title: Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis.
abstract: OBJECTIVE
  Articulation paper mark size is widely accepted as an indicator of forceful tooth contacts. However, mark size is indicative of contact location and surface area only, and does not quantify occlusal force. The purpose of this study is to determine if a relationship exists between the size of paper marks and the percentage of force applied to the same tooth.
  
  
  METHODS
  Thirty dentate female subjects intercuspated into articulation paper strips to mark occlusal contacts on their maxillary posterior teeth, followed by taking photographs. Then each subject made a multi-bite digital occlusal force percentage recording. The surface area of the largest and darkest articulation paper mark (n = 240 marks) in each quadrant (n = 60 quadrants) was calculated in photographic pixels, and compared with the force percentage present on the same tooth.
  
  
  RESULTS
  Regression analysis shows a bi-variant fit of force % on tooth (P<.05). The correlation coefficient between the mark area and the percentage of force indicated a low positive correlation. The coefficient of determination showed a low causative relationship between mark area and force (r(2) = 0.067). The largest paper mark in each quadrant was matched with the most forceful tooth in that same quadrant only 38.3% of time. Only 6 2/3% of mark surface area could be explained by applied occlusal force, while most of the mark area results from other factors unrelated to the applied occlusal force.
  
  
  CONCLUSIONS
  The findings of this study indicate that size of articulation paper mark is an unreliable indicator of applied occlusal force, to guide treatment occlusal adjustments.
authors.affiliation: Department of Prosthodontics, Graduate School of Clinical Dentistry, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Sarah
authors.initials: S
authors.lastname: Qadeer
authors.forename: Robert
authors.initials: R
authors.lastname: Kerstein
authors.forename: Ryan Jin Yung
authors.initials: RJ
authors.lastname: Kim
authors.forename: Jung-Bo
authors.initials: JB
authors.lastname: Huh
authors.forename: Sang-Wan
authors.initials: SW
authors.lastname: Shin