Astrid C Valdivia-Tapia, J Sebastian Lara, E Angeles Martinez-Mier, Frank Lippert, George J Eckert, Giovanna C Denucci, Anderson T Hara
The 3D IOS showed promising performance across all three dental conditions and surface types evaluated. Agreement with visual examination was consistently high, supporting IOS may serve as a useful adjunct tool for the assessment of dental hard-tissue conditions.
OBJECTIVE: To evaluate the diagnostic agreement between a 3D intraoral scanner (IOS) and standard visual examinations for the assessment of dental hard-tissue conditions, including caries and erosive tooth wear (ETW) and enamel fluorosis METHODS: A total of 4,620 surfaces assessments were performed using three indices, corresponding to 2,351, 1,280, and 989 surfaces, respectively. Assessments were conducted using full-mouth IOS scans and visual scoring using the International Caries Detection and Assessment System - ICDAS for caries; Basic Erosive Wear Examination - BEWE for ETW and Thylstrup-Fejerskov- TF index for enamel fluorosis. Agreement was examined overall and by tooth location (anterior/posterior) and surface (buccal, lingual, incisal). Statistical analyses included Cohen's κ, weighted κ, percent absolute agreement, and Spearman correlation coefficients for ordinal consistency.
RESULTS: For ICDAS, IOS demonstrated excellent agreement with visual examination (κ=0.82; weighted κ=0.89; 97% agreement; ρ=0.87). Anterior teeth (weighted κ=0.91) showed greater agreement than posterior teeth (weighted κ=0.86), with highest agreement on lingual surfaces. Discrepancies occurred mainly within intermediate lesion stages. For BEWE, agreement was substantial overall (κ=0.69; weighted κ=0.75; 79% agreement; ρ=0.78). Anterior and posterior surfaces exhibited similar agreement (81% and 78% agreement, respectively). For TFI, similar substantial agreement was observed (κ=0.67; weighted κ=0.74; 84% agreement; ρ=0.78). Anterior-lingual surfaces demonstrated the strongest performance (99% agreement), while posterior-buccal surfaces showed the lowest, though still acceptable, agreement.
CONCLUSION: The 3D IOS showed promising performance across all three dental conditions and surface types evaluated. Agreement with visual examination was consistently high, supporting IOS may serve as a useful adjunct tool for the assessment of dental hard-tissue conditions.
CLINICAL SIGNIFICANCE: IOS technology may enhance clinical decision-making, facilitate longitudinal monitoring, and improve standardization in research protocols involving enamel health.