Identification of occlusal prematurity by clinical examination and cone-beam computed tomography

Abstract

The aim of this study was to evaluate the ability to identify occlusal prematurity by images from paraxial slices of cone-beam computed tomography (CBCT). For such purpose, a pilot study was performed in which 16 asymptomatic young patients were subjected to a clinical examination, including a careful occlusal analysis and then individual deprogrammer devices ("Lucia's JIG") were fabricated. Premature contacts were clinically identified in centric relation (CR) for each patient by jaw manipulation and interocclusal marking with articulating paper (Accufilm). Subsequently, these devices were adjusted in CR and used during the tomographic exams in such a way that CBCT in CR could be obtained. After routine processing, the images were analyzed in order to identify occlusal prematurity on the displayed images by 30 professionals divided according to areas of activity (occlusion specialist, general practitioner and radiologist; n=10 per area) and time of professional experience (less than 5, between 5 and 10, and over 10 years). By comparing the premature contacts identified in the clinical analysis and CBCT images, an agreement index between these two variables was calculated. Data were analyzed statistically by ANOVA and Scott-Knott test (α=0.05). The results showed that the identification of occlusal prematurity by paraxial CBCT slices was proven to be a method of average reliability.