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Beck F, Lettner S, Zupancic Cepic L, Schedle A. Comparison of Virtual Intersection and Occlusal Contacts between Intraoral and Laboratory Scans: An In-Vivo Study. J Clin Med 2023; 12:996. [PMID: 36769645 PMCID: PMC9917590 DOI: 10.3390/jcm12030996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The inaccurate maxillomandibular relationship of virtual casts following alignment by the vestibular scan may result in intersection (intermesh penetration) between opposing dental arch surfaces. Intersection occurs at short interocclusal distances in the occlusal contact area (OCA) and may result in infra-occluded definitive restorations. The purpose of this clinical study was to compare initial (by the proprietary scanner software) and new alignments (by a standalone 3D software) of virtual casts regarding OCA and intersection failure. New alignments aimed to rectify intersections by refinement of occlusal contacts. MATERIAL AND METHODS The virtual casts of 30 patients following digital and conventional impression-taking were analyzed, which were acquired for single implant restoration in the posterior site. Digital impressions were performed by both IOS 1 (3M True Definition) and IOS 2 (TRIOS 3), either as complete- or partial-arch scans, respectively. Mounted gypsum casts were digitized as complete-arch by a laboratory scanner (LS) in enabled and disabled mode to avoid intersection [LS (+)/LS (-)]. All virtual casts were newly aligned by a 3D software. The difference of the OCA and the area of intersection were calculated for initial and new alignments, using interocclusal distance ranges of 0-100 μm, 0-10 μm or <0 μm (=intersection). The difference of the OCA was compared using a linear mixed model. The distribution of occlusal contact points per modality and alignment was assessed independently by three observers and estimated by inter- and intraclass correlation (ICC) coefficients. RESULTS Virtual casts following initial alignment demonstrated intersections irrespective of the modality. The mean area of the intersection was most for IOS 2 (79.23 mm2), followed by IOS 1 (48.28 mm2), LS (-) (2.77 mm2), and LS (+) (2.01 mm2) in partial-arch scans. Complete-arch scans demonstrated an area of intersection of 70.63 mm2 for IOS 1 followed by 65.52 mm2 (IOS 2), 6.13 mm2 [LS (-)] and 2.76 mm2 [LS (+)]. Newly aligned scans showed no intersections. The overall distribution of occlusal contact points demonstrated moderate reliability (ICC 0.63). Good reliability could be observed (ICC 0.9) for LS (-) scans. CONCLUSIONS Intersections in the area of occlusal contact points are a phenomenon restricted to virtual casts, which should be considered in CAD/CAM. Initial alignments of LS are less affected by this virtual phenomenon, and contact points may be more distinct according to their anatomic region compared to IOS. Furthermore, intersections can be rectified in a 3D software by adjustment of the maxillomandibular relationship.
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Affiliation(s)
- Florian Beck
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Lettner
- Core Facility Hard Tissue Research and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Lana Zupancic Cepic
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Schedle
- Competence Center Dental Materials, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans. Part 1: Operator factors. J ESTHET RESTOR DENT 2023; 35:230-240. [PMID: 36479807 DOI: 10.1111/jerd.12985] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe the factors related to the operator skills and decisions that influence the scanning accuracy of intraoral scanners (IOSs). A new classification for these factors is proposed to facilitate dental professionals' decision making when using IOSs and maximize the accuracy and reliability of intraoral digital scans. OVERVIEW Each IOS system is limited by the hardware and software characteristics of the selected device. The operator decisions that can influence the accuracy of IOSs include the scanning technology and system selection, scanning head size, calibration, scanning distance, exposure of the IOS to ambient temperature changes, ambient humidity, ambient lighting conditions, operator experience, scanning pattern, extension of the scan, cutting off, rescanning, and overlapping procedures. CONCLUSIONS The knowledge and understanding of the operator factors that impact scanning accuracy of IOSs is a fundamental element for maximizing the accuracy of IOSs and for successfully integrating IOSs in daily practices. CLINICAL SIGNIFICANCE Operator skills and clinical decisions significantly impact intraoral scanning accuracy. Dental professionals must know and understand these influencing operator factors for maximizing the accuracy of IOSs.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Dean E Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA.,Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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Papaspyridakos P, AlFulaij F, Bokhary A, Sallustio A, Chochlidakis K. Complete Digital Workflow for Prosthesis Prototype Fabrication with Double Digital Scanning: Accuracy of Fit Assessment. J Prosthodont 2023; 32:49-53. [PMID: 35176178 DOI: 10.1111/jopr.13492] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/05/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To assess the accuracy of a complete digital workflow protocol for fabrication of printed prosthesis prototypes for maxillary immediate loading treatment. MATERIALS AND METHODS A maxillary stone cast with 4 abutment-level implant analogs with adequate antero-posterior spread was fabricated. This stone cast served as a reference cast and a zirconia prosthesis was also fabricated to serve as an interim prosthesis. Double digital scanning was used for digital scans of the reference cast and the interim prosthesis, respectively. An intraoral scanner (TRIOS® 3) was used to capture the standard tessellation language (STL) files. These STL files were then imported to computer-aided design (CAD) software (Exocad DentalCAD) and superimposed into a final design STL file that was exported to 3 different (Form 3b+, Carbon M2, Sprintray Pro95) three-dimensional (3D) printers to produce a total of 90 printed prototypes (n = 30 from each 3D printer). Two blinded clinicians assessed the accuracy of fit of each digitally fabricated prosthesis prototype on the reference cast, utilizing the screw-resistance test and radiographs. The Fisher's exact test was used to test the difference between the groups. RESULTS Out of the 90 digitally fabricated prototypes, 86 (95.6%) presented with accurate fit. The accuracy of fit ranged from 87% (26/30) for Sprintray Pro95 to 100% (30/30) for the Form 3b+ and M2 Carbon groups. CONCLUSIONS Digitally fabricated prosthesis prototypes can be generated with a complete digital workflow leading to clinically acceptable fit, while reducing the number of appointments and treatment time. The 3D printer had an effect on the accuracy of prosthesis prototype fit.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Fahad AlFulaij
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Abdullah Bokhary
