Dental Materials Journal 2009; 28(2): 212－218

Original Paper

Bite force measurement system using pressure-sensitive sheet and silicone

impression material

Katsuya ANDO, Yuji FUWA, Masahiro KUROSAWA, Takamasa KONDO and Shigemi GOTO

Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Nagoya, Aichi 464-8651, Japan
Corresponding author,  Katsuya ANDO;  E-mail:  ankatsu@dpc.aichi-gakuin.ac.jp

This study was conducted to reduce the bias in measured values caused by the thickness of materials used in occlusal
examinations. To this end, a silicone impression material for bite force measurement and an experimental model of a
simplified stomatognathic system were employed in this study. By means of this experimental model, results showed that
the effect of bias toward the posterior arch could be reduced in the anterior-posterior distribution of bite forces and in the
occlusal contact areas due to the thickness of the materials used in occlusal examinations.

Key words: Bite force, Occlusal contact area, Silicone impression material

Received Dec 21, 2007: Accepted Sep 18, 2008

　　In light of the over-detection drawback, there

INTRODUCTION
During an occlusal examination, the occlusal contact
area and bite force of a patient provide valuable
information for oral disease diagnosis, treatment,
and prognosis1-11,13). Presently, a variety of occlusal
examination methods are available. They include
occlusal registration by articulating paper,
examination with dental cast models mounted on an
articulator, and occlusal analysis by muscle activity
or mandibular movements. However, these methods
have been indicated to be frequently and heavily
influenced by the subjectivity and clinical experience
of practitioners. Against this background, an
accurate measurement method and a set of objective
measurement standards for bite force analysis are
not only highly desired, but that they must be
established promptly.
　　In 2004, a system was introduced which
comprised a CCD camera (Occluzer FPD 707, Fuji
Film Corp., Tokyo, Japan) and a bite force
measurement system using a pressure-sensitive
sheet (Dental Prescale 50H, type R, Fuji Film Corp.).
In terms of advantages, this new bite force
measurement system is first of all not influenced by
the subjectivity and experience of practitioners14,15).
Another advantage is that it requires only a simple
chairside procedure to measure occlusal contact areas
and bite forces easily, objectively, and quantitatively
(Figs. 1 and 2). However, a disadvantage of this
occlusal examination method has been indicated.
The disadvantage lies in the use of an interocclusal
material with a certain thickness, such as the
pressure-sensitive sheet. As a result, over-detection
of the occlusal contact area and bite force of the
posterior teeth near the hinge axis occurs16-19).
arose a need to measure the occlusal contact area
objectively and quantitatively using a silicone
impression material that has high fluidity and almost
non-existent thickness at the occlusal contact area.
In conjunction, a light transmission device was
developed to read the silicone impression material
using a bite force measurement system (Fig. 3). With
which, the occlusal contact area of the silicon
impression material and its thickness limit of
readable range were measured, thereby demonstrat-
ing its efficaciousness.
　　The objective of this study was to compare the
occlusal contact areas obtained from the silicone
impression material and pressure-sensitive sheet
using the herein-mentioned experimental model of a
simplified stomatognathic system. The occlusal
contact area obtained from the silicone impression
material and the average bite pressure obtained from
the pressure-sensitive sheet were then multiplied to
estimate the bite force when there was nothing
between the occlusal surfaces. Thereafter, the
estimated bite forces were compared with the bite
forces obtained from the pressure sensors, which
were incorporated into the experimental model and
used in place of teeth.
MATERIALS  AND  METHODS
Experimental model
Apart from the thickness of materials used in an
occlusal examination, another aspect of concern in
occlusal contact area measurement is the anterior-
posterior distribution of bite forces. Several factors
integrally affect the anterior-posterior distribution of
bite forces. They are namely: changes in the
 Dent Mater J 2009; 28(2): 212－218
Fig. 1 Pressure-sensitive sheet becomes red when
microcapsules with various sizes in the sheet
break ― depending on the load that is placed on
the sheet. A constant correlation existed between
the intensity of red color and the load pressure in
the range of 5－120 MPa.
Fig. 2 Occluzer FPD 707 comprised a CCD camera.
positions of teeth and mandible, elastic deformation
of the jaw bone, load on the periodontal soft tissue,
lever effect, and masticatory muscle activities. To
minimize the influence of these factors, an
