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Taghva M, Mosaddad SA, Ansarifard E, Sadeghi M. Could various angulated implant depths affect the positional accuracy of digital impressions? An in vitro study. J Prosthodont 2024; 33:791-800. [PMID: 37675589 DOI: 10.1111/jopr.13764] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE The purpose of this in vitro investigation was to assess how implant depth could affect the three-dimensional positional accuracy of digital impressions made from angulated implants. MATERIALS AND METHODS Four modified maxillary models were printed and divided into four study groups. In each model, two angulated implant analogs were placed at the sites of the first premolar and first molar at four different depths of 1 (G1), 2 (G2), 3 (G3), and 4 (G4) mm from the models' edentate area. Scan bodies were connected to the analogs, and one operator made 10 full-arch scans for each master model using an intraoral scanner. Afterward, the marginal gingival part of all models was removed, and digital scans were performed for each model using a laboratory scanner to achieve a reference STL file as the control group. One-way ANOVA and Leven's tests were used to measure and compare the 3D distance deviations across research groups after the superimposing test and control scans. RESULTS A significant difference between research groups was revealed by trueness and precision analysis (p < 0.001). The trueness and precision results obtained for G1 and G4 were significantly better than those for G2 and G3 (p < 0.05). CONCLUSION This study demonstrated that implant depth could affect the digital implant impressions' 3D positional accuracy.
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Affiliation(s)
- Masumeh Taghva
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Ansarifard
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Nanomedicine and Nanobiology Research Center, Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Sadeghi
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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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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Palantza E, Sykaras N, Zoidis P, Kourtis S. In vitro comparison of accuracy between conventional and digital impression using elastomeric materials and two intra-oral scanning devices. J ESTHET RESTOR DENT 2024; 36:1179-1198. [PMID: 38534043 DOI: 10.1111/jerd.13227] [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: 10/22/2023] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
AIM The aim of this study was to compare the accuracy of full-arch conventional implant impressions using two different materials (A-silicone and polyether) to full-arch digital implant impressions produced from two intraoral scanning devices. MATERIALS AND METHODS A master model was fabricated representing an edentulous mandible with four implants with internal connection placed at the sites of canines and first molars. The anterior implants were parallel to the residual ridge, while the two posterior implants had an angulation of 15° to the distal and 15° to the lingual respectively. The conventional technique was performed with open-tray of non-splinted impression copings. Two different impression materials were used, A-silicone and polyether at monophase medium body consistencies. The digital impressions were obtained with the use of two different intraoral scanners, after the connection of scan bodies. A total of 10 impressions were produced for each of the four experimental groups. The conventional models as well as the master model were digitized using a high-resolution laboratory scanner. The STL files of the models and of the intraoral impressions were imported in a powerful superimposition software, for the conduction of measurements in pairs of files. The software calculated the 3D deviations, as well as the linear and angular displacements among scan bodies at the digital files. For "trueness" measurements every STL file of each experimental group was superimposed to the digital master model, while for "precision" measurements all STL files of each experimental group were superimposed to each other. RESULTS AND CONCLUSIONS The accuracy of full arch mandibular implant impressions was influenced both by the impression technique used (conventional vs. digital) and the impression material used (A-silicone vs. polyether) or the intraoral scanner used (Trios vs. Heron). In terms of "trueness," A-silicone showed the highest impression accuracy with the lowest deviation values, followed by polyether and Trios, but the differences between the three groups were in the majority not statistically significant. Heron showed statistically lower accuracy results in all measurements compared to the other groups. In terms of "precision", conventional impressions with the use of A-Silicone or polyether were statistically significantly superior to digital impressions with either scanner. A-Silicone and polyether showed no statistically significant difference between them.
