A Simple Technique to Fabricate Custom Made

Occlusal Plane Template

Muley BY, Patil PG, Khalikar AN, Puri SB.
Journal of Indian Prosthodontic Society (December 2014)
SPECIFIC LEARNING OBJECTIVES

Serial Learning Objectives Domain Significance

No.
1. Technique Cognitive & Must know
Psychomotor
2. Discussion Cognitive & Must know
Psychomotor
3. Critical Analysis Psychomotor Must know
CONTENTS

“
 Introduction

 Technique

 Discussion

 Conclusion

 References
 INTRODUCTION

SINGLE COMPLETE DENTURE

▷ The making of a maxillary or mandibular denture as distinguished from a set of

complete dentures. – GPT 1

▷ A complete denture that occludes against some or all of the natural teeth, a fixed

restoration, or a previously constructed removable partial denture or a complete

denture. - Winkler
▷ There can be two scenarios;

○ Maxillary edentulous arch opposing mandibular teeth

○ Mandibular edentulous arch opposing maxillary teeth

▷ The first scenario is more frequently encountered.

▷ Construction can be a real challenge, especially when the opposing natural teeth do
not provide for the harmonious occlusion necessary to achieve adequate stability of
the denture.

▷ The natural dentition should be recontoured especially if

○ The inclination of the existing occlusal plane is unfavorable
○ The teeth have supra-erupted to disproportionate heights
○ There are excessively steep cuspal inclines.
▷ The plane of occlusion represents the average curvature of the occlusal surfaces of

anterior and posterior teeth rather than a flat surface.

▷ According to GPT9, the Occlusal Plane is the average plane established by the

incisal and occlusal surfaces of the teeth; generally, it is not a plane but represents

the planar mean of the curvature of these surfaces.

▷ The position of posterior teeth is determined by an anteroposterior curve, the
curve of Spee and the mediolateral curve, the curve of Wilson.

▷ An uneven alignment of the natural teeth is often seen in patients.

▷ The causes of this uneven dentition may be any one or combination of the
improper eruption, shape, position or abrasion of the teeth.
▷ Several methods exist where the occlusal adjustments which are necessary can be
experimentally determined before any adjustments are made in the mouth.

 Swenson (1964) :
• Involves proceeding to the stage of recording a provisional centric
relation without making any adjustments to the natural occlusion.
• Time consuming if it needs several impressions and mountings before the
occlusion is finalized.
 Yurkstas (1968) :
• Method of assessing the amount of occlusal adjustments of the natural teeth
involving the use of a U-shaped curved metallic occlusal template.
 Bruce (1971) :
• Described a technique for predetermining the amount of occlusal adjustment
of natural teeth.
• Mounting of lower diagnostic cast.
• Clear acrylic resin template fabricated
• Necessary modifications marked on the stone cast.
▷ Boucher (1975) :

• Involves making the natural teeth fit to the established plane and inclines of

the maxillary porcelain teeth.

• Mounting of cast on the articulator.

• The maxillary artificial teeth are arranged to obtain the best possible

occlusal balancing contacts.

• Denture is processed, a comparison of the natural teeth and the altered

stone cast is made and the areas to be reshaped are noted and are ground.
 Broadrick occlusal plane analyser (BOPA)
▷ Broadrick’s Occlusal Plane Analyzer is a flag-like component attached superiorly
to the upper member of an articulator.

▷ The technique incorporates Monson’s spherical theory of occlusion to develop the

occlusal plane.

▷ The Broadrick Flag facilitates the construction and evaluation of the Curve of
Spee and Wilson.
▷ The Broadrick’s Occlusal Plane Analyzer consists of :
1. Card Index.
2. Bow Compass with graphite leads with an extra center point and needle
point.
3. Scribing knife.
4. Plastic Record cards.
 ▷ In this technique a compass is used to scribe two intersecting arcs with a
four-inch radius in which the centers of rotation are located at the canine
cusp tip and the distobuccal cusp tip of the second molar.

▷ The point of bisection of the arcs that are scribed on the Broadrick analyzer
determines the center of rotation for the arc with a four inch radius that
determines the occlusal plane

Gupta R, Luthra RP, Sheth HH. Broadrick’s occlusal plane analyzer: A review. International Journal of Applied Dental Sciences. 2019;5(1):95-8.
▷ Alsaileek et al in 2019 conducted a study in which they compared the Broadrick
flag method and Yurkstas method in assessment of mandibular over erupted teeth.

▷ The Broadrick Flag method produced occlusal curve closely approximated the
natural occlusal curve and may be considered as an acceptable alternative for
providing Curve of Spee.

▷ Yurkstas Metal Occlusal Template is more conservative than Broadrick Flag

Occlusal Plane Analyzer and it is commonly used for the analysis and correction of
the plane of occlusion.
Alsaileek Z, Alqurayqiri N, Elsamahi M. Comparison between Broadrick flag Vs Yurkstas metal occlusal template in the assessment of
mandibular Over-erupted teeth. SRM J Res Dent Sci 2019;10:187-93
PURPOSE STATEMENT

▷ This article describes a simple procedure to fabricate a transparent

occlusal plane template made of thermoforming polymethyl methacrylate

to address the non-transparency of Yurkstas metal occlusal plane

template.
 “
TECHNIQUE
▷ A polymer ball of 8 inches diameter was selected which simulates Monson
sphere.

