Occlusal Scheme Research Articles

Periodontal and orthodontic management of impacted canines.

The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contributes toward functional as well as neuromuscular stability, harmony, esthetics, and dentofacial balance. When an aberration is noted with the normal eruptive and development process, early diagnosis with strategic intervention is critical and may often require a multidisciplinary approach. A proper diagnosis, risk assessment, and management of the soft tissues, hard tissues, and adjacent structures are vital for a successful outcome. This review highlights the diagnostic and treatment modalities that require consideration for the orthodontic as well as the periodontal management of impacted canines. The reader is guided through the etiology, diagnosis, prevention, and intervention of clinical cases that were managed with different approaches.

Metal-Free Custom-Made Zirconia Implants-A Prospective 5-Year Follow-Up Single-Arm Clinical Trial.

Dental implants made of zirconia (ZrO2) are a potential alternative for titanium implants in dentistry because of their good biocompatibility, mechanical properties and excellent aesthetic results. However, solid long-term scientific data to prove clinical success of ZrO2 implants are scarce. The aim of this study was to describe and to examine the clinical performance of custom-made two-piece ZrO2 implants, to identify possible influencing factors: a) manipulation of the implant after placement and b) the occlusal scheme on the survival rate, and to evaluate the performance of the implant-supported crown. This follow-up study collected and examined the 5-year data to answer the main question: What are the survival and the success rates of custom-made ZrO2 implants in the maxillary premolar region after 5 years? Of the 31 included patients in this prospective 5-year follow-up single-arm clinical trial, 30 received a custom-made ZrO2 implant to replace a missing single maxillary premolar, which was subsequently restored with a lithium disilicate crown. Parameters regarding clinical performance, marginal bone-level (MBL) changes, and patient-related outcome measures (PROMs) were assessed preoperatively, at the baseline, as well as 1 and 5 years after crown placement. Chances of survival and success of the implant were calculated and displayed using Kaplan-Meier statistics. Kaplan-Meier survival analysis was also performed with stratification based on the variables "manipulation of the implant prior to impression taking" and "occlusal scheme" and compared using log-rank tests. Bone-level moderation in time was compared using a paired samples t-test. Patient's expectations and satisfaction after 5 years were compared as a measure of fulfilled expectations, using a Wilcoxon signed-rank test. Performance of the implant-supported crowns was evaluated using validated criteria. Survival and success probabilities after 5 years were, respectively, 75.8% (95% CI [60.0%; 91.0%]) and 71.0% (95% CI [54.0%; 88.0%]) for the custom-made ZV3 implants. No significant differences in survival rate were found after stratification on "manipulation of the implant" and on "occlusal scheme." Mean bone-level alteration between baseline and the first follow-up was +0.06 mm (95% CI [-0.23 mm; 0.12 mm]; SD = 0.42 mm) and between baseline and the second follow-up was +0.04 mm (95% CI [-0.35 mm; 0.26 mm]; SD = 0.54 mm). Patients' satisfaction for patients with implants still in function after 5 years was 91.7% (IQR = [90.5%-97.3%]), indicating satisfaction with the treatment. Pooled satisfaction in patients with successful implants after 5 years was significantly higher than patients' expressed expectations before treatment. None of the crowns failed, and no interventions were required. Survival rate of these particular ZV3 implants in our study was lower than expected and clinically not acceptable. Hence, ZV3 implant placement as applied in this study cannot be recommended for clinical practice. Further research on the different appearances of mechanical failure in ZrO2 implants would be highly recommended before a larger prospective randomized clinical trial is conducted to evaluate treatment with custom-made ZrO2 dental implants.

Analyzing The Correlation Between The Conventional Complete Denture Occlusal Contact Points And Patient’s Satisfaction

Background: Conventional complete dentures continue to be a vital and essential method for restoring oral function in edentulous adults. However the quality of complete dentures influences the satisfaction level, thereby improves the psychological wellbeing of dentulous adults. Aim: A prospective in vivo study aims to analyse the presence of conventional complete denture occlusal contact points significantly influence patients' satisfaction levels. Materials and methods: Thirty patients who had received complete dentures were evaluated for their occlusal contact points one the day of insertion and 2 weeks later. Patient satisfaction questionnaire, which included subjective parameters such as initial adaptability, post insertion problems, aesthetics, masticatory ability, speech, retention was conducted at day 1 (day of insertion) and 2 weeks later. Results: Number of contact points almost were same on day 1 and 2 weeks later. The overall satisfaction of the patient has improved during the time interval. But correlation of the occlusal contact points to the patient satisfaction has no statistically significant value. Conclusion: Therefore, the overall satisfaction of the patient increased while using the complete denture from 1st day of denture insertion and after 14 days irrespective of number of contact points in the conventional complete denture with same occlusal scheme

