数字化时代𬌗学理论的验证与革新：虚拟现实、人工智能与临床咬合设计的融合

Partially edentulous dentition presents a challenging problem for the surgical planning of digital dental occlusion in the field of craniomaxillofacial surgery because of the incorrect maxillomandibular distance caused by missing teeth. We propose an innovative approach called Dental Reconstruction with Symmetrical Teeth (DRST) to achieve accurate dental occlusion for the partially edentulous cases. In this DRST approach, the rigid transformation between two symmetrical teeth existing on the left and right dental model is estimated through probabilistic point registration by matching the two shapes. With the estimated transformation, the partially edentulous space can be virtually filled with the teeth in its symmetrical position. Dental alignment is performed by digital dental occlusion reestablishment algorithm with the reconstructed complete dental model. Satisfactory reconstruction and occlusion results are demonstrated with the synthetic and real partially edentulous models.

… Occlusal reconstruction refers to a treatment approach aimed at adjusting occlusion in patients with abnormal occlusion, for example, malocclusion, upper and lower jaw disorders, and …

In the field of craniomaxillofacial (CMF) surgery, surgical planning can be performed on composite 3-D models that are generated by merging a computerized tomography scan with digital dental models. Digital dental models can be generated by scanning the surfaces of plaster dental models or dental impressions with a high-resolution laser scanner. During the planning process, one of the essential steps is to reestablish the dental occlusion. Unfortunately, this task is time-consuming and often inaccurate. This paper presents a new approach to automatically and efficiently reestablish dental occlusion. It includes two steps. The first step is to initially position the models based on dental curves and a point matching technique. The second step is to reposition the models to the final desired occlusion based on iterative surface-based minimum distance mapping with collision constraints. With linearization of rotation matrix, the alignment is modeled by solving quadratic programming. The simulation was completed on 12 sets of digital dental models. Two sets of dental models were partially edentulous, and another two sets have first premolar extractions for orthodontic treatment. Two validation methods were applied to the articulated models. The results show that using our method, the dental models can be successfully articulated with a small degree of deviations from the occlusion achieved with the gold-standard method.

The free flap reconstructive protocols of the jaws have been refined over the years and presently are based on bone‐driven approaches that generally use the lower border of the mandible or the anterior surface of the maxilla as the templates for reconstruction because these contours are deemed important to the eventual cosmetic outcomes of patients. The ultimate goal of functional jaw reconstruction, however, is the reconstruction of the dental occlusion and oral rehabilitation. The purpose of the present study was to evaluate the Alberta reconstructive technique (ART), which is a new approach of occlusion‐driven jaw reconstruction with digitally planned immediate osseointegrated implant installation.

OBJECTIVES The reliability and validity of three digital occlusion analysis methods was evaluated in vivo. METHODS THE THREE METHODS EVALUATED WERE: : scanning of articulating paper marks (SA), dental prescale occlusal analysis system (DP) and a virtual occlusion constructed method (VO). A conventional silicone transmission method (ST) was used as the standard for comparison. Each of the 20 enrolled human subjects was tested with the four methods. Retest of each method was performed at 2-week intervals. Occlusal contact area (OCA) and occlusal contact numbers (OCN) were calculated for analyses. For reliability evaluation, intraclass correlation coefficients (ICC) of the OCA and OCN values obtained from each method were compared. For validity evaluation, Pearson correlations coefficients, paired t-tests, regression analysis and Bland-Altman analysis were examined. RESULTS THE ICC VALUES OF OCA AND OCN WERE IN THE ORDER: : ST>SA>DP>VO. The highest OCA and OCN values were found ST while the lowest values were obtained from DP. Paired t-test identified a significant difference when OCA values obtained from the three digital methods were compared with ST, and between the OCN values of DP and ST. Pearson correlation showed high coefficients between ST and three digital methods (0.583-0.885 for OCA; 0.779-0.836 for OCN). A significant linear correlation was found between the results from ST and those from SA or VO. Bland-Altman analysis showed good agreement between OCN values of SA and ST, and between those of VO and ST. CONCLUSIONS The three digital occlusal analysis methods showed good reliability and validity for in vivo clinical application. CLINICAL SIGNIFICANCE . The three digital occlusion analysis systems examined demonstrate good potential in in vivo quantitative analysis, with good reliability and validity. The use of these analytical methods should facilitate digital workflow in clinical practice.

PURPOSE The current standard for mandibular reconstruction is a contour-based approach using a fibular flap offering good cosmetic results but challenging to reconstruct using dental implants. An iliac flap is more amenable to implant placement and better suited for occlusion-driven reconstruction. We aimed to describe an occlusion-driven workflow that involves the use of digital surgical guides to perform mandibular reconstruction using an iliac flap; we also aimed to compare our results to those we achieved with conventional contour-based reconstruction. METHODS This was a retrospective cohort study. All patients who underwent mandibular reconstruction with an iliac flap at our university hospital between September 2017 and December 2019 were considered eligible for the study. The inclusion criteria included mandibular defects after tumor ablation and stable preoperative occlusal relationship. The exclusion criteria were as follows: defects involving the condyle and ramus, temporomandibular joint disease, and obvious preoperative nontumor-related facial asymmetry. To evaluate surgical outcomes, patients were assigned to 2 groups based on the implemented surgical workflow: the occlusion-driven and traditional contour-driven groups. The intermaxillary distance, intermaxillary angle, surface deviation, and implantation rates were compared between the 2 groups. The operating time, length, and number of iliac bone segments were recorded. Intergroup differences were investigated using an independent samples t test and Fisher exact test. RESULTS Overall, 24 patients were included (13 in the occlusion-driven group and 11 in the contour-driven group). Implantation rate was higher in the occlusion-driven group (61.5%) compared with the contour-driven group (18.2%; P = .047). The average acceptable intermaxillary distance was greater in the occlusion-driven group (92.3 ± 27.7%) than in the contour-driven group (47.0 ± 47.6%; P = .01). The average intermaxillary angle was 88.2 ± 8.4° in the occlusion-driven group and 76.4 ± 10.3° in the contour-driven group (P < .01). CONCLUSIONS Digital surgical guides can precisely transfer virtual surgical planning to real-world mandibular surgery. An occlusion-driven workflow might provide a better intermaxillary jaw relationship than traditional contour-driven surgical procedures, resulting in improved mastication.

… Accurately reconstructing occlusion is critical for diagnosis, … capture occlusion accurately, the validity of artificial intelligence (AI)-driven alignment algorithms for reconstructing occlusion …

Digital dental models are widely used compared to dental impressions or plaster-dental models for occlusal analysis as well as fabrication of prosthodontic and orthodontic appliances. The digital dental model has been considered as one of the significant measures for the analysis of dental occlusion. However, the process requires more computation time with less accuracy during the re-establishment of dental occlusion. In this research, a modern method to re-establish dental occlusion has been designed using a Reconstructed-based Identical Matrix Point (RIMP) technique. The curvature of the dental regions has been reconstructed using distance mapping in order to minimize the computation time, and an iterative point matching approach is used for accurate re-establishment. Satisfactory restoration and occlusion tests have been analyzed using a dental experimental setup with high-quality digital camera images. Further, the high-quality camera images are converted to grayscale images for mathematical computation using MATLAB image processing toolbox. Besides, 70 images have been taken into consideration in which 30 planar view images has been utilized for experimental analysis. Indeed, based on the outcomes, the proposed RIMP outperforms overall accuracy of (91.50%) and efficiency of (87.50%) in comparison with conventional methods such as GLCM, PCR, Fuzzy C Means, OPOS, and OGS.

INTRODUCTION SmileMate (SmileMate, Dental Monitoring SAS, Paris, France) is an artificial intelligence (AI)-based Web site that uses intraoral photographs to assess patients' dental and orthodontic parameters and provide a report. This study aimed to investigate the ability of an AI assessment tool (SmileMate) for orthodontic and dental parameters. METHODS A United Kingdom-based prospective clinical study enrolled 35 participants in the study. The participants' occlusal and dental parameters were assessed, and standardized orthodontic photographs were taken and uploaded to the SmileMate Web site to produce an AI-generated assessment. A total of 19 parameters were evaluated: 9 orthodontic parameters and 10 dental parameters covering both soft and hard tissues. A crosstabulation for AI and clinician assessments was reported using Fisher exact tests. Cohen's kappa was calculated to provide an agreement between the gold standard (clinician assessment) and SmileMate (AI assessment). Finally, the sensitivity, specificity, and area under the curve were calculated. RESULTS Statistically significant differences between a direct in-person assessment and the SmileMate AI assessment were noted across 9 of the 19 parameters (P <0.05, Fisher exact test). The overall kappa value was fair (0.29), with a variety of agreements between AI and clinician assessments; the level of agreement ranged from poor in 2 parameters (lateral open bite and teeth fracture) to almost perfect for missing and retained teeth. The level of agreement ranged from slight to moderate for the other variables in this study. The overall sensitivity of the AI-generated assessments was 72%, and the specificity was 54%. The specificity of AI was very low for gingivitis and oral hygiene, indicating a very high probability of false-positive findings for those parameters. CONCLUSIONS The overall agreement between SmileMate and the clinician's assessment was slight to moderate. AI-generated assessments are inadequate for evaluating malocclusion.