experimental model (Hanau H2-0) (Water Pik
Technology Inc., Colorado, USA) of a simplified sto-
matognathic system, without premature contacts
using a semi-adjustable articulator (Fig. 4), was
213
Fig. 3 A red electroluminescence sheet of 0.25 mm
thickness uniformly luminesced when an
alternating voltage was applied to the fluorescent
substances dispersed in a binder with a high
dielectric constant. A power source which could be
continuously varied to a maximum applied voltage
of 12 V was used in conjunction to make a light
transmission device.
constructed in this study.
　　The lower arch of the articulator had pressure
sensors (LM-10KA, Kyowa Electronic Instruments
Corp., Tokyo, Japan) substituted for teeth. Each
sensor had a sensitive element which comprised a
spherical surface of 4 mm radius to directly measure
the bite force at each occlusal contact point. A total
of four sensors were placed, with one sensor each in
the left and right regions of anterior teeth and the
left and right molar regions. In the maxillary arch of
the articulator, an attached glass plate came into
contact simultaneously with the four pressure
sensors.
　　As for the condylar spheres of the articulator,
they were designed to reduce the lever effect upon
detecting a biting force in the region of the anterior
teeth from the time a small load was applied. To
achieve this reduction in lever effect, a path of
condylar guidance with the molar region as the
fulcrum was established so that the condyle could
slide anterosuperiorly without resistance. To prevent
loading the articulator in advance, a counterbalance
was added to the maxillary posterior region so that
weights were balanced in the anterior and posterior
regions in the maxillary arch centering on the
articulator hinge axis. In addition, anterosuperior
214 Dent Mater J 2009; 28(2): 212－218
Fig. 4 An experimental model of a simplified stomatognathic system without premature contacts
using a semi-adjustable articulator (Hanau H2-0).
movements of the condylar spheres were allowed
without hindrance from the weight of the counterbal-
ance or the maxillary arch in articulator. To achieve
these movements, the load was lifted immediately
before the right and left condylar spheres floated
from the superior direction. Then, a constant-load
compression tester (AGS-A, Shimadzu Corp., Kyoto,
Japan) was used to apply a load to the articulator in
the center of each of the four sensors, whereby real-
time value at each pressure sensor was measured
using an instrumentation amplifier (WGI-300B-1,
Kyowa Electronic Instruments Corp.) (Fig. 5).
　　The load applied ranged from 1 kgf to 7 kgf at 1-
kgf intervals and at a speed of 1 mm/min. At each
load value, 10 measurements were made with the
instrumentation amplifier. To examine whether the
experimental model had the adequate accuracy
required for this investigation, the relationship
between loads applied with a constant-load
compression tester and the values measured by the
pressure sensors was studied.
Occlusal contact areas obtained from the silicone
impression material and pressure-sensitive sheet
The materials placed between the occlusal surfaces of
the articulator were namely a dark gray silicone
impression material, a single pressure-sensitive
sheet, or a stack of two pressure-sensitive sheets.
Loads ranging from 4 kgf to 7 kgf, increasing at 1-kgf
intervals, were applied.
　　The mixed silicone impression material was
molded using a 1-mm-thick frame as a guide, which
was placed on the peripheral border of the glass plate
of the maxillary arch in the articulator. For occlusal
contact area measurement using the silicone
impression material, it was performed 10 times each
at the four points of the anterior, posterior, right,
and left areas. Occlusal contact area measurement
was then carried out using the bite force
measurement system with a built-in light
transmission device. Similarly, for occlusal contact
area measurements using the single pressure-
sensitive sheet and a stack of two pressure-sensitive
sheets, they were performed 10 times each using the
bite force measurement system.
　　Average values of the right and left
measurements of these three types of materials were
used as representative values for scattergrams’
plotting. Regression equations, which expressed the
anterior-posterior distributions in the regions of
anterior and posterior teeth, were calculated and
comparisons were made.
Comparison of bite forces obtained from a single
pressure-sensitive sheet, two pressure-sensitive sheets,
and silicone impression material and estimation of
bite force with nothing between the occlusal surfaces
To measure the bite force when there was nothing
between the occlusal surfaces, measurements were
performed at the four pressure sensors located in the
anterior, posterior, left, and right areas. Loads of 4
kgf to 7 kgf were applied at 1-kgf intervals, and
 Dent Mater J 2009; 28(2): 212－218 215

