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Gómez-Polo M, Sallorenzo A, Cascos R, Ballesteros J, Barmak AB, Revilla-León M. Conventional and digital complete arch implant impression techniques: An in vitro study comparing accuracy. J Prosthet Dent 2024; 132:809-818. [PMID: 36539313 DOI: 10.1016/j.prosdent.2022.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 12/23/2022]
Abstract
STATEMENT OF PROBLEM Varying complete arch digital-implant-scanning techniques have been described, but their accuracy remains uncertain. PURPOSE The purpose of this in vitro investigation was to assess the effect of the implant angulation and impression method (conventional, intraoral digital scan, intraoral scan with a splinting framework, and combining cone beam computed tomography [CBCT] and intraoral scan) on the accuracy of complete arch implant recording. MATERIAL AND METHODS The following 2 casts were obtained: one with 4 parallel (P group) and the other with 4 angled (up to 30 degrees) implant abutment analogs (NP group). Both the casts were digitized (7Series Scanner) (control file). The following 4 subgroups were created: conventional polyether impression with a splinted framework (CNV subgroup), intraoral scan (IOS subgroup), intraoral scan with a splinting framework (S-IOS subgroup), and intraoral scan combined with CBCT scan (CBCT-IOS subgroup) (n=10). For each file, an implant-supported bar was designed and imported into a program (Netfabb) to perform linear and angular interimplant abutment measurements. Two-way ANOVA (Analysis of Variance) and Tukey tests were selected to examine the data (α=.05). RESULTS Implant angulation (P=.010) and impression method (P=.003) significantly influenced the linear trueness. The P group (112 μm) obtained better linear trueness than the NP group (144 μm). The CNV subgroup obtained the best linear trueness, while the IOS and CBCT-IOS showed the worst trueness. Group (P<.001) significantly influenced angular trueness. Group (P=.009) and subgroup (P<.001) influenced the linear precision. The P group (72 μm) obtained better linear precision than the NP group (91 μm). The IOS subgroup obtained the best linear precision. Group (P=.034) significantly influenced the angular precision. The P group (0.46 degrees) had higher angular precision compared with the NP group (0.60 degrees). CONCLUSIONS Implant angulation and the impression methods tested, impacted the accuracy of the complete arch implant recording. Parallel implants had better trueness and precision values than nonparallel implants. The conventional impression method showed the best trueness and precision. Among the digital implant scan methods assessed, the S-IOS and CBCT-IOS subgroups acquired significantly better trueness and precision than the IOS subgroup.
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Affiliation(s)
- Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alessandro Sallorenzo
- PhD Candidate and Postgraduate Resident in Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Cascos
- PhD Candidate and Postgraduate Resident in Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics Department, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
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Revilla-León M, Gómez-Polo M, Rutkunas V, Ntovas P, Kois JC. Classification of Complete-Arch Implant Scanning Techniques Recorded by Using Intraoral Scanners. J ESTHET RESTOR DENT 2024. [PMID: 39329344 DOI: 10.1111/jerd.13322] [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: 07/28/2024] [Revised: 09/11/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024]
Abstract
OBJECTIVES To classify the complete-arch implant scanning techniques recorded by using intraoral scanners (IOSs). OVERVIEW Different implant scanning techniques have been described for recording complete-arch implant scans by using IOSs. However, dental literature lacks on a classification of these implant scanning techniques. Implant scanning techniques aim is to record the 3-dimensional position of the implants being scanned, while implant scanning workflows require additional scans to record all the information needed for designing an implant prosthesis. This additional information includes soft tissue information, tooth position, antagonist arch, and maxillomandibular relationship. CONCLUSIONS There are five complete-arch implant scanning techniques captured by using IOSs: non-splinting, non-calibrated splinting, calibrated implant scan bodies, calibrated frameworks, and reverse impression methods. The digital workflow varies depending on the implant scanning technique selected. CLINICAL SIGNIFICANCE The understanding of the varying implant scanning techniques and the main differences among them may ease the decision criteria for recording digital implant scans by using intraoral scanners.
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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, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Vygandas Rutkunas
- Digitorum Research Center, Vilnius, Lithuania
- Faculty of Medicine, Department of Prosthodontics, Institute of Odontology, Vilnius University, Vilnius, Lithuania
| | - Panagiotis Ntovas
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
- Department of Operative Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - John C Kois
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
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Revilla-León M, Fry E, Zeitler JM, Li J, Barmak AB, Kois JC, Pérez-Barquero JA. Influence of apical finish line location of tooth preparations on the scanning accuracy of intraoral scanners with various focal lengths and scanning technologies. J Prosthet Dent 2024:S0022-3913(24)00413-X. [PMID: 39153939 DOI: 10.1016/j.prosdent.2024.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 08/19/2024]
Abstract
STATEMENT OF PROBLEM Limited studies have reported the influence of finish line location on the accuracy of intraoral scanners (IOSs). Focal length is a hardware characteristic of IOSs. Whether there is a relationship between scanning accuracy of tooth preparations with the finish located at different apical positions and focal length and IOS technology or system remains uncertain. PURPOSE The purpose of the present in vitro study was to assess the influence of the apical finish line location of tooth preparations on the accuracy of 4 IOSs with various focal lengths and scanning technologies. MATERIAL AND METHODS A maxillary typodont with a crown preparation on the left first molar was digitized (T710). Afterwards, a removable die was created on the prepared first molar of the virtual cast and duplicated to create 4 dies with different apical finish line locations: 2- or 1-mm supragingival, 0-mm or equigingival, and -0.5-mm or intracrevicular. The cast and die designs were additively fabricated (Asiga Pro 4K with Keystone Model Ultra). Each die was independently scanned by using the same laboratory scanner (reference scans). Four groups were created: TRIOS 5, i700, iTero, and Primescan. Four subgroups were developed depending on the apical position of the finish line (n=15). In each subgroup, the cast was assembled by positioning the corresponding die into the cast. The cast was then scanned by using the corresponding IOS. The reference scans were used as a control to compute the root mean square (RMS) error discrepancies with each experimental scan on the preparation and margin of the preparation areas. Two-way ANOVA and pairwise comparisons were used to analyze trueness (α=.05). The Levene and pairwise comparisons using the Wilcoxon Rank sum test were used to analyze precision (α=.05). RESULTS Trueness discrepancies in the preparation area were found among the groups (P=.010) and subgroups (P<.001), with a significant interaction between group×subgroup (P<.001). The -0.5 mm location obtained significantly worse trueness in the preparation area. The TRIOS 5 and i700 obtained the best trueness in the preparation area. Trueness discrepancies in the margin area were found among the groups (P=.002) and subgroups (P<.001), with a significant interaction between group×subgroup (P=.004). The -0.5 mm location obtained the worst trueness in the margin area. The i700 and Primescan obtained the best trueness in the margin area. Precision discrepancies were found in the preparation area (P<.001). The TRIOS 5 obtained the best precision in the preparation area (P=.001). Precision discrepancies in the margin area were obtained (P<.001). The 1-mm subgroup obtained the best precision (P=.001). CONCLUSIONS The apical position of the finish line of the tooth preparation tested affected the trueness and precision of the IOSs tested.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash.; and Adjunct Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass..
| | - Elizabeth Fry
- Director, Clinical Operations, Kois Center, Seattle, Wash
| | | | - Junying Li
- Clinical Assistant Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Adjunct Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Mourouzis P, Dionysopoulos D, Gogos C, Tolidis K. Beyond the surface: A comparative study of intraoral scanners in subgingival configuration scanning. Dent Mater 2024; 40:1184-1190. [PMID: 38849226 DOI: 10.1016/j.dental.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVES This study conducted a comprehensive comparative analysis of three intraoral scanners (CEREC Primescan, TRIOS, CEREC Omnicam) and a lab scanner (inEosX5) assessing their precision in simulating subgingival tooth preparations. METHODS Utilizing a dental simulation mannequin with a 3D-printed resin structure, 100 structures with depths ranging from 0.5 to 4.0 mm were created within a square mimicking a rectangular tank surface. Four scanner groups (A-D) and five subgroups were established. Two digitization methods, a customized parallelometer and an intraoral simulation, were applied, ensuring a standardized scanning sequence. Trueness was evaluated by comparing CAD-calculated surface areas with actual dimensions, and qualitative trueness analysis was conducted using MeshLab. Surface areas were computed using the formula SA = 2lw + 2lh + 2wh. Statistical analyses, including Pearson's correlation coefficient, Kolmogorov-Smirnoff and Levene's tests, three-way ANOVA, and paired sample t-tests, elucidated relationships and differences (a=0.05). RESULTS A robust correlation (r = 0.850, p < 0.001) between intraoral scanner choice and scanned area depth was found. Inverse correlations were noted for experimental methods. Three-way ANOVA demonstrated significant scanner-depth interaction (F(12,760) = 760.801, p < 0.001). SIGNIFICANCE Emphasizing high-resolution sensors and advanced technologies, the study underscores the optimal choice for subgingival digitization, acknowledging variations among scanners.
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Affiliation(s)
- Petros Mourouzis
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece.
| | - Dimitrios Dionysopoulos
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Christos Gogos
- Department of Dental Tissues Pathology and Therapeutics, Division of Endodontology Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Kosmas Tolidis
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
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Revilla-León M, Gómez-Polo M, Zeitler JM, Barmak AB, Kois JC, Pérez-Barquero JA. Does the available interocclusal space influence the accuracy of the maxillomandibular relationship captured with an intraoral scanner? J Prosthet Dent 2024; 132:435-440. [PMID: 36349566 DOI: 10.1016/j.prosdent.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022]
Abstract
STATEMENT OF PROBLEM The accuracy of a maxillomandibular relationship acquired by intraoral scanners (IOSs) has been previously analyzed; however, the impact of the interocclusal space on the accuracy of the maxillomandibular relationship remains unknown. PURPOSE The purpose of this in vitro investigation was to evaluate the influence of the interocclusal space (0, 1, 2, 3, or 4 degrees of incisal opening in the articulator) on the accuracy of the maxillomandibular relationship captured with an IOS. MATERIAL AND METHODS Markers were attached to the first molars and canines of maxillary and mandibular diagnostic casts, which were mounted on a semi-adjustable articulator, and digital scans were acquired (TRIOS 4). Both digital scans were duplicated 100 times and distributed into 5 groups depending on the incisal pin opening in the articulator (n=20): 0 (Group 0), 1 (Group 1), 2 (Group 2), 3 (Group 3), and 4 degrees (Group 4). In Group 0 (control), the casts were maintained in maximum intercuspation (MIP) with the incisal pin of the articulator set at 0 degrees. Then, a bilateral virtual occlusal record was acquired and automatically processed by using the IOS software program. A laboratory scanner (Medit T500) was used to digitize the mounted casts. The same procedures were completed in Groups 1, 2, 3, and 4 but with the incisal pin set at 1, 2, 3, and 4 degrees respectively. The interlandmark distances were used to calculate the discrepancies between the control and groups tested. One-way analysis of variance (ANOVA) and pairwise comparison Tukey HSD tests were used to inspect the data (α=.05). RESULTS The interocclusal space available when capturing the occlusal records affected the trueness of the maxillomandibular virtual relationship measured (P<.001). Group 0 (135 μm) obtained the highest distortion, while Group 3 (73 μm) and Group 4 (71 μm) showed the lowest distortion. Additionally, the interocclusal space available (P<.001) impacted the precision of the maxillomandibular virtual relationship measured. Group 0 (111 μm) obtained the highest distortion, while Group 4 (precision mean value of 59 μm) had the lowest distortion among the groups tested. CONCLUSIONS The interocclusal space available when acquiring virtual bilateral occlusal records using the IOS tested impacted the accuracy of the maxillomandibular relationship. The smallest available interocclusal space tested (maximum intercuspation) showed the worst trueness and precision mean values, while the group with the largest interocclusal space available had the highest trueness and precision mean values among the groups studied.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Miguel Gómez-Polo
- Associate Professor and Program Director of Graduate in Advanced Implant Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - John C Kois
- Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate in Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Chen Y, Gao S, Tu P, Chen X. Automatic 3D Teeth Reconstruction From Five Intra-Oral Photos Using Parametric Teeth Model. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:4780-4791. [PMID: 37204961 DOI: 10.1109/tvcg.2023.3277914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Orthodontic treatment is a lengthy process that requires regular in-person dental monitoring, making remote dental monitoring a viable alternative when face-to-face consultation is not possible. In this study, we propose an improved 3D teeth reconstruction framework that automatically restores the shape, arrangement, and dental occlusion of upper and lower teeth from five intra-oral photographs to aid orthodontists in visualizing the condition of patients in virtual consultations. The framework comprises a parametric model that leverages statistical shape modeling to describe the shape and arrangement of teeth, a modified U-net that extracts teeth contours from intra-oral images, and an iterative process that alternates between finding point correspondences and optimizing a compound loss function to fit the parametric teeth model to predicted teeth contours. We perform a five-fold cross-validation on a dataset of 95 orthodontic cases and report an average Chamfer distance of 1.0121 mm2 and an average Dice similarity coefficient of 0.7672 on all the test samples in the cross-validation, demonstrating a significant improvement compared with the previous work. Our teeth reconstruction framework provides a feasible solution for visualizing 3D teeth models in remote orthodontic consultations.
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Towle I, Krueger KL, Hernando R, Hlusko LJ. Assessing tooth wear progression in non-human primates: a longitudinal study using intraoral scanning technology. PeerJ 2024; 12:e17614. [PMID: 39006010 PMCID: PMC11244035 DOI: 10.7717/peerj.17614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/31/2024] [Indexed: 07/16/2024] Open
Abstract
Intraoral scanners are widely used in a clinical setting for orthodontic treatments and tooth restorations, and are also useful for assessing dental wear and pathology progression. In this study, we assess the utility of using an intraoral scanner and associated software for quantifying dental tissue loss in non-human primates. An upper and lower second molar for 31 captive hamadryas baboons (Papio hamadryas) were assessed for dental tissue loss progression, giving a total sample of 62 teeth. The animals are part of the Southwest National Primate Research Center and were all fed the same monkey-chow diet over their lifetimes. Two molds of each dentition were taken at either two- or three-year intervals, and the associated casts scanned using an intraoral scanner (Medit i700). Tissue loss was calculated in WearCompare by superimposition of the two scans followed by subtraction analysis. Four individuals had dental caries, and were assessed separately. The results demonstrate the reliability of these techniques in capturing tissue loss data, evidenced by the alignment consistency between scans, lack of erroneous tissue gain between scans, and uniformity of tissue loss patterns among individuals (e.g., functional cusps showing the highest degree of wear). The average loss per mm2 per year for all samples combined was 0.05 mm3 (0.04 mm3 for females and 0.08 mm3 for males). There was no significant difference in wear progression between upper and lower molars. Substantial variation in the amount of tissue loss among individuals was found, despite their uniform diet. These findings foster multiple avenues for future research, including the exploration of wear progression across dental crowns and arcades, correlation between different types of tissue loss (e.g., attrition, erosion, fractures, caries), interplay between tissue loss and microwear/topographic analysis, and the genetic underpinnings of tissue loss variation.
