Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis
01 Feb 2012-The Journal of Advanced Prosthodontics (The Korean Academy of Prosthodontics)-Vol. 4, Iss: 1, pp 7-12
TL;DR: The findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment Occlusal adjustments.
Abstract: PURPOSE Articulation paper mark size is widely accepted as an indicator of forceful tooth contacts. However, mark size is indicative of contact location and surface area only, and does not quantify occlusal force. The purpose of this study is to determine if a relationship exists between the size of paper marks and the percentage of force applied to the same tooth. MATERIALS AND METHODS Thirty dentate female subjects intercuspated into articulation paper strips to mark occlusal contacts on their maxillary posterior teeth, followed by taking photographs. Then each subject made a multi-bite digital occlusal force percentage recording. The surface area of the largest and darkest articulation paper mark (n = 240 marks) in each quadrant (n = 60 quadrants) was calculated in photographic pixels, and compared with the force percentage present on the same tooth. RESULTS Regression analysis shows a bi-variant fit of force % on tooth (P<.05). The correlation coefficient between the mark area and the percentage of force indicated a low positive correlation. The coefficient of determination showed a low causative relationship between mark area and force (r(2) = 0.067). The largest paper mark in each quadrant was matched with the most forceful tooth in that same quadrant only 38.3% of time. Only 6 2/3% of mark surface area could be explained by applied occlusal force, while most of the mark area results from other factors unrelated to the applied occlusal force. CONCLUSION The findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment occlusal adjustments.
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TL;DR: The reported low scores obtained from a large group of participant dentists suggest clinicians are unable to reliably differentiate high and low occlusal force from looking at articulating paper marks, suggesting this longstanding method of visually observing articulate paper marks for occluse force content should be replaced with a measurement-based, objective method.
Abstract: Aims:The aim of this study was to determine whether Subjective Interpretation of paper markings is a reliable method for identifying the relative occlusal force content of tooth contacts.Methodology:295 clinicians selected the “Most Forceful” and “Least Forceful” occlusal contacts in six occlusal-view photographs of articulating paper marks that were later compared against computerized occlusal analysis relative occlusal force measurements of the same tooth contacts. Means and standard deviations were calculated by years in clinical practice and by number of occlusion courses taken. A Chi-square analysis was also performed.Results:The mean correct for 295 participant dentists was 1·53 (±1·234). There were no significant differences found for years in practice (P>0·16) or number of occlusion courses taken (P>0·75). The Chi-square analysis showed a sensitivity of 12·6%, a specificity of 12·4%, a positive predictive value of 12·58%, and a negative predictive value of 12·42%. Chance was calculated at ...
79 citations
TL;DR: According to the evidence available, the computerized occlusal analysis system is the only Occlusal indicator that demonstrates the ability to provide quantifiable force and time variance in a real-time window from the initial tooth contact into maximum intercuspation.
Abstract: Background: All disciplines of dentistry require that clinicians assess the articulation of the teeth/prosthesis with respect to simultaneous contacts, bite force and timing.Aims: This article intends to describe the advantages and limitations of the data acquired when using a computerized occlusal analysis as a dynamic occlusal indicator.Methodology: A search of the literature was completed (Medline, PubMed) using the keywords occlusion, occlusal registration, computerized occlusal analysis and T-Scan for dental.Results: According to the evidence available, the computerized occlusal analysis system is the only occlusal indicator that demonstrates the ability to provide quantifiable force and time variance in a real-time window from the initial tooth contact into maximum intercuspation.Conclusion: The reported advantages to accurately indicate occlusal contacts make the computerized occlusal analysis system a better occlusal indicator when compared with other non-digital convention indicator mater...
69 citations
TL;DR: Among the dynamic occlusal parameters evaluated centric slide and balancing side interferences were found to be highly influential in TMD etiology.
Abstract: Context: Dental researchers are contradictory in their opinion on the role of occlusion in TMD. Occlusal evaluation of both conventional and digital methods in TMD patients will provide the accurate information about the factors accountable for occlusal instability. Identifying the factors responsible will facilitate precise diagnosis and treatment for TMD.
Aim: The Aim of the study was to determine the dynamic occlusal parameters strongly associated with the etiology of Temporomandibular disorders.
