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Dinçer G, Molinero-Mourelle P, Donmez MB, Kahveci Ç, Yilmaz B, Çakmak G. Scan accuracy of wireless intraoral scanners while digitizing a combined scan body-healing abutment system: Scan accuracy of wireless scanners. J Dent 2024:105413. [PMID: 39419370 DOI: 10.1016/j.jdent.2024.105413] [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: 08/29/2024] [Revised: 10/02/2024] [Accepted: 10/15/2024] [Indexed: 10/19/2024] Open
Abstract
OBJECTIVES To investigate the accuracy (trueness and precision) of wireless and wired intraoral scanners (IOSs) when scanning an implant with the combined healing abutment-scan body (CHA-SB) system. METHODS A partially edentulous mandibular model with a CHA-SB at the right first molar site was digitized with 2 wireless (NeoScan 2000 (NW) and TRIOS 4 wireless (T4W)) and 2 wired (NeoScan 1000 (N) and TRIOS 4 wired (T4)) IOSs 44 times in total (n=11). The reference scan file was generated by digitizing the same master model and CHA-SB with an industrial-grade optical scanner. All files were imported into a metrology-grade analysis software program to evaluate the surface (root mean square, RMS), linear, and angular deviations of the top part of the SB. The average deviation values defined the precision of the scans. The data were statistically analyzed (α = 0.05). RESULTS IOS type affected the surface and angular deviations and the precision (linear deviations on the x-axis) of the scans (p ≤ 0.043). T4W had lower RMS than N and T4 (p ≤ 0.031). T4 had higher angular deviations than N on the XZ plane and had the lowest angular deviations on the YZ plane (p ≤ 0.011). T4W scans had higher precision than N scans (p = 0.024). CONCLUSION Despite some differences in the trueness or precision of scans, tested IOSs mostly enabled similar scan accuracy. Regardless of the IOS, the implant scans had a tendency to tilt mesiobuccally, which can be considered clinically small. CLINICAL SIGNIFICANCE Tested wireless intraoral scanners may be suitable alternatives to their wired counterparts while digitizing an implant with a combined healing abutment-scan body system in the posterior region. However, the crowns fabricated from tested scans might require buccal, mesial, and occlusal surface veneering and distal surface adjustments.
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Affiliation(s)
- Gökçen Dinçer
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland; Department of Conservative Dentistry and Prosthodontics, Faculty of Odontology, Complutense University of Madrid, Spain
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey.
| | | | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, 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 College of Dentistry, OH, USA
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
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Eggmann F, Blatz MB. Recent Advances in Intraoral Scanners. J Dent Res 2024:220345241271937. [PMID: 39382136 DOI: 10.1177/00220345241271937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
Intraoral scanners (IOSs) have emerged as a cornerstone technology in digital dentistry. This article examines the recent advancements and multifaceted applications of IOSs, highlighting their benefits in patient care and addressing their current limitations. The IOS market has seen a competitive surge. Modern IOSs, featuring continuous image capture and advanced software for seamless image stitching, have made the scanning process more efficient. Patient comfort with IOS procedures is favorable, mitigating the discomfort associated with conventional impression taking. There has been a shift toward open data interfaces, notably enhancing interoperability. However, the integration of IOSs into large dental institutions is slow, facing challenges such as compatibility with existing health record systems and extensive data storage management. IOSs now extend beyond their use in computer-aided design and manufacturing, with software solutions transforming them into platforms for diagnostics, patient communication, and treatment planning. Several IOSs are equipped with tools for caries detection, employing fluorescence technologies or near-infrared imaging to identify carious lesions. IOSs facilitate quantitative monitoring of tooth wear and soft-tissue dimensions. For precise tooth segmentation in intraoral scans, essential for orthodontic applications, developers are leveraging innovative deep neural network-based approaches. The clinical performance of restorations fabricated based on intraoral scans has proven to be comparable to those obtained using conventional impressions, substantiating the reliability of IOSs in restorative dentistry. In oral and maxillofacial surgery, IOSs enhance airway safety during impression taking and aid in treating conditions such as cleft lip and palate, among other congenital craniofacial disorders, across diverse age groups. While IOSs have improved various aspects of dental care, ongoing enhancements in usability, diagnostic accuracy, and image segmentation are crucial to exploit the potential of this technology in optimizing patient care.
