MUCOLABIAL FOLD IN IMPRESSION-MAKING
3. Friedman, S.: Edentulous impression procedures for maximum
retention and stability. J PROSTHETDENT 7:14, 1957.
4. Lott, F., and Levin, B.: Flange technique: An automatic and
physiologic approach to increased retention, function, comfort,
and appearance of dentures. J PROSTHETDENT 16~394, 1966.
5. Fry, K.: The retention of complete dentures. Br Dent J 44:97,
1923.
6. Moses, C. H.: Physical considerations in impression making. J
PROSTHETDENT 3~449, 1953.
7. Howland, C. A.: The retention of artificial dentures. Dent Digest
27~159, 19’1.
8. Stamoulis, S.: Physical factors affecting the retention of complete
dentures. J PROSTHETDENT 12:857, 1962.
9. Brill, N.: Factors in the mechanism of full denture retention-A
discussion of selected papers. Dent Pratt (Bristol) l&9, 1967.
10. Stanitz, J. D.: An analysis of the part played by the fluid film in
denture retention. J Am Dent Assoc 32:445, 1948.
11. Snyder, F. C., Kimball, H. D., Bunch, W. B., and Beaton, J. H.:
Effect of reduced atmospheric pressure upon retention of den-
tures. J Am Dent Assoc 32~445, 1945.
12. Tyson, K. W.: Physical factors in retention of complete upper
dentures. J PROSTHETDENT 18~90, 1967.
13. Skinner, E. W., and Chung, P.: The effect of surface contact in
the retention of a denture. J PROSTHETDENT 1:229, 1951.
The ala-tragus line in complete denture
prosthodontics
F. W. van Niekerk, B.D.S., D.D.S.,* V. J. Miller, B.Ch.D., B.Sc., M.R.I.C., C.Chem.,* and
R. E. Bibby, B.M.Sc., B.D.S., M.M.Sc., M.Dent.**
University of the Western Cape, Faculty of Dentistry, Tygerberg, Republic of South Africa
M any methods have been used to establish the
occlusal plane in complete denture prosthodontics. How-
ever, no single method seems to be fully accepted.‘z2
Anteriorly, esthetic considerations help define the occlu-
sal plane, and posteriorly the tongue, retromolar pad,
and Stenson’s duct are considered.1-5Some dentists bisect
the space between the residual ridges.6
The technique of using the ala-tragus line (Camper’s
line) to establish the occlusal plane is well docu-
mented.2,4~7-”However, definitions of the ala-tragus line
cause confusion, because the exact points of reference do
not agree. For example, the Glossary of Prosthodontic
TermslO states that the ala-tragus line runs from the
inferior border of the ala of the nose to the superior
*Senior Lecturer, Prosthetic Department.
**Professor and Head, Orthodontic Department.
THE JOURNAL OF PROSTHETIC DENTISTRY
14. Tilton, G. E.: The denture periphery. J PROWHET DENT 2:290,
1952.
15. Lammie, G. A.: The retention of complete dentures. J Am Dent
Assoc 55:502, 1957.
16. Edwards, L. F., and Boucher, C. 0.: Anatomy of the mouth in
relation to complete dentures. J Am Dent Assoc 29:331, 1942.
17. Barone, J. V.: Physiologic complete denture impressions. J
PROSTHETDENT 13~800, 1963.
18. Jacobson, T. E., and Krol, A. J.: A contemporary review of the
factors involved in complete denture retention, stability and
support. Part I: Retention. J PROSTHETDENT 49:5, 1983.
19. Jacobson, T. E., and Krol, A. J.: A contemporary review of the
factors involved in complete dentures. Part 11: Stability. J
PROSTHETDENT 49:165, 1983.
20. Jacobson, T. E., and Krol, A. J.: A contemporary review of the
factors involved in complete dentures. Part III: Support. J
PROSTHETDENT 49:306, 1983.
Rqmnt reques1s to:
DR. D. RAY MCARTHUR
UNIVEKSITYOF NORTH CAROLINA
SCHOOLOF DENTISTRY 209 H
CHAPEL HILL, NC 27514
border of the tragus of the ear, while Spratley’ describes
it as running from the center of the ala to the center of
the tragus; and Ismail and Bowman2 define it as a line
that passes from the ala of the nose to the center of the
tragus of the external auditory meatus. The latter plane
proved unsatisfactory in our prosthetic clinic, because
the plane thus established often allowed insufficient
space to arrange the maxillary molar teeth. Therefore,
the posterior reference point was dropped to the inferior
border of the tragus (Fig. 1). This article concerns the
relationship of the newly defined ala-tragus line to an
occlusal plane established with criteria that ignore the
ala-tragus line during jaw registration procedures.
MATERIAL AND METHODS
Thirty-three sets of complete dentures were made
with criteria other than the ala-tragus line used to
67

Fig. 1. Ala-tragus line with inferior border of tragus.
establish the occlusal plane. Patients were completely
satisfied with esthetics, function, and comfort. Lead foil
adapted to the right mandibular posterior teeth indicated
the occlusal plane. A strip of foil taped to the’ face
pointed at the inferior borders of the ala and tragus.
Lateral cephalometric radiographs were made of each
patient by a standard method and traced on acetate
paper to show the functional occlusal plane and the
ala-tragus line. All radiographs were made with the
teeth in centric occlusion (Fig. 2). The relationship
between the two planes was measured and the angle
between them given a positive value for posterior conver-
gence. Mean and standard deviation values were then
calculated for the relationship.
RESULTS
The angle formed by the functional occlusal plane and
the ala-tragus line had -a .mean of +2.45 degrees, a
standard deviation of 3.24 degrees, and a range of +8-to
-7.5 degrees. The mean difference between the planes
was 2.45 degrees with a standard deviation of 3.24
degrees. Such relatively narrow limits showed’s close
relationship between the two planes.