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Affiliation(s)
- Ian Towle
- Centro Nacional de Investigación sobre la Evolución Humana (CENIEH), Burgos, Spain
| | - Kristin L. Krueger
- Department of Anthropology, Loyola University Chicago, Chicago, IL, United States of America
| | - Raquel Hernando
- Centro Nacional de Investigación sobre la Evolución Humana (CENIEH), Burgos, Spain
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES), Tarragona, Spain
| | - Leslea J. Hlusko
- Centro Nacional de Investigación sobre la Evolución Humana (CENIEH), Burgos, Spain
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Revilla-León M, Gómez-Polo M, Barmak AB, Kois JC, Yilmaz B, Alonso Pérez-Barquero J. Influence of occlusal collision corrections completed by two intraoral scanners or a dental design program on the accuracy of the maxillomandibular relationship. J Prosthet Dent 2024; 132:191-203. [PMID: 37365066 DOI: 10.1016/j.prosdent.2023.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
STATEMENT OF PROBLEM Occlusal collisions of articulated intraoral digital scans can be corrected by intraoral scanners (IOSs) or dental design software programs. However, the influence of these corrections on the accuracy of maxillomandibular relationship is unclear. PURPOSE The purpose of this clinical investigation was to measure the effect of occlusal collision corrections completed by the IOSs or dental design software programs on the trueness and precision of maxillomandibular relationship. MATERIAL AND METHODS Casts of a participant mounted on an articulator were digitized (T710). The experimental scans were obtained by using 2 IOSs: TRIOS 4 and i700. The intraoral digital scans of the maxillary and mandibular arches were obtained and duplicated 15 times. For each duplicated pair of scans, a bilateral virtual occlusal record was acquired. Articulated specimens were duplicated and assigned into 2 groups: IOS-not corrected and IOS corrected (n=15). In the IOS-not corrected groups, the IOS software program postprocessed the scans maintaining the occlusal collisions, while in the IOS-corrected groups, the IOS software program eliminated the occlusal collisions. All articulated specimens were imported into a computer-aided design (CAD) program (DentalCAD). Three subgroups were developed based on the CAD correction: CAD-no change, trimming, or opening the vertical dimension. Thirty-six interlandmark distances were measured on the reference and each experimental scan to compute discrepancies by using a software program (Geomagic Wrap). Root mean square (RMS) was selected to compute the cast modifications performed in the trimming subgroups. Trueness was examined using 2-way ANOVA and pairwise comparison Tukey tests (α=.05). Precision was evaluated with the Levene test (α=.05). RESULTS The IOS (P<.001), the program (P<.001), and their interaction (P<.001) impacted the trueness of the maxillomandibular relationship. The i700 obtained higher trueness than the TRIOS 4 (P<.001). The IOS-not corrected-CAD-no-changes and IOS-not-corrected-trimming subgroups obtained the lowest trueness (P<.001), while the IOS-corrected-CAD-no-changes, IOS-corrected-trimming, and IOS-corrected-opening subgroups showed the highest trueness (P<.001). No significant differences in precision were found (P<.001). Furthermore, significant RMS differences were found (P<.001), with a significant interaction between Group×Subgroup (P<.001). The IOS-not corrected-trimmed subgroups obtained a significantly higher RMS error discrepancy than IOS-corrected-trimmed subgroups (P<.001). The Levene test showed a significant discrepancy in the RMS precision among IOSs across subgroups (P<.001). CONCLUSIONS The trueness of the maxillomandibular relationship was influenced by the scanner and program used to correct occlusal collisions. Better trueness was obtained when the occlusal collisions were adjusted by the IOS program compared with the CAD program. Precision was not significantly influenced by the occlusal collision correction method. CAD corrections did not improve the results of the IOS software. Additionally, the trimming option caused volumetric changes on the occlusal surfaces of intraoral scans.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain; Director, Specialist in Advanced Implant-Prosthesis Postgraduate Program, Complutense University of Madrid, Madrid, Spain.
| | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - John C Kois
- Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate in Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private Practice, Seattle, Wash
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - Jorge Alonso Pérez-Barquero
- Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Revilla-León M, Zeitler JM, Kois DE, Kois JC. Utilizing an additively manufactured Kois deprogrammer to record centric relation: A simplified workflow and delivery technique. J Prosthet Dent 2024; 132:20-25. [PMID: 35934572 DOI: 10.1016/j.prosdent.2022.04.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
A technique for fabricating an additively manufactured Kois deprogrammer is described from the initial patient data collection with an intraoral scanner to the 3D printing methods to fabricate the device. The incorporation of digital technologies for manufacturing a Kois deprogrammer provides new clinical and manufacturing tools, providing more efficient and less time-consuming design and manufacturing techniques than conventional techniques while maintaining conventional prosthodontic concepts.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, MA.
| | | | - Dean E Kois
- Faculty, Kois Center, Seattle, Wash; Private practice, Seattle, Wash
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; Private Practice, Seattle, Wash
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Hamilton A, Negreiros WM, Jain S, Finkelman M, Gallucci GO. Influence of scanning protocol on the accuracy of complete-arch digital implant scans: An in vitro study. Clin Oral Implants Res 2024; 35:641-651. [PMID: 38567801 DOI: 10.1111/clr.14259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/20/2024] [Accepted: 03/14/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE This in-vitro study assessed the influence of two intraoral scanning (IOS) protocols on the accuracy (trueness and precision) of digital scans performed in edentulous arches. METHODS Twenty-two abutment-level master casts of edentulous arches with at least four implants were scanned repeatedly five times, each with two different scanning protocols. Protocol A (IOS-A) consisted of scanning the edentulous arch before inserting the implant scan bodies, followed by their insertion and its subsequent digital acquisition. Protocol B (IOS-B) consisted of scanning the edentulous arch with the scan bodies inserted from the outset. A reference scan from each edentulous cast was obtained using a laboratory scanner. Trueness and precision were calculated using the spatial fit analysis, cross-arch distance, and virtual Sheffield test. Statistical analysis was performed using generalized estimating equations (GEEs). Statistical significance was set at α = .05. RESULTS In the spatial fit test, the precision of average 3D distances was 45 μm (±23 μm) with protocol IOS-A and 25 μm (±10 μm) for IOS-B (p < .001), and the trueness of average 3D distances was 44 μm (±24 μm) with protocol IOS-A and 24 μm (±7 μm) for IOS-B (p < .001). Cross-arch distance precision was 59 μm (±53 μm) for IOS-A and 41 μm (±43 μm) for IOS-B (p = .0035), and trueness was 64 μm (±47 μm) for IOS-A and 50 μm (±40 μm) for IOS-B (p = .0021). Virtual Sheffield precision was 286 μm (±198 μm) for IOS-A and 146 μm (±92 μm) for IOS-B (p < .001), and trueness was 228 μm (±171 μm) for IOS-A and 139 μm (±92 μm) for IOS-B (p < .001). CONCLUSIONS The IOS-B protocol demonstrated significantly superior accuracy. Placement of scan bodies before scanning the edentulous arch is recommended to improve the accuracy of complete-arch intraoral scanning.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - William Matthew Negreiros
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shruti Jain
- Department of Public Health and Community Service, 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
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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11
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Revilla-León M, Zeitler JM, Kois JC. An overview of the different digital facebow methods for transferring the maxillary cast into the virtual articulator. J ESTHET RESTOR DENT 2024. [PMID: 38778662 DOI: 10.1111/jerd.13264] [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: 03/04/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The purposes of this study were to classify the described digital facebow techniques for transferring the maxillary cast into the semi-adjustable virtual articulator based on the digital data acquisition technology used and to review the reported accuracy values of the different digital facebow methods described. OVERVIEW Digital data acquisition technologies, including digital photographs, facial scanners, cone beam computed tomography (CBCT) imaging, and jaw tracking systems, can be used to transfer the maxillary cast into the virtual articulator. The reported techniques are reviewed, as well as the reported accuracy values of the different digital facebow methods. CONCLUSIONS Digital photographs can be used to transfer the maxillary cast into the virtual articulator using the true horizontal reference plane, but limited studies have assessed the accuracy of this method. Facial scanning and CBCT techniques can be used to transfer the maxillary cast into the virtual articulator, in which the most frequently selected references planes are the Frankfort horizontal, axis orbital, and true horizontal planes. Studies analyzing the accuracy of the maxillary cast transfer by using facial scanning and CBCT techniques are restricted. Lastly, optical jaw trackers can be selected for transferring the maxillary cast into the virtual articulator by using the axis orbital or true horizontal planes, yet the accuracy of these systems is unknown. CLINICAL IMPLICATIONS Digital data acquisition technologies, including digital photographs, facial scanning methods, CBCTs, and optical jaw tracking systems, can be used to transfer the maxillary cast into the virtual articulator. Studies are needed to assess the accuracy of these digital data acquisition technologies for transferring the maxillary cast into the virtual articulator.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, USA
- Kois Center, Seattle, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, USA
| | | | - John C Kois
- Kois Center, Seattle, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, USA
- Seattle, Washington, USA
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12
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Revilla-León M, Kois JC. True horizontal or gravity plane for transferring the maxillary cast into the virtual articulator by using an optical jaw tracking system. J Prosthet Dent 2024:S0022-3913(24)00275-0. [PMID: 38714458 DOI: 10.1016/j.prosdent.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/09/2024]
Abstract
Different techniques of transferring the maxillary cast into the analog semi-adjustable articulator by using the true horizontal or gravity reference plane have been reported. However, procedures are required for recording this reference plane and transferring the maxillary cast into the virtual semi-adjustable articulator. In the present manuscript, a technique is described for registering the true horizontal or gravity plane in relationship to the natural head position of the patient by using an optical jaw tracking system. Additionally, the recorded true horizontal plane is used to transfer the maxillary cast into the virtual semi-adjustable articulator by using a dental computer-aided design program. This technique facilitates the maxillary cast transfer into the virtual articulator by using the true horizontal plane recorded with an optical jaw tracking system, maximizing the functionality of the optical jaw tracking device.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Director, Research and Digital Dentistry, Kois Center, Seattle, Wash.; and Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, Mass.
