In vitro comparison of digital occlusal analyzers and articulating paper in static and dynamic occlusion

Intraoral scanners (IOS) are generally limited to capturing static occlusion, whereas digital occlusal analyzers and mandibular tracking devices enable dynamic occlusion recording. To date, no direct comparison has been made between these technologies and the conventional method, articulating paper. This in vitro study aimed to compare the performance of one digital occlusal analyzer and three IOS devices, used alone or in combination with a mandibular tracking device, against articulating paper under static and dynamic conditions.

Five pairs of plaster models mounted on articulators were analyzed in maximum intercuspation (MIP), protrusion, and right laterotrusion using eight protocols: articulating paper, Occlusense, Trios 3, Trios 5, Primescan, Modjaw-Trios 3, Modjaw-Trios 5, and Modjaw-Primescan. Contact points were recorded by two evaluators following a standardized protocol, which segmented dental arches into anatomical zones and classified contacts as identical, additional, or missing compared with articulating paper. Concordance rates, dissimilarity types, and intra- and inter-examiner reproducibility were statistically assessed.

Significant differences were observed among devices. In static conditions, Trios and Primescan achieved similar concordance but tended to overgenerate contacts. Occlusense produced fewer false positives but a higher number of missing contacts. In dynamic conditions, standalone IOS devices underperformed, particularly during lateral movements. Modjaw-integrated systems demonstrated the highest concordance, with Modjaw-Trios 3 excelling in both protrusion and laterotrusion. Reproducibility was high across methods, with Occlusense showing excellent consistency despite reduced overall accuracy.

No digital system fully matched articulating paper. However, jaw-tracking devices significantly improved dynamic occlusion analysis and may enhance prosthetic outcomes. Further research involving diverse patient populations is recommended.

While IOS and digital occlusal analyzers alone provide different information compared with articulating paper, integrating them with jaw-tracking devices significantly improves accuracy in dynamic occlusion. Clinically, such hybrid digital workflows may enhance the precision of prosthetic and restorative treatments, though validation in clinical environments is still needed.