Telemetry system to study functional occlusal forces

W. D. McCall, Jr., Ph.D,* J. A. De Boever, L.D.S., D.M.D., Ph.D,** and

M. M. Ash, Jr., D.D.S., M.S.‘**
Univemity of ?v4ichigan, School of Dentistry. Ann Plrhor. %lich,

S tatic bite (closing) force has been investigated

centuries by many investigators using different
for 100 to 200, whereas foil or wire gauges have gauge
factors of 2. Prior to gauge installation, stone casts of
methods, equipment, and conditions.‘-“’ Occlusal the patient were mounted on an articulator and the
forces exerted by the masticatory muscles have also occlusal surface of the pontic was waxed up accord-
been investigated during chewing and swallowing, ing to a wax-added technique. The occlusal surface
using strain gauges,“.” pressure transducers,‘“-‘” and was then cast in gold. A negative of this surface and
piezoelectric devices.“‘-Z! the abutment teeth was made in plaster and also
Methods of simultaneously recording functional cast. The gold occlusal surface was reduced 1.5 mm.
occlusal forces and mandibular movements have also providing an occlusal table for mounting the sensors.
been reported.‘!‘-” In very few reports, however, has The occlusal table was soldered to a rigid frame and
the electrical activity of the masticatory muscles to the two partial denture attachments for the
been related to the occlusal forces.“-” abutment teeth. The eight strain gauges* were
These investigations have contributed significant- attached to the occlusal table; four sensors were in
ly to our understanding of the neuromuscular basis the mesial, central, and distal fossae; two sensors
of the masticatory system. However, factors such as under the supporting cusps; and two under the
the disturbing influence of transoral linkages have nonsupporting cusps (Fig. 1). The sensors were
caused a continued search for more precise and covered with a uniform layer of cold-cure acrylic
independent methods that do not disturb the system. resint using the negative mold previously obtained
Therefore, telemetric devices have been developed to from the occlusal surface.
continously monitor occlusal forces during func- Description of the transmitter. Since the electron-
tion 1I-L’i. ic characteristics of the present telemetric system for
The purpose of the present research was to develop measuring occlusal forces have been described else-
an intraoral force telemetry system that would regis- where.:’ only the essential features will be summa-
ter occlusal forces during function without the rized here.
disturbing influence of transoral linkages. The transmittert is composed of three main
elements: the ring counter, analog switches, and
METHODS radio frequency (RF) module. The transmitter
Occlusal surface and transducer placement. components are shown in Fig. 2. The ring counter is
Strain gauges vary their resistance in response to used as a commutator to operate a series of field
deformation and. in conjunction with beams, effect transitor (FET) switches. There is one switch
measure forces. The development of semiconductor for each sensor and one additional switch for a
strain gauges has made available gauge factors of synchronization (SYNC) pulse. These FET switches
are operated sequentially by the ring counter to form
‘Awxiate Professor, Department of Oral .Medicinc, School of a nine-pulse commutated signal. The solid-state
Dentist?. State University of New York at Buffalo. Buffalo.
strain sensors have an output of 20 mV maximum.
N. Y.
l *Associate Profcuor, Department of Prosthodontics, Ghent State This is amplified by a factor of five in a DC
University, C;hent. Belgium.
***Professor and ChaIrman, Department of Occlusion. School of ‘Mcdel DOI-04..5OCO. Celesko Electronics, (:anoga Park. Calit
IIcntistry, University of Michigan, Ann Arbor, STich. tKcsin Perm. Dental Manufacturing Company. Akron. Ohm
Supported by USPHS Grant DE 02i31. $Film Microclcctronics, Burlington. Mass.

