Application of Intraoral Scanners in Dental Health Guidance: Guidance Effectiveness

Purpose: We have been studying the use of an intraoral scanner (IOS) in dental health guidance to quantify and visualize changes in periodontal tissues, to make it easier for patients to understand the state of periodontal tissues, and to improve the accuracy of examining the effects of treatment. I...

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Published inThe Japanese Journal of Conservative Dentistry Vol. 66; no. 1; pp. 35 - 46
Main Authors Akina, TANI, Kumiko, KAJI, Kazutoshi, KAKIMOTO, Akane, OMORI, Sizuo, HIGUCHI
Format Journal Article
LanguageJapanese
Published The Japanese Society of Conservative Dentistry 28.02.2023
特定非営利活動法人 日本歯科保存学会
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ISSN0387-2343
2188-0808
DOI10.11471/shikahozon.66.35

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Abstract Purpose: We have been studying the use of an intraoral scanner (IOS) in dental health guidance to quantify and visualize changes in periodontal tissues, to make it easier for patients to understand the state of periodontal tissues, and to improve the accuracy of examining the effects of treatment. In this study, the usefulness of dental health guidance using IOS was examined by comparing conventional dental health guidance methods and dental health guidance using IOS for faculty, staff, and students of the University who had not received dental health guidance. Subjects and Methods: The study subjects were a total of 9 faculty, staff, and students (mean age 41.6 years) who had never received adequate dental health guidance. Three dental hygienists provided the following dental health guidance at intervals of at least two weeks for each subject, in different order. (1) Conventional method 1: Dental health guidance without intraoral photographs, study models, or IOS records. (2) Conventional method 2: Dental health guidance using intraoral photographs and study models. (3) IOS method: Dental health guidance using IOS records (images showing changes in intraoral conditions and gingiva). In each dental health guidance, periodontal examination, plaque control record (PCR), and gingival condition were recorded on the survey form, and the oral cavity was scanned by IOS (TRIOS 3, 3Shape, Denmark). After the second recording, the subjects were asked to fill out a questionnaire about their discomfort during recording and the ease of understanding the instructions. IOS records were exported as 3D data in STL format and analyzed using 3D measurement data evaluation software. Results: The IOS recordings allowed for a more detailed examination of gingival changes than the conventional periodontal examination. The deviation of the marginal gingival surface obtained by aligning the IOS records had a poor relationship with the results of probing depth, gingival swelling and redness, and changes in BOP. No difference in guidance effectiveness was found between dental health guidance using IOS and conventional guidance methods. Conclusion: Currently, the clinical usefulness of dental health guidance using IOS is not high. Although the positional alignment of IOS records one tooth at a time can provide a very detailed examination of gingival changes, it is not clinically useful because it takes a very long time; block-by-block alignment is regarded as more appropriate. However, recording by IOS is a method that allows detailed gingival evaluation from a different viewpoint than conventional periodontal examination and is easy to understand for both the dental hygienist and the patient.
