wileyonlinelibrary.com/journal/joor J Oral Rehabil. 2018;45:574.
© 2018 John Wiley & Sons Ltd
Response to letter to the editor: “Does the presence of an
occlusal indicator product affect the contact forces between
J. A. Mitchem
| T. R. Katona
| E. A. S. Moser
Private Practice, Reno, NV, USA
Department of Orthodontics and Oral Facial Genetics, School of Dentistry, Indiana University, Indianapolis, IN, USA
Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, IN, USA
T. R. Katona, Indiana University School of Dentistry, IUPUI, Indianapolis, IN, USA.
We appreciate the comments and readily acknowledge the merits of
some semantic/nomenclature criticisms. Those failings occurred, in
part, because of word- count restrictions and because of our writing
to be understood rather than not to be misunderstood. But contrary
to suggestions in the letter, we did not intend to single out T- Scan.
Responding to the letter, however, does provide the pretext, context
and opportunity to do so.
In the title of the article, “Does the presence of an occlusal indicator
product affect the contact forces between full dentitions?” and in the
text itself, our focus was clearly on the occlusion itself, not its clinical
assessment, whether it be with blue ink vs. red ink vs. state- of- the-
art electronic technology.
The authors of the letter point out that we did not bother to
hook- up the T- Scan system. But as a matter of fact, we did not even
peek at the ink markings. That is because the T- Scan displays and the
markings were entirely irrelevant for our purposes.
They object to the association of T- Scan with the other products
because, for one, T- Scan does not do markings. Therefore, the au-
thors argue, our statements that “their markings cannot characterise
the actual occlusion” and “long- standing controversies about occlu-
sal mark interpretations are focused on artefactual observations”
cannot apply to T- Scan. We agree. Instead, however, we should have
stated that ink marks (and T- Scan- recorded data) are based on “arte-
factual occlusions.” That is why the ink mark interpretation contro-
versy is moot, and although it was not emphasised, that is why the
raw T- Scan sensor data are fundamentally flawed.
As far as the artefactual occlusions, the letter authors admit sev-
eral times that T- Scan alters the occlusion, stating that (underlined
• “… although the T-Scan sensor does alter the load moments of the
casts (like all the interocclusal indicators tested by the authors)”
• “… regardless of what minor load modifications result from the
interposed occlusal registration materials.”
• “… despite that it sits between the teeth which alters the loading
to some degree (like all the indicators tested did)”.
• “All this study showed about the TScan sensor, was that it creates
load alterations similarly to all of the tested materials, because
this deficiency is inherent in using occlusal registration materials
in between teeth.”
In the context of this response, we must take strong exception to
the above underlined qualifications. While it is true that all products
distorted the occlusion, T- Scan was the worst offender, by far. Thus,
the impressive T- Scan clinical presentations, described at length in the
letter, are derived from grossly unrealistic data.
J. A. Mitchem
T. R. Katona http://orcid.org/0000-0001-9949-7237
E. A. S. Moser http://orcid.org/0000-0002-2673-3662