ABSTRACT Objective To evaluate the impact of occlusion type and artificial intelligence‐based computer‐aided design (CAD) software on the geometric accuracy and clinical quality of auto‐generated anterior and posterior crown designs. Methods Five typodont models representing various occlusion types (normal, Class I anterior diastema, Class II division 1, Class II division 2, and Class III anterior crossbite occlusion) underwent crown preparation for the maxillary right central incisor and first molar. Ten sets of intraoral scans were obtained from each prepared model, and crown designs were automatically generated using two software programs: deep learning‐based (DL; Dentbird) and conventional automated (CA; Auto Workflow, 3Shape) (n = 10). Surface deviations between the crown designs and preoperative tooth morphology were quantified using root mean square (RMS) values. Clinical crown quality was assessed using World Dental Federation (FDI) criteria. Scheirer–Ray–Hare and Fisher's exact tests were conducted (α = 0.05). Results Significant differences in surface deviation and clinical quality were observed between the various occlusion and software types. The DL group demonstrated higher RMS values than the CA group (p < 0.001). However, DL‐generated crowns were of significantly better clinical quality (FDI scores) than CA‐generated crowns, particularly for posterior teeth, in terms of marginal adaptation, proximal contacts, and anatomical form and contour (p < 0.05). The DL group demonstrated generally favorable outcomes when designing crowns for normal occlusion, but outcomes were less satisfactory when designing anterior crowns with diastemas. Conclusions Occlusal scenarios influenced the surface deviation and quality of auto‐generated anterior and posterior crown designs. DL software produced higher‐quality molar designs than CA software. Clinical Significance Automated crown design outcomes depend on occlusal scenarios and CAD software selection. DL‐based CAD software demonstrated superior clinical quality, particularly for posterior crowns, indicating higher clinical suitability. However, further software refinement is needed to consistently produce clinically acceptable crowns under diverse occlusal conditions, such as anterior diastemas.

STATEMENT OF PROBLEM Artificial intelligence (AI) models have been developed for different applications, including the automatic design of occlusal devices; however, the design discrepancies of an experienced dental laboratory technician and these AI automatic programs remain unknown. PURPOSE The purpose of this in vitro study was to compare the overall, intaglio, and occlusal surface discrepancies of the occlusal device designs completed by an experienced dental laboratory technician and two AI automatic design programs. MATERIAL AND METHODS Virtually articulated maxillary and mandibular diagnostic casts were obtained in a standard tessellation language (STL) file format. Three groups were created depending on the operator or program used to design the occlusal devices: an experienced dental laboratory technician (control group) and two AI programs, namely Medit Splints from Medit (Medit group) and Automate from 3Shape A/S (3Shape group) (n=10). To minimize the discrepancies in the parameter designs among the groups tested, the same printing material and design parameters were selected. In the control group, the dental laboratory technician imported the articulated scans into a dental design program (DentalCAD) and designed a maxillary occlusal device. The occlusal device designs were exported in STL format. In the Medit and 3Shape groups, the diagnostic casts were imported into the respective AI programs. The AI programs automatically designed the occlusal device without any further operator intervention. The occlusal device designs were exported in STL format. Among the 10 occlusal designs of the control group, a random design (shuffle deck of cards) was used as a reference file to calculate the overall, intaglio, and occlusal discrepancies in the specimens of the AI groups by using a program (Medit Design). The root mean square (RMS) error was calculated. Kruskal-Wallis, and post hoc Dwass-Steel-Critchlow-Fligner pairwise comparison tests were used to analyze the trueness of the data. The Levene test was used to assess the precision data (α=.05). RESULTS Significant overall (P<.001), intaglio (P<.001), and occlusal RMS median value (P<.001) discrepancies were found among the groups. Significant overall RMS median discrepancies were observed between the control and the Medit groups (P<.001) and the control and 3Shape groups (P<.001). Additionally, significant intaglio RMS median discrepancies were found between the control and the Medit groups (P<.001), the Medit and 3Shape groups (P<.001), and the control and 3Shape groups (P=.008). Lastly, significant occlusal RMS median discrepancies were found between the control and the 3Shape groups (P<.001) and the Medit and 3Shape groups (P<.001). The AI-based software programs tested were able to automatically design occlusal devices with less than a 100-µm trueness discrepancy compared with the dental laboratory technician. The Levene test revealed significant overall (P<.001), intaglio (P<.001), and occlusal (P<.001) precision among the groups tested. CONCLUSIONS The use of a dental laboratory technique influenced the overall, intaglio, and occlusal trueness of the occlusal device designs obtained. No differences were observed in the precision of occlusal device designs acquired among the groups tested.

OBJECTIVES To compare the morphological characteristics of full crowns designed by an experienced dental technician and a data-driven artificial intelligence (AI) system, with particular attention to their similarity to natural teeth. METHODS Twelve digital casts, including mandibular right second premolars, were collected, three-dimensional (3D) printed, and prepared by an experienced dentist. For each case, two crowns were independently designed by an experienced dental technician (ET) and the AI system. Morphological characteristics, including buccal and lingual cusp angle, buccal-lingual diameter, mesial-distal diameter, functional cusp wear facets, 3D similarity, and occlusal contact point counts, were compared among natural teeth, ET crowns, and AI crowns. Functional cusp wear and occlusal contacts were evaluated qualitatively, based on morphological observation and visual analysis under virtual articulating paper conditions. Statistical analysis was performed using one-way analysis of variance with least significant difference post-hoc testing, with the significance level set at α = 0.05. RESULTS Both AI crowns (56.2°±5.1°) and ET crowns (57.5°±6.3°) exhibited larger buccal cusp angles than natural teeth (45.7°±4.9°) (p < 0.05), while no significant differences were found in lingual cusp angles among the groups (p = 0.434, 0.607, 0.787). The buccal-lingual diameter of AI crowns closely matched natural teeth (p = 0.094), whereas ET crowns were significantly smaller than both AI crowns (p = 0.034) and natural teeth (p = 0.044). The mesial-distal diameter of AI crowns also showed no significant difference from natural teeth (p = 0.223), while ET crowns differed significantly from both groups (p = 0.047, 0.002). Although AI crowns exhibited slightly lower 3D discrepancy (0.43 ± 0.07) than ET crowns (0.48 ± 0.06), the difference was not statistically significant (p = 0.089). AI did not accurately reproduce functional cusp wear facets, whereas technician designs tended to overcompensate. Occlusal contact counts showed no significant differences among groups. CONCLUSIONS AI systems can reproduce overall crown morphology to a degree comparable with experienced technicians but remain limited in replicating functional wear facets. CLINICAL IMPLICATIONS AI offers a practical and efficient tool for crown design, with potential to improve consistency and reduce manual workload in prosthodontics. However, further refinement is required before these systems can fully replicate functional morphological details for widespread clinical application.

OBJECTIVES This in vitro study evaluated the influence of artificial intelligence-driven occlusal contact adjustment (AI-OCA) on the trueness of virtual occlusal records (VORs) acquired using two intraoral scanner (IOS) systems (TRIOS4 [TR4] and TRIOS5 [TR5]). The tests were conducted in models representing either mandibular free-end edentulism or single molar defects requiring implant rehabilitation. METHODS A typodont model of a partially edentulous mandible (missing teeth: #35-37, #46) with four implants was mounted on a semi-adjustable articulator. Twelve stainless-steel spheres were fixed to the maxillary and mandibular arches as fiducial reference points. Reference datasets were obtained using a high-precision laboratory scanner. Each IOS performed 10 scans of both arches, and VORs were generated via bilateral buccal scans. Each dataset was duplicated and processed with or without AI-OCA, yielding four experimental groups: TR4 No-Adj, TR4 Adj, TR5 No-Adj, and TR5 Adj. Six inter-arch distances (D16-46, D13-43, D23-33, D25-35, D26-36, and D27-37) were calculated based on distances between corresponding sphere centers using reverse-engineering software. Deviations between the IOS-derived measurements and the reference data were analyzed in terms of both signed and unsigned linear discrepancies. Data were analyzed using non-parametric statistical tests due to non-normal data distribution (Shapiro-Wilk, P < 0.001). Trueness was reported as median (interquartile range) and was assessed using Wilcoxon signed-rank tests (α = 0.05). RESULTS AI-OCA significantly affected VOR trueness in a position-dependent manner. For TR5, occlusal adjustment enhanced trueness at D25-35, D26-36, and D27-37 (P < 0.01), while TR4 showed improvement only at D25-35 (P < 0.01). However, both scanners showed reduced trueness at D16-46 following AI-OCA (P < 0.01). CONCLUSIONS The effect of AI-OCA on VOR trueness varied according to the scanner type and the span of edentulism. Results from both scanners for single posterior molar defects were more accurate when AI-OCA was not used. TR5 performed better in assessing VOR trueness for implant-supported restorations in free-end scenarios. CLINICAL SIGNIFICANCE The clinical effectiveness of AI-OCA use is dependent on both the specific IOS used and the anatomical extent of edentulism. While beneficial in certain implant scenarios, AI-OCA may compromise trueness when applied to limited-span defects such as single posterior tooth loss.

