Clinician accuracy when subjectively interpreting articulating paper markings

Area of Science:

• Dental Occlusion
• Biomechanical Analysis
• Clinical Diagnostics

Background:

• Articulating paper marks are traditionally used to visually assess occlusal contacts.
• The accuracy of subjective interpretation of these marks for determining occlusal force has not been rigorously evaluated.

Purpose of the Study:

• To evaluate the reliability of Subjective Interpretation of articulating paper marks.
• To determine if this method can accurately identify relative occlusal force content of tooth contacts.

Main Methods:

• 295 clinicians assessed occlusal contacts from paper mark photographs.
• Assessments were compared against computerized occlusal analysis measurements.
• Statistical analyses included Chi-square, means, and standard deviations.

Main Results:

• The average correct identification rate was only 1.53 (chance was 12.5%).
• No significant differences were found based on clinical experience or occlusion courses taken.
• Sensitivity, specificity, and predictive values were all around 12.5%, indicating poor diagnostic accuracy.

Conclusions:

• Subjective Interpretation of articulating paper marks is an ineffective method for assessing occlusal force.
• Clinicians demonstrate a low ability to reliably differentiate occlusal force levels visually.
• Objective, measurement-based methods should replace the visual assessment of articulating paper marks.