Tooth contacts at the mandibular retruded position, influence of operator's skill on bite registration

Occlusal conditions at the retruded contact position (RCP) have been thought to be among the aetiological factors for temporomandibular disorders. However, the role of these occlusal factors still remain unclear. The purpose of a series of studies was to investigate the locations of RCP contacts and to discuss their implication by the authors. In the study reported here, the influence of the operator's skill on bite registration was surveyed. Eighty-six dental students were selected as subjects. One specialist in prosthetic dentistry moved the subject's mandible up and down while guiding it gently backward until it rotated on its retruded axis. Once the initial tooth contacts were established, the operator checked them by using a thin articulating paper (direct method). On the other hand, six younger operators following precise instruction from the specialist about the technique of jaw guidance examined each of the subjects for location of RCP contacts using the indirect method. Silicone-based impression material was used for bite registration while the subject kept the jaw at this contact position (indirect method). Wilcoxon signed rank test was applied to evaluate differences between the expert operator and six younger operators regarding locations of RCP contacts. Results from the expert operator (direct method) showed that tooth contact at the first premolar was most frequently observed and the number of subjects who possessed unilateral tooth contacts was more than that with bilateral tooth contacts. On the other hand, in the case of the indirect method performed by younger operators, tooth contact patterns significantly differed from those of the direct method.