Journal of dentistry · 2026
From static digital articulation to the dynamic (4D) digital virtual patient: an umbrella review of digital occlusal analysis and jaw-motion tracking.
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Farronato Marco, Giannini Lucia, Farronato Davide, di Iasio Giada, Maspero Cinzia
Аннотация
OBJECTIVES: To synthesize review-level evidence on static digital articulation, computerized occlusal analysis, jaw-motion tracking and dynamic (4D) digital virtual patient integration, while distinguishing the specific claims each technology can support.
DATA: Review characteristics, technical accuracy, repeatability, validity, clinical outcomes, primary-study overlap and review-level risk of bias.
SOURCES: PubMed/MEDLINE, Europe PMC, Crossref, OpenAlex, the Cochrane Library and Epistemonikos were searched or checked through 10 July 2026. Reference-list and citation searching supplemented database retrieval.
STUDY SELECTION: Thirty-four reports were included: 29 systematic reviews, four scoping reviews and one structured evidence map, representing 663 review-study occurrences. Of the 29 ROBIS-rated reviews, two were at low risk, 15 at unclear risk and 12 at high risk of bias. Static digital articulation was conditionally accurate in dentate, stable-contact and short-span settings. Contact location was more defensible than intensity, area or absolute force. Jaw tracking and digital virtual patient integration were technically feasible, but heterogeneous reference frames, small studies and sparse clinical outcomes constrained inference.
CONCLUSIONS: Digital occlusion is not a single validated construct. Maxillomandibular relationship transfer, contact location, relative force/timing, movement trajectory and integrated clinical decisions require distinct validation. Technical accuracy, precision, repeatability and feasibility should not be interpreted as evidence of clinical effectiveness or patient benefit. Current systems are best used as calibrated, clinician-verified adjuncts.
CLINICAL SIGNIFICANCE: Static digital articulation can support selected restorative workflows, whereas complex spans, edentulous arches, force interpretation, dynamic simulation and diagnostic use require independent verification. Reliable upstream registration does not establish downstream patient benefit.
DATA: Review characteristics, technical accuracy, repeatability, validity, clinical outcomes, primary-study overlap and review-level risk of bias.
SOURCES: PubMed/MEDLINE, Europe PMC, Crossref, OpenAlex, the Cochrane Library and Epistemonikos were searched or checked through 10 July 2026. Reference-list and citation searching supplemented database retrieval.
STUDY SELECTION: Thirty-four reports were included: 29 systematic reviews, four scoping reviews and one structured evidence map, representing 663 review-study occurrences. Of the 29 ROBIS-rated reviews, two were at low risk, 15 at unclear risk and 12 at high risk of bias. Static digital articulation was conditionally accurate in dentate, stable-contact and short-span settings. Contact location was more defensible than intensity, area or absolute force. Jaw tracking and digital virtual patient integration were technically feasible, but heterogeneous reference frames, small studies and sparse clinical outcomes constrained inference.
CONCLUSIONS: Digital occlusion is not a single validated construct. Maxillomandibular relationship transfer, contact location, relative force/timing, movement trajectory and integrated clinical decisions require distinct validation. Technical accuracy, precision, repeatability and feasibility should not be interpreted as evidence of clinical effectiveness or patient benefit. Current systems are best used as calibrated, clinician-verified adjuncts.
CLINICAL SIGNIFICANCE: Static digital articulation can support selected restorative workflows, whereas complex spans, edentulous arches, force interpretation, dynamic simulation and diagnostic use require independent verification. Reliable upstream registration does not establish downstream patient benefit.