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Revilla-León M, Zeitler JM, Kois JC. Intraoral scanners as tracking devices: A dental protocol for assessing volumetric changes between intraoral scans. J Prosthet Dent 2024:S0022-3913(24)00364-0. [PMID: 38955599 DOI: 10.1016/j.prosdent.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 07/04/2024]
Abstract
Intraoral scanners (IOSs) are digital data acquisition technologies that ease the recording of virtual diagnostic casts. Some IOSs have a specific software tool to assess volumetric changes between 2 scans acquired on the patient at different times. The scans are superimposed and volumetric differences between both meshes are reported. However, these software tools may be limited to scans captured only by the IOS of the same manufacturer. The present manuscript describes a protocol for comparing volumetric changes between 2 scans recorded using any IOS. Additionally, 1 of the scans is divided into 3 sections to minimize the alignment distortion and maximize the evaluation of the volumetric changes.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty & Director, Research and Digital Dentistry, Kois Center, Seattle, Wash.; and Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, Mass.
| | | | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
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Chawhuaveang DD, Mei ML, Chu CH, Yu OY. Preventive dental erosion with silver diamine fluoride: An in vitro study. J Dent 2024; 145:105022. [PMID: 38670330 DOI: 10.1016/j.jdent.2024.105022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/14/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES To evaluate the erosion preventive effect of 38 % silver diamine fluoride (SDF) solution in enamel and dentin of human permanent teeth. METHODS Ninety enamel and ninety dentin blocks were prepared from permanent molars and allocated into three groups. Gp-SDF received a one-off application of 38 % SDF solution. Gp-SNF received a one-off application of a solution containing 800 ppm stannous chloride and 500 ppm fluoride. Gp-DW received a one-off application of deionized water. The blocks were submitted to acid challenge at pH 3.2, 2 min, 5 times/day for 7 days. All blocks were immersed in human saliva between cycles for one hour. The crystal characteristics, percentage of surface microhardness loss (%SMHL), surface loss, and elemental analysis and surface morphology were examined by X-ray diffraction (XRD), microhardness test, non-contact profilometry, and energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM), respectively. Data of%SMHL and surface loss were analyzed by one-way ANOVA. RESULTS XRD spectra revealed that fluorapatite and silver compounds formed in Gp-SDF, while fluorapatite and stannous compounds formed in Gp-SNF. Gp-DW presented only hydroxyapatite. The median (interquartile range) of%SMHL in Gp-SDF, Gp-SNF and Gp-DW were 27.86(3.66), 43.41(2.45), and 46.40(3.54) in enamel (p< 0.001), and 14.21(1.57), 27.99(1.95), and 33.18(1.73) in dentin, respectively (p < 0.001). The mean (standard deviation, μm) of surface loss of Gp-SDF, Gp-SNF, and Gp-DW were 2.81(0.59), 4.28(0.67), and 4.63(0.64) in enamel (p < 0.001) and 4.13(0.69), 6.04(0.61), and 7.72(0.66) in dentin, respectively (p < 0.001). SEM images exhibited less enamel corruption and more dentinal tubular occlusion in Gp-SDF compared to Gp-SNF and Gp-DW. EDS analysis showed silver was detected in Gp-SDF while stannous was detected in the dentin block of Gp-SNF. CONCLUSION 38 % SDF yielded superior results in protecting enamel and dentin blocks from dental erosion compared to SNF and DW. CLINICAL SIGNIFICANCE Topical application of 38 % SDF is effective in preventing dental erosion in human enamel and dentin.
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Affiliation(s)
- Darren Dhananthat Chawhuaveang
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China
| | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China; Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China.
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Díaz-Flores García V, Freire Y, David Fernández S, Gómez Sánchez M, Tomás Murillo B, Suárez A. Intraoral Scanning for Monitoring Dental Wear and Its Risk Factors: A Prospective Study. Healthcare (Basel) 2024; 12:1069. [PMID: 38891145 PMCID: PMC11171938 DOI: 10.3390/healthcare12111069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Dental wear arises from mechanical (attrition or abrasion) and chemical (erosion) factors. Despite its prevalence and clinical significance, accurately measuring and understanding its causes remain challenging in everyday practice. This one-year study with 39 participants involved comprehensive examinations and full-arch intraoral scans at the start and after 12 months. Volume loss exceeding 100 µ on each tooth's surfaces (buccal, lingual/palatine and incisal/occlusal) was measured by comparing three-dimensional scans from both time points. This study also assessed factors such as abrasion and erosion through clinical exams and questionnaires. There were no significant differences in dental wear in participants with sleep bruxism. However, noticeable wear occurred in the front teeth of those with waking bruxism and joint-related symptoms. Increased wear was associated with frequent consumption of acidic drinks, regular swimming, dry mouth, nocturnal drooling and heartburn, while no significant wear was found in patients with reflux. The used methodology proved effective in accurately assessing the progression of dental wear, which is important as many patients may initially be asymptomatic. The variability observed in dental wear patterns underscores the need to develop specific software applications that allow immediate and efficient comparison of wear areas based on extensive analysis of patient databases.
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Affiliation(s)
- Víctor Díaz-Flores García
- Department of Pre-Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain; (V.D.-F.G.); (A.S.)
| | - Yolanda Freire
- Department of Pre-Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain; (V.D.-F.G.); (A.S.)
| | - Susana David Fernández
- Department of Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Margarita Gómez Sánchez
- Department of Pre-Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain; (V.D.-F.G.); (A.S.)
| | - Beatriz Tomás Murillo
- Department of Pre-Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain; (V.D.-F.G.); (A.S.)
| | - Ana Suárez
- Department of Pre-Clinical Dentistry, School of Biomedical Sciences, Universidad Europea de Madrid, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain; (V.D.-F.G.); (A.S.)
