Clinical Decision Support Model to Predict Occlusal Force in Bruxism Patients

OBJECTIVES: The aim of this study was to develop a decision support model for the prediction of occlusal force from the size and color of articulating paper markings in bruxism patients. METHODS: We used the information from the datasets of 30 bruxism patients in which digital measurements of the size and color of articulating paper markings (12-µm Hanel; Coltene/Whaledent GmbH, Langenau, Germany) on canine protected hard stabilization splints were measured in pixels (P) and in red (R), green (G), and blue (B) values using Adobe Photoshop software (Adobe Systems, San Jose, CA, USA). The occlusal force (F) was measured using T-Scan III (Tekscan Inc., South Boston, MA, USA). The multiple regression equation was applied to predict F from the P and RGB. Model evaluation was performed using the datasets from 10 new patients. The patient's occlusal force measured by T-Scan III was used as a ‘gold standard’ to compare with the occlusal force predicted by the multiple regression model. RESULTS: The results demonstrate that the correlation between the occlusal force and the pixels and RGB of the articulating paper markings was positive (F = 1.62×P + 0.07×R –0.08×G + 0.08×B + 4.74; R(2) = 0.34). There was a high degree of agreement between the occlusal force of the patient measured using T-Scan III and the occlusal force predicted by the model (kappa value = 0.82). CONCLUSIONS: The results obtained demonstrate that the multiple regression model can predict the occlusal force using the digital values for the size and color of the articulating paper markings in bruxism patients.