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Validity and reliability of digital occlusal analyzing methods in Dentistry. A systematic review
Chahak Seth-Johansen1, Klaus Gotfredsen1
1Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Objective:
This systematic review aimed to evaluate the validity and reliability of digital occlusal analyzing methods in terms of intraoral scanning (IOS) and sensor-based systems.
Material And Methods:
Following PRISMA guidelines, a comprehensive search was conducted across the databases: PubMed, Cochrane Library, Web of Science, Scopus and Embase. In vitro and in vivo studies published between January 1990 and July 2024, assessing the focused question: "Do digital occlusal analyzing methods provide sufficient reliability and validity in occlusal registration". In vivo studies were limited to dentate or partially dentate patients. Exclusion criteria were systematic reviews, case reports, questionnaires, and studies not available in English.
Results:
Thirty-nine studies were included (11 in vitro, 28 in vivo). Intraoral scanners (IOS) were assessed in 27 studies, while 15 studies investigated T-scan technology, 3 studies evaluated Dental Prescale, 2 studies explored the Accura system, and 2 studies with Occlusense®. Both IOS and the sensor-based systems demonstrated high degree of reliability in identifying occlusal contacts. However, validity in assessing contact intensity and exact interocclusal relationships was limited. Methodological heterogeneity between studies and lack of patient-reported outcomes were noted.
Conclusions:
Digital methods, including both sensor-based systems and IOS, provide relatively reliable and valid illustration of teeth with interocclusal contacts, but show limited validity in evaluating contact intensity and area.
Clinical Implications:
Digital methods can indicate the location of tooth contacts, but their validity remains insufficient for making occlusal diagnoses used for occlusal corrections. These limitations suggest that digital occlusal tools are best used as adjuncts rather than replacements for traditional occlusal analysis. Future directions could be to include patient-reported outcomes and calibration guidelines for digital occlusal analysis systems.
