accepted, ideal denture
occlusion was meshed cusps in centric relation,
and equalized contacts between upper and
lower teeth in eccentric relation, within the
range o f function.
94 ■ J A D A , V o l. 8 5 , J u l y 1 9 7 2
for c o m p le te d e n tu re s
the accepted belief that the occlusion o f ideal
natural dentitions provided for similar contacts.
Today, students of the occlusion o f natural
teeth say that ideal balance is seldom a charac­
teristic of excellent natural dentitions. F ed i1
wrote that such an arrangement does not indi­
cate a necessarily desirable occlusion for na­
tural teeth.
Members o f the states’ boards o f dental ex­
aminers discovered that such a tooth arrange­
ment could be included in their examinations.
Thus, the pattern was formed for the teaching
o f the method in the dental schools. It contin­
ued to be accepted, almost without challenge,
for 50 years and commonly was referred to as
the spherical theory o f occlusion.
T h e spherical theory
In 1949, Harry Young2 described the estab­
lished and traditional concepts of complete den­
ture occlusion: . the spherical theory dic­
tates that tooth contacts be multiple and in har­
mony with the anatomic guides and functional
characteristics of each patient. With a variation
in the angulation o f the condylar and incisal
guidance, the movement paths o f intervening
teeth must be arced and the paths must lie prin­
cipally in the horizontal plane. The teeth, there­
fore, must be arranged with a compound curve
running anterio-posteriorly and a M onson curve
running transversely.” In the paper, Young
added, “ Arrangement for the spherical concept
has been standard practice for perhaps half a
century.”
It was axiomatic that posterior teeth with def­
inite cusps and inclined planes would be used;
and it was hoped that such procedures would
result in a balanced occlusion, defined as being,
“ A n occlusion o f the teeth that presents a har­

Fig 1 »Complete records made with Stansbery tracing device
for setting the controls of a highly adjustable articulator. Shown
are plaster checks for centric occlusion, right lateral and left
lateral relationships, and protrusion.
monious relation o f the occluding surfaces in
centric and eccentric positions within the func­
tional range.” 3 Such an arrangement has been
called the “ three-point contact” by generations
of dental students. It is perhaps best termed
eccentric balance. This arrangement was ac­
cepted almost universally in dental colleges and
such a setup on experimental casts became the
accepted prosthodontic requirement of most
state boards.
Several patient records are required to repro­
duce such an occlusal pattern, and they are as
unreliable as they are time-consuming. The
determination o f the hinge axis of the condyles
is necessary. The upper cast must be mounted
on the articulator in the same relation to the
hinge axis of the instrument as the maxilla is in
relation to the hinge axis of the patient. Various
eccentric jaw records must be obtained and the
controls of an adjustable articulator must be set
to these records (Fig 1). Anatomic teeth then
are arranged to meet the definition of balanced
occlusion on the articulator, as well as in the
mouth.
■ A rticulators: Although 28 artificial teeth
could be set on trial bases directly in the mouth,
the use of an articulator simplifies the problem
of the arrangement of teeth for complete den­
tures. Countless articulators were designed
during this period by dentists who were as me­
chanically adept as they were conscientious.
Each articulator possessed its advantages and
disadvantages. They were intended to enable the
dentist to obtain that nebulous ideal—balanced
occlusion. Designers such as G y si, Stansbery,
House, Phillips, and Terril were serious stu­
dents of prosthodontics and the value of their
J o n e s : M O N O P L A N E O C C L U S IO N F O R C O M P L E T E D E N T U R E S > 9 5
Fig 2 ■ Diagram of chewing cycle compared with articulator
movements as registered on frontal plane. CO, centric occlu­
sion; AM, articulator movements; and CC, chewing cycle. Only
common point is centric occlusion.
contributions to the background o f the profes­
sion and the specialty cannot be overempha­
sized. They were also dynamic individuals who
zealously stimulated interest in their instru­
ments. Indeed, by 1945, the designing of articu­
lators had reached such a point that one might
have repeated the statement made by Dexter4
in 1876, “ Articulators have been so far and per­
fectly developed as to leave little to be desired
in that direction.”
