Centre for Clinical, Oral and Translational Sciences, King's College London, London, United Kingdom.
University of Leeds, Leeds, United Kingdom.
J Med Internet Res. 2020 Nov 27;22(11):e17150. doi: 10.2196/17150.
Three-dimensional scans are increasingly used to quantify biological topographical changes and clinical health outcomes. Traditionally, the use of 3D scans has been limited to specialized centers owing to the high cost of the scanning equipment and the necessity for complex analysis software. Technological advances have made cheaper, more accessible methods of data capture and analysis available in the field of dentistry, potentially facilitating a primary care system to quantify disease progression. However, this system has yet to be compared with previous high-precision methods in university hospital settings.
The aim of this study was to compare a dental primary care method of data capture (intraoral scanner) with a precision hospital-based method (laser profilometer) in addition to comparing open source and commercial software available for data analysis.
Longitudinal dental wear data from 30 patients were analyzed using a two-factor factorial experimental design. Bimaxillary intraoral digital scans (TrueDefinition, 3M, UK) and conventional silicone impressions, poured in type-4 dental stone, were made at both baseline and follow-up appointments (mean 36 months, SD 10.9). Stone models were scanned using precision laser profilometry (Taicaan, Southampton, UK). Three-dimensional changes in both forms of digital scans of the first molars (n=76) were quantitatively analyzed using the engineering software Geomagic Control (3D Systems, Germany) and freeware WearCompare (Leeds Digital Dentistry, UK). Volume change (mm) was the primary measurement outcome. The maximum point loss (μm) and the average profile loss (μm) were also recorded. Data were paired and skewed, and were therefore compared using Wilcoxon signed-rank tests with Bonferroni correction.
The median (IQR) volume change for Geomagic using profilometry and using the intraoral scan was -0.37 mm (-3.75-2.30) and +0.51 mm (-2.17-4.26), respectively (P<.001). Using WearCompare, the median (IQR) volume change for profilometry and intraoral scanning was -1.21 mm (-3.48-0.56) and -0.39 mm (-3.96-2.76), respectively (P=.04). WearCompare detected significantly greater volume loss than Geomagic regardless of scanner type. No differences were observed between groups with respect to the maximum point loss or average profile loss.
As expected, the method of data capture, software used, and measurement metric all significantly influenced the measurement outcome. However, when appropriate analysis was used, the primary care system was able to quantify the degree of change and can be recommended depending on the accuracy needed to diagnose a condition. Lower-resolution scanners may underestimate complex changes when measuring at the micron level.
三维扫描越来越多地用于量化生物地形变化和临床健康结果。传统上，由于扫描设备成本高和需要复杂的分析软件，3D 扫描的使用仅限于专业中心。技术进步使牙科领域更便宜、更易于访问的数据捕获和分析方法成为可能，这可能促进了一种用于量化疾病进展的初级保健系统。然而，与大学医院环境中以前的高精度方法相比，这种系统尚未得到比较。
本研究的目的是比较一种牙科初级保健数据采集方法（口腔内扫描仪）与一种基于医院的精密方法（激光轮廓仪），并比较可用于数据分析的开源和商业软件。
使用两因素析因实验设计分析 30 名患者的纵向牙磨损数据。在基线和随访预约时（平均 36 个月，SD 10.9）分别制作双侧口腔内数字扫描（TrueDefinition，3M，英国）和常规硅橡胶印模，注入 4 型牙科石膏。使用精密激光轮廓仪（Taicaan，南安普敦，英国）扫描石膏模型。使用工程软件 Geomagic Control（3D Systems，德国）和免费软件 WearCompare（Leeds Digital Dentistry，英国）对第一磨牙的两种数字扫描形式的三维变化进行定量分析。（n=76）。主要测量结果为体积变化（mm）。还记录了最大点损失（μm）和平均轮廓损失（μm）。数据是配对的和偏态的，因此使用 Wilcoxon 符号秩检验和 Bonferroni 校正进行比较。
Geomagic 使用轮廓测量法和口腔内扫描的中位数（IQR）体积变化分别为-0.37 毫米（-3.75-2.30）和+0.51 毫米（-2.17-4.26）（P<.001）。使用 WearCompare，轮廓测量法和口腔内扫描的中位数（IQR）体积变化分别为-1.21 毫米（-3.48-0.56）和-0.39 毫米（-3.96-2.76）（P=.04）。无论扫描类型如何，WearCompare 检测到的体积损失都明显大于 Geomagic。在最大点损失或平均轮廓损失方面，各组之间没有差异。
正如预期的那样，数据采集方法、使用的软件和测量指标都对测量结果有显著影响。然而，当使用适当的分析方法时，初级保健系统能够量化变化程度，并根据诊断病情所需的准确性进行推荐。当以微米级测量时，较低分辨率的扫描仪可能会低估复杂的变化。