▷ A single thickness baseplate wax sheet was rolled into the shape of a normal
dentulous-cast base and secured on the surface of the ball to make a mould.
▷ Type III gypsum material was poured into this wax-box to make a concave
stone-form

▷ This concave stone-form could be used to fabricate Occlusal Plane Template

(OPT) of different shapes according to individual arch symmetry.
▷ A 2 mm thick, rigid, transparent pressure-

thermoforming polymethyl methacrylate

(PMMA) plate was selected to fabricate the

OPT.

▷ The PMMA plate was adapted on the concave

stone form by using heat and pressure molding

machine by using the program setting code of

the PMMA plate.

▷ The adapted PMMA plate from the stone form was separated with care
without any damage to the stone-form.

▷ The PMMA plate was trimmed to outline the template in the shape of a
mandibular arch (U shape) to fabricate the OPT.
▷ Finally the trimmed OPT can be used to evaluate the irregular and uneven
occlusal plane.
 “
DISCUSSION
▷ Modification of Yurkstas technique.

▷ Occlusal plane correction in Maxillary single complete denture.

▷ The occlusal plane needs to be developed in a harmonious relation so that a

balanced occlusion can be achieved to maintain good bilateral stability of the
single complete denture.
▷ Lack of occlusal balance usually results in several clinical problems such as
denture instability, mucosal soreness and accelerated ridge resorption.

▷ Easy to fabricate and visualisation of contacts.

▷ This occlusal template overcomes the major disadvantage i.e. non-transparency

of the Yurkstas metal occlusal template.
 “
OTHER TECHNIQUES
▷ In 1996, using of a polyvinyl siloxane prosthetic template, natural dentition can
be reduced to a more favorable plane, that facilitated denture construction.

▷ Eliminate the risk of arbitrary grinding and minimize guesswork through guided
intraoral reduction.
▷ In 2008, used the metal occlusal template as reference and fabrication of a
custom occlusal plate using thermoplasticized resin.
▷ In 2018, used a volleyball with a circumference of 65–67 cm and diameter of
approximately 20.7 cm (8.1 in.) that was close to that of the Monson’s (8
inches diameter).

▷ Thermoforming polymethyl methacrylate.

▷ The author has well explained the technique with appropriate photographs.

▷ The major advantage of this technique is its better visualisation due to

transparency of the template.

▷ Customised template needs to be fabricated for every patient.

CONCLUSION
▷ The use of Occlusal Plane Template aids the clinician in the development of a
harmonious occlusal plane from a deranged one.

▷ The OPT can be used during pre-treatment and planning stages on a stone-
cast as well as used during treatment directly intra-orally.

▷ The technique of fabrication of the OPT described in this article results in a

quick, easy, adjustable and very cost-effective way.

▷ Furthermore, the OPT fabricated is made of a transparent material which

allows better visualization of progress during planning and treatment phases.
REFERENCES
▷ Winkler S, editor. Essentials of complete denture prosthodontics. Year Book Medical Pub; 1988.
2nd Edition, Chapter 46: 417-426.
▷ Sharry JJ (1974) Complete denture prosthodontics, 3rd edn. McGraw-Hill, New York, 313–314
▷ Dawson PE (1989) Evaluation, diagnosis and treatment of occlusal problems, 2nd ed. Elsevier,
St Louis, pp 85, 373–381.
▷ Zarb GA, Bolender CL, Hickey JH, Carlsson GE. Single complete dentures opposing natural
teeth. Boucher’s treatment for edentulous patients. 10th ed, St Louis: The CV Mosby Co,
1990:563-73.
▷ Heartwell CM. Syllabus of complete denture.4th ed. Philalea & Febiger,1986:487-97.
▷ The glossary of prosthodontic terms 9th ed. J Prosthet Dent 2017,94:10–92
▷ Muley BY, Patil PG, Khalikar AN, Puri SB. A simple technique to fabricate custom made
occlusal plane template. The Journal of Indian Prosthodontic Society. 2014 Dec 1;14(1):334-6.
REFERENCES
▷ Foong KW, Patil PG. Fabrication of maxillary single complete denture in a patient with deranged
mandibular occlusal plane: A case report. The Saudi dental journal. 2019 Jan 1;31(1):148-54.
▷ Alsaileek Z, Alqurayqiri N, Elsamahi M. Comparison between Broadrick flag Vs Yurkstas metal
occlusal template in the assessment of mandibular Over-erupted teeth. SRM J Res Dent Sci
2019;10:187-93.
▷ Gupta R, Luthra RP, Sheth HH. Broadrick’s occlusal plane analyzer: A review. International
Journal of Applied Dental Sciences. 2019;5(1):95-8.
▷ Bruce RW. Complete dentures opposing natural teeth. Journal of Prosthetic Dentistry
1971;26:448-55.
▷ Javid N, Esquivel JF. Polyvinyl siloxane template aids in recontouring natural teeth opposing
single dentures. The Journal of prosthetic dentistry. 1996 Sept 1;76(3):325-6.
▷ Baker PS, Londono J. Method for fabrication of a custom occlusal template. Journal of Prosthetic
Dentistry. 2008 Jun 1;99(6):492-3.
THANK YOU!!