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.

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