98 JULY 1978 VOLUME 40 NUMBER I

TELEMETRIC STUDY OF OCCLUSAL FORCES

BUCCAL

LINGUAL
Fig. 1. Placement of strain gauges. The placement of the
semiconductor strain gauges under the occlusal surface is
shown schematically. The view is from the occlusal
surface. The force information from each strain gauge was
multiplexed for transmission and demultiplexed for Fig. 2. Electronic components of the eight-channel occlu-
analog presentation. sal force transmitter. Clockwisr fronl :efi [L) 7ighi: Ring
counter, FET-switches, DC amplifier, RF-module, coil,
resistor of the sync pulse, capacitor, fr>zlr I .S V
amplifier, and the resulting signal is applied to the batteries.
RF module. The RF module frequency modulates
the nominally 120 MHz carrier proportionally to the
pulse amplitude (PAM) commutated from the
sensors. Full pulse amplitude causes 0.25 MHz of
deviation from the carrier. The eight data pulses are
0.30 to 0.45 of the sync pulse (Fig. 3). The sampling
rate is approximately 300 Hz for each channel.
A small antenna in the buccal fold provides
radiation of the signals for several feet. The power for
the transmitter is provided by four small 1.5 V DC
batteries* in a waterproof battery case with a screw Fig. 3. The signal emitted by the transmitter and demo-
cap. The battery drain is 3.5 mA. By meticulous dulated by the receiver consists of a sync pulse and eight
pulses varying linearly in amplitude with the resistance of
selection of batteries, a continuous experimental
the strain gauges under the occlusal surface. Calibrations:
session of up to 2 hours could be obtained. 1 V and 0.5 msec.
Construction of the transmitter. All electronic
components of the transmitter were mounted on a used to drive a sample and hold circuit for each
board and tested on the bench. After all the compo- channel. Thus the output of the decoder is eight
nents were soldered underneath the pontic, the analog signals corresponding to the volta,qes from the
transmitter was embedded with epoxy resin.t Test- eight sensors.
ing and assembly time for each transmitter was Tests and calibration. The transmitter underwent
approximately 250 hours. The configuration of the a series of tests prior to use in the patient. The
assembled transmitter is shown in Figs. 4 and 5. embedded transmitter was checked for both elecrri-
Receiver and decoder. A loop antenna around the cal and water leakage by operating it in water.
patient’s neck picks up the RF signal and sends it to Afterward, the stability of the signal was verified by
a conventional FM superheterodyne receiverx for connecting the transmitter to a power supply and
amplification and demodulation into a video signal. recording for 24 hours. Each channel of each trans-
The sync pulse is extracted from the video signal and mitter was calibrated by applying knowrl forces on
used both to reset a counter and to delete the sync the occlusal surface and recording the response from
pulse from the nine pulses, leaving the data pulses. the decoder. A semidynamic calibration instrumen-
Clock pulses are generated from the data pulses and tation system was developed to move the precision
XY (horizontal) table on which the transmitter was
mounted in the XY plane automatically in either a
*Mallory MS 212.
tResin 5005. Amrez Co., Sterling Heights, Mich. continuous or intermittent mode.” In this way the
fModel GPR-20, Defense Electronics Inc., Ann Arbor, Mich force could be applied anywhere on the occlusal

THE JOURNAL OF PROSTHETK DENTISTRY 99

 MCCALL, DeBClEVER, AND ASH

Fig, 4. Configuration of the assembled transmitter. I,

Strain gauges. 2, Gold occlusal table. 3, Ring counter. 4,
FET-switches. 5, DC amplifier. 6, RF-module. 7, Coil. 8,
Antenna. 9, Battery case. A, Acrylic resin occlusal surface.
B, Waterproof epoxy resin.

surface. The table could be repositioned to the

starting point to within +0.04 mm.
Force was applied to the occlusal surface in the Z
(vertical) direction by means of a small ball
connected to an air piston, spring loaded in a
retracted position. Precise force values were obtained
with this system. All calibration curves were re- Fig. 5. A, Occlusal view of the radiotransmltter partial
corded on polygraph paper and measured twice with denture under construction before putting the resin on the
surface. Arrows, Micro semiconductor strain gauges; Bu.
Boley gauges to 0.1 mm. The average of the two
Partial denture attachment. B. View of the finished trans-
measurements was recorded. mitter bridge before insertion into the mouth. 6rc. Partial
The velocity of the movement of the calibration denture attachment.
table had a minimal influence on the output, since
increasing the velocity of the table by 300 times decoded as described above, were available along
changed the output by less than 5%. Calibrations at with electromyographic (EMG) data, described in a
22” C and 37” C did not show any variation in companion paper.“’ These data were recorded on the
amplitude. same polygraph by using the pen driver amplifier
The effect of the acrylic resin covering the strain only. A block diagram of the data recording and
gauges on the transient response or the frequency analysis equipment is shown in Fig. 6. Three force
response was not investigated. The immediate repro- channels and the EMG from the masseter muscle on
ducibility was checked by three calibrations during the partial denture side were also recorded on FM
and after each recording session involving the tape for later replay in time expansion.
patient. The reproducibility of the telemetry system Data analysis. The experimental protocol was
was verified and found to be within 2% of the means. planned around functional events, chewing various
Variations due to temperature, water leakage, the foods under various occlusal conditions, and a few
speed of the calibration procedure, and movement voluntary but nonchewing movements such as
were found to be minimal. tapping the teeth together. Each event consisted ot
The eight channels of force data, transmitted from 15 strokes, occasionally fewer if swallowing occurred.
the patient’s partial denture and received and The raw data, then. consisted of a polygraph record-

