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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.

The Commission on Dental Accreditation (CODA)'s accreditation standards for dental schools state that "graduates must demonstrate the ability to self-assess." Therefore, dental schools have developed preclinical and clinical self-assessment (SA) protocols aimed at fostering a reflective process. This study comparing students' visual SA with students' digital SA and with faculty assessment was designed to test the hypothesis that higher agreement would occur when utilizing a digital evaluation. Twenty-five first-year dental students at one dental school participated by preparing a mesial occlusal preparation on tooth #30 and performing both types of SAs. A faculty evaluation was then performed both visually and digitally using the same evaluation criteria. The Kappa statistic was used to measure agreement between evaluators. The results showed statistically significant moderate agreement between the faculty visual and faculty digital modes of evaluation for occlusal shape (K=0.507, p=0.002), proximal shape (K=0.564, p=0.001), orientation (K=0.425, p=0.001), and definition (K=0.480, p=0.001). There was slight to poor agreement between the student visual and faculty visual assessment, except for preparation orientation occlusal shape (K=0.164, p=0.022), proximal shape (K=-0.227, p=0.032), orientation (K=0.253, p=0.041), and definition (K=-0.027, p=0.824). This study showed that the students had challenges in self-assessing even when using CAD/CAM and the digital assessment did not improve the amount of student/faculty agreement.