JMIR Publications

ABSTRACT

Background:

Intraoral Scanners are devices used for creating 3D models of teeth in dentistry. Integrating fluorescence technology into some intraoral scanner hardware can support early caries detection. The performance of on-screen assessment of 3D models for caries detection in primary teeth has yet to be established. Whether these methods could replace visual examination (VE) for caries data collection in epidemiological research involving children is unknown.

Objective:

This study aims to compare the diagnostic agreement between VE, on-screen assessment of 3D models in approximate natural colours with and without fluorescence and application of an automated caries scoring system for caries detection in primary teeth.

Methods:

The study sample will be drawn from eligible participants in a randomised controlled trial at the Royal Children’s Hospital, Melbourne, Australia, specifically from the 219 children remaining at follow-up at five years of age, where a dental assessment was conducted, including VE using the International Caries Detection and Assessment System (ICDAS) index and intraoral scan using the TRIOS 4 (3Shape TRIOS A/S, Copenhagen, Denmark). Their clinical records will be collected, and all records meeting eligibility criteria will be subject to an on-screen assessment of 3D models by multiple dental practitioners. First, all primary tooth surfaces will be examined for caries based on 3D geometry and colour, using a merged ICDAS index. Second, the on-screen assessment of 3D models will include fluorescence, where caries will be classified using a modified, merged ICDAS index. This process will be replicated after four weeks. Finally, an automated caries scoring system will be used to classify caries on primary occlusal surfaces.

Results:

The agreement in the total number of caries detected per person between methods will be assessed using a Bland-Altman analysis. Agreement between methods in detecting caries at a tooth surface level will be assessed using generalised estimating equations accounting for the clustering of dental data.

Conclusions:

The study results will inform whether 3D models can be used interchangeably with VE for detecting and classifying dental caries. The outcomes will impact how intraoral scanners are recommended for caries data collection in epidemiological research settings. Clinical Trial: This protocol has registration with the Australian New Zealand Clinical Trials Registry (ANZCTR). Registration number: ACTRN12622001237774p