AbstractList Purpose: We have been studying the use of an intraoral scanner (IOS) in dental health guidance to quantify and visualize changes in periodontal tissues, to make it easier for patients to understand the state of periodontal tissues, and to improve the accuracy of examining the effects of treatment. In this study, the usefulness of dental health guidance using IOS was examined by comparing conventional dental health guidance methods and dental health guidance using IOS for faculty, staff, and students of the University who had not received dental health guidance. Subjects and Methods: The study subjects were a total of 9 faculty, staff, and students (mean age 41.6 years) who had never received adequate dental health guidance. Three dental hygienists provided the following dental health guidance at intervals of at least two weeks for each subject, in different order. (1) Conventional method 1: Dental health guidance without intraoral photographs, study models, or IOS records. (2) Conventional method 2: Dental health guidance using intraoral photographs and study models. (3) IOS method: Dental health guidance using IOS records (images showing changes in intraoral conditions and gingiva). In each dental health guidance, periodontal examination, plaque control record (PCR), and gingival condition were recorded on the survey form, and the oral cavity was scanned by IOS (TRIOS 3, 3Shape, Denmark). After the second recording, the subjects were asked to fill out a questionnaire about their discomfort during recording and the ease of understanding the instructions. IOS records were exported as 3D data in STL format and analyzed using 3D measurement data evaluation software. Results: The IOS recordings allowed for a more detailed examination of gingival changes than the conventional periodontal examination. The deviation of the marginal gingival surface obtained by aligning the IOS records had a poor relationship with the results of probing depth, gingival swelling and redness, and changes in BOP. No difference in guidance effectiveness was found between dental health guidance using IOS and conventional guidance methods. Conclusion: Currently, the clinical usefulness of dental health guidance using IOS is not high. Although the positional alignment of IOS records one tooth at a time can provide a very detailed examination of gingival changes, it is not clinically useful because it takes a very long time; block-by-block alignment is regarded as more appropriate. However, recording by IOS is a method that allows detailed gingival evaluation from a different viewpoint than conventional periodontal examination and is easy to understand for both the dental hygienist and the patient.  目的:われわれは,歯科保健指導に口腔内スキャナー(IOS)を活用することで,歯周組織の変化の定量化と可視化を図り,患者が歯周組織の状態を理解しやすくするとともに治療効果の診査の確度を向上させることを目的として検討を進めてきた. 本研究では,従来の歯科保健指導方法とIOSを用いた歯科保健指導を比較検討し,IOSを用いた歯科保健指導の有用性について検討した. 対象と方法:研究対象は,十分な歯科保健指導を受けた経験がない本学教職員および学生の計9名(平均年齢41.6歳)とし,歯科衛生士3名が,以下の歯科保健指導を研究対象者ごとに2週間以上の間隔をあけ,順序を変えて実施した.①従来法1:鏡のみを利用した歯科保健指導,②従来法2:鏡に加え口腔内写真とスタディーモデルを利用した歯科保健指導,③IOS法:IOS記録のみを利用した歯科保健指導.各回の歯科保健指導時には,歯周精密検査,プラークコントロールレコード(PCR)および歯肉の状態を記録するとともにIOSで口腔内を記録した.2回目以降は,研究対象者に記録時の不快感や指導のわかりやすさについて調査票に回答してもらった.IOSの記録は,3D測定データ評価ソフトウェアにて分析した. 結果:IOSでの記録では,従来の歯周組織検査よりも詳細に歯肉の変化を把握できた.IOSによる記録を重ね合わせて求めた辺縁歯肉表面の偏差,すなわち変化量においては,プロービングデプス,歯肉の腫脹,発赤の検査結果およびBOPの変化との関係性が低かった.IOSを用いた歯科保健指導と従来の指導法との間には,指導効果の差は認められなかった.IOSによる記録を不快に感じる研究対象者がいたが,多くはIOSによる保健指導はわかりやすく,受けたい指導であると回答した. 結論:現状では,IOSを用いた歯科保健指導の臨床的有用性は必ずしも高いとはえいない.また,IOSの記録を1歯ずつ位置合わせすることで詳細に歯肉の変化を把握できるが,非常に長い時間を費やすために臨床的に有用とはいえず,ブロック単位での位置合わせが適切と考えられた.しかしながら,IOSによる記録は,これまでの歯周組織検査とは異なる視点で歯肉を詳細に評価できる方法であり,患者・術者両者にとって理解しやすい方法である.今後,研究を進めることで歯科保健指導に効果的に活用できる可能性があると考えられる.