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Affiliation(s)
- Eirini Palantza
- Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikitas Sykaras
- Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Zoidis
- Division Prosthodontics, Department of Restorative Dentistry, College of Dentistry, University of Florida, Gainsville, Florida, USA
| | - Stefanos Kourtis
- Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Athens, Greece
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Alkindi S, Hamdoon Z, Aziz AM. Effect of different impression coping and scan body designs on the accuracy of conventional versus digital implant impressions: An in vitro study. J Dent 2024; 146:105045. [PMID: 38714241 DOI: 10.1016/j.jdent.2024.105045] [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: 07/10/2023] [Revised: 04/15/2024] [Accepted: 05/02/2024] [Indexed: 05/09/2024] Open
Abstract
OBJECTIVES This in vitro study compared the accuracy of conventional versus digital impression techniques for angulated and straight implants using two different impression coping and scan body designs. METHODS Two implant systems were used: Straumann and Dentegris. Two implants were placed for each system, straight and angulated at 15 degrees mesiodistally. Conventional impressions were made using the splinted open-tray technique using narrow impression coping (NIC) and wide impression coping (WIC). The stone casts produced from the conventional impression were digitized with a lab scanner (3Shape D2000). Digital impressions were made using four intraoral scanners (IOS): 3Shape Trios 3, Medit i700, Cerec Omnicam, and Emerald Planmeca using short scanbodies (SSB) and long scanbodies (LSB). The scanning was repeated ten times to generate the Standard Tessellation Language (STL) files. The distance and angle deviations between impression copings and scanbodies were measured in reference to the master model. RESULTS The trueness and precision of SSB and WIC were significantly better than LSB and NIC (p<0.001). The range trueness of the platform deviation was better with SSB (37.1 to 51.9) than LSB (89.6 to 127.9 μm) and for WIC than NIC in conventional impressions (58.2 and 75.1 μm, respectively). The trueness of the angle deviation of digital scans with SSB (0.11 to 0.25 degrees) was significantly better than scans with LSB (0.31 to 0.57 degrees) and for WIC than NIC (0.21 and 0.52 degrees, respectively). The precision of the platform deviation of digital scans with SSB (12.4 to 34.5 μm) was higher than other scans and conventional impressions (42.9 to 71.4 μm). The precision of the angle deviation of Medit i700 and Trios 3 with SSB (0.17 and 0.20 degrees, respectively) was higher than other scans with SSB and conventional impressions (0.54 to 1.63 degrees). CONCLUSIONS Digital scans with SSB were more accurate than conventional splinted open-tray impressions. The type of impression coping and scanbody significantly affected the impression accuracy. CLINICAL SIGNIFICANCE The use of a short scanbody can increase the accuracy of digital impressions, and wide impression coping can increase the accuracy of conventional impressions, resulting in improved clinical outcomes.
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Affiliation(s)
| | - Zaid Hamdoon
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Ahmed M Aziz
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
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Zhu J, Zhao K, Gu X. Research progress on accuracy of intraoral digital impressions for implant-supported full-arch prostheses. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024:1-9. [PMID: 38832462 DOI: 10.3724/zdxbyxb-2024-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
With the rapid development of implant techniques and digital technology, digital impressions have become a commonly used impression method in implant restoration. At present, the accuracy of intraoral digital impressions directly applied to implant-supported full-arch prostheses remains inadequate, which is due to the high accuracy requirement of full-arch implant impressions, while there are still technical challenges in intraoral digital impressions about recognition and stitching. In this regard, scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scan, including mucosal modifications, auxiliary devices and novel scan bodies. At the same time photogrammetry, as a new digital impression technique, has been developing steadily and exhibits promising accuracy. This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions, to provide reference for clinical application.
