Comparative Clinical Evaluation of Digital Intra-oral Scanner and Conventional Clinical Photograph for Assessing Occlusal Tooth Wear

Abstract

Background: Occlusal tooth wear, resulting from attrition, abrasion, and erosion, poses significant diagnostic challenges in dental practice. While clinical photography remains the gold standard for documentation and assessment, its two-dimensional nature limits comprehensive evaluation of wear, making it difficult to gauge depth, volume loss, and subtle changes over time Aim: This study compared the reliability of Prime scan IOS (Dentsply Sirona) versus clinical photography for occlusal wear assessment using a standardized index. Methods: Twenty-five participants (18-55 years) were evaluated by two calibrated examiners using: (1) clinical intraoral photography and (2) Prime scan IOS. Tooth wear was scored on first molars, premolars, canines, and incisors using Scott's index (0-10 scale). Inter- and intra-examiner reliability were analysed using weighted Kappa statistics, while method agreement was assessed via Friedman tests and Bland-Altman plots over 30-day intervals. Results: Inter-examiner agreement was substantial for both methods (Day 1: κ=0.76, 88% agreement; Day 30: κ=0.70, 84%). Mean wear scores showed no significant differences between examiners (Day 1: 2.12±1.24 vs 2.20±1.19, p=0.80; Day 30: 2.28±1.19 vs 2.24±1.08, p=0.90). The Friedman test confirmed consistency across assessments (χ²=1.48, p=0.686). Bland-Altman analysis revealed minimal systematic error (mean bias=-0.05) with narrow limits of agreement (±0.25). Conclusion: Prime scan IOS demonstrated substantial reliability comparable to clinical photography for qualitative wear assessment, with excellent inter-method agreement. Digital scanning offers clinically viable advantages for longitudinal monitoring while maintaining diagnostic accuracy. These findings support the integration of IOS into routine practice, though examiner calibration remains crucial for optimal reproducibility.