Purpose: We have been studying the use of an intraoral scanner (IOS) in dental health guidance to quantify and visualize changes in periodontal tissues, to make it easier for patients to understand the state of periodontal tissues, and to improve the accuracy of examining the effects of treatment. In this study, the usefulness of dental health guidance using IOS was examined by comparing conventional dental health guidance methods and dental health guidance using IOS for faculty, staff, and students of the University who had not received dental health guidance. Subjects and Methods: The study subjects were a total of 9 faculty, staff, and students (mean age 41.6 years) who had never received adequate dental health guidance. Three dental hygienists provided the following dental health guidance at intervals of at least two weeks for each subject, in different order. (1) Conventional method 1: Dental health guidance without intraoral photographs, study models, or IOS records. (2) Conventional method 2: Dental health guidance using intraoral photographs and study models. (3) IOS method: Dental health guidance using IOS records (images showing changes in intraoral conditions and gingiva). In each dental health guidance, periodontal examination, plaque control record (PCR), and gingival condition were recorded on the survey form, and the oral cavity was scanned by IOS (TRIOS 3, 3Shape, Denmark). After the second recording, the subjects were asked to fill out a questionnaire about their discomfort during recording and the ease of understanding the instructions. IOS records were exported as 3D data in STL format and analyzed using 3D measurement data evaluation software. Results: The IOS recordings allowed for a more detailed examination of gingival changes than the conventional periodontal examination. The deviation of the marginal gingival surface obtained by aligning the IOS records had a poor relationship with the results of probing depth, gingival swelling and redness, and changes in BOP. No difference in guidance effectiveness was found between dental health guidance using IOS and conventional guidance methods. Conclusion: Currently, the clinical usefulness of dental health guidance using IOS is not high. Although the positional alignment of IOS records one tooth at a time can provide a very detailed examination of gingival changes, it is not clinically useful because it takes a very long time; block-by-block alignment is regarded as more appropriate. However, recording by IOS is a method that allows detailed gingival evaluation from a different viewpoint than conventional periodontal examination and is easy to understand for both the dental hygienist and the patient.
Author Akane, OMORI
Sizuo, HIGUCHI
Kazutoshi, KAKIMOTO
Akina, TANI
Kumiko, KAJI
Author_FL 樋口 鎮央
谷 亜希奈
梶 貢三子
柿本 和俊
大森 あかね
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References 2) Sanikop MV, Yadav SC, Kumar V. Patient education and motivation in periodontics. Indian J Dent 2017; 9: 48-54.
7) Ender A, Zimmermann M, Mehl A. Accuracy of complete- and partial-arch impressions of actual intraoral scanning systems in vitro. Int J Comput Dent 2019; 22: 11-19.
4) Tani A, Higuchi S, Kakimoto K. Application of intraoral scanners in dental health guidance―Clinical study on recording accuracy and changes in the simulated display of the periodontal tissue―. J Osaka Dent Univ 2021; 55: 245-250.
5) Tani A, Omori A, Higuchi S, Kakimoto K. Application of intraoral scanners in dental health guidance―Quantification and visualization of marginal gingival changes―. ODEP 2022; 2: 60-71.
1) 池野直人, 笹谷育郎, 高瀬俊博, 藤井敦子, 石川 純. ブラッシング指導におけるモチベーションの効果について. 日歯周誌 1979 ; 21 : 193-200.
3) Tani A, Higuchi S, Kakimoto K. Application of an intraoral scanner for dental health guidance―High precision in vitro detection of periodontal tissue changes―. J Osaka Dent Univ 2020; 54: 263-272.
8) Kannan S, Mathew CA, Paulraj RS. Intraoral scanning systems―A current overview. IJAR 2020; 8: 1214-1223.
11) 梁川輝行. 健全例と歯周病変例におけるプロービング圧と歯周ポケット深度との関連. 日歯保存誌 1998 ; 41 : 449-460.
12) Listgarten MA. Periodontal probing: What does it mean?. J Clin Priodontol 1980; 7: 165-176.
9) 友藤孝明, 東 哲司, 草野弘揮, 山本龍生, 多田 徹, 森田 学, 渡邊達夫. 歯周病におけるプロービングデプス, アタッチメントレベルの臨床的意義に関する研究. 日歯周誌 2004 ; 46 : 253-258.