The fact that these articulators are no longer
obtainable is an indication of their practicabil­
ity and reliability and supports the judgments of
their critics. Kurth5 said that the only common
point in the movements of the adjustable articu­
lator and the mandible during the chewing cycle
is centric relation (Fig 2). The border move­
ments o f the articulator correspond to bruxing
movements of the mandible. It thus appears
that the efforts to produce eccentric balance on
the articulator are directed simply toward pleas­
ant and comfortable bruxing. (I would prefer
that my patients not brux, because it can be
most destructive to natural teeth, or to the mu­
cosa trapped between the bone and the denture
base. D eV an6 is so concerned with such dan­
gers that he does not use a needle point tracing
device for fear that he will induce a bruxing
habit.)
Craddock7 demonstrated the unreliability of
eccentric records for setting articulators even
though he worked with patients with natural
teeth. Who needs to be reminded of the quote
from Prime,8 “ Enter bolus, exit balance.” ?
The five articulators for use with anatomic
teeth mentioned earlier have become museum
pieces, to be used once a year by the graduate
student in removable prosthodontics who wants
to broaden his range of clinical experiences.

Later trends
Som e pioneer dentists early in this century ob­
served that the comfort and efficiency o f den­
tures did not increase in proportion to the in­
crease in the cuspal height of the more natural-
looking posterior tooth forms, but that in many
instances the opposite occurred. A t about this
time, Campbell introduced his “ D ecusper,” a
large stone for use with a lathe that conformed
to the M onson curve, and on which the cuspal
height o f the posterior teeth, then available from
the manufacturers, could be reduced before
they were set.
Finally, the first nonanatomic posterior teeth
becam e available commercially—the True Kusp
in 1929 and the Hall Self-Balancing teeth in
1931. Sears9 said that the larger tooth manu­
facturers tried to hold back the change and that
some in the profession were against the use of
the newer forms. H owever, because o f the
teachings o f such men as Sears, Hall, Hardy,
Porter, Kurth, and D eV an, the use o f nonana­
tomic teeth increased.
Various terms have been used to designate
teeth o f this type: cuspless, noncusped, non­
anatomic, zero degree, monoplane, mechanical,
and flat. In the “ Glossary o f Prosthodontic
T erm s,” 3 cuspless teeth, zero degree teeth, and
nonanatomical teeth are accepted terms. Be­
cause a tooth might be nonanatomical or even
cuspless, but also might possess inclined planes
(as the Sears1 Channel Teeth) on the occlusal
surface, I prefer to use the term zero degree
teeth. Zero degree teeth may be used to produce
a monoplane occlusion, that is, on one plane
only. H ow ever, the use o f zero degree teeth
does not necessarily result in a monoplane
occlusion because they may be set to a curve or
may be set with balancing units, resulting in one
or more additional planes.
Z ero d eg ree teeth
In recent years, the profession has given in­
creased recognition to the superiority o f zero de­
gree teeth for dentures. These observations are
offered in support o f that statement:
— A s late as 1940, only two zero degree pos­
terior teeth were readily available from the den­
tal laboratories. Today, a wide range of such
occlusal carvings is available from the major
9 6 ■ J A D A , V o l. 8 5 , J u l y 1 9 7 2
suppliers, with a choice of plastic, porcelain, or
metal.
— O f about 30 applicants who took the clin­
ical examination o f the American Board of
Prosthodontics in 1953, only three selected zero
degree teeth for their patients. In 1970, a major­
ity o f the 32 applicants selected zero degree
teeth for the dentures to be delivered to their
patients.
— In 1950, only two U S dental schools rou­
tinely used zero degree teeth for their clinic pa­
tients. In 1969, in a study reported by Levin and
Sauer,10 33 schools responding to a survey used
zero degree teeth in their clinics with a fre­
quency that equaled that for the anatomic teeth.
Furthermore, the traditional setup with ana­
tomic teeth has almost disappeared from state
board examinations.
