DIAGNOSTIC, MEASUREMENT, AND MONITORING PERFORMANCE OF INTRAORAL SCANNER-BASED WORKFLOWS FOR EROSIVE TOOTH WEAR: A NARRATIVE REVIEW OF CLINICAL AND EXPERIMENTAL EVIDENCE
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6654Keywords:
Erosive Tooth Wear, Intraoral Scanning, Digital Dentistry, Three-dimensional Imaging, Longitudinal Monitoring, Diagnostic AccuracyAbstract
Background: Erosive tooth wear (ETW) requires reliable documentation of severity and progression. Intraoral scanner (IOS)-based workflows can generate serial three-dimensional datasets, but their diagnostic and measurement performance depends on acquisition, registration, and analysis procedures.
Objective: To review the diagnostic, measurement, and monitoring performance of IOS-based workflows for ETW.
Methods: PubMed/MEDLINE, Embase, and Scopus were searched on 1 September 2026 without date or language restrictions, supplemented by reference-list and citation searching. Clinical diagnostic, agreement, longitudinal, method-comparison, and experimental validation studies were considered. Methodological quality was appraised narratively and matched to study design, and findings were synthesised by evidence domain because designs, reference standards, units of analysis, scanners, software, and outcomes were heterogeneous.
Results: Twenty clinical and experimental reports published between 2016 and 2026 were discussed. Direct clinical evidence was limited. One 2026 study reported high sensitivity but lower specificity for scan-based assessment relative to clinical BEWE. Experimental studies generally detected progressive surface loss, but performance varied by scanner, software, registration method, lesion severity, and outcome metric. Longitudinal studies supported quantitative documentation, although alignment failures, clustered observations, and overlapping cohorts limited inference.
Conclusions: Predominantly small and heterogeneous evidence suggests that IOS-based workflows may be useful adjuncts for ETW documentation and longitudinal monitoring. They should complement rather than replace clinical assessment. System-specific thresholds should not be generalised without standardised prospective clinical validation.
References
Alaraudanjoki, V., Saarela, H., Pesonen, R., Laitala, M.-L., Kiviahde, H., Tjäderhane, L., Lussi, A., Pesonen, P., & Anttonen, V. (2017). Is a Basic Erosive Wear Examination (BEWE) reliable for recording erosive tooth wear on 3D models? Journal of Dentistry, 59, 26-32. https://doi.org/10.1016/j.jdent.2017.02.001
Alharbi, G., Valdivia Tapia, A. C., Türkkahraman, H., Eckert, G., Hara, A. T., & Soto-Rojas, A. E. (2026). Analyzing 2D photographs and 3D intraoral scans for dental caries and erosive tooth wear assessments. Digital Dentistry Journal, 4(1), 100098. https://doi.org/10.1016/j.ddj.2026.100098
Aly, A. Y., Abdel-Fattah, W. M., Gepreel, M. A., & Afifi, R. R. (2025). Correlation between intraoral scanner and 3D confocal laser microscopy in early measurement of enamel loss due to dental erosion. BMC Oral Health, 25, 1901. https://doi.org/10.1186/s12903-025-07311-5
Angelone, F., Ponsiglione, A. M., Ricciardi, C., Cesarelli, G., Sansone, M., & Amato, F. (2023). Diagnostic applications of intraoral scanners: A systematic review. Journal of Imaging, 9(7), 134. https://doi.org/10.3390/jimaging9070134
Bartlett, D., Ganss, C., & Lussi, A. (2008). Basic Erosive Wear Examination (BEWE): A new scoring system for scientific and clinical needs. Clinical Oral Investigations, 12(Suppl 1), S65-S68. https://doi.org/10.1007/s00784-007-0181-5
Bartlett, D., O'Toole, S., Chen, V., Kuralt, M., Buzalaf, M. A. R., Yar, R., Creeth, J., Mehta, S., West, N. X., Awad, M., Hoekstra, E., Clarke-Irons, R., & Lussi, A. (2026). BEWE 2.0: Basic erosive tooth wear examination revisited: Introducing an additional level for more severe erosive tooth wear. Journal of Dentistry, 166, 106514. https://doi.org/10.1016/j.jdent.2026.106514
Bors, A., Bereșescu, G. F., & Székely, M. (2025). Longitudinal assessment of dental erosion in a Romanian cohort of young adults: A ten-year follow-up pilot study. Dentistry Journal, 13(7), 302. https://doi.org/10.3390/dj13070302
Jablonski-Momeni, A., Hanselmann, F., Bottenberg, P., & Korbmacher-Steiner, H. (2023). Detection of erosive changes on smooth surfaces with and without orthodontic brackets using an intraoral scanner-an in vitro study. Diagnostics, 13(20), 3232. https://doi.org/10.3390/diagnostics13203232
Kumar, S., Keeling, A., Osnes, C., Bartlett, D., & O'Toole, S. (2019). The sensitivity of digital intraoral scanners at measuring early erosive wear. Journal of Dentistry, 81, 39-42. https://doi.org/10.1016/j.jdent.2018.12.005
Loumprinis, N., Michou, S., & Rahiotis, C. (2024). Different methods of scan alignment in erosive tooth wear measurements: An in vitro study. Dentistry Journal, 12(2), 34. https://doi.org/10.3390/dj12020034
Machado, A. C., Phillips, T. S., Zimmerman, R. L., Scaramucci, T., & Amaechi, B. T. (2022). Monitoring erosive tooth wear with intraoral 3D scanner: A feasibility study. American Journal of Dentistry, 35(1), 49-54.
