PubMed · 4532382
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E Ulrich. 1974. [The orofacial system].. https://pubmed.ncbi.nlm.nih.gov/4532382/
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STATEMENT OF PROBLEM: The controversy continues regarding the efficacy of several commercially available devices that are used as aids in the diagnosis of occlusal abnormalities. PURPOSE: This article reviews the reliability, validity, and utility of instruments that claim to detect occlusal interferences and abnormal vertical dimension of occlusion. MATERIAL AND METHODS: Data, opinions, and technical information from 37 published articles were reviewed. Evidence for method reliability, validity, and utility was assessed. RESULTS: Although occlusal contact detection devices can document the occlusal contact patterns on teeth, the basic in vivo testing of their reproducibility and validity has not been performed. Moreover, while EMG and jaw tracking systems can indeed measure jaw muscle activation and jaw position, no cost-benefit analysis of these devices has yet been conducted. One manufacturer suggests that these instruments be used in conjunction with an electrical muscle stimulation device to find a new resting jaw position that is more open vertically. This new, more open position has been inappropriately labeled as evidence of vertical dimension of occlusion over-closure. CONCLUSION: None of the instruments reviewed can be said to be more than ancillary documentation devices and they have been inadequately tested for reliability and validity. Moreover, because scientifically acceptable disease definitions are not available for these 2 conditions, the issue of over-diagnosing becomes a substantial concern.
The purposes of this experimental study are the following: (1) to compare the anterior and overall tooth size ratios reported by Bolton to values reported in epidemiologic studies, (2) to assess the accuracy of tooth size discrepancy measurements, (3) to investigate to what extent generalized tooth size discrepancy affects occlusion, (4) to investigate the effect of leveling the curve of Spee, and (5) to evaluate the effect of extraction therapy of 4 premolars on occlusion. For the first part of the study, Bolton's mean anterior and overall tooth size ratio (as well as the extraction values) were compared with calculations derived from 4 publications reporting mean mesiodistal tooth width by using the t test (P </=.05). The second part of the study was carried out on a setup made from 1 dental cast of a male patient judged to have an ideal occlusion at the end of a nonextraction treatment. Our data reveal (1) no significant difference between the overall tooth size ratios of the Bolton values compared to 4 studies, but the anterior ratios were significantly different, (2) high reproducibility (99%) of tooth size discrepancy measurements, (3) that severe tooth size discrepancy affects the occlusion only a little, (4) that an excessive (6 mm) curve of Spee creates the poorest setup result, and (5) that extraction therapy only slightly affected the final occlusion. The effect of generalized tooth size discrepancy appears to be limited.