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Garikano X, Amezua X, Iturrate M, Solaberrieta E. Evaluation of repeatability of different alignment methods to obtain digital interocclusal records: An in vitro study. J Prosthet Dent 2024; 131:709-717. [PMID: 36115710 DOI: 10.1016/j.prosdent.2022.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 10/14/2022]
Abstract
STATEMENT OF PROBLEM The alignment of the maxillary and mandibular digital scans obtained with an intraoral scanner (IOS) generates digital interocclusal records. Although the accuracy of maxillary and mandibular digital scans obtained from an IOS is widely studied, the accuracy of digital interocclusal records obtained with them is not; even less studied is the accuracy (trueness and precision) of the alignment methods that are available to obtain them. PURPOSE The purpose of this in vitro study was to assess the precision under repeatability conditions (repeatability) of the different alignment methods used to obtain digital interocclusal records. MATERIAL AND METHODS Digital scans of maxillary and mandibular casts of a dentate healthy adult were acquired with an IOS. Casts were then mounted in maximum intercuspal position in a semi-adjustable mechanical articulator (1801 AR Model PSH Articulator), and left and right occlusal digital scans were acquired with the IOS. Occlusal digital scans were repeated 7 times under repeatability conditions. After obtaining each pair of occlusal digital scans, the software program of the IOS automatically aligned the maxillary and mandibular digital scans with occlusal digital scans (TRI method), resulting in 7 digital interocclusal records composed of aligned maxillary and mandibular digital scans and occlusal digital scans. All 7 sets of aligned digital scans were exported and realigned in a dental computer-aided design software program by means of global and reference alignment methods (EXO-B and EXO-R methods, respectively). To assess the repeatability, the 7 aligned digital scan sets of each group were repositioned in the common coordinate system by aligning maxillary digital scans, and repeatability was calculated in terms of the distance between the vertices of the mandibular digital scans for each of the possible nonrepeating combinations of pairs (7C2=21). The repeatability was tested by using the Kruskal-Wallis test for nonparametric distribution followed by the Mann-Whitney U test and Bonferroni correction for pairwise comparisons (α=.05). RESULTS The median with interquartile range for the TRI alignment method was 47 (27) μm for the EXO-B method 41 (25) μm and 16 (5) μm for EXO-R. The Kruskal-Wallis test showed statistical difference between test groups (P<.05). The post hoc Dunn test with Bonferroni adjustment detected significant statistical differences between the EXO-R-TRI (P<.001) and EXO-R-EXO-B (P<.001) alignment methods. CONCLUSIONS This study found that the alignment method could influence the repeatability of digital interocclusal records. The reference best-fit alignment method (EXO-R) provided better repeatability.
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Affiliation(s)
- Xabier Garikano
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country UPV/EHU, San Sebastian, Spain
| | - Xabier Amezua
- Research Assistant, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country UPV/EHU, San Sebastian, Spain; Assistant Professor, Department of Business Management, Faculty of Engineering Gipuzkoa, University of the Basque Country UPV/EHU, San Sebastian, Spain
| | - Mikel Iturrate
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country UPV/EHU, San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country UPV/EHU, San Sebastian, Spain.
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Michou S, Tsakanikou A, Bakhshandeh A, Ekstrand KR, Rahiotis C, Benetti AR. Occlusal caries detection and monitoring using a 3D intraoral scanner system. An in vivo assessment. J Dent 2024; 143:104900. [PMID: 38412900 DOI: 10.1016/j.jdent.2024.104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE To assess the agreement in detecting and monitoring occlusal caries over thirty months using conventional visual and radiographic assessment and an intraoral scanner system which supports automated caries scoring. METHODS Ninety-one young participants aged 12-19 years were included in the study. All occlusal surfaces were examined visually, radiographically (when indicated), and scanned with the TRIOS 4 intraoral scanner. TRIOS Patient Monitoring software (vers. 2.3, 3Shape TRIOS A/S, Denmark) was used for automated caries detection on the 3D digital models. RESULTS Fifty-five of the study participants were re-examined after 30-months. Significant differences regarding caries detection were found between the conventional methods and the automated caries scoring system (p < 0.01), with moderate positive percent agreement (49-61%) and high negative percent agreement (87-98%). All methods reported significant caries progression over the follow-up period (p < 0.01). However, the automated system showed significantly more caries progression than the other methods (p < 0.01). CONCLUSIONS The software for automated caries detection and classification showed moderate positive agreement and strong negative agreement with the conventional methods considering both the baseline and the follow-up assessments. The automated caries scoring system detected significantly fewer caries lesions and tended to underestimate the caries severity. All methods indicated significant caries progression over the follow-up period, while the automated system detected more caries progression. CLINICAL SIGNIFICANCE The TRIOS system supporting automated occlusal caries detection and classification can assist in detecting and monitoring occlusal caries on permanent teeth as a complementary tool to the conventional methods. However, the operator should be aware that the automated system shows a tendency to underestimate the caries presence and lesion severity.
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Affiliation(s)
- Stavroula Michou
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 København N, Denmark.
| | - Angeliki Tsakanikou
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Goudi, Athens, Greece
| | - Azam Bakhshandeh
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 København N, Denmark
| | - Kim R Ekstrand
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 København N, Denmark
| | - Christos Rahiotis
- School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Goudi, Athens, Greece
| | - Ana R Benetti
- Department of Odontology, University of Copenhagen, Nørre Allé 20, 2200 København N, Denmark
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Roehl JC, Katzer L, Jakstat HA, Wetselaar P, Ahlers MO. Tooth Wear Evaluation System 2.0-Evaluation of diagnostic reliability in the assessment of signs and symptoms for tooth wear by non-experts. J Oral Rehabil 2024; 51:712-723. [PMID: 38087990 DOI: 10.1111/joor.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Tooth wear is a multifactorial condition that manifests through various signs and symptoms. These individual signs and symptoms were described in multiple studies, leading to the inclusion in TWES 2.0 (Tooth Wear Evaluation System 2.0) and the forthcoming DC-TW (Diagnostic Criteria for Tooth Wear). However, a study evaluating their reliability has yet to be conducted. OBJECTIVE The aim of the study was to examine the reliability in the assessment of 6 signs of pathological tooth wear and 18 clinical signs and symptoms determining aetiology, all of which are included in the TWES 2.0/DC-TW. METHODS 48 dental students (operators) evaluated patient cases from a patient pool of 14 patients on dental casts and high-resolution intraoral photographs. The agreement between all operators for each sign and symptom was calculated based on ICC (Intraclass Correlation Coefficients). Additionally, the agreement of each operator's evaluation with a predefined sample solution was calculated based on Cohen's kappa. RESULTS Inter-user agreement ranged from near perfect (0.91) to poor (0.02) for the various pathology signs or aetiology symptoms of tooth wear (mean 0.32). The agreements of the operator's ratings compared to the sample solution resulted in Cohen's kappa from 0.18 to 1 (mean 0.59) for the pathology signs and ranged from 0.02 to 0.51 for the aetiology signs (mean 0.38). CONCLUSIONS The reliability of the signs and symptoms examined and the ability of individual investigators to correctly identify and assign signs and symptoms varied widely. The current assessment tools for the qualification of tooth wear need further refinement, and examiners need intensive training in tooth wear assessment.
