Introduction: Intraoral scanning techniques, laser scans and cone-beam computed tomography (CBCT) are becoming widely diffused in dental practice. These instruments can replace dental plaster casts with digital models; recent investigations have found that measurements taken on digital models do not differ clinically from those obtained on CBCT scans and physical models, but only intra-examiner reliability has been assessed. In the current study we tested both intra-and inter-examiner variations, together with intertechniques reliability. Methodology: Data from six adult subjects were retrospectively obtained. Twelve dental distances were measured on dental plaster casts using a digital calliper; on digital 3D CBCT images using inVivoDental software (Anatomage, San Jose, CA); and on laser scanned surfaces using Mirror Vectra Software (Canfield Scientific, Fairfield, NJ). Two different operators performed all measurements twice. Bland-Altman analysis, Kruskal-Wallis and Wilcoxon tests were used for comparisons.
Results:The intra-and inter-operator biases range was 0-0.34 mm. The reproducibility range was 72-99%. The three different techniques gave very similar measurements, with biases between ±0.1 mm. Reproducibility ranged between 90 and 100%; the best reproducibility coefficients were found between plaster and digital casts, and only three differences were larger than 0.5 mm. Calliper measurements slightly overestimated digital casts values. Only the mesiodistal distance of tooth 24 (p=0.002) was significantly different among techniques. Conclusion: Measurements on digital dental models and CBCT reconstructions of the dental arches seem clinically reliable as direct calliper measurements. The inter-and intra-operator reliabilities were acceptable, some more care may be needed for CBCT measurements.