Reliability, validity, and utility of various occlusal measurement methods and techniques

Abstract

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.