Accurate recording of the intermaxillary relationship is crucial for achieving successful restorative outcomes. In cases of occlusal support loss, determining and recording the intermaxillary relationship becomes more complex. This study aims to compare the occlusal compatibility of restorations fabricated using either an intraoral scanner or a jaw motion tracking and analysis device for recording the intermaxillary relationship in patients with occlusal support loss.
This study is designed to fabricate bilateral fixed prosthetic restorations in the maxillary posterior region and to evaluate the clinical success, efficiency, and patient satisfaction associated with different intermaxillary relationship recording methods. The study will compare the clinical outcomes of restorations produced using two techniques: Group I: Centric relation (CR) determined by bimanual manipulation and recorded with an intraoral scanner. Group II: Centric relation (CR) determined by neuromuscular deprogramming and recorded with a jaw movement/tracking analysis device. All tooth preparations will follow standard preparation principles, ensuring minimum material thickness. Preparations will be completed by the investigator (ESK). After preparation, intraoral scans of the upper and lower jaws will be obtained using an intraoral scanner. Centric relation will be recorded first with bimanual manipulation stabilized with wax, then digitized via intraoral scanning. In a subsequent session, centric relation will be recorded using a neuromuscular deprogrammer and jaw movement tracking analysis. Both recordings will be sent to a dental laboratory for the fabrication of restorations. A randomization protocol will be applied to vary the adjustment order of the restorations fabricated by each method. During clinical evaluation: Distal and mesial proximal contacts will be checked and adjusted as needed. Internal fit will be evaluated and corrected if necessary. Occlusal adjustment will be performed using 100 µm and 40 µm articulation papers (Arti-Check micro-thin, Bausch, Cologne, Germany). After occlusal adjustment: The adjusted surfaces will be colored, photographed, and measured using ImageJ software to determine the adjusted surface area (in mm²). Adjustment time and number of articulation paper applications will also be recorded. These clinical parameters (adjusted area, adjustment time, and number of papers used) will be scored to assess the clinical success of the restorations. Additionally, patient-reported outcomes will be collected: Occlusal comfort and technique preference will be evaluated via a Visual Analog Scale (VAS, 0 = complete dissatisfaction, 10 = complete satisfaction) and a method preference survey. This evaluation aims to determine which technique offers better patient comfort and overall satisfaction.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
14
Tooth-supported fixed prostheses were fabricated using centric relation records obtained by two different methods: 1. Bimanual manipulation technique, with jaw relation records captured using an intraoral scanner. 2. Neuromuscular deprogramming technique, with jaw relation records obtained using a jaw movement tracking and analysis device.
Hacettepe University, Faculty of Dentistry
Ankara, Turkey (Türkiye)
RECRUITINGAdjustment Time for Restoration
The time required to adjust the restoration will be recorded in minutes and scored on a 0-4 scale as follows: 0 (≤1 min), 1 (1-5 min), 2 (5-10 min), 3 (10-15 min), 4 (≥15 min).
Time frame: 1 year
Adjusted Surface Area of the Restoration
The surface area requiring adjustment will be measured in square millimeters (mm²) using ImageJ software and scored from 0 to 4: 0 (≤1 mm²), 1 (1-6 mm²), 2 (6-10 mm²), 3 (10-15 mm²), 4 (≥15 mm²).
Time frame: 1 year
Number of Articulation Paper Uses
The number of articulation paper uses will be counted and scored from 0 to 4 as follows: 0 (2-4 uses), 1 (5-7), 2 (8-10), 3 (10-13), 4 (≥14 uses).
Time frame: 1 year
Composite Clinical Success Score of the Restoration
The clinical success of each restoration will be evaluated using a composite score derived from three parameters: Adjustment Time, Adjusted Surface Area,Number of Articulation Paper Uses. Each parameter is scored from 0 to 4, yielding a total score between 0 and 12. Based on the total score, restorations will be categorized as follows: Excellent (Score 0-1): Restoration has a clinically optimal fit. Occlusal contacts are properly and evenly distributed. Successful (Score 2-4): Restoration shows good clinical fit with minor occlusal adjustments. Moderate (Score 5-7): Restoration is clinically acceptable with occlusal adjustments. Weak (Score 8-10): Restoration has issues in clinical fit and required major occlusal adjustments. Unsuccessful (Score 11-12): Clinical fit is unacceptable. Adjustments caused morphological distortion or resulted in occlusal gaps. Restoration must be replaced. This composite score will serve as the primary measure of overall clinical success.
Time frame: 1 year
Occlusal Comfort Evaluated Using Visual Analog Scale
Secondary outcome will assess patient-reported occlusal comfort following the clinical application of the restoration. Occlusal comfort will be measured using a 10-point Visual Analog Scale (VAS), where 0 indicates no comfort and 10 indicates maximum comfort. Patients will rate their experience immediately after the restoration trial.
Time frame: 1 year
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