Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis

Abstract

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.

Effect of different dental articulating papers on SEMG activity during maximum clenching

“…For example, specific drawbacks have been described in the literature for articulating papers: they range from poor association between mark size and occlusal load (Qadeer et al , 2012), to low-reproducibility of contacts or operator-variability (Kerstein, 2008). The moisture (saliva) of intraoral environment, or some smooth materials adopted for tooth restorations (i.e: gold, metal alloys or ceramics), along with a repeated use of the indicator, are also able to affect the ink-release from articulating paper and thus impair reproducibility of markings (Saracoglu and Ozpinar, 2002).…”

Identification of occlusal prematurity by clinical examination and cone-beam computed tomography

“…With so many variables there is a clear need for standardizing clinical examination as well as for keeping a constant search for additional resources that enhance information and provide more effective ways of reaching these goals (17)(18)(19).…”

The Dogma of occlusal paradigms: What do we really have figured out?

“…The authors concluded when clinicians select teeth to adjust, they should not assume the size of paper markings can reliably describe a contact's force content [1]. Qadeer et al [2] showed that the largest paper mark in a quadrant was on the most forceful tooth in that quadrant only 38.3% of the time. These findings indicate that the majority of the time, the largest paper mark in a quadrant is not the most forceful contact.…”