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Affiliation(s)
- F Eggmann
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M B Blatz
- Department of Preventive and Restorative Sciences, Robert Schattner Center, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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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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Fu XJ, Liu M, Shi JY, Deng K, Lai HC, Gu W, Zhang XM. Comparison of Different Intraoral Scanners With Prefabricated Aid on Accuracy and Framework Passive Fit of Digital Complete-Arch Implant Impression: An In Vitro Study. Clin Oral Implants Res 2024. [PMID: 39233386 DOI: 10.1111/clr.14353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/12/2024] [Accepted: 08/13/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVES This study aimed to compare the accuracy of digital complete-arch implant impressions with prefabricated aids using three intraoral scanners (IOSs) and explore the correlation between virtual deviation measurement and physical framework misfit. MATERIALS AND METHODS Four edentulous maxillary master models with four and six parallel and angular implants were fabricated and scanned by a laboratory scanner as reference scans. Ten scans of each master model were acquired using three IOSs (IOS-T, IOS-M, and IOS-A) with and without prefabricated aids. Trueness and precision of root mean square (RMS) errors were measured. Ten aluminum alloy frameworks were fabricated, and the misfit was measured with a micro-computed tomography scan with one screw tightened. RESULTS Trueness and precision showed significant improvement when prefabricated aids were used for all three IOSs (p < 0.010). Median (interquartile range) RMS errors of trueness reduced from 67.5 (30.4) to 61.8 (30.3) μm, from 100.6 (35.4) to 45.9 (15.1) μm, and from 52.7 (33.2) to 41.1 (22.5) μm for scanner IOS-T, IOS-M, and IOS-A, respectively (p < 0.010). The precision of IOS-A and IOS-M was significantly better than IOS-T when using prefabricated aid (p < 0.001). RMS errors and the maximum marginal misfit of the framework were significantly correlated (p < 0.001, R2 = 0.845). CONCLUSIONS With the prefabricated aids, the accuracy of IOSs enhanced significantly in digital complete-arch implant impressions. Three IOSs showed different levels of improvement in accuracy. Virtual RMS errors <62.2 μm could be the clinically acceptable threshold (150 μm) for framework passive fit.
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Affiliation(s)
- Xiao-Jiao Fu
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Min Liu
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jun-Yu Shi
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ke Deng
- Division of Periodontology and Implant Dentistry, The Faulty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Hong-Chang Lai
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wen Gu
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiao-Meng Zhang
- Department of Oral and Maxillofacial Implantology, Shanghai PerioImplant Innovation Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
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Gómez-Polo M, Cascos R, Ortega R, Barmak AB, Kois JC, Pérez-Barquero JA, Revilla-León M. Influence of scanning pattern on accuracy, time, and number of photograms of complete-arch implant scans: A clinical study. J Dent 2024; 150:105310. [PMID: 39153542 DOI: 10.1016/j.jdent.2024.105310] [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: 02/09/2024] [Revised: 08/01/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES To measure the influence of scanning pattern on the accuracy, time, and number of photograms of complete-arch intraoral implant scans. METHODS A maxillary edentulous patient with 7 implants was selected. The reference implant cast was obtained using conventional methods (7Series Scanner). Four groups were created based on the scanning pattern used to acquire the complete-arch implant scans by using an intraoral scanner (IOS) (Trios4): manufacturer's recommended (Occlusal-Buccal-Lingual (OBL)), zig-zag (Zig-zag), circumferential (Circumf), and novel pattern that included locking an initial occlusal scan (O-Lock group) (n = 15). Scanning time and number of photograms were recorded. The linear and angular measurements were used to assess scanning accuracy. One-way ANOVA and Tukey tests were used to analyze trueness, scanning time, and number of photograms. The Levene test was selected to assess precision (α=0.05). RESULTS Statistically significant differences in trueness were detected among OBL, Zig-zag, Circumf, and O-Lock regarding linear discrepancy (P<0.01), angular discrepancy (P<0.01), scanning time (P<0.01), and number of photograms (P<0.01). The O-Lock (63 ± 20 µm) showed the best linear trueness with statistically significant differences (P < 0.01) with Circumferential (86 ± 16 µm) and OBL (87 ± 19 µm) groups. The O-Lock (93.5 ± 13.4 s, 1080 ± 104 photograms) and Circumf groups (102.9 ± 15.1 s, 1112 ± 179 photograms) obtained lower scanning times (P < 0.01) and number of photograms (P < 0.01) than OBL (130.3 ± 19.4 s, 1293 ± 161 photograms) and Zig-zag (125.7 ± 22.1 s, 1316 ± 160 photograms) groups. CONCLUSIONS The scanning patterns tested influenced scanning accuracy, time, and number of photograms of the complete-arch scans obtained by using the IOS tested. The zig-zag and O-Lock scanning patterns are recommended to obtain complete-arch implant scans when using the selected IOS.
