Technological Innovation and Dental Medicine

New paradigms brought on by technological advances offer fresh perspectives and solutions to old problems. As an example, the Hubble telescope is a technological advance that changed humanity’s perception of the universe. Concepts evolve over years or decades, and sometimes over centuries. Technology can validate concepts developed by master teachers of the past, not by seeking to change the definition or the parameters of a concept, but rather to provide undeniable proof of a concept’s inherent soundness.

Relative Occlusal Force Measurement as an Advance in Dental Occlusion

Experience and clinical observation teach that an occlusion can adapt and change. Measuring the force of an occlusal contact that has been generated by the envelope of function over time, illustrates where, when, why, and how adaptation to the applied force has occurred within the stomatognathic system. The resultant occlusal force patterns tell the story about the occlusion’s past, dictates treatment in the present, and predicts the survivability of the occlusion going forward into the future. Digital force recordings are simple to take, require less than a minute to complete, do not emit radiation, and require as little as 100 KB of storage to maintain.

Qualitative interpretation of articulating paper ink marks made by the clinician has been the accepted Standard of Care. Dentists use articulating ink to mark the occlusal contacts in vertical and horizontal directions, but the real question for clinicians to consider is, “what do the colored marks truly describe?” Current research is showing clearly that paper markings do not correlate to force levels, which is contrary to what has been advocated and widely accepted for a very long time. And, this method has recently come under scientific scrutiny as being highly inaccurate. A Subjective Interpretation study performed with 295 practicing dentists reported that older, more experienced practitioners demonstrated no better skills at choosing forceful occlusal contacts than did younger, less experienced clinicians. More importantly, the studies showed that when dentists observe articulating paper markings to choose high and low force occlusal contacts, they will choose incorrect contacts 77 to 95% of the time when basing their contact selections on the appearance characteristics of the paper marking.

As an alternative to the subjective interpretation of articulating paper markings, digital force scans can clarify which colored articulating paper markings are the truly problematic contacts by grading the occlusal contacts to 256 differing levels of relative occlusal force. This method objectively determines the contacts that are time-premature, or possess occlusal force excess.

In the past, the art and science of measuring oral articulations and cycles of repetitive occlusal contact depended solely on the skill and knowledge of clinicians who interpreted what the colored ink that was transferred onto the occlusal surfaces of teeth meant clinically. A digital force pattern added to an articulating paper marking’s appearance will either validate the original diagnosis or offer an alternative thought process, because of the clinical visualization of the additional relative occlusal force data. Articulating paper has value in marking the occlusal contacts, but computer generated occlusal force measurements divide and organize the differing contact points into accurate, meaningful information that is not available to the clinician who solely relies on traditional ink markings. Digitally, the occlusal contact forces are represented to the clinician by colored pixels and columns that form the building blocks of a 3-Dimensional occlusal force video which greatly improves the study of a patient’s occlusion.

Digital Occlusal Force Measurement as Part of a Comprehensive Patient Exam

The diagnosis made from a comprehensive oral health assessment is usually multifactorial. Three components of a comprehensive oral exam are diagnosing how teeth occlude, how healthy is the supportive anatomy, and how efficient is a patient’s ability to function. Alternatively, subjective ink interpretation limits the profession’s ability to translate ink markings into meaningful force information. Recorded occlusal force data studied over time can be obtained from any patient, taken at any age in their occlusion’s evolution. The ultimate goal could become to turn comprehensive oral exams into clinical opportunities that prevent, or limit pathology from further compromising stomatognathic system anatomic structures.

Digital occlusal force scans often illustrate violations of sound occlusal force distribution that challenge the anterior and condylar guidance, while exposing the existence and locations of forceful, prolonged, and premature occlusal interferences. This information will likely transform the clinicians’ diagnostic skills, and motivate them to update their practice business model to provide patient’s with faster, more accurate, and higher-quality occlusal services.

The addition of the T-Scan computerized occlusal analysis system to the comprehensive examination gives clinicians:

• A diagnostic tool capable of predicting impending occlusal force problems that, once isolated, can be prevented with targeted intervention
• A precision tool for identifying problematic occlusal contact points
• An orientation tool that accurately pinpoints areas within the dental arches where the anatomy is stressed by excess occlusal force and might lead to altered mandibular function
• A documentation  tool that collects and stores occlusal force and timing measurements for future comparison
• An educational tool for doctors, staff, and patients
• A communication tool effective at boosting case acceptance by motivating patients to accept treatment
• A monitoring tool that measures occlusal force changes over time
• A treatment tool that measures immediate and long-term occlusal intervention results
• A practice-enhancement tool
• A digital upgrade to traditional analog articulating paper interpretation.