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CLINICAL RESEARCH  临床研究

Accuracy of digital and conventional systems in locating occlusal contacts: A clinical study
数字和传统系统定位咬合接触的准确性：一项临床研究

Bernat Rovira-Lastra, DDS, PhD, a a ^(a){ }^{a} Laura Khoury-Ribas, DDS, PhD, a a  ^("a "){ }^{\text {a }} Elan-Ignacio Flores-Orozco, DDS, PhD, b b  ^("b "){ }^{\text {b }} Raul Ayuso-Montero, DDS, PhD, c c  ^("c "){ }^{\text {c }} Akhilanand Chaurasia, BDS, MDS, PhD, d d ^(d){ }^{d} and Jordi Martinez-Gomis, DDS, PhD e PhD e PhD^(e)\mathrm{PhD}^{e}
Bernat Rovira-Lastra，DDS，博士， a a ^(a){ }^{a} Laura Khoury-Ribas，DDS，博士， a a  ^("a "){ }^{\text {a }} Elan-Ignacio Flores-Orozco，DDS，博士， b b  ^("b "){ }^{\text {b }} Raul Ayuso-Montero，DDS，博士， c c  ^("c "){ }^{\text {c }} Akhilanand Chaurasia，BDS，MDS，博士和 d d ^(d){ }^{d} Jordi Martinez-Gomis，DDS， PhD e PhD e PhD^(e)\mathrm{PhD}^{e}

Mastication is the main function of the oral system, with occlusal force and dental occlusion key factors. 1 − 3 1 − 3 ^(1-3){ }^{1-3} Clinical practice often requires modifications to the dental occlusion for restorative or prosthetic treatment. 4 , 5 Al 4 , 5 Al ^(4,5)Al{ }^{4,5} \mathrm{Al} though most patients adapt to their new occlusion easily, a few can develop discomfort and even pain, especially in the presence of an occlusal interference. 6 6 ^(6){ }^{6} Therefore, occlusion analysis systems should meet minimal accuracy standards to detect, quantify, and locate occlusal contacts.
咀嚼是口腔系统的主要功能，咬合力和牙齿咬合是关键因素。 1 − 3 1 − 3 ^(1-3){ }^{1-3} 临床实践通常需要修改牙齿咬合以进行修复或修复治疗。 4 , 5 Al 4 , 5 Al ^(4,5)Al{ }^{4,5} \mathrm{Al} 尽管大多数患者很容易适应新的咬合，但少数患者会出现不适甚至疼痛，尤其是在存在咬合干扰的情况下。 6 6 ^(6){ }^{6} 因此，咬合分析系统应满足最低精度标准，以检测、量化和定位咬合接触。
Articulating film has been the most widely used system because it is economical, available in different thicknesses, and allows rapid location of occlusal contacts. 7 − 9 7 − 9 ^(7-9){ }^{7-9} However, silicone occlusal registration, scanned with a light source and analyzed
铰接膜一直是使用最广泛的系统，因为它经济实惠，有不同的厚度可供选择，并且可以快速定位咬合接触。 7 − 9 7 − 9 ^(7-9){ }^{7-9} 然而，用光源扫描并分析硅胶咬合配准

Abstract  抽象

Statement of problem. The accuracy of methods used for locating occlusal contacts throughout the entire clinical procedure has been poorly studied.
问题陈述。在整个临床过程中用于定位咬合接触的方法的准确性研究不足。

Purpose. The purpose of this clinical study was to determine the reproducibility and criterion validity for different methods of locating occlusal contacts.
目的。本临床研究的目的是确定定位咬合接触的不同方法的可重复性和标准有效性。