Should zero degree teeth be arranged to pro­
vide for eccentric balance? A s a carry-over from
the spherical era, some o f the early proponents
o f zero degree teeth continued to strive for
eccentric balance by the use o f the Monson
curve or balancing ramps. Research reported
by Trapazzano,11 Jones,12 and Brewer and co ­
workers13 indicate that such complications to
the technique do not result in detectable advan­
tages for the patient. The research of Jankelson
and co-workers,14 published in 1953, may ex­
plain why this is true. The law o f parsimony
would seem to dictate the use o f simpler pro­
cedures that eliminate balancing contacts.
■ D ifferences betw een natural and artificial
teeth and their environm ents: T hose progres­
sive dentists who first considered modifying the
occlusal form o f anatomic teeth were impressed
with several differences that exist between the
natural and artificial teeth.
—A natural tooth functions as an individual
unit, whereas 14 artificial teeth attached to the
denture base constitute a single unit. This causes
a single force, exerted on a denture tooth, to be
felt throughout the area that supports the base.
— A resilient media (the mucosa), which
varies in thickness between 2 and 6 mm, lies be­
tween the teeth and the supporting bone. This
tissue possesses an extremely well-developed
sensory nervous system.
— The differences in the attachment to the
jawbones are obvious. Extraction o f a loose
natural tooth requires a surgical operation that
involves a degree o f force, whereas the most
retentive mandibular denture that can be toler-

Fig 3 ■ Reduction in vertical dimension of occlusion, because
of changes in ridge height, produces forward movement of man­
dible in relation to maxilla. Arrows indicate areas of heavy con­
tact that result if teeth with cusps are used.
ated by a patient may be plucked from the ridge
with a minimum of muscular effort. Someone
has commented that the height o f the cusps
should be directly proportional to the length of
the roots.
—The most significant difference is a charac­
teristic of the edentulous ridge in that it under­
goes a negative change in height throughout the
life of the patient. Changes in the occlusal re­
lations result from this inevitable resorption,
but the monoplane occlusion suffers less of a
derangement. The mandible closes somewhat
as a hinge. The reduction of 0.5 mm in the height
o f the lower and upper ridges results in a de­
crease of 1 mm in the nose-to-chin distance. At
the same time, it is estimated that the mandible
moves forward by 1 mm. Although a denture
made with anatomic teeth may show perfect
centric and eccentric balance on the day that it
is presented to the patient, how long will such
perfection be maintained? The slightest change
in ridge height will result in heavier forces on
the forward-facing inclines of the lower teeth
against the distal inclines of the upper teeth
(Fig 3). This will result in a sliding of the weaker
denture base on the mucosa with all that that
implies: inflammation, pain, bone destruction,
and soft tissue hyperplasia. Unfortunately, the
proprioceptive reflex that protects natural teeth
and their supporting structures when centric re­
lation is no longer equal to centric occlusion is
lost with the removal of the natural teeth and
their periodontal membrane.
Sears15 recommended that the occlusal sur­
faces o f anatomic teeth could be rendered more
efficient if the cusps were unlocked (flattened),
J o n e s : M O N O P L A N E O C C L U S IO N F O R C O M P L E T E D E N T U R E S ■ 9 7
if the teeth were narrowed buccolingually, and
if cutting blades and sluiceways were provided.
What is the ideal form in nature may not be the
ideal form of the mechanical equivalent. Crad­
dock16 pointed out that birds and airplanes both
fly, but that the airplane is not covered with
feathers, and that it does not flap its wings.
A d v a n ta g e s o f th e m o n o p la n e
o c c lu s io n
These advantages are offered by the zero de­
gree posterior teeth. They are more adaptable
to unusual jaw relations such as the Class II and
Class III malocclusions. They are used more
easily when variations in the width of the upper
and lower jaws indicate a crossbite setup. Zero
degree teeth impart to the patient a sense of
freedom, because they do not lock the mandible
in one position only. They eliminate horizontal
forces that may be more damaging than vertical
forces. Because zero degree teeth occlude in
more than one relationship, and if the mono­
plane occlusion is used, the debate on whether
centric relation is a point or an area need not
concern the practitioner. Zero degree teeth per­
mit the use of a simplified and less time-consum­
ing technique and offer greater comfort and
efficiency for a longer period. They accommo­
date better to the inevitable negative changes in
ridge height that occur with aging.