Comparison of full‐arch mandibular reconstruction with dental implants using completely splinted or segmentally splinted prostheses with two different occlusal schemes: A finite‐element analysis

Comparison of full‐arch mandibular reconstruction with dental implants using completely splinted or segmentally splinted prostheses with two different occlusal schemes: A finite‐element analysis

The Influence of Occlusion Type on Oral Health-Related Quality of Life in Patients with Complete Dentures-Lingualized vs. Bilaterally Balanced Occlusion.

This randomized, single-blind controlled study aimed to investigate the QoL and satisfaction of patients wearing complete dentures with lingualized (LO) and bilaterally balanced occlusion (BBO). Participants were stratified based on their prior experience with complete dentures. The study involved 131 complete denture wearers who were categorized into four groups: G1-first-time prosthesis wearers treated with LO (n = 33); G2-first-time prosthesis wearers treated with BBO (n = 31); G3-participants with prior prosthesis experience treated with LO (n = 34); G4-participants with prior prosthesis experience treated with BBO (n = 33). After wearing the prosthesis for one month, all participants completed the Oral Health Impact Profile (OHIP-14) questionnaire. A statistical analysis was conducted using the χ2 test, Kruskal-Wallis analysis and Mann-Whitney test, with significance determined at p < 0.05. After dividing the respondents into two groups, a statistically significant difference was observed in the distribution of scores for three questions related to oral pain severity, anxiety, and difficulty relaxing. However, the distribution of scores for all other questions did not show a statistically significant difference between the groups studied (p < 0.05). The total OHIP-14 score was also not statistically different (z = 0.469; p = 0.639). However, when respondents were divided into four groups, the median score for first-time denture wearers was 3.9 points higher in respondents who received dentures with BBO compared to those with LO (p < 0.001). Furthermore, the median score for first-time denture wearers who received BBO was higher than for those in the second group who received BBO (p = 0.013). Patients wearing complete dentures for the first time demonstrated significantly higher satisfaction with the LO scheme compared to the BBO scheme. In contrast, satisfaction levels between occlusal schemes did not significantly differ among patients with prior denture-wearing experience. Novice denture wearers reported heightened sensations of oral discomfort, anxiety, and difficulty relaxing regardless of the occlusal scheme compared to experienced wearers, likely due to the unrealistic expectations that first-time wearers often have about complete dentures.

Impact of occlusal schemes on prognosis of conventional complete dentures in patients with severely resorbed alveolar ridges

Bilateral Balanced Occlusion (BBO) and Canine Guidance (CG) are occlusal schemes that have been successfully used in complete dentures (CDs). The objective of this study was to evaluate the effects of CG compared to BBO on satisfaction, oral health-related quality of life (OHRQoL) and masticatory performance in CDs wearers with severe resorbed alveolar ridge by means of a crossover trial. Sixteen edentulous patients with severe resorbed ridges were treated with new maxillary and mandibular CDs. After adaptation period, they were randomly divided into two groups according to a sequence of occlusal schemes: BBO for 30 days followed by CG for 30 days or, CG for 30 days followed by BBO for 30 days. Patient satisfaction with their dentures, OHRQoL and masticatory performance were assessed immediately 30 days after of using each occlusal scheme. The results of satisfaction and quality of life were using Wilcoxon test, and data regarding masticatory performance were analyzed through paired t-test (α = .05). The occlusal scheme used in complete dentures had no significant influence on general patient satisfaction (p = 0.06), overall quality of life (p = 0.09), or masticatory performance of patients (p = 0.182). Both BBO and CG can be considered as suitable for oral rehabilitation with CDs in patients with severe resorbed alveolar ridges. However, CG may be considered as a scheme of choice by clinicians due to its greater simplicity and shorter execution time.

