Medial mandibular flexure (MMF) is the functional approximation of hemi-mandibles in jaw opening and protrusion, which may affect conventional or implant-supported arch prostheses. Objectives: This study evaluated the intra- and inter-rater reliability of a digital image method for linear measurement of MMF in dentate subjects. Methods: Mandibular occlusal impressions in polyvinylsiloxane were obtained during rest, protrusion, and maximum opening from seven dentate adult volunteers. The impressions and a Mitutoyo digital caliper with a 10mm opening were scanned at a 200% magnification. Each image was processed by Adobe Photoshop software to obtain reference points on contralateral first molars. Linear measurements were taken using the Image Tool software (UTHSCSA), which was calibrated with the standard opening of the digital caliper. Intermolar distance was measured three times for each image by two independent examiners. MMF was calculated by subtracting the intermolar distance in maximum opening (or protrusion) from the distance in rest position. Intra- and inter-rater reliabilities were estimated by using intraclass correlation coefficients (ICC) at a confidence level of 95%. Results: Intra-rater ICCs were 0.982 and 0.993, and inter-rater ICC was 0.696, at a confidence level of 95%. Conclusion: Our results show excellent intra-rater and good inter-rater reliability of this digital image method for measuring MMF in dentate subjects.

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