Some within the profession who do not share
my enthusiasm for zero degree teeth will, how­
ever, use them for their patients who have an
unfavorable prognosis. I think that the advan­
tages that they offer these patients also indicate
their use for the patient with a favorable prog­
nosis. The ideal mouth for dentures will prob­
ably be less than favorable two or three decades
later. We must remember D eV an’s admonition
that we be as concerned with preserving what
is left as with the restoration of what is missing.
T e c h n iq u e f o r t h e m o n o p la n e
concept
Some principles are fundamental to success in
denture construction regardless o f the technique
used. The examination of the patient should in­
clude radiographs, a discussion with the patient
 of his problems, and a careful oral examination.
If indicated, surgical preparation o f the mouth
should be performed. M ucosa that shows evi­
dence o f abuse should be given a recovery per­
iod. Impressions should be made with a mini­
mum o f pressure and should cover the maxi­
mum area possible, compatible with physiologic
function. A vertical dimension o f occlusion
should be established that provides for a correct
interocclusal distance and an adequate closest
speaking space. Centric relation must be record­
ed accurately.
T he first departure from the traditional tech­
nique, if zero degree teeth are used, concerns
the articulator, because it need m eet only these
requirements: it should accommodate large
casts; it should not wobble or show lost motion;
it should possess an incisal guide pin. A barn­
door hinge m eets these specifications fully, al­
though it is admittedly less convenient to use
than certain other simple designs. Only an
occluding frame is needed. The manner in which
the casts are related to the hinge axis o f the
articulator is not important, if vertical dimen­
sion is never changed on the articulator without
a new centric record being made. (This is a
good rule to follow regardless o f the care with
which the casts are related to the hinge axis.)
A t this point, another departure from the pro­
cedure that is normally associated with ana­
tomic teeth is encountered: the upper and lower
anterior teeth are best arranged without any
vertical overlap. The maxillary anterior teeth
are arranged with regard to appearance. The
incisal edges o f the lower anterior teeth are set
to the same horizontal plane, resulting in a ver­
tical overlap of 0 mm (Fig 4). In the protrusive
position o f the mandible at the edge-to-edge
relationship, a light contact is made, but there
should be no locking or interference. (Zero de­
gree or anatomic anterior teeth that have been
set without adequate clearance are the most fre­
quently observed cause of hyperplastic tissue
and bone destruction in the anterior portion of
the ridges.) The amount of horizontal overlap is
determined by the jaw relationship; a few milli­
meters is the average for the Class I malocclu­
sion. The range can be from 0 mm (edge-to-
edge) for a severe Class III malocclusion to as
much as 12 mm for the extreme Class II mal­
occlusion. A vertical overlap for appearance
can be used, provided that an adequate hori­
zontal overlap is included to guard against inter­
ference, within the functional range.
9 8 ■ J A D A , V o l. 8 5 , J u l y 1 9 7 2
I
T he design or brand o f the modified posterior
teeth is not significant, so long as the cuspal in­
clination is zero. The occlusal surfaces o f sev­
eral brands o f posterior teeth are so cleverly
carved that to the patient they look as much like
natural teeth as the anatomic forms. Indeed,
one study13 showed some patients to be un­
aware o f an exchange o f anatomic teeth and zero
degree teeth.
The maxillary posterior teeth should be set
first. Before this is done, the occlusal plane
should be determined. A plane can be con­
sidered to be a line drawn to connect tw o points
in space. The anterior point is represented by
the incisal edges of the canines. Then, the deter­
mination o f the posterior point, as the articu­
lator is viewed from the side, is made (Fig 5).
Three factors determine the location o f that
point.
— It should result in an occlusal plane that
evenly divides the space between the upper and
lower ridges.
— It should provide an occlusal plane that
parallels the mean foundation plane.
— The occlusal plane should fall at the junc­
tion of the upper and middle thirds of the retro-
molar pads.
