Dental Materials Journal 2009; 28(2): 212－218

Original Paper

Bite force measurement system using pressure-sensitive sheet and silicone

impression material

Katsuya ANDO, Yuji FUWA, Masahiro KUROSAWA, Takamasa KONDO and Shigemi GOTO

Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Nagoya, Aichi 464-8651, Japan
Corresponding author,  Katsuya ANDO;  E-mail:  [email protected]

This study was conducted to reduce the bias in measured values caused by the thickness of materials used in occlusal
examinations. To this end, a silicone impression material for bite force measurement and an experimental model of a
simplified stomatognathic system were employed in this study. By means of this experimental model, results showed that
the effect of bias toward the posterior arch could be reduced in the anterior-posterior distribution of bite forces and in the
occlusal contact areas due to the thickness of the materials used in occlusal examinations.

Key words: Bite force, Occlusal contact area, Silicone impression material

Received Dec 21, 2007: Accepted Sep 18, 2008

　　In light of the over-detection drawback, there

INTRODUCTION
arose a need to measure the occlusal contact area
During an occlusal examination, the occlusal contact objectively and quantitatively using a silicone
area and bite force of a patient provide valuable impression material that has high fluidity and almost
information for oral disease diagnosis, treatment, non-existent thickness at the occlusal contact area.
and prognosis1-11,13). Presently, a variety of occlusal In conjunction, a light transmission device was
examination methods are available. They include developed to read the silicone impression material
occlusal registration by articulating paper, using a bite force measurement system (Fig. 3). With
examination with dental cast models mounted on an which, the occlusal contact area of the silicon
articulator, and occlusal analysis by muscle activity impression material and its thickness limit of
or mandibular movements. However, these methods readable range were measured, thereby demonstrat-
have been indicated to be frequently and heavily ing its efficaciousness.
influenced by the subjectivity and clinical experience 　　The objective of this study was to compare the
of practitioners. Against this background, an occlusal contact areas obtained from the silicone
accurate measurement method and a set of objective impression material and pressure-sensitive sheet
measurement standards for bite force analysis are using the herein-mentioned experimental model of a
not only highly desired, but that they must be simplified stomatognathic system. The occlusal
established promptly. contact area obtained from the silicone impression
　　In 2004, a system was introduced which material and the average bite pressure obtained from
comprised a CCD camera (Occluzer FPD 707, Fuji the pressure-sensitive sheet were then multiplied to
Film Corp., Tokyo, Japan) and a bite force estimate the bite force when there was nothing
measurement system using a pressure-sensitive between the occlusal surfaces. Thereafter, the
sheet (Dental Prescale 50H, type R, Fuji Film Corp.). estimated bite forces were compared with the bite
In terms of advantages, this new bite force forces obtained from the pressure sensors, which
measurement system is first of all not influenced by were incorporated into the experimental model and
the subjectivity and experience of practitioners14,15). used in place of teeth.
Another advantage is that it requires only a simple
chairside procedure to measure occlusal contact areas
MATERIALS  AND  METHODS
and bite forces easily, objectively, and quantitatively
(Figs. 1 and 2). However, a disadvantage of this Experimental model
occlusal examination method has been indicated. Apart from the thickness of materials used in an
The disadvantage lies in the use of an interocclusal occlusal examination, another aspect of concern in
material with a certain thickness, such as the occlusal contact area measurement is the anterior-
pressure-sensitive sheet. As a result, over-detection posterior distribution of bite forces. Several factors
of the occlusal contact area and bite force of the integrally affect the anterior-posterior distribution of
posterior teeth near the hinge axis occurs16-19). bite forces. They are namely: changes in the
 Dent Mater J 2009; 28(2): 212－218 213

Fig. 1 Pressure-sensitive sheet becomes red when Fig. 3 A red electroluminescence sheet of 0.25 mm
microcapsules with various sizes in the sheet thickness uniformly luminesced when an
break ― depending on the load that is placed on alternating voltage was applied to the fluorescent
the sheet. A constant correlation existed between substances dispersed in a binder with a high
the intensity of red color and the load pressure in dielectric constant. A power source which could be
the range of 5－120 MPa. continuously varied to a maximum applied voltage
of 12 V was used in conjunction to make a light
transmission device.

constructed in this study.

