A Comparison of Orthodontic Intraoral Scan Results Between Staff and Volunteers
Creators: name: Lee, Andrew
Publisher: name: University of Nevada, Las Vegas
Year: 2020
Subjects: subject: Dentistry
subject: FOS: Clinical medicine
subject: FOS: Clinical medicine

description: Objective: This pilot study is the first to assess and compare a trained staffs intraoral scan to a clinical examination by comparing the overbite, overjet, Angle canine and molar classification, and gingival health. The second part of this study is to determine if the self-scan scan from a patient is as reliable to the staffs scan. Introduction: Orthodontic treatment is usually provided over a sequence of appointments. During each appointment, the doctor clinically evaluates the patient, analyzes the progress and provides adjustments to continue with the treatment. The most common clinical criteria evaluated are overbite, overjet, upper and lower midlines, canine and molar classification, spaces or the lack of spaces, compliance, emergencies and both soft and hard tissue health. The rise of powerful, accurate and easy-to-use imaging technologies such as intraoral scanners and personal monitoring devices is changing the landscape of orthodontic practice. This study focused on the potential for impact of intraoral scanners, which have been proven to have clinical reproducibility and validity. In this context, if intraoral scans can provide enough information as to replace a visual clinical exam, then the impact on orthodontic practice would be vast. A reliable scan would give the orthodontist a full 360-degree model of a patients intraoral cavity, allowing the provider to pre-analyze the patient stage, and postpone adjustment visits if the patient is not ready for them. The clinician could also be prepared with a full list of all adjustments necessary and armamentarium to deliver the most efficient adjustments at the precise timely following visit. This could save the clinician and treatment duration a lot of time and make his or her practice more efficient. Additional aspects are to find new ways to improve the patient experience and to make orthodontic practice more pleasant and less time-consuming for patients. This study analyzed if there are ways to harness the power of intraoral scanners technologies to allow patients to self-scan themselves accurately enough to portray the information gathered from a routine orthodontic visit or prior to the visit. This would facilitate the possibility of orthodontic teledentistry and dental monitoring and allow for orthodontic treatment to be delivered in rural and restricted areas. Materials and Methods: Volunteers (n=39) from the University of Nevada Las Vegas School of Dental Medicine who were first time intraoral scanner users participated in this study. This group included: patients that were seeking treatment, currently receiving treatment or that had finished treatment. The volunteers age, gender, current treatment phase, Angle molar and canine classification (I, II, III), overbite (mm), overjet (mm), and gingival health (good, fair, poor) were recorded. Step-by-step instructions to perform intraoral scanning and a 7-minute-long 3Shape Trios intraoral scanner video tutorial were shown to the volunteer. After answering any remaining questions, subjects were seated in front of the intraoral scanner so they could see the scanning computers monitor while performing a self-scan. The volunteers were allowed to finish, restart or abandon their self-scan any time they wished. The STL files from both the staffs and the volunteers were imported in the Trios software to measure and note OB, OJ, canine and molar Angle classification, and gingival health. Then the STL files were imported into 3D inspection and metrology software (Geomagic Control 2017; Geomagic, North Carolina, USA) where the volunteers scans were compared to the trained staffs scans by tridimensional superimpositions. A discrepancy of over 0.5mm anywhere within the two scans was deemed to be clinically unacceptable. Results: The mean average difference between OB exam and OB scan was 0.26mm and for OJ exam and OJ scan 0.11mm. These mean averages were statistically equivalent. The Angle canine and molar classification, and the gingival health results were equivalent between the clinical exam and the staffs scan. For the second part, 34/39 volunteers finished both upper and lower scans to the best of their capabilities. 23/39 volunteers self-scanned themselves at the time of when fixed appliances or clear aligners were terminated, 15/39 volunteers were at the time of records and 1/39 volunteer while it was in treatment. 12/39 volunteers produced clinically acceptable self-scans. Conclusion: The intraoral scan provided the equivalent data as the clinical exam when evaluating OB, OJ, Angle canine and molar classification, and gingival health. In the second part of the study, a 12/39 volunteers provided clinically acceptable first-time self-scans.