U sually, a harmonious relationship will be
found between these factors; if not, then the
dominant factor is the relationship of the occlu­
sal plane to the retromolar pad. After he has set
the anterior teeth, the unexperienced operator
may find it helpful to form the occlusal plane
with wax rims on the lower base that extend
from the distal side o f the canines to the retro-
molar pads. These rims should be slightly wider
than a molar tooth and must be flat buccolingual-
ly. A t this point, lines can be scribed, on the
occlusal surfaces o f the wax rims, that extend
from the distoincisal edges of the canines to
points on the cast, immediately back o f the buc-
colingual centers o f the retromolar pads.
The upper premolars and first molars then
are set to the upper base so that their central
grooves coincide with the line on the wax rim.
This is a tentative buccolingual position for
these teeth, and may be changed after the lower
posterior teeth are arranged.
The wax rim is removed and the lower teeth
are set to occlude with the upper teeth. The
anteroposterior relationship of a mandibular
tooth to its antagonist is not critical. The lower
teeth are placed buccolingually so that the cen­
tral grooves form a straight line that coincides
Fig 4 ■ Upper and lower anterior teeth set without vertical over­ Fig 5 ■ Diagram showing correct occlusal plane. Also shown
lap. are planes too high and low in relation to three factors dis­
cussed.

with the imaginary line from the distoincisal

angle of the canine to the buccolingual center of
the retromolar pad. The lower second molar is
placed in the same manner with its occlusal sur­
face on the occlusal plane (Fig 6).
The buccal overjet is not considered as the
lower teeth are being set but instead, the over­
jet is evaluated later. If the overjet is insufficient
to guard against cheek-biting, the upper poster­
ior teeth are moved more to the buccal aspect.
Such an arrangement favors the lower denture
at the expense of the upper one. The lower pos­
terior teeth are always directly over the crest of
the lower ridge, and the upper teeth are usually
to the buccal side of the upper ridge. This con­
dition is well tolerated because of the greater
retention of the upper denture. In extreme in­ Fig 6 ■ Occlusal view of lower posterior teeth. Central grooves
stances, the crossbite arrangement should be are in line with the distoincisal edge of the canine and center of
used. retromolar pad.

Usually the lower second molar will be placed

on the molar slope area, sometimes called “ skid
row.” In this instance, the occlusal surface of
the upper second molar would be set parallel to
the occlusal surface of the lower second molar,
but 2 mm above the occlusal plane, thus well
out of occlusion.
From the standpoint of lower denture stabil­
ity, the ideal position for a molar tooth would
be the center of the bearing area of the lower
ridge; this would result in a completely central­
ized occlusion. In the scheme o f occlusion des­
cribed, the occlusal forces are centralized to a
great degree. This arrangement might be des­
cribed as keeping the load amidships (Fig 7).
The primary purpose of anterior teeth is to
produce a desired appearance. The first and
second premolars and first molars masticate
food. The second molars are space fillers and do
not function. Without them, however, many
dentures have a vacant look in that region. They
may well be omitted whenever space is a prob­
lem.
P o s tp r o c e s s in g p r o c e d u r e s
Posterior teeth frequently migrate during pro­
cessing. For this reason, keyed casts should be
used so that, with the processed denture unre­
moved, they can be returned to the original
mounting plaster on the articulator. The amount
of processing error can be detected and the in­
cisal guide pin can be returned to the guide plane
with the aid of articulating paper and a heatless
stone.
If an accurate centric relation was recorded
by the use of the needle point tracer as shown in
Figure 8, a remount procedure, with use of a
new interocclusal record obtained from the pa-

J o n e s : M O N O P L A N E O C C L U S IO N F O R C O M P L E T E D E N T U R E S ■ 9 9
 Fig 7 ■Diagram of recommended occlusion, as viewed from
buccal side. It results in centralization of occlusal forces.
tient, will accomplish nothing. In fact, such a
procedure is as illogical as checking the accur­
acy of a micrometer measurement with a yard­
stick. H owever, the use of a Coble or Hardy
balancer at this point offers the bonus of an addi­
tional refinement of the occlusion.