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Affiliation(s)
- Miguel Gómez-Polo
- Associate Professor Department of Conservative Dentistry and Prosthodontics, Complutense University of Madrid, Madrid, Spain, Director of Postgraduate Program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Rocío Cascos
- Student Postgraduate Program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Adjunct Professor Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - John C Kois
- Kois Center, Private Practice, Seattle, Wash and Assistant Professor, Graduate Prosthodontics, School of Dentistry, University of Washington, Seattle, Wash, USA
| | - Jorge Alonso Pérez-Barquero
- Adjunct Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, WA; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA, USA
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Tarce M, Becker K, Lahoud P, Shujaat S, Jacobs R, Quirynen M. Non-invasive oral implant position assessment: An ex vivo study using a 3D industrial scan as the reference model to mimic the clinical situation. Clin Oral Implants Res 2024; 35:854-863. [PMID: 37927146 DOI: 10.1111/clr.14206] [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: 07/31/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
AIM To introduce an objective method to evaluate the accuracy of implant position assessment in partially edentulous patients by comparing different techniques (conventional impression, intraoral scan, CBCT) to a reference 3D model obtained with an industrial scanner, the latter mimicking the clinical situation. MATERIALS AND METHODS Twenty-nine implants were placed in four human cadaver heads using a fully guided flapless protocol. Implant position was assessed using (a) a conventional impression, (b) an intraoral scan, and (c) CBCT and compared to an industrial scan. Three-dimensional models of intraoral scan body and implant were registered to the arch models and the deviation at implant shoulder, apex, and the angle of deviation were compared to each other as well as to the reference model. RESULTS The three assessment techniques showed statistically significant deviations (p < .01) from the industrial scan, for all measurements, with no difference between the techniques. The maximum deviation at the implant shoulder was 0.16 mm. At the implant apex this increased to 0.38 mm. The intraoral scan deviated significantly more than the CBCT (0.12 mm, p < .01) and the conventional impression (0.10 mm, p = .02). The maximum implant angle deviation was 1.0°. The intraoral scan deviated more than the conventional impression (0.3°, p = .02). CONCLUSION All assessment techniques deviated from the reference industrial scan, but the differences were relatively small. Intraoral scans were slightly less accurate than both conventional impressions and CBCT. Depending on the application, however, this inaccuracy may not be clinically relevant.
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Affiliation(s)
- Mihai Tarce
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Kathrin Becker
- Charité- Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthodontics and Dentofacial Orthopedics, Berlin, Germany
| | - Pierre Lahoud
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
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Ochoa-López G, Revilla-León M, Gómez-Polo M. Impact of color temperature and illuminance of ambient light conditions on the accuracy of complete-arch digital implant scans. Clin Oral Implants Res 2024; 35:898-905. [PMID: 38014704 DOI: 10.1111/clr.14220] [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: 06/11/2023] [Revised: 10/21/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE The purpose of the present study was to assess the influence of color temperature and illuminance of ambient light on the accuracy of different intraoral scanners (IOSs) in complete-arch implant scans. METHODS An edentulous model with six implants and scan bodies was digitized by using a laboratory scanner (DW-7-140; Dental Wings) to obtain a reference mesh. Fifteen scans were performed employing two intraoral scanners (Trios 4;3Shape A/S and i700; Medit Co) at two illuminances (500 and 1000 lux) and three color temperatures (3200, 4400, and 5600 K). Scanning accuracy was measured by using a 3D metrology software program (Geomagic Control X). Kruskal-Wallis, one-way ANOVA, and pairwise comparison tests were used to analyze the data (α = .05). RESULTS Significant differences in trueness and precision values were found among the different IOSs under the same ambient lighting condition and among the different lighting conditions for a given IOS (p < .05) except for trueness in i700 groups (p > .05). CONCLUSIONS The influence on the accuracy of color temperature and illuminance varied depending on the intraoral scanner. An optimal ambient scanning light condition was not found; this should be adjusted based on the specific IOS system used. 3200 K of ambient light influences the precision of i700 when performed at 1000 lux, decreasing the accuracy. The variation of color temperature at the same illuminance does not affect the scanning accuracy of TRIOS 4, which obtained better accuracy in all scans at 1000 lux.
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Affiliation(s)
- Gastón Ochoa-López
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Revilla Research Center, Madrid, Spain
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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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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9
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Ma Y, Guo YQ, Saleh MQ, Yu H. Influence of ambient light conditions on intraoral scanