Quantitative assessment of tooth wear using intraoral scanners: A comparative analysis of two monitoring tools

Abstract

Objectives: To evaluate the accuracy of a digital monitoring tool integrated in two intraoral scanners (Trios 3 and Trios 4) in detecting and quantifying tooth wear, using a validated ISO-based reference standard. Methods: An in vitro model was developed with a structured digital reference design incorporating vertically embedded slot structures to enable standardized sectioning and reduce operator variability. The Patient Monitoring Tool within the 3Shape IOS software was assessed by comparing its measurements to those obtained using a validated method conforming to ISO 20,896-1 Annex C. Tooth wear of varying depths (ranging from shallow to advanced) was simulated and measured across both systems. Measurement differences were statistically analyzed for accuracy evaluation. Results: The monitoring tool demonstrated clinically acceptable levels of accuracy in assessing moderate to advanced wear depths. However, the tool showed increased variability and decreased precision at lower wear levels, indicating limitations in detecting early-stage tooth wear. Conclusions: Intraoral scanner-based monitoring using the 3Shape Patient Monitoring Tool is a promising noninvasive method for longitudinal tooth wear assessment. Nevertheless, clinicians should interpret early wear measurements with caution due to limited accuracy in shallow wear detection. Further improvements in digital tool sensitivity are warranted to enhance early diagnostic capability. Clinical Significance: This study highlights the clinical potential of intraoral scanner-based monitoring for tooth wear. While effective in detecting advanced wear, clinicians should interpret minimal changes with caution. Understanding its limitations can aid in selecting appropriate tools for long-term, non-invasive wear assessment and early intervention in preventive and restorative dental care.