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Affiliation(s)
- Jieying Zhu
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ke Zhao
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xinhua Gu
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Sicilia E, Lagreca G, Papaspyridakos P, Finkelman M, Cobo J, Att W, Revilla-León M. Effect of supramucosal height of a scan body and implant angulation on the accuracy of intraoral scanning: An in vitro study. J Prosthet Dent 2024; 131:1126-1134. [PMID: 36828728 DOI: 10.1016/j.prosdent.2023.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
STATEMENT OF PROBLEM Intraoral scanners (IOSs) provide a digital alternative to conventional implant impression techniques. However, the effect of the supramucosal height of the scan body and implant angulation on the accuracy of IOSs remains unclear. PURPOSE The purpose of this in vitro study was to measure the impact of the supramucosal height of the scan body and implant angulation on the accuracy (trueness and precision) of intraoral digital implant scans in partially edentulous models. MATERIAL AND METHODS Two maxillary partially edentulous casts with 4 implant analogs were fabricated, 1 with 4 parallel implants (P-groups) and 1 with 2 implants distally inclined 18 degrees (A-groups). An implant scan body was positioned on each implant analog (CARES RC Mono Scanbody). For each cast, 3 subgroups were determined based on the soft tissue moulage fabricated for each reference cast exposing 3 mm (P-3 and A-3 subgroups), 5 mm (P-5 and A-5 subgroups), and 7 mm (P-7 and A-7 subgroups) of the implant scan bodies. The 2 reference casts were registered by using a coordinate measurement machine and desktop scanner (7 Series Dental Wings) and then scanned using an IOS (TRIOS 4) (n=15). Linear and angular discrepancy values and root mean square (RMS) error values between the implant scan bodies measured on the reference and experimental scans were computed with an inspection software program (Geomagic). Mann-Whitney U tests with Bonferroni correction were applied for planned comparisons (α=.05/9 ≈ .006). RESULTS For linear discrepancies, statistically significant differences were found between groups P-3 and A-3 (P=.004) and between P-7 and A-7 (P=.005). For angular discrepancies, statistically significant differences were found between groups A-3 and A-5 (P=.002) and between P-7 and A-7 (P=.003). The RMS error analysis found no statistically significant differences among the groups. CONCLUSIONS Implant angulation of 18 degrees did not significantly affect the accuracy of the intraoral scans in terms of 6 of the 9 planned comparisons, although the angled groups had lower mean values. Also, the supramucosal height of the scan body did not significantly affect the accuracy of the intraoral scans in terms of 17 of the 18 planned comparisons. Results may vary with different implant scan body designs.
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Affiliation(s)
- Elena Sicilia
- PhD Candidate, Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, Oviedo, Spain.
| | - Gabriela Lagreca
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Juan Cobo
- Director of Orthodontics, Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Medical and Dental School, Instituto Asturiano de Odontologia, University of Oviedo, Oviedo, Spain
| | - Wael Att
- Department Chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Ochoa-López G, Revilla-León M, Gómez-Polo M. Influence of the ambient color lighting on the accuracy of complete arch implant scans recorded by using two intraoral scanners. J Prosthet Dent 2024:S0022-3913(24)00224-5. [PMID: 38653690 DOI: 10.1016/j.prosdent.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
STATEMENT OF PROBLEM The influence of different ambient factors including lighting has been previously studied. However, the influence of ambient color lighting settings on intraoral scanning accuracy remains uncertain. PURPOSE The purpose of this in vitro study was to assess the influence of ambient color lighting on the accuracy of complete arch implant scans recorded by using 2 intraoral scanners (IOSs). MATERIAL AND METHODS An edentulous maxillary cast with 6 implant scan bodies was digitized by using a laboratory scanner (DW-7-140) to obtain a reference file. Two groups were created based on the IOS tested: TRIOS 4 (IOS-1) and i700 (IOS-2). Seven subgroups were developed depending on the ambient color lighting (red, green, blue, yellow, cyan, magenta, and white) (n=15). Scanning accuracy was analyzed by using a metrology software program (Geomagic Control X). The Kruskal-Wallis, 1-way ANOVA, and pairwise comparisons were used to analyze the data (α=.05). RESULTS Significant trueness and precision values were found across the groups (P<.05) and subgroups (P<.05). For IOS-1, blue ambient lighting obtained the best trueness (19.8 ±1.8 µm) (P<.05); in precision, white light (20.8 ±7.3 µm) and blue light (22.1 ±13.5) showed the best results (P<.05). For IOS-2, white light showed the best trueness (51.9 ±16.7 µm); the best precision was obtained under magenta (38.6 ±10.4 µm) and yellow light (52.6 ±24.0 µm) (P<.05). CONCLUSIONS The optimal ambient color lighting varied between the IOSs assessed. As the best condition for maximizing accuracy was not found, ambient color lighting must be individualized for the IOS system used.
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Affiliation(s)
- Gastón Ochoa-López
- PhD Candidate, Department of Prosthodontics and Restorative Dentistry, School of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - 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 Researcher, Revilla Research Center, Madrid, Spain
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain; and Director, Postgraduate Program (Specialist in Advanced Implant-Prosthesis), Complutense University of Madrid (UCM), Madrid, Spain.