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Affiliation(s)
- Jakob C Roehl
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- CMD-Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Holger A Jakstat
- Department of Prosthetic Dentistry and Dental Materials and Special Care, Center for Dental and Oral Medicine, University of Leipzig, Leipzig, Germany
| | - Peter Wetselaar
- Department of General Oral Health Care, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Oliver Ahlers
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- CMD-Center Hamburg-Eppendorf, Hamburg, Germany
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Denucci GC, Alzahrani L, O'Toole S, Turssi CP, Hara AT. Objective assessment of simulated non-carious cervical lesion by tridimensional digital scanning - An in vitro study. J Dent 2024; 142:104851. [PMID: 38262586 DOI: 10.1016/j.jdent.2024.104851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Clinical assessment of progression of non-carious cervical lesions (NCCLs) is currently based on subjective methods. We hypothesize that 3D digital intraoral scanners (IOS) can provide quantitative outcomes for objective measuring and monitoring of NCCLs. This in vitro study verified the reliability of IOS to monitor dental structure loss of simulated NCCLs, in comparison to a reference bench-top 3D optical profilometer (BTS). METHODS NCCLs of different severity levels (early, moderate, or severe, n = 150) were simulated in a preceding study. Impressions of the lesions were taken and scanned with both BTS (ProScan; Scantron) and IOS (TRIOS4; 3Shape). Generated 3D images were analyzed for volumetric tooth loss (mm3) by superimposition followed by subtraction analysis. ProForm (Scantron) and WearCompare (Leeds Digital Dentistry) software were used in association to BTS and IOS, respectively. Agreement was assessed using intraclass correlation coefficient (ICC, alpha=0.05) and Bland-Altman plots. RESULTS ICC (confidence interval at 95 %) between IOS and BTS for all data combined was 0.962 (0.942-0.973), showing excellent reliability. Subset analyses showed that NCCLs with lower volume loss (early- and moderate-stage lesions) resulted in moderate ICCs, whereas severe lesions showed excellent ICC. Bland-Altman plots demonstrated general good agreement, with narrower limits for early stage-lesions. CONCLUSION IOS data demonstrated good agreement to BTS, when measuring tooth structure loss in simulated NCCLs, with particularly higher ICC in more severe lesions. Considering the accessibility and ease-of-use, IOS showed to be a good alternative for the objective assessment of NCCLs in vitro. CLINICAL SIGNIFICANCE 3D intraoral scanners' accessibility and objectivity make them potentially valuable tools for assessing and monitoring NCCLs.
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Affiliation(s)
- Giovanna Corrêa Denucci
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, 415N Lansing St, Indianapolis, IN 46202, United States
| | - Lina Alzahrani
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, 415N Lansing St, Indianapolis, IN 46202, United States; Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia
| | - Saoirse O'Toole
- Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, Guy´s Campus, London, United Kingdom
| | - Cecilia Pedroso Turssi
- Division of Cariology and Restorative Dentistry, São Leopoldo Mandic Dental Institute, R. Dr. José Rocha Junqueira, 13, Campinas, SP 13045-755, Brazil
| | - Anderson Takeo Hara
- Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, 415N Lansing St, Indianapolis, IN 46202, United States.
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Vertuan M, da Silva JF, de Souza BM, Braga AS, Magalhães AC. Effect of an experimental TiF 4/NaF solution in preventing tooth erosion. Arch Oral Biol 2024; 157:105823. [PMID: 37890417 DOI: 10.1016/j.archoralbio.2023.105823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE This was a randomized, double-blind, parallel, placebo-controlled in vivo study investigating the protective potential of a titanium tetrafluoride/ sodium fluoride (TiF4/NaF) solution compared to its respective positive and negative controls under an in vivo model, as well as the perception of participants regarding the use of this experimental solution. METHODS After the ethics approval and the selection procedures, 33 participants were divided into three treatments: TiF4/NaF solution (500 ppm F, pH 4.4); AmF/NaF/SnCl2-mouthwash (500 ppm F, pH 4.5) and water (pH 7.0) (n = 11). After professional cleaning, the participants rinsed with one of the solutions for one minute and waited two hours for the erosive challenge. The erosive solution (1 % citric acid, pH 2.5) was applied for 10 s on each central incisor (enamel area: 4 mm2) and collected for calcium analysis using III Arsenazo colorimetric method. The Ca2+ release data were compared using Kruskal-Wallis/ Dunn tests (p < 0.05). RESULTS Teeth treated with both fluoride solutions released less calcium into the acid (median and interquartile interval: TiF4/NaF - 0.45/0.19 mM and AmF/NaF/SnCl2 - 0.46/0.15 mM Ca2+, p = 0.99) compared to the negative control (1.12/0.42 mM Ca2+, 60 % reduction, p < 0.0006). For both F solutions, only one participant per group reported unpleasant taste. Four participants belonging to AmF/NaF/SnCl2-mouthwash reported burning sensation post-rinse, while only one participant described such feeling after TiF4/NaF rinsing. CONCLUSION The experimental TiF4/NaF solution was as effective as the commercial AmF/NaF/SnCl2-mouthwash in protecting enamel against erosive demineralization with a good acceptability by the participants.
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Affiliation(s)
- Mariele Vertuan
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Júlia França da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Beatriz Martines de Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
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Angelone F, Ponsiglione AM, Ricciardi C, Cesarelli G, Sansone M, Amato F. Diagnostic Applications of Intraoral Scanners: A Systematic Review. J Imaging 2023; 9:134. [PMID: 37504811 PMCID: PMC10381333 DOI: 10.3390/jimaging9070134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
In addition to their recognized value for obtaining 3D digital dental models, intraoral scanners (IOSs) have recently been proven to be promising tools for oral health diagnostics. In this work, the most recent literature on IOSs was reviewed with a focus on their applications as detection systems of oral cavity pathologies. Those applications of IOSs falling in the general area of detection systems for oral health diagnostics (e.g., caries, dental wear, periodontal diseases, oral cancer) were included, while excluding those works mainly focused on 3D dental model reconstruction for implantology, orthodontics, or prosthodontics. Three major scientific databases, namely Scopus, PubMed, and Web of Science, were searched and explored by three independent reviewers. The synthesis and analysis of the studies was carried out by considering the type and technical features of the IOS, the study objectives, and the specific diagnostic applications. From the synthesis of the twenty-five included studies, the main diagnostic fields where IOS technology applies were highlighted, ranging from the detection of tooth wear and caries to the diagnosis of plaques, periodontal defects, and other complications. This shows how additional diagnostic information can be obtained by combining the IOS technology with other radiographic techniques. Despite some promising results, the clinical evidence regarding the use of IOSs as oral health probes is still limited, and further efforts are needed to validate the diagnostic potential of IOSs over conventional tools.
