Digital plaque monitoring: An evaluation of different intraoral scanners

Katja Jung; Katja Giese-Kraft; Maximiliane Amelie Schlenz; Bernd Wöstmann; Carolina Ganss

doi:10.1016/j.jdent.2024.104978

Digital plaque monitoring: An evaluation of different intraoral scanners

J Dent. 2024 Mar 29:145:104978. doi: 10.1016/j.jdent.2024.104978. Online ahead of print.

Authors

Katja Jung¹, Katja Giese-Kraft², Maximiliane Amelie Schlenz³, Bernd Wöstmann³, Carolina Ganss⁴

Affiliations

¹ Department of Operative Dentistry, Endodontics, and Paediatric Dentistry, Section of Cariology, Medical Centre of Dentistry, Philipps-University Marburg, Marburg, Germany. Electronic address: Katja.jung@uni-marburg.de.
² Department of Restorative Dentistry and Endodontology, Dental Clinic, Justus-Liebig-University Giessen, Giessen, Germany.
³ Department of Prosthodontics, Dental Clinic, Justus-Liebig-University Giessen, Giessen, Germany.
⁴ Department of Operative Dentistry, Endodontics, and Paediatric Dentistry, Section of Cariology, Medical Centre of Dentistry, Philipps-University Marburg, Marburg, Germany.

PMID: 38556195
DOI: 10.1016/j.jdent.2024.104978

Abstract

Objectives: Intraoral scanners (IOS) display disclosed plaque, and the scientific literature has reported that plaque levels can be monitored on intraoral scans using one IOS system (Dexis 3800; control IOS). This study aimed to investigate whether this is also possible with other IOS systems (i700, Primescan, Trios 5; test IOS).

Materials and methods: Ten participants (29.6 ± 5.5 years) were enrolled. After plaque accumulation and subsequent toothbrushing, intraoral scans were performed with the control IOS and the three test IOS. All scans were aligned and the vestibular/oral surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed with automated planimetry using a predefined threshold value. The proportion of pixels assigned to plaque-covered areas was expressed as a percentage of the total number of pixels (P%). We then assessed whether the planimetrically determined plaque-covered areas corresponded to those identified visually. This revealed that a threshold correction (P%_corr) was required for approximately 20 % (i700 and Trios 5) to over 65 % (Primescan) of the images.

Results: Bland-Altman analysis showed no significant systematic bias and limits of agreement ranging from approximately -20 to +20 P% units, with a tendency towards lower values at higher plaque coverage. Manual correction improved the agreement and halved the limits of agreement. All test IOS could detect a reduction in plaque after brushing, as well as the typical site-dependant plaque distribution patterns.

Conclusions: All test IOS appeared to be suitable for plaque monitoring. Planimetric methods must be adapted to the colour representation of the IOS.

Clinical significance: Plaque monitoring using IOS opens a new field of application in preventive dentistry.

Keywords: Biofilm; Dental plaque; Intraoral scanner; Monitoring; Planimetry; Preventive dentistry.