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Ashry A, Abdelhamid AM, Ezzelarab S, Khamis MM. Effect of using scan body accessories and inter-implant distances on the accuracy of complete arch implant digital impressions: An in vitro study. J Prosthodont 2024. [PMID: 38594949 DOI: 10.1111/jopr.13856] [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: 11/11/2023] [Accepted: 03/23/2024] [Indexed: 04/11/2024] Open
Abstract
PURPOSE To introduce a novel design for scan body accessory parts that are reusable, easy to attach and detach without permanent change of the scan body, and can be used with different inter-implant distances to enhance the accuracy of complete arch implant scans. MATERIALS AND METHODS A maxillary polymethylmethacrylate (PMMA) model with a soft tissue replica was fabricated with four implant analogs located at tooth positions 17, 13, 22, and 27 with 18, 25, and 30 mm inter-implant distances. Four scan bodies (SBs) were attached to the implants. The model was scanned with a laboratory scanner to be used as a reference scan. A total of 40 scans were made with the same intraoral scanner and they were divided equally into two groups. Group A: Complete arch implant scans without scan body accessories (n = 20), and Group B: Complete arch implant scans with scan body accessories (n = 20). Intraoral scans were exported and superimposed on the reference scan using reverse engineering inspection software to be evaluated for 3D deviations, angular deviations, and linear deviations. Statistical analysis was performed with student t-test and analysis of variance (ANOVA) with repeated measures followed by post hoc adjusted Bonferroni test. The level of significance was set at P = 0.05. RESULTS The scan body accessories decreased both the 3D and linear deviations, with a statistically significant difference at SB4 for the 3D deviation (P = 0.043) and the linear inter-implant discrepancies between SB1-SB2 and SB3-SB4 (P = 0.029 and < 0.001), respectively. However, there was no statistically significant difference in angular deviation between the study groups. Implant positions had significant differences within each group. CONCLUSIONS A significant improvement in the accuracy of the complete arch implant digital impression was achieved by using the scan body accessories, particularly in reducing the 3D and linear deviations at the most distant implant positions.
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Affiliation(s)
- Amal Ashry
- Department of Prosthodontics, Faculty of Dentistry, Damanhour University, El-Behaira, Egypt
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed M Abdelhamid
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Salah Ezzelarab
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Moataz Khamis
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Siadat H, Chitsaz F, Zeighami S, Esmaeilzadeh A. Accuracy of maxillary full-arch digital impressions of tooth and implant models made by two intraoral scanners. Clin Exp Dent Res 2024; 10:e857. [PMID: 38433306 PMCID: PMC10909798 DOI: 10.1002/cre2.857] [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: 04/26/2023] [Revised: 01/20/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES Limited studies are available on the accuracy of intraoral scanners (IOSs) for full-arch implant and tooth models. This study aimed to assess the accuracy of maxillary full-arch digital impressions of tooth and implant models made by two IOSs. MATERIALS AND METHODS This in vitro, experimental study was conducted on two maxillary dentiform models: one with six prepared natural teeth and the other with six implants at the site of canine, first premolar, and first molar teeth, bilaterally. A highly accurate industrial scanner was used for actual measurements on the models that served as the reference scan. TS (Trios3) and CO (CEREC Omnicam) IOSs were then used to scan each model 10 times according to the manufacturer's instructions. All scans were saved in STL format. The GOM Inspect software was used according to the best-fit algorithm to compare the accuracy of measurements in the groups with the reference scan. The trueness and precision were calculated. Statistical analyses were carried out using SPSS by one-way analysis of variance and t-test (α = .05). RESULTS TS showed a significantly higher trueness than CO for both tooth and implant models (p < .05). TS also revealed significantly higher precision than CO for the tooth model; however, the difference in precision for the implant model was not significant between the two IOSs (p > .05). CONCLUSIONS TS showed higher accuracy than CO in both tooth and implant models.
