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Olsen Kipp J, Petersen ET, Falstie-Jensen T, Frost Teilmann J, Zejden A, Jellesen Åberg R, de Raedt S, Thillemann TM, Stilling M. Glenohumeral joint kinematics during apprehension-relocation test in patients with anterior shoulder instability and glenoid bone loss. Bone Joint J 2024; 106-B:1133-1140. [PMID: 39348902 DOI: 10.1302/0301-620x.106b10.bjj-2024-0419.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
Aims This study aimed to quantify the shoulder kinematics during an apprehension-relocation test in patients with anterior shoulder instability (ASI) and glenoid bone loss using the radiostereometric analysis (RSA) method. Kinematics were compared with the patient's contralateral healthy shoulder. Methods A total of 20 patients with ASI and > 10% glenoid bone loss and a healthy contralateral shoulder were included. RSA imaging of the patient's shoulders was performed during a repeated apprehension-relocation test. Bone volume models were generated from CT scans, marked with anatomical coordinate systems, and aligned with the digitally reconstructed bone projections on the RSA images. The glenohumeral joint (GHJ) kinematics were evaluated in the anteroposterior and superoinferior direction of: the humeral head centre location relative to the glenoid centre; and the humeral head contact point location on the glenoid. Results During the apprehension test, the centre of the humeral head was 1.0 mm (95% CI 0.0 to 2.0) more inferior on the glenoid for the ASI shoulder compared with the healthy shoulder. Furthermore, the contact point of the ASI shoulder was 1.4 mm (95% CI 0.3 to 2.5) more anterior and 2.0 mm (95% CI 0.8 to 3.1) more inferior on the glenoid compared with the healthy shoulder. The contact point of the ASI shoulder was 1.2 mm (95% CI 0.2 to 2.6) more anterior during the apprehension test compared to the relocation test. Conclusion The humeral head centre was located more inferior, and the GHJ contact point was located both more anterior and inferior during the apprehension test for the ASI shoulders than the healthy shoulders. Furthermore, the contact point displacement between the apprehension and relocation test revealed increased joint laxity for the ASI shoulder than the healthy shoulders. These results contribute to existing knowledge that ASI shoulders with glenoid bone loss may also suffer from inferior shoulder instability.
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Affiliation(s)
- Josephine Olsen Kipp
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Emil T Petersen
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Johanne Frost Teilmann
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anna Zejden
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Sepp de Raedt
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Theis M Thillemann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Maiken Stilling
- AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark
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Malmberg C, Jensen SE, Michaud B, Andreasen KR, Hölmich P, Barfod KW, Bencke J. Three-dimensional measurements of scapular kinematics: Interrater reliability and validation of a skin marker-based model against an intracortical pin model. Heliyon 2024; 10:e29414. [PMID: 38644878 PMCID: PMC11033140 DOI: 10.1016/j.heliyon.2024.e29414] [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: 07/27/2023] [Revised: 03/15/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
A skin marker-based motion capture model providing measures of scapular rotations was recently developed. The aim of this study was to investigate the concurrent validity and the interrater reliability of the model. Shoulder range of motion (RoM) and activities of daily living (ADL) were tested in healthy volunteers with reflective markers on the scapula and thorax. To investigate the validity, the model was compared to simultaneous data collection from markers on a scapular intracortical pin. The interrater reliability was tested by comparing the skin marker-based protocol performed by two investigators. The mean root mean square error (RMSE) and the intraclass correlation coefficient (ICC(2,1)) were calculated to determine the validity and the interrater reliability, respectively. Eight subjects were included in the validity test: female/male = 2/6, mean (SD) age 35.0 (3.0) and BMI 23.4 (3.3). The mean RMSE of all scapular rotations ranged 2.3-6.7° during shoulder RoM and 2.4-7.6° during ADL. The highest errors were seen during sagittal and scapular plane flexions, hair combing and eating. The reliability test included twenty subjects: female/male = 8/12, mean (SD) age 31.4 (4.9) and BMI 22.9 (1.7). The ICC(2,1) for measuring protraction ranged 0.07-0.60 during RoM and 0.27-0.69 for ADL, for upward rotation the corresponding ICC(2,1) ranged 0.01-0.64 and 0.38-0.60, and anterior tilt 0.25-0.83 and 0.25-0.62. The validity and interrater reliability of the model are task dependent, and interpretation should be made with caution. The model provides quantitative measurements for objective assessment of scapular movements and can potentially supplement the clinical examination in certain motion tasks.