STATEMENT OF PROBLEM Artificial intelligence (AI)-driven programs and occlusal collision correction algorithms have been proposed to improve the accuracy of articulating intraoral scans in maximum intercuspal position (MIP). However, the effect of each post-processing method on the accuracy of the MIP relationship remains unclear. PURPOSE The purpose of this clinical comparative study was to assess the influence of occlusal collision correction method and AI-driven registration on the accuracy of occlusal contacts recorded in MIP using an intraoral scanner (IOS). MATERIAL AND METHODS Occlusal contacts in MIP were recorded using articulating film in 46 participants and digitized using maxillary and mandibular scans captured with an IOS (TRIOS 4; 3Shape A/S). For each participant, a bilateral virtual occlusal record was generated in MIP. The scans were duplicated and assigned to 3 groups: non-articulated (NA), IOS-non-corrected (INC), and IOS-corrected (IC). Using a computer-aided design (CAD) software program (Elefsina 3.2; exocad GmbH) the INC and the IC scans were post-processed implementing 3 different methods: Cast trimming (CT) and increasing vertical dimension either by moving the jaws apart (IVDM) or by opening articulator's incisal pin (IVDA). An AI-driven software program (Bite-Finder) was also used to post-process both the INC and IC scans. The same AI program was also used to articulate the NA scans in MIP, generating the NA-AI group. Occlusal contact accuracy was assessed by 2 calibrated examiners, using the digitized articulating film contacts as reference. One-way ANOVA was used to examine if average True positive contacts and false positive contacts were different across the post-processing methods (P<.05). RESULTS Significant differences were observed in both the proportion of true positive contacts and the mean number of false positive contacts among the evaluated groups (P<.05). The IC demonstrated a higher proportion of true positive contacts compared to the INC, but also exhibited a higher mean number of false positives (P<.05). The highest proportions of true positive contacts were found in the AI-registered groups (NA-AI, INC-AI, IC-AI) and the IOS-corrected groups (IC, IC-CT). AI-registered groups showed significantly fewer false positive contacts compared to their counterparts without CAD-based post-processing (IC, INC). CONCLUSIONS Both occlusal collision correction via IOS or a CAD software program and AI-based registration significantly influenced the accuracy of occlusal contact representation in MIP. The choice of occlusal correction method affected the rate of true and false positive contacts.

Background/purpose The uniqueness of human teeth necessitated that dental restorations be customized primarily through extensive manual labor. Therefore, this study explored the potential of AI designed dental restorations for clinical applications. Materials and methods Digital artificial design and AI design crown restorations were replicated 10 times, for a total of 20 samples. The zirconia crown restoration was completed by strengthening and glazing according to standard clinical procedures. Samples were digitally archived using a dental scanner to assess reproducibility, precision, and occlusion. The human trial portion included natural tooth preparations by clinical standards. Three participants each designed two crowns, resulting in a total of six crowns. Dental x-rays were used for image evaluation. Results The 3D accuracy showed that stereolithography (STL) and scan files of the AI design group were 3.4 and 6.6 times lower than the digital group, respectively (P < 0.05). The space of the occlusal surface of the AI-designed crown was 1.8-times higher than that of the digital design (P < 0.05). Intraoral optical images demonstrated that the AI designed crown closely resembled the human-designed counterpart in appearance. Comparison of color distribution showed more differences on the buccal and lingual sides between the two design patterns. Conclusion Clinical images indicate that the shape, precision, and space of AI designed crowns are comparable to those of digitally designed crowns. Despite the spatial differences in contact between AI designed and digitally designed crowns, the in vivo and in vitro test results demonstrated favorable realism and contact quality.

OBJECTIVES Within the development of digital technologies, dental professionals aim to integrate virtual diagnostic articulated casts obtained by using intraoral scanners (IOSs), the mandibular motion of the patient recorded by using an optical jaw tracking system, and the information provided by computerized occlusal analysis systems. This article describes the various digital technologies available for obtaining the digital occlusion of a patient and outlines its challenges and limitations. OVERVIEW The factors that influence the accuracy of the maxillomandibular relationship of diagnostic casts obtained by using IOSs are reviewed, as well as the occurrence of occlusal collisions or mesh interpenetrations. Different jaw tracking systems with varying digital technologies including ultrasonic systems, photometric devices, and artificial intelligence algorithms are reviewed. Computerized occlusal analysis systems for detecting occlusal contacts in a time sequential manner with the pressure distribution on the occlusal surfaces are reviewed. CONCLUSIONS Digital technologies provide powerful diagnostic and design tools for prosthodontic care. However, the accuracy of these digital technologies for acquiring and analyzing the static and dynamic occlusion need to be further analyzed. CLINICAL SIGNIFICANCE Efficiently implementing digital technologies into dental practice requires an understanding of the limitations and state of current development of the digital acquisition methods for digitizing the static and dynamic occlusion of a patient by using IOSs, digital jaw trackers, and computerized occlusal analysis devices.

Background Automation and artificial intelligence (AI) are increasingly applied to digital dentistry, aiming to improve efficiency and accuracy in restorative and surgical workflows. The precise design of mandibular first molar occlusal surfaces remain a time-consuming manual task that limits scalability. This study aimed to develop and validate a fully automated AI framework for individualized occlusal surface reconstruction from intraoral scans, supporting the integration of automation into prosthodontic procedures. Methods Intraoral scans from 110 patients were partitioned into three cohorts: a training set (n = 90), a validation set (n = 10), and a testing set (n = 10). Occlusal surfaces of maxillary premolars and molars were encoded into a 30-dimensional latent space via a Dimension Elevator Module. An attention-guided fusion network integrated multi-scale geometric features to reconstruct mandibular first molar occlusal surfaces. Performance was assessed using point-to-point error, Dice similarity coefficient (DSC), and surface normal cosine similarity. Clinical validation was conducted through structured evaluation by ten dental professionals using a five-point Likert scale. Results The framework achieved a mean point-to-point error of 0.66 mm, a DSC of 86.9%, and a surface normal cosine similarity exceeding 87%. Expert evaluation yielded mean scores above 4.0 across all criteria, with favorable ratings in occlusal accuracy (4.08 ± 0.78), clinical feasibility (4.09 ± 0.78), and overall acceptability (4.10 ± 0.78). Conclusions The proposed AI-driven workflow enables automated and clinically validated occlusal surface design, demonstrating both quantitative accuracy and expert endorsement. By streamlining digital prosthodontic workflows, this approach aligns with the broader trend of robotics and automation in dental surgery, offering potential to enhance surgical precision, reduce manual workload, and improve patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-026-07874-x.

Artificial intelligence (AI) is increasingly integrated into dental computer‑aided design (CAD) workflows, offering automated restoration and occlusal device design with reduced operator input and potentially higher efficiency. In parallel, conventional CAD systems remain the standard for digital occlusal splint fabrication, relying on rule‑driven algorithms, tooth libraries, and virtual articulation to generate splint geometry. Emerging AI‑assisted platforms, such as Medit Splints and 3Shape Automate, extend concepts originally developed for crown design to occlusal splints, automatically generating complete devices from articulated digital models with minimal manual adjustment. However, the extent to which these systems match or exceed established CAD software in terms of geometric accuracy, occlusal morphology, and reproducibility remains unclear. This narrative review summarizes current evidence on AI‑assisted and conventional CAD software for occlusal splint design. Early in vitro data suggest that AI‑generated splints can achieve clinically acceptable intaglio fit and occlusal contact patterns, with precision comparable to technician‑designed or conventionally designed controls. Larger, well‑designed clinical studies are required to determine whether AI‑assisted splint design offers meaningful advantages in clinical performance, patient comfort, and long‑term outcomes beyond gains in efficiency and standardization.

Objective This study aimed to develop and validate an artificial intelligence (AI) system for measuring and categorizing anterior vertical relationships, and to evaluate its performance …

STATEMENT OF PROBLEM Maxillary and mandibular scans can be articulated in maximum intercuspal position (MIP) by using an artificial intelligence (AI) based program; however, the accuracy of the AI-based program locating the MIP relationship is unknown. PURPOSE The purpose of the present clinical study was to assess the accuracy of the MIP relationship located by using 4 intraoral scanners (IOSs) and an AI-based program. MATERIAL AND METHODS Conventional casts of a participant mounted on an articulator in MIP were digitized (T710). Four groups were created based on the IOS used to record a maxillary and mandibular scan of the participant: TRIOS4, iTero, i700, and PrimeScan. Each pair of nonarticulated scans were duplicated 20 times. Three subgroups were created: IOS, AI-articulated, and AI-IOS-corrected subgroups (n=10). In the IOS-subgroup, 10 duplicated scans were articulated in MIP by using a bilateral occlusal record. In the AI-articulated subgroup, the remaining 10 duplicated scans were articulated in MIP by using an AI-based program (BiteFinder). In the AI-IOS-corrected subgroup, the same AI-based program was used to correct the occlusal collisions of the articulated specimens obtained in the IOS-subgroup. A reverse engineering program (Geomagic Wrap) was used to calculate 36 interlandmark measurements on the digitized articulated casts (control) and each articulated specimen. Two-way ANOVA and pairwise multiple comparison Tukey tests were used to analyze trueness (α=.05). The Levene and pairwise multiple comparison Wilcoxon rank tests were used to analyze precision (α=.05). RESULTS Significant trueness discrepancies among the groups (P<.001) and subgroups (P<.001) were found, with a significant interaction group×subgroup (P<.001). The Levene test showed significant precision discrepancies among the groups (P<.001) and subgroups (P=.005). The TRIOS4 and iTero groups obtained better trueness and lower precision than the i700 and PrimeScan systems. Additionally, the AI-articulated subgroup showed worse trueness and precision than the IOS and AI-IOS-corrected subgroups. The AI-based program improved the MIP trueness of the scans articulated by using the iTero and PrimeScan systems but reduced the MIP trueness of the articulated scans obtained by using the TRIOS4 and i700. CONCLUSIONS The trueness and precision of the maxillomandibular relationship was impacted by the IOS system and program used to locate the MIP.

