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Comparing effectiveness of intraoral scanner in caries detection
Alruwaili, Mohand
Alruwaili, Mohand
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Thesis/Dissertation
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2025-05
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Oral Biology
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https://doi.org/10.34944/v279-sx52
Abstract
Background: Dental caries is the most common oral health conditions globally, necessitating the development of a diagnostic tool which is most accurate and reliable diagnostic for timely detection and intervention. Traditional diagnostic methods like visual checks and X-rays are not always the most reliable. They can miss details, give false positives, or vary depending on who is interpreting them. That is where digital intraoral scanners (IOS) come in. These scanners offer high-resolution imaging and real-time analysis, making them a promising tool for spotting cavities more accurately. However, concerns regarding their diagnostic accuracy, specificity, and agreement with traditional methods remain under investigation. This study evaluates the performance of the TRIOS 5 intraoral scanner in detecting carious lesions compared to examiner-based assessments and radiographic findings.
Objectives: The primary objective of this study was to assess how accurately the TRIOS 5 intraoral scanner can detect cavities. It also compared the scanner’s sensitivity and specificity to traditional examiner-based assessments and X-rays, which served as the gold standard. Another key objective was to evaluate inter-examiner variability in caries detection and determine the level of agreement between different diagnostic modalities.
Methods: A comparative diagnostic accuracy study designed to assess the performance of the TRIOS 5 intraoral scanner in detecting dental caries. A total of 21 patients were evaluated using three diagnostic modalities: visual-tactile examination by independent examiner, TRIOS 5 intraoral scanner assessment, and radiographic evaluation. Each patient underwent an examination by two calibrated clinicians, followed by scanning with the TRIOS 5 intraoral scanner. The radiographic findings were used as the gold standard to determine the accuracy of the other methods.
Statistical analysis was performed to compare the diagnostic modalities. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the performance of each method. Cohen’s Kappa test was applied to measure agreement between the TRIOS 5 scanner and radiographic findings. McNemar’s test was conducted to assess the significance of discordant diagnoses between the scanner and radiographic findings.
Results: The TRIOS 5 intraoral scanner had a high sensitivity of 89.4%, meaning it was very effective at detecting actual caries. However, its specificity was considerably low at 26.4%, leading to a significant number of false-positive results. The positive predictive value (PPV) was 31.1%, indicating that only 31.1% of caries cases detected by the scanner were truly present. The negative predictive value (NPV) was 87.0%, demonstrating high reliability in correctly identifying non-caries cases. The agreement analysis showed poor concordance between the TRIOS 5 scanner and radiographic findings, with Cohen’s Kappa score of 0.100, indicating substantial discrepancies in diagnostic outcomes. McNemar’s test revealed a statistically significant difference (p = 4.648) between the scanner and radiographic findings, suggesting that the scanner tends to over-diagnose caries.
Conclusion: The TRIOS 5 intraoral scanner can be a useful tool for improving cavity detection. Its high sensitivity but low specificity means it works best when combined with traditional diagnostic methods for more accurate results. More research is needed to create standardized protocols that ensure consistent diagnoses.
Clinical Implications: The TRIOS 5 intraoral scanner could be a helpful tool for early cavity detection, but radiographs are still necessary to avoid overtreatment. Future improvements in AI-driven diagnostic algorithms might boost the scanner’s accuracy and clinical usefulness. Standardized training and calibration for clinicians could also help reduce subjectivity in visual exams, leading to more consistent and reliable diagnoses.
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