Digital occlusion scan to analyze the effect of occlusal adjustment with persistent pain after endodontics
Assoc. Prof. Hans Van Pelt, Asst. Prof. Mariëlle Peuchen
Dept. Restorative Dentistry and Prosthodontics
BACKGROUND. Two of the common treatment options for (persistent) tooth ache are an endodontic treatment or extraction of the tooth. Digital occlusion using pressure sensors is a very sensitive technique and was used to analyze pressure spots on the occlusal surface before and after (minor) occlusal adjustment.
MATERIALS AND METHOD. The research population contains patients formed into two groups who have (unexplainable) persistent pulpitis-like complaints; a group with endodontic treated teeth and a group with healthy vital teeth. As a control, a group was analyzed without persisting pain after endodontic treatment. The treatment contained occlusal adjustment (ICAGD), guided by the digital occlusion analysis (T-scan® III). Pain was measured using the NRS-score and the occlusion was measured by the digital occlusal analysis (T-scan® III) using the variables: occlusion time, force outliers and analysis of the Center of Force (COF) pattern from initial contact till MIP.
RESULTS 22 patients with persisting pain were included in this study, 12 with pain on endodontic treated teeth and 10 with pain on healthy vital teeth. Another 12 patients were in the control group. A statistically significant difference was measured for all three variables (p < .05) except for the variable force outliers for the endodontic treated group (p = .121). There appears to be no linear correlation between the pain and the occlusion time, nor the force outliers (p > .35). All patients in the control group showed the ideal COF pattern (a straight line from initial contact to MIP).
CONCLUSION Occlusal adjustment guided by a digital occlusion analysis seems to be helpful to diagnose the role of the shape of the occlusal surface in initial as well as persisting endodontic pain. As conclusion can be drawn that the digital occlusion analysis can have a significant contribution in the diagnosis of unexplainable toothache.