PURPOSEArticulation 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 METHODSThirty 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.RESULTSRegression 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 (r2 = 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.CONCLUSIONThe findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment occlusal adjustments.
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 materials available.
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. T-Scan® III digital occlusal analysis may be recommended for orthodontic case finishing, to make visible to the clinician the severity of the orthodontically created occlusal force imbalance, such that it can be minimized during orthodontic case finishing.
Significantly longer disclusion time, higher posterior frictional contacts, and more TMD symptoms were observed in the post-orthodontic group, suggesting that orthodontic treatment increases posterior tooth friction. Computerized occlusal analysis is an objective diagnostic tool determining the quality of excursive movements following orthodontic treatment.
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