A clinical comparative analysis using an optical tracking device versus conventional tracking device in the production of occlusal appliances.

Abstract

Purpose: Optical tracking devices (OTDs) hold promise for enhancing patient-centered prostheses, but their efficacy remains underexplored. This clinical study aimed to comprehensively evaluate differences in static and dynamic occlusions among occlusal appliances fabricated using optical tracking, conventional tracking, and average articulator values (AAVs), providing insights into their efficacy in clinical and research-based practices.

Materials and methods: Twelve dentate participants aged over 25 years, with Angle Class I and II occlusal relationships, were enrolled. Occlusal appliances were fabricated by different condylar guidance values obtained by the three systems. The condylar guidance values were measured by an OTD via MODJAW, a conventional tracking device (CTD) via Cadiax compact 2, and the AAV with Bennett angle 10°, immediate mandibular lateral translation 0.5 mm, and sagittal condylar inclination (SCI) 35°. Occlusal appliances were designed using computer-aided design (CAD) software with the measured condylar guidance values from three systems. Subsequently, standard tessellation language (STL) files were transferred to computer-aided manufacturing (CAM) software for 3D printing with photopolymer resin. Each participant received three occlusal appliances fabricated using the three different systems. The accuracy of the systems was evaluated by accessing the clinical outcomes of the occlusal appliances. After placement, the number of contact points in maximal intercuspation position (MIP) and dynamic occlusion interferences were recorded, along with any discrepancies between designed and recorded contact points. Any anterior open bites at MIP with the appliance in place were measured from the maxillary incisal edge to the mandibular incisal edge. Statistical analysis included Kruskal-Wallis one-way analysis of variance (ANOVA) and Mann-Whitney tests with Bonferroni correction for pairwise comparisons (α = 0.05).

Results: In assessing static occlusion, significant differences were found in contact point discrepancies at MIP. OTD exhibited the lowest mean discrepancy of contact points compared with the original design (1.833 ± 0.312), followed by CTD (4.083 ± 0.758) and AAV (4.833 ± 1.389), with a statistical significance (p = 0.047). At the final protrusive position, OTD (0.400 ± 0.204) and CTD (1.400 ± 0.438) methods showed significantly lower discrepancies compared with AAV (3.583 ± 0.352) (p < 0.001). Additionally, the OTD method demonstrated a statistically significant reduction in anterior open bite at MIP (0.115 ± 0.044 mm) compared with AAV (0.617 ± 0.246 mm) (p = 0.049). In dynamic occlusion, OTD showed no interferences in all subjects during protrusive movement, significantly outperforming both CTD (0.917 ± 0.474) and AAV (0.417 ± 0.202) (p = 0.033). No significant differences were observed among the methods for working and nonworking side laterotrusive movements.

Conclusions: The OTD offers superior accuracy over traditional methods, with reduced discrepancies and interferences in occlusal appliance fabrication, signifying a substantial advancement in mandibular movement assessment and improving treatment efficiency and outcomes in clinical practice.