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 40 , 50 , 100 40,50,10040,50,100, and 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m} ) and Occlufast CAD ( 40 and 50 μ m 50 μ m 50 mum50 \mu \mathrm{~m} ); virtual occlusion ( 100 , 200 , 300 100 , 200 , 300 100,200,300100,200,300, and 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} ); articulating film ( 12 − , 40 − , 100 − 12 − , 40 − , 100 − 12-,40-,100-12-, 40-, 100-, and 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m}-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 FIJ software program. Reproducibility was expressed as 95 % 95 % 95%95 \% confidence intervals ( 95 % Cl ) ( 95 % Cl ) (95%Cl)(95 \% \mathrm{Cl}) 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 % Cl 95 % Cl 95%Cl95 \% \mathrm{Cl} 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).
材料和方法。32 名具有天然牙列的成年人参加了这项横断面重测研究。总共使用 15 种方法记录了最大尖裂处的咬合接触：使用 Occlufast Rock （ 40 , 50 , 100 40 , 50 , 100 40,50,10040,50,100 ， 和 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m} ） 和 Occlufast CAD （ 40 和 50 μ m 50 μ m 50 mum50 \mu \mathrm{~m} ）进行硅胶透射;虚拟遮挡 （ 100 , 200 , 300 100 , 200 , 300 100,200,300100,200,300 ， 和 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} ）;铰接膜 （ 12 − , 40 − , 100 − 12 − , 40 − , 100 − 12-,40-,100-12-, 40-, 100- ， 和 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m} -thick）;和 T-Scan III。对咬合记录的图像进行空间缩放和校准，并使用 FIJ 软件程序划定右后下颌牙的咬合接触。再现性表示为 95 % 95 % 95%95 \% 来自测试会话的图像与使用相同方法的重新测试会话之间的咬合接触位置的一致性百分比的置信区间 ( 95 % Cl ) ( 95 % Cl ) (95%Cl)(95 \% \mathrm{Cl}) 。标准效度表示为 95 % Cl 95 % Cl 95%Cl95 \% \mathrm{Cl} 来自测试会话的图像与来自 Occlufast Rock 的图像（标准标准）之间的咬合接触位置的一致性百分比。

Results. Occlufast Rock achieved 85 % 85 % 85%85 \% to 95 % 95 % 95%95 \% agreement in the location of the occlusal contacts between the 2 sessions, whereas Occlufast CAD, 200- μ m μ m mum\mu \mathrm{m} articulating film, and T-Scan offered 79 % 79 % 79%79 \% to 86 % , 68 % 86 % , 68 % 86%,68%86 \%, 68 \% to 75 % 75 % 75%75 \%, and 65 % 65 % 65%65 \% to 75 % 75 % 75%75 \% agreement, respectively. The most valid method was Occlufast CAD ( 74 % 74 % 74%74 \% to 80 % 80 % 80%80 \% ) followed by the 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m} articulating film ( 57 % 57 % 57%57 \% to 63 % 63 % 63%63 \% ), 400 − μ m 400 − μ m 400-mum400-\mu \mathrm{m} virtual occlusion ( 53 % 53 % 53%53 \% to 62 % 62 % 62%62 \% ), 100 − μ m 100 − μ m 100-mum100-\mu \mathrm{m} articulating film ( 52 % 52 % 52%52 \% to 60 % 60 % 60%60 \% ), and T-Scan ( 48 % 48 % 48%48 \% to 56 % 56 % 56%56 \% ).
结果。Occlufast Rock 在 2 次治疗之间的咬合接触位置上达成 85 % 85 % 85%85 \% 95 % 95 % 95%95 \% 了协议，而 Occlufast CAD、200 关节 μ m μ m mum\mu \mathrm{m} 膜和 T-Scan 分别提供了 79 % 79 % 79%79 \% 86 % , 68 % 86 % , 68 % 86%,68%86 \%, 68 \% 和 75 % 75 % 75%75 \% 65 % 65 % 65%65 \% 75 % 75 % 75%75 \% 协议。最有效的方法是闭塞 CAD（ 74 % 74 % 74%74 \% 到 80 % 80 % 80%80 \% ），然后是 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m} 铰接膜 （ 57 % 57 % 57%57 \% to 63 % 63 % 63%63 \% ）、 400 − μ m 400 − μ m 400-mum400-\mu \mathrm{m} 虚拟闭塞 （ 53 % 53 % 53%53 \% to 62 % 62 % 62%62 \% ）、 100 − μ m 100 − μ m 100-mum100-\mu \mathrm{m} 铰接膜 （ 52 % 52 % 52%52 \% to 60 % 60 % 60%60 \% ） 和 T 扫描 （ 48 % 48 % 48%48 \% to 56 % 56 % 56%56 \% ）。

Conclusions. Conventional methods, such as 100 - and 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m} articulating film and digital methods, including 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} virtual occlusion and T-Scan, offer sufficient accuracy in locating the occlusal contacts. However, strategies are needed to improve accuracy. (J Prosthet Dent xxxx;xxx:xxx-xxx)
结论。传统方法（如 100 毫米）和 200 − μ m 200 − μ m 200-mum200-\mu \mathrm{m} 铰接胶片和数字方法（包括 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} 虚拟咬合和 T 扫描）在定位咬合触点方面提供了足够的精度。但是，需要策略来提高准确性。（J Prosthet Dent xxxx;xxx：xxx-xxx）

