Department of Conservative and Preventive Dentistry, Justus Liebig University Giessen, Giessen, Germany,
Department of Conservative and Preventive Dentistry, Justus Liebig University Giessen, Giessen, Germany.
Caries Res. 2021;55(3):215-224. doi: 10.1159/000514666. Epub 2021 Mar 22.
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.
口腔内扫描仪 (IOS) 已被用于量化牙齿磨损，但迄今为止，它们尚未被系统地验证用于监测组织损失。本体外研究的目的是探讨 IOS 是否可用于检测组织损失的进展，以及 IOS 值是否与作为标准方法的非接触式轮廓测量 (PRO) 相符。模型颌被安装在牙科椅上的幻影头中。在第一磨牙的非承重尖上制备扁平区域（模型牙；n = 16），以便用实验区域和参考区域固定平的釉质样本。在基线 PRO 和 IOS 后，实验釉质区域用 35% H3PO4 凝胶逐步蚀刻（4×30 s 和 4×15 s）。每次蚀刻后，进行 PRO 和 IOS，并测量参考区和实验区之间的垂直组织损失，每次均在 3 个相同的测量点进行。此外，通过用球形钻石车逐步制备模型牙的承重尖来模拟杯状尖，并且仅通过 IOS 测量每次制备步骤后的最大垂直深度。Trios3（3Shape，丹麦）、Carestream CS3600（Carestream，美国）和光学轮廓仪（MicroProf，Fries，德国）用于测量釉质样本的扁平区域，而仅 IOS 用于测量模型牙承重杯状尖的曲面。使用外部软件（GOM Inspect，德国）和各自的内部 IOS 软件分析 IOS 数据。PRO 显示，在 30 s 蚀刻步骤后，组织损失的平均值（±SD）为 17.1 ± 4.7 µm，在 15 s 蚀刻步骤后为 10.1 ± 5.1 µm。IOS 和软件类型能够在每次蚀刻步骤后检测到组织损失的进展（每次 p≤0.001）；Bland-Altman 图显示与 PRO 具有良好的一致性，无论组织损失的顺序如何，均未发现系统差异。所有 IOS 都检测到杯状病变深度的增加，IOS 与分析方法之间无显著差异。IOS 能够在模拟临床条件下检测到少量的组织损失，并且似乎是监测甚至初始侵蚀性牙齿磨损的有前途的工具。
