Automated monitoring of tooth wear progression using AI on intra-oral scans.

ABSTRACT

OBJECTIVES: This study aimed to develop and evaluate a fully automated method for visualizing and measuring tooth wear progression using pairs of intra-oral scans (IOSs) in comparison with a manual protocol. METHODS: Eight patients with severe tooth wear progression were retrospectively included, with IOSs taken at baseline and 1-year, 3-year, and 5-year follow-ups. For alignment, the automated method segmented the arch into separate teeth in the IOSs. Tooth pair registration selected tooth surfaces that were likely unaffected by tooth wear and performed point set registration on the selected surfaces. Maximum tooth profile losses from baseline to each follow-up were determined based on signed distances using the manual 3D Wear Analysis (3DWA) protocol and the automated method. The automated method was evaluated against the 3DWA protocol by comparing tooth segmentations with the Dice-Sørensen coefficient (DSC) and intersection over union (IoU). The tooth profile loss measurements were compared with regression and Bland-Altman plots. Additionally, the relationship between the time interval and the measurement differences between the two methods was shown. RESULTS: The automated method completed within two minutes. It was very effective for tooth instance segmentation (826 teeth, DSC = 0.947, IoU = 0.907), and a correlation of 0.932 was observed for agreement on tooth profile loss measurements (516 tooth pairs, mean difference = 0.021mm, 95% confidence interval = [-0.085, 0.138]). The variability in measurement differences increased for larger time intervals. CONCLUSIONS: The proposed automated method for monitoring tooth wear progression was faster and not clinically significantly different in accuracy compared to a manual protocol for full-arch IOSs. CLINICAL SIGNIFICANCE: General practitioners and patients can benefit from the visualization of tooth wear, allowing quantifiable and standardized decisions concerning therapy requirements of worn teeth. The proposed method for tooth wear monitoring decreased the time required to less than two minutes compared with the manual approach, which took at least two hours.