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Affiliation(s)
- Francesca Angelone
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Alfonso Maria Ponsiglione
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Giuseppe Cesarelli
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Mario Sansone
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Francesco Amato
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
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Elkady AAM, Ameen SA, Sami RN. Intraoral occlusal adjustment time and volume required for CAD/CAM crowns fabricated with different virtual mounting methods (A randomized crossover trial). BDJ Open 2023; 9:19. [PMID: 37164989 PMCID: PMC10172387 DOI: 10.1038/s41405-023-00146-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE To measure the required clinical time and volume of occlusal adjustment when the maxillary cast is positioned in a virtual articulator using one of three methods: digitization of a facebow-mounted mechanical articulator (group A), virtual Bonwill triangle (group B) or a 3D face scan (group F). MATERIALS AND METHODS In this randomized, triple-blind, crossover trial; 11 participants were enrolled. Every participant had one molar indicated for a single crown restoration. Three crowns were designed and milled for every participant molar totaling 33 crowns. Each of the three crowns was fabricated with the participant's casts virtually mounted utilizing a different method. An impression was taken of the crown in place before occlusal adjustment. The occlusal adjustment was then performed and timed with the three crowns in the different groups. After the occlusal adjustment, an impression of the adjusted crown was taken. The pre-adjustment and post-adjustment impressions were digitally superimposed and the volume difference was measured. The Kruskal-Wallis test was used to compare the groups. RESULTS Group A showed the shortest mean adjustment time (3:44.59 ± 3:39.07) followed by group F (4:30.09 ± 2:01.50) and group B (4:35.30 ± 2:32.33). The mean adjustment volume for group A was (28 ± 19.1 mm3) followed by group F (30.5 ± 18.8 mm3) and group B (40.6 ± 29.5 mm3). Different virtual mounting methods had no statistically significant effect on adjustment time (P-value = 0.538) or adjustment volume (P-value = 0.490). CONCLUSIONS A simplified approach in virtual articulator mounting appears to be justified in the construction of a single full-coverage prosthesis. Added labor, time and cost of more elaborate virtual mounting methods seem to be counterproductive.
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Affiliation(s)
| | - Shereen Adel Ameen
- Fixed Prosthodontics Department and Vice Dean for Community Service and Environmental Development, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Rasha Nabil Sami
- Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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11
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Cuadrado-Ríos S, Huamán-Garaicoa F, Cruz-Moreira K. Anorexia and bulimia nervosa in the practice of the paediatric dentist. EUROPEAN EATING DISORDERS REVIEW 2023; 31:9-23. [PMID: 35962774 DOI: 10.1002/erv.2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/29/2022] [Accepted: 07/18/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This systematic review aimed to highlight the usefulness of the clinical examination of the oral cavity for the diagnostic suspicion of anorexia (AN) and bulimia nervosa (BN), being of main interest to the paediatric dentist and paediatrician due to the early onset of symptoms in Eating Disorders (EDs). METHOD A systematic search, applying PICO question, was carried out in biomedical and other electronic databases from 2005 to 2020. Both case reports and case series of patients under 65 years of age with AN and BN were included. Data were extracted and statistically analysed. RESULTS A sample of 111 studies was obtained (n = 192; 92.78% female). The most prevalent diagnosis was restrictive type AN (n = 110; 57.29%). Only 16 (8.33%) patients had been clinically examined at the oral cavity, indicating the presence or absence of oral manifestations (OM) and showing dental erosion (n = 10) as the most frequent. CONCLUSION There is a lack of information about the oral examination of anorexic and bulimic patients. Dental erosion and other oral manifestations can help us to make an early ED diagnosis. Clinical observation and basic erosive wear examination (BEWE) Index are necessary steps to detect and record any anomaly in oral cavity during the evaluation of these patients.
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Affiliation(s)
| | - Fuad Huamán-Garaicoa
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Instituto Oncológico Nacional "Dr. Juan Tanca Marengo". SOLCA, Guayaquil, Ecuador
| | - Karla Cruz-Moreira
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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12
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Ning K, Bronkhorst E, Crins L, van der Meer W, Pereira-Cenci T, Yang F, Leeuwenburgh S, Loomans B. Wear behaviour of direct composite restorations in tooth wear patients: a 5-year clinical study. J Dent 2022; 127:104354. [PMID: 36351488 DOI: 10.1016/j.jdent.2022.104354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the wear behaviour of direct composite restorations after 5 years and associated patient factors. METHODS 38 patients (6 females, 32 males; 35.2 ± 7.6y) from the Radboud Tooth Wear Project with generalized moderate to severe tooth wear were treated with direct composite restorations on all teeth. Ethical approval was sought and granted before the study was undertaken. Intraoral 3D scans were recorded at 1 month (baseline) and 5 years (recall) after treatment. The amount of height loss was measured at six index teeth (first molars and upper central incisors). Patient factors (age, vertical dimension of occlusion increase, bite force, aetiology score, jaw position and bearing/ non-bearing cusps) were included in the analysis. Multilevel multiple regression with bootstrapping was used to analyse the influence of these factors on wear behaviour of restorations. Observer reliability was tested by paired t-tests and Band-Altman plots (p<0.05) RESULTS: After 5 years, the mean height loss was 0.23± 0.19 mm for incisors and 0.43± 0.24 mm for molars (p≤0.001). Patient factors did not show any significant influence on height loss of the composite restorations, while bearing cusps showed significant more wear compared to non-bearing cusps (p≤0.001). The observer reliability tests confirmed the repeatability (correlation of 0.809, DME 0.103). CONCLUSIONS Wear of composite restorations is a significant and relevant factor over time in patients treated with severe tooth wear. Within the limitations of this clinical study, patient factors were found not to have a significant effect on wear behaviour of direct composite restorations.
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Affiliation(s)
- Ke Ning
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Ewald Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Luuk Crins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Wicher van der Meer
- University of Groningen, University Medical Center Groningen, Department of Orthodontics, Groningen, the Netherlands; W.J. Kolff Institute of Biomedical Engineering and Materials Science, Groningen, the Netherlands
| | - Tatiana Pereira-Cenci
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Fang Yang
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Sander Leeuwenburgh
- Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Department of Dentistry - Regenerative Biomaterials, Philips van Leydenlaan 25, Nijmegen, the Netherlands
| | - Bas Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry - Restorative Dentistry, Philips van Leydenlaan 25, Nijmegen, the Netherlands.