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
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13
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Revilla-León M, Gómez-Polo M, Barmak AB, Yilmaz B, Kois JC, Alonso Pérez-Barquero J. Influence of scan extension and starting quadrant on the accuracy of four intraoral scanners for fabricating tooth-supported crowns. J Prosthet Dent 2024:S0022-3913(24)00208-7. [PMID: 38641480 DOI: 10.1016/j.prosdent.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/21/2024]
Abstract
STATEMENT OF PROBLEM Multiple factors can influence the accuracy of intraoral scanners (IOSs). However, the impact of scan extension and starting quadrant on the accuracy of IOSs for fabricating tooth-supported crowns remains uncertain. PURPOSE The purpose of the present in vitro study was to measure the influence of scan extension (half or complete arch scan) and the starting quadrant (same quadrant or contralateral quadrant of the location of the crown preparation) on the accuracy of four IOSs. MATERIAL AND METHODS A typodont with a crown preparation on the left first molar was digitized (T710) to obtain a reference scan. Four scanner groups were created: TRIOS 5, PrimeScan, i700, and iTero. Then, 3 subgroups were defined based on the scan extension and starting quadrant: half arch (HA subgroup), complete arch scan starting on the left quadrant (CA-same subgroup), and complete arch scan starting on the right quadrant (CA-contralateral subgroup), (n=15). The reference scan was used as a control to measure the root mean square (RMS) error discrepancies with each experimental scan on the tooth preparation, margin of the tooth preparation, and adjacent tooth areas. Two-way ANOVA and pairwise multiple comparisons were used to analyze trueness (α=.05). The Levene and pairwise comparisons using the Wilcoxon Rank sum tests were used to analyze precision (α=.05). RESULTS For the tooth preparation analysis, significant trueness and precision differences were found among the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P=.002). The iTero and TRIOS5 groups obtained better trueness than the PrimeScan and i700 groups (P<.001). Moreover, half arch scans obtained the best trueness, while the CA-contralateral scans obtained the worst trueness (P<.001). The iTero group showed the worst precision among the IOSs tested. For the margin of the tooth preparation evaluation, significant trueness and precision differences were found among the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P=.005). The iTero group obtained best trueness (P<.001), but the worst precision (P<.001) among the IOSs tested. Half arch scans obtained the best trueness and precision values. For the adjacent tooth analysis, trueness and precision differences were found among the groups (P<.001) and subgroups tested (P<.001), with a significant interaction group×subgroup (P=.005). The TRIOS 5 obtained the best trueness and precision. Half arch scans obtained the best accuracy. CONCLUSIONS Scan extension and the starting quadrant impacted the scanning trueness and precision of the IOSs tested. Additionally, the IOSs showed varying scanning discrepancies depending on the scanning area assessed. Half arch scans presented the highest trueness and precision, and the complete arch scans in which the scan started in the contralateral quadrant of where the crown preparation was obtained the worst trueness and precision.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Associate Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Adjunct Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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14
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Revilla-León M, Barmak AB, Lanis A, Kois JC. Influence of connected and nonconnected calibrated frameworks on the accuracy of complete arch implant scans obtained by using four intraoral scanners, a desktop scanner, and a photogrammetry system. J Prosthet Dent 2024:S0022-3913(24)00048-9. [PMID: 38443245 DOI: 10.1016/j.prosdent.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 03/07/2024]
Abstract
STATEMENT OF PROBLEM Different techniques have been proposed for increasing the accuracy of complete arch implant scans obtained by using intraoral scanners (IOSs), including a calibrated metal framework (IOSFix); however, its accuracy remains uncertain. PURPOSE The purpose of this in vitro study was to compare the accuracy of complete arch scans obtained with connecting and non-connecting the implant scan bodies (ISBs) recorded using intraoral scanners (IOSs), a laboratory scanner (LBS), and photogrammetry (PG). MATERIAL AND METHODS A cast with 6 implant abutment analogs was obtained. Six groups were created: TRIOS 4, i700, iTero, CS3800, LBS, and PG groups. The IOSs and LBS groups were divided into 3 subgroups: nonconnected ISBs (ISB), splinted ISBs (SSB), and calibrated framework (CF), (n=15). For the ISB subgroups, an ISB was positioned on each implant abutment analog. For the SSB subgroups, a printed framework was used to connect the ISBs. For the CF subgroups, a calibrated framework (IOSFix) was used to connect the ISBs. For the PG group, scans were captured using a PG (PIC Camera). Implant positions of the reference cast were measured using a coordinate measurement machine, and Euclidean distances were used as a reference to calculate the discrepancies using the same distances obtained on each experimental scan. Wilcoxon squares 2-way ANOVA and pairwise multiple comparisons were used to analyze trueness (α=.05). The Levene test was used to analyze precision (α=.05). RESULTS Linear and angular discrepancies were found among the groups (P<.001) and subgroups (P<.001). Linear (P=.008) and angular (P<.001) precision differences were found among the subgroups. CONCLUSIONS The digitizing method and technique impacted the trueness and precision of the implant scans. The photogrammetry and calibrated framework groups obtained the best accuracy. Except for TRIOS 4, the calibrated framework method improved the accuracy of the scans obtained by using the IOSs tested.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash.; and Adjunct Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Alejandro Lanis
- Director, Advanced Graduate Education in Implant Dentistry, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; and Private practice, Seattle, Wash
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An H. Ceramic veneer shade evaluation using a multicolored 3D-printed model-A case report. J ESTHET RESTOR DENT 2024; 36:415-420. [PMID: 37737648 DOI: 10.1111/jerd.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/18/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE This article demonstrates the use of a multicolored 3D-printed model for laboratory shade evaluation of ceramic veneers. CLINICAL CONSIDERATIONS A young female patient presented with peg lateral incisors and diastemata between her maxillary incisors. Four ceramic veneers for her maxillary incisors were fabricated using a digital workflow. A multicolored 3D-printed model was manufactured using material jetting technology. The multicolored model and try-in pastes were used to evaluate and adjust the shade of the veneers. Clinically acceptable color matching was achieved, the veneers were delivered without further chairside shade adjustments. CONCLUSIONS Successful color evaluation and adjustment were achieved using the combination of multicolored 3D-printed model and try-in pastes. The use of this approach saved time for stump shade taking and fabrication of tooth-colored dies. CLINICAL SIGNIFICANCE A multicolored 3D-printed model can be a useful tool for color evaluation and adjustment of ceramic restorations.