Clinical Implications  临床意义

The accuracy of occlusal contact location depends mainly on the occlusal system and interocclusal distances used. Although these methods are clinically acceptable, the accuracy of conventional methods can be improved with new protocols for clinical and interpretation procedures, while digital methods could benefit from improved software programs.
咬合接触位置的准确性主要取决于所使用的咬合系统和咬合间距离。尽管这些方法在临床上是可接受的，但传统方法的准确性可以通过新的临床和解释程序方案来提高，而数字方法可以从改进的软件程序中受益。
by using an image software program, has been reported to offer the highest reliability and validity for determining the occlusal contact area (OCA) 10 − 14 10 − 14 ^(10-14){ }^{10-14} and has been claimed to be the criterion standard method. 12 12 ^(12){ }^{12} Recently introduced digital systems, including the T-Scan and digital casts, have also become available for occlusal assessment. 15 − 17 15 − 17 ^(15-17){ }^{15-17}
据报道，通过使用图像软件程序，为确定咬合接触区域 （OCA） 10 − 14 10 − 14 ^(10-14){ }^{10-14} 提供了最高的可靠性和效度，并被称为标准方法。 12 12 ^(12){ }^{12} 最近引入的数字系统，包括 T 扫描和数字石膏，也可用于咬合评估。 15 − 17 15 − 17 ^(15-17){ }^{15-17}
Static occlusal analysis comprises 3 steps. First, the patient closes in the maximum intercuspation position while an articulation indicator, a silicone material, or a sensor is placed in this position or scans are made with an intraoral scanner. Second, the dentist interprets the occlusal records by examining the marks intraorally or with a software program. Third, the occlusal record can be stored and transferred. However, each step can introduce variability and error that affects the results. Although studies have assessed the reliability and validity of different occlusal methods, 7 , 18 − 24 7 , 18 − 24 ^(7,18-24){ }^{7,18-24} few have analyzed all steps. 10 , 12 10 , 12 ^(10,12){ }^{10,12}
静态咬合分析包括 3 个步骤。首先，患者在最大耳尖位置闭合，同时将关节指示器、硅胶材料或传感器放置在该位置，或者使用口内扫描仪进行扫描。其次，牙医通过口腔内或使用软件程序检查标记来解释咬合记录。第三，可以存储和传输咬合记录。但是，每个步骤都可能引入影响结果的可变性和错误。尽管研究评估了不同咬合方法的可靠性和有效性，但 7 , 18 − 24 7 , 18 − 24 ^(7,18-24){ }^{7,18-24} 很少有人分析所有步骤。 10 , 12 10 , 12 ^(10,12){ }^{10,12}
Most researchers have focused on the number of occlusal contacts and the OCA, 10 , 12 , 20 10 , 12 , 20 ^(10,12,20){ }^{10,12,20} whereas the location of those contacts is often more relevant in clinical practice. 9 , 18 , 19 , 25 − 27 9 , 18 , 19 , 25 − 27 ^(9,18,19,25-27){ }^{9,18,19,25-27} The reliability or reproducibility, concerning the extent to which scores remain unchanged over time, are key to the accuracy of an occlusal method. 28 28 ^(28){ }^{28} Criterion validity, defined as how well location with a given method agrees with that for the criterion standard, is also useful. 28 28 ^(28){ }^{28} Unfortunately, reports on the accuracy of methods for locating occlusal contacts throughout the entire clinical procedure are sparse.
大多数研究人员都关注咬合接触的数量和 OCA， 10 , 12 , 20 10 , 12 , 20 ^(10,12,20){ }^{10,12,20} 而这些接触的位置在临床实践中通常更相关。 9 , 18 , 19 , 25 − 27 9 , 18 , 19 , 25 − 27 ^(9,18,19,25-27){ }^{9,18,19,25-27} 可靠性或可重复性，即分数随时间变化的程度，是咬合方法准确性的关键。 28 28 ^(28){ }^{28} 准则效度（定义为给定方法的定位与准则标准的位置的一致性程度）也很有用。 28 28 ^(28){ }^{28} 不幸的是，关于在整个临床过程中定位咬合接触的方法准确性的报告很少。
The purpose of this clinical study was to determine the criterion validity of different digital and nondigital occlusal methods for locating occlusal contacts by using the Occlufast Rock transillumination system for reference. The reproducibility of different occlusal methods in locating the occlusal contacts was also assessed. The null hypothesis was that different methods would have similar criterion validity for locating occlusal contacts.
本临床研究的目的是通过使用 Occlufast Rock 透射系统作为参考，确定不同数字和非数字咬合方法定位咬合接触的标准有效性。还评估了不同咬合方法在定位咬合接触方面的可重复性。原假设是不同的方法在定位咬合接触时具有相似的标准有效性。

