Evaluation of Digital Scanning to Quantify Tooth Wear

Objectives: Review of the literature on indices for tooth wear is confusing. There is not one ideal standardized index that can be used for epidemiological prevalence studies, clinical staging, and monitoring. Digital scanning for prosthodontic procedures is becoming popular. It is proposed that dentists can utilize digital scanning as a recording tool to keep tooth wear records and educate patients.

Objective: To investigate the use of an intraoral scanner (IOS) with installed alignment software to record potential erosive tooth wear objectively and accurately.
Methods: We tested the hypothesis using a bovine tooth set up we employed in a bleaching study. A Trios3 scanner (3SHAPE, Denmark) with 3SHAPE Unite software was used initially to record digital images of 13 (one control) bovine teeth prior to immersion into six different staining mediums. After staining, the teeth were immersed into two different bleaching agents with some time variation. After 14 days the IOS with the Patient Monitoring System (PMS) with a color map tool was used to evaluate any changes in depth (mm). Changes in color occurred if the change in depth was greater than 0.1mm.
Results: After 14 days 8 of the 13 teeth recorded a greater than 0.1 mm tooth structure loss of depth. This was recorded by a color change. This installed software does not record area or volume changes.
Conclusions: The installed PMS software was accurate in recording the location of depth loss > 0.1mm. The real key to improving the capabilities for the PMS software lies in the alignment to reduce human error. To measure additional parameters such as volume and area, independent software such as WearCompare (Leeds Digital Dentistry) with improved alignment system needs to be installed. Also, small changes within the enamel cannot be detected unless the sensitivity of the software is increased beyond 0.1mm.