Occlusal considerations in maintaining health of implants and their restorations

Dental implants are a regular feature in daily clinical practice and there is a need to undertake routine assessment and maintenance of implants and their restorations on par with that provided for natural teeth. Occlusal checks form an important part of the maintenance regime for preserving the integrity of implants, their restorations, and health of the peri-implant tissues. Implant restorations are subjected to the full characteristics and magnitude of occlusal forces, including those associated with parafunction. Compared with the periodontal ligament around teeth, the biophysical response to occlusal forces of osseointegration is different through the more rigid link of implant to bone and reduced proprioception. Risks attributable to occlusal forces primarily affect implant restorations and they are elevated in the presence of bruxism. The occlusal guidelines recommended by the literature are aimed at reducing these risks and regular assessment and maintenance of the occlusion is essential. A four-step sequence is presented to ensure that the annual occlusal checks include the patient's input and evaluation of restoration integrity, occlusal scheme, additional protection, and spatial changes.

Resultater fra rapportering til Bivirkningsgruppen 2023

English summary Nor Tannlegeforen Tid. 2024; 134: 418-24. This case study describes the oral rehabilitation of a patient with severe wear on teeth and restorations. A successful rehabilitation was achieved with emphasis on an even and axial force distribution throughout the dentition. Adjustable composites and temporary restorations were used to establish a favorable occlusal scheme before moving on to permanent restorations.

A proof of concept on implant-supported bilateral cantilever bridges: The T-Bridge approach.

The concept of bilateral cantilevers on a single central implant (T-design) for three-unit implant-supported fixed dental prostheses (ISFDPs) has not been explored nor tested. This technical hypothesis aimed to explore the feasibility of such an approach as a cost-effective alternative to conventional treatments. Careful considerations regarding implant diameter, length, ideal position, occlusal scheme, and bone remodeling are essential to ensure adequate support, stability, and prevention of complications. In this proof of concept, we present a preliminary case with this novel design to replace missing posterior teeth in a patient with narrow bone conditions. In addition, a series of planned investigations and preliminary results, including preclinical studies, are presented to illustrate our concept and its potential clinical implications. Clinically, after two-year follow-up, healthy and stable peri-implant tissues around the ISFDP exemplarily demonstrated excellent stability, functionality, and comfort, which is supported by acceptable fracture resistance data in vitro, suggesting indeed the practical potential and suitability. Thus, we claim that such a treatment modality has the at least theoretical potential to revolutionize implant dentistry by providing innovative and cost-effective treatment options for patients with partial ISFDPs in very specific cases. Of course, further research and evaluations are necessary to validate the clinical implications of this innovative hypothesis. Implementing the 3-on-1 T-bridge approach in partial ISFDPs could offer a promising alternative to traditional methods. If proven successful, this technique may lead to significant advancements in clinical practice, providing a less invasive cost-effective treatment option.

Occlusal schemes in complete denture concerning age, gender and mandibular resorption-A review

This review aims to evaluate various occlusal schemes in complete dentures concerning age, gender, and mandibular resorption to determine their relative effectiveness and suitability. This narrative review was performed through scientific articles published between 1998 and 2020, indexed in MEDLINE and PubMed databases. Various occlusal schemes are employed to enhance masticatory ability and ensure patient satisfaction. Despite the availability of multiple occlusal schemes, determining the optimal one linked explicitly to the highest level of patient acceptance remains inconclusive. This review presents scientific data from selected sources, elucidating various occlusal scheme patterns and summarizing the most suitable based on age, gender, and mandibular resorption.

Evaluating Communication through Work Authorization between Dentists and Dental Technicians for Fixed Prosthesis

Communication within the dental profession can be challenging and may affect the quality of prostheses delivered to the patient. A methodical investigation into the dynamics between dentists and dental technicians is lacking in Lahore. Objective: To assess adequate practice of communication between dentists and dental technicians through work authorization for fixed prosthesis. Methods: This cross-sectional study was conducted in dental laboratories of Lahore. A questionnaire concerning work authorization forms was distributed to 80 dental technicians through Google Forms and hard copies. The survey concentrated on inquiries related to various aspects of work authorization, including gender, years of experience, impression disinfection, patient demographic data, impression materials used, fixed prosthesis design, and shade selection. An adequate work authorization was assessed in the end. Statistical analysis was conducted SPSS version 25.0 and was analyzed using chi-square, with significance set at p ≤ 0.05. Results: Out of the 80 survey forms disbursed, only 73 completely filled responses were accepted, giving a response rate of 91%. Information regarding patient demographic data (19.2%), patient photographic record (5.5%), pontic design (13.7%), margin design (37%), surfaces covered by metal (9.6%) and occlusal scheme (6.8%), were all on the inferior side of the scale ranging below 40%. Adequate practice of work authorization was discouraging, at only 17.8%. Conclusions: Poorly filled work authorization forms lead to patient and dentist dissatisfaction with fixed dental prostheses. This highlights the importance of clear communication between technicians and dentists. Dental students should learn to complete these forms during their training.