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Affiliation(s)
- Catarina Malmberg
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Stefan E. Jensen
- Human Movement Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Benjamin Michaud
- Laboratoire de simulation et modélisation du mouvement (S2M), École de kinésiologie et des sciences de l'activité physique, Université de Montréal, 2100 Edouard Montpetit Blvd, Montreal, Québec, Canada
| | - Kristine R. Andreasen
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Kristoffer W. Barfod
- Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Jesper Bencke
- Human Movement Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
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Malmberg C, Andreasen KR, Bencke J, Hölmich P, Barfod KW. Anterior-posterior glenohumeral translation in shoulders with traumatic anterior instability: a systematic review of the literature. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:477-493. [PMID: 37928995 PMCID: PMC10625004 DOI: 10.1016/j.xrrt.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background Reports of glenohumeral translation in shoulders with traumatic anterior instability have been presented. The aim of this systematic review was to investigate anterior-posterior translation in shoulders with traumatic anterior instability. Methods This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies including patients aged ≥15 years with previous traumatic anterior shoulder dislocation or subluxation were included. The outcome was anterior-posterior glenohumeral translation. A search of PubMed, Embase, and Cochrane library was performed on July 17, 2022. Two reviewers individually screened titles and abstracts, reviewed full text, extracted data, and performed quality assessment. Results Twenty studies (582 unstable shoulders in total) of varying quality were included. There was a lack of standardization and unity across studies. Radiography, ultrasound, computed tomography, magnetic resonance imaging, motion tracking, instrumentation, and manual testing were used to assess the glenohumeral translation. The glenohumeral translation in unstable shoulders ranged from 0.0 ± 0.8 mm to 11.6 ± 3.7 mm, as measured during various motion tasks, arm positions, and application of external force. The glenohumeral translation was larger or more anteriorly directed in unstable shoulders than in stable when contralateral healthy shoulders or a healthy control group were included in the studies. Several studies found that the humeral head was more anteriorly located on the glenoid in the unstable shoulders. Conclusion This systematic review provides an overview of the current literature on glenohumeral translation in traumatic anterior shoulder instability. It was not able to identify a threshold for abnormal translation in unstable shoulders, due to the heterogeneity of data. The review supports that not only the range of translation but also the direction hereof as well as the location of the humeral head on the glenoid seem to be part of the pathophysiology. Technical development and increased attention to research methodology in recent years may provide more knowledge and clarity on this topic in the future.
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Affiliation(s)
- Catarina Malmberg
- Department of Orthopedic Surgery, Sports Orthopedic Research Center – Copenhagen (SORC-C), Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
| | - Kristine Rask Andreasen
- Department of Orthopedic Surgery, Sports Orthopedic Research Center – Copenhagen (SORC-C), Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
| | - Jesper Bencke
- Department of Orthopedic Surgery, Sports Orthopedic Research Center – Copenhagen (SORC-C), Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
- Human Movement Analysis Laboratory, Department of Orthopedic Surgery, Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
| | - Per Hölmich
- Department of Orthopedic Surgery, Sports Orthopedic Research Center – Copenhagen (SORC-C), Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
| | - Kristoffer Weisskirchner Barfod
- Department of Orthopedic Surgery, Sports Orthopedic Research Center – Copenhagen (SORC-C), Copenhagen University Hospital Amager & Hvidovre, Hvidovre, Denmark
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Daher B, Hunter J, Athwal GS, Lalone EA. How does computed tomography inform our understanding of shoulder kinematics? A structured review. Med Biol Eng Comput 2023; 61:967-989. [PMID: 36692800 DOI: 10.1007/s11517-022-02755-1] [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: 09/01/2021] [Accepted: 12/22/2022] [Indexed: 01/25/2023]
Abstract
The objective of this structured review was to review how computed tomography (CT) scanning has been used to measure the kinematics of the shoulder. A literature search was conducted using Evidence-based Medicine Reviews (Embase) and PubMed. In total, 29 articles were included in the data extraction process. Forty percent of the studies evaluated healthy participants' shoulder kinematics. The glenohumeral joint was the most studied, followed by the scapulothoracic, acromioclavicular, and sternoclavicular joints. Three-dimensional computed tomography (3DCT) and 3DCT with biplane fluoroscopy are the two primary imaging techniques that have been used to measure shoulder joints' motion under different conditions. Finally, many discrepancies in the reporting of the examined motions were found. Different authors used different perspectives and planes to report similar motions, which results in confusion and misunderstanding of the actual examined motion. The use of 3DCT has been widely used in the examination of shoulder kinematics in a variety of populations with varying methods employed. Future work is needed to extend these methodologies to include more diverse populations, to examine the shoulder complex as a whole, and to standardize their reporting of motion examined to make study to study comparisons possible.