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Mitrirattanakul S, Neoh SP, Chalarmchaichaloenkit J, Limthanabodi C, Trerayapiwat C, Pipatpajong N, Taechushong N, Chintavalakorn R. Accuracy of the Intraoral Scanner for Detection of Tooth Wear. Int Dent J 2022; 73:56-62. [PMID: 35931558 PMCID: PMC9875261 DOI: 10.1016/j.identj.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this work was to study the accuracy of the intraoral scanner for detection of tooth wear in natural teeth by using micro-computed tomography (micro-CT) as a gold standard. MATERIALS AND METHODS Twenty premolars were prepared, fixed in acrylic blocks, and scanned with an intraoral scanner (iTero Element® 2) and micro-CT for baseline reference images before artificial tooth wear induction. The samples were then scrubbed with abrasive sandpaper 20 times and scanned with the intraoral scanner. They were then superimposed with the reference images utilising the "TimeLapse" feature of the scanner until the abraded area appeared yellow, indicating tooth surface loss in the 50-200 μm range. The same samples were then rescanned by micro-CT to measure the actual tooth surface loss. This procedure was repeated for the subsequent experimental tooth surface loss of 200-400 μm range (orange areas) and 400-750 μm range (red areas). The collected data were analysed for sensitivity, positive predictive value (PPV), and accuracy. Level of statistical significance was set at .05. RESULTS In the detection of experimental tooth surface loss, the specificity, PPV, and accuracy of the intraoral scanner were 98%, 98%, and 97%, respectively. CONCLUSIONS The iTero® intraoral scanner can be recommended to be a suitable screening tool for tooth wear in routine dental practice.
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Affiliation(s)
- Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Siew Peng Neoh
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | | | | | | | | | - Rochaya Chintavalakorn
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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14
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Charalambous P, O'Toole S, Austin R, Bartlett D. The threshold of an intra oral scanner to measure lesion depth on natural unpolished teeth. Dent Mater 2022; 38:1354-1361. [PMID: 35750507 PMCID: PMC10112273 DOI: 10.1016/j.dental.2022.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/28/2022] [Accepted: 06/05/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate the threshold and accuracy of intraoral scanning in measuring freeform human enamel surfaces. METHODS Software softgauges, ranging between 20 and 160 µm depth, were used to compare four workflow analysis techniques to measure step height on a freeform surface; with or without reference areas and in combination with surface-subtraction to establish which combination produced the most accurate outcome. Having established the optimum combination, 1.5 mm diameter, individual depths ranging from 11 to 81 µm were created separately on 14 unpolished human enamel samples and then scanned with gold standard laboratory optical profilometry (NCLP, TaiCaan Technologies™, XYRIS2000CL, UK) and a clinical intraoral scanner (TrueDefinition™, Midmark Corp., USA). The sequence of surface registration and subtraction determined from the softgauges was used to measure step height on natural human enamel surfaces. Step heights (μm) were compared using two-way ANOVA with post-hoc Bonferroni (p < 0.05) and Bland-Altman analyses. RESULTS Software differences were significantly reduced from - 29.7 to - 32.5% without, to - 2.4 to - 3.6% with reference areas (p < 0.0001) and the addition of surface-subtraction after registration reduced this further to 0.0 to - 0.3% (p < 0.0001). The intraoral scanner had a depth discrimination threshold of 73 µm on unpolished natural enamel and significant differences (p < 0.05) were observed compared to NCLP below this level. SIGNIFICANCE The workflow of combining surface-registration and subtraction of surface profiles taken from intraoral scans of freeform unpolished enamel enabled confident measurement of step height above 73 µm. The limits of the scanner is related to data capture and these results provide opportunities for clinical measurement.
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Affiliation(s)
- Polyvios Charalambous
- King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Guy's Hospital, Tower wing, London SE1 9RT, UK.
| | - Saoirse O'Toole
- King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Guy's Hospital, Tower wing, London SE1 9RT, UK.
| | - Rupert Austin
- King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Guy's Hospital, Tower wing, London SE1 9RT, UK.
| | - David Bartlett
- Centre for Oral, Clinical & Translational Sciences, King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Guy's Hospital, Tower wing, London SE1 9RT, UK.
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15
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Marro F, O'Toole S, Bernabé E, Bartlett D, Aránguiz V. Associated risk factors with quantitative erosive tooth wear progression. J Dent 2022; 123:104179. [DOI: 10.1016/j.jdent.2022.104179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/13/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022] Open
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16
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Application of the Intraoral Scanner in the Diagnosis of Dental Wear: An In Vivo Study of Tooth Wear Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084481. [PMID: 35457351 PMCID: PMC9025239 DOI: 10.3390/ijerph19084481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023]
Abstract
In recent years, there has been an increase in the incidence of dental wear; thus, an early diagnosis is important. Conventional methods of diagnosis are based primarily on the visual abilities of the dentist, and therefore the use of new technologies for the detection of dental wear may be very useful. The aim of the study was to analyze the sensitivity and specificity of the intraoral scanner for measuring dental wear, as well as to evaluate patients' satisfaction with the use of the scanner. The study was conducted with 46 volunteers who underwent three intraoral analyses: a first baseline scanning, a second scanning after 6 months and a final scanning after one year performed by four operators divided into two groups. One of the operators performed the visual analysis of dental wear, and the other performed the analysis using the intraoral scanner 3M™ True Definition intraoral scanner (ESPE, Seefeld, Germany). The data obtained from the intraoral scanner showed levels of specificity and sensitivity that enable the intraoral scanner to be used as a diagnostic tool in the assessment of tooth wear. The participants also showed a high degree of satisfaction with the scanner as a communication tool.
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17
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The development of a restorative Managed Clinical Network within the defence primary healthcare organisation. Br Dent J 2021; 231:584-589. [PMID: 34773031 DOI: 10.1038/s41415-021-3611-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/11/2021] [Indexed: 11/08/2022]
Abstract
The United Kingdom Armed Forces introduced a Managed Clinical Network to transform care provision for military patients referred with complex restorative treatment needs. This article discusses the processes that underpinned this transformation of service, from assessment of populations needs to implementation of clinical delivery.