Comparison of Stress and Strain Distribution Patterns in Canine Implant and Maxillary Bone in Three Occlusal Schemes Using Finite Element Analysis.

This study aimed to compare the pattern of stress and strain distribution in canine implant and maxillary bone in the anterior group function (AGF), posterior group function (PGF), and canine guidance (CG) occlusal schemes by finite element analysis (FEA). In this in vitro experimental study, a dental implant (10 × 4.1 mm) was inserted at the site of the maxillary canine in a model of the maxilla in Mimics software. The implant was scanned three-dimensionally and the data were transferred to SolidWorks software. The von Mises stress, shear stress, deformation, and strain were calculated in the AGF, PGF, and CG occlusal schemes by FEA. Data were analyzed by ABAQUS software to calculate the stress transferred to the canine implant and maxillary bone in the three occlusal schemes. The maximum and minimum von Mises stress, elastic strain, shear stress, and deformation were noted in the AGF and PGF occlusal schemes, respectively, in all teeth. The PGF showed minimum von Mises stress, elastic strain, shear stress, and deformation in the canine implant and maxillary bone. Thus, it appears than the PGF is the best occlusal scheme for maxillary canine implant followed by the CG scheme.

Digital Analysis of Occlusion in Fixed Partial Implant Prostheses: How to Overcome Age-Related Changes in the Stomatognathic System

Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients must be considered because of their effects on the stomatognathic system’s physiology. Operators must manage all the changes to obtain good sensations during mastication and a better occlusal scheme for implanting fixed partial prostheses. Dentists should try to protect this type of prosthesis using adjacent teeth and the PL. This is why new digital systems were created. The combination of T-Scan® (digital software for occlusal analysis) and electromyography (EMG) could allow doctors to find areas where it is necessary to act and to find suitable solutions for the problems generated by using conventional methods of occlusal analysis (such as articulating paper). In this study, a new method for establishing occlusion on fixed partial implant prostheses has been created, combining digital systems with conventional articulating paper. This method consists of asking the patient to bite down with different forces and situations in an attempt to achieve Implant-Protected Occlusion (IPO). The use of digital systems has been shown to be more effective than using only conventional systems. This new method allows a safer mode of occlusion which protects implants and prostheses, saving all the differences between them and natural teeth, and increasing the satisfaction of patients. This method also helps to overcome the changes in the stomatognathic system as age increases, adjusting the occlusion to changes in PLs with age.

Evaluating the chewing efficiency of complete dentures using bilateral balanced occlusion and lingualized occlusion: A comparative study

Background -Dentistry plays one of the major role in the battlefield of medical sciences. It covers the major part of the human body which deals with the complex orofacial structures and associated complex stomatognathic system. The complex stomatognathic system has to be maintained in every pathological or abnormal condition like partial to complete edentulism. The maintainance of the stomatognathic system is significantly dependent on the branch of dentistry that deals with the part or complete replacement of lost or missing functional and complex structures known as prosthodontics. The occlusion serves the basic function of the complete denture prosthesis as one of the central goal of complete denture therapy is restoring occlusion. The occlusal scheme is still the topic of debate (that which occlusal scheme is best suited for the complete denture prosthesis), as no occlusal scheme has proved best in all cases. It is revealed that the choice of occlusal scheme used in complete denture prosthesis is primarily to the practitioners personal preference and experiences that varies from patient to patient. Aim -The purpose of this study was to evaluate the chewing efficiency of two different occlusal schemes i.e. conventional bilateral balanced occlusion and bilateral balanced lingualized occlusion in complete denture patients. Method- 20 edentulous patients aged between 40 - 70 years with a mean age value of 55 years attending among the out-patient department of Patna Dental College and Hospital Patna, were selected for the present study. A thorough screening of general and systemic health is carried out and found free of all major systemic diseases. After the selection of the patients it was decided that all the 20 patients were provided complete denture with conventional bilateral balanced occlusion and after 45 days of post insertion of the newly fabricated complete dentures, the patients were recalled and asked for the subjective qualities of the complete denture. Result -Confirming better chewing ability by BBLO than CBBO. Conclusion- The result of the present study concludes that the complete dentures with BBLO performed significantly better chewing ability than CBBO Since in the present study, all the test were carried out with same set of complete dentures by modifying CBBO to BBLO upon the same patient, which had not been taken into account by any of the previous studies. All the previous studies had used two different set of complete dentures with two different patients. Thus, this is a remarkable milestone in the present study providing a definite authenticity of the study.

