Basel Kharbot, Maike Riegel, Falk Schwendicke, Sebastian Paris, Gerd Göstemeyer
{"title":"Accuracy and Reliability of Intraoral 3D Scans for Diagnostic Evaluations in Nursing Home Residents.","authors":"Basel Kharbot, Maike Riegel, Falk Schwendicke, Sebastian Paris, Gerd Göstemeyer","doi":"10.1111/ger.12817","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the accuracy and reliability of intraoral 3D scans for assessing the oral health of older patients living in nursing homes.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Scans were suitable for basic diagnostic evaluations but showed considerable shortcomings in detecting caries and poor oral hygiene. Assessing scans was relatively reliable.</p><p><strong>Clinical relevance: </strong>Using scans may allow telemedical assessments of nursing home residents, but users should be aware of the differential accuracy for different diagnostic targets.</p>","PeriodicalId":12583,"journal":{"name":"Gerodontology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gerodontology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ger.12817","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
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.
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.