- Department of Dental Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | | | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans: Part 2-Patient factors. J ESTHET RESTOR DENT 2023; 35:241-249. [PMID: 36639916 DOI: 10.1111/jerd.12993] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To describe the factors related to patient intraoral conditions that impact the scanning accuracy of intraoral scanners (IOSs). A new classification for these influencing factors is proposed to facilitate dental professionals' decision-making and maximize the accuracy and reliability of intraoral digital scans. OVERVIEW Variables related to intraoral conditions of the patient that can influence the scanning accuracy of IOSs include tooth type, presence of interdental spaces, arch width variations, palate characteristics, wetness, existing restorations, characteristics of the surface being digitized, edentulous areas, interimplant distance, position, angulation, and depth of existing implants, and implant scan body selection. CONCLUSIONS The knowledge and understanding of the patient's intraoral conditions that can impact the scanning accuracy of IOSs is a fundamental element for maximizing the accuracy of IOSs. CLINICAL SIGNIFICANCE The patient's intraoral conditions, or patient factors, can significantly impact intraoral scanning accuracy. Dental professionals must know and understand these influencing patient factors to maximize the accuracy of IOSs.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Research and Digital Dentistry, Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Dean E Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA.,Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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55
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Papaspyridakos P, Vazouras K, Gotsis S, Bokhary A, Sicilia E, Kudara Y, Bedrossian A, Chochlidakis K. Complete digital workflow for prosthesis prototype fabrication with double digital scanning: A retrospective study with 45 edentulous jaws. J Prosthodont 2022. [PMID: 36527731 DOI: 10.1111/jopr.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To assess the accuracy of fit of complete-arch printed prosthesis prototypes generated with a digital workflow protocol for completely edentulous jaws. MATERIALS AND METHODS Forty-five edentulous jaws (35 patients) underwent intraoral complete-arch digital scans with the double digital scanning (DDS) technique and the generated standard tessellation language (STL) files were superimposed and imported into computer-aided design software. After STL merging, each master STL file was used for printing a prosthesis prototype. The primary outcome was the accuracy of fit assessment of the printed prototypes on verified master stone casts. Two experienced clinicians tested the accuracy of fit with radiographs and screw-resistance tests. Secondary outcomes were the effect of the scan body shape and implant number on the accuracy of fit. RESULTS Out of the 45 DDS-generated prosthesis prototypes, 39 presented with accurate fit on verified master stone casts, yielding an 86.70% accuracy of fit. Cylindrical scan bodies led to 100% accuracy of fit (25/25), whereas polygonal scan bodies presented with 70% accuracy of fit (14/20). Four implant-supported prostheses yielded 100% accuracy of fit (12/12), compared with 25/29 (86.30%) accuracy of fit for the six-implant-supported ones. Fisher's exact test was used to assess the effect of different scan body shapes (p = 0.005) and implant number on accuracy of fit. Chi-squared test was used to assess the association between the number of implants per arch and the accuracy of fit (p = 0.039). CONCLUSIONS Thirty-nine out of 45 complete-arch prosthesis prototypes generated with a completely digital workflow presented with clinically acceptable fit. The effect of the scan body design and implant number was statistically significant, favoring cylindrical scan bodies and four-implant-supported prostheses.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
| | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Sotirios Gotsis
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Yukio Kudara
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, Washington, USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
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56
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Gómez-Polo M, Ortega R, Sallorenzo A, Agustín-Panadero R, Barmak AB, Kois JC, Revilla-León M. Influence of the surface humidity, implant angulation, and interimplant distance on the accuracy and scanning time of complete-arch implant scans. J Dent 2022; 127:104307. [PMID: 36162637 DOI: 10.1016/j.jdent.2022.104307] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/22/2022] [Accepted: 09/22/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess the influence of implant angulation, humidity, and interimplant distance on the accuracy and scanning time of complete-arch implant scans. METHODS A definitive cast with 4 parallel implant abutment analogs (P group), and another cast with 4 angulated (up to 30 degrees) implant abutment analogs (NP group) were digitized by using a scanner (7Series) (reference scans). Two subgroups were created: dry (D subgroup) and wet (W subgroup). For the D subgroup, the casts were digitized without altering the surface humidity by using an intraoral scanner (IOS) (TRIOS 3). For the W subgroup, the cast surface was humidified with artificial saliva and digitized by using the same IOS. The interimplant distance discrepancies were assessed by computing linear and angular measurements. Trueness data was analyzed using 3-way ANOVA followed by the pairwise comparison Tukey tests. The Bartlett test, followed by the pairwise comparison tests, was used to assess the precision (α=.05). RESULTS Regarding the trueness, implant angulation (P<.001) and inter-implant distance measurement (P<.001) influenced the linear discrepancies. Implant angulation (P=.002), humidity conditions (P<.001), and inter-implant distance (P=.001) influenced the angular discrepancies. Regarding the precision, significant differences in the variance of linear and angular measurements and inter-implant distances were found. Humidity conditions (P<.001) influenced the scanning time. CONCLUSIONS Implant angulation, humidity, and interimplant distance influenced the accuracy and scanning time of complete-arch implant scans. Parallel implants resulted in higher trueness and precision values. Dry conditions resulted in slightly higher scanning trueness and precision and shorter scanning time. CLINICAL SIGNIFICANCE Drying the surface being scanned increases intraoral scanning accuracy and decreases intraoral scanning time.
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Affiliation(s)
- Miguel Gómez-Polo
- Associate Professor Department of Conservative Dentistry and Prosthodontics, Director of postgraduate program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Adjunct Professor Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Alessandro Sallorenzo
- Postgraduate Specialist in Advanced-Prosthodontics. Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rubén Agustín-Panadero
- Associate Professor Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - John C Kois
- Founder and Director Kois Center, Seattle, WA, USA; Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, WA, USA; Private Practice, Seattle, WA, USA
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, WA, USA; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA, USA.
