T scan – A review on an occlusal indicator in dentistry

Assembly

A sensor and support, a holder assembly, the system element, computer software, and a laser printer are among the system's components. The U-shaped sensor is housed in the hand-held gadget, which is connected to a computer's USB port and fits into the subject’s oral cavity between the occlusal surfaces of their teeth. 3

By recording factors including bite length, timing, and force of tooth contact, the T-Scan enables the quantification of occlusal contact data. The data is then stored on a hard drive and may be incrementally played for data analysis in a time-based video. 10

Sensor

It serves as the primary tool for recording occlusal registration. Occlusal biting forces accurately measured quantitatively by the sensor. It assists in capturing the timing of the occlusal contacts (as a film) and the force that each occlusal contact generates. It is a polyester film that is 60 micrometres thick. 11

Two sizes of T-Scan sensors are available: 2

Small size sensors have 1122 sensels whereas large size sensors have 1370 sensels and can accept arches up to 58 mm wide & 51 mm deep. Large size sensors can accommodate arches up to 66 mm wide & 56 mm deep. The sensor has a 0.1 mm thick. 12

The first-generation (G1) blue sensor remained prepared of a pressure-sensitive ink grid made of Mylar laminated and shaped like a dental arch. When loaded and inserted intraorally, the relative force information interpreted 16 levels of intraoral force in time increments of 0.01 seconds. The second-generation (G2) T-Scan sensor was more pliable and thinner. 13 For use in the third generation (G3) of T-Scan sensors, which were created in combination by the T-Scan II, Tek scan created its own exclusive resistive ink. The hysteresis, gist & repeatability of the sensor were all intended to be enhanced by this new ink. It was made up of two coatings of Mylar that were sandwiched together by a lattice of resistive inked rows & columns that had been screen-printed. 14

The ultra-thin (0.004-inch, 0.1-mm), reusable sensor used by T-scan III v10 is tailored to accommodate the dental arch. The HD sensor's structural design comprises of two coats of Mylar that are sandwiched together by a printed lattice of resistive ink rows and columns. 12 To reliably register absolute bite forces, the T-Scan sensors must be calibrated. A trustworthy calibration would enable converting the output of the ‘T-Scan sensor’ through biting in hominid test participants into absolute force units. 8

Advantages 15, 17

In restorative dentistry and prosthodontics

Occlusal incongruities are unique of the most harmful functional issues experienced following treatment in prosthodontic rehabilitation. 18 Therefore, it is crucial to use a permanent restoration to create an occlusion that is both mechanically and physiologically sound. Numerous occlusal analysers are used in dentistry to record the occlusal-articulation relation. These occlusal analysers can be broadly classified as gauges, both quantitative and qualitative. 19

Halili R et al., 20 conducted an electronic search using Google Scholar, PubMed, MEDLINE, and Web of Science. A number of studies revealed that the T-Scan computerised occlusal analysis be able to afford measureable occlusal load and timing statistics that will allow for better protection of brittle dental ceramic and, most importantly, an improvement in the comfort and function of the patient's bite.

Bozhkova T P et al.,6 explained that by revolving qualitative data into assessable information and digitally showing it, the T-SCAN technology offers the only precise method of determining and evaluating the timing and force of occlusal interactions. Using the T Scan III technology, Vladutu DE et al., 21 analysed the occlusal connections in students who grind their teeth and found a positive link between these relationships and the activity of the mastication muscles as measured by surface electromyography.

Implant dentistry

Due to its durability, high patient satisfaction, predictable aftereffects, and minimum harm to surrounding tissues, dental implant repair is among the top treatment substitutes for supplanting absent teeth, especially free-ends. Occlusion is the foundation of masticatory purpose and a crucial sign of oral implant restoration success that can be determined by T Scan. 22

In their work, Wu ML et al., 23 used the T-SCAN III scanner to gather dynamic quantitative data prior to and following the renovation of free-end implants and to investigate how the T-SCAN III may be used to redistribute the occlusal force of free-end implants. Using a computerised occlusal analysis system, Ding Q et al., 24 examined the longitudinal change of occlusal strength dissemination and occlusal connexion interval in posterior implant-supported single crowns.