PURPOSE Artificial intelligence (AI) may be used to learn and predict the maxillomandibular relationship, particularly when the number of occluding teeth pairs is insufficient. This study aimed to investigate the feasibility of training a new two-stage coarse-to-fine teeth alignment pipeline AI system in predicting maxillomandibular relationships based on the occlusal morphology of antagonistic teeth. METHODS Maxillary and mandibular stone casts were collected and scanned at the maximal intercuspal position (MIP). A deep learning alignment network was trained using 90% of cast pairs. The remaining 10% of pairs were input into the trained AI system for validation. The maxillomandibular relationships predicted by the AI system were superimposed and compared with those of the mounted casts. Cartesian x-, y-, and z-coordinates were defined for each mandibular tooth scan with respect to (w.r.t.) its occlusal plane and dental midline. The discrepancy in the position of maxillary teeth scans was described based on rotation and translation. RESULTS A total of 325 pairs of maxillary and mandibular stone casts were collected, with 300 pairs used for training and 25 for validation. For the AI-predicted maxillomandibular relationship, the mean rotational discrepancies w.r.t. the x-, y-, and z-axis were 1.407°±1.548°, 1.269°±8.476°, and 0.730°±1.334°, respectively. The mean translational discrepancies w.r.t. the x-, y-, and z-axis were 0.185±1.324 mm, 1.222±0.848 mm, -1.034±0.273 mm, respectively. CONCLUSIONS The AI-predicted maxillomandibular relationship for maxillary and mandibular teeth scans shows discrepancies of less than 1.3 mm and 1.5° compared to the actual relationships.

Digital technology is broadly used in almost every part of medicine. As tools of digital technology, augmented reality and virtual reality have been adopted in all disciplines of dentistry and dental education. In particular, virtual articulators have allowed for a full analysis of occlusion with dental models that can simulate all mandibular movements in static and dynamic positions. When combined with additional software, virtual articulators can also enhance education and practice, allow for quicker and more precise individualized diagnoses and enable discussions of dental treatment planning options with patients during their first appointment. This article reviews the requirements for virtual articulators and occlusal recordings and assesses their advantages and disadvantages in various aspects.

… for simulating occlusal dynamics. First, we tested the proposition that scanned interocclusal records could index the virtual … Second, we postulated that mathematical simulation based on …

… In [21], the virtual dental occlusion was obtained by manually defining the occlusal plane in … on the accuracy of identification of the correct occlusal plane. The lack of contact detection …

The occlusal registration of virtual models taken by intraoral scanners sometimes shows patterns which seem much different from the patients’ occlusion. Therefore, this study aims to evaluate the accuracy of virtual occlusion by comparing virtual occlusal contact area with actual occlusal contact area using a plaster model in vitro. Plaster dental models, 24 sets of Class I models and 20 sets of Class II models, were divided into a Molar, Premolar, and Anterior group. The occlusal contact areas calculated by the Prescale method and the virtual occlusion by scanning method were compared, and the ratio of the molar and incisor area were compared in order to find any particular tendencies. There was no significant difference between the Prescale results and the scanner results in both the molar and premolar groups (p = 0.083 and 0.053, respectively). On the other hand, there was a significant difference between the Prescale and the scanner results in the anterior group with the scanner results presenting overestimation of the occlusal contact points (p < 0.05). In Molars group, the regression analysis shows that the two variables express linear correlation and has a linear equation with a slope of 0.917. R2 is 0.930. Groups of Premolars and Anteriors had a week linear relationship and greater dispersion. Difference between the actual and virtual occlusion revealed in the anterior portion, where overestimation was observed in the virtual model obtained from the scanning method. Nevertheless, molar and premolar areas showed relatively accurate occlusal contact area in the virtual model.

The future of dental practice is closely linked to the utilization of computer-based technology, specifically virtual reality, which allows the dental surgeon to simulate true life situations in patients. The virtual articulator has been designed for the exhaustive analysis of static and dynamic occlusion, with the purpose of substituting mechanical articulators and avoiding their errors. These tools will help both odontologists and dental prosthetists to provide the best individualized treatment for each patient. The present review analyzes the studies published in the literature on the design, functioning and applications of virtual articulators. A Medline-PubMed search was made of dental journals, with the identification of 137 articles, of which 16 were finally selected. The virtual articulator can simulate the specific masticatory movement of the patient. During mandibular animation, the program calculates the sites where the opposing teeth come into contact. The studies made to assess the reliability of the virtual articulator show good correspondence in visualization of the number and position of the dynamic contacts. The virtual articulator is a precise tool for the full analysis of occlusion in a real patient. Key words: Virtual articulator, dental occlusion, dental articulator.

Mandibular motion tracking system (ManMoS) has been developed for orthognathic surgery. This article aimed to introduce the ManMoS and to examine the accuracy of this system. Skeletal and dental models are reconstructed in a virtual space from the DICOM data of three-dimensional computed tomography (3D-CT) recording and the STL data of 3D scanning, respectively. The ManMoS uniquely integrates the virtual dento-skeletal model with the real motion of the dental cast mounted on the simulator, using the reference splint. Positional change of the dental cast is tracked by using the 3D motion tracking equipment and reflects on the jaw position of the virtual model in real time, generating the mixed-reality surgical simulation. ManMoS was applied for two clinical cases having a facial asymmetry. In order to assess the accuracy of the ManMoS, the positional change of the lower dental arch was compared between the virtual and real models. With the measurement data of the real lower dental cast as a reference, measurement error for the whole simulation system was less than 0.32 mm. In ManMoS, the skeletal and dental asymmetries were adequately diagnosed in three dimensions. Jaw repositioning was simulated with priority given to the skeletal correction rather than the occlusal correction. In two cases, facial asymmetry was successfully improved while a normal occlusal relationship was reconstructed. Positional change measured in the virtual model did not differ significantly from that in the real model. It was suggested that the accuracy of the ManMoS was good enough for a clinical use. This surgical simulation system appears to meet clinical demands well and is an important facilitator of communication between orthodontists and surgeons.

Virtual articulators have emerged as promising digital tools for simulating jaw movements and occlusal contacts in dentistry. However, few studies have compared the performance of different virtual articulators and their impact on recording occlusal contacts. This study designed to evaluate the effects of various virtual articulators on occlusal contact distribution and morphology and identify the most accurate system. TRIOS 3Shape intraoral scans of lower and upper arches of five dentate patients with digital bite registration on both sides were performed and exported to dental CAD software (3Shape OrthoSystem). The occlusal plane was standardized using three points on 3Shape OrthoAnalyzer. Eight virtual articulators were evaluated during this study in motion: Ivoclar Vivadent, SHUFO Proarch IV, Kavo Protar, 3Shape Generic, Denar Marta 330, ACR (Atex compatible), SAM 2P, and BIO ART A7 Plus. Occlusal contacts were recorded during motions for left, right, retrusive, and protrusive movements. The result of occlusal map was recorded and analyzed by Python code written by the researcher (Ian Code) to capture the information for the number and regions of occlusal contact and convert it to numerical values for comparison. Significant differences were found between articulators in the number and area of occlusal contact distributions. The 3Shape Generic articulator showed the highest number of contact regions with a mean of 19.6 ± 6.8 regions, while the ACR (Atex compatible) articulator showed the lowest number with a mean of 15.8 ± 7.3 regions. The result of contact areas shows the highest area with mean of 32 ± 6.4 mm2 in the Ivoclar Vivadent articulator and the lowest area with a mean of 26.6 ± 6.3 mm2 in the BIO ART A7 Plus articulator. These findings suggest that the choice of a virtual articulator can significantly influence the representation of occlusal contact regions and area, with potential effects on its implications for planning and treatment outcomes. Dental laboratories and clinicians should be aware of the specific characteristics and limitations of their chosen virtual articulator system and consider these factors when interpreting the results and making decisions in treatment. Future researches consider on validating these findings in clinical application in dentistry by investigation the effect of dynamic and static virtual articulation, this may lead to developing a new virtual articulator that incorporates advanced algorithms and technologies that can improve the accuracy of occlusal contact simulations.

… This study was designed to develop a virtual reality system for simulating … of the occlusal plane, and mandibular prognathism can be recognized. The inclination between the occlusal …

The design and fabrication of teeth restorations in dentistry rely increasingly on CAD/CAM techniques. We present an approach for interactive design of the occlusal surface of teeth based on simulation of jaw articulation and computer-aided diagnosis of occlusal disorders. To bridge the cognitive gap between the dentist and the computer system, we propose a virtual reality user interface, which applies the metaphors of tools and techniques known in dentistry. This makes the restoration design more intuitive for dentists. The system uses Virtual Reality Modeling Language (VRML) and HTML standards to generate a treatment report and exchange data in an electronic form.

PURPOSE Reconstruction of patients' dental occlusion should be performed to fulfill esthetic and functional demands. These applied restorations should be in harmony with the existing occlusion and should not have any negative effects on intraoral dynamics. The aim of this clinical study is to compare the accuracy of the occlusal design shaped by conventional Wax Up methods and computer-aided design (CAD) regarding their similarity to the natural tooth morphology. METHODS Impressions of 10 caries-free jaws were taken, and the resulting gypsum casts were scanned with a laboratory scanner. Preparations for all-ceramic full crowns were performed on second premolars and second molars. Occlusal design of 40, 3-member fixed partial dentures (FPD) were obtained with two different methods 10 FPD was designed with conventional wax up technique (Wax Up), 30 design was performed with CAD Dental wings open system (DWOS) software using three different anatomy libraries (Dental Wings (DW), Merz, Vita). The data of the bridges in the STereo-Lithography Interface Format (STL) was compared with the pre-cut data, which was regarded as a reference in terms of accuracy in the Atos so high end 3D digitizer. RESULTS According to the results of Kruskal-Wallis test, there was no statistical difference between the Wax Up, Vita, Merz and Dental Wings groups (p>0.05) when compared to the natural teeth. The main difference between all four groups and natural surface was 550±130μm. CONCLUSIONS Occlusal design produced by conventional techniques and CAM DWOS system compared to natural tooth morphology showed no statistically significant difference.