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57
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Kao TY, Hsieh MC, Hsu CP, Liao CC, Chang CL. Accuracy of digital impressions for three-unit and four-unit implant supported fixed dental prostheses using a novel device. J Dent Sci 2022; 18:702-708. [PMID: 37021250 PMCID: PMC10068367 DOI: 10.1016/j.jds.2022.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background/ purpose Accuracy of digital implant impressions was considered questionable due to the lack of anatomical reference points between implants and the similarities in scan body morphology, which lead to the purpose of this research is to propose a simple and convenient technique to improve the accuracy of scanning. Materials and methods Four implant analogues (teeth: 15, 17, 24, and 27) were inserted into a stone model of a partially edentulous maxilla; two implants were inserted on each side, creating a three-unit span and a four-unit span. The model was scanned using a 3Shape E4 dental laboratory scanner for reference and a TRIOS 3 intraoral scanner for testing. Each side was scanned 10 times, both with and without the novel device attached to the scan bodies. The trueness and precision of interimplant distances (linear deviations), and interimplant angulations (angle deviations) between the scan bodies were determined using software. A Mann-Whitney U test was used to determine statistical differences between subgroups. Results Significant differences were discovered in the trueness of angular deviations (-0.20° ± 0.15° vs. -0.01° ± 0.11º) and precision of linear deviations (11.14 ± 6.35 vs. 3.10 ± 2.14 μm) for the four-unit groups. Conclusion The novel device significantly improved scanning accuracy for a four-unit groups (approximately 22.93 mm) compared to three-unit groups.
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Affiliation(s)
- Tzu-Yung Kao
- Department of Prosthodontics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Min-Chieh Hsieh
- Department of Prosthodontics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chi-Pin Hsu
- High Speed 3D Printing Research Center, National Taiwan University of Science and Technology, Taipei, Taiwan
| | | | - Chih-Ling Chang
- Department of Prosthodontics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Dentistry, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Corresponding author. Department of Prosthodontics, Shin Kong Wu Ho-Su Memorial Hospital, B1F., No. 95, Wen Chang Road, Shih Lin District, Taipei, 11101, Taiwan.
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Yang CH, Cheng CW, Ye SY, Chien CH. A double blinded trial to compare the patient satisfaction and crown accuracy of two different intraoral scanners for the fabrication of monolithic lithium disilicate single crowns. J Dent Sci 2022. [DOI: 10.1016/j.jds.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Abdeen L, Chen Y, Kostagianni A, Finkelman M, Papathanasiou A, Chochlidakis K, Papaspyridakos P. Prosthesis accuracy of fit on 3D‐printed casts versus stone casts: A comparative study in the anterior maxilla. J ESTHET RESTOR DENT 2022; 34:1238-1246. [DOI: 10.1111/jerd.12954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Layal Abdeen
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts USA
| | - Yo‐wei Chen
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts USA
| | - Aikaterini Kostagianni
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts USA
| | - Matthew Finkelman
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston Massachusetts USA
| | - Aikaterini Papathanasiou
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester New York USA
| | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts USA
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester New York USA
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60
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Kernen FR, Recca M, Vach K, Nahles S, Nelson K, Flügge TV. In vitro scanning accuracy using different aids for multiple implants in the edentulous arch. Clin Oral Implants Res 2022; 33:1010-1020. [PMID: 35861128 DOI: 10.1111/clr.13982] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Optical impressions of implants in the edentulous arch are challenged by the absence of distinct surface morphology between multiple implant scan bodies. The purpose of this in vitro study was to evaluate a newly developed scan aid in various designs and colors to improve the accuracy of multi-implant scans. MATERIAL AND METHODS A universal scan aid in three different designs (circular, square, irregular) and three different materials (colors: beige, gray, white) was applied to the implant scan bodies of a master model of 6 implants in an edentulous maxilla. Ten scans using an intra-oral scanner of each scan aid were acquired. Reference scanning was performed using a desktop optical scanner. Alignment of scans was performed at the first scan body in a three-dimensional modeling and inspection software and deviations for trueness and precision were calculated using the signed nearest neighbor method and then statistically analyzed (α=.05). RESULTS Overall, the beige irregular scan aid had the highest trueness and showed significant differences compared to unsplinted scans. The precision showed more heterogenous results and decreased when using the scan aid. Ease of use was observed with the irregular gray scan aid due to its increased elongation at break. CONCLUSIONS The evaluated scan aid led to improved trueness when compared to unsplinted scans. Even though the irregular design in beige color showed highest trueness, the poor fracture strength of the tested material requires further improvement.
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Affiliation(s)
- Florian Robert Kernen
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mario Recca
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Susanne Nahles
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tabea Viktoria Flügge
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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Pan Y, Tsoi JKH, Lam WYH, Zhao K, Pow EHN. The cumulative effect of error in the digital workflow for complete-arch implant-supported frameworks: an in vitro study. Clin Oral Implants Res 2022; 33:886-899. [PMID: 35770363 DOI: 10.1111/clr.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/01/2022] [Accepted: 06/18/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the error accumulation and distribution through various stages of the digital workflow for complete-arch implant-supported framework fabrication. MATERIALS AND METHODS A resin model of edentulous maxilla with 6 dental implants was scanned using an intraoral scanner for 10 times (Complete-digital group). Ten conventional gypsum casts were made and digitized by a laboratory scanner (Analogue-digital group). Five implant frameworks were designed and milled using CAD-CAM technique for each workflow. Inter-implant distances and angles of the resin model (reference) and frameworks were measured by a coordinate measuring machine, while the scans and virtual frameworks were examined by an inspection software. Effect of type of workflow and the individual stage on the accuracy of the frameworks were analysed by Two-way ANOVA. RESULTS The expanded uncertainty of both workflows was ~150 μm and ~0.8°. The accuracy of the CAD stage was the highest. In the complete-digital workflow, the greatest distortion was found in the data acquisition stage, while in the analogue-digital workflow, it was found in the CAM stage. Compared to the analogue-digital group, the complete-digital group showed a significant higher precision in first-quadrant but lower trueness in second-quadrant in data acquisition, and a significantly lower precision in second-quadrant at the CAD stage. CONCLUSIONS Linear distortions of the complete-digital and analogue-digital workflows were clinically acceptable, while angular distortions were not. Distortions were generally derived from data acquisition and CAM stage. The CAD precision depended on the distortions derived from data acquisition. The complete-digital workflow was not as accurate as the analogue-digital in complete-arch implant rehabilitation.