Fig. 5 Different aspects of the experimental model.

measurement at each sensor was performed 10 times

using an instrumentation amplifier. Values obtained
were converted from kgf to N.
　　With the single pressure-sensitive sheet and two
pressure-sensitive sheets, their average bite forces
were measured 10 times each using the bite force
measurement system. To estimate the bite force
with nothing between the occlusal surfaces, it was
obtained by multiplying the occlusal contact area
obtained from the silicone impression material and
the average bite pressure from the single pressure-
sensitive sheet. For the four different conditions
(namely the three types of materials and with
nothing between the occlusal surfaces), the average
values of the calculated or measured left and right
values were used as the representative values, and a
scattergram was plotted for each. Thereafter, the
regression equations, which expressed the anterior-
posterior distributions in the regions of anterior and Fig. 6 Two regression equations expressed the
posterior teeth, were calculated and comparisons relationship between the loads applied with a
were made. constant-load compression tester and the values
measured by the pressure sensors.

RESULTS
Accuracy of the experimental model
The relationship between the loads applied with a
constant-load compression tester and the values
measured by the pressure sensors was expressed by
the regression line, y=0.24x+0.04, for the anterior
teeth region, and y=0.24x+0.09 for the posterior teeth
region. The y-intercepts of the regression lines
converged at almost 0. A proportional relationship
was found between the loads applied and the values
measured by the pressure sensors for the two
216 Dent Mater J 2009; 28(2): 212－218
Fig. 7 The regression equations expressed the anterior-
posterior distribution of occlusal contact areas
obtained from the silicone impression material,
single pressure-sensitive sheet, and two pressure-
sensitive sheets.
regression lines. In addition, the slopes and y-
intercepts of the two regression lines were similar
(Fig. 6).
Occlusal contact areas obtained from the silicone
impression material and pressure-sensitive sheet
The following regression equations expressed the
anterior-posterior distributions of occlusal contact
areas obtained from the silicone impression material,
single pressure-sensitive sheet, and two pressure-
sensitive sheets, respectively: y=0.57x+0.04,
y=0.32x+0.03, and y=0.23x+0.01 (Fig. 7).
Comparison of bite forces obtained from single
pressure-sensitive sheet, two pressure-sensitive sheets,
and silicone impression material and estimation of
the bite force with nothing between the occlusal
surfaces
The regression equation, y=0.96x+0.05, expressed the
anterior-posterior distribution of bite forces obtained
from the pressure sensors. The regression equation,
y=0.47x+0.01, expressed the anterior-posterior
distribution of the bite forces obtained by multiplying
the average bite pressure of the single pressure-
sensitive sheet and the occlusal contact area of the
silicone impression material. The regression
equation, y=0.33x－0.43, expressed the anterior-
posterior distribution of the bite forces obtained from
the single pressure-sensitive sheet. The regression
equation, y=0.21x－0.64, expressed the anterior-
posterior distribution of the bite forces obtained from
Fig. 8 The regression equations expressed the anterior-
posterior distribution of bite forces obtained from
the silicone impression material, single pressure-
sensitive sheet, two pressure-sensitive sheets, and
the pressure sensors.
the stack of two pressure-sensitive sheets (Fig. 8).
DISCUSSION
Accuracy of the experimental model
The y-intercepts of the regression lines of the
anterior teeth and posterior teeth regions almost
converged at 0. The regression lines expressed the
relationship between the values measured by the
pressure sensors and the loads applied by the
constant-load compression tester. From this result,
it seemed that the weights in the anterior and
posterior regions of the maxillary arch centering on
the articulator hinge axis were balanced by adding
the counterbalance. Therefore, loading the maxillary
anterior arch in advance was thought to have a coun-
terbalancing effect.
　　The regression lines of the anterior and posterior
teeth regions were directly proportional and were
almost the same. From this result, the anterior and
posterior pressure sensors could be considered to
have the necessary accuracy within the predeter-
mined loading range (i.e., 1 kgf to 7 kgf) for this
investigation. Therefore, by virtue of this result, the
constructed experimental model enabled the under-
standing of the anterior-posterior distribution of bite
forces when nothing was between the occlusal
surfaces by using pressure sensors in place of teeth.
Study of the occlusal contact areas obtained from the
silicone impression material and pressure-sensitive
 Dent Mater J 2009; 28(2): 212－218
sheet
The slope of the regression equation expressing the
anterior-posterior distribution of the occlusal contact
areas for the single pressure-sensitive sheet was
smaller than that for the silicone impression
