Thomas J. Greany, DDS, is Director of Academic Technology Initiatives and Assistant Clinical Professor, Department of Restorative Dentistry, University of Colorado School of Dental Medicine, as well as Assistant Professor, Modern Human Anatomy Program, Department of Cellular and Developmental Biology, University of Colorado School of Medicine; Ala Yassin, DDS, is an MS student, Graduate Periodontics Department, University of Colorado School of Dental Medicine; and K. Chase Lewis, MS, is a DDS student, University of Colorado School of Dental Medicine.
J Dent Educ. 2019 Nov;83(11):1314-1322. doi: 10.21815/JDE.019.133. Epub 2019 Jul 22.
In Part I of this study, evidence was presented that visual inspection (VI) of dental student waxups exhibited low precision (ICC=0.332) and accuracy, resulting in questionable grade validity. VI inappropriately assesses morphology in part due to oversimplified grading rubrics and inappropriate application of ratio measurement to ordinal data. The aim of Part II of this study was to develop, apply, and compare with VI a digital assessment workflow and report the outcomes. After inclusion criteria were met, 67 (83%) student waxups were scanned with an intraoral scanner and analyzed using open source surface comparison software. Each was digitally compared to the homologous standard typodont tooth. Percentage contour variation within a stipulated tolerance was computed. The acceptable tolerance was derived from clinical literature reporting how contour deviations impact the biological and biomechanical stability of teeth and periodontium. Surface roughness of each waxup was also computed and compared with the reference teeth. A formula for digital assessment was developed and applied to each waxup. On average, digital grades exceeded the VI assessments, while correcting individual errors for greater accuracy and precision (ICC=0.866). Students were able to easily apply the digital workflow for visualization and accurate self-evaluation. In this study, a digital grading workflow was developed that used portable data formats and freely available open source analysis software, so the method could be introduced at any dental school where intraoral scanning is available.
在本研究的第一部分，有证据表明，对牙科学生蜡型的肉眼检查（VI）显示出低精度（ICC=0.332）和准确性，导致评分的有效性值得怀疑。VI 不恰当地评估形态，部分原因是简化的评分标准和对顺序数据的不恰当的比率测量的应用。本研究第二部分的目的是开发、应用一种数字评估工作流程，并与 VI 进行比较，并报告结果。符合纳入标准后，用口腔内扫描仪对 67 个（83%）学生蜡型进行扫描，并使用开源表面比较软件进行分析。每个蜡型都与同源标准模型牙进行数字比较。规定容差内的轮廓变化百分比被计算出来。可接受的公差是从临床文献中得出的，报告了轮廓偏差如何影响牙齿和牙周组织的生物和生物力学稳定性。还计算了每个蜡型的表面粗糙度并与参考牙齿进行了比较。开发了一个数字评估公式并应用于每个蜡型。平均而言，数字等级超过了 VI 评估，同时纠正了个别错误以提高准确性和精度（ICC=0.866）。学生能够轻松地应用数字工作流程进行可视化和准确的自我评估。在本研究中，开发了一种数字评分工作流程，该流程使用便携式数据格式和免费的开源分析软件，因此可以在任何可以进行口腔内扫描的牙科学校中引入该方法。