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Affiliation(s)
- Yu Pan
- Department of Dentistry, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.,Faculty of Dentistry, The University of Hong Kong, Hong Kong special administrative region, China
| | - James Kit Hon Tsoi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong special administrative region, China
| | - Walter Y H Lam
- Faculty of Dentistry, The University of Hong Kong, Hong Kong special administrative region, China
| | - Ke Zhao
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Edmond H N Pow
- Faculty of Dentistry, The University of Hong Kong, Hong Kong special administrative region, China
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Papaspyridakos P, De Souza A, Finkelman M, Sicilia E, Gotsis S, Chen YW, Vazouras K, Chochlidakis K. Digital VS Conventional Full-Arch Implant Impressions: A Retrospective Analysis of 36 Edentulous Jaws. J Prosthodont 2022; 32:325-330. [PMID: 35524647 DOI: 10.1111/jopr.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE There is a paucity of comparative clinical studies assessing the accuracy of full-arch digital versus conventional implant impressions. The aim of this retrospective study was to compare the three-dimensional (3D) deviations between full-arch digital and conventional implant impressions for edentulous maxillae and mandibles. MATERIALS AND METHODS Twenty-seven patients (36 edentulous jaws) were treated with one-piece, screw-retained implant-supported fixed complete dental prostheses (IFCDPs). Twenty-one jaws were maxillary, and 15 were mandibular. Full-arch conventional impressions and intraoral digital scans with scan bodies and an intraoral scanner had been taken during the impression phase. Following verification of the conventional stone casts, the casts were digitized. The generated standard tessellation language (STL) files from both impression techniques were merged and analyzed with reverse engineering software. The primary aim was to evaluate the accuracy between conventional and digital full-arch scans, while the effect of the edentulous jaw in 3D accuracy was the secondary aim. RESULTS The cumulative 3D (mean ±SD) deviations between virtual casts from intraoral full-arch digital scans and digitized stone casts generated from conventional implant impressions were found to be 88 ±24 μm. In the maxillary group, the mean ±SD 3D deviation was 85 ±25 μm, compared to 92 ±23 μm for the mandibular group (P = .444). CONCLUSION The 3D implant deviations found between the full-arch digital and conventional impressions lie within the clinically acceptable threshold. No statistically significant difference was identified between maxillary and mandibular jaws in terms of 3D deviations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Andre De Souza
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Matthew Finkelman
- Department of Public Health, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Sotirios Gotsis
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Yo-Wei Chen
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
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63
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Influence of the implant scan body geometry bevel feature position, implant angulation, and position on intraoral scanning accuracy: An in vitro study. J Dent 2022; 121:104122. [PMID: 35395345 DOI: 10.1016/j.jdent.2022.104122] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To assess the influence of the scan body geometry bevel position and implant angulation and position of complete-arch implant digital scans. MATERIAL AND METHODS Two definitive casts with 4 implant analogs placed parallel (P group) or angulated up to 30 degrees (NP group) were fabricated. Five subgroups were created based on the scan body geometry bevel position: facial, mesial, distal, lingual, or random (F, M, D, L, and R subgroup). Casts were digitized using a laboratory scanner (reference) (7Series Desktop Scanner) and an intraoral scanner (TRIOS 3). The implant position discrepancies between the reference and experimental scans were calculated. Data was analyzed using 3-way ANOVA and Tukey tests (α=.05). RESULTS The scan body geometry bevel position (P<.001) and the inter-implant distance (P<.001) were shown as significant predictors of the linear discrepancies obtained. The L subgroup had a significantly lower discrepancy compared with the other subgroups. Implant angulation (P<.001), the scan body geometry bevel position (P<.001), and the inter-implant distance (P<.001) were all significant predictors on the angular discrepancies obtained. CONCLUSIONS The scan body geometry bevel feature position and implant angulation and position influenced the accuracy of the IOS tested. The lingual orientation obtained significantly better accuracy values compared with the other positions. The parallel implant analog position obtained better accuracy than the angulated positions. Lastly, the implant positioned in the dental arch where the intraoral digital scan was started obtained significantly higher distortion than the contralateral implant.
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64
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ACCURACY OF INTRAORAL SCANNERS VERSUS TRADITIONAL IMPRESSIONS: A RAPID UMBRELLA REVIEW. J Evid Based Dent Pract 2022; 22:101719. [DOI: 10.1016/j.jebdp.2022.101719] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/29/2022] [Accepted: 03/11/2022] [Indexed: 12/13/2022]
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65
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Accuracy of Digital Dental Implants Impression Taking with Intraoral Scanners Compared with Conventional Impression Techniques: A Systematic Review of In Vitro Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042026. [PMID: 35206217 PMCID: PMC8872312 DOI: 10.3390/ijerph19042026] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/20/2022]
Abstract
The aim of this systematic review was to evaluate the in vitro accuracy of dental implants impressions taken with intraoral scanner compared with impressions taken with conventional techniques. Two independent reviewers conducted a systematic electronic search in the PubMed, Web of Science and Scopus databases. Some of the employed key terms, combined with the help of Boolean operators, were: "dental implants", "impression accuracy", "digital impression" and "conventional impression". Publication dates ranged from the earliest article available until 31 July 2021. A total of 26 articles fulfilled the inclusion criteria: 14 studies simulated complete edentation (CE), nine partial edentation (PE) and only two simulated a single implant (SI); One study simulated both CE and SI. In cases of PE and SI, most of the studies analyzed found greater accuracy with conventional impression (CI), although digital impression (DI) was also considered adequate. For CE the findings were inconclusive as six studies found greater accuracy with DI, five found better accuracy with CI and four found no differences. According to the results of this systematic review, DI is a valid alternative to CI for implants in PE and SI, although CI appear to be more accurate. For CE the findings were inconclusive, so more studies are needed before DI can be recommended for all implant-supported restorations.
