在牙科治療中，咬合調整為一項重要且普遍的臨床步驟。於牙齒修復填補或贋復物置入後，患者的咬合需經過精確調整。若未能適當移除咬合干擾 (Occlusal Interference)，可能會造成咬合創傷 (Occlusal Trauma)、機械性併發症 (mechanical complications)或甚至引發顳顎關節症候群 (Temporomandibular Disorders, TMD)。事實上，咬合調整應基於準確的咬合分析結果而施行。然而，臨床上常用之不同咬合分析工具，其對於干擾點大小、形態與受力特性的反應機制並不相同，可能導致對同一干擾點之判讀產生差異。因此，本研究的目的在於評估不同咬合分析工具，包含傳統咬合紙、Dental Prescale II (GC Corp.)與T-Scan (T-Scan Novus, Tekscan, Inc.)，在咬合接觸分析中的效能，並嘗試識別其相關模式，進而為臨床咬合調整提供深入見解。本研究特別聚焦於不同工具在不同大小尺度干擾下之反應差異，其中小尺度干擾定義為高度不超100 μm且直徑不超過1 mm的干擾點，而大尺度干擾則指高度達150 μm或直徑達1.5 mm之干擾點，以利後續數據解讀與比較。研究方法包括運用數位牙科設計軟體 (DentalCAD 3.1, Exocad GmbH)來設計咬合干擾模型，並透過3D列印機將模型實體化。這些模型於萬能試驗機上以固定之垂直向載重模式500N的力量進行咬合模擬測試，本研究僅探討垂直咬合模式，模擬最大咬頭嵌合 (Maximum Intercuspation)下緊咬 (Clenching)之咬合狀態，不包含任何側向運動，聚焦分析工具於垂直受力條件下之表現。實驗將採用三種咬合分析工具：12微米厚的咬合紙 (AP)、Prescale II (PS)，以及T-Scan (TS)。在上顎右側第一大臼齒增加直徑0.5 mm、1 mm、1.5 mm，高度50 μm、100 μm、150 μm共九種組合之圓頂型 (Dome-shaped)干擾點，藉此模擬不同尺度之咬合干擾。最後進一步分析工具標記對於干擾點的覆蓋率，以判斷各種分析工具針對干擾點的探測能力。各組條件皆進行三次重複量測，並採用Spearman相關係數、偏Spearman相關係數、標準化迴歸係數(β)、MAE、RMSE以及Wilcoxon符號等級檢定進行統計分析。不論在有/無PDL情境下，AP與PS皆對小尺度干擾呈現明顯高估；雖然PS顯示出顯著較佳的再現性，但兩者與理論干擾面積皆未呈現穩定的單調相關。於模擬PDL條件中，AP與真實干擾面積呈中度且具統計顯著性之相關，並對干擾直徑所反映的接觸面積橫向擴張具高度敏感性；相對地，PS則對干擾高度所造成的垂直壓縮更為敏感，此現象亦與其壓力探測機制相符。相較之下，TS所量測者為整體牙弓之相對力分布，在靜態負載條件下，無法準確定位單一局部接觸點，顯示其較適合用於動態或整體咬合力分配之評估。基於上述結果，本研究提出一套具臨床可行性的咬合調整流程：當干擾位置未知時，宜先以PS判定高壓力集中區；其後使用AP進行精確的干擾點定位與微調；最終再以PS確認壓力是否已降至探測閾值以下，以確保咬合調整充分且避免過度去除齒質。

Occlusal adjustments of dental restorations are crucial for ensuring their optimal long-term outcomes. Mismanagement of occlusal interferences can lead to occlusal trauma, mechanical complications, and potential temporomandibular joint disorders. This study evaluates the effectiveness of various occlusal indicators, including traditional articulating paper and quantifiable occlusal indicators such as the Dental Prescale II (GC Corp.) and the T-Scan (T-Scan Novus, Tekscan, Inc.), in analyzing occlusal contacts. Additionally, this study aims to identify associated patterns and is expected to offer insights into clinical occlusal adjustment protocols. Occlusal interference models were digitally designed using DentalCAD 3.1 (exocad GmbH) and fabricated with a 3D printer. These models were tested on a vertical stand to simulate jaw articulation under a 500 N force. Three types of occlusal indicators were employed: 12 μm-thick articulating paper (AP), Dental Prescale II (PS), and T-Scan (TS). Dome-shaped interferences with diameters of 0.5 mm, 1 mm, and 1.5 mm and heights of 50 μm, 100 μm, and 150 μm were added to the upper right first molar (Tooth 16), representing small-scale (≤100 μm height and ≤1 mm diameter) and large-scale interferences (≥150 μm height or ≥1.5 mm diameter). The coverage of indicator markings over the interference sites was further analyzed to evaluate the detection capability of each occlusal analysis tool. Each condition was measured three times, and statistical analyses included Spearman and partial Spearman correlations, standardized regression coefficients (β), MAE, RMSE, and Wilcoxon signed-rank tests. Regardless of the presence or absence of PDL simulation, both AP and PS markedly overestimated small-scale interferences. PS demonstrated significantly superior repeatability, though neither system showed strong monotonic correlation with theoretical areas. With simulated PDL, AP showed a significant moderate correlation with true area and primarily responded to diameter-related lateral expansion. By contrast, PS primarily responded to height-dependent vertical compression, consistent with its pressure-based detection mechanism. TS, which measures relative force distribution across the dental arch, was unable to localize point-specific contacts under static loading, indicating limited utility for static interference detection. Based on these findings, a clinically applicable workflow is proposed: PS should be used first to identify high-pressure regions when the interference site is unknown, followed by thin AP for precise localization and adjustment, and finalized by PS confirmation of adequate pressure reduction.

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