Comparison between digital and conventional occlusal indicators.


  • Wan M. Dizayee Department of Prosthodontic Dentistry, College of Dentistry, Tishk University, Erbil, Iraq.
  • Fahd S. Ikram Department of Prosthodontics, College of Dentistry, Hawler Medical University, Erbil, Iraq.



OccluSense, Digital occlusal analysis, Articulating paper, Articulating silk


Background and objective: Occlusal adjustments are an integral part of any dental restorations; any occlusal discrepancy will affect the masticatory system generally and the occlusal scheme specifically. This unsolved problem may cause restoration and/or tooth fracture, and also may result in TMJ problems.

The objective of this study is to find out the best material and method for occlusal adjustment.

Methods: An upper metal cast with a lower resin cast was made and mounted to an apparatus that moves like the mandibular movement during mastication. Four different occlusal indicators (articulating paper with 100 and 40 microns, OccluSense (digital occlusal analysis device) with 60 microns, and Articulating silk with 80 microns) were used to evaluate their occlusal adjustments.

Results: Test of variance revealed a highly significant difference between the articulating paper 40 microns with the other indicators except for 100 microns articulating paper, while there was a significant difference between the OccluSense and Articulating silk.

Conclusion: The OccluSense digital device significantly was the most accurate occlusal adjusting indicator, followed by articulating silk, while the articulating paper 40 micron was the least accurate one.


Ferro KJ, Morgano SM, Driscoll CF, Freilich MA, Guckes AD, Knoernschild KL, et al. The glossary of prosthodontic terms. The Journal of prosthetic dentistry. 2017;117(5S).

Davies S, Gray RMJ. What is occlusion? British Dental Journal. 2001;191(5):235 -45. DOI:


Alani A, Patel M. Clinical issues in occlusion - Part I. Singapore Dent J. 2014;35C:31-8. DOI:


Mishra SK, Somkuwar S, Chowdhary R. Occlusion and Temporomandibular Joint Disorders. In: Bhargava D, editor. Temporomandibular Joint Disorders: Principles and Current Practice. Singapore: Springer Singapore; 2021. p. 133-43.

Carey JP, Craig M, Kerstein RB, Radke J. Determining a relationship between applied occlusal load and articulating paper mark area. Open Dent J. 2007;1:1-7. DOI: 10.2174/1874210600701010001.

Saad MN, Weiner G, Ehrenberg D, Weiner S. Effects of load and indicator type upon occlusal contact markings. J Biomed Mater Res B Appl Biomater. 2008;85(1):18-22. DOI: 10.1002/jbm.b.30910.

Bozhkova TP. Comparative Study of Occlusal Contact Marking Indicators. Folia Med (Plovdiv). 2020;62(1):180-4. DOI: 10.3897/folmed.62.e48018.12

Qadeer S, Kerstein R, Kim RJ, Huh JB, Shin SW. Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis. J Adv Prosthodont. 2012;4(1):7-

DOI: 10.4047/jap.2012.4.1.7.

Afrashtehfar KI, Qadeer S. Computerized occlusal analysis as an alternative occlusal indicator. Cranio. 2016;34(1):52-7. DOI: 10.1179/2151090314Y.0000000024

Aldhuwayhi S. Occlusal Indicators: A Key To Achieving Stomatognathic System Harmony During Prosthodontic And Restorative Treatments -A Literature Review. TITLE- International Journal of Dental and Medical Specialty. 2019;7(1):16-23.

Helms RB, Katona TR, Eckert GJ. Do occlusal contact detection products alter the occlusion? J Oral Rehabil. 2012;39(5):357-63. DOI: 10.1111/j.1365-2842.2011.02277.x.

Kerstein RB, Radke J. Clinician accuracy when subjectively interpreting articulating paper markings. Cranio. 2014;32(1):13-23. DOI: 10.1179/0886963413Z.0000000001.

Sutter BA. A digital poll of dentists testing the accuracy of paper mark subjective interpretation. Cranio. 2018;36(6):396-403. DOI: 10.1080/08869634.2017.1362786.

Basson E, Kerstein R, Radke J. Ability to correctly select high force occlusal contacts from articulating paper markings. Advanced Dental Technologies Techniques. 2020;2(1):101 -10.

Pearl EE, Joevitson M, Sreelal T, Chandramohan G, Mohan A, Hines AJ. Marking the invisible –A review of the various occlusal indicators and techniques. International Journal of Applied Dental Sciences 2020;6(2):377-81.

Barzilay I. Articulation paper and other occlusal marking devices revisited. J Dentist's Guide/CDE. 1996:23-6.

Sutter B. Digital occlusion analyzers: a product review of T-Scan 10 and OccluSense. Advanced Dental Technologies Techniques. 2019;2(1):1-31.

Sidana V, Pasricha N, Makkar M, Banwait S. Computerized Occlusal Analysis. Indian Journal of Dental Sciences. 2013;5(2):141-4.

Aung MH, Nyan M. Clinical Application of a Digital Occlusal Analyzer in Occlusal Equilibration: A case report. 2022:40-4.13

Buduru S, Mesaros A, Talmaceanu D, Baru O, Ghiurca R, Cosgarea R. Occlusion in the digital era: a report on 3 cases. Med Pharm Rep. 2019;92(Suppl No 3):S78-S84. DOI: 10.15386/mpr-1524.

Millstein P, Maya A. An evaluation of occlusal contact marking indicators. A descriptive quantitative method. J Am Dent Assoc. 2001;132(9):1280-6; quiz 319. DOI: 10.14219/jada.archive.2001.0373.


Dias RAB, Rodrigues MJP, Messias AL, Guerra F, Manfredini D. Comparison between conventional and computerised methods in the assessment of an occlusal scheme. J Oral Rehabil. 2020;0(0):1 -8. DOI: 10.1111/joor.12905.

Cabral CWLF, Silva FA, Silva WAB, Landulpho AB, Silva LB. Comparison between two methods to record occlusal contacts in habitual maximal intercuspation. Brazilian Journal of Oral Sciences. 2016;5(19):1239-43. DOI: 10.20396/bjos.v5i19.8642954.

Bozhkova T, Musurlieva N, Slavchev D. Comparative Study Qualitative and Quantitative Techniques in the Study of Occlusion. Biomed Res Int. 2021;2021:1163874. DOI: 10.1155/2021/1163874.

Koos B, Godt A, Schille C, Göz G. Precision of an Instrumentation-based Method of Analyzing Occlusion and its Resulting Distribution of Forces in the Dental Arch. Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie. 2010;71(6):403-10. DOI: 10.1007/s00056-010-1023-7.

Reddy S, Kumar PS, Grandhi VV. Relationship Between the Applied Occlusal Load and the Size of Markings Produced Due to Occlusal Contact Using Dental Articulating Paper and T-Scan: Comparative Study. JMIR Biomedical Engineering. 2018;3(1):e11347. DOI: 10.2196/11347.




How to Cite

Dizayee WM, Ikram FS. Comparison between digital and conventional occlusal indicators. EDJ [Internet]. 2023 Jun. 30 [cited 2024 Jun. 13];6(1):10-9. Available from:



Original Articles