In vivo prospective randomised study of the wear of dental restorations using an intraoral scanner and its correlation with visual assessment.

Abstract

Objectives

To evaluate the efficacy of the True Definition® intraoral scanner in quantifying the wear of glass ionomer restorative materials (Ketac^TM Universal and Ketac^TM Molar) over 1 year. We also studied the correlation between visual and digital assessments of restoration wear.

Methods

This was a clinical follow-up study of a post-marketed material with a prospective, controlled, randomised, split-mouth, and blinded assessment design. Intraoral optical impression and visual assessment were carried out over three appointments over 12 months, starting with 36 patients.

Results

According to the visual indices, all restorations in this study were clinically healthy. However, in the digital measurement of wear, 94.74% and 94.44% of the restorations during the T0-T6 and T6-T12 observation periods, respectively, showed deterioration greater than 41 microns. Moreover, in the analysis of agreement between measurement techniques, no agreement was obtained in the two analysed time periods: T0-T6 yielded a kappa (k) value of 0.000, and T6-T12 yielded $k=0.0030$. Discordant results were obtained in the correlation analysis. In T0-T6, the results were not considered statistically significant ($p=0.838$); however, the results obtained during T6-T12 showed a correlation ($p$-value $<0.001$).

Conclusions

The wear of dental materials as observed by the human eye did not agree with that observed by intraoral scanning. The scanner effectively measures wear, detecting details that are beyond the capability of the human eye and conventional photographs. The surface deterioration of the restorations at both observation times can be considered non-physiological, potentially leading to premature occlusal alterations and accelerated physiological ageing.

Clinical Relevance

Early diagnosis is crucial for avoiding alterations in the function of the stomatognathic system due to the wear of dental restorations. Additionally, since most of the tools applied are qualitative in nature, such as visual inspection, it is essential to find a standardised and precise tool that offers diagnosis, monitoring, and records of the evolution of tooth wear. This study has been registered at https://www.ClinicalTrials.gov, under the identifier NCT06275581.