Material and Methods: Study group consisted of 100 patients; it included 50 patients with normal TMJ(Group I) and remaining 50 patients had a minimum of one positive sign or symptom of Temporomandibular disorder (GroupII). The patient’s dynamic occlusal contacts were evaluated by both conventional and digital methods. The Articulating paper was utilized for conventional occlusion analysis. During conventional analysis centric, lateral and protrusive interferences were evaluated along with loss of vertical dimension. Digital occlusal analysis was performed with T-Scan III. Clusion time, disclusion times were recorded for both groups.
Chi-square and Student‘t’ statistical analyses were performed to ascertain the association and statistically significant difference between the groups using SPSS19.
Results: Group II patients predominantly (66%)had Group-function occlusion compared to Group I subject. Centric slide more than 2 mm found to have strong influence (p value 0.008) on the etiology of TMD. Among the occlusal interferences evaluated balanced side interferences had a strong correlation with TMD with p-value of 0.003. Working side interferences, protrusive interferences had a p-value of 0.157, 0.826 respectively, indicating weak association. T-Scan analysis showed Group I had 0.689, 0.9136, 0.7952, 0.9794 seconds of clusion, left, right, protrusive disclusion time respectively compared to corresponding 1.862, 1.7995, 1.6978, 1.9296 seconds for Group II. Statistically significant difference (p≤0.05) was found between the mean values of both groups.
Conclusion: Among the dynamic occlusal parameters evaluated centric slide and balancing side interferences were found to be highly influential in TMD etiology. TMD patients had prolonged clusion and disclusion times compared to healthy TMJ patients.
51 citations
Cites background from "Relationship between articulation p..."
...Studies have reported that no demonstrable relation between paper mark area and occlusal force [8]....
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TL;DR: T-Scan is good for assessing occlusion discrepancies and can be used to portray the pre- and post-operative occlusal contact distribution during treatment planning and follow-up, and was better after surgery than before surgery.
Abstract: Dental occlusion varies among individuals, and achieving correct physiological occlusion after osteotomy is essential for the complex functioning of the stomatognathic system. The T-Scan system records the centre of force, first contact, maximum bite force, and maximum intercuspation. The aim of the present study was to investigate the usefulness and consistency of T-Scan in assessing occlusion before and after orthognathic surgery. Occlusal information was evaluated for 30 healthy adults with normal occlusion and 40 patients undergoing orthognathic surgery. T-Scan had a high degree of reliability for consecutive measurements (Pearson correlation, r = 0.98). For most parameters, occlusal distribution was better after surgery than before surgery. More teeth contributed to occlusion at maximum intercuspation after surgery than before surgery (14 vs. 10). In addition, the difference in the posterior force distribution was reduced after surgery (17.6 ± 13.8 vs. 22.7 ± 21.4 before surgery), indicating better occlusal force distribution after surgery. The maximum percentage force on teeth (p = 0.004) and the number of teeth contributing to occlusion (p < 0.001) also differed significantly. Thus, T-Scan is good for assessing occlusal discrepancies and can be used to portray the pre- and post-operative occlusal contact distribution during treatment planning and follow-up.
42 citations
TL;DR: A significant occlusal force discrepancy was found in the post-orthodontic subjects, with higher force percentages observed posteriorly and much less percentage force anteriorly, when compared to the natural dentition subjects.
Abstract: Objective: Balanced occlusal force distribution is a critical factor for restorative, prosthetic or orthodontic treatment. It has been postulated that orthodontic treatment may lead to occlusal discrepancies in the arch due to changing the occlusal relationships. This study was conducted to compare the occlusal force parameters between natural dentition patients and a post-orthodontic treatment group.Method and Materials: Fifty Thai subjects were divided into non-orthodontic and post-orthodontic groups comprised of 25 subjects each (mean age 24.8 years). The T-Scan® III computerized occlusal analysis system was used to record a multi-bite closure for each subject. The initial occlusal contact location, the bilateral percentage force distribution, the percentage force in the anterior and posterior quadrants, and the individual tooth force percentages were calculated for both groups. The Student’s Paired t-Test compared the in-group differences, while a one-way ANOVA analyzed the differences between the two...