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Affiliation(s)
- Hakimeh Siadat
- Department of Prosthodontics, School of Dentistry, Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Foujan Chitsaz
- School of Mechanical and Manufacturing EngineeringUniversity of New South WalesSydneyNew South WalesAustralia
| | - Somayeh Zeighami
- Department of Prosthodontics, School of Dentistry, Dental Research Center, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Alireza Esmaeilzadeh
- Department of Prosthodontics, School of DentistryArak University of Medical SciencesArakIran
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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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González Menéndez H, Lorrio Castro J, Rodríguez Torres P, de la Vega Buró S, Zubizarreta-Macho Á, Riad Deglow E, Lobo Galindo AB, Hernández Montero S. Influence of parallel pins on the angle deviation for placement of dental implants: an in vitro study. BMC Oral Health 2024; 24:134. [PMID: 38279099 PMCID: PMC10811900 DOI: 10.1186/s12903-024-03883-w] [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: 03/28/2023] [Accepted: 01/10/2024] [Indexed: 01/28/2024] Open
Abstract
The aim of the present study was to analyze and compare the angle deviation of two, four and six adjacent dental implants placed with and without straight parallel pins. MATERIALS AND METHODS Two hundred and forty (240) dental implants were selected and randomly allocated into the following study groups: Two dental implants placed with straight parallel pins (Ref.: 144-100, BioHorizons, Birmingham, AL, USA) (n = 10) (2PP); Two dental implants placed without parallel pins (n = 10) (2withoutPP); Four dental implants placed with straight parallel pins hT(n = 10) (4PP); Four dental implants placed without parallel pins (n = 10) (4withoutPP); Six dental implants placed with straight parallel pins (n = 10) (6PP) and Six dental implants placed without parallel pins (n = 10) (6withoutPP). The dental implants randomly assigned to groups 2PP and 2withoutPP were placed into standardized polyurethane models of partially edentulous upper jaws in tooth positions 2.4 and 2.6, the dental implants randomly assigned to groups 4PP and 4withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 2.4 and 2.6, and the dental implants randomly assigned to groups 6PP and 6withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 1.2, 2.2, 2.4 and 2.6. Afterwards, postoperative CBCT scans and digital impressions were aligned in a 3D implant-planning software to compare the angle deviation (°) of two, four and six adjacent dental implants placed with and without straight parallel pins using the General Linear Model statistical analysis. RESULTS Statistically significant differences were found between the angle deviation of 2 dental implants placed with straight parallel pins (p < 0.0001) and between the angle deviation of 4 dental implants placed with straight parallel pins (p = 0.0024); however, no statistically significant differences were found in the angle deviation of 6 dental implants placed with straight parallel pins (p = 0.9967). CONCLUSION The use of a straight parallelization pin results in lower angle deviation between two and four adjacent dental implants; however, it is not effective for a larger number of dental implants.
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Affiliation(s)
- Héctor González Menéndez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
| | - Juan Lorrio Castro
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
| | - Paulina Rodríguez Torres
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
| | - Susana de la Vega Buró
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain.
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain.
| | - Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
| | - Ana Belén Lobo Galindo
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain
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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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13
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Papaspyridakos P, Bedrossian EA, Ntovas P, Kudara Y, Bokhary A, Chochlidakis K. Reverse scan body: The scan pattern affects the fit of complete-arch prototype prostheses. J Prosthodont 2023; 32:186-191. [PMID: 37721306 DOI: 10.1111/jopr.13772] [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: 06/10/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
PURPOSE To assess the effect of different scan patterns on the fit of implant-supported complete-arch prototype prostheses fabricated via a complete digital extraoral protocol with a reverse scan body. MATERIALS AND METHODS A mandibular cast with four multi-unit abutment (MUA) implant analogs with adequate antero-posterior spread served as the reference cast, simulating a common clinical patient situation, and a polymethylmethacrylate interim screw-retained prosthesis was fabricated on it. Novel reverse scan bodies were connected to the interim prosthesis on the intaglio of the MUA abutments and extraoral scanning was performed with a white light intraoral scanner (TRIOS 4; 3 shape) and three different scan patterns: starting from the occlusal surface of the interim prosthesis (O-group), starting from the intaglio (I-group), and helix pattern (H-group). The resulting STL files from the three groups were then imported to computer-aided design (CAD) software and after the digital design, the STL files were exported to a computer-aided manufacturing (CAM) milling machine which generated a total of 15 CAD-CAM milled prototype prostheses per group. Two clinicians assessed the fit of each digitally fabricated prototype prosthesis on the reference cast, utilizing the screw-resistance test and radiographic evaluation. Fisher's exact test was used to test the difference between the three groups, and Cohen's k-score was used to assess the inter-examiner agreement. RESULTS Out of the three different groups, the O-group scan pattern led to 100% prosthesis fit, while the prototype prostheses generated from I- and H-groups had 80% and 53% fit, respectively. The results were statistically significant (p = 0.008). CONCLUSIONS Occlusal scan pattern leads to fitting milled prototype prostheses after extraoral scanning with reverse scan bodies without intraoral implant data acquisition.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - E Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, Washington, USA
