Tooth Wear Evaluation System (TWES) 2.0-Reliability of diagnosis with and without computer-assisted evaluation

Area of Science:

• Dental diagnostics
• Tooth wear assessment
• Clinical reliability studies

Background:

• Tooth wear leads to dental hard tissue loss, necessitating early detection and monitoring.
• The Tooth Wear Evaluation System (TWES) aids in diagnosing tooth wear, with TWES 2.0 offering a comprehensive taxonomy.
• Validation of TWES 2.0's reliability was previously lacking.

Purpose of the Study:

• To assess the reproducibility of diagnoses made using the TWES 2.0 taxonomy in a randomized controlled trial.
• To compare the reproducibility of TWES 2.0 diagnoses between traditional (paper-based) and computer-assisted methods.
• To validate the reliability of the TWES 2.0 system for clinical dental use.

Main Methods:

• A randomized controlled trial involving 44 dental students trained in TWES 2.0.
• Students evaluated anonymized patient cases using gypsum models and intra-oral photographs.
• An AB/BA crossover design was employed, switching between paper-based and computer-assisted (CMDfact/CMDbrux) evaluations.

Main Results:

• Agreement with the sample solution showed moderate reliability (Cohen's kappa: 0.46 manual, 0.44 computer-assisted).
• Inter-examiner agreement was fair to moderate (Fleiss' kappa: 0.38 manual, 0.48 computer-assisted).
• Computer-assisted evaluation demonstrated slightly higher inter-examiner agreement than manual methods.

Conclusions:

• The TWES 2.0 taxonomy exhibits acceptable reliability for dental practitioners.
• The TWES 2.0 system is quickly learnable, even for untrained individuals.
• Computer-assisted evaluation yields comparable diagnostic results to traditional methods.