41 citations
References
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Book•
01 Jan 1989
TL;DR: Diagnostic Algorithms for Masticatory Muscle Disorders and Temporomandibular Joint Disorders and Restorative considerations in occlusal therapy are presented.
Abstract: PART I: Functional Anatomy 1. Functional anatomy and biomechanics of the masticatory system 2. Functional neuroanatomy and physiology of the masticatory system 3. Alignment and occlusion of the dentition 4. Mechanics of mandibular movement 5. Criteria for optimum functional occlusion 6. Determinants of occlusal morphology PART II: Etiology and Identification of Functional Disturbances in the Masticatory System 7. Etiology of functional disturbances in the masticatory system 8. Signs and symptoms of temporomandibular disorders 9. History of and examination for temporomandibular disorders 10. Diagnosis of temporomandibular disorders PART III: Treatment of Functional Disturbances of the Masticatory System 11. General considerations in the treatment of temporomandibular disorders 12. Treatment of masticatory muscle disorders 13. Treatment of temporomandibular joint disorders 14. Treatment of chronic mandibular hypomobility and growth disorders 15. Occlusal appliance therapy 16. Treatment sequencing PART IV: Occlusal Therapy 17. General considerations in occlusal therapy 18. Use of articulators in occlusal therapy 19. Selective grinding 20. Restorative considerations in occlusal therapy Appendix Diagnostic Algorithms for Masticatory Muscle Disorders and Temporomandibular Joint Disorders
1,404 citations
Book•
31 Jul 2006
TL;DR: １ 機能的調和（完全な歯科医療の概念；咬合の展望と““日常歯 科臨床”：�ara合病 ほか）
Abstract: １ 機能的調和（完全な歯科医療の概念；咬合の展望と“日常歯科臨床”；咬合病 ほか） ２ 機能障害（ＴＭＤの鑑別診断；咬合‐筋障害；顎関節内障 ほか） ３ 治療（咬合の安定のための要件；規格化された治療計画の立案に基づく咬合問題の解決法；診断用ワックスアップ ほか）
376 citations
Book•
01 Jan 1997
TL;DR: Part 1 Biologic principles and interactive jaw mechanics: form and function - development of mandibular form, morphology and mechanism of the jaw joint jaw muscle structure and function, neural control of oral behaviour and its impact on occlusion.
Abstract: Part 1 Biologic principles and interactive jaw mechanics: form and function - development of mandibular form - phylogeny, ontogeny, and function, morphology and mechanism of the jaw joint jaw muscle structure and function, neural control of oral behaviour and its impact on occlusion, the dynamics of occlusal relationships, supporting structures and dental adaptation growth and development - effect of function on growth and remodelling of the TMJ, macromelecular components of connective tissues and their roles in determining tissue mechanical properties, effect of the physical environment on growth of the TMJ relationship between growth, function, and stress in the TMJ, adaptive changes in mandibular muscles during postnatal development biomechanics - engineering principles and modelling strategies, in vivo bone strain patterns in the craniofacial region of primates simulated physics of the human mandible, computer simulations of jaw biomechanics, biomechanical and biomaterial considerations of root-form dental implants tissue responses - connective tissue response to mechanical stimulation, disc displacement internal derangements, biology of TMJ degeneration - role of matrix-degrading enzymes, distribution of local and general stresses in the stomatognathic system. Part 2 Clinical considerations for a favourable tissue response: decision-making and biologically based treatment goals - maxillomandibular relationships - mandibular asymmetry, occlusion, and imaging, clinical decision-making in occlusion - a paradigm shift, fundamental treatment goals baseline records and diagnostic tests - history and examination, mounted study casts and cephalometric analysis, maxillofacial imaging, jaw tracking and temporomandibular joint animation problem solving and treatment planning - interocclusal appliances - do they offer a biologic advantage? role of occlusion in periodontal disease, selective tooth grinding and equilibration, fundamental occlusal therapy considerations restorative and prosthodontics therapy - occlusal considerations for complex restorative therapy occlusal considerations in complete dentures, masticatory performance measures for maxillofacial prosthodontics, occlusion and crestal bone resorption - etiology and treatment planning strategies for implants orthodontic and related surgical therapy - long-term stability of mandibular orthopaedic repositioning, gnathologic considerations for orthodontic therapy, occlusal considerations for orthognatic surgery.