100 IULY 1971) VOLUME 40 NUMBER 1

TELEMETRIC STUDY OF OCCLUSAL FORCES
_- _.-
Fig. 6. Block diagram of the recording and analyzing system. All equipment, except the path
from digitizer to cards to computer, were operational during the experiment. The patient /ZI
with the bridge (I) is sitting in a radiofrequency-shielded room (3). The received signal (4) is
decoded (61 and recorded on a polygraph (10) together
The signals are stored on a tape recorder (13). The recordings are digitized at a later date (I J)
and analyzed by computer (Ji).
ing of the eight channels of force data and four
channels of EMG data for each of the 15 strokes. The
force data on the polygraph paper were measured by
an electronic digitizer accurate to 0.001 inch which
punched the data and an identifying code number
on cards for later computer analysis. The data
recorded on FM tape were replayed with the time
scale expanded by four and recorded on the poly-
graph with a paper speed of 100 mm/set. From each
event, 15 chewing strokes were replayed, and for
each stroke up to 25 parameters were measured and
punched onto cards by the digitizer.
A number of special computer programs were
written to convert the measurements from inches to
pounds by incorporating the calibration data. The
results were plotted with a Calcomp plotter” and
analyzed statistically.
DISCUSSION
The forces exerted on the occlusal surface by
patients vary in time, duration, and position. Since
the calibration system is only semidynamic, it is not
ideal. In some reports however, the recording devices
were calibrated by applying a static force to a part or
the whole occlusal surface by means of a ballzo, 23 or
a loading platform.‘4 In other reports the pressure
transducers were calibrated before incorporation
into prostheses,6. lb or the calibration remained
unknown.”
The output of the sensors is a function of three
variables: the magnitude of the force, the area of
contact between the force and the occlusal surface,
and the distance from the force to the sensor. The
calibration showed the linearity of the strain gauges
THE JOURNAL OF PROSTHETIC DENTISTRY
.- -~ - ..-- ~.. E
~~ _ ~. .~-
with the electrical muscle activity (7j.
with the magnitude of the applied force. The cali-
brations were performed with a standardized contact
surface between calibrator and transmitter. Occlusal
contact telemetry studies showed that in almost 75%
of the chewing strokes occlusal contact occ~rs.‘~ In
these cases the zone and the extent of contact are
known.
In other instances, with food between the teeth,
the contact surface varied and depended on the kind
of food. Therefore, comparison of data obtained by
chewing different kinds of food even in the same
session must be made very carefully. On the other
hand, the comparison of the values obtained in
chewing the same food in different sessions can be
made with more confidence. Other authors have
discussed methods and devices to measure oral
muscle forces.“’ They have stressed that artifacts can
arise from several sources and that consideration
must be given to each. From the description and
calibration of the present transmitter, no artifacts
exist from muscle displacement by the intraoral
device, temperature fluctuations in the mouth, inad-
equate waterproofing of the electrical components,
extraneous force due to movement of wires, nonlin-
ear response of the device, internal factors affecting
reproducibility, or movement of the transducer rela-
tive to the tooth surface.
The system bandwidth is a possible limitation to
accuracy. The overall bandwidth of each channel
was limited to 10 Hz by the final DC amplifier in the
decoder. This bandwidth would preclude analysis of
pulse shape and transient phenomena if this infor-
mation had been desired. Comparisons of tape-
recorded data indicated that the peak was increased
only about 10% by increasing the bandwidth from
10 Hz to 100 Hz. Thus this bandwidth limitation
 MCCALL, DcBOEVER, AND ASH

does not unduly affect the peak data. In the analysis 15. Anderson, D. J., and P.icton, I). C.: Masticatory ctress in
normal and modified occlusion. J Dent Res 37:3 12, 1958.
of the direct tracings, the bandwidth was not taken
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In measuring lateral muscle forces, e.g., from the 17. Windecker, D.: Messung des durchschnittlichen Kaukraf-
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measuring functional occlusal forces of the mastica- measurement of occlusal forces in three directions. Hclvet
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ments and the resulting force. Arch Oral Biol 12:195,
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1967.
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102 JULY 1978 VOLUME 40 NUMBER 1