Marro, F., De Lat, L., Martens, L., Jacquet, W., & Bottenberg, P. (2018). Monitoring the progression of erosive tooth wear (ETW) using BEWE index in casts and their 3D images: A retrospective longitudinal study. Journal of Dentistry, 73, 70-75. https://doi.org/10.1016/j.jdent.2018.04.008
Marro, F., Jacquet, W., Martens, L., Keeling, A., Bartlett, D., & O'Toole, S. (2020). Quantifying increased rates of erosive tooth wear progression in the early permanent dentition. Journal of Dentistry, 93, 103282. https://doi.org/10.1016/j.jdent.2020.103282
Marro, F., O'Toole, S., Bernabé, E., Bartlett, D., & Aránguiz, V. (2022). Associated risk factors with quantitative erosive tooth wear progression. Journal of Dentistry, 123, 104179. https://doi.org/10.1016/j.jdent.2022.104179
Meireles, A. B., Vieira, A. W., Corpas, L., Vandenberghe, B., Bastos, F. S., Lambrechts, P., Campos, M. M., & Las Casas, E. B. (2016). Dental wear estimation using a digital intra-oral optical scanner and an automated 3D computer vision method. Computer Methods in Biomechanics and Biomedical Engineering, 19(5), 507-514. https://doi.org/10.1080/10255842.2015.1043627
Michou, S., Vannahme, C., Ekstrand, K. R., & Benetti, A. R. (2020). Detecting early erosive tooth wear using an intraoral scanner system. Journal of Dentistry, 100, 103445. https://doi.org/10.1016/j.jdent.2020.103445
O'Toole, S., Lau, J. S., Rees, M., Warburton, F., Loomans, B., & Bartlett, D. (2020a). Quantitative tooth wear analysis of index teeth compared to complete dentition. Journal of Dentistry, 97, 103342. https://doi.org/10.1016/j.jdent.2020.103342
O'Toole, S., Bartlett, D., Keeling, A., McBride, J., Bernabé, E., Crins, L., & Loomans, B. (2020b). Influence of scanner precision and analysis software in quantifying three-dimensional intraoral changes: Two-factor factorial experimental design. Journal of Medical Internet Research, 22(11), e17150. https://doi.org/10.2196/17150
O'Toole, S., Marro, F., Loomans, B. A. C., & Mehta, S. B. (2023). Monitoring of erosive tooth wear: What to use and when to use it. British Dental Journal, 234(6), 463-467. https://doi.org/10.1038/s41415-023-5623-1
O'Toole, S., Gerhardt, M. N., Kuralt, M., Hallberg, N., Kang, J., Austin, R., & Bartlett, D. (2026). Digital and artificial intelligence-based screening for erosive tooth wear. Journal of Dentistry, 173, 106829. https://doi.org/10.1016/j.jdent.2026.106829
Schlueter, N., Amaechi, B., Bartlett, D., Buzalaf, M., Carvalho, T., Ganss, C., Hara, A., Huysmans, M.-C., Lussi, A., Moazzez, R., Vieira, A., West, N., Wiegand, A., Young, A., & Lippert, F. (2020). Terminology of erosive tooth wear: Consensus report of a workshop organized by the ORCA and the Cariology Research Group of the IADR. Caries Research, 54(1), 2-6. https://doi.org/10.1159/000503308
Tsiafitsa, M., Mourouzis, P., Dionysopoulos, D., Kouros, P., & Tolidis, K. (2026). Accuracy of intraoral scanners for simulated tooth wear using RMS surface deviation analysis. Prosthesis, 8(5), 49. https://doi.org/10.3390/prosthesis8050049
Valdivia Tapia, A. C., Lara, J. S., Martinez-Mier, E. A., Denucci, G. C., Lippert, F., Eckert, G. J., & Hara, A. T. (2025). 3D intraoral scanner as an auxiliary tool for the diagnosis of dental hard-tissue conditions. Clinical Oral Investigations, 29, 605. https://doi.org/10.1007/s00784-025-06683-w
Valdivia-Tapia, A. C., Haines, G., Sankuratri, B., Walayat, I., Castelluccio, P. F., Hara, A. T., & Castilho, A. (2026). A validation of 3D imaging for non-invasive, tech-assisted diagnosis of caries and erosive tooth wear in primary teeth-an in vitro study. Scientific Reports, 16, 5043. https://doi.org/10.1038/s41598-026-35718-9
Witecy, C., Ganss, C., Wöstmann, B., Schlenz, M. B., & Schlenz, M. A. (2021). Monitoring of erosive tooth wear with intraoral scanners in vitro. Caries Research, 55(3), 215-224. https://doi.org/10.1159/000514666
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Weronika Jagiełło, Natalia Le Hong, Natalia Dymel, Natasza Jankowska, Karolina Kukuczka, Gabriela Karpińska, Kamila Kędzior, Sonia Krzykawska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