161 citations
TL;DR: No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load.
Abstract: Articulating paper mark size has been widely accepted in the dental community to be descriptive of occlusal load. The objective of this study is to determine if any direct relationship exists between articulating paper mark area and applied occlusal load. A uniaxial testing machine repeatedly applied a compressive load, beginning at 25N and incrementally continuing up to 450N, to a pair of epoxy dental casts with articulating paper interposed. The resultant paper markings (n = 600) were photographed, and analyzed the mark area using a photographic image analysis and sketching program. A two-tailed Student's t-test for unequal variances compared the measured size of the mark area between twelve different teeth (p < 0.05). Graphical interpretation of the data indicated that the mark area increased non-linearly with increasing load. When the data was grouped to compare consistency of the mark area between teeth, a high variability of mark area was observed between different teeth at the same applied load. The Student's t-test found significant differences in the size of the mark area approximately 80% of the time. No direct relationship between paper mark area and applied load could be found, although the trend showed increasing mark area with elevating load. When selecting teeth to adjust, an operator should not assume the size of paper markings, accurately describing the markings' occlusal contact force content.
133 citations
"Relationship between articulation p..." refers background in this paper
...The inclusion criteria for the subjects were: (1) Class I Angles’classification with normal occlusal relations (2) Presence of existing anterior tooth contact (3) Presence of healthy non-crowned premolars in the maxillary arch with contacting lower counterparts (4) Presence of healthy first and second non-crowned molars in the maxillary arch with contacting lower counterparts Exclusion criteria were: (1) Presence of an anterior open occlusion (2) Presence of a Class II and III malocclusion (3) Presence of a deep overbite (4) Presence of chronic bruxism (5) Presence of TMD symptomotology (6) Presence of healthy non-crowned premolars present in the maxillary arch (7) Absence of healthy first and second non-crowned molar present in the maxillary arch (8) Absence of contacting lower molar and premolar counterparts (9) Presence of orthodontic appliances The presence or absence of third molar was not a criteria considered in the study....
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TL;DR: Indicators vary, and their markings may not be repeatable even when they are used alike, and the development of an indicator measuring standard is required.
Abstract: Background Dentistry needs an accurate means of recording occlusal contacts. The authors undertook a study to evaluate the accuracy of occlusal contact marking indicators and the reproducibility of their results. Methods The authors recorded occlusal contact areas using occlusal indicators made of paper, film and silk. They studied 10 indicators by testing them on articulator-mounted, impact-resistant casts and measuring the surface area of the resultant contact marks made on impact using a video camera, a frame grabber and a computer-linked image analyzer. Results All indicators differed in surface area markings between and within groups. The indicator's thickness and color and the material from which it was made separately and interactively had an effect on the size of the markings. Measurements were evaluated at a P = .05 significance level. The authors used Bonferroni-adjusted cutoffs when computing post hoc pairwise comparisons. The data were grouped into four categories: descriptive statistics, comparison of indicators by surface area marked, indicator thickness and repeatability. Conclusions Indicators vary, and their markings may not be repeatable even when they are used alike. Further study is required, as is the development of an indicator measuring standard. Clinical Implications Indicators are used to determine occlusal disharmony and to establish occlusal harmony. Since the accuracy of the markings can be questioned, the interpretation of the markings may be correct but the accuracy of the markings themselves may be misleading.
96 citations
"Relationship between articulation p..." refers background in this paper
...The inclusion criteria for the subjects were: (1) Class I Angles’classification with normal occlusal relations (2) Presence of existing anterior tooth contact (3) Presence of healthy non-crowned premolars in the maxillary arch with contacting lower counterparts (4) Presence of healthy first and second non-crowned molars in the maxillary arch with contacting lower counterparts Exclusion criteria were: (1) Presence of an anterior open occlusion (2) Presence of a Class II and III malocclusion (3) Presence of a deep overbite (4) Presence of chronic bruxism (5) Presence of TMD symptomotology (6) Presence of healthy non-crowned premolars present in the maxillary arch (7) Absence of healthy first and second non-crowned molar present in the maxillary arch (8) Absence of contacting lower molar and premolar counterparts (9) Presence of orthodontic appliances The presence or absence of third molar was not a criteria considered in the study....
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