Pain-related analysis on a resorbed ridge with various denture occlusal schemes using finite element method.

Resorbed alveolar ridges, particularly in the lower jaw, have a small denture supporting area, which may cause the stress distribution of mastication load to exceed the pressure-pain threshold (PPT) and induce pain in the mucosa or potentially worsen the ridge resorption. Thus, choosing the ideal occlusal scheme among bilateral balanced (BBO), lingualized (LO), and monoplane (MO) for such conditions becomes crucial. The experiment was conducted using the finite element method on a modeling of a resorbed alveolar ridge in the lower jaw with three dentures placed on top, each of which was given different loading points according to the tooth arrangement of BBO, LO, and MO. The axial load was 100 N, and the resultant oblique loads on BBO and LO were 119 N and 106 N, respectively. The von Mises stresses for BBO, LO, and MO were observed in nine denture-supporting areas, and the results showed that the axial load did not produce stresses that exceeded the PPT value (0.64925 MPa) for BBO, LO, and MO with the highest value on area H, 0.43229 MPa, 0.39715 MPa, and 0.31576 MPa, respectively. However, the oblique load direction showed that the BBO had more areas (area E 0.80778 MPa and area H 0.76256 MPa) that exceeded the PPT than LO (area E 0.64394 MPa). The lingualized occlusal scheme is ideal for patients with resorbed alveolar ridge conditions, especially in terms of limiting interferences when the denture is functioning while maintaining comfort but still providing good masticatory performance and satisfactory esthetics.

Revolutionizing CAD/CAM-based restorative dental processes and materials with artificial intelligence: a concise narrative review.

Artificial intelligence (AI) is increasingly prevalent in biomedical and industrial development, capturing the interest of dental professionals and patients. Its potential to improve the accuracy and speed of dental procedures is set to revolutionize dental care. The use of AI in computer-aided design/computer-aided manufacturing (CAD/CAM) within the restorative dental and material science fields offers numerous benefits, providing a new dimension to these practices. This study aims to provide a concise overview of the implementation of AI-powered technologies in CAD/CAM restorative dental procedures and materials. A comprehensive literature search was conducted using keywords from 2000 to 2023 to obtain pertinent information. This method was implemented to guarantee a thorough investigation of the subject matter. Keywords included; "Artificial Intelligence", "Machine Learning", "Neural Networks", "Virtual Reality", "Digital Dentistry", "CAD/CAM", and "Restorative Dentistry". Artificial intelligence in digital restorative dentistry has proven to be highly beneficial in various dental CAD/CAM applications. It helps in automating and incorporating esthetic factors, occlusal schemes, and previous practitioners' CAD choices in fabricating dental restorations. AI can also predict the debonding risk of CAD/CAM restorations and the compositional effects on the mechanical properties of its materials. Continuous enhancements are being made to overcome its limitations and open new possibilities for future developments in this field.

Patient Satisfaction with Lingualized Occlusion Compared to Bilateral Balanced Occlusion in Conventional Complete Dentures: A Systematic Review

Purpose: The purpose of this systematic review is to determine Lingualized Occlusion (LO) as an alternative occlusal scheme for routine complete dentures in terms of patient satisfaction and comfort. Material and Methods: Electronic research was conducted using for articles published between January 1, 2000 and July 31, 2020, search PubMed (including MEDLINE), the Cochrane database, and Google Scholar. The inclusion criteria were used to choose studies relating different occlusal schemes for complete denture. The risk of bias was evaluated using the Cochrane’s Risk of Bias (ROB -2) tool. Results: After applying the inclusion and exclusion criteria 12 articles were systematically reviewed. The random sequence generation domain reveals a high risk of bias in the studies with Nadira et al, Mohammad et al, Deniz et al, Kawai et al and Jiyar et al. These authors did not use computers or computer-generated random numbers or random block assessment for random sequence generation. Low risk of bias was found in the studies with Shirani et al, Hedaiat et al, Abdallah et al, Savvas et al and Caitlin et al as they have used tools such as computers or computer- generated random numbers or random block assessment for random sequence generation for random sequence generation thereby decreasing the bias and improving the quality of their study. Thus, most of the studies included in this systematic review revealed that the patient satisfaction levels were significantly higher for lingualized occlusion as compared to bilateral balanced occlusion. Conclusion: According to this comprehensive review, BBO does not improve satisfaction or masticatory performance. Thus, in terms of quality of life/satisfaction and masticatory function, lingualized occlusion can be deemed a predictable occlusal scheme for complete dentures. As a result, additional research is required to corroborate the study’s findings.