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66
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Cone-Beam Angle Dependency of 3D Models Computed from Cone-Beam CT Images. SENSORS 2022; 22:s22031253. [PMID: 35162003 PMCID: PMC8837983 DOI: 10.3390/s22031253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 12/26/2022]
Abstract
Cone-beam dental CT can provide high-precision 3D images of the teeth and surrounding bones. From the 3D CT images, 3D models, also called digital impressions, can be computed for CAD/CAM-based fabrication of dental restorations or orthodontic devices. However, the cone-beam angle-dependent artifacts, mostly caused by the incompleteness of the projection data acquired in the circular cone-beam scan geometry, can induce significant errors in the 3D models. Using a micro-CT, we acquired CT projection data of plaster cast models at several different cone-beam angles, and we investigated the dependency of the model errors on the cone-beam angle in comparison with the reference models obtained from the optical scanning of the plaster models. For the 3D CT image reconstruction, we used the conventional Feldkamp algorithm and the combined half-scan image reconstruction algorithm to investigate the dependency of the model errors on the image reconstruction algorithm. We analyzed the mean of positive deviations and the mean of negative deviations of the surface points on the CT-image-derived 3D models from the reference model, and we compared them between the two image reconstruction algorithms. It has been found that the model error increases as the cone-beam angle increases in both algorithms. However, the model errors are smaller in the combined half-scan image reconstruction when the cone-beam angle is as large as 10 degrees.
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67
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Pan Y, Heng C, Wu ZJ, Tam J, Hsung RT, Pow EH, Lam WY. Comparison of the virtual techniques in registering single implant position with a universal-coordinate system: An in vitro study. J Dent 2021; 117:103925. [PMID: 34929339 DOI: 10.1016/j.jdent.2021.103925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/12/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of this in-vitro study was to compare the virtual techniques for registering single-implant position to the physical gold standard using a universal-coordinate system. MATERIALS AND METHODS Thirty dentate maxillary resin models with a dental implant inserted in the incisor region were prepared. On each model, a tooth-supported acrylic stent with a 1 cm x 1 cm x 1 cm cubic-corner (CC) was prepared. The Cartesian x,y,z-coordinate of the implant neck and apex were measured physically by a coordinate-measuring machine (CMM) with reference to this CC and served as the gold-standard. The resin models were scanned by a benchtop scanner (Group BS), cone-beam computed tomography (Group CBCT), and intraoral scanner (Group IOS). Stone casts, poured from open-tray polyether impression of the resin models, were scanned by the benchtop scanner (Group BS-cast). The implant neck and apex coordinates with reference to the CC were measured and the differences in the coordinates (∆x, ∆y, ∆z) and distance r from the gold standard were calculated. The data were analyzed by one-sample t-test and one-way ANOVA/Kruskal-Wallis test with the level of significance set at 0.05. RESULTS The implant neck and apex positions of Group BS were statistically different from that of the CMM, r>0 (p<0.001). Group IOS showed a significant less ∆z and r at the implant neck than Group BS-cast (p = 0.006). No significant difference was found in the coordinates and distance at implant apex among Groups BS, CBCT, IOS and BS-cast. CONCLUSIONS The physical measurements could be adopted as the gold standard in assessing the single-implant positions. The IOS was more accurate in registering the single-implant neck positions than scanning of the cast. CLINICAL SIGNIFICANCE A universal-coordinate system defined by the cubic-corner allows comparing the virtual techniques in registering single-implant positions to the physical gold standard.
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Affiliation(s)
- Yu Pan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Caiyun Heng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Zhi-Jie Wu
- School of Information Engineering, Guangdong University of Technology, Guangzhou, China
| | - Juliana Tam
- Industrial Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Richard Tc Hsung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; School of Information Engineering, Guangdong University of Technology, Guangzhou, China; Department of Computer science, Chu Hai College of Higher Education, Hong Kong SAR, China
| | - Edmond Hn Pow
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Walter Yh Lam
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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68
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Bishti S, Tuna T, Rittich A, Wolfart S. Patient-reported outcome measures (PROMs) of implant-supported reconstructions using digital workflows: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:318-335. [PMID: 34642981 DOI: 10.1111/clr.13846] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To summarize the existing evidence on patient-reported outcome measures (PROMs) of implant-supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. METHODS A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant-supported restorations. Only clinical trials assessing conventional versus digital workflows for implant-supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta-analyses, while implant planning/placement was reported descriptively. RESULTS Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta-analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. CONCLUSION Most of the studies reporting about PROMs were published during the last ten years and limited to implant-supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.
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Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, RWTH University, Aachen, Germany
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69
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De Souza AB, Kang M, Negreiros WM, El-Rafie K, Finkelman M, Papaspyridakos P. A comparative retrospective study of different surgical guide designs for static computer-assisted implant surgery in posterior single edentulous sites. Clin Oral Implants Res 2021; 33:45-52. [PMID: 34587320 DOI: 10.1111/clr.13858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 08/10/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this retrospective clinical study was to compare the accuracy of static Computer-assisted implant surgery (sCAIS) in posterior single edentulous patients using different surgical guide designs. MATERIALS AND METHODS Thirty-seven partially edentulous patients with a total of 54 implants were included in the study. Seventeen implants were included in Group 1-Unbounded Tooth-Mucosa Supported; 18 implants in Group 2-Unbounded Tooth Supported; and 19 implants in Group 3 (Control)-Bounded Tooth Supported. All partially edentulous patients were treated with fully guided implant surgery using the corresponding surgical guide. Discrepancies between the pre-planned and post-operative implant position were evaluated. RESULTS The mean angular deviation ± standard deviation (SD) was 2.91 ± 1.56°, 3.33 ± 1.72° and 2.25 ± 1.13° for Groups 1, 2, and 3, respectively. The mean ± SD 3D offset at base was 0.66 ± 0.29 mm, 0.77 ± 0.24 mm, and 0.49 ± 0.22 mm; and 3D offset at tip was 0.84 ± 0.45 mm, 1.07 ± 0.38 mm, and 0.75 ± 0.25 mm for Groups 1, 2, and 3, respectively. No statistically significant differences between groups were found for angular deviation. There were statistically significant differences between Groups 2 and 3 for 3D offset at base (p = .002) and 3D offset at tip (p = .010). CONCLUSIONS Different surgical guide designs for posterior single edentulous areas appear to be associated with the accuracy level of sCAIS. In unbounded sites, having additional posterior attached soft tissue support is preferable.