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Affiliation(s)
- Baraa Daher
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada.,Bone and Joint Institute, Western University, London, Canada
| | - James Hunter
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada.,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada
| | - George S Athwal
- Bone and Joint Institute, Western University, London, Canada.,Department of Surgery, Western University, London, Canada.,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Emily A Lalone
- Faculty of Engineering, School of Biomedical Engineering, Western University, London, Canada. .,Department of Mechanical and Materials Engineering, The University of Western Ontario, Thompson Engineering Building, Room 353, London, ON, N6A 5B9, Canada. .,Bone and Joint Institute, Western University, London, Canada. .,Department of Surgery, Western University, London, Canada. .,Roth
- McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada. .,Lawson Health Research Institute, London, ON, Canada.
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Inoue J, Takenaga T, Tsuchiya A, Okubo N, Takeuchi S, Takaba K, Nozaki M, Kobayashi M, Fukushima H, Kato J, Murakami H, Yoshida M. Ultrasonographic Assessment of Glenohumeral Joint Stability Immediately After Arthroscopic Bankart-Bristow Procedure. Orthop J Sports Med 2022; 10:23259671221131600. [PMID: 36389618 PMCID: PMC9647262 DOI: 10.1177/23259671221131600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The changes in glenohumeral joint stability after surgery in a clinical
setting are yet unknown. Purpose/Hypothesis: This study aimed to compare the anterior humeral head translation between
pre- and postsurgical conditions using ultrasonography. It was hypothesized
that ultrasonographic assessment would reveal decreased anterior
translation. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients (24 male, 3 female; mean age, 24.1 ± 9.7 years) with
anterior shoulder instability were studied prospectively. All the patients
underwent the arthroscopic Bankart-Bristow procedure under general
anesthesia, and ultrasonographic evaluation was performed before and
immediately after surgery. The forearm was fixed with an arm positioner in
the beach-chair position, and the ultrasonographic transducer was located at
the posterior part of the shoulder to visualize the humeral head and glenoid
rim at the level of interval between the infraspinatus tendon and teres
minor tendon. The upper arm was drawn anteriorly with a 40-N force at 0°,
45°, and 90° of shoulder abduction with neutral rotation. The distance from
the posterior edge of the glenoid to that of the humeral head was measured
using ultrasonography with and without anterior force. Anterior translation
was defined by subtracting the distance with anterior force from the
distance without anterior force. Results: The humeral head position was translated posteriorly immediately after
surgery in all patients. Anterior translation decreased significantly after
surgery at 45° (7.7 ± 4.3 vs 5.8 ± 2.0 mm; P = .031) and
90° (8.9 ± 3.4 vs 6.1 ± 2.2 mm; P < .001) of abduction,
whereas there was no difference between pre- and postsurgical translation at
0° of abduction (4.9 ± 2.3 vs 4.0 ± 2.1 mm, P = .089). Conclusion: Ultrasonographic assessment immediately after a Bankart-Bristow procedure
showed the humeral head was translated posteriorly relative to the glenoid
at 0°, 45°, and 90° of abduction. The surgery also decreased anterior
translation in response to an anteriorly directed force at 45° and 90° of
abduction.