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18
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Schlenz MA, Schlenz MB, Wöstmann B, Jungert A, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 12-month results. Clin Oral Investig 2021; 26:1869-1878. [PMID: 34498100 PMCID: PMC8816769 DOI: 10.1007/s00784-021-04162-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/24/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To investigate tooth wear in young adults, intraoral scanning was used for digital monitoring of the mandibular first molar over 12 months. A possible influence of aetiological factors obtained by a questionnaire on tooth wear was investigated. MATERIALS AND METHODS A total of 109 participants (mean age at the start of the study: 21.0 ± 2.2 years) were included in this clinical study. At baseline (T0), an intraoral scan (Trios 3, 3Shape) of the study tooth (FDI # 36 or #46) was conducted. After a mean observation period of 373 ± 19 days, a second intraoral scan (T1, n = 94) of the same tooth as at T0 was performed and standard tessellation language datasets were superimposed with 3D analysis software (GOM Inspect). The occlusal surface of the study tooth was divided into 7 areas (5 cusps, 2 ridges) and maximum vertical substance loss was measured between T0 and T1 (n = 91). Three types of tooth wear were defined: cupping (C), facet (F) and combined cupping-facet (CF). Furthermore, a questionnaire on aetiological factors, such as dietary behaviour, was filled out at T0. Data were analysed with non-parametric tests (p < 0.05). RESULTS Only one study tooth exhibited no tooth wear at T0, whereas 3 teeth showed C, 47 teeth F and 40 teeth CF. A progression of vertical substance loss for all three types was shown. Most affected were the mesiobuccal cusps (43, 38/47 µm; median, 95%CI) followed by distobuccal (36, 33/39 µm), mesiolingual (35, 26/40 µm), distolingual (34, 27/36 µm) and distal (31, 25/34 µm). On mesial and distal ridges, only F was detected with the lowest vertical substance loss of all areas (mesial ridge: 0, 0/0 µm; distal ridge: 0, 0/0 µm). An association between aetiological factors and loss values could not be shown. CONCLUSIONS All study teeth showed clear signs of wear, and after only 1 year, further substance loss was detectable. This result is of significance for young adults. CLINICAL RELEVANCE Since data of young adults regarding tooth wear are scarce, the results give a first idea of the amount of vertical loss per year and its relation to aetiological factors such as dietary behaviour. Therefore, further studies over a longer observation period are highly recommended.
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Affiliation(s)
- Maximiliane Amelie Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany.
| | - Moritz Benedikt Schlenz
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic of the Justus Liebig University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Alexandra Jungert
- Biometry and Population Genetics, Institute of Agronomy and Plant Breeding II, Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Justus Liebig University Giessen, Giessen, Germany
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus Liebig University Giessen, Giessen, Germany
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19
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Witecy C, Ganss C, Wöstmann B, Schlenz MB, Schlenz MA. Monitoring of Erosive Tooth Wear with Intraoral Scanners In vitro. Caries Res 2021; 55:215-224. [PMID: 33752205 DOI: 10.1159/000514666] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/13/2021] [Indexed: 11/19/2022] Open
Abstract
Intraoral scanners (IOS) have been used to quantify tooth wear, but so far they have not been systematically validated for monitoring of tissue loss. The aim of this in vitro study was to investigate whether progression of tissue loss can be detected with an IOS and whether IOS values agree with those obtained with noncontacting profilometry (PRO) serving as a standard method. Model jaws were mounted in a phantom head positioned in a dental chair. Flattened areas were prepared on the non-load-bearing cusps of the first molars (model teeth; n = 16) in order to fix flat enamel samples with an experimental area and a reference area. After baseline PRO and IOS, the experimental enamel area was stepwise etched with 35% H3PO4 gel (4 × 30 s and 4 × 15 s). After each etching, PRO and IOS was performed and the vertical tissue loss between the reference and experimental areas was measured, each at the same 3 measurement points. Furthermore, cupped cusps were simulated by stepwise preparation of the load-bearing cusps of the model teeth with a spherical diamond bur, and the maximum vertical depth after each preparation step was measured only by IOS. Trios3 (3Shape, Denmark), Carestream CS3600 (Carestream, USA) and an optical profilometer (MicroProf, Fries, Germany) were used to measure the flat areas of the enamel samples, whereas only IOS were used to measure curved surfaces on the load-bearing cupped cusps of the model teeth. The IOS data were analyzed with an external software (GOM Inspect, Germany) and with the respective internal IOS software. PRO revealed a mean (±SD) tissue loss of 17.1 ± 4.7 µm after 30-s etching steps and 10.1 ± 5.1 µm after the 15-s etching steps. IOS and software types were able to detect the progression of tissue loss after each etching step (p ≤ 0.001 each); Bland-Altmann plots revealed good agreement with PRO regardless of the order of tissue loss, and no systematic difference was found. Increasing cupped lesion depths were detected by all IOS, with no significant differences between IOS and analysis methods. IOS were able to detect small amounts of tissue loss under simulated clinical conditions and seem to be a promising tool for monitoring even initial erosive tooth wear.
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Affiliation(s)
- Corinna Witecy
- Department of Conservative and Preventive Dentistry, Justus Liebig University Giessen, Giessen, Germany,
| | - Carolina Ganss
- Department of Conservative and Preventive Dentistry, Justus Liebig University Giessen, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Justus Liebig University Giessen, Giessen, Germany
| | - Moritz B Schlenz
- Department of Prosthodontics, Justus Liebig University Giessen, Giessen, Germany
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The measurement threshold and limitations of an intra-oral scanner on polished human enamel. Dent Mater 2021; 37:648-654. [PMID: 33573841 DOI: 10.1016/j.dental.2021.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the measurement threshold of an intra-oral scanner (IOS) on polished human enamel. METHODS The optical performance of an IOS was compared to a gold-standard non contacting laser profilometer (NCLP), on a painted microscope slide, compared to increasing particle size of silicon-carbide papers (21.8-269.0 μm) and separately on polished human enamel with increasing step-heights. The enamel samples were randomised (n = 80) and scanned using the IOS and NCLP at increasing step-height depths (μm) (1.87-86.46 μm) and quantified according to ISO:5436-1. The measurement threshold of the IOS was determined using a custom designed automated lesion localisation algorithm, corroborated by Gaussian skewness (Ssk) and kurtosis (Sku) analysis, to assess the minimum step-height measured on each enamel sample. RESULTS The NCLP showed statistically increased Sq surface roughness for all silicon carbide particle sizes compared to the microscope slide, whereas, the IOS Sq roughness discriminated silicon-carbide particles above 68.0 μm compared to the glass slide (p ≤ 0.02). On polished enamel, the automated minimum detectable step-height measurable on each sample was 44 μm. No statistically significantly different step-height enamel lesion measurements were observed between NCLP and IOS above this threshold (p > 0.05). SIGNIFICANCE This study revealed the fundamental optical metrological parameters for the IOS, was step-heights above 44 μm and this reflects the data acquisition of the system. These results highlight the limitations of IOS used in this study, mandating further research to optimise the performance of other IOS systems, for measuring wear of materials or tooth wear on human unpolished natural enamel surfaces.