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Affiliation(s)
| | - Michael Kang
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | | | - Khaled El-Rafie
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
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70
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
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71
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Altemimi A, Rodriguez J, Nahon M. A Combined Digital Technique for Manufacturing Functional Fixed Implant Prosthesis Prototypes Using a CAD/CAM Software. J Prosthodont 2021; 31:85-90. [PMID: 34453372 DOI: 10.1111/jopr.13416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 11/29/2022] Open
Abstract
The manufacture of complete-arch fixed implant prostheses requires many technical steps to ensure a successful outcome. With the use of monolithic materials such as zirconia, the design of the prosthesis is crucial for a superior result. The aim of this article is to outline a combined technique using a CAD/CAM software for the manufacture of fixed implant prosthesis prototypes for complete-arch implant rehabilitations, which can be done in-house with minimal equipment. This makes it accessible and feasible for those who wish to be involved in the design phase of such prostheses. The method involves collecting several 3D data files including the patient's current prosthesis, the definitive cast, occlusal records and photographs. The technique is described using a patient case that has been provided with digitally designed and in-house manufactured prototypes.
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Affiliation(s)
- Aseel Altemimi
- Department of Prosthodontics, Nova Southeastern University College of Dental Medicine, Ft Lauderdale, FL
| | - Julio Rodriguez
- Department of Prosthodontics, Nova Southeastern University College of Dental Medicine, Ft Lauderdale, FL
| | - Max Nahon
- Department of Prosthodontics, Nova Southeastern University College of Dental Medicine, Ft Lauderdale, FL
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72
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Marinis A, Papaspyridakos P, Sicilia E, Bernandes SR, Touloumi F, Chochlidakis K, Weber HP. Digital Workflow for Double Complete Arch Zirconia Prostheses Utilizing a Novel Scan Body. J Prosthodont 2021; 31:4-8. [PMID: 34453373 DOI: 10.1111/jopr.13417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Abstract
The purpose of this clinical report is to present a complete digital workflow for the fabrication of complete arch fixed zirconia implant restorations. An intraoral scanner was used to capture the implants' position at the abutment level and also the patient's existing interim prostheses with the double digital scanning technique. A novel scan body and impression pin were utilized throughout the scanning process which allowed for the accurate and reproducible superimposition of the generated Standard Tesselation Language (STL) files. Prosthesis prototypes were digitally designed and fabricated, tried in, and verified intraorally. The definitive zirconia prostheses were then fabricated and delivered to the patient. This technique can be utilized in both arches overcoming the absence of stable intraoral landmarks for superimposition of STL files.
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Affiliation(s)
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Sergio Rocha Bernandes
- The Latin American Institute of Dental Research and Education, Head of New Product Development and Clinical Practice at Neodent, Curitiba, Brazil
| | - Foteini Touloumi
- Division of Prosthodontics, University of Connecticut Health Center, Farmington, CT
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Clear Choice Dental Implant Center, Quincy, MA
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The Influence of Hard- and Software Improvement of Intraoral Scanners on the Implant Transfer Accuracy from 2012 to 2021: An In Vitro Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11157166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate the transfer accuracy (trueness and precision) of three different intraoral scanning families using different hardware and software versions over the last decade from 2012 to 2021, compared to a conventional impression. Therefore, an implant master model with a reference cube was digitized and served as a reference dataset. Digital impressions of all three scanning families (True definition, TRIOS, CEREC) were recorded (n = 10 per group), and conventional implant impressions were taken (n = 10). The conventional models were digitized, and all models (conventional and digital) were measured. Therefore, it was possible to obtain the deviations between the master model and the scans or conventional models in terms of absolute three-dimensional (3D) deviations, deviations in rotation, and angulation. The results for deviations between the older and newer scanning systems were analyzed using pairwise comparisons (p < 0.05; SPSS 26). The absolute 3D deviations increased with increasing scan path length, particularly for the older hardware and software versions (old vs. new (MW ± SD) True Definition: 355 ± 62 µm vs. 483 ± 110 µm; TRIOS: 574 ± 274 µm vs. 258 ± 100 µm; and CEREC: 1356 ± 1023 µm vs. 110 ± 49 µm). This was also true for deviations in rotation and angulation. The conventional impression showed an advantage only regarding the absolute 3D deviation compared to the older systems. Based on the data of the present study, the accuracy of intraoral scanners is decisively related to hardware and software; though, newer systems or software do not necessarily warrant improvement. Nevertheless, to achieve high transfer accuracy, regular updating of digital systems is recommended. The challenge of increasing errors with increasing scan paths is overcome in the most recent systems. The combination of two different scanning principles in a single device seems to be beneficial.
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74
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Sinada N, Papaspyridakos P. Digitally Designed and Milled Verification Jigs Generated from Photogrammetry Data Acquisition: A Clinical Report. J Prosthodont 2021; 30:651-655. [PMID: 34296484 DOI: 10.1111/jopr.13409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
The objective of the present report is to illustrate a proof-of-concept protocol for CAD/CAM fabrication of milled verification jigs during full-arch implant rehabilitation using photogrammetry for data acquisition. The present report aims to bridge the gap between analog and digital workflows by introducing a CAD/CAM technique to intraorally verify digitally acquired information without the use of the technique-sensitive and labor-intensive conventional resin verification jig. One patient was treated with a digital prosthodontic protocol where a digitally designed CAD/CAM milled verification jig (generated from intraoral digital scans) was used to confirm implant 3D positioning prior to the fabrication of double full-arch monolithic definitive zirconia prostheses. The procedures are presented step-by-step after clinical and radiographic observation.
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Affiliation(s)
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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Zandinejad A, Liang H, Fisher Cosio NA, Revilla-León M. Fabrication of a complete-arch implant-supported fixed interim prosthesis by using a cone beam computed tomography digital scan for a patient with primordial dwarfism: A dental technique. J Prosthet Dent 2021; 128:1179-1183. [PMID: 33933270 DOI: 10.1016/j.prosdent.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022]
Abstract
A complete-arch implant-supported interim prosthesis was fabricated from a cone beam computed tomography digital scan of the implant abutments for a patient with primordial dwarfism. The patient presented with limited mouth opening, which hindered the use of a conventional impression technique. The described technique provided an alternative digital procedure to obtain a virtual implant definitive cast.
