In order to use CAD CAM (Computer Aided Design, Computer Aided Manufacturing) technology as an assessment tool when evaluating the preclinical performance of dental students, it is imperative that one has confidence in the reliability of the process. In this study, a variety of alignment methods were compared to determine both the consistency and accuracy of each method. Although the "Tooth Dots Diagonal" method exhibited the best precision (coefficient of variation=5.4 percent), it also represented the least accurate method when compared to the other methods tested. Using "Small Dots Diagonal" on the gingiva appears to be the best option, exhibiting an acceptable coefficient of variation (17.6 percent) and a high degree of accuracy in terms of tolerance (mean ± standard deviation=0.163 ± 0.029). Based on the results of this study, further investigation of CAD CAM technology for the purpose of assessment and education of dental students is recommended.
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