Utilizing CAD/CAM to measure total occlusal convergence of preclinical dental students' crown preparations

Traditionally, faculty assessment of preclinical crown preparations occurs by visualizing preparation features. However, contemporary CAD/CAM tools have the ability to more precisely evaluate preparation features, which is beneficial for psychomotor development. Taper is one of the most challenging features to objectively assess. The aim of this study was twofold: first, to validate the software's ability to distinguish differences in taper, and second, to compare traditional faculty assessment with digital assessment of taper. In the study, 30 all-metal crown preparations were created on typodont teeth with varying degrees of axial reduction and placed into three groups based on amount of taper (minimum, moderate, or excessive). Each tooth was scanned with the D4D scanner, and the taper was analyzed using E4D Compare. A second experiment used 50 crown preparations of tooth #19, which were done as a formative exercise. A comparison faculty assessment with CAD/CAM assessments of taper was performed. The results showed that when the taper was varied, E4D Compare was able to distinguish those differences; the Tukey post-hoc test revealed a significant difference (p=0.001). The qualitative analysis comparing faculty grading to CAD/CAM grading demonstrated a trend for CAD/CAM to be more precise. These results suggest that E4D Compare is an effective means of quantitatively measuring the amount of total occlusal convergence or taper on a crown preparation and that digital assessment may be more precise than faculty visual grading.