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Affiliation(s)
- Amirali Zandinejad
- Associate Professor and Program Director AEGD Residency Program, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, Texas
| | - Hui Liang
- Professor and Pre-Doctoral Program Director of Oral Radiology, Department of Diagnostic Sciences, College of Dentistry, Texas A&M University, Dallas, Texas
| | - Nicole A Fisher Cosio
- AEGD Resident, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, Texas
| | - Marta Revilla-León
- Assistant Professor and Assistant Program Director AEGD Residency Program, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, Texas; Affiliate Faculty Graduate Prosthodontics, Restorative Dentistry Department, School of Dentistry, University of Washington, Seattle, Wash; Researcher at Revilla Research Center, Madrid, Spain.
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76
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Papaspyridakos P, De Souza A, Bathija A, Kang K, Chochlidakis K. Complete Digital Workflow for Mandibular Full-Arch Implant Rehabilitation in 3 Appointments. J Prosthodont 2021; 30:548-552. [PMID: 33811713 DOI: 10.1111/jopr.13356] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2021] [Indexed: 11/28/2022] Open
Abstract
The aim of this clinical report is to describe a complete digital workflow protocol for mandibular full-arch implant rehabilitation from guided surgery to definitive prosthesis in only 3 appointments. This expedited protocol allows for guided implant placement with a system of stackable surgical templates and CAD/CAM prosthodontic rehabilitation using a digital workflow. At the first appointment, a guided implant placement protocol with the stackable template concept was done followed by immediate loading with a prefabricated interim prosthesis. At the same appointment, the Double Digital Scanning (DDS) technique was used for scanning, maxillomandibular relationship registration and virtual articulation. The anchor pins from guided surgery were used as fiducial markers for DDS data superimposition. At the second appointment, the prosthesis prototype was tried-in and adjustments were made. At the third appointment, the definitive monolithic zirconia full-arch prosthesis was delivered.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Andre De Souza
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Anshu Bathija
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Kiho Kang
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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77
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Schmidt A, Rein PE, Wöstmann B, Schlenz MA. A comparative clinical study on the transfer accuracy of conventional and digital implant impressions using a new reference key-based method. Clin Oral Implants Res 2021; 32:460-469. [PMID: 33469983 DOI: 10.1111/clr.13715] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objective of this study was to systematically compare the transfer accuracy of conventional and digital implant impressions in patients using a new reference key-based method. MATERIAL AND METHODS Thirty-nine cases were included in the study (upper jaw 22 edentulous, 8 partially edentulous, average distance between implants 30.15 ± 11.18 mm; lower jaw 6 cases edentulous, 3 cases partially edentulous, average distance between implants 33.19 ± 14.85 mm). Individual reference keys were manufactured and reversibly fixed on implants. A conventional (CVI) and a digital (DI) implant impression was made. The implant positions (center points) of conventional and digital models were measured (coordinate-measuring machine/three-dimensional analysis software) and superimposed with the positions of the reference keys to compare the deviations of the conventional and digital models. For statistical analysis, ANOVA with MIXED procedure was applied (p < .05). RESULTS Mean deviation ranged from 0.040±0.029 mm (DI/upper jaw) to 0.079 ± 0.050 mm (DI/lower jaw). There were significant differences between the CVI and DI impressions in the lower jaw (p < .05). No significant differences in transfer accuracy were found between partially and completely edentulous patients for the impression methods. CONCLUSIONS Within the limits of the present study, it can be concluded that full-arch digital implant impressions of the upper jaw in partially or completely edentulous patients showed comparable results to conventional implant impressions. However, with regard to the implant position transfer accuracy, there are still limitations for digital impression in the lower jaw.
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Affiliation(s)
- Alexander Schmidt
- Department of Prosthodontics - School of Dental Medicine, Justus Liebig University, Giessen, Germany
| | | | - Bernd Wöstmann
- Department of Prosthodontics - School of Dental Medicine, Justus Liebig University, Giessen, Germany
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Banjar A, Chen YW, Kostagianni A, Finkelman M, Papathanasiou A, Chochlidakis K, Papaspyridakos P. Accuracy of 3D Printed Implant Casts Versus Stone Casts: A Comparative Study in the Anterior Maxilla. J Prosthodont 2021; 30:783-788. [PMID: 33474754 DOI: 10.1111/jopr.13335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To conduct an in vitro comparison of the amount of three-dimensional (3D) deviation of 3D printed casts generated from digital implant impressions with an intraoral scanner (IOS) to stone casts made of conventional impressions. MATERIAL AND METHODS A maxillary master cast with partially edentulous anterior area was fabricated with two internal connection implants (Regular CrossFit, Straumann). Stone casts (n = 10) that served as a control were fabricated with the splinted open-tray impression technique. Twenty digital impressions were made using a white light IOS (TRIOS, 3shape) and the Standard Tesselation Language (STL) files obtained were saved. Based on the STL files, a digital light processing (DLP) and a stereolithographic (SLA) 3D printer (Varseo S and Form 2) were used to print casts (n = 10 from each 3D printer). The master cast and all casts generated from each group were digitized using the same IOS. The STL files obtained were superimposed on the master cast STL file (reference) to evaluate the amount of 3D deviation with inspection software using the root mean square value (RMS). The independent-samples Kruskal-Wallis test and Dunn's test with Bonferroni correction (for post hoc comparisons) were used for statistical analyses. RESULTS The Varseo S group had the lowest median RMS value [77.5 µm (IQR = 91.4-135.4)], followed closely by the Conventional group [77.7 µm (IQR = 61.5-93.4)]. The Form 2 had the highest mean value [98.8 µm (IQR = 57.6-87.9)]. The independent-samples Kruskal-Wallis test revealed a significant difference between the groups (p = 0.018). Post hoc testing revealed a significant difference between Varseo S and Form 2 (p = 0.009). CONCLUSION The casts generated from the Varseo S 3D printer had better 3D accuracy than did those from the Form 2 3D printer. Both the Varseo S group and the conventional stone casts groups had similar 3D accuracy.