T o o th m a teria ls
Experience in a school clinic, where complete
dentures with plastic teeth have been used ex­
clusively for 25 years, has shown the advantages
o f this material. Plastic anterior teeth can be
characterized more readily and thus have a bet­
ter appearance. The greatest advantage of plas­
tic posterior teeth is that they undergo wear in
function. Slight prematurities that may develop
because o f settling of the bases tend to be self-
eliminating during the normal period of useful­
ness o f the dentures.
For the rare patient who reports an inability
to masticate food with previous dentures, the
metal occlusal teeth of Hardy17 may be indi­
cated.'H ow ever, they appear to be more trau­
matic to supporting tissues.
C o n c lu s io n s
The complex denture procedures, associated
with the use of the highly adjustable articulators,
enjoyed widespread popularity in the past. It is
significant that all such aforementioned articu­
lators are no longer available.
Young2 also wrote in 1949, “ The necessity
for continued health and preservation o f oral
tissues places anatomic tooth forms in the exit
doorway, ready to be shoved out.” Twenty-
two years later, it could be added that the ana­
1 0 0 ■ J A D A , V o l. 8 5 , J u l y 1 9 7 2
Fig 8 ■Needle point tracing made with intraoral device. Al­
though complete movement in horizontal plane was recorded,
only point indicating extreme retrusion is used in suggested
technique.
tomic tooth forms have progressed to a point
half-way down the front steps, and that they
were preceded by the highly adjustable articu­
lators used for denture construction.
Dr. Jones is professor and chairman of the department of com­
plete prosthodontics, School of Dentistry, University of Missouri
at Kansas City. His address is 650 E 25th St, Kansas City, Mo
64108
1. Fedi, P.F., Jr. Cardinal differences in occlusion of natural
teeth and that of artificial teeth. JADA 64:482 April 1962.
2. Young, H.A. Diagnosis of problems in complete denture
prosthesis. JADA 39:185 Aug 1949.
3. Glossary of prosthodontic terms. J Prosthet Dent (Part 2)
10:9 Nov 1960.
4. Boucher, C.O., ed. Swenson’s complete dentures, ed 6.
St. Louis, C.V. Mosby Co., 1970, p 567.
5. Kurth, L.E. Mandibular movement and articulator occlu­
sion. JADA 39:37 July 1949.
6. DeVan, M.M. Personal communication, 1951.
7. Craddock, F.W. Accuracy and practical value of records
of condyle path inclinations. JADA 38:697 June 1949.
8. Boswell, J.V. Practical occlusion in relation to complete
dentures. J Prosthet Dent 1:307 May 1951.
9. Sears, V.H. Thirty years of nonanatomic teeth. J Prosthet
Dent 3:596 Sept 1953.
10. Levin, B., and Sauer, J.L ., Jr. Results of a survey of com­
plete denture procedures taught in American and Canadian den­
tal schools. J Prosthet Dent 22:171 Aug 1969.
11. Trapozzano, V.R. Tests of balanced and nonbalanced
occlusions. J Prosthet Dent 10:476 May-June 1960.
12. Jones, P.M. Efficient, nontraumatic posterior occlusion.
JADA 64:345 March 1962.
13. Brewer, A.A.; Reibel, P.R.; and Nasslf, N.J. Comparison
of zero degree teeth and anatomic teeth on complete dentures.
J Prosthet Dent 17:28 Jan 1967.
14. Jankelson, B.; Hoffman, G.M.; and Hendron, J.A. Physio­
logy of the stomatognathic system. JADA 46:375 April 1953.
15. Sears, V.H. Principles and technics for complete denture
construction. St. Louis, C.V. Mosby Co., 1949, p 274.
16. Craddock, F.W. Prosthetic dentistry; a clinical outline,
ed 2. St. Louis, C.V. Mosby Co., 1951, p 218.
17. Hardy, I.R. Developments in the occlusal patterns of arti­
ficial teeth. J Prosthet Dent 1:14 Jan-March 1951.