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Affiliation(s)
- Hongseok An
- Department of Oral Rehabilitation and Biosciences, Oregon Health & Science University School of Dentistry, Portland, Oregon, USA
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16
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Gómez-Polo M, Cimolai A, Ortega R, Barmak AB, Kois JC, Revilla-León M. Accuracy, scanning time, and number of photograms of various scanning patterns for the extraoral digitalization of complete dentures by using an intraoral scanner. J Prosthet Dent 2024; 131:521-528. [PMID: 35527066 DOI: 10.1016/j.prosdent.2022.03.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM The use of intraoral scanners (IOSs) has been described as a method of digitizing complete dentures (CDs) extraorally; however, accuracy, scanning time, and number of photograms remain unclear. PURPOSE The purpose of this in vitro study was to assess the accuracy, scanning time, and number of photograms of different scanning patterns for digitizing CDs extraorally with an IOS. MATERIAL AND METHODS The virtual design of a maxillary and mandibular CD was used to manufacture milled CDs. The maxillary (Mx group) and mandibular (Mb group) CDs were digitized extraorally by using an IOS (Medit i500). Three subgroups were created depending on the scanning pattern: using the protocol of the IOS selected (Medit Link) (ML subgroup), using the technique recommended by the implant manufacturer (DIOnavi) (DIO subgroup), and using a custom method (C subgroup). The design of the CDs (reference files) was used to compare the discrepancy between each virtual design and the corresponding scans by using the root mean square (RMS) error. The scanning time and number of photograms were recorded. Two-way ANOVA and Tukey tests were used to analyze the trueness data. The Bartlett test was used to analyze the precision values (α=.05). RESULTS The group (P<.001) was a significant predictor of trueness. The Mx group (RMS mean of 0.452 mm) obtained higher trueness than the Mb group (RMS mean of 0.536 mm). The Mx-C and Mb-DIO subgroups obtained the highest trueness, and the Mx-ML and Mb-ML subgroups showed the lowest trueness. Significant differences were found in precision among groups (P<.01) and across subgroups (P<.01). The Mb group obtained the highest precision mean (0.586 mm) and was significantly different from the Mx group that obtained the lowest precision mean (0.611 mm). The C subgroup obtained the highest precision mean (0.339 mm) and was significantly different from the DIO subgroup that obtained the lowest precision mean (0.425 mm). The group (P<.01) and scanning pattern (P<.01) were significant predictors of the scanning time and number of photograms obtained. The Mb group showed lower scanning time and number of photograms than the Mx group. CONCLUSIONS The scanning patterns tested significantly influenced the trueness and precision values, scanning time, and number of photograms of the extraoral digitalization of maxillary and mandibular CDs by using the IOS tested.
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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.
| | - Augusto Cimolai
- Postgraduate student of Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and 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
| | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash
| | - Marta Revilla-León
- Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
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Gómez-Polo M, Donmez MB, Çakmak G, Yilmaz B, Revilla-León M. Influence of implant scan body design (height, diameter, geometry, material, and retention system) on intraoral scanning accuracy: A systematic review. J Prosthodont 2023; 32:165-180. [PMID: 37771200 DOI: 10.1111/jopr.13774] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE To evaluate the influence of implant scan body (ISB) design (height, diameter, geometry, material, and retention system) on the accuracy of digital implant scans. MATERIAL AND METHODS A literature search was completed in five databases: PubMed/Medline, Scopus, Embase, World of Science, and Cochrane. A manual search was also conducted. Studies reporting the evaluation of ISB design on the accuracy of digital scans obtained by using IOSs were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. Articles were classified based on the ISB features of height, geometry, material, and retention system. RESULTS Twenty articles were included. Among the reviewed studies, 11 investigations analyzed the influence of different ISB geometries, 1 study assessed the impact of ISB diameter, 4 studies investigated the effect of ISB splinting, 2 articles evaluated ISB height, and 2 studies focused on the effect of ISB material on scan accuracy. In addition, 8 studies involved ISBs fabricated with different materials (1- and 2-piece polyetheretherketone and 1-piece titanium ISBs), and all of the reviewed articles tested screw-retained ISBs, except for 3 in vitro studies. CONCLUSIONS The findings did not enable concrete conclusions regarding the optimal ISB design, whether there is a relationship between IOS technology and a specific ISB design, or the clinical condition that maximizes intraoral scanning accuracy. Research efforts are needed to identify the optimal ISB design and its possible relationship with the IOS selected for acquiring intraoral digital implant scans.
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Affiliation(s)
- Miguel Gómez-Polo
- Department of Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye Univeristy, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Revilla-León M, Lanis A, Yilmaz B, Kois JC, Gallucci GO. Intraoral digital implant scans: Parameters to improve accuracy. J Prosthodont 2023; 32:150-164. [PMID: 37586762 DOI: 10.1111/jopr.13749] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE To report the means to maximize the predictability and accuracy of intraoral digital implant scans through the evaluation of operator and patient-related factors. MATERIALS AND METHODS A search of published articles related to factors that can decrease the scanning accuracy of intraoral digital implant scans was completed in four data sources:MEDLINE, EMBASE, EBSCO, and Web of Science. All studies related to variables that can influence the accuracy of intraoral digital implant scans obtained by using intraoral scanners (IOSs) were considered. These variables included ambient lighting, scanning pattern, implant scan body (ISB) design, techniques for splinting ISBs, arch location, implant position, and inter-implant distance. RESULTS Among operator-related factors, ambient lighting conditions, scanning pattern, and ISB design (material, geometry, and retention design) can impact the accuracy of intraoral digital implant scans. The optimal ISB for maximizing IOS accuracy is unclear; however, polymer ISB can wear with multiple reuse and sterilization methods. Among patient-related factors, additional variables should be considered, namely arch (maxillary vs. mandibular arch), implant position in the arch, inter-implant distance, implant depth, and angulation. CONCLUSIONS Ambient lighting conditions should be established based on the IOS selected to optimize the accuracy of intraoral digital implant scans. The optimal scanning pattern may vary based on the IOS, clinical situation, and the number of implants. The optimal ISB design may vary depending on the IOS used. Metallic implant scan bodies are preferred over polymer ISB designs to minimize wear due to multiple use and sterilization distortion. Among patient-related factors, additional variables should be considered namely the arch scanned, implant position in the arch, inter-implant distance, implant depth, and angulation. The impact of these factors may vary depending on the IOS selected.