material. This result indicated a bias of the anterior-
posterior distribution of the occlusal contact areas
toward the molar region. Such a slope for the stack
of two pressure-sensitive sheets was smaller than
that of the single pressure-sensitive sheet. This
result further confirmed the notion that the anterior-
posterior distribution of occlusal contact areas was
indeed biased toward the molar region.
　　When an impression material used in an occlusal
examination has some thickness, it has the effect of
biasing the anterior-posterior distribution of occlusal
contact areas toward the posterior arch near the
hinge axis. From the above results, it was shown
that occlusal contact area measurement using
silicone impression material with almost non-existent
thickness at the occlusal contacts could reduce the
effect of such bias.
Comparison of bite forces obtained from the single
pressure-sensitive sheet, two pressure-sensitive sheets,
and silicone impression material and the estimation
of bite force with nothing between the occlusal
surfaces
The slope of the regression equation expressing the
anterior-posterior distribution of bite forces obtained
from the single pressure-sensitive sheet was smaller
than that obtained from the pressure sensors. This
result indicated that the anterior-posterior
distribution was biased toward the molar region.
Further, the slope of the regression equation
expressing the anterior-posterior distribution of bite
forces obtained from the two pressure-sensitive
sheets was small compared to that obtained from the
single pressure-sensitive sheet. Similarly, this result
indicated a bias of the anterior-posterior distribution
of bite forces toward the molar region. Upon
comparing the following regression equations which
expressed the anterior-posterior distribution of bite
forces, namely (1) multiplying the average bite
pressure of the single pressure-sensitive sheet and
the occlusal contact area of the silicone impression
material; (2) values measured from the pressure
sensors; and (3) values obtained from pressure-
sensitive sheets, it was found that the regression
equation from (1) was more similar to (2) than to (3).
　　When an impression material used in an occlusal
examination has some thickness, it has the effect of
biasing the anterior-posterior distribution of bite
forces toward the posterior arch near the hinge axis.
From the above results, the method which derived
the bite force by multiplying the average bite
pressure (obtained from the single pressure-sensitive
217
sheet) and the occlusal contact area (obtained from
the silicone impression material) was thought to
reduce the effect of such bias. In addition, the
method which derived the bite force using the
pressure-sensitive sheet and silicone impression
material could be used as a means to establish the
criteria for estimating the bite force with nothing
between the occlusal surfaces. In the future, the
next step forward is to establish a reliable and
accurate method of obtaining occlusal contact areas
using pressure-sensitive sheet and silicone
impression material.
CONCLUSIONS
This study was conducted to reduce the bias of
measured values due to the thickness of materials
used for occlusal examinations. Silicone impression
material was applied to a bite force measurement
system, and comparisons were made between the
occlusal contact areas obtained from the pressure-
sensitive sheet and the silicone impression material
using the experimental model ― a simplified sto-
matognathic system. Bite force was obtained by
multiplying the occlusal contact area from the
silicone impression material and the average bite
pressure obtained from the pressure-sensitive sheet.
This estimated bite force was then compared against
the bite force obtained from the pressure sensors
incorporated into the experimental model. By this
comparison process involving different methods and
the results thereof yielded in this study, it was thus
determined whether it was possible to estimate the
bite force with nothing between the occlusal surfaces.
(1) A method was used to measure occlusal
contact areas by means of a silicone impression
material with the bite force measurement
system and with a light transmission device.
Results of this study showed that this method
reduced the effect of bias toward the posterior
arch in the anterior-posterior distribution of
occlusal contact areas, which is typically
caused by the thickness of materials used in
occlusal examinations.
(2) A method was used to derive the bite force by
multiplying the average bite pressure obtained
from the pressure-sensitive sheet and the
occlusal contact area obtained from the silicone
impression material. Results of this study
showed this method reduced the effect of bias
toward the posterior arch in the anterior-
posterior distribution of bite forces due to the
thickness of materials used in occlusal
examinations. In light of the encouraging
results of this study, it was thus suggested
that such a method of deriving bite forces
could be used as a means of establishing
218 Dent Mater J 2009; 28(2): 212－218

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