Wenceslao Piedra-Cascón1, Matthew J Meyer2, Mohammad M Methani3, Marta Revilla-León4. 1. Affiliate Faculty, Esthetic Dentistry Program, Complutense University of Madrid, Spain; Researcher, Revilla Research Center, Madrid, Spain. Electronic address: wpiedra@ucm.es. 2. Undergraduate student, College of Dentistry at Texas A&M University, Dallas, Texas. 3. Graduate Prosthodontic Resident, Rutgers School of Dental Medicine, Newark, NJ. 4. Assistant Program Director and Assistant Professor, AEGD Program, College of Dentistry, Texas A&M University, Dallas, Texas; Affiliate Faculty, Graduate Prosthodontics, School of Dentistry, University of Washington, Seattle, Wash; Researcher, Revilla Research Center, Madrid, Spain.
Abstract
STATEMENT OF PROBLEM: Digital waxing procedures should be guided by facial references to improve the esthetic outcome of a restoration. The development of facial scanners has allowed the digitalization of the extraoral soft tissues of the patient's face. However, the reliability of facial digitizers is questionable. PURPOSE: The purpose of this study was to evaluate the accuracy (trueness and precision) of extraoral 3D facial reconstructions performed by using a dual-structured light facial scanner and to measure the interexaminer variability. MATERIAL AND METHODS: Ten participants were included. Six soft-tissue landmarks were determined on each participant, specifically reference (Ref), glabella (Gb), subnasal (Sn), menton (Me), chelion right (ChR), and chelion left (ChL). Interlandmark distances Ref-Sn, Sn-Gb, Ref-Gb, Sn-Me, and ChR-ChL (intercommissural) were measured by 2 different operators by using 2 different methods: directly on the participant' face (manual group) and digitally (digital group) on the 3D facial reconstruction of the participant (n=20). For the manual group, interlandmark measurements were made by using digital calipers. For the digital group, 10 three-dimensional facial reconstructions were acquired for each participant by using a dual-structured light facial scanner (Face Camera Pro Bellus; Bellus3D). Interlandmark measurements were made by using an open-source software program (Meshlab; Meshlab). Both operators were used to note 10 measurements for each manual and digital interlandmark distance per participant. The intraclass correlation coefficient between the 2 operators was calculated. The Shapiro-Wilk test revealed that the data were not normally distributed. The data were analyzed by using the Mann-Whitney U test. RESULTS: Significant differences were found between manual and digital interlandmark measurements in all participants. The mean value of the manual and digital group discrepancy was 0.91 ±0.32 mm. The dual-structured light facial scanner tested obtained a trueness mean value of 0.91 mm and a precision mean value of 0.32 mm. Trueness values were always higher than precision mean values, indicating that precision was relatively high. The intraclass correlation coefficient between the 2 operators was 0.99. CONCLUSIONS: The facial digitizing procedure evaluated produced clinically acceptable outcomes for virtual treatment planning. The interexaminer reliability between the 2 operators was rated as excellent, suggesting that the type of facial landmark used in this study provides reproducible results among different examiners.
STATEMENT OF PROBLEM: Digital waxing procedures should be guided by facial references to improve the esthetic outcome of a restoration. The development of facial scanners has allowed the digitalization of the extraoral soft tissues of the patient's face. However, the reliability of facial digitizers is questionable. PURPOSE: The purpose of this study was to evaluate the accuracy (trueness and precision) of extraoral 3D facial reconstructions performed by using a dual-structured light facial scanner and to measure the interexaminer variability. MATERIAL AND METHODS: Ten participants were included. Six soft-tissue landmarks were determined on each participant, specifically reference (Ref), glabella (Gb), subnasal (Sn), menton (Me), chelion right (ChR), and chelion left (ChL). Interlandmark distances Ref-Sn, Sn-Gb, Ref-Gb, Sn-Me, and ChR-ChL (intercommissural) were measured by 2 different operators by using 2 different methods: directly on the participant' face (manual group) and digitally (digital group) on the 3D facial reconstruction of the participant (n=20). For the manual group, interlandmark measurements were made by using digital calipers. For the digital group, 10 three-dimensional facial reconstructions were acquired for each participant by using a dual-structured light facial scanner (Face Camera Pro Bellus; Bellus3D). Interlandmark measurements were made by using an open-source software program (Meshlab; Meshlab). Both operators were used to note 10 measurements for each manual and digital interlandmark distance per participant. The intraclass correlation coefficient between the 2 operators was calculated. The Shapiro-Wilk test revealed that the data were not normally distributed. The data were analyzed by using the Mann-Whitney U test. RESULTS: Significant differences were found between manual and digital interlandmark measurements in all participants. The mean value of the manual and digital group discrepancy was 0.91 ±0.32 mm. The dual-structured light facial scanner tested obtained a trueness mean value of 0.91 mm and a precision mean value of 0.32 mm. Trueness values were always higher than precision mean values, indicating that precision was relatively high. The intraclass correlation coefficient between the 2 operators was 0.99. CONCLUSIONS: The facial digitizing procedure evaluated produced clinically acceptable outcomes for virtual treatment planning. The interexaminer reliability between the 2 operators was rated as excellent, suggesting that the type of facial landmark used in this study provides reproducible results among different examiners.