Abstract
Aims: To assess the usability of 3D models in erosive tooth wear assessment and the use of the Basic Erosive Wear Examination (BEWE) on 3D models.
Methods: In 2012-2013, a total of 1,962 members, (62%) of all those invited from the Northern Finland Birth Cohort 1966, accepted to participate in a standardized clinical dental examination including the Basic Erosive Wear Examination (BEWE) and dental 3D modelling in the Oulu dental clinic. Of those examined, 600 (31%) were randomly selected for this study. Selected 3D models were analyzed using the same BEWE criteria as in the clinical examination. Kappa values and the prevalence and severity of erosive wear, according to the clinical examination and 3D models, were compared. To calculate intra- and inter-method and -examiner agreements, re-examinations were performed. The Ethical Committee of the Northern Ostrobothnia Hospital District approved the study.
Results: The 3D models were straightforward to use and sensitive, especially with respect to finding those in need of treatment. Erosive tooth wear was assessed as more severe in 3D models than in the clinical examination. The use of the BEWE index on 3D models was reproducible and easy to adapt; the mean intra- and inter- examiner agreement Kappa values were both 0.9 for sextant level, and 0.6 and 1, respectively, for BEWE sum scores. Inter-method agreement was 0.4 for severe erosive wear (BEWE sum>8).
Conclusions: The assessment of erosive wear clinically and on 3D models is not entirely comparable due to highly detailed nature of 3D models. The BEWE index seems to be suitable and reproducible in the assessment of erosive wear on 3D models. The use of 3D models could offer an advantage in the assessment of erosive tooth wear compared with a clinical examination alone.
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