Cheong Chan W, Radomski Kyle, Otten James, Lee Sang J
Advanced Graduate Prosthodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Private Practice, Lawrence, Kansas, USA.
J Prosthodont. 2025 Apr;34(4):350-356. doi: 10.1111/jopr.13989. Epub 2024 Dec 4.
Optical tracking devices (OTDs) hold promise for enhancing patient-centered prostheses, but their efficacy remains underexplored. This clinical study aimed to comprehensively evaluate differences in static and dynamic occlusions among occlusal appliances fabricated using optical tracking, conventional tracking, and average articulator values (AAVs), providing insights into their efficacy in clinical and research-based practices.
Twelve dentate participants aged over 25 years, with Angle Class I and II occlusal relationships, were enrolled. Occlusal appliances were fabricated by different condylar guidance values obtained by the three systems. The condylar guidance values were measured by an OTD via MODJAW, a conventional tracking device (CTD) via Cadiax compact 2, and the AAV with Bennett angle 10°, immediate mandibular lateral translation 0.5 mm, and sagittal condylar inclination (SCI) 35°. Occlusal appliances were designed using computer-aided design (CAD) software with the measured condylar guidance values from three systems. Subsequently, standard tessellation language (STL) files were transferred to computer-aided manufacturing (CAM) software for 3D printing with photopolymer resin. Each participant received three occlusal appliances fabricated using the three different systems. The accuracy of the systems was evaluated by accessing the clinical outcomes of the occlusal appliances. After placement, the number of contact points in maximal intercuspation position (MIP) and dynamic occlusion interferences were recorded, along with any discrepancies between designed and recorded contact points. Any anterior open bites at MIP with the appliance in place were measured from the maxillary incisal edge to the mandibular incisal edge. Statistical analysis included Kruskal-Wallis one-way analysis of variance (ANOVA) and Mann-Whitney tests with Bonferroni correction for pairwise comparisons (α = 0.05).
In assessing static occlusion, significant differences were found in contact point discrepancies at MIP. OTD exhibited the lowest mean discrepancy of contact points compared with the original design (1.833 ± 0.312), followed by CTD (4.083 ± 0.758) and AAV (4.833 ± 1.389), with a statistical significance (p = 0.047). At the final protrusive position, OTD (0.400 ± 0.204) and CTD (1.400 ± 0.438) methods showed significantly lower discrepancies compared with AAV (3.583 ± 0.352) (p < 0.001). Additionally, the OTD method demonstrated a statistically significant reduction in anterior open bite at MIP (0.115 ± 0.044 mm) compared with AAV (0.617 ± 0.246 mm) (p = 0.049). In dynamic occlusion, OTD showed no interferences in all subjects during protrusive movement, significantly outperforming both CTD (0.917 ± 0.474) and AAV (0.417 ± 0.202) (p = 0.033). No significant differences were observed among the methods for working and nonworking side laterotrusive movements.
The OTD offers superior accuracy over traditional methods, with reduced discrepancies and interferences in occlusal appliance fabrication, signifying a substantial advancement in mandibular movement assessment and improving treatment efficiency and outcomes in clinical practice.
光学跟踪装置（OTD）有望改善以患者为中心的假体，但尚未充分探索其疗效。本临床研究旨在全面评估使用光学跟踪、传统跟踪和平均牙合架值（AAV）制作的牙合垫在静态和动态咬合方面的差异，为其在临床和研究实践中的疗效提供见解。
招募了12名年龄超过25岁、安氏I类和II类咬合关系的有牙颌参与者。通过三种系统获得的不同髁导值制作牙合垫。髁导值通过OTD经MODJAW测量、通过传统跟踪装置（CTD）经Cadiax compact 2测量以及AAV（Bennett角10°、下颌即时侧方移动0.5 mm、矢状髁倾斜度（SCI）35°）测量。使用计算机辅助设计（CAD）软件根据三种系统测量的髁导值设计牙合垫。随后，将标准镶嵌语言（STL）文件传输到计算机辅助制造（CAM）软件中，用光敏树脂进行3D打印。每位参与者接受使用三种不同系统制作的三种牙合垫。通过评估牙合垫的临床结果来评价系统的准确性。放置后，记录最大牙尖交错位（MIP）的接触点数量和动态咬合干扰，以及设计和记录的接触点之间的任何差异。在牙合垫就位时，测量MIP处的任何前牙开牙合情况，从上颌切缘到下颌切缘进行测量。统计分析包括Kruskal-Wallis单因素方差分析（ANOVA）和Mann-Whitney检验，并采用Bonferroni校正进行两两比较（α = 0.05）。
在评估静态咬合时，发现MIP处的接触点差异存在显著差异。与原始设计相比，OTD的接触点平均差异最低（1.833 ± 0.312），其次是CTD（4.083 ± 0.758）和AAV（4.833 ± 1.389），具有统计学意义（p = 0.047）。在最终前伸位时，OTD（数值0.400 ± 0.204）和CTD（数值1.400 ± 0.438）方法与AAV（数值3.583 ± 0.352）相比差异显著更低（p < 0.001）。此外，与AAV（数值0.617 ± 0.246 mm）相比，OTD方法在MIP处的前牙开牙合有统计学意义的降低（数值0.115 ± 0.044 mm）（p = 0.049）。在动态咬合中，OTD在所有受试者的前伸运动过程中均未显示干扰，显著优于CTD（数值0.917 ± 0.474）和AAV（数值0.417 ± 0.
