Remote assessment of dental records by using intraoral scan-based digital 3D models in an elderly patient population: an exploratory study

Aim: To assess the agreement rates of dental records derived from intraoral scan-based digital 3D models (3DM) and 3DM plus panoramic radiographs (3DM+PAN-X) compared with clinical findings.
Materials and methods: Based on the 3DM/3DM+PAN-X of 50 patients undergoing supportive periodontal therapy (SPT), 10 remote raters (inexperienced in using intraoral scanners [IOSs] or 3DM) assessed for each site of the dental scheme (32 sites) whether a tooth was missing (M), filled (F), restoration- and caries-free (H), replaced by an implant (I), or decayed (D). Remote records were compared with the clinical reference record of each patient at tooth level. The clinical records were assessed by an experienced dentist who supplemented the clinical findings with information from available radiographs and the patient records to define the clinical reference record.
Results: The agreement rates for 3DM/3DM+PAN-X at tooth level were: M: 93%/94%, F: 84%/88%, H: 92%/92%, I: 65%/96%, D: 29%/29%. The overall agreement rate (odds ratio [OR]) was 88% for the 3DM-based dental records (14,093 of 16,000 entries true), and 91% for 3DM+PAN-X (14,499 of 16,000 entries true). Using 3DM for dental record assessment, posterior teeth had higher odds of correct findings compared with anterior teeth (maxillary jaw OR = 2.34, mandibular jaw OR = 1.27).
Conclusions: The remote detection of healthy, missing, and filled teeth as well as implants by raters inexperienced in using IOSs or 3DM showed a high agreement rate with the clinical findings. The additional evaluation of PAN-X increased the agreement rate significantly for implants. Thus, the remote assessment of dental records using 3DM+PAN-X had a high accuracy when applied in SPT patients with low caries activity.