OBJECTIVES This study aimed to assess the effectiveness of patient-specific motion in restoring anterior guidance and to investigate the influence of occlusal plane position within a virtual articulator on the design of the anterior guide slope for incisors. METHODS Twenty participants' intraoral scan, occlusal plane position, and jaw motion data were recorded. The maxillary anterior teeth were virtually prepared, and the crowns were designed based on average virtual articulator (AVR), personalized virtual articulator (ART), and patient-specific motion (PSM). The anterior guide slope of maxillary central incisors (S1, S2, Sc, Sp) and the mesio-distal angle (MDA) of the canine of prostheses were compared to that of natural teeth (NAT). One-Way ANOVA was utilized to evaluate the effectiveness of the three methods in restoring the anterior guidance of maxillary anterior teeth. RESULTS The comparison of Sp and MDA showed no significant difference between the PSM and NAT groups (p >0.05). However, Sp of the ART group was significantly smaller, while MDA was higher than that of the NAT group (p <0.05). Sp did not differ significantly (p >0.05) when the angle of the occlusal plane (AOP) was small. As the AOP increased, Sp of the ART and AVR groups were significantly smaller than that of the NAT group (p <0.05). With a large AOP, Sp of the ART group was notably smaller than that of the NAT group (p <0.05), while there was no significant difference between the AVR and NAT groups (p >0.05). CONCLUSIONS Occlusal design based on patient-specific motion proved more effective in restoring natural anterior guidance. The anterior guidance of prostheses designed using a virtual articulator was influenced by occlusal plane position. CLINICAL SIGNIFICANCE The utilization of a jaw motion tracer facilitated the transfer of personalized occlusal plane positions and recorded jaw motion, which can be integrated into the digital prosthetic workflow for virtual occlusion adjustment. Occlusal design based on patient-specific motion more effectively restored lingual guidance of maxillary anterior crowns.

… dental devices, flexible design software must be used … designing and producing occlusal splints. The system is similar to other dental computer-aided design (CAD) and computer-aided …

… with the preparation impression for designing the occlusal surface (eg, of a full crown). … the occlusal design. Semichair-side and laboratory computer-aided design/computer-aided …

… 2.2 Computer-aided adjustment of occlusal contact points In order to assist in designing the occlusal contacts of a crown using dental CAD, we propose a totally new technique using …

STATEMENT OF PROBLEM The conventional waxing method of designing occlusion relies on the skill of the dental laboratory technician and the use of articulating paper, resulting in limited accuracy. However, the clinical effects of computer-aided design (CAD) occlusal contacts and clearance in implant-supported crowns remain insufficiently investigated. PURPOSE The purpose of this randomized clinical trial was to compare the effects of CAD occlusal contacts and clearance with those of the waxing method in posterior implant-supported single crowns. MATERIAL AND METHODS Sixty patients with a single missing posterior tooth scheduled for an implant-supported crown were enrolled and randomized into 2 groups. After making impressions and pouring definitive casts, crowns with an 80-μm occlusal clearance for light contacts were designed. The control group used the waxing method with articulating paper to design the occlusion, while the test group adopted a digital antagonist tool after cast scanning. The designed occlusal clearance was calculated by using digital casts of the designed crowns. Occlusal clearance of finished crowns on the definitive casts was evaluated with a silicone interocclusal record. During delivery, the crowns were scanned, and the occlusion was evaluated. Occlusal adjustment indicators were calculated. The independent-samples t test, Mann-Whitney U test, and Pearson chi-squared test were used to analyze the statistical differences (α=.05). RESULTS Compared with the control group, the test group showed significantly lower mean ±standard deviation maximum occlusal adjustment distance (361.0 ±126.1 µm versus 451.5 ±179.3 µm, P=.037), but the root mean square (RMS) in the 2 groups was not significantly different (P=.121). The test group demonstrated significantly higher median (interquartile range) minimum designed occlusal clearance (72.4 [6.0] μm versus 26.1 [54.2] μm, P<.001) and lower median (interquartile range) RMS of occlusal clearance of finished crowns (116.2 [117.1] μm versus 227.3 [126.4] μm, P=.005) than the control group, both of which were closer to the design value (80 µm). Patient satisfaction before adjustment was significantly higher in the test group than in the control group (P=.005). Adjustment time and volume, lateral interference, and occlusal contact scores in the 2 groups were not significantly different (P>.05). CONCLUSIONS Compared with the waxing method, CAD occlusion for implant-supported single crowns reduced occlusal adjustment distance, controlled occlusal clearance closer to the design value, and improved initial patient satisfaction.

STATEMENT OF PROBLEM The growing adoption of digital workflows and artificial intelligence (AI)-assisted design has revolutionized occlusal device fabrication, offering improved precision, efficiency, and reproducibility. However, the clinical reliability of digitally predicted occlusal contacts, particularly across different intensity levels and anatomic regions, remains insufficiently validated. PURPOSE This study aimed to evaluate the accuracy and reliability of AI-predicted occlusal contacts in computer-aided design and computer-aided manufacture (CAD-CAM) occlusal devices fabricated through a fully digital workflow, with comparisons stratified by contact intensity and anatomic region. MATERIAL AND METHODS A cross-sectional observational study was conducted with 53 occlusal devices (45 maxillary, 8 mandibular) fabricated using intraoral scanning, AI-based CAD software program (Medit Link v3.2.2; Medit), and 3-dimensional (3D) printing. Predicted occlusal contacts were automatically generated by the software program and compared with clinical markings obtained using articulating paper during the initial adjustment session. Agreement rates were calculated by contact intensity (low, medium, high) and anatomic region (anterior, posterior). Statistical analyses included descriptive statistics, the Friedman test for repeated-measures comparisons across intensity levels, Bonferroni-adjusted post hoc tests, and intraclass correlation coefficients [ICC(2,1)] to assess internal consistency among continuous measurements within each device (α=.05). RESULTS Agreement between digitally predicted and clinically verified contacts increased systematically with intensity, with mean coincidence rates of 59.4%, 69.7%, and 79% for low-, medium-, and high-intensity contacts, respectively. Low-intensity contacts showed the greatest dispersion, while high-intensity contacts displayed the most stable agreement values. Internal consistency among the 3 continuous agreement measurements was supported by ICC(2,1) values ranging from 0.797 to 0.867. Region-specific analyses demonstrated clearer separation among intensity levels in the anterior region, whereas medium- and high-intensity contacts overlapped more extensively in the posterior region. CONCLUSIONS AI-assisted CAD-CAM workflows demonstrated progressively higher predictive accuracy as occlusal contact intensity increased, with high-intensity contacts showing the most consistent correspondence with clinical markings. In contrast, the reduced accuracy and greater variability observed for low-intensity contacts-particularly in posterior regions-underscore the continued necessity of clinical verification during device adjustment.

… strength of compromised molars restored with computer-aided-design/computer-assisted-… The occlusal surface was designed based on the reminiscent occlusal enamel contours. …

ABSTRACT Objective: To describe a technique used to measure wear on the surface of occlusal splints using dental Computer-Aided Design (CAD) software. Material and Methods: The technique employs intuitive CAD software (Exocad), which features innovative tools capable of providing qualitative analysis and quantitative data regarding wear and structural modifications of occlusal splints in patients with sleep bruxism. The workflow for file acquisition and wear evaluation is described as follows: Digitization of occlusal splints; Importation of STL files; Initial mesh alignment; Automated superimposition of STL files; Assessment of mesh agreement degree. Results: The technique enabled the quantitative analysis of the wear on the occlusal surface of the splints. After the superimposition of the standard tessellation language (STL) files of the splints with and without wear, the CAD software displayed the chromatic deviations that indicated areas of thickness reduction. The highest degrees of wear were observed in the anterior guidance and posterior contact areas. This wear pattern provided evidence of the different muscle activity behaviors associated with the bruxism, including predominantly eccentric movements in the anterior region and centric forces in the posterior region. Conclusion: Dental CAD software can be utilized as a viable complementary tool to identify the thickness of occlusal splints after adjustments and, consequently, diagnose the severity level of sleep bruxism, providing predictable treatment and effective patient management during clinical follow-up visits.

Artificial intelligence (AI) has been expanding into areas that were thought to be reserved for human experts and has a tremendous potential to improve patient care and revolutionize the healthcare field. Recently launched AI-powered dental design solutions enable automated occlusal device design. This article describes a dental method for the complete digital workflow for occlusal device fabrication using two different AIpowered design software programs (Medit Splints and 3Shape Automate) and additive manufacturing. Additionally, the benefits and drawbacks of this workflow were reviewed and compared to conventional workflows.

