Dental Anatomy Grading: Comparison Between Conventional Visual and a Novel Digital Assessment Technique

Abstract

Conventional grading of dental students' projects in preclinical courses has mainly relied on visual evaluation by experienced instructors. The purpose of this study was to compare conventional visual grading in a dental anatomy course at one U.S. dental school to a novel digital assessment technique. A total of sixty samples comprised of two sets of faculty wax-ups (n=30), student wax-ups (n=15), and dentoform teeth of tooth #14 (n=15) were used for this study. Two additional faculty members visually graded the samples according to a checklist and then repeated the grading after one week. The sample wax-up with the highest score based on the visual grading was selected as the master model for the digital grading, which was also performed twice with an interim period of one week. Descriptive statistics and signed rank tests for systematic bias were used for intra-and interrater comparisons. The intraclass correlation (ICC) was used as a measure of intra-and interrater reliability. None of the faculty members achieved the minimum acceptable intrarater agreement of 0.8. Interrater agreement was substantially less than intrarater agreement for the visual grading, whereas all measures of intrarater agreement were greater than 0.9 and considered excellent for the digital assessment technique. These results suggest that visual grading is limited by modest intrarater reliability and low interrater agreement. Digital grading is a promising evaluation method showing excellent intrarater reliability and correlation. Correlation for visual and digital grading was consistently modest, partly supporting the potential use of digital technology in dental anatomy grading.

Evaluation of an Innovative Digital Assessment Tool in Dental Anatomy

“…This is relevant to other studies that evaluated the repeatability of digital evaluation with the use of the same scanner at different time points and showed excellent intra class correlation of 0.93 to 0.98. 3,4 However, excellent repeatability does not necessarily indicate valid evaluation as good samples from the visual paradigm could consistently be graded as poor samples in the digital paradigm and vice versa. Therefore, the correlation of visual and digital evaluation scores was used to examine this possibility.…”

“…Through this new technology, students can generate a high quality 3-D virtual model of their project and receive immediate feedback on discrepancies by comparing it to the gold standard determined by the course director. 4 An ideal ratio in a dental classroom setting is to accommodate one scanner for every ten students. 3 Therefore, multiple scanners are usually used to facilitate proper teaching and learning experience for all students.…”

Use of Digital Technology to Improve Objective and Reliable Assessment in Dental Student Simulation Laboratories

“…The digital grading system had previously been found to be of great help in properly evaluating students' work 20 . In addition to providing accurate measurements, the use of digital grading has been found to reduce the workload of dental instructors 23 . To use digital grading, each typodont model needs to be digitally scanned before and after tooth preparation.…”

“…Their study found that the digital method provided a significantly more precise and reliable assessment of students' work than the hand‐grading method. Kateeb et al and Kwon et al also reported improved inter‐and intra‐grader agreement with the use of a digital assessment over the traditional visual grading method 22, 23 . Thus, the use of a digital assessment software program appeared to reduce subjectivity and variability.…”

Developing an All‐Digital Workflow for Dental Skills Assessment: Part I, Visual Inspection Exhibits Low Precision and Accuracy

“…Furthermore, formal and anecdotal reports abound that visual inspection is lawed due to a variety of human factors. 1,2 What seems irrefutable is that replicating the morphology, symmetry, and cosmetic attributes of an individual's dentition must provide the best possible function, greatest longevity, and most desirable esthetics achievable. Accordingly, dental students may appropriately be counseled to recreate nature as closely as possible when restoring the human dentition.…”