I3IscUSSK)N
It is easier for the less experienced dentist to use the
ala-tragus line rather than intraoral reference points
when the upper occlusion rim is trimmed to the occlusal
68
Y.&NNIEKERK, MILLER, AND UYEtB’r
Fig. 2. Foil strips show relationship between occlus~i
plane and ala-tragus line with teeth in centric occiir-
sion.
plane. Conflicting definitions of the ala-tragus line must
affect the usefulness of this technique. The location of
the posterior landmark of the ala-tragus line defined in
this article required investigation.
In this study, the ala-tragus line was ignored during
the jaw registrations and the try-in. The occlusal plane
of the dentures was checked against the ala-tragus line
only at the final visit. Results showed a close relationship
between the two planes.
It is interesting to speculate on the reason for the close
correlation between the two planes. A radiographic
investigation of the bony landmarks involved could
throw light on the question.
CONCLUSION
The ala-tragus line described in this article has a close
relationship with the occlusal plane and could be used as
a landmark when the maxillary occlusion rim is trimmed
to the occlusal plane. Positioning of the occlusal plane
depends on mature clinical judgment and must ultimate-
ly satisfy esthetics, function, and denture stability.
REFERENCES
1. Spratley, M. Ii.: A simplified technique for determining rhe
occlusal plane in full denture construction. 1 Oral Rehabil 73 1,
1980.
JANUARY 1985 VOLUME 53 NUMBER I
ALA-TRAGUS LINE
2. Ismail, Y. H., and Bowman, J. F.: Position of the occlusal plane
in natural and artificial teeth. J PROSTHET DENT !20:407,
1968.
3. Yasaki, M.: Height of the occlusion rim and the interocclusal
distance. J PROSTHETDENT 11:26, 1961.
4. Boucher, C. O., Hickey, J. C., and Zarb, G. A.: Prosthodontic
Treatment for Edentulous Patients, ed 7. St. Louis, 1975, The
C.V. Mosby Co.
5. Standard, S. G.: Establishing the plane of occlusion in complete
denture construction. J Am Dent Assoc 54845, 1957.
6. De Van, M. M.: An analysis of stress counter action on the part
of the alveolar bone with a view to its preservation. Dent Cosmos
77:109, 1935.
7. Landa, S. L.: Practical guidelines for complete denture esthetics.
Dent Clin North Am 21:289, 1977.
Studies of biologic parameters for denture design.
Part III: Effects of occlusal adjustment, base
retention, and fit on masseter muscle activity and
masticatory performance
Paul Perez, D.M.D.,* Krishan K. Kapur, D.M.D., M.D.,** and Neal R. Garrett, Ph.D.***
Veterans Administration Medical Center, Sepulveda, Calif.
lhe influence of denture factors on masticatory perfor-
mance is limited.le6 It was unexpected to find that neither
denture retention nor occlusal scheme affects the masti-
catory ability of denture wearers significantly. The
denture factors that did influence masticatory perfor-
mance were those related to the manipulation of food
during chewing. It is important to recognize that masti-
catory performance in these studies was measured mere-
ly in terms of the ability of denture wearers to pulverize
food. No attention was paid to the force or muscle effort
exerted by denture wearers during chewing.
Results of several studies indicate that poor masticato-
ry function in denture wearers may stem from altera-
tions in oral neuromuscular activity.‘-” An impairment
in the ability of denture wearers to discriminate particle
size and texture has been shown. A previous study also
revealed that integrated masseter muscle activity, record-
Presented at the 58th Annual Meeting of the American Association for
Dental Research, Los Angeles, Calif.
Supported by the Medical Service of the Veterans Administration.
*Staff Dentist and Adjunct Assistant Professor, University of Califor-
nia, School of Dentistry, Los Angeles, Calif.
**Chief, Dental Service, Professor-in-Residence, University of Cali-
fornia, School of Dentistry, Los Angeles, Calif.
***Staff Physiologist.
THE JOURNAL OF PROSTHETIC DENTISTRY
8. Sharry, J. J.: Complete Denture Prosthodontics, ed 3. New
York, 1974, McGraw-Hill Book Co., p 236.
9. Payne, S. H.: The trial dentures. Dent Clin North Am 21:326,
1977.
10. Academy of Denture Prosthetics: Glossary of Prosthodontic
Terms. St. Louis, 1977, The C.V. Mosby Co.
Refmnt request, to:
DR. F. W. VAN NIEKERK
UNIVERSITYOFTHE WESTERNCAPE
ORAL AND DENTAL TEACHING HOSPITAL
FACULTYOF DENTISTRY
PRIVATE BAG Xl2
TYCERBERC7505
REPUBLICOF SOUTH AFRICA
ed during chewing of test foods, was markedly less in
denture wearers than in subjects with natural denti-
tion.” It was hypothesized that the reduced muscle effort
applied by denture wearers might contribute to their
diminished chewing ability.
The present study was undertaken to determine the
effects of denture base fit and occlusal correction on the
masseter muscle activity during chewing and the rela-
tionship between the electromyographic (EMG) activity
and masticatory performance.
METHODS
Twenty denture wearers, ranging from 46 to 80 years
of age (g = 62.7 years), were selected from the patient
population of the Veterans Administration Medical
Center in Sepulveda, Calif. The total complete denture
experience for patients ranged from 2 to 46 years
(Z = 22.5 years). Subjects were screened to be healthy
through a medical history and examination of the oral
cavity. Each denture was assessedseparately for reten-
tion and stability on a four-point ordinal scale. The
maxillary and mandibular dentures were evaluated
together on a three-point scale separately for the vertical
and horizontal occlusal relationships. Similarly, the
ridge shape and size, mucosal consistency, and location
69