　　The lower arch of the articulator had pressure
sensors (LM-10KA, Kyowa Electronic Instruments
Corp., Tokyo, Japan) substituted for teeth. Each
sensor had a sensitive element which comprised a
spherical surface of 4 mm radius to directly measure
the bite force at each occlusal contact point. A total
of four sensors were placed, with one sensor each in
the left and right regions of anterior teeth and the
left and right molar regions. In the maxillary arch of
the articulator, an attached glass plate came into
contact simultaneously with the four pressure
sensors.
　　As for the condylar spheres of the articulator,
they were designed to reduce the lever effect upon
Fig. 2 Occluzer FPD 707 comprised a CCD camera. detecting a biting force in the region of the anterior
teeth from the time a small load was applied. To
achieve this reduction in lever effect, a path of
positions of teeth and mandible, elastic deformation condylar guidance with the molar region as the
of the jaw bone, load on the periodontal soft tissue, fulcrum was established so that the condyle could
lever effect, and masticatory muscle activities. To slide anterosuperiorly without resistance. To prevent
minimize the influence of these factors, an loading the articulator in advance, a counterbalance
experimental model (Hanau H2-0) (Water Pik was added to the maxillary posterior region so that
Technology Inc., Colorado, USA) of a simplified sto- weights were balanced in the anterior and posterior
matognathic system, without premature contacts regions in the maxillary arch centering on the
using a semi-adjustable articulator (Fig. 4), was articulator hinge axis. In addition, anterosuperior
214 Dent Mater J 2009; 28(2): 212－218

Fig. 4 An experimental model of a simplified stomatognathic system without premature contacts

using a semi-adjustable articulator (Hanau H2-0).

movements of the condylar spheres were allowed molded using a 1-mm-thick frame as a guide, which
without hindrance from the weight of the counterbal- was placed on the peripheral border of the glass plate
ance or the maxillary arch in articulator. To achieve of the maxillary arch in the articulator. For occlusal
these movements, the load was lifted immediately contact area measurement using the silicone
before the right and left condylar spheres floated impression material, it was performed 10 times each
from the superior direction. Then, a constant-load at the four points of the anterior, posterior, right,
compression tester (AGS-A, Shimadzu Corp., Kyoto, and left areas. Occlusal contact area measurement
Japan) was used to apply a load to the articulator in was then carried out using the bite force
the center of each of the four sensors, whereby real- measurement system with a built-in light
time value at each pressure sensor was measured transmission device. Similarly, for occlusal contact
using an instrumentation amplifier (WGI-300B-1, area measurements using the single pressure-
Kyowa Electronic Instruments Corp.) (Fig. 5). sensitive sheet and a stack of two pressure-sensitive
　　The load applied ranged from 1 kgf to 7 kgf at 1- sheets, they were performed 10 times each using the
kgf intervals and at a speed of 1 mm/min. At each bite force measurement system.
load value, 10 measurements were made with the 　　Average values of the right and left
instrumentation amplifier. To examine whether the measurements of these three types of materials were
experimental model had the adequate accuracy used as representative values for scattergrams’
required for this investigation, the relationship plotting. Regression equations, which expressed the
between loads applied with a constant-load anterior-posterior distributions in the regions of
compression tester and the values measured by the anterior and posterior teeth, were calculated and
pressure sensors was studied. comparisons were made.

Occlusal contact areas obtained from the silicone Comparison of bite forces obtained from a single
impression material and pressure-sensitive sheet pressure-sensitive sheet, two pressure-sensitive sheets,
The materials placed between the occlusal surfaces of and silicone impression material and estimation of
the articulator were namely a dark gray silicone bite force with nothing between the occlusal surfaces
impression material, a single pressure-sensitive To measure the bite force when there was nothing
sheet, or a stack of two pressure-sensitive sheets. between the occlusal surfaces, measurements were
Loads ranging from 4 kgf to 7 kgf, increasing at 1-kgf performed at the four pressure sensors located in the
intervals, were applied. anterior, posterior, left, and right areas. Loads of 4
　　The mixed silicone impression material was kgf to 7 kgf were applied at 1-kgf intervals, and
 Dent Mater J 2009; 28(2): 212－218 215