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Affiliation(s)
- Ayman Banjar
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Yo-Wei Chen
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | | | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA
| | | | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
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Mangano FG, Admakin O, Bonacina M, Lerner H, Rutkunas V, Mangano C. Trueness of 12 intraoral scanners in the full-arch implant impression: a comparative in vitro study. BMC Oral Health 2020; 20:263. [PMID: 32962680 PMCID: PMC7509929 DOI: 10.1186/s12903-020-01254-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The literature has not yet validated the use of intraoral scanners (IOSs) for full-arch (FA) implant impression. Hence, the aim of this in vitro study was to assess and compare the trueness of 12 different IOSs in FA implant impression. METHODS A stone-cast model of a totally edentulous maxilla with 6 implant analogues and scanbodies (SBs) was scanned with a desktop scanner (Freedom UHD®) to capture a reference model (RM), and with 12 IOSs (ITERO ELEMENTS 5D®; PRIMESCAN® and OMNICAM®; CS 3700® and CS 3600®; TRIOS3®; i-500®; EMERALD S® and EMERALD®; VIRTUO VIVO® and DWIO®; RUNEYES QUICKSCAN®). Ten scans were taken using each IOS, and each was compared to the RM, to evaluate trueness. A mesh/mesh method and a nurbs/nurbs method were used to evaluate the overall trueness of the scans; linear and cross distances between the SBs were used to evaluate the local trueness of the scans. The analysis was performed using reverse engineering software (Studio®, Geomagics; Magics®, Materialise). A statistical evaluation was performed. RESULTS With the mesh/mesh method, the best results were obtained by CS 3700® (mean error 30.4 μm) followed by ITERO ELEMENTS 5D® (31.4 μm), i-500® (32.2 μm), TRIOS 3® (36.4 μm), CS 3600® (36.5 μm), PRIMESCAN® (38.4 μm), VIRTUO VIVO® (43.8 μm), RUNEYES® (44.4 μm), EMERALD S® (52.9 μm), EMERALD® (76.1 μm), OMNICAM® (79.6 μm) and DWIO® (98.4 μm). With the nurbs/nurbs method, the best results were obtained by ITERO ELEMENTS 5D® (mean error 16.1 μm), followed by PRIMESCAN® (19.3 μm), TRIOS 3® (20.2 μm), i-500® (20.8 μm), CS 3700® (21.9 μm), CS 3600® (24.4 μm), VIRTUO VIVO® (32.0 μm), RUNEYES® (33.9 μm), EMERALD S® (36.8 μm), OMNICAM® (47.0 μm), EMERALD® (51.9 μm) and DWIO® (69.9 μm). Statistically significant differences were found between the IOSs. Linear and cross distances between the SBs (local trueness analysis) confirmed the data that emerged from the overall trueness evaluation. CONCLUSIONS Different levels of trueness were found among the IOSs evaluated in this study. Further studies are needed to confirm these results.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, 119992 Moscow, Russia
| | - Oleg Admakin
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, 119992 Moscow, Russia
| | - Matteo Bonacina
- Ars and Technology, Sotto il Monte Giovanni XXIII, 24039 Bergamo, Italy
| | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, 60323 Frankfurt am Main, Germany
| | - Vygandas Rutkunas
- Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Carlo Mangano
- Department of Dental Sciences, Vita and Salute University San Raffaele, 20132 Milan, Italy
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Albayrak B, Sukotjo C, Wee AG, Korkmaz İH, Bayındır F. Three-Dimensional Accuracy of Conventional Versus Digital Complete Arch Implant Impressions. J Prosthodont 2020; 30:163-170. [PMID: 32935894 DOI: 10.1111/jopr.13264] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The accuracy of digital impressions is still controversial for complete arch implant cases. The aim of this study is to compare the accuracy of different intraoral scanners with the conventional technique in terms of trueness and precision in a complete arch implant model. MATERIAL AND METHODS Eight implants were inserted asymmetrically in a polyurethane edentulous mandibular model with different angulations. A 3-dimensional (3D) reference model was obtained by scanning this polyurethane model with an optical scanner. First, digital impressions were made by using 3 different intraoral scanners: Carestream 3500 (DC), Cerec Omnicam (DO) and 3Shape Trios 3 (DT). Subsequently, a nonsplinted open tray impression technique was used for conventional impression group (C) and then the master casts were digitalized with a lab scanner. Each 10 STL files belonging to 4 different impression groups were imported to a reverse engineering program, to measure distance and angle deviations from the reference model. All statistical analyses were performed after taking absolute values of the data. After comparing the impression groups with one-way ANOVA, the trueness and precision values were analyzed by Tukey post hoc test and 0.05 was used as the level of significance. RESULTS The mean trueness of distance was 123.06 ± 89.83 µm for DC, 229.72 ± 121.34 µm for DO, 209.75 ± 47.07 µm for DT, and 345.32 ± 75.12 µm for C group (p < 0.0001). While DC showed significantly lower deviation compared to DO and C, no significant difference was found between DC and DT. C showed the highest distance deviation significantly in all groups; and no significant difference was found between DO and DT groups. In angle measurements; the trueness was 0.26° ± 0.07° for DC, 0.53° ± 0.42° for DO, 0.33° ± 0.30° for DT, and 0.74° ± 0.65° for C group. There was no significant difference between the groups in terms of angular trueness (p = 0.074). In terms of the precision for distance, the results of DC 80.43 ± 29.69 µm, DO 94.06 ± 69.96 µm, DT 35.55 ± 28.46 µm and C 66.97 ± 36.69 µm were determined (p = 0.036). The significant difference was found only between DT and DO among all groups. Finally, angular precision was determined to be 0.19° ± 0.11° for DC, 0.30° ± 0.28° for DO, 0.22° ± 0.19° for DT, and 0.50° ± 0.38° for Group C. No significant difference was found between the groups, in terms of angular precision (p = 0.053). CONCLUSIONS All digital impression groups yielded superior data compared to conventional technique in terms of trueness. DC formed the impression group with the highest trueness in both distance and angular measurements. The results of this in vitro study suggest the use of intraoral scanners compared to the conventional impression techniques in complete arch implant cases with high angulations.
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Affiliation(s)
- Berkman Albayrak
- Department of Prosthodontics, Bahçeşehir University School of Dental Medicine, Istanbul, Turkey
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois at Chicago College of Dentistry, Chicago, IL
| | - Alvin G Wee
- Division of Prosthodontics, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, MN
| | - İsmail Hakkı Korkmaz
- Department of Mechanical Engineering, Erzurum Technical University Faculty of Engineering and Architecture, Erzurum, Turkey
| | - Funda Bayındır
- Department of Prosthodontics, Atatürk University Faculty of Dentistry, Erzurum, Turkey
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