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Affiliation(s)
- Jumpei Inoue
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
- Department of Orthopedic Surgery, Meitetsu Hospital, Nagoya, Japan
| | - Tetsuya Takenaga
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Atsushi Tsuchiya
- Arthroscopy and Sports Medicine Center, Meitetsu Hospital, Nagoya, Japan
| | - Norio Okubo
- Department of Orthopedic Surgery, Meitetsu Hospital, Nagoya, Japan
| | - Satoshi Takeuchi
- Department of Orthopedic Surgery, Toyohashi Medical Center, Toyohashi, Japan
| | - Keishi Takaba
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masahiro Nozaki
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Makoto Kobayashi
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Hiroaki Fukushima
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Jiro Kato
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Hideki Murakami
- Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Masahito Yoshida
- Department of Musculoskeletal Sports Medicine, Research and Innovation, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
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Kim D, Lee B, Yeom J, Cha J, Han J. Three-dimensional in vivo comparative analysis of the kinematics of normal shoulders and shoulders with massive rotator cuff tears with successful conservative treatment. Clin Biomech (Bristol, Avon) 2020; 75:104990. [PMID: 32222472 DOI: 10.1016/j.clinbiomech.2020.104990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study used in vivo three-dimensional to two-dimensional image registration techniques to compare the glenohumeral kinematics of shoulders with massive rotator cuff tears that were successfully treated conservatively and those of normal shoulders. METHODS Ten patients (age, 67.4 ± 3.63 years) with massive rotator cuff tears on one side and without contralateral tears were enrolled. We performed computed tomography and fluoroscopy on both shoulder joints and created three-dimensional bone models of the humerus and scapula using image registration techniques. We measured the humeral superoinferior translation, angle of humeral external rotation, scapular upward rotation, scapular anteroposterior tilt, and scapular external rotation of the torn shoulders with good range of motion after effective conservative treatment and compared these measurements to those of the contralateral normal shoulders. FINDINGS There was a significant difference in the initial position of the humeral head relative to the glenoid in the tear group; it was 2.0 mm higher than that in the normal group (p < .05). This difference disappeared in the range from 40° to full elevation. The scapular motion of the tear group was significantly more upwardly rotated than that of the normal group: by 9.9° at rest (p < .05) and by 11.6° at terminal elevation (p < .05). No significant differences were detected for humeral head external rotation, scapular anteroposterior tilt, and scapular external rotation between the two groups. INTERPRETATION Kinematics of shoulders with massive cuff tears could not be recovered completely even though the patients had no significant symptoms after successful conservative treatment.
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Affiliation(s)
- Doosup Kim
- Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Severance Christian Hospital, Republic of Korea.
| | - Bonggun Lee
- Department of Orthopedic Surgery, Hanyang University, Seoul, Republic of Korea.
| | - Junseop Yeom
- Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Severance Christian Hospital, Republic of Korea
| | - Jaehack Cha
- Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Severance Christian Hospital, Republic of Korea
| | - Jinyoung Han
- Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Severance Christian Hospital, Republic of Korea
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Jeon JH, Hwang SS, Kim JH, Kim WC. Trueness and precision of scanning abutment impressions and stone models according to dental CAD/CAM evaluation standards. J Adv Prosthodont 2018; 10:335-339. [PMID: 30370023 PMCID: PMC6202429 DOI: 10.4047/jap.2018.10.5.335] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 04/15/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The purpose of the present study was to compare scanning trueness and precision between an abutment impression and a stone model according to dental computer-aided design/computer-aided manufacturing (CAD/CAM) evaluation standards. MATERIALS AND METHODS To evaluate trueness, the abutment impression and stone model were scanned to obtain the first 3-dimensional (3-D) stereolithography (STL) file. Next, the abutment impression or stone model was removed from the scanner and re-fixed on the table; scanning was then repeated so that 11 files were obtained for each scan type. To evaluate precision, the abutment impression or stone model was scanned to obtain the first 3-D STL file. Without moving it, scanning was performed 10 more times, so that 11 files were obtained for each scan type. By superimposing the first scanned STL file onto the other STL files one by one, 10 color-difference maps and reports were obtained; i.e., 10 experimental scans per type. The independent t-test was used to compare root mean square (RMS) data between the groups (α=.05). RESULTS The RMS±SD values of scanning trueness of the abutment impression and stone model were 22.4±4.4 and 17.4±3.5 µm, respectively (P<.012). The RMS±SD values of scanning precision of the abutment impression and stone model were 16.4±2.9 and 14.6±1.6 µm, respectively (P=.108). CONCLUSION There was a significant difference in scanning trueness between the abutment impression and stone model, as evaluated according to dental CAD/CAM standards. However, all scans showed high trueness and precision.
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Affiliation(s)
- Jin-Hun Jeon
- Department of Dental Technology, Medical Campus, Kyung-Dong University, Wonju, Republic of Korea
| | - Seong-Sig Hwang
- Department of Dental Technology, Medical Campus, Kyung-Dong University, Wonju, Republic of Korea
| | - Ji-Hwan Kim
- Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Woong-Chul Kim
- Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea
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