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21
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Objective assessment of simulated non-carious cervical lesion by tridimensional digital scanning. Clin Oral Investig 2021; 25:4069-4074. [PMID: 33464418 DOI: 10.1007/s00784-020-03737-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To explore the use of 3D intraoral scanner/image analysis for the detection and monitoring of simulated non-carious cervical lesions (NCCLs) in vitro. MATERIALS AND METHODS A total of 288 NCCLs of different severities and simulated using a laboratorial model associating toothbrush stiffness (soft, medium, and hard) and toothpaste abrasivity (low, medium, high, and negative control) were analyzed. Dental impressions were taken from specimens before and after 35K and 65K brushing strokes, and then scanned with a CEREC Omnicam scanner. 3D models were analyzed for volumetric tooth loss. 3D optical profilometry was considered as the gold standard. Data were analyzed using ANOVA and Fisher's PLSD tests (alpha = 0.05), and agreement between methods by using intraclass correlation coefficient. RESULTS Toothbrushes of hard and mid stiffness caused higher tooth loss than soft when associated with the highest abrasive, at 35K and 65K strokes (p < 0.001). Variation in slurry abrasivity led to differences in tooth loss (with control < low < medium < high, p < 0.0001) after both 35K and 65K strokes, regardless of the type of toothbrush used, except at 35K, wherein control = low (p = 0.55). 35K strokes caused less tooth loss than 65K for all abrasive slurries (p < 0.0001) except controls. The intraclass correlation coefficient for agreement between the test and gold standard methods was 0.85. CONCLUSIONS Analysis of 3D images from intraoral scanner could detect and monitor NCCL progression, although this ability was limited on incipient lesions. Overall good agreement was found between the test method and optical profilometry. CLINICAL RELEVANCE The suggested method may be applicable to detect and monitor NCCLs clinically.
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22
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Mehta SB, Bronkhorst EM, Crins L, Huysmans MCDNJ, Wetselaar P, Loomans BAC. A comparative evaluation between the reliability of gypsum casts and digital greyscale intra-oral scans for the scoring of tooth wear using the Tooth Wear Evaluation System (TWES). J Oral Rehabil 2021; 48:678-686. [PMID: 33370476 PMCID: PMC8248338 DOI: 10.1111/joor.13141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/28/2022]
Abstract
Background The Tooth Wear Evaluation System (TWES) is a type of tooth wear index. To date, there is the lack of data comparing the reliability of the application of this index on gypsum cast records and digital greyscale intra‐oral scan records. Objectives A comparative evaluation between the use of gypsum cast records and digital greyscale intra‐oral scan records with the reliability of tooth wear scoring using the TWES amongst a group of patients with tooth wear. Methods Records for 10 patients with moderate to severe tooth wear (TWES ≥ 2) were randomly selected from a larger clinical trial. TWES grading of the occlusal/incisal, buccal and palatal/lingual surfaces was performed to determine the levels of intra‐ and interobserver agreement. Intra‐observer reproducibility was based on the findings of one examiner only. For the interobserver reproducibility, the findings of two examiners were considered. One set of models/ records were used per patient. Cohen's weighted kappa (κW) was used to ascertain agreement between and within the observers. Comparison of agreement was performed using t tests (P < .05). Results For the scoring of the of the total occlusal/incisal surfaces, the overall levels of intra‐ and interobserver agreement were significantly higher using the gypsum cast records than with the digital greyscale intra‐oral scan records, (P < .001) and (P < .001), respectively. For the overall buccal surfaces, only a significant difference was found in the intra‐observer agreement using gypsum casts, (P = .013). For the palatal/lingual surfaces, a significant difference was only reported in the interobserver agreement using gypsum casts, (P = .043). At the occlusal/incisal surfaces, grading performed using gypsum casts, culminated in significantly higher TWES scores than with the use of the digital greyscale intra‐oral scans (P < .001). At the buccal and palatal/lingual surfaces, significantly higher wear scores were obtained using digital greyscale intra‐oral scan records (P < .009). Conclusions The TWES can offer a reliable means for the scoring of wearing occlusal/incisal surfaces using gypsum casts. The reliability offered by digital greyscale intra‐oral scans for consecutive scoring was in general, inferior.
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Affiliation(s)
- Shamir B Mehta
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Conservative & MI Dentistry, Unit of Distance Learning, King's College London Faculty of Dentistry, Oral & Craniofacial Sciences, Guy's Campus, London, UK
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Luuk Crins
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Marie-Charlotte D N J Huysmans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Bas A C Loomans
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Detecting early erosive tooth wear using an intraoral scanner system. J Dent 2020; 100:103445. [DOI: 10.1016/j.jdent.2020.103445] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/22/2023] Open
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The impact of e-training on tooth wear assessments using the BEWE. J Dent 2020; 100:103427. [DOI: 10.1016/j.jdent.2020.103427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/21/2022] Open
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O'Toole S, Lau JS, Rees M, Warburton F, Loomans B, Bartlett D. Quantitative tooth wear analysis of index teeth compared to complete dentition. J Dent 2020; 97:103342. [PMID: 32360512 DOI: 10.1016/j.jdent.2020.103342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Recent software advancements have facilitated quantification of erosive tooth wear progression using intraoral scans. This paper investigated if wear on commonly affected surfaces (central incisors and first molars) was representative of wear on the full arch. METHODS Bimaxillary digital intraoral scans (True Definition, 3 M, USA) of patients (n = 30) from the monitoring arm of the Radboud Tooth Wear Project, were taken at baseline and at 3 years (+/-10months). The occlusal/incisal surface of each tooth (excluding 3rd molars) was analysed for volume change and volume change per mm of analysed surface area in WearCompare (www.leedsdigitaldentistry.com/Wearcompare) following previously published protocols. Data were normal, descriptives and multi-level linear regression analysis was performed in Stata v15.1 taking patient level and surface type data into account. RESULTS Data from 556 surfaces in 29 patients were included in analysis. Per patient, mean volume loss (95 % CI) was -0.91mm3(-1.28,-0.53) on all surfaces, -1.85mm3(-2.83,-0.86) on index surfaces, -2.53mm3(-3.91,-1.15) on molar surfaces and -0.83 mm3(-1.34,-0.31) on upper central incisal surfaces. Statistical differences were observed between analysing all surfaces and index teeth(p = 0.002) in addition to molar surfaces(p < 0.0001). Mean volume loss per mm2 of surface analysed was -0.024 mm3 (-0.031,-0.017), -0.028mm3 (-0.041,-0.014), -0.030mm3 (-0.046,-0.013) and -0.025mm3 (-0.041,-0.010) for all surfaces, index surfaces, first molar surfaces and central incisor surfaces respectively with no statistical differences between groups. CONCLUSIONS Wear on upper central incisors was not statistically different to full arch wear analysis. If the surface area is standardised, wear on both index surfaces are statistically similar to wear on the full arch. CLINICAL SIGNIFICANCE These results suggest that analysing rates of wear on index teeth can be a resource-saving substitute for analysing rates of wear on the entire dentition, provided the surface area is standardised. If whole surfaces are analysed, the molar surfaces will show greater rates of wear.