In orthodontics

The lack or presence of asymmetric connections can point to the necessity for additional finishing and correction in orthodontics. The T-Scan system is used to compare the symmetry of the occlusal force before and after treatment as well as to trace and locate traumatic occlusal contacts. The T-Scan device can also be a helpful tool for monitoring patients and determining whether a relapse has occurred. 25, 26

F Fritz et al., 27 assessed the comparative dispersal of occlusal loads after orthodontic management and throughout the initial 3 months of the retention stage using a high-tech occlusal exploration co-ordination. The goal of the last phase should be an equitable distribution of occlusal loads because T Scan did not show any qualified benefits for any retention plan in terms of post-debond improvement throughout the retention phase. Chaikla K et al., 28 employing the T-Scan III system, it was possible to assess and compare the initial tooth interaction region, occlusion time, time to create total force, and strength dispersal between patients with open bites and those who weren't, at the maximum intercuspation position..

In orthognathic surgery

The intricate operation of the stomatognathic system depends on the optimal physiological occlusion being achieved following osteotomy. Dental occlusion differs from person to person. The T-Scan system logs the bite force maximum, first contact, and maximum intercuspation. 26

The efficacy and reliability of T-Scan in evaluating occlusion previously and afterward orthognathic surgery were examined by Agbaje JO et al.,29 in 40 individuals undergoing orthognathic surgery and 30 hale and hearty adults through typical occlusion had their occlusal information examined. When designing a course of therapy and monitoring its effectiveness, T-Scan can be utilised to show the distribution of occlusal contacts before and after surgery. By means of T-Scan III System precise analysis, Trpevska V et al., 30 examined the occlusal force and occlusal contacts distribution over time in patients with neutroocclusion.

In pedodontics

Some of the digital dental technologies now on the market have been shown to be helpful in paediatric dentistry. One such cutting-edge computerised analyzer that is quite helpful for youngsters to check for occlusal discrepancies is the T Scan. 31 The repeatability and clinical presentation of the T-Scan system in children were discussed by K. Okamoto et al., 32, 33 In order to ascertain whether the extreme intercuspation locus in children is affected by the installation of an SSC, whether it returns to normal after 4 weeks, and whether local anaesthesia affects the child's capacity to reach MIP, Gallangher S et al. 34 Occlusal contacts were measured using the T-Scan III.

In periodontics

The periodontium has the capacity to bear the pressure that the tooth applies during occlusal contact. The main causes of changes in tooth occlusion are early interactions or interferences. The occurrence, degree, interval, and path of occlusal compressions all have an influence on the periodontium. The occlusal status of a person is primarily described by two key traits. They are (a) intra-architectural relationship and (b) inter-architectural relationship.2

Deepika BA et al.,35 figured out if periodontal therapy calls for occlusal modification. The T-scan approach is unquestionably a suitable means for assessing and evaluating the occlusal contacts during maximal intercuspation, it was also concluded.

Saravanan R36 investigated the effects of elevated occlusal force on the severity of periodontal disease and the effects of occlusal correction based on T-Scan evaluation on healing following periodontal therapy. The findings showed a strong correlation between occlusal force and the severity of periodontitis. Occlusal correction reduced periodontal parameters, however this correlation was not statistically significant.

Sreelakshmi CK et al.,37 using T-Scan III, it was determined how occlusal loading forces, occlusal contact variability, and their correction were managed in cases of periodontitis.

In temporomandibular joint disorders

Chronic Disclusion Time, occlusal interferences, and occlusal surface friction have all contributed to the symptoms of Temporomandibular Disorder (TMD) in hyperactive masticatory muscles.12 TMD has a complex aetiology. Occlusion is thought to be a key factor in the beginning of a condition, however this hasn't been shown beyond a reasonable doubt. There is ongoing debate on the part of occlusion as causative influence for TMD. Disclusion The T-Scan can reduce the amount of time spent in TMDs.17

The T-scan method offers information on functional occlusion and allows the physician to objectively assess the occlusal contacts during continuous mandibular movement. In the realm of TMDs, the T scan I technology (Tscan 2000; Tekscan Inc.) was first released in 1984 and cleared the way for studies that were backed by research that showed dental occlusion as an causative element for TMD. A new occlusal functional movement parameter to assess prolonged excursive movement durations was developed because the T-scan I could measure occlusal contact time sequences in 0.01 s increments. 38

Thumati P et al., 26 on 100 patients, the ICAGD technique was used to assess the impact of occlusal equilibration on the patients' subjective myofascial pain symptoms. The reduction of the anterior DT to 0.4s was the main goal, and the symptoms and indicators of myofascial pain were the secondary goals. Dzingute et al., 39 employing the T-scan II computerised occlusal analysis system on 44 TMD patients. The patient's occlusion as well as static occlusal data such the OT, asymmetry index of maximal occlusal force, and centre of occlusal force were noted. The findings indicated a connection between static occlusion factors and TMD.