Clinical Strategies to Improve the Accuracy of Articulating Paper for Detecting Occlusal Contact Points in Adults with Natural Dentitions

Abstract

Background/Objectives: This clinical study assessed the validity of articulating paper for detecting occlusal contacts points, including examining the effects of clinical technique, paper thickness, and the arch. Methods: This cross-sectional test–retest study included 32 adults with natural dentitions. Four occlusal registrations were obtained from each participant using articulating paper with a thickness of 100 or 200 μm, applying one of two different clinical techniques (holding in place or pulling with forceps at the intercuspal position), and scanning the occlusal surfaces of their mandibular and maxillary arches. Silicone registrations were obtained and used as the reference standard. Mandibular and maxillary images were scaled and calibrated spatially, and two new images were created based on the sum or the areas of coincidence between the mandibular and maxillary occlusal scheme. Occlusal contact points on the right posterior teeth were analyzed using computer software. Results: The articulating paper produced true-positive contacts in 81% and false-positive contacts in 15%, regardless of the method used. Considering occlusal contact when marks matched on both arches accounted for 2.0% of false-positive contact points. General linear models with repeated measures revealed that the mandibular arch offered a higher true-positive percentage than the maxillary arch, that the 100 µm-thick paper produced higher false-positive contacts (20.6%) than the 200 µm-thick paper (9.4%), and that the pulling technique had no significant effect. Conclusions: Articulating paper offers good validity when detecting occlusal contact points and can be improved by using 200 µm articulating paper and exploring both arches.