Digital occlusal analysis of the impact of natural dentition and different types of rehabilitation on the occlusal force variations: systematic review and meta-analysis

Abstract

Statement of problem

Dental restorations reduce occlusal force through a compensatory feedback mechanism. Thus, the type of restoration used during rehabilitation plays a vital role in altering occlusal force and contact area. The effects of factors such as the remaining dentition, occlusal contact area, and different types of rehabilitation on occlusal force need further exploration.

Aim

Evaluate the evidence of occlusal contact areas and various rehabilitation methods on influencing the occlusal force assessed using digital occlusal analyzers.

Materials & Method: The protocol followed the Cochrane standards for systematic reviews and was registered in PROSPERO (CRD42024623551). The literature search used the Population, Exposure, Comparator, Outcome, Study Design (PECOS) strategy. Database for searched until December 2024. Randomized controlled trial, observational studies including cohort, case-control, and cross-sectional studies that investigated the relationship of occlusal force with occlusal contact area, masticatory force, occlusal time, and number of remaining natural dentition using Dental Prescale or T scan.

Results

545 articles were retrieved, and based on inclusion and exclusion criteria 13 observation studies were systematically filtered, 3 studies were included in the meta-analysis and all 13 studies were taken for qualitative data synthesis. Cochrane ROBINS 1 tool revealed a moderate risk of bias for the included studies. The fixed effect model showed moderate heterogeneity(I² = 46 %) in the quantitatively assessed studies. The mean difference of occlusal force with rehabilitation was −10.02[95 % C.I(13.03, −7.03)] depicting prosthesis improved the occlusal force. However, qualitative analysis revealed that the occlusal force with prosthesis was lesser than the natural dentition quadrant.

Conclusion

Occlusal force was increased with rehabilitation compared to the edentulous site, however, the amount of force established in a complete set of natural dentitions was more than the rehabilitated site. The location of teeth in the arch, and the number of remaining dentitions played a role in occlusal force.