The impact of mandibular flexure on digital implant position capture, meaning the difference between measurements taken at a rest position and taken with the jaw open, remains widely uninvestigated by the dental industry. This paper examined 13 peer-reviewed articles across The Journal of Prosthetic Dentistry, The Journal of Dentistry, and the Journal of Oral and Maxillofacial Surgery, among others, including two literature reviews that each examined and compiled the findings of more than 60 publications.
Articles report a wide range of mandibular flexure and deformation among patients, with measured linear distortion ranging from 30 to 1,000 micrometers (µm). Reported values include 30 µm (Regli et al., 1967), 114 µm (Fischman, 1990), 437 µm (Chen et al., 2000), and 870 µm (Londono et al., 2023), with values approaching 1,000 µm also documented (Choi et al., 2015). The variation in data acquisition and evaluation should be considered when assessing the clinical validity of mandibular deformation claims within these articles, and it could help explain the wide variation of values reported for mandibular flexure.
Additional research must be done using digital dentistry workflows to determine the extent of the impact mandibular flexure has on position-capture devices and their resulting restorations. Best practices for reducing that impact at the time of implant position capture include scanning as close to rest position as possible, meaning less than 20 mm of opening, and avoiding protrusion of the jaw.