A Comparison of Occlusal Schemes with Condylar Inclination and Anterior Guidance in Dentate Individuals.

To compare occlusal schemes with condylar inclination and anterior guidance in dentate individuals. A total of 26 dentate patients of Indian origin between the ages of 18 and 30 with canine-guided occlusion and 26 patients with group function occlusion were included in the study. The School of Articulator Munich (SAM) Axioquick system was used to assess the condylar guidance and eccentric tracings of the patients. For analyses, Student t test was used. For quantitative data, the means and SDs were calculated. For statistical analyses, the probability of type-I error of .05 was considered statistically significant. The mean condylar guidance for canine-guided and group function occlusion was 38.4 ± 12.7 degrees and 30.5 ± 12.5 degrees on the right side, respectively. On the left side it was 36.5 ± 13.0 degrees and 27.5 ± 12.0 degrees for canine-guided and group function occlusion, respectively, with a statistically significant difference (P &#61; .01). The condylar guidance, incisal guidance, Bennett angle, protrusion, left lateral and right lateral movement, and left and right lateral angles were analyzed statistically between the two types of occlusions. The results showed a statistically significant difference between the two groups for all parameters except right condylar guidance. Furthermore, all parameters were higher in the canine-guided occlusion group over group function occlusion. Within the study limitations, it was concluded that the condylar guidance was steeper in canine-guided occlusion than in group function occlusion. The eccentric parameters were steeper in canine-guided occlusion than in group function occlusion. This study showcases that the condylar guidance might not play a major role in determining the occlusal scheme but that the incisal guidance determines the occlusal scheme predominantly in Class 1 occlusion patients.

The Effect of Different Occlusal Schemes on Masticatory Performance for Conventional and Digital Complete Dentures

The Effect of Different Occlusal Schemes on Masticatory Performance for Conventional and Digital Complete Dentures

Clinical evaluation of the agreement between virtual and clinical occlusal registrations: A comparative clinical study

The accuracy of virtual interocclusal records has been evaluated, but clinical studies comparing the clinical output to the virtual design are lacking. The purpose of this clinical study was to evaluate the agreement between the virtual occlusal scheme designed by a computer-aided design and computer-aided manufacturing software program and the occlusal scheme obtained clinically on the definitive prosthesis assessed with articulating paper. The virtual occlusal scheme design of 20 single monolithic crowns and their adjacent teeth was obtained by using an intraoral scanning system in 17 participants. These registrations were compared with conventional occlusal records obtained by applying articulating paper in 2 stages: first with 200-μm blue film and the second with 12-μm metallic red articulation tape. The analysis included both the quantity and the quality of the contacts of the conventional occlusal records referred to as the standard method. For accuracy analysis, virtual record sensitivity was calculated per crown as the percentage of true positive virtual contacts of the actual contacts identified by articulating paper. Specificity was also calculated as the percentage of true negative virtual contacts of the actual sites of clearance. The virtual record sensitivity was 98.5 (95% confidence interval [CI] 96-100) for the crowns and 95 (95% CI 85-100) for the adjacent teeth. The virtual record specificity was 88.6 (95% CI 82.4-94.8) for the crowns and 82.6 (95% CI 77.5-87.6) for the adjacent teeth. The agreement between the clinical and virtual contact intensities on the crowns was 83 (95% CI 73-93) and 67.3 (95% CI 56-78.7) for the adjacent teeth. The positive predictive value was 72.83 (95% CI 60-86). The negative predictive value was 100% (95% CI 100-100). The intraoral scanning system provided clinically sufficient sensitivity and specificity for identifying the occlusal surface contacts of monolithic crowns. A slight decrease was detected in the system's sensitivity and specificity in identifying contacts on adjacent teeth and a larger decrease identifying the intensity of these contacts.