| | - Panagiotis Ntovas
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
| | - Yukio Kudara
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
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14
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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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Gómez-Polo M, Barmak AB, Ortega R, Rutkunas V, Kois JC, Revilla-León M. Accuracy, scanning time, and patient satisfaction of stereophotogrammetry systems for acquiring 3D dental implant positions: A systematic review. J Prosthodont 2023; 32:208-224. [PMID: 37591510 DOI: 10.1111/jopr.13751] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/17/2023] [Accepted: 06/25/2023] [Indexed: 08/19/2023] Open
Abstract
PURPOSE To evaluate accuracy, scanning time, and patient satisfaction of photogrammetry (PG) systems for recording the 3D position of dental implants. 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 use of commercially available PG systems 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. RESULTS A total of 14 articles were included: 3 in vivo, 6 in vitro, and 6 case report manuscripts. One clinical study evaluated trueness, another one tested precision, and the third one assessed impression time and patient and operator satisfaction. All the in vitro studies evaluated the trueness and precision of a PG system. Additionally, all the reviewed studies investigated completely edentulous conditions with multiple implants. The number of placed implants per arch among the reviewed clinical studies varied from 4 to 8 implants, while the number of implants placed on the reference casts included 4, 5, 6, or 8 implants. Not all the studies compared the accuracy of PG systems with conventional impression methods, using intraoral scanners as additional experimental groups. For the PIC system, trueness ranged from 10 to 49 μm and precision ranged from 5 to 65 μm. For the iCam4D system, trueness ranged from 24 to 77 μm and the precision value ranged from 2 to 203 μm. CONCLUSIONS PG systems may provide a reliable alternative for acquiring the 3D position of dental implants. However, this conclusion should be interpreted carefully, as one study reported a mean precision value of one PG system higher than the clinically acceptable discrepancy. Lower scanning time and higher patient and operator satisfaction have been reported when compared with conventional techniques. Further studies are needed to increase the evidence regarding the accuracy, scanning time, and patient and operator satisfaction of the commercially available PG systems.
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Affiliation(s)
- Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Vygandas Rutkunas
- Digitorum Research Center, Vilnius, Lithuania
- Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - John C Kois
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Marta Revilla-León
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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16
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Papaspyridakos P, Vazouras K, Gotsis S, Bokhary A, Sicilia E, Kudara Y, Bedrossian A, Chochlidakis K. Complete digital workflow for prosthesis prototype fabrication with double digital scanning: A retrospective study with 45 edentulous jaws. J Prosthodont 2022. [PMID: 36527731 DOI: 10.1111/jopr.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To assess the accuracy of fit of complete-arch printed prosthesis prototypes generated with a digital workflow protocol for completely edentulous jaws. MATERIALS AND METHODS Forty-five edentulous jaws (35 patients) underwent intraoral complete-arch digital scans with the double digital scanning (DDS) technique and the generated standard tessellation language (STL) files were superimposed and imported into computer-aided design software. After STL merging, each master STL file was used for printing a prosthesis prototype. The primary outcome was the accuracy of fit assessment of the printed prototypes on verified master stone casts. Two experienced clinicians tested the accuracy of fit with radiographs and screw-resistance tests. Secondary outcomes were the effect of the scan body shape and implant number on the accuracy of fit. RESULTS Out of the 45 DDS-generated prosthesis prototypes, 39 presented with accurate fit on verified master stone casts, yielding an 86.70% accuracy of fit. Cylindrical scan bodies led to 100% accuracy of fit (25/25), whereas polygonal scan bodies presented with 70% accuracy of fit (14/20). Four implant-supported prostheses yielded 100% accuracy of fit (12/12), compared with 25/29 (86.30%) accuracy of fit for the six-implant-supported ones. Fisher's exact test was used to assess the effect of different scan body shapes (p = 0.005) and implant number on accuracy of fit. Chi-squared test was used to assess the association between the number of implants per arch and the accuracy of fit (p = 0.039). CONCLUSIONS Thirty-nine out of 45 complete-arch prosthesis prototypes generated with a completely digital workflow presented with clinically acceptable fit. The effect of the scan body design and implant number was statistically significant, favoring cylindrical scan bodies and four-implant-supported prostheses.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
| | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Sotirios Gotsis
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Yukio Kudara
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, Washington, USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
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