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Study finds intra-oral scanner viable alternative to visual clinical evaluation in detecting caries

A recent study has indicated that the use of an intra-oral scanner for caries detection can be just as effective as standard visual clinical evaluation. (Image: vetkit/Shutterstock)

ATHENS, Greece/COPENHAGEN, Denmark: There has been very little research done to compare the efficacy of intra-oral scanners with that of visual examinations in detecting dental caries. By comparing the two methodologies in detecting and classifying occlusal caries, researchers have now determined that use of a 3D intra-oral scanner is as valuable as a visual clinical inspection and can be particularly useful for remote assessment and research.

The primary findings noted that, by using an intra-oral scanner, clinicians can avoid the common pitfalls that come with visual examination and associated 2D dental photographs. Standard dental photographs can be significantly affected by lack of suitable lighting and magnification and also by the angle at which an image is taken. Further obstacles to detecting occlusal caries can include non-carious lesions, excessive saliva and dental plaque. Extensive travel can be required to reach certain patient populations, and this can make it difficult for clinicians to conduct adequate oral examinations.

The researchers used both methodologies to evaluate three surfaces on more than 50 permanent posterior teeth pre-and post-extraction. Prior to extraction, each tooth underwent plaque removal and was evaluated in a standard visual clinical examination in addition to intra-oral scanning. Six months later, the models were evaluated for colour and fluorescence and given a histological score evaluating enamel and dentine demineralisation in relation to thickness. There were no significant differences observed between the caries detection capabilities of the two methodologies.

The researchers suggest that a lack of existing literature is to blame for the hesitancy of some clinicians to adopt an intra-oral scanner for use in detecting caries. They also noted the value of further investigation into additional methods of caries detection using an intra-oral scanner including fluorescence using blue light excitation for early enamel demineralisation and caries detection, transillumination, and near-infrared reflectance.

It was also suggested that intra-oral scanners provide consulting clinicians with easily transferable data useful for comparison and that, therefore, they prove a viable alternative to standard visual evaluation, particularly for clinicians with harder-to-reach patient populations.

The study, titled “Occlusal caries detection on 3D models obtained with an intraoral scanner. A validation study”, was published in the April 2023 issue of the Journal of Dentistry.

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