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June 4, 2026The Angle Orthodontist0 citationsOpen Access

Quantitative evaluation of an artificial intelligence–driven remote monitoring system for occlusion assessment using patient-captured images

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DBDaniel BillsBBBarry BentonWDWilliam Dabney

Key Points

  • To assess the accuracy of an AI model for evaluating occlusal parameters from patient-captured images compared to IOS-derived 3D measurements.
  • Multicenter prospective study with 430 orthodontic patients across three clinics in the US.
  • Participants performed DentalMonitoring scans and received clinician-acquired IOS scans.
  • Agreement between AI and reference measurements assessed using Passing-Bablok regression and relative bias analyses.
  • Midline deviation and overbite demonstrated high concordance with relative biases below 3%.
  • Overjet was modestly overestimated (mean bias = +0.29 ± 0.52 mm).
  • Canine class showed increased underestimation at higher values (mean bias = -0.31 ± 0.91 mm).

Abstract

Objectives: To evaluate the accuracy of an artificial intelligence (AI) model developed by DentalMonitoring for assessing occlusal parameters from patient-acquired intraoral images, using intraoral scanner (IOS)-derived three-dimensional (3D)measurements as the reference standard. Materials and Methods: This multicenter prospective study included 430 orthodontic patients from three clinics in the United States. Each participant completed a DentalMonitoring scan using the DM ScanBox and a clinician-acquired IOS scan. Midline deviation, overbite, overjet, and canine class were measured on IOS-generated 3D models using metrology-grade software (ZEISS Inspect). Three independent, blinded technicians performed measurements, with the median value used as the reference. Agreement between AI-generated and reference measurements was assessed using Passing-Bablok regression and relative bias analyses at predefined clinical thresholds. Results: All occlusal parameters demonstrated agreement within clinically acceptable limits. Midline deviation and overbite showed the highest concordance, with intercepts near 0.00 mm, relative biases below 3%, and mean biases of -0.01 ± 0.26 mm and -0.04 ± 0.39 mm, respectively. Overjet was modestly overestimated (mean bias = +0.29 ± 0.52 mm), while canine class showed increasing underestimation at higher values (mean bias = -0.31 ± 0.91 mm). Conclusions: The evaluated AI model demonstrated high agreement with IOS-based 3D measurements for midline deviation and overbite, with greater variability for overjet and canine classification. These results support the use of AI-assisted monitoring for screening and follow-up, while highlighting the need for further validation prior to routine clinical implementation.

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Cite This Study

Bills et al. (2026) studied this question.

synapsesocial.com/papers/6a211549d499ed480b16e7a8https://doi.org/10.2319/010926-30.1
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