MATERIAL AND METHODS  材料和方法

This cross-sectional test-retest study recruited 35 adult predoctoral dental students with a minimum of 24 natural teeth, without edentulous spaces. Those with
这项横断面重测研究招募了 35 名成年博士前牙科学生，他们至少有 24 颗天然牙齿，没有无牙颌间隙。那些
dental prostheses, extensive restorations, severe malocclusion, periodontal disease, excessive tooth wear, orofacial pain, or active orthodontic treatment were excluded. All participants were fully informed and signed the written informed consent form before participating in the study. The Ethics Committee of Barcelona University Dental Hospital approved the informed consent form and the study protocol (Ref. 11/2020). All procedures were conducted in accordance with the principles of the Helsinki Declaration, and the study was reported in accordance with the strengthening the reporting of observational studies in epidemiology (STROBE) guidelines.
排除了修复牙、广泛的修复体、严重的咬合不正、牙周病、牙齿过度磨损、口面部疼痛或积极的正畸治疗。所有参与者在参与研究前均已充分知情并签署书面知情同意书。巴塞罗那大学牙科医院伦理委员会批准了知情同意书和研究方案（参考文献 11/2020）。所有程序均根据赫尔辛基宣言的原则进行，并根据加强流行病学观察性研究报告 （STROBE） 指南报告了该研究。
A single operator (B.R.-L.), with more than 10 years of clinical experience, performed all clinical procedures with participants seated in a dental chair at the 90 -degree position with their Frankfort plane parallel to the floor. The participant’s age and gender were recorded, and the distance between the most distal points of the mandibular canines was measured with digital calipers (Absolute; Vogel) to calibrate the scale for image processing. The operator ensured the occlusal surfaces had no debris before performing the occlusal recordings with 8 different systems in a random order determined with permuted blocks established with a web-based software program (http://www.randomization.com). Half of the participants were assigned to 1 of the 2 sequences and rested for 2 minutes between occlusal records to avoid muscle fatigue. To determine the reliability of the occlusal methods, all occlusal records were repeated once for each participant in a retest session, following the same sequence and at the same time of day, 2 weeks after the test session.
一名具有 10 多年临床经验的操作员 （B.R.-L.） 执行了所有临床程序，参与者以 90 度的位置坐在牙科椅上，他们的法兰克福平面与地板平行。记录参与者的年龄和性别，并用数字卡尺测量下颌尖牙最远端点之间的距离（绝对;Vogel） 校准图像处理的刻度。操作员确保咬合表面没有碎屑，然后用 8 个不同的系统以随机顺序进行咬合记录，这些记录是使用基于 Web 的软件程序 （http://www.randomization.com） 建立的排列块确定的。一半的参与者被分配到 2 个序列中的 1 个，并在咬合记录之间休息 2 分钟以避免肌肉疲劳。为了确定咬合方法的可靠性，在测试会话后 2 周，按照相同的顺序和一天中的同一时间，为重新测试会话中的每个参与者重复一次所有咬合记录。
In system Occlufast Rock, a polyvinyl siloxane occlusal registration material (Occlufast Rock; Zhermack) was applied to the occlusal surfaces of the mandibular teeth. Participants were asked to occlude with maximum force at the maximum intercuspation position for 1 minute. System Occlufast CAD was comparable with system Occlufast Rock but used a scannable polyvinyl siloxane material (Occlufast CAD; Zhermack). Both occlusal registrations were trimmed and scanned by using the transparent materials adapter of a flatbed scanner (HP Scanjet G4050; Hewlett Packard).
在系统 Occlufast Rock 中，聚乙烯基硅氧烷闭塞配准材料（Occlufast Rock;Zhermack） 应用于下颌牙的咬合面。参与者被要求在最大尖间位置以最大力闭塞 1 分钟。系统 Occlufast CAD 与系统 Occlufast Rock 相当，但使用可扫描的聚乙烯硅氧烷材料（Occlufast CAD;Zhermack）。使用平板扫描仪的透明材料适配器（HP Scanjet G4050;惠普）。
