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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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Wan Q, Daher R, Lee H, Kwon HB, Han JS, Lee JH. Reliability of digital repeated-scan superimposition and single-scan techniques for wear volume loss assessment on flat surfaces. J Dent 2023; 138:104738. [PMID: 37806382 DOI: 10.1016/j.jdent.2023.104738] [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: 03/05/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Evidence on the reliability of digital techniques for wear volume assessment using three-dimensional (3D) scan datasets is scarce. This study evaluated the reliability of a repeated-scan superimposition technique and two single-scan techniques in assessing wear volume loss on flat surfaces of 3D-printed resin specimens. METHODS Cuboid-shaped (15×10×10 mm) resin specimens were 3D-printed (n = 14) and scanned before and after 200,000 cycles of masticatory simulation. For the repeated-scan superimposition technique, digital 3D models of specimens before and after masticatory simulation were superimposed, and the volume loss was determined. The first single-scan technique utilized a computer-aided design freeware program, while the second one employed a 3D-metrology software program. In the freeware program, the worn area of 3D objects was edited directly to obtain a flat surface. In the 3D-metrology software program, the worn area was deleted first and then filled to the flat surface. The volume differences before and after editing were calculated in each software program. Agreement between the three measurement techniques was determined through intraclass correlation coefficients (ICCs). One-way analysis of variance was performed to compare the wear volume loss assessed by the three techniques (α = 0.05). RESULTS High inter-technique reliability was observed between the three assessment techniques (ICC = 0.998, p < .001). On pair-wise comparisons of two of the three techniques, all pairs showed high consistency (ICC ≥ 0.999, p < .001). No significant difference was found in the wear volume loss assessed using the three techniques (p = .996). CONCLUSIONS Digital repeated-scan superimposition and two single-scan techniques demonstrated high reliability in assessing wear volume loss on flat surfaces. CLINICAL SIGNIFICANCE The repeated-scan superimposition technique can be effectively utilized to assess wear volume loss of anatomically shaped specimens and flat surfaces. This study indicates that the single-scan techniques may serve as a suitable alternative to the repeated-scan superimposition technique when evaluating wear volume loss of flat surfaces.
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Affiliation(s)
- Qiucen Wan
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - René Daher
- Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
| | - Hyeonjong Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Jung-Suk Han
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Jae-Hyun Lee
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea.
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Ashley M, Leven AJ. The opinions of GDPs on the challenges of managing tooth wear in primary dental care. Br Dent J 2023; 234:459-462. [PMID: 36964377 PMCID: PMC10037362 DOI: 10.1038/s41415-023-5582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 03/26/2023]
Abstract
As patients access most of their dental care within the primary care setting, it is relevant to consider how the experience and opinions of general dental practitioners (GDPs) influence the diagnosis, monitoring and treatment of their patients with tooth wear. This paper records the agreed outcomes of semi-structured discussions with three experienced GDPs. The aim is to continue the broader debate about how patients with tooth wear currently are and ideally could be managed within the primary care settings in England. The outcomes are also likely to be applicable to other countries, regardless of the local funding models for routine patient care.
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Affiliation(s)
- Martin Ashley
- Consultant and Honorary Professor in Restorative Dentistry and Oral Health, University Dental Hospital of Manchester, Manchester, UK.
| | - A Johanna Leven
- Consultant in Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
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Vach K, Schlueter N, Ganss C, Vach W. Understanding the Influence of Patient Factors on Accuracy and Decision-Making in a Diagnostic Accuracy Study with Multiple Raters-A Case Study from Dentistry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1781. [PMID: 36767148 PMCID: PMC9914814 DOI: 10.3390/ijerph20031781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
In diagnostic accuracy studies, the test of interest is typically applied only once in each patient. This paper illustrates some possibilities that arise when diagnoses are carried out by a sufficiently large number of multiple raters. In a dental study, sixty-one examiners were asked to diagnose 49 tooth areas with different grades of tissue loss (minor, moderate, and advanced) to decide whether dentine was exposed (positive status) or not (negative status). The true status was determined by histology (reference). For each tooth, the rate of correct decisions reflecting the difficulty to diagnose this tooth and the positive rate reflecting the perception of the tooth by the raters was computed. Meta-analytical techniques were used to assess the inter-tooth variation and the influence of tooth-specific factors on difficulty or perception, respectively. A huge variation in diagnostic difficulty and perception could be observed. Advanced tissue loss made diagnoses more difficult. The background colour and tissue loss were associated with perception and may hint to cues used by the raters. The use of multiple raters in a diagnostic accuracy study allows detailed investigations which make it possible to obtain further insights into the decision-making process of the raters.