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Affiliation(s)
- Saoirse O'Toole
- Centre of Clinical Oral and Translational Sciences, King's College London Faculty of Dental, Oral and Craniofacial Sciences, Floor 17 Tower Wing, Guy's Hospital, London, SE1 9RT, UK.
| | - Jia Shang Lau
- King's College London Faculty of Dental, Oral and Craniofacial Sciences, Floor 25 Tower Wing, Guy's Hospital, London, SE1 9RT, UK.
| | - Morgan Rees
- King's College London Faculty of Dental, Oral and Craniofacial Sciences, Floor 25 Tower Wing, Guy's Hospital, London, SE1 9RT, UK.
| | - Fiona Warburton
- Statistics, The Oral Clinical Research Unit, Floor 25, Tower Wing, Guy's Hospital, London, SE1 9RT, UK.
| | - Bas Loomans
- Radboud University of Nijmegen, Ph. van Leydenlaan 25, 6525 EX, Nijmegen, Netherlands.
| | - David Bartlett
- Centre of Clinical Oral and Translational Sciences, King's College London Faculty of Dental, Oral and Craniofacial Sciences, Floor 25 Tower Wing, Guy's Hospital, London, SE1 9RT, UK.
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Marro F, Jacquet W, Martens L, Keeling A, Bartlett D, O'Toole S. Quantifying increased rates of erosive tooth wear progression in the early permanent dentition. J Dent 2020; 93:103282. [PMID: 32006669 DOI: 10.1016/j.jdent.2020.103282] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/14/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To investigate if quantitative analysis of intraoral scans of study models can identify erosive tooth wear progression. METHODS Data were collected from a retrospective longitudinal study, using pre-and post-orthodontic treatment casts of 11-13 year olds, recorded at two consecutive appointments 29 months apart. Casts were digitised with intra-oral scanner TRIOS™ (3Shape, Copenhagen, Denmark) and first molar scan pairs used for analysis. Occlusal surfaces of each molar pair were visually assessed using the BEWE index as having no BEWE progression (n = 42) or BEWE progression (n = 54). Scan pairs were aligned and analysed for volume loss, maximum profile loss and mean profile loss in WearCompare (Leedsdigitaldentistry.com/wearcompare) using previously published protocols. Data were analysed in SPSS and not normal. Mann-Whitney U test with a Bonferroni correction assessed differences between progression groups. Receiver-operating-characteristic (ROC) curves were used to identify the sensitivity and specificity of quantified wear progression rates at determining visual wear progression. RESULTS Surfaces with visible progression demonstrated a median volume loss of -2.19 mm3 (IQR-3.65, -0.91) compared to a median volume loss of -0.37 mm3 (IQR -1.02, 0.16) in the no visible progression group (p < 0.001). Mean profile loss was -75.2 μm (IQR-93.9, -61.0) and 63.2 μm (IQR -82.5, -49.7) for the progression and no-progression groups respectively (p = 0.018). Volume loss of -1.22mm3 represented a 79 % sensitivity and 61 % specificity. The estimated area under the curve for volume loss was 0.80 (95 %CI 0.71-0.89, p < 0.001). CONCLUSIONS This is the first study to propose rates of high wear progression in adolescents. Limited sensitivity and specificity confirms that quantitative analysis is an adjunct tool to be used alongside history taking and clinical judgement. CLINICAL SIGNIFICANCE The rapid advancement of digital technologies may result in improved diagnosis in erosive tooth wear (ETW). Intra-oral scans and registration software are a promising adjunct for monitoring ETW progression in clinical practice.
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Affiliation(s)
- Francisca Marro
- Department of Paediatric Dentistry, PAECOMEDIS research cluster, Gent University, C. Heymanslaan 10 (P8), B-9000, Gent, Belgium.
| | - Wolfgang Jacquet
- Oral Health Research Group ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Luc Martens
- Department of Paediatric Dentistry, PAECOMEDIS research cluster, Gent University, C. Heymanslaan 10 (P8), B-9000, Gent, Belgium.
| | - Andrew Keeling
- Department of Restorative Dentistry, Leeds School of Dentistry, Clarendon Way, Leeds LS2 9LU, UK.
| | - David Bartlett
- Department of Prosthodontics, King's College London Dental Institute, London, UK.
| | - Saoirse O'Toole
- Department of Prosthodontics, King's College London Dental Institute, London, UK.
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Warreth A, Abuhijleh E, Almaghribi MA, Mahwal G, Ashawish A. Tooth surface loss: A review of literature. Saudi Dent J 2019; 32:53-60. [PMID: 32071532 PMCID: PMC7016226 DOI: 10.1016/j.sdentj.2019.09.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/08/2019] [Accepted: 09/16/2019] [Indexed: 12/19/2022] Open
Abstract
Objectives Tooth surface loss (TSL) or tooth wear (TW) is an irreversible loss of hard tooth structure caused by factors other than those responsible for dental caries. TSL is observed clinically as attrition, abrasion, abfraction, and erosion. It may be associated with symptoms such as tooth hypersensitivity and function impairment, and may lead to change in the morphology of the affected tooth. However, it may also be asymptomatic, meaning the patient may not be aware of it. In this instance, the dentist is encouraged to make the patient aware of this issue. The aim of this review is to provide an overview of the classification and management of TSL. Material and methods The PubMed (MEDLINE) search engine was used to gather the most recent information on TSL. The search was restricted to a five year period (1 September 2014–31 August 2019), and only English-language studies were included. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: (Tooth surface loss OR tooth wear) AND (tooth attrition OR tooth Abrasion OR tooth erosion OR tooth abfraction OR non-carious cervical lesions) AND (humans). Studies were also obtained by manual searches and from Google Scholar. Results By this process, 560 articles and studies were obtained. More studies were also obtained by manual searches and from Google Scholar. The most relevant published studies were chosen and used in the current review. The selected articles are included in the reference list. Conclusion TSL is a clinical problem that dentists face on a daily basis. Therefore, a sound clinical approach by which TSL can be prevented and managed is essential. While this approach requires that dentists are knowledgeable about the issue, increasing public awareness of TSL is also vital.
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Affiliation(s)
- Abdulhadi Warreth
- Restorative Department, College of Dentistry, University of Science and Technology of Fujairah, United Arab Emirates
| | - Eyas Abuhijleh
- Orthodontic Department, College of Dentistry, University of Science and Technology of Fujairah, United Arab Emirates
| | | | - Ghanim Mahwal
- Restorative Department, Ajman University, United Arab Emirates
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Detection threshold of non-contacting laser profilometry and influence of thermal variation on characterisation of early surface form and textural changes in natural human enamel. Dent Mater 2019; 35:e140-e152. [DOI: 10.1016/j.dental.2019.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/14/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
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