Influence of Articulating Paper Thickness and Loading Pattern on Occlusal Markings: A Cross-sectional Study

Abstract Objectives: To evaluate the influence of articulating paper thickness and occlusal loading pattern on the number and character of occlusal markings, and to propose clinically relevant recommendations for occlusal analysis. Methods: This prospective observational study included 20 participants aged 18–25 years with class I molar relation. Three articulating papers—100 µm (AP100), 40 µm (AP40), and 12 µm (AP12)—were used under swallow-and-bite (SB), firm bite, and repeated tapping (RT) loading conditions. The number of occlusal markings and their character were analyzed. Markings were categorized as structured ( brigh t, well-defined , and discrete markings with sharp margins ) or smudged ( faint and diffuse markings with blurred margins suggestive of ink spread ). Statistical analysis included one-way analysis of variance, Tukey’s post hoc test, chi-square test, confidence intervals, and “Statistical Package for the Social Sciences version 23.0.” Results: The number of markings increased with loading intensity, lowest with SB, and highest with RT. Statistically significant differences were observed across loading types for AP100 ( F = 33.16, P < 0.001), AP40 ( F = 34.59, P < 0.001), and AP12 ( F = 8.02, P = 0.001). AP100 and AP40 produced comparable results, predominantly bright structured markings, whereas AP12 demonstrated fainter smudged marks and showed reduced sensitivity. Conclusion: Articulating paper thickness and loading type significantly affect occlusal contact registration. Thicker papers (100 and 40 µm) are more reliable, whereas ultra-thin paper (12 µm) has limited diagnostic value. A sequential protocol—screening with thicker papers under light closure and confirming with thinner films under firm closure—may enhance accuracy in clinical occlusal analysis.