Fig. 5 Different aspects of the experimental model.

measurement at each sensor was performed 10 times

using an instrumentation amplifier. Values obtained
were converted from kgf to N.
　　With the single pressure-sensitive sheet and two
pressure-sensitive sheets, their average bite forces
were measured 10 times each using the bite force
measurement system. To estimate the bite force
with nothing between the occlusal surfaces, it was
obtained by multiplying the occlusal contact area
obtained from the silicone impression material and
the average bite pressure from the single pressure-
sensitive sheet. For the four different conditions
(namely the three types of materials and with
nothing between the occlusal surfaces), the average
values of the calculated or measured left and right
values were used as the representative values, and a
scattergram was plotted for each. Thereafter, the
regression equations, which expressed the anterior-
posterior distributions in the regions of anterior and Fig. 6 Two regression equations expressed the
posterior teeth, were calculated and comparisons relationship between the loads applied with a
were made. constant-load compression tester and the values
measured by the pressure sensors.

RESULTS
Accuracy of the experimental model teeth region, and y=0.24x+0.09 for the posterior teeth
The relationship between the loads applied with a region. The y-intercepts of the regression lines
constant-load compression tester and the values converged at almost 0. A proportional relationship
measured by the pressure sensors was expressed by was found between the loads applied and the values
the regression line, y=0.24x+0.04, for the anterior measured by the pressure sensors for the two
216 Dent Mater J 2009; 28(2): 212－218

Fig. 7 The regression equations expressed the anterior- Fig. 8 The regression equations expressed the anterior-
posterior distribution of occlusal contact areas posterior distribution of bite forces obtained from
obtained from the silicone impression material, the silicone impression material, single pressure-
single pressure-sensitive sheet, and two pressure- sensitive sheet, two pressure-sensitive sheets, and
sensitive sheets. the pressure sensors.

regression lines. In addition, the slopes and y- the stack of two pressure-sensitive sheets (Fig. 8).
intercepts of the two regression lines were similar
(Fig. 6).
DISCUSSION
Occlusal contact areas obtained from the silicone Accuracy of the experimental model
impression material and pressure-sensitive sheet The y-intercepts of the regression lines of the
The following regression equations expressed the anterior teeth and posterior teeth regions almost
anterior-posterior distributions of occlusal contact converged at 0. The regression lines expressed the
areas obtained from the silicone impression material, relationship between the values measured by the
single pressure-sensitive sheet, and two pressure- pressure sensors and the loads applied by the
sensitive sheets, respectively: y=0.57x+0.04, constant-load compression tester. From this result,
y=0.32x+0.03, and y=0.23x+0.01 (Fig. 7). it seemed that the weights in the anterior and
posterior regions of the maxillary arch centering on
Comparison of bite forces obtained from single the articulator hinge axis were balanced by adding
pressure-sensitive sheet, two pressure-sensitive sheets, the counterbalance. Therefore, loading the maxillary
and silicone impression material and estimation of anterior arch in advance was thought to have a coun-
the bite force with nothing between the occlusal terbalancing effect.
surfaces 　　The regression lines of the anterior and posterior
The regression equation, y=0.96x+0.05, expressed the teeth regions were directly proportional and were
anterior-posterior distribution of bite forces obtained almost the same. From this result, the anterior and
from the pressure sensors. The regression equation, posterior pressure sensors could be considered to
y=0.47x+0.01, expressed the anterior-posterior have the necessary accuracy within the predeter-
distribution of the bite forces obtained by multiplying mined loading range (i.e., 1 kgf to 7 kgf) for this
the average bite pressure of the single pressure- investigation. Therefore, by virtue of this result, the
sensitive sheet and the occlusal contact area of the constructed experimental model enabled the under-
silicone impression material. The regression standing of the anterior-posterior distribution of bite
equation, y=0.33x－0.43, expressed the anterior- forces when nothing was between the occlusal
posterior distribution of the bite forces obtained from surfaces by using pressure sensors in place of teeth.
the single pressure-sensitive sheet. The regression
equation, y=0.21x－0.64, expressed the anterior- Study of the occlusal contact areas obtained from the
posterior distribution of the bite forces obtained from silicone impression material and pressure-sensitive
 Dent Mater J 2009; 28(2): 212－218 217

