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.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Prosthetic Dentistry
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Fundamentals of esthetics.Quintessence, Chicago1990: p.121-p.127
- Esthetics of anterior fixed prosthodontics.Quintessence, Chicago1996: 33-50
- A multidisciplinary approach to esthetic dentistry.Dent Clin North Am. 2007; 51: 487-505
- Esthetic rehabilitation in fixed prosthodontics. Vol 1: esthetic analysis: a systematic approach to prosthetic treatment.Quintessence, Chicago2004: 22-30
- Smile analysis and design in the digital era.J Clin Orthod. 2002; 36: 221-236
- Facially generated and cephalometric guided 3D digital design for complete mouth implant rehabilitation: a clinical report.J Prosthet Dent. 2017; 117: 577-586
- Digital photography enhances diagnostics, communication, and documentation.Compend Contin Educ Dent. 2011; 32: 36-38
- Digital smile design a tool for treatment planning and communication in esthetic dentistry.Quintessence Dent Technol. 2012; 35: 1-9
- Cerec Smile Design a software tool for the enhancement of restorations in the esthetic zone.Int J Comput Dent. 2013; 16: 255-269
- Three-dimensional esthetic analysis in treatment planning for implant-supported fixed prosthesis in the edentulous maxilla: review of the esthetics literature.J Esthet Restor Dent. 2011; 23: 219-237
- Digital technologies to support planning, treatment and fabrication processes and outcome assessments in implant dentistry. Summary and consensus statements. The 4th EAO consensus conference.Clin Oral Implants Res. 2015; 26: 97-101
- Defining digital dentistry. A survey of recent literature.J Dent. 2017; 59: 1
- Integrating a facial scan, virtual smile design, and 3D virtual patient for treatment with CAD-CAM ceramic veneers: a clinical report.J Prosthet Dent. 2018; 119: 200-205
- A report on a diagnostic digital workflow for esthetic dental rehabilitation using additive manufacturing technologies.Int J Esthet Dent. 2018; 13: 184-196
- Digital tools and 3D printing technologies integrated into the workflow of restorative treatment: a clinical report.J Prosthet Dent. 2019; 121: 3-8
- Digital dental cast placement in 3-dimensional, full-face reconstruction: a technical evaluation.Am J Orthod Dentofacial Orthop. 2010; 138: 84-88
- Facially generated and additively manufactured baseplate and occlusion rim for treatment planning a complete-arch rehabilitation: a dental technique.J Prosthet Dent. 2019; 121: 741-745
- Systematic literature review of digital three- dimensional superimposition techniques to create virtual dental patients.Int J Oral Maxillofac Implants. 2015; 30: 330-337
- Integrating 3D facial scanning in a digital workflow to CAD/CAM design and fabricate complete dentures for immediate total mouth rehabilitation.J Adv Prosthodont. 2017; 9: 381-386
- Combining intraoral scans, cone beam computed tomography and face scans: the virtual patient.J Craniofac Surg. 2018; 29: 2241-2246
- Accuracy of digital technologies for the scanning of facial, skeletal and intraoral tissues: a systematic review.J Prosthet Dent. 2019; 121: 246-251
- Use of 3-dimensional surface acquisition to study facial morphology in 5 populations.Am J Orthod Dentofacial Orthop. 2010; 137: S56.e1-S56.e9
- Validity of the 3-D VECTRA photogrammetric surface imaging system for craniomaxillofacial anthropometric measurements.Oral Maxillofac Surg. 2014; 18: 297-304
- The 3-DMD photogrammetric photo system in craniomaxillofacial surgery: validation of interexaminer variations and perceptions.J Craniomaxillofac Surg. 2015; 43: 1798-1803
- Quantification of facial asymmetry: a comparative study of landmark based and surface based registrations.J Craniomaxillofac Surg. 2016; 44: 1131-1136
- Reliability of a three-dimensional facial camera for dental and medical applications: a pilot study.J Prosthet Dent. 2019; 122: 282-287
- Anthropometric precision and accuracy of digital three-dimensional photogrammetry: comparing the Genex and 3dMD imaging systems with one another and with direct anthropometry.J Craniofac Surg. 2006; 17: 477-483
- Three-dimensional surface imaging: limitations and considerations from the anthropometric perspective.J Craniofac Surg. 2005; 16: 847-851
- Digital three-dimensional image fusion processes for planning and evaluating orthodontics and orthognathic surgery: a systematic review.Int J Oral Maxillofac Surg. 2011; 40: 341-352
- Three-dimensional imaging techniques: a literature review.Eur J Dent. 2014; 8: 132-140
- Validation of a three-dimensional facial scanning system based on structured light techniques.Comput Methods Programs Biomed. 2009; 94: 290-298
- Three-dimensional facial anthropometry of unilateral cleft lip infants with a structured light scanning system.J Plast Reconstr Aesthet Surg. 2013; 66: 1109-1116
- Evaluation of the accuracy, reliability and reproducibility of two different 3D face-scanning systems.Int J Prosthodont. 2016; 29: 213-218
- Accuracy of dental digitizers.Int Dent J. 2006; 56: 301-309
- Digital dentistry: an overview of recent developments for CAD/CAM generated restorations.Br Dent J. 2008; 204: 505-511
- Facial three dimensional surface imaging: an overview.Arch Orofac Sci. 2010; 5: 1-8
- Glossary of digital dental terms.J Prosthodont. 2016; 25: S2-S9
- ISO 5725-1. Accuracy (trueness and precision) of measurement methods and results – Part 1: general principles and definitions.(Available at:)
- Comparison of three-dimensional scanner systems for craniomaxillofacial imaging.J Plast Reconstr Aesthet Surg. 2017; 70: 441-449
Published online: January 13, 2020
© 2019 by the Editorial Council for The Journal of Prosthetic Dentistry.