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Affiliation(s)
- Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Stefan-Meier-Str. 26, D-79104 Freiburg, Germany
- Center for Dental Medicine, Department of Operative Dentistry and Periodontology, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Straße 55, D-79106 Freiburg, Germany
| | - Nadine Schlueter
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany
| | - Carolina Ganss
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology of Ageing, Philipps-University Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Werner Vach
- Basel Academy for Quality and Research in Medicine, Steinenring 6, CH-4051 Basel, Switzerland
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Agreement between two common tooth wear indices: Guidance on indications for use. J Dent 2022; 122:104126. [DOI: 10.1016/j.jdent.2022.104126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
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Lee JH, Myagmar G, Kwon HB, Han JS. A digital method for wear volume loss analysis using a single-scan three-dimensional dataset. J Dent Sci 2022; 17:638-641. [PMID: 35028110 PMCID: PMC8740104 DOI: 10.1016/j.jds.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
A straightforward digital method of evaluating wear volume loss is described. This method allows the measurement of the wear by analyzing only the three-dimensional scan dataset of the worn specimen without needing a separate baseline scan. Compared to the conventional method, involving superimposition of the two datasets scanned before and after the wear test, this method can reduce labor and accuracy errors caused by repeated scans and superimposition procedures. Further, this analysis can be conducted using free computer-aided design software, which makes it more efficient for the analysis of wear volume loss of restorative materials.
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Affiliation(s)
- Jae-Hyun Lee
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.,MAS Program of Digital Dental Technologies, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Gerelmaa Myagmar
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jung-Suk Han
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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Entezami S, Peres KG, Li H, Albarki Z, Hijazi M, Ahmed KE. Tooth wear and socioeconomic status in childhood and adulthood: Findings from a systematic review and meta-analysis of observational studies. J Dent 2021; 115:103827. [PMID: 34600044 DOI: 10.1016/j.jdent.2021.103827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To evaluate the association and level of evidence between socioeconomic status (SES) and tooth wear (TW) in children, adolescents, and adults. DATA Eligibility criteria comprised population-based observational studies assessing the association between SES and TW in permanent dentition of adolescents and adults. Interventional and descriptive studies or those without an internal comparison between exposed and nonexposed groups were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied where applicable. Risk of bias (RoB) was assessed using the Newcastle-Ottawa scale. Meta-analyses were conducted to estimate the pooled effect measures. Q-statistic, I2statistic, subgroup and sensitivity analyses assessed study heterogeneity. SOURCES PubMed/Medline, Embase, Scopus, Web of Science, LILACS, SciELO, Cochrane Library, and Google Scholar databases were searched for articles published in English between 1st January 1980 and 31st March 2021. RESULTS Sixty-five studies were included, involving 63,893 participants in over 30 countries. A positive association was found between TW and education (OR=1.25 [0.96; 1.62]), family income (OR=1.18 [0.91; 1.53]), and private school (OR= 1.24 [0.90; 1.72]) among adolescents. Higher educated adults had a lower risk for TW (OR=0.70 [0.52; 0.93]). Most included studies had a moderate RoB. Limitations relating to population representation and assessment methodologies were identified in the included studies. CONCLUSIONS SES was associated with TW with its direction depending on the individuals' age. The overall quality of evidence was moderate. CLINICAL SIGNIFICANC SES should be included as part of the routine screening and risk assessment for tooth wear.
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Affiliation(s)
- Sheema Entezami
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Karen Glazer Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore.
| | - Huihua Li
- National Dental Centre, ACP Research Office, Duke-NUS Medical School, Centre for Quantitative Medicine, Singapore.
| | - Zahra'a Albarki
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Mariam Hijazi
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Khaled E Ahmed
- School of Medicine and Dentistry, Griffith University, Gold Coast, Griffith Health Centre (G40), Office 7.59, QLD 4222, Australia.
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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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