… of ML techniques in the reconstruction of the occlusal surface, thus providing insights into … Machine learning is a branch of artificial intelligence (AI) and computer science that focuses …

STATEMENT OF PROBLEM The advent of machine learning in the complex subject of occlusal rehabilitation warrants a thorough investigation into the techniques applied for successful clinical translation of computer automation. A systematic evaluation on the topic with subsequent discussion of the clinical variables involved is lacking. PURPOSE The purpose of this study was to systematically critique the digital methods and techniques used to deploy automated diagnostic tools in the clinical evaluation of altered functional and parafunctional occlusion. MATERIAL AND METHODS Articles were screened by 2 reviewers in mid-2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible articles were critically appraised by using the Joanna Briggs Institute's Diagnostic Test Accuracy (JBI-DTA) protocol and Minimum Information for Clinical Artificial Intelligence Modeling (MI-CLAIM) checklist. RESULTS Sixteen articles were extracted. Variations in mandibular anatomic landmarks obtained via radiographs and photographs produced notable errors in prediction accuracy. While half of the studies adhered to robust methods of computer science, the lack of blinding to a reference standard and convenient exclusion of data in favor of accurate machine learning suggested that conventional diagnostic test methods were ineffective in regulating machine learning research in clinical occlusion. As preestablished baselines or criterion standards were lacking for model evaluation, a heavy reliance was placed on the validation provided by clinicians, often dental specialists, which was prone to subjective biases and largely governed by professional experience. CONCLUSIONS Based on the findings and because of the numerous clinical variables and inconsistencies, the current literature on dental machine learning presented nondefinitive but promising results in diagnosing functional and parafunctional occlusal parameters.

Deep learning is increasingly integrated into oral rehabilitation workflows, particularly in implant planning, prosthodontic design automation, and peri-implant diagnosis. However, reported performance is heterogeneous and difficult to compare across tasks, modalities, and validation designs. The goal of this study was to critically analyze deep learning architecture families applied to oral rehabilitation and to provide task-driven selection guidance supported by an evidence table reporting dataset characteristics, validation strategy, and performance metrics. A focused narrative review was conducted using transparent, database-specific search criteria (final n = 10 included studies), emphasizing implant planning (cone–beam computed tomography [CBCT]-based segmentation), prosthodontic design (intraoral scan [IOS]/mesh inputs), and peri-implant diagnosis (periapical/panoramic radiographs). Evidence certainty for each clinical task was assessed using GRADE-informed ratings (High/Moderate/Low/Very Low). Extracted variables included clinical task, imaging modality, dataset size, architecture, validation strategy (internal vs. internal + external), split level, ground truth protocol, and performance metrics. A structured computational and hardware feasibility analysis was conducted for each architecture family to support real-world deployment planning. Encoder–decoder networks (U-Net/nnU-Net) dominate CBCT segmentation for implant planning, while detection architectures (Faster R-CNN, YOLO) support implant localization and peri-implant assessment on radiographs. Generative models (3D GANs, transformer-based point-to-mesh networks) enable crown design from three-dimensional scans. Hybrid CNN–Transformer architectures show promise for multimodal CBCT–IOS fusion, though direct evidence from the included studies remains limited to a single study. External validation remains uncommon yet essential given the risk of domain shift. In conclusion, architecture selection should be anchored to task geometry (2D vs. 3D), artifact burden, and required clinical output type. Reporting standards should prioritize dataset transparency, validation rigor, multi-center external testing, and uncertainty-aware outputs.

BACKGROUND: In recent years, artificial intelligence (AI) has made remarkable advancements and achieved significant accomplishments across the entire field of dentistry. Notably, efforts to apply AI in prosthodontics are continually progressing. This scoping review aims to present the applications and performance of AI in dental crown prostheses and related topics. METHODS: We conducted a literature search of PubMed, Scopus, Web of Science, Google Scholar, and IEEE Xplore databases from January 2010 to January 2024. The included articles addressed the application of AI in various aspects of dental crown treatment, including fabrication, assessment, and prognosis. RESULTS: The initial electronic literature search yielded 393 records, which were reduced to 315 after eliminating duplicate references. The application of inclusion criteria led to analysis of 12 eligible publications in the qualitative review. The AI-based applications included in this review were related to detection of dental crown finish line, evaluation of AI-based color matching, evaluation of crown preparation, evaluation of dental crown designed by AI, identification of a dental crown in an intraoral photo, and prediction of debonding probability. CONCLUSIONS: AI has the potential to increase efficiency in processes such as fabricating and evaluating dental crowns, with a high level of accuracy reported in most of the analyzed studies. However, a significant number of studies focused on designing crowns using AI-based software, and these studies had a small number of patients and did not always present their algorithms. Standardized protocols for reporting and evaluating AI studies are needed to increase the evidence and effectiveness.

… of deep learning for the classification of dental occlusion using … results on difficult image classification problems where the … in artificial intelligence or machine learning and can use the …

… Issues concerning the occlusion tasks and the duration and timing of occlusion are … for occlusion. The paper concludes with a description of some alternatives to occlusion and future …

The aim of this retrospective study was to determine whether a virtually created occlusion is as accurate as a conventionally created occlusion. Seventeen orthognathic patients were included in the study, which was conducted in a university clinic. Plaster cast models were obtained and digitized. Two experienced observers created the conventional (gold standard) and virtual occlusion to assess inter-observer variability. One observer created the conventional and virtual occlusion a second time to assess the intra-observer variability. The criterion for accepting the virtual occlusion was that the difference between the gold standard and the virtual occlusion was not larger than the intra-observer variability for the gold standard. A non-parametric Kruskal-Wallis H test was performed to detect statistically significant differences between the intra- and inter-observer groups for both the conventional and virtual occlusion. No statistically significant differences were found between the different groups. The difference between the conventional and virtual occlusion group was 0.20mm larger than the intra-observer variability of the gold standard. The virtual occlusion tool presented here can be utilized in daily clinical practice and makes the use of physical dental models redundant.

Orthognathic surgery plays a vital role in correcting various skeletal discrepancies of the maxillofacial region. Achieving optimal occlusion is a fundamental aspect of orthognathic surgery planning, as it directly influences postoperative outcomes and patient satisfaction. Traditional methods for setting final occlusion involve the use of dental casts which are time-consuming, prone to errors and cannot be easily shared among collaborating specialties. In recent years, advancements in digital technology have introduced innovative approaches, such as virtual occlusion, which may offer enhanced accuracy and efficiency in orthognathic surgery planning. Furthermore, the emergence of mixed reality devices and their 3D visualization capabilities have brought about novel benefits in the medical field, particularly in computer-assisted planning. This paper presents for the first time a prototype tool for setting virtual occlusion during orthognathic surgery planning using mixed reality technology. A complete walkthrough of the workflow is presented including an explanation of the implicit advantages of this novel tool. The new approach to defining virtual occlusion is set into context with other published methods of virtual occlusion setting, discussing advantages and limitations as well as concepts of surgical occlusion for orthognathic surgery.

OBJECTIVES The present in vitro study evaluated the reliability and validity of two computerised occlusion analysis systems. METHODS Three occlusion analysis methods were evaluated. The methods included one traditional method (scanning of articulating paper marks (SAP)) and two computerised systems: (dental prescale occlusion analysis system (DPO) and a modified virtual occlusion construction method (VOC)). For reliability evaluation, the occlusion of an articulator-mounted anatomic dentoform was analysed ten times with each of the three methods. Occlusal contact areas and contact number values were obtained and the coefficient of variation (CoV) of each method was compared. For validity evaluation, resin casts of the dentition of 10 human subjects were used for analysis. Paired t-tests, regression analysis and Bland-Altman analysis were used to evaluate the difference and agreement among the three methods. RESULTS The CoV values of occlusal contact areas from the entire dentition were in the order: SAP (5.7%) < DPO (12.7%) < VOC (15.6%). Higher values was found in the anterior teeth (19.8-40.8%). Significant differences were identified in the occlusal contact areas of the entire dentition and posterior teeth obtained from SAP and DPO; a significant correlation was detected between the two methods (P < 0.01). Bland-Altman agreement analysis indicated good agreement between SAP and VOC. CONCLUSIONS Both DPO and VOC have good reliability and validity. They are potential alternatives for analysis of occlusal contacts. CLINICAL SIGNIFICANCE The dental prescale occlusion analysis system and the modified virtual occlusion constructed method combine convenience with the objectivity of digital technology. These computerised occlusion analysis systems may be used for quantitative analysis of occlusal contacts in clinical practice, with good reliability and validity.

… dental appliance manufacture accuracy. The study also attempts to optimize STL mesh triangles to improve digital … utilizing a multi-objective optimization approach to find the optimal …

STATEMENT OF PROBLEM Artificial intelligence (AI) has been applied to crown design and can produce acceptable morphology. However, occlusal morphology and contact area distribution generated by AI may differ from natural teeth. Whether they can approach ideal static and dynamic occlusion remains unknown. PURPOSE The purpose of this prospective clinical study was to assess whether using a technique based on the wear facets of antagonist teeth improved the performance of occlusal morphology and contact area distribution of AI generated crowns. MATERIAL AND METHODS In the study, 23 participants were enrolled. Four types of crowns for maxillary first molars were analyzed: natural tooth (NA), technician designed crown (TE), AI generated crown (AT), and the Facets Align technique adjusted AT crown (FA). Occlusal morphology was evaluated by cusp inclination and root mean square (RMS). Occlusal contact area distribution was evaluated by area, F1-score, and occlusal contact separation distance. Finite element analysis (FEA) was used to analyze the stress distribution of the crowns. Statistical analysis was performed using the Friedman 2-way rank nonparametric test and Bonferroni post hoc tests (α=.05). RESULTS The cusp inclination of AT was lower than that of NA (P<.01) on the distobuccal and distopalatal cusps. The occlusal contact area of AT was smaller than that of NA (P<.01). The occlusal contact separation distance of AT was the shortest during protrusive, working side, and nonworking side lateral movements (P<.01). FA did not differ significantly from NA and AT in cusp inclination. FA had smaller RMS (P<.01) and larger occlusal contact area (P<.001) than AT in several regions. FA improved the occlusal contact separation distance of AT during lateral movement on the working side (P<.05), while no significant difference was observed during protrusive and nonworking side lateral movement. The mean F1-score was 0.60 for FA, and the difference was significant between FA and AT (P<.001). As for finite element analysis (FEA), FA tended to exhibit higher stress and deformation values than AT but remained lower than NA. CONCLUSIONS The Facets Align technique optimized AI generated crowns in both static and dynamic occlusion when there were wear facets on the antagonist tooth.

