Occlusal Force and Chewing After Periodontal Therapy

Digital Assessment of Occlusal Force Distribution and Chewing Cycles Before and After Periodontal Therapy in Patients With Stage III-IV Periodontitis

Stage III and Stage IV periodontitis are associated with loss of periodontal support, tooth mobility, and impaired oral function, which may affect occlusal force distribution and chewing performance. Although non-surgical periodontal therapy effectively improves periodontal health, its effect on functional occlusal parameters and mandibular movements has not been comprehensively evaluated using digital technologies.

This prospective interventional study will investigate changes in occlusal force distribution and chewing cycle characteristics in patients with Stage III or Stage IV periodontitis before and after non-surgical periodontal therapy. Participants will receive standardized periodontal treatment and will be assessed at baseline, 8-12 weeks after completion of active therapy, and 3 months following re-evaluation. The T-Scan digital occlusal analysis system will be used to record occlusal force distribution, occlusion time, disocclusion time, and force balance. The Modjaw jaw-tracking system will be used to look at chewing cycle characteristics and mandibular movements. The study aims to determine whether periodontal therapy leads to measurable improvements in oral function and to provide objective functional outcome measures that may support periodontal and prosthodontic treatment planning.

Inclusion Criteria:

1. Adults aged 18-70 years.
2. Diagnosis of Stage III or Stage IV periodontitis (Grade A, B, or C) according to the 2018 World Workshop Classification.
3. Presence of at least 20 natural teeth, including posterior occlusal support.
4. No periodontal treatment within the preceding 12 months.
5. Willing and able to attend all scheduled follow-up appointments

Exclusion Criteria:

1. Systemic conditions known to impair periodontal healing, including:

   • Uncontrolled diabetes mellitus (HbA1c >7%)
   • Immunosuppressive therapy
   • Bisphosphonate therapy

2. Removable prostheses replacing multiple posterior teeth.

3. Pregnancy or breastfeeding.

4. Current occlusal splint wearers.

5. Planned dental treatment other than periodontal therapy during the study period.

6. Heavy smokers (>20 cigarettes/day).

7. Stage I or Stage II periodontitis, gingivitis, or a healthy periodontium.

8. Severe manual dexterity impairment preventing adequate oral hygiene.

9. Currently undergoing periodontal treatment.