Comparing Bite Force Distribution to Periodontal Support Markers of Lower Anterior Teeth in Orthodontically Untreated Adults using T-scan

Abstract

A crucial challenge for orthodontists is to fully analyze the components of a patient's malocclusion and address the needs of the patient by providing orthodontic treatment that adjusts the individual's natural balance harmoniously. To meet targeted objectives such as esthetics, function, and stability by positioning the teeth within the dentoalveolar housing, it is critical to expand our understanding of bite force distribution as it can significantly improve treatment planning and mechanotherapy of orthodontic patients. Digital occlusion analysis systems can offer this information rapidly and accurately at the initial patient visit. Conventional methods, such as the use of occlusal marking paper and intraoral scanners, deliver an incomplete record in comparison. The objective of this investigation was to identify a relationship between bite force distribution in centric relation and periodontal health. T-scan technology was utilized to record premature contacts, heavy forces, and right, left, anterior, posterior, and single tooth force distribution. For the study, a sample of 26 orthodontically untreated adults aged 18 to 40 was recruited during consultations for comprehensive treatment at the Orthodontic clinic at Harvard School of Dental Medicine. Inclusion criteria for participants required them to be within the skeletal range of -7°°, to be in permanent dentition. Exclusion criteria included patients with a history of orthodontic care, those with craniofacial defects, musculoskeletal disorders, and participants whose wisdom teeth were involved in occlusion. The null hypothesis posited that bite force distribution would not correlate directly with markers of periodontal health. To analyze periodontal support, the study focused on collecting ultrasound measurements of the buccal bone and soft tissue surrounding the six mandibular anterior teeth. The positioning of these specific teeth has long since been regarded as crucial for establishing a healthy and well-balanced occlusion. Additionally, cephalometric indicators of lower anterior tooth positioning, such as IMPA and L1-NB, were analyzed to assess their role in the interplay between occlusion and periodontal support. In our study, we could not identify a statistically significant correlation between bite force distribution and the measurements of periodontal tissue thickness. However, analyses suggest potential relationships between the cephalometric positioning of the lower incisors and the robustness of the soft tissue housing. Future research will need larger sample sizes to more thoroughly explore the relationship between bite force equilibrium and periodontal support.