Clinical Comparison of Articulating Paper, Intraoral Scanner, and Jaw-Tracking Device for Occlusal Analysis

Recent advances in digital dentistry have transformed occlusal analysis through the introduction of new digital workflows for recording static and dynamic occlusal contacts. This clinical study aimed to evaluate the reliability and concordance of two digital clinical workflows, the Medit i700 intraoral scanner and the Tizian JMA-Optic jaw-tracking system, using 100 μm articulating paper as the reference comparator for static and dynamic occlusal-contact recordings. Materials and Methods: Twenty-six participants aged 20 to 25 years were included in this study. For each participant, static and dynamic occlusal contacts were recorded in maximum intercuspation position (MIP), protrusive, and right and left laterotrusive movements, using 100 μm articulating paper, Medit i700, and Tizian JMA-Optic system. Intra-rater reliability was assessed using ICC(A,1) for the quantitative number of MIP contacts and Cohen's kappa for dynamic occlusal-contact recordings. Sensitivity, specificity, positive predictive value, and negative predictive value of the digital systems were evaluated relative to the articulating-paper reference comparator. Agreement between articulating paper and the two digital workflows was assessed using the intraclass correlation coefficient for the quantitative variables. Results: Intra-rater reliability was generally high but varied according to the recording method and occlusal-contact category. Overall, the Medit i700 showed numerically higher sensitivity and positive predictive value point estimates in several dynamic occlusal-contact categories than Tizian JMA-Optic, while specificity and negative predictive values were generally high for both systems. Both digital workflows showed good overall agreement with articulating paper in recording the number of occlusal contacts in MIP. Agreement was good at arch level, poor in the anterior regions, and moderate in the posterior regions. Conclusions: Both digital workflows showed generally high intra-rater reliability for dynamic occlusal recordings, with reliability varying according to the occlusal-contact category. Both systems demonstrated good agreement with the articulating-paper reference comparator for quantifying occlusal contacts in MIP, although substantial differences in measured contact area were observed. The numerical differences between Medit i700 and Tizian JMA-Optic should be interpreted descriptively rather than as evidence of superiority of either workflow. Although the digital systems provide valuable quantitative information for occlusal analysis, articulating paper remains a widely used conventional method for clinical identification of occlusal contacts and served as the reference comparator in the present study.