Creating Digital Dental Plaque Scoring

The (h1) hypothesis of this study was that dental plaque scores measured through digital camera and intraoral scanner images can replace clinical visual scoring. This study aimed to compare dental plaque areas measured on images taken by digital camera and intraoral scanner and to evaluate these areas with clinical plaque scores with the help of a software program and provide a novel plaque index to score dental plaque on the taken intraoral images.

Study Design The tooth arches of the volunteers were stained with a plaque-disclosing solution (Tri Plaque ID Gel, GC Corporation, Tokyo, Japan). The Turesky Modified Quigley Hein Plaque Index (TMQHPI) of anterior teeth of the volunteers' was recorded using clinical visual examination.

Intraoral photographs of the volunteers were taken by using a digital camera (Canon EOS 700D; 100 mm macrolens, Canon Inc., Tokyo, Japan), and 3D images were recorded by an intraoral scanner (iTero Element Flex, Align Technologies, San Jose, California, USA). Photograph and intraoral scanner images were overlapped and pixel-synchronized using the Keynote program.

After synchronization, all taken images were transferred to the Image J V1.53 (National Institute for Health, Bethesda, USA) program. The plaque-covered area and the total surface area of the teeth were marked in the manual mode of the program and the areas were measured in square pixels. Measurements were made on a total of 66 teeth, which can be easily seen on the images. Intraoral scanner plaque area/ tooth surface area ratio and intraoral photograph plaque area/ tooth surface area ratio were calculated and recorded for each tooth.

Inclusion criteria

• Patients without orthodontic brackets, fixed or implant restorations and without severe tooth crowding were included in the study.

Exclusion criteria

• Among the patients with orthodontic brackets, severe tooth crowding that could not be visually verified on images, fixed or implant restorations were excluded in the study.