Background: Three-dimensional surgical planning for orthognathic surgery is becoming prevalent, with improving outcomes. However, conventional dental casts are still used for evaluations, digital image conversion, surgical planning, and occlusal splint production. This study used intraoral scanning for the three-dimensional planning of the final digital occlusion and compared this method with the conventional dental cast approach. Methods: Thirty consecutive patients who underwent two-jaw orthognathic surgery to treat mandibular prognathism and asymmetry were included. Dental casts (control group) and intraoral scans (study group) were collected simultaneously for designing the final dental occlusion. A step-by-step setup of the final digital occlusion was established for the study group. To validate results, the intraoral scanning–based virtual occlusion was superimposed over the dental model–based final digital occlusion for comparison. Intraobserver and interobserver variability were assessed for setting up the final digital occlusion. The fitness of splints fabricated using the conventional and virtual occlusion methods were compared. Results: The steps for setting up the final digital occlusion were applicable in all cases. The average root-mean-square difference of final occlusion images between the two groups was 0.45 mm, indicating a comparable occlusal relationship. The intraobserver reproducibility and interobserver reliability for setting up the virtual occlusion were satisfactory. Moreover, no significant difference existed in the splint fitness test between the groups. Conclusions: The proposed intraoral scan and setup process of the final digital occlusion was reliable and accurate. Thus, the method can replace the dental model approach for the three-dimensional planning of orthognathic surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

OBJECTIVES This study compared the tooth morphology, internal fit, occlusion, and proximal contact of dental crowns automatically generated via two deep learning (DL)-based dental software systems with those manually designed by an experience dental technician using conventional software. METHODS Thirty partial arch scans of prepared posterior teeth were used. The crowns were designed using two DL-based methods (AA and AD) and a technician-based method (NC). The crown design outcomes were three-dimensionally compared, focusing on tooth morphology, internal fit, occlusion, and proximal contacts, by calculating the geometric relationship. Statistical analysis utilized the independent t-test, Mann-Whitney test, one-way ANOVA, and Kruskal-Wallis test with post hoc pairwise comparisons (α=.05). RESULTS The AA and AD groups, with the NC group as a reference, exhibited no significant tooth morphology discrepancies across entire external or occlusal surfaces. The AD group exhibited higher root mean square and positive average values on the axial surface (P<0.05). The AD and NC groups exhibited a better internal fit than the AA group (P<.001). The cusp angles were similar across all groups (P=.065). The NC group yielded more occlusal contact points than the AD group (P=.006). Occlusal and proximal contact intensities varied among the groups (both P<.001). CONCLUSIONS Crowns designed by using both DL-based software programs exhibited similar morphologies on the occlusal and axial surfaces; however, they differed in internal fit, occlusion, and proximal contact. Their overall performance was clinically comparable to that of the technician-based method in terms of the internal fit and number of occlusal contact points. CLINICAL SIGNIFICANCE DL-based dental software for crown design can streamline the digital workflow in restorative dentistry, ensuring clinically-acceptable outcomes on tooth morphology, internal fit, occlusion, and proximal contact. It can minimize the necessity of additional design optimization by dental technician.

OBJECTIVE To establish a digitally integrated protocol for managing failed full-arch occlusal rehabilitations through dynamic jaw tracking, virtual occlusal analysis, and computer-guided equilibration. CLINICAL CONSIDERATIONS A virtual patient model was reconstructed using multimodal three-dimensional datasets including cone-beam computed tomography, intraoral scans, photographs and jaw motion records. Dynamic occlusal simulations identified premature contact asymmetry, and digital occlusal equilibration evaluated the discrepancy between the initial occlusion and centric relation occlusion. Guided by these findings, intraoral equilibration and computer-aided design/manufacturing (CAD/CAM) transitional restorations were implemented, followed by definitive restorations, eliminating conventional articulator mounting and manual analysis. CONCLUSIONS The reintervention protocol for compromised full-arch occlusal rehabilitation achieved biomechanical stability and esthetic harmony via a digital workflow. CLINICAL SIGNIFICANCE Digital occlusal analysis and equilibration combined with staged CAD/CAM workflows addresses complex rehabilitation failures by synchronizing functional demands with esthetic parameters, reducing clinical adjustments compared to analog methods. The biologic adaptation phase proved critical for patients with preexisting occlusal dysfunction.

While tooth alignment is crucial for digital dentistry, especially in orthodontic treatment, existing computer-aided methods mainly focus on the 3D dental crown but overlook the entire teeth, which is essential for applications in orthodontics. Besides, clinical orthodontic rules are not fully considered in these methods, i.e., there should be no collisions and gaps between teeth, the upper jaw and lower jaw should have correct occlusion relationships, the teeth should comply with a reasonable dental arch curve, etc. To generate optimal tooth alignment results, we propose a rule-based optimization method for solving the tooth alignment problem that takes into consideration the clinical rules functionally and aesthetically. We optimize rule-driven objective functions by adjusting the 6-DoF transformations of each tooth. Besides, our optimization formulation supports customization for different clinical scenarios by specifying the various energy terms. Extensive experiments, ablation studies, and user studies have been conducted to validate the effectiveness of our method. Quantitative and qualitative comparisons demonstrate that our method generates better tooth alignments than previous methods.

The purpose of this clinical report was to describe the use of a piezographic impression associated with computer-aided design and computer-aided manufacturing (CAD-CAM) for teeth set-up and of digital tools for neuro-musculo-kinetic analyses. An edentulous patient with hemiglossectomy and heavily resorbed mandible consulted for complete denture rehabilitation to improve their masticatory function and speech. Master casts, wax rims and piezographic impression were scanned for digital prosthetic work. Two digital try-ins were performed to respect the neutral zone: try-in 1 with posterior crossbite and try-in 2 without crossbite. Muscle activity and mandibular kinetics were performed for each try-ins following the MAC2 protocol (six criteria): muscular tone, contraction synchrony, contraction efficiency, interocclusal rest distance, amplitude of mandibular movement and velocity. Try-in 2 showed better data than try-in 1 in all criteria: muscle tone (respectively 71% vs 59%), contraction synchrony (79% vs 75%), contraction efficiency (85% vs 77%), an increase in range of motion of 3.3 mm and a better velocity (0.35 sec ± 0.12 sec vs 0.57 sec ± 0.14 sec, p = 0.008). The piezographic impression, in combination with CAD-CAM, allowed the comparison of two prosthetic designs and the selection of the try-in with best neuro-musculo-kinetic results. This article is protected by copyright. All rights reserved.

… Implant localization can be optimized. Occlusion analysis also has a major role in … are based on digital dental models reconstructed from conventional dental impressions [13]. In that …

… guidance optimization via jaw motion tracking and dynamic articulation simulation. This digital … and guided reconstruction, achieving stable occlusion and reproducible centric relation in …

One critical step in routine orthognathic surgery is to reestablish a desired final dental occlusion. Traditionally, the final occlusion is established by hand articulating stone dental models. To date, there are still no effective solutions to establish the final occlusion in computer-aided surgical simulation. In this study, we consider the most common one-piece maxillary orthognathic surgery and propose a three-stage approach to digitally and automatically establish the desired final dental occlusion. The process includes three stages: (1) extraction of points of interest and teeth landmarks from a pair of upper and lower dental models; (2) establishment of Midline-Canine-Molar (M-C-M) relationship following the clinical criteria on these three regions; and (3) fine alignment of upper and lower teeth with maximum contacts without breaking the established M-C-M relationship. Our method has been quantitatively and qualitatively validated using 18 pairs of dental models. Qualitatively, experienced orthodontists assess the algorithm-articulated and hand-articulated occlusions while being blind to the methods used. They agreed that occlusion results of the two methods are equally good. Quantitatively, we measure and compare the distances between selected landmarks on upper and lower teeth for both algorithm-articulated and hand-articulated occlusions. The results showed that there was no statistically significant difference between the algorithm-articulated and hand-articulated occlusions. The proposed three-stage automatic dental articulation method is able to articulate the digital dental model to the clinically desired final occlusion accurately and efficiently. It allows doctors to completely eliminate the use of stone dental models in the future.

Statement of problem Dental restorations reduce occlusal force through a compensatory feedback mechanism. Thus, the type of restoration used during rehabilitation plays a vital role in altering occlusal force and contact area. The effects of factors such as the remaining dentition, occlusal contact area, and different types of rehabilitation on occlusal force need further exploration. Aim Evaluate the evidence of occlusal contact areas and various rehabilitation methods on influencing the occlusal force assessed using digital occlusal analyzers. Materials & Method: The protocol followed the Cochrane standards for systematic reviews and was registered in PROSPERO (CRD42024623551). The literature search used the Population, Exposure, Comparator, Outcome, Study Design (PECOS) strategy. Database for searched until December 2024. Randomized controlled trial, observational studies including cohort, case-control, and cross-sectional studies that investigated the relationship of occlusal force with occlusal contact area, masticatory force, occlusal time, and number of remaining natural dentition using Dental Prescale or T scan. Results 545 articles were retrieved, and based on inclusion and exclusion criteria 13 observation studies were systematically filtered, 3 studies were included in the meta-analysis and all 13 studies were taken for qualitative data synthesis. Cochrane ROBINS 1 tool revealed a moderate risk of bias for the included studies. The fixed effect model showed moderate heterogeneity(I2 = 46 %) in the quantitatively assessed studies. The mean difference of occlusal force with rehabilitation was −10.02[95 % C.I(13.03, −7.03)] depicting prosthesis improved the occlusal force. However, qualitative analysis revealed that the occlusal force with prosthesis was lesser than the natural dentition quadrant. Conclusion Occlusal force was increased with rehabilitation compared to the edentulous site, however, the amount of force established in a complete set of natural dentitions was more than the rehabilitated site. The location of teeth in the arch, and the number of remaining dentitions played a role in occlusal force.