For systems Articulating Film 12, 40, 100, and 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m}, the participants were asked to close their mouth firmly 3 times while the operator placed 12 − μ m 12 − μ m 12-mum12-\mu \mathrm{m} (Black and Red, Arti-Fol Metallic Shimstock-Film; Bausch), 40 − μ m 40 − μ m 40-mum40-\mu \mathrm{m} (Blue, Arti-Check Micron-Thin; Bausch), 100- μ m μ m mum\mu \mathrm{m} (Blue, Progress 100 μ m 100 μ m 100 mum100 \mu \mathrm{~m}; Bausch), or 200- μ m μ m mum\mu \mathrm{m} (Blue, Articulating Paper BK01; Bausch) articulating film on each hemiarch held by 2 Miller forceps (Forceps f. articulating paper Miller; Carl Martin). Before placing the films, cheek retractors (Spandex; Hager Worldwide) were inserted, saliva was suctioned with a standard saliva ejector (Monoart; Euronda), and the occlusal surfaces were air dried with an air-syringe. After removing
对于发音膜 12、40、100 和 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m} 的系统，要求参与者在操作员放置 12 − μ m 12 − μ m 12-mum12-\mu \mathrm{m} （黑色和红色，Arti-Fol 金属垫片薄膜;Bausch）， 40 − μ m 40 − μ m 40-mum40-\mu \mathrm{m} （蓝色，Arti-Check 微米薄;Bausch）， 100- μ m μ m mum\mu \mathrm{m} （蓝色， 进步 100 μ m 100 μ m 100 mum100 \mu \mathrm{~m} ;Bausch） 或 200- μ m μ m mum\mu \mathrm{m} （蓝色，铰接纸 BK01;Bausch） 由 2 个米勒镊子固定的每个半拱上的铰接膜（镊子 f. 铰接纸米勒;卡尔·马丁 （Carl Martin））。在放置薄膜之前，脸颊牵开器（氨纶;Hager Worldwide）插入，用标准唾液喷射器（Monoart;Euronda），并用空气注射器风干咬合面。移除后
the film, the marks on the assessed mandibular arch were scanned (TRIOS 3; 3Shape A/S). Before every occlusal test, the teeth were cleaned with a cotton roll and nylon brush (Proclinic; Stoddard Manufacturing Co) to remove any occlusal marks.
扫描胶片，扫描评估的下颌弓上的标记 （TRIOS 3;3Shape A/S）。在每次咬合测试之前，用棉卷和尼龙刷清洁牙齿（Proclinic;Stoddard Manufacturing Co） 去除任何咬合痕迹。
System T-Scan used an occlusal analysis system (TScan III; Tekscan, Inc) to obtain occlusal records. Participants were instructed to close in the maximum intercuspation position with maximum force on a 100 μ m μ m mum\mu \mathrm{m} sensor foil. The software program (T-Scan 10.0.28; Tekscan, Inc) generated a dynamic report showing the relative occlusal force detected for each sensor. System Virtual Occlusion involved the intraoral scanning (TRIOS 3; 3Shape A/S) of all teeth in the maxillary and mandibular arches, together with the intermaxillary relationship when the teeth closed in the maximum intercuspation position.
系统 T-Scan 使用咬合分析系统（TScan III;Tekscan， Inc） 获取咬合记录。参与者被指示在 100 μ m μ m mum\mu \mathrm{m} 个传感器箔上以最大力在最大冲击位置闭合。软件程序（T-Scan 10.0.28;Tekscan， Inc） 生成了一份动态报告，显示了为每个传感器检测到的相对咬合力。系统虚拟咬合涉及上颌弓和下颌弓中所有牙齿的口内扫描 （TRIOS 3;3Shape A/S），以及当牙齿在最大牙尖位置闭合时的颌间关系。
For each participant, 1 image of the mandibular arch from each system was captured and saved in Joint Photographic Experts Group (JPEG) format (Fig. 1). For the T-Scan system, an image was captured from the
对于每个参与者，从每个系统捕获 1 张下颌弓图像，并以联合图像专家组 （JPEG） 格式保存（图 1）。对于 T-Scan 系统，从
