Accuracy and Reliability of Intraoral 3D Scans for Diagnostic Evaluations in Nursing Home Residents.

IF 2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Gerodontology Pub Date : 2025-03-31 DOI:10.1111/ger.12817
Basel Kharbot, Maike Riegel, Falk Schwendicke, Sebastian Paris, Gerd Göstemeyer
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引用次数: 0

Abstract

Objectives: To evaluate the accuracy and reliability of intraoral 3D scans for assessing the oral health of older patients living in nursing homes.

Materials and methods: One examiner recorded missing teeth, restorations, caries lesions and oral hygiene (Geriatric-Debris-Index Simplified [GDI-S] ≥ 1.9) in nursing home residents using visual-tactile diagnostics (reference test) and afterwards obtained intraoral scans with an intraoral scanner (TRIOS 4, 3Shape). Two other independent investigators and the clinical examiner assessed only the scans to delineate the same diagnostic outcomes. For these outcomes, we assessed accuracy, sensitivity, specificity and the Area-under-the-Receiver-Operating-Characteristics Curve (AUROC). Kappa values (κ) were calculated to evaluate inter-examiner and intra-examiner reliability after re-examination by all examiners after a minimum interval of 3 weeks.

Results: Forty-three partially dentate patients (65-95 years of age) in need of care living in four nursing homes with a total of 486 teeth (mean [SD]: 11 [9] teeth per patient) were examined. Scans were perfectly accurate for detecting missing teeth (AUROC [sensitivity/specificity]: 1 [1/1]) and showed high accuracy for detecting restorations (0.96 [0.93/0.98]), too. Accuracy was lower to detect caries (0.77 [0.58/0.97]) and insufficient for oral hygiene (0.76 [0.54/0.99]). Agreement between examiners was perfect for missing teeth (κ: 1), very good for the detection of restorations (0.94), and good for caries or insufficient oral hygiene (0.73 and 0.72, respectively).

Conclusions: Scans were suitable for basic diagnostic evaluations but showed considerable shortcomings in detecting caries and poor oral hygiene. Assessing scans was relatively reliable.

Clinical relevance: Using scans may allow telemedical assessments of nursing home residents, but users should be aware of the differential accuracy for different diagnostic targets.

口腔内3D扫描在疗养院居民诊断评估中的准确性和可靠性。
目的:评价口腔内三维扫描评估老年人口腔健康状况的准确性和可靠性。材料和方法:一名检查员使用视觉触觉诊断(参考测试)记录养老院居民缺牙、修复体、龋齿病变和口腔卫生(Geriatric-Debris-Index Simplified [GDI-S]≥1.9),然后使用口腔内扫描仪(TRIOS 4,3shape)进行口腔内扫描。另外两名独立调查人员和临床检查人员仅评估扫描结果来描述相同的诊断结果。对于这些结果,我们评估了准确性、敏感性、特异性和接受者工作特征曲线下面积(AUROC)。计算Kappa值(κ),以评估所有审查员在至少间隔3周后重新检查后审查员之间和审查员内部的信度。结果:共检查了43例居住在4家养老院的部分有牙患者(65 ~ 95岁),共检查了486颗牙齿(平均[SD]: 11[9]颗)。扫描对缺失牙的检测准确率非常高(AUROC[灵敏度/特异性]:1[1/1]),对修复体的检测准确率也很高(0.96[0.93/0.98])。龋齿检测正确率较低(0.77[0.58/0.97]),口腔卫生检测正确率较低(0.76[0.54/0.99])。检查员对缺失牙齿的一致性非常好(κ: 1),对修复体的检测非常好(0.94),对龋齿或口腔卫生不足的检测很好(分别为0.73和0.72)。结论:扫描可用于基本的诊断评价,但在发现龋齿和口腔卫生不良方面存在较大缺陷。评估扫描结果相对可靠。临床相关性:使用扫描可能允许对养老院居民进行远程医疗评估,但用户应该意识到不同诊断目标的不同准确性。
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来源期刊
Gerodontology
Gerodontology 医学-老年医学
CiteScore
4.10
自引率
10.00%
发文量
50
审稿时长
3-6 weeks
期刊介绍: The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.
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