Background: In dentistry, digitization of dental arches with intraoral scanners could one day replace impressions and plaster model digitization processes, if accuracy is clinically sufficient. This study aimed to assess the reliability, validity and conformity of an intraoral scanning procedure (Lythos©, Ormco) and of two extraoral digitization workflows via alginate impression and plaster model scanning with the D810© (3shape) or the Atos II Triple Scan© (GOM) under clinical conditions.
Methods: In 20 subjects three consecutive intraoral scans, three alginate and one reference polyether impression were taken of both the upper and lower dental arch, respectively. The digital models created from the corresponding plaster models and the intraoral scans were superimposed with the polyether reference standard by both a global and a local best-fit algorithm. Reliability, validity and conformity of the three digital workflows were assessed via intraclass (ICC) and Lin's concordance correlation coefficients (CCC) as well as analyses according to Bland-Altman.
Results: The digital models created from the intraoral scanning procedure were less in agreement with the polyether reference (validity) than those from the extraoral procedures with reduced conformity and reliability. Local numerical deviations from the reference standard were approximately twice as high compared to the extraoral procedures, which showed high conformity and were equivalent and clinically acceptable in terms of reliability and validity.
Conclusions: Although the intraoral scanning method with Lythos© seems to have drawbacks in terms of reliability, validity and conformity to the indirect alginate methods, all procedures proved to be clinically equivalent for diagnostic purposes.
Keywords: Diagnostic accuracy; Digital dental models; Digitization; Method reliability; Orthodontics; Scanning.
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