dynamic record of the mandibular arch at maximum intercuspation. For the virtual occlusion system, 4 images of the mandibular occlusal contacts were captured at interocclusal distances of 100, 200, 300, and 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} (Fig. 1). Each color image was calibrated spatially and by scale with a reference image for articulating film or virtual occlusion in the FIJI software program (ImageJ; National Institutes of Health) (Supplemental Fig. 1 and Supplemental Video 1, available online). The reference image was first scale-calibrated with the known intercanine distances by using the FIJI software program, before selecting and saving the occlusal perimeter of the premolars and first to molars on the right in regions of interest (ROI) format. All color images were transformed by using multiple points of equivalence on the scale-calibrated reference image with the “transform” plugin, applying a similarity class transformation with the least squares transformation method. The selected occlusal perimeter (ROI file) was applied to the transformed image, cleaned, and saved as a spatially calibrated color image.
最大腔间下颌弓的动态记录。对于虚拟咬合系统，在 100、200、300 和 400 μ m 400 μ m 400 mum400 \mu \mathrm{~m} （图 1）的咬合间距离处捕获了 4 张下颌咬合接触的图像。每个彩色图像都经过空间和比例校准，并使用 FIJI 软件程序中的参考图像来阐明薄膜或虚拟遮挡（ImageJ;美国国立卫生研究院）（补充图 1 和补充视频 1，可在线获取）。首先使用 FIJI 软件程序使用已知的犬间距离对参考图像进行比例校准，然后选择并保存前磨牙的咬合周长，首先以感兴趣区域 （ROI） 格式保存右侧的磨牙。所有彩色图像都是通过使用 “transform” 插件在比例校准的参考图像上使用多个等价点进行转换的，并使用最小二乘变换方法应用相似性类变换。将选定的咬合周长（ROI 文件）应用于转换后的图像，进行清理并保存为空间校准的彩色图像。
Figure 1. Image processing for occlusal records. A, Systems Occlufast Rock and Occlufast-CAD, Articulating film 12 and 40 μ m 40 μ m 40 mum40 \mu \mathrm{~m}. B, Systems Articulating Film 100 and 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m}, and T-Scan. C, System Virtual Occlusion. CAD, computer-aided design.
图 1.咬合记录的图像处理。A， 系统 Occlufast Rock 和 Occlufast-CAD， 铰接膜 12 和 40 μ m 40 μ m 40 mum40 \mu \mathrm{~m} .B、系统超声胶片 100 和 200 μ m 200 μ m 200 mum200 \mu \mathrm{~m} 和 以及 T 扫描。c， System Virtual Occlusion （系统虚拟遮挡）。CAD、计算机辅助设计。
  1. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Conflict of interest: None.
    资金： 这项研究没有从公共、商业或非营利部门的资助机构获得任何具体资助。利益冲突：无。
    a a  ^("a "){ }^{\text {a }} Assistant Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain.
    a a  ^("a "){ }^{\text {a }} 西班牙加泰罗尼亚巴塞罗那大学医学与健康科学学院口腔医学系助理教授。
    b b ^(b){ }^{\mathrm{b}} Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Autonomous University of Nayarit, Tepic, Mexico.
    b b ^(b){ }^{\mathrm{b}} 墨西哥特皮克纳亚里特自治大学牙科学院口腔修复学系副教授。
    c c ^(c){ }^{c} Associate Professor, Department of Odontostomatology, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Campus de Bellvitge 08907 L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain.
    c c ^(c){ }^{c} 巴塞罗那大学医学与健康科学学院牙科学院口腔医学系副教授，Campus de Bellvitge 08907 L'Hospitalet de Llobregat，巴塞罗那，加泰罗尼亚，西班牙。
    d d ^(d){ }^{d} Associate Professor, Department of Oral Medicine and Radiology, King George’s Medical University, Lucknow, India.
    d d ^(d){ }^{d} 印度勒克瑙乔治国王医科大学口腔医学和放射学系副教授。
    e e ^("e"){ }^{\text {e}} Associate Professor, Serra Hunter Fellow, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain; and Researcher, Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain
    e e ^("e"){ }^{\text {e}} 西班牙加泰罗尼亚巴塞罗那大学医学与健康科学学院齿状科副教授，Serra Hunter 研究员;和研究员，口腔健康和咀嚼系统组（Bellvitge 生物医学研究所）IDIBELL，L'Hospitalet de Llobregat，巴塞罗那，加泰罗尼亚，西班牙