Konathala Santosh Venkata Ramesh
* 
, Saikeerthi Kalluri .
, Divyabhavani Vasamsetti
, Sowmya Srinivas
, Jagadeesan Bhuvaneswari, Nagasaireddy Konda
, Guduri Vineeth
, Sruthima Naga Venkata Satya Gottumukkala
, Pasupuleti Swetha
, Penmetsa Subhadra Gautami
, Sri Lalitha Mohana Mahankali
Abstract
Background: Intraoral scanners (IOS) provide high-resolution 3D surface mapping and are increasingly explored as non-invasive tools in periodontology; however, evidence on their clinical diagnostic accuracy versus conventional standards remains variable. This study aimed to systematically evaluate the clinical accuracy, reproducibility, and applicability of IOS in periodontal assessment. Methods: PubMed, Cochrane Library, and Google Scholar were searched until October 2025, yielding 923 records; 18 clinical studies were included following PRISMA 2020 and PROSPERO registration (CRD420251242067). Continuous plaque outcomes from three studies were pooled using inverse-variance random-effects modeling, with heterogeneity assessed using I². Risk of bias ranged from low to high, with most observational studies showing moderate concerns. Results: IOS plaque scores were numerically higher than clinical references (MD = 2.15; 95% CI –2.09 to 6.40) but not statistically significant (P = 0.32; I² = 46%). Evidence was most consistent for plaque quantification (six studies) and tissue landmark reproducibility (six studies), although certainty was low. Gingival inflammation (four studies) and gingival displacement (one RCT) showed positive trends but limited evidence. Gingival recession (three studies) and periodontal defect detection (two studies) showed very low certainty due to heterogeneity and lack of standardized validation. Conclusion: IOS enable non-invasive surface assessment and show potential for plaque quantification and soft-tissue measurements. However, evidence remains limited and heterogeneous, particularly for recession and defect detection. IOS should complement, not replace, clinical probing, and findings should be interpreted cautiously given the limited number of quantitative studies and lack of standardization across outcomes.