13) Andrade R, Espinoza M, Gómez EM, Espinoza JR, Cruz E. Intra- and inter-examiner reproducibility of manual probing depth. Braz Oral Res 2012; 26: 57-63.
6) 堀田康弘. 口腔内スキャナーの種類とその仕組み. 疋田一洋, 馬場一美. 口腔内スキャナー入門 デジタル印象採得の基礎と臨床. 補綴臨床別冊. 医歯薬出版 : 東京 ; 2019 ; 12-22.
10) 中村 太, 佐藤拓実, 塩見 晶, 奥村暢旦, 石崎裕子, 伊藤晴江, 中島貴子, 藤井規孝. 高頻度歯科治療における処置時の力のコントロールに関する研究. 日歯教誌 2016 ; 32 : 22-28.
References_xml – reference: 2) Sanikop MV, Yadav SC, Kumar V. Patient education and motivation in periodontics. Indian J Dent 2017; 9: 48-54.
– reference: 8) Kannan S, Mathew CA, Paulraj RS. Intraoral scanning systems―A current overview. IJAR 2020; 8: 1214-1223.
– reference: 9) 友藤孝明, 東 哲司, 草野弘揮, 山本龍生, 多田 徹, 森田 学, 渡邊達夫. 歯周病におけるプロービングデプス, アタッチメントレベルの臨床的意義に関する研究. 日歯周誌 2004 ; 46 : 253-258.
– reference: 5) Tani A, Omori A, Higuchi S, Kakimoto K. Application of intraoral scanners in dental health guidance―Quantification and visualization of marginal gingival changes―. ODEP 2022; 2: 60-71.
– reference: 12) Listgarten MA. Periodontal probing: What does it mean?. J Clin Priodontol 1980; 7: 165-176.
– reference: 13) Andrade R, Espinoza M, Gómez EM, Espinoza JR, Cruz E. Intra- and inter-examiner reproducibility of manual probing depth. Braz Oral Res 2012; 26: 57-63.
– reference: 11) 梁川輝行. 健全例と歯周病変例におけるプロービング圧と歯周ポケット深度との関連. 日歯保存誌 1998 ; 41 : 449-460.
– reference: 6) 堀田康弘. 口腔内スキャナーの種類とその仕組み. 疋田一洋, 馬場一美. 口腔内スキャナー入門 デジタル印象採得の基礎と臨床. 補綴臨床別冊. 医歯薬出版 : 東京 ; 2019 ; 12-22.
– reference: 4) Tani A, Higuchi S, Kakimoto K. Application of intraoral scanners in dental health guidance―Clinical study on recording accuracy and changes in the simulated display of the periodontal tissue―. J Osaka Dent Univ 2021; 55: 245-250.
– reference: 3) Tani A, Higuchi S, Kakimoto K. Application of an intraoral scanner for dental health guidance―High precision in vitro detection of periodontal tissue changes―. J Osaka Dent Univ 2020; 54: 263-272.
– reference: 7) Ender A, Zimmermann M, Mehl A. Accuracy of complete- and partial-arch impressions of actual intraoral scanning systems in vitro. Int J Comput Dent 2019; 22: 11-19.
– reference: 1) 池野直人, 笹谷育郎, 高瀬俊博, 藤井敦子, 石川 純. ブラッシング指導におけるモチベーションの効果について. 日歯周誌 1979 ; 21 : 193-200.
– reference: 10) 中村 太, 佐藤拓実, 塩見 晶, 奥村暢旦, 石崎裕子, 伊藤晴江, 中島貴子, 藤井規孝. 高頻度歯科治療における処置時の力のコントロールに関する研究. 日歯教誌 2016 ; 32 : 22-28.
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SubjectTerms dental health guidance
intraoral scanner
periodontal examination
口腔内スキャナー
歯周組織検査
歯科保健指導
Title Application of Intraoral Scanners in Dental Health Guidance: Guidance Effectiveness
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