sheet sheet) and the occlusal contact area (obtained from

The slope of the regression equation expressing the the silicone impression material) was thought to
anterior-posterior distribution of the occlusal contact reduce the effect of such bias. In addition, the
areas for the single pressure-sensitive sheet was method which derived the bite force using the
smaller than that for the silicone impression pressure-sensitive sheet and silicone impression
material. This result indicated a bias of the anterior- material could be used as a means to establish the
posterior distribution of the occlusal contact areas criteria for estimating the bite force with nothing
toward the molar region. Such a slope for the stack between the occlusal surfaces. In the future, the
of two pressure-sensitive sheets was smaller than next step forward is to establish a reliable and
that of the single pressure-sensitive sheet. This accurate method of obtaining occlusal contact areas
result further confirmed the notion that the anterior- using pressure-sensitive sheet and silicone
posterior distribution of occlusal contact areas was impression material.
indeed biased toward the molar region.
　　When an impression material used in an occlusal
CONCLUSIONS
examination has some thickness, it has the effect of
biasing the anterior-posterior distribution of occlusal This study was conducted to reduce the bias of
contact areas toward the posterior arch near the measured values due to the thickness of materials
hinge axis. From the above results, it was shown used for occlusal examinations. Silicone impression
that occlusal contact area measurement using material was applied to a bite force measurement
silicone impression material with almost non-existent system, and comparisons were made between the
thickness at the occlusal contacts could reduce the occlusal contact areas obtained from the pressure-
effect of such bias. sensitive sheet and the silicone impression material
using the experimental model ― a simplified sto-
Comparison of bite forces obtained from the single matognathic system. Bite force was obtained by
pressure-sensitive sheet, two pressure-sensitive sheets, multiplying the occlusal contact area from the
and silicone impression material and the estimation silicone impression material and the average bite
of bite force with nothing between the occlusal pressure obtained from the pressure-sensitive sheet.
surfaces This estimated bite force was then compared against
The slope of the regression equation expressing the the bite force obtained from the pressure sensors
anterior-posterior distribution of bite forces obtained incorporated into the experimental model. By this
from the single pressure-sensitive sheet was smaller comparison process involving different methods and
than that obtained from the pressure sensors. This the results thereof yielded in this study, it was thus
result indicated that the anterior-posterior determined whether it was possible to estimate the
distribution was biased toward the molar region. bite force with nothing between the occlusal surfaces.
Further, the slope of the regression equation (1) A method was used to measure occlusal
expressing the anterior-posterior distribution of bite contact areas by means of a silicone impression
forces obtained from the two pressure-sensitive material with the bite force measurement
sheets was small compared to that obtained from the system and with a light transmission device.
single pressure-sensitive sheet. Similarly, this result Results of this study showed that this method
indicated a bias of the anterior-posterior distribution reduced the effect of bias toward the posterior
of bite forces toward the molar region. Upon arch in the anterior-posterior distribution of
comparing the following regression equations which occlusal contact areas, which is typically
expressed the anterior-posterior distribution of bite caused by the thickness of materials used in
forces, namely (1) multiplying the average bite occlusal examinations.
pressure of the single pressure-sensitive sheet and (2) A method was used to derive the bite force by
the occlusal contact area of the silicone impression multiplying the average bite pressure obtained
material; (2) values measured from the pressure from the pressure-sensitive sheet and the
sensors; and (3) values obtained from pressure- occlusal contact area obtained from the silicone
sensitive sheets, it was found that the regression impression material. Results of this study
equation from (1) was more similar to (2) than to (3). showed this method reduced the effect of bias
　　When an impression material used in an occlusal toward the posterior arch in the anterior-
examination has some thickness, it has the effect of posterior distribution of bite forces due to the
biasing the anterior-posterior distribution of bite thickness of materials used in occlusal
forces toward the posterior arch near the hinge axis. examinations. In light of the encouraging
From the above results, the method which derived results of this study, it was thus suggested
the bite force by multiplying the average bite that such a method of deriving bite forces
pressure (obtained from the single pressure-sensitive could be used as a means of establishing
218 Dent Mater J 2009; 28(2): 212－218

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