Computerized Assessment of Articulating Paper Occlusal Adjustment for Implant Crowns Restoring Modification Spaces of Kennedy Class II Cases

Document Type : Original Article


Prosthodontic department, faculty of Dentistry, Ain Shams University


Objective: The study was conducted to evaluate the effectiveness of articulating paper-guided occlusal equilibration for single implant crowns used to restore the modification space anterior to the second premolar as a pier abutment in mandibular Kennedy class II cases using T-Scan. Materials and methods: Eighteen patients had lower Kennedy class II with a second premolar as a pier abutment, removable partial dentures (RPD) were constructed after restoring the modification spaces with implant-supported screw-retained metal-ceramic crowns. The occlusal contacts on the implant crowns were marked using articulating paper, standardized photographs were taken to compare with T-scan recordings, the percentage of force applied to the implant abutment crowns (POFI) and contralateral teeth (POFT) was evaluated using T-Scan before and after the adjustments. The data were analyzed using the paired t-test and the student t-test, while regression analysis was carried out for assessing the frequency of matchings and non-matchings between the paper marks and the T-scan. Results: The POFI values were decreased, and the POFT values were increased, after articulating paper occlusal adjustments however, the changes were not significant for the natural teeth. The correlation coefficient between the most apparent paper marks and the number of red columns presented in T-scan recordings indicated fair correlation. Conclusion: Choosing forceful tooth contacts utilizing paper marking’s appearance as a guide is, at best not evidence-based, and at worst, highly error-prone, however, for clinical correlation, occlusal accuracy in such cases will not suffer if more readily feasible and simpler ways are employed to guide occlusal equilibration.


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