Crown preparations by undergraduate dental students: A comparison of conventional versus digital assessment via an intraoral scanner

Abstract

This study aims to assess the effectiveness of the 3Shape TRIOS intraoral scanner (IOS) in student crown preparation evaluation. Design: Students were tasked to perform a full metal crown preparation on the upper left first molar on a patient simulator within 45 minutes. Marginal Width, Occlusal Reduction, Presence of Undercuts, Taper, Planes of Reduction, Line Angles, Conformity to Gingival Contour, and Smoothness were evaluated via 3 assessment modes: (a) Conventional assessment by 2 supervisors; (b) Conventional assessment by students; (c) Digital assessment by students. Agreement between assessment modes was investigated using Kappa (κ), with a threshold set at κ > 0.4. Effectiveness of IOS for objective parameters was determined via physical verification, while that for subjective parameters was defined by agreement with the stricter supervisor grade. Results: Substantial agreement (κ = 0.631) was found between IOS measurement of Marginal Width and physical verification. Two of 5 subjective parameters met κ > 0.4 for agreement between IOS and the stricter supervisor grade. Agreement between supervisors ranged from slight (κ = 0.103) for Occlusal Reduction to Fair (κ = 0.399) for Marginal Width. Agreement between conventional assessments of supervisors and students ranged from less than chance (κ = −0.142) for Occlusal Reduction to moderate (κ = 0.577) for Line Angles. Agreement between conventional assessments of supervisors and digital assessments of students ranged from slight (κ = 0.130) for Planes of Reduction to moderate (κ = 0.538) for Line Angles. Conclusions: IOS may be used to overcome limitations in conventional assessment of objective parameters and some subjective parameters. Digital assessment of crown preparations cannot completely replace conventional assessment.

Re‐defining the virtual reality dental simulator: Demonstrating concurrent validity of clinically relevant assessment and feedback

“…This finding is in agreement with the IRR scores per cavity feature and, anecdotally with the authors’ experience, that depth and undercut appear to be the most challenging of the criteria to reliably assess. The finding is also in keeping with Seet et al 36 who reported that less obvious features of crown preparations (such as occlusal reduction) resulted in lower inter‐rater agreement than features that were more easily assessed (such as marginal width). Here, the kappa values reported for IRR were significantly lower, ranging from κ = 0.103 (slight agreement) to κ = 0.399 (fair agreement).…”

“…Whilst calibration of assessors may have led to an increased IRR across all of the exercises and cavity features, the authors felt that calibration for a routine operative dental exercise (assessed against standardised features) would not be representative of a routine assessment of operative skills. Furthermore, a degree of variance is expected between clinical teachers even when assessing preparations against objective criteria, and this phenomenon is reported by Seet et al 36 . As such, we expected that obtaining high levels of agreement between the clinicians and the VR simulator would be challenging.…”

3D Digital technology as an alternative educational tool in preclinical dentistry

“…These results may allow us to consider implementing digital assessment in preclinical operative education without compromising quality of education. Previous studies have also shown promising results of digital assessment compared with conventional assessment as a more accurate evaluation tool 13,19‐22 . Callan et al demonstrated that CAD/CAM presented a high level of precision to analyse the tooth preparations 23 .…”

“…Previous studies have also shown promising results of digital assessment compared with conventional assessment as a more accurate evaluation tool. 13,[19][20][21][22] Callan et al demonstrated that CAD/CAM presented a high level of precision to analyse the tooth preparations. 23 Similarly, other studies showed that CAD/CAM precision was comparable to, 24 or even greater 9,25 than the conventional assessment performed by faculty members.…”

Immersive 3D Educational Contents: A Technical Note for Dental Educators

“…A large number of other applications based on IOS and 3D files to improve learning and assessment of students during tooth preparation is possible [22][23][24]. It was also proposed to use 3D files as 3D printed educational tools in medical education [25].…”