… This study highlights the role of digital technology in … of occlusion transfer, impression registration and color selection. … to achieve syner- gistically optimized outcomes in both functional …

Precision in diagnosis is essential for achieving optimal outcomes in prosthodontics, or-thodontics, and orthognathic treatments. Virtual articulators provide a sophisticated digital alternative to conventional methods, integrating intraoral scans, facial scans, and CBCT to enhance treatment predictability. This review examines advancements in virtual articulator technology, including digital workflows, virtual facebow transfer, and occlusal analysis, with a focus on AI-driven methodologies such as machine learning and artificial neural networks. The clinical implications, particularly in condylar guidance and sagittal condylar inclination, are investigated. By streamlining the acquisition and articulation of digital dental models, virtual articulators minimize material handling errors and opti-mize workflow efficiency. Advanced imaging techniques enable precise alignment of digital maxillary models within CAD/CAM systems, facilitating accurate occlusal sim-ulations. However, challenges include potential distortions during digital file integration and the necessity for robust algorithms to enhance data superimposition accuracy. The adoption of virtual articulators represents a transformative advancement in digital den-tistry, with promising implications for diagnostic precision and treatment outcomes. Nevertheless, further clinical validation is essential to ensure the reliable transfer of maxillary casts and refine digital algorithms. Future developments should prioritize the integration of AI to enhance predictive modeling, positioning virtual articulators as a standard tool in routine dental practice, thereby revolutionizing treatment planning and interdisciplinary collaboration.

OBJECTIVE Treating patients with worn dentition is complex and requires comprehensive consideration of function, esthetics, and tissue preservation. An important aspect of contemporary dentistry is to be conservative and have proper protocols to plan and treat these situations while protecting the remaining tooth structures. The purpose of this article is to present an organized and conservative digitally aided treatment protocol for patients with worn dentition, which takes into account pre-established parameters that allow increasing the occlusal vertical dimension following the GRS Concept-the Generated restorative space. CLINICAL CONSIDERATIONS This protocol emphasizes the need to assess each clinical scenario and plan prosthetic designs that increase predictability; it also establishes guidelines that promote minimal invasion, proper material selection, and an approach guided by the existing wear pattern, patient-specific factors, and biological preservation. CLINICAL SIGNIFICANCE Properly planned treatment and the use of digital technology will enable clinicians to be more conservative and retain the largest amount of the residual tooth structure in wear patients. CONCLUSION Treating patients with generalized worn dentition is a challenging task, and proper treatment planning and execution are needed. Digital assets such as the "cross-sectional view" in CAD software allow the clinician to analyze the generated restorative space, be more conservative, and support the long-term success and predictability of the restorations.

Purpose: Digital dental alignment is not readily available to automatically articulate the upper and lower models. The purpose of this study was to assess the accuracy of our newly developed 3-stage automatic digital articulation approach by comparing it to the gold standard of orthodontist-articulated occlusion. Materials and methods: Thirty pairs of stone dental models from double-jaw orthognathic surgery patients who had undergone a one-piece Le Fort I osteotomy were used. Two experienced orthodontists together, hand articulated the models to their perceived final occlusion for surgery. Each pair of the models was then scanned twice: while they were in orthodontist-determined occlusion, and while the upper and lower models were separated and positioned randomly. The separately scanned models were automatically articulated to the final occlusion using our 3-stage algorithm, resulting in an algorithm-articulated occlusion (experimental group). The models scanned together represented the hand-articulated occlusion (control group). The qualitative evaluation was completed using a 3-point categorical scale by the same orthodontists, who were blinded from the methods used to articulate the models. A quantitative evaluation was also completed to determine whether there was a difference in midline, canine and molar relationship between the algorithm- and hand-articulated occlusions using repeated measures analysis of variance (ANOVA). Finally, means and standard deviations were used to present the differences between the 2 methods. Results: The results of the qualitative evaluation revealed that all the algorithm-articulated occlusions were as good as the hand-articulated ones. The results of repeated measures ANOVA showed that there was no statistically significant difference between the two methods (F(1,28)=0.03, P=0.87). The mean differences between the two methods were all within 0.2mm. Conclusions: The results of our study have demonstrated that the dental models can be accurately, reliably and automatically articulated using our 3-stage algorithm approach to the standards of orthodontists.

STATEMENT OF PROBLEM The accuracy of methods used for locating occlusal contacts throughout the entire clinical procedure has been poorly studied. PURPOSE The purpose of this clinical study was to determine the reproducibility and criterion validity for different methods of locating occlusal contacts. MATERIAL AND METHODS Thirty-two adults with natural dentitions participated in this cross-sectional test-retest study. In total, occlusal contacts at maximum intercuspation were recorded by using 15 methods: silicone transillumination with Occlufast Rock (40, 50, 100, and 200 µm) and Occlufast CAD (40 and 50 µm); virtual occlusion (100, 200, 300, and 400 µm); articulating film (12-, 40-, 100-, and 200-µm-thick); and T-Scan III. Images of the occlusal records were scaled and calibrated spatially, and the occlusal contacts of the right posterior mandibular teeth were delimited by using the FIJI software program. Reproducibility was expressed as 95% confidence intervals (95% CI) of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against retest sessions using the same method. Criterion validity was expressed as 95% CI of the percentage of agreement in the location of the occlusal contacts between images from the test sessions against images from Occlufast Rock (criterion standard). RESULTS Occlufast Rock achieved 85% to 95% agreement in the location of the occlusal contacts between the 2 sessions, whereas Occlufast CAD, 200-µm articulating film, and T-Scan offered 79% to 86%, 68% to 75%, and 65% to 75% agreement, respectively. The most valid method was Occlufast CAD (74% to 80%) followed by the 200-µm articulating film (57% to 63%), 400-µm virtual occlusion (53% to 62%), 100-µm articulating film (52% to 60%), and T-Scan (48% to 56%). CONCLUSIONS Conventional methods, such as 100- and 200-µm articulating film and digital methods, including 400 µm virtual occlusion and T-Scan, offer sufficient accuracy in locating the occlusal contacts. However, strategies are needed to improve accuracy.

Tooth or material wear in a dentition is a common finding that requires timely diagnosis for management and prevention of further loss or associated esthetic or functional impairment. Various qualitative and quantitative methods have been suggested to measure tooth or material wear, but they present with limitations, such as imprecision, subjectivity, or high complexity. Here we developed and assessed an efficient 3D superimposition method to accurately measure occlusal tooth wear on 3D digital dental models. For this purpose, teeth on plaster casts were manually grinded on their occlusal surfaces to simulate various degrees of tooth wear. The casts were scanned using a surface scanner. Grinded tooth crowns (T1) were segmented and compared to the original crowns (T0) using five 3D surface superimposition techniques and a gold standard technique (GS). GS measurements were obtained by using intact adjacent structures as superimposition references. The technique of choice (complete crown with 30% estimated overlap of meshes) showed the best reproducibility (maximum difference < 0.050 mm3) and excellent agreement with the GS technique (median difference: 0.032 mm3). The suggested 3D superimposition method offers a highly efficient and accurate tool for tooth wear assessment, which could be applicable to clinical conditions.

The forces of the jaw muscles are transmitted to the dentition and the temporomandibular joints (TMJs). Imbalances in the force distribution can lead to occlusal trauma, excessive tooth wear, or TMJ osteoarthritis, making the assessment of bite force (BF) distribution clinically significant. Existing thin-film BF measurement devices capture the magnitudes of a system of BFs distributed at multiple occlusal contacts (OCs), but fail to capture their directional components, limiting their clinical utility. This study aimed to develop a method for representing BF systems as a wrench, a simplified force-couple model, using digital dentistry tools and to evaluate its reliability in terms of interexaminer reproducibility. A semi-automated system was developed to integrate thin-film BF measurement data with digital models of maxillary and mandibular dental arches. BF systems were represented as wrenches with six parameters: force magnitude, axis location (x, y), axis orientation (frontal, sagittal), and pitch (moment-to-force ratio).Ten young adult participants (5 women, 5 men; mean age: 20.1 ± 2.9 years) were recruited. BF measurements were performed on all participants using the developed system. Two independent examiners manually assigned BFs to the identified OCs separately, and the reliability of these assignments was evaluated based on inter-examiner agreement. Intraclass correlation coefficients (ICCs) for wrench parameters were calculated to assess the consistency of biomechanical outcomes using appropriate statistical tests, with significance set at p < 0.05. The proposed system allowed substantial automation, and the manual steps were limited to segmenting the interocclusal record model for each mandibular tooth and assigning BFs to the identified OCs. The interexaminer agreement was evaluated for the BFs assigned to the identified OCs, which yielded an 87% match rate. Furthermore, the impact on wrench parameters was assessed using ICCs, which ranged from 0.93 to 0.99, indicating high reliability. The developed system efficiently integrates BF measurements and three-dimensional OC analysis, providing a practical method for clinical evaluation of the BF systems. In addition, the system provided consistent outcomes in biomechanical analyses across different examiners.