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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, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - John C Kois
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Vag J, Stevens CD, Badahman MH, Ludlow M, Sharp M, Brenes C, Mennito A, Renne W. Trueness and precision of complete arch dentate digital models produced by intraoral and desktop scanners: An ex-vivo study. J Dent 2023; 139:104764. [PMID: 37898433 DOI: 10.1016/j.jdent.2023.104764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/21/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES The study aimed to compare the trueness and precision of five intraoral scanners (Emerald S, iTero Element 5D, Medit i700, Primescan, and Trios 4) and two indirect digitization techniques for both teeth and soft tissues on fresh mandibular and maxillary cadaver jaws. METHODS The maxilla and mandible of a fully dentate cadaver were scanned by the ATOS industrial scanner to create a master model. Then, the specimens were scanned eight times by each intraoral scanner (IOS). In addition, 8 polyvinylsiloxane (PVS) impressions were made and digitized with a Medit T710 desktop scanner. Stone models were then poured and again scanned with the desktop scanner. All IOS, PVS, and stone models were compared to the master model to calculate the mean absolute surface deviation for mandibular teeth, maxillary teeth, and palate. RESULTS For mandibular teeth, the PVS trueness was only significantly better than the Medit i700 (p < 0.001) and Primescan (p < 0.05). In maxillary teeth, the PVS trueness was significantly better than all IOSs (p < 0.05-0.001); the stone trueness was significantly better than Emerald S (p < 0.01), Medit i700 (p < 0.001) and Primescan (p < 0.01). In the palate, PVS and stone trueness were significantly lower than the iTero Element 5D (p < 0.01) and Trios 4 (p < p < 0.01). Stone trueness was significantly lower than the Medit i700 (p < 0.05). The precision in the palate was significantly lower for PVS and stone than for Emerald S (p < 0.01, p < 0.05), iTero Element 5D (p < 0.01, p < 0.01), Primescan (p < 0.001, p < 0.001), and Trios 4 (p < 0.001, p < 0.01). Significant differences in trueness between the IOSs were observed only in the mandibular teeth. The Medit i700 performed worse than Emerald S (p < 0.01) and iTero Element 5D (p < 0.01). For mandibular teeth, the Medit i700 was significantly more precise than Primescan (p < 0.01) and the Emerald S (p < 0.05). The Trios 4 was significantly less precise than Emerald S (p < 0.05). The precision of Medit i700 was significantly worse than iTero Element 5D (p < 0.01) for maxillary teeth, as well as the Primescan (p < 0.01) and Trios 4 (p < 0.05) for the palate. CONCLUSIONS In general, indirectly digitized models from PVS impressions had higher trueness than IOS for maxillary teeth; precision between the two methods was similar. IOS was more accurate for palatal tissues. The differences in trueness and precision for mandibular teeth between the various techniques were negligible. CLINICAL SIGNIFICANCE All investigated IOSs and indirect digitization could be used for complete arch scanning in mandibular and maxillary dentate arches. However, direct optical digitization is preferable for the palate due to the low accuracy of physical impression techniques for soft tissues.
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Affiliation(s)
- Janos Vag
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi Street 47, Budapest 1088, Hungary.
| | | | - Mohammed H Badahman
- Digital Dentistry Masters Program, Medical University of South Carolina, Charleston, SC, USA
| | - Mark Ludlow
- Section Head of Implant Dentistry, Digital Dentistry, And Removable Prosthodontics at the University of Utah School of Dentistry, UT, USA
| | - Madison Sharp
- Senior Dental Student, Medical University of South Carolina, Charleston, SC, USA
| | - Christian Brenes
- Director of Digital Dentistry Masters Program, Medical University of South Carolina, Charleston, SC, USA
| | | | - Walter Renne
- Modern Optimized Dentistry Institute, Charleston, SC, USA
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Akl MA, Daifallah K, Pérez-Barquero JA, Barmak AB, Wee AG, Revilla-León M. Influence of interdental spaces and the palate on the accuracy of maxillary scans acquired using different intraoral scanners. J Prosthodont 2023; 32:125-134. [PMID: 37591814 DOI: 10.1111/jopr.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023] Open
Abstract
PURPOSE To assess the influence of interdental spaces and scanning the palate on the accuracy of maxillary scans acquired using three intraoral scanners (IOSs). MATERIALS AND METHODS A virtual completely dentate maxillary cast without interdental spaces was obtained and modified to create 1, 2, and 3 mm of interdental spacing between the anterior teeth. These three files (reference standard tessellation language files) were used to print three reference casts. The reference casts were scanned using three IOSs: TRIOS4, iTero Element 5D, and Aoralscan2. Three groups were created based on the interdental spaces: 0, 1, 2, and 3 mm (n = 10). The groups were subdivided into two subgroups: no palate (NP subgroup) and palate (P subgroup). The reference STL files were used to measure the discrepancy with the experimental scans by calculating the root mean square (RMS) error. Three-way analysis of variance (ANOVA) and post hoc Tukey pairwise comparison tests were used to analyze trueness. The Levene test was used to analyze precision (α = 0.05). RESULTS Trueness ranged from 91 to 139 μm and precision ranged from 5 to 23 μm among the subgroups tested. A significant correlation was found between IOS*group (p<0.001) and IOS*subgroup ( p<0.001). Tukey test showed significant trueness differences among the interdental spaces tested (p<0.001). The 1- and 2-mm groups obtained better trueness than the 0- and 3-mm groups (p<0.001). An 11 μm mean trueness discrepancy was measured among the different interdental space groups tested. The P subgroups demonstrated significantly higher trueness when compared to the NP subgroups (p<0.001). The discrepancy between the maxillary scans with and without the palate was 4 μm. Significant precision discrepancies were found (p = 0.008), with the iTero group showing the lowest precision. CONCLUSION Interdental spaces and incorporation of the palate on maxillary intraoral scans influenced trueness and precision of the three IOSs tested. However, the scanning discrepancy measured may be of no clinical relevance.
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Affiliation(s)
- Mohammed A Akl
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
| | - Khaled Daifallah
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Alvin G Wee
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Rokhshad R, Mazaheri Tehrani A, Zarbakhsh A, Revilla-León M. Influence of fabrication method on the manufacturing accuracy and internal discrepancy of removable partial dentures: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00256-1. [PMID: 37474386 DOI: 10.1016/j.prosdent.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 07/22/2023]
Abstract
STATEMENT OF PROBLEM Removable partial dentures (RPDs) can be fabricated with conventional casting procedures or computer-aided design and computer-aided manufacturing (CAD-CAM) technologies; however, the manufacturing accuracy and internal discrepancy differences among these manufacturing methods remain uncertain. PURPOSE The purpose of this systematic review and meta-analysis was to assess the influence of the fabricating method (casting, milling, or additive manufacturing) on the accuracy and internal discrepancy of RPDs. MATERIAL AND METHODS An electronic search of the literature was performed in 6 databases: PubMed/Medline, Embase, Web of Science, Scopus, Cochrane, and Google Scholar. The studies that assessed the accuracy and internal discrepancy of RPDs fabricated from casting, milling, and additive manufacturing were included. Studies reporting gaps (mean) and standard deviations were included in the meta-analysis. Publication bias was identified using funnel plot asymmetry and the Egger test. RESULTS A total of 25 articles were included. The internal discrepancy of the additively manufactured RPDs ranged from 14.4 to 511 μm and from 7 to 419 μm in conventionally fabricated RPDs. For the milling method, 20 to 66 μm horizontal and 17 to 59 μm vertical discrepancies were reported. The Egger tests indicated no publication bias among the studies that were included in the meta-analysis. Four included studies resulted in more than the acceptable clinical gap (311 μm) for the CAD-CAM method. Independently of the manufacturing method, the greatest internal discrepancies reported were observed under the major connectors. RPDs fabricated by using CAD-CAM techniques required fewer clinical appointments, the RPD design was easier to reproduce, and laboratory time was less than with conventional procedures. However, the reviewed studies described several disadvantages, including limited RPD design programs, difficulties in defining the occlusal plane, expensive materials, and increased laboratory cost. CONCLUSIONS Additive and subtractive technologies provide accurate methods for RPD fabrication; however, all challenges, including limited design software programs have not yet been overcome, and casting is still needed when the framework pattern is milled or printed.
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Affiliation(s)
- Rata Rokhshad
- Researcher, Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany; and Researcher, Department of Medicine, Section of Endocrinology, Boston University Medical Center, Boston, Mass
| | - Azita Mazaheri Tehrani
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arash Zarbakhsh
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, Mass
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Mikolicz A, Simon B, Gáspár O, Shahbazi A, Vag J. Reproducibility of the digital palate in forensic investigations, a two-year retrospective cohort study of twins. J Dent 2023:104562. [PMID: 37230239 DOI: 10.1016/j.jdent.2023.104562] [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: 12/18/2022] [Revised: 05/09/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES The palatal scans of the same individuals were compared after two years to assess forensic reproducibility. The effect of orthodontic treatment, the comparison area and the digitization approach were investigated. METHODS The palate was scanned in 20 pairs of monozygotic twins by an intraoral scanner (IOS) three times to assess repeatability. They were rescanned two years later by two different IOSs. An elastic impression and a plaster model were also made and scanned by a laboratory scanner (indirect digitization). Mean absolute distance between scans was compared after best-fit alignment. Scans from the two sessions were compared to evaluate the combined effect of aging, orthodontic treatment and different digitization methods (forensic reproducibility). Additionally, the scans of different digitization methods from the second session were compared (technical reproducibility). The between-siblings difference was compared in the two sessions to evaluate the effect of aging on palatal morphology. RESULTS The anterior palatal area showed significantly better repeatability and forensic reproducibility than the whole palate (p<0.001), but orthodontic treatment had no effect. Indirect digitization produced lower forensic and technical reproducibility than IOSs. For IOSs, repeatability (22 µm) was significantly (p<0.001) better than either forensic (75-77 µm) or technical reproducibility (37 µm). No significant changes were observed from the first to the second session in the between-sibling comparison. The closest between-sibling value (239 µm) considerably exceeded the highest forensic reproducibility value (141 µm). CONCLUSIONS Reproducibility is acceptable between the different IOSs, even two years apart, but is poor between IOS and indirect digitization. The anterior palate is relatively stable in young adults. CLINICAL SIGNIFICANCE Intraoral scanning of the anterior palatal area has superior reproducibility, regardless of the IOS brand. Therefore, the IOS method could be suitable for identifying humans through anterior palatal morphology. However, the digitization of elastic impressions or plaster models had low reproducibility, preventing their application for forensic purposes.
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Affiliation(s)
- Akos Mikolicz
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Botond Simon
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Orsolya Gáspár
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Arvin Shahbazi
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Department of Anatomy, Histology and Embryology (Oral Morphology Group), Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Janos Vag
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
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23
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Agustín-Panadero R, Estada MIC, Alonso Pérez-Barquero J, Zubizarreta-Macho Á, Revilla-León M, Gómez-Polo M. Effect of relative humidity on the accuracy, scanning time, and number of photograms of dentate complete arch intraoral digital scans. J Prosthet Dent 2023:S0022-3913(23)00254-8. [PMID: 37210222 DOI: 10.1016/j.prosdent.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/22/2023]
Abstract
STATEMENT OF PROBLEM Intraoral scanners (IOSs) have been used in dentistry for diagnostic and treatment purposes; however, the influence of environmental factors such as humidity or temperature on the accuracy of intraoral scanning is uncertain. PURPOSE The purpose of this in vitro study was to evaluate the influence of relative humidity and ambient temperature on the accuracy, scanning time, and number of photograms of dentate complete arch intraoral digital scans. MATERIAL AND METHODS A completely dentate mandibular typodont was digitized by using a dental laboratory scanner. Four calibrated spheres were attached following the International Organization for Standardization (ISO) standard 20 896. A watertight box was designed to simulate 4 different relative humidity conditions (50%, 70%, 80%, and 90%) (n = 30). An IOS (TRIOS 3) was used to obtain a total of 120 complete arch digital scans (n = 120). Scanning time and number of photograms of each specimen were recorded. All the scans were exported and compared with the master cast by using a reverse engineering software program. The linear distances among the reference spheres were used to calculate trueness and precision. A unifactorial analysis of variance (ANOVA) and Levene tests followed by the post hoc Bonferroni test were used to analyze trueness and precision data, respectively. A unifactorial ANOVA followed by a post hoc Bonferroni test was also conducted to analyze scanning time and the number of photogram data. RESULTS Statistically significant differences were found in trueness, precision, number of photograms, and scanning time (P<.05). Regarding trueness and precision, significant differences were found between the 50% and 70% relative humidity groups and the 80% and 90% relative humidity groups (P<.01). Regarding scanning time and number of photograms, significant differences were obtained among all groups, except between the 80% and 90% relative humidity groups (P<.01). CONCLUSIONS The relative humidity conditions tested influenced accuracy, scanning time, and number of photograms in complete arch intraoral digital scans. High relative humidity conditions resulted in the decreased scanning accuracy, longer scanning time, and greater number of photograms of complete arch intraoral digital scans.
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Affiliation(s)
- Rubén Agustín-Panadero
- Associate Professor, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | | | - Jorge Alonso Pérez-Barquero
- Adjunct Professor, Department of Implantology, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Adjunct Professor, Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Spain
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Miguel Gómez-Polo
- Associate Professor, Department of Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain; and Director, Advanced in Implant-Prosthodontics (Post-graduate program), School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Gómez-Polo M, Cascos R, Ortega R, Barmak AB, Kois JC, Revilla-León M. Influence of arch location and scanning pattern on the scanning accuracy, scanning time, and number of photograms of complete-arch intraoral digital implant scans. Clin Oral Implants Res 2023. [PMID: 37052054 DOI: 10.1111/clr.14069] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 03/03/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To measure the influence of arch location and scanning pattern on the accuracy, scanning time, and number of photograms of complete-arch implant scans acquired using an intraoral scanner (IOS). MATERIALS AND METHODS A maxillary (maxillary group) and mandibular (mandibular group) model with 6 implant abutments on each cast was digitized using a desktop scanner (control scans). Six subgroups were created based on the scanning pattern used to acquire the scans using an IOS (Trios 4): occluso-buccal-lingual (OBL subgroup), occluso-linguo-buccal (OLB subgroup), bucco-linguo-occlusal (BLO subgroup), linguo-buccal-occlusal (LBO subgroup), zigzag (ZZ subgroup), and circumferential (C subgroup). The control scans were used as a reference to measure the discrepancy with the experimental scans calculating the root mean square error. Two-way ANOVA and the pairwise comparison Tukey tests were used to analyze the data (α = .05). RESULTS Significant discrepancies in trueness (p < .001), precision (p < .001), scanning time (p < .001), and number of photograms (p < .001) were found. The maxillary group obtained poorer trueness and precision values, higher scanning times, and a larger number of photograms than the mandibular group. The C subgroup obtained the best trueness and precision values, but was not significantly different from the OLB, BLO, and LBO subgroups. The ZZ subgroup obtained the worst trueness and precision values (p < .05). The C subgroup obtained the lowest scanning time and number of photograms (p < .05). CONCLUSIONS Arch location and scanning pattern influenced scanning accuracy, scanning time, and number of photograms of complete-arch implant scans.
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Affiliation(s)
- Miguel Gómez-Polo
- 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 Cascos
- Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - John C Kois
- Kois Center, Private Practice, University of Washington, Seattle, Washington, USA
- Graduate Prosthodontics, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Marta Revilla-León
- Graduate Prosthodontics, 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, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Button H, Kois JC, Barmak AB, Zeitler JM, Rutkunas V, Revilla-León M. Scanning accuracy and scanning area discrepancies of intraoral digital scans acquired at varying scanning distances and angulations among 4 different intraoral scanners. J Prosthet Dent 2023:S0022-3913(23)00067-7. [PMID: 36872156 DOI: 10.1016/j.prosdent.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 03/06/2023]
Abstract
STATEMENT OF PROBLEM The accuracy of intraoral scanners (IOSs) can be affected by operator handling; however, the scanning area and accuracy discrepancies acquired at different scanning distances and angulations among IOSs remain uncertain. PURPOSE The objective of this in vitro study was to compare the scanning area and scanning accuracy of the intraoral digital scans obtained at 3 scanning distances with 4 different scanning angulations among 4 different IOSs. MATERIAL AND METHODS A reference device (reference file) was designed with 4 inclinations (0, 15, 30, and 45 degrees) and printed. Four groups were created based on the IOS: i700, TRIOS4, CS 3800, and iTero scanners. Four subgroups were generated depending on the scanning angulation (0, 15, 30, and 45 degrees). Each subgroup was divided into 3 subgroups based on the scanning distance: 0, 2, and 4 mm (N=720, n=15). The reference devices were positioned in a z-axis calibrated platform for standardizing the scanning distance. In the i700-0-0 subgroup, the 0-degree reference device was positioned in the calibrated platform. The wand of the IOS was positioned in a supporting framework with a 0-mm scanning distance, and the scans were acquired. In the i700-0-2 subgroup, the platform was lowered for a 2-mm scanning distance followed by the specimen acquisition. In the i700-0-4 subgroup, the platform was further lowered for a 4-mm scanning distance, and the scans were obtained. For the i700-15, i700-30, and i700-45 subgroups, the same procedures were carried out as in the i700-0 subgroups respectively, but with the 10-, 15-, 30-, or 45-degree reference device. Similarly, the same procedures were completed for all the groups with the corresponding IOS. The area of each scan was measured. The reference file was used to measure the discrepancy with the experimental scans by using the root mean square (RMS) error. Three-way ANOVA and post hoc Tukey pairwise comparison tests were used to analyze the scanning area data. Kruskal-Wallis and multiple pairwise comparison tests were used to analyze the RMS data (α=.05). RESULTS IOS (P<.001), scanning distance (P<.001), and scanning angle (P<.001) were significant factors of the scanning area measured among the subgroups tested. A significant group×subgroup interaction was found (P<.001). The iTero and the TRIOS4 groups obtained higher scanning area mean values than the i700 and CS 3800 groups. The CS 3800 obtained the lowest scanning area among the IOS groups tested. The 0-mm subgroups obtained a significantly lower scanning area than the 2- and 4-mm subgroups (P<.001). The 0- and 30-degree subgroups obtained a significantly lower scanning area than the 15- and 45-degree subgroups (P<.001). The Kruskal-Wallis test revealed significant median RMS discrepancies (P<.001). All the IOS groups were significantly different from each other (P<.001), except for the CS 3800 and TRIOS4 groups (P>.999). All the scanning distance groups were different from each other (P<.001). CONCLUSIONS Scanning area and scanning accuracy were influenced by the IOS, scanning distance, and scanning angle selected to acquire the digital scans.
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Affiliation(s)
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; and Private Practice, Seattle, Wash
| | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | | | - Vygandas Rutkunas
- Director Digitorum Research Center, Vilnius, Lithuania; and Professor, Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
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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: 48] [Impact Index Per Article: 48.0] [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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Implementation of a Full Digital Workflow by 3D Printing Intraoral Splints Used in Dental Education: An Exploratory Observational Study with Respect to Students' Experiences. Dent J (Basel) 2022; 11:dj11010005. [PMID: 36661542 PMCID: PMC9858622 DOI: 10.3390/dj11010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
Fully digital workflows gained acceptance in dental practice and thereby are of interest for undergraduate education. An exploratory clinical observation was designed to track the implementation of such a workflow with novice digital users in order to describe its feasibility, time investment, and pitfalls. METHODS Students were invited to provide feedback for their experiences with a training module that consisted of the following: intraoral scanning, computer-aided design (CAD), manual finishing, and insertion of a 3D-printed bite splint for the lower jaw. RESULTS A total of 82 fourth-year students participated in the module. The average time required to perform an intraoral scan was 17 m 5 s, and all students were able to design a splint with an average time of 2 h 38 m. Students who indicated prior experience with CAD seem to outperform inexperienced students in both CAD task completion and intraoral scanning. The initial fit was reported as clinically acceptable by 68.5% of the participants, while 79% rated the workflow as very good to satisfactory and indicated that the training was helpful for dental practice. CONCLUSIONS The implementation of a digital workflow in undergraduate dental education is feasible and has acceptable clinical results. However, CAD is time-intensive, and the experience can be challenging.
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Huang M, Wang Y, Sun Y, Zhou Y, Liu Y, Ye H. The accuracies of three intraoral scanners with regards to shade determination: An in vitro study. J Prosthodont 2022. [PMID: 35848886 DOI: 10.1111/jopr.13571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare the accuracy of three intraoral scanners for shade determination function in vitro, and to preliminarily investigate the shade-matching characteristics of the three intraoral scanners. MATERIALS & METHODS The shade of the middle third region of each shade tab on the Vita Classical A1-D4 shade guide (VC) was measured by a spectrophotometer (Vita Easyshade V, VE) and three intraoral scanners, including CEREC Omnicam (OM), 3Shape TRIOS 3 (T3), and TRIOS 4 (T4). A conversion table between VC values and CIELAB values was established from the database of VE to analyze the trueness. The reproducibility of the instruments was then compared by repeating the measurements five times. RESULTS The mean color difference for each instrument was highest in the OM, followed by the T4, and lowest in the T3 and VE, repectively. The L* and a* value for OM, and the b* value for T4, were significantly different from those for VE (p <0.05). The reproducibility of the instrument was highest in the VE (Fleiss' kappa: 0.95), followed by the T3 (Fleiss' kappa: 0.89), T4 (Fleiss' kappa: 0.87), and OM (Fleiss' kappa: 0.78). CONCLUSIONS Of the three intraoral scanners, the trueness was best on the T3. The reproducibility of all the instruments was excellent. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mingming Huang
- Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yong Wang
- Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yuchun Sun
- Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
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Kuralt M, Cmok Kučič A, Gašperšič R, Grošelj J, Knez M, Fidler A. Gingival shape analysis using surface curvature estimation of the intraoral scans. BMC Oral Health 2022; 22:283. [PMID: 35820843 PMCID: PMC9275066 DOI: 10.1186/s12903-022-02322-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022] Open
Abstract
Background Despite many advances in dentistry, no objective and quantitative method is available to evaluate gingival shape. The surface curvature of the optical scans represents an unexploited possibility. The present study aimed to test surface curvature estimation of intraoral scans for objective evaluation of gingival shape. Methods The method consists of four main steps, i.e., optical scanning, surface curvature estimation, region of interest (ROI) definition, and gingival shape analysis. Six different curvature measures and three different diameters were tested for surface curvature estimation on central (n = 78) and interdental ROI (n = 88) of patients with advanced periodontitis to quantify gingiva with a novel gingival shape parameter (GS). The reproducibility was evaluated by repeating the method on two consecutive intraoral scans obtained with a scan-rescan process of the same patient at the same time point (n = 8). Results Minimum and mean curvature measures computed at 2 mm diameter seem optimal GS to quantify shape at central and interdental ROI, respectively. The mean (and standard deviation) of the GS was 0.33 ± 0.07 and 0.19 ± 0.09 for central ROI using minimum, and interdental ROI using mean curvature measure, respectively, computed at a diameter of 2 mm. The method’s reproducibility evaluated on scan-rescan models for the above-mentioned ROI and curvature measures was 0.02 and 0.01, respectively. Conclusions Surface curvature estimation of the intraoral optical scans presents a precise and highly reproducible method for the objective gingival shape quantification enabling the detection of subtle changes. A careful selection of parameters for surface curvature estimation and curvature measures is required. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02322-y.
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Affiliation(s)
- Marko Kuralt
- Department of Restorative Dentistry and Endodontics, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia. .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | | | - Rok Gašperšič
- Department of Oral Medicine and Periodontology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jan Grošelj
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
| | - Marjeta Knez
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
| | - Aleš Fidler
- Department of Restorative Dentistry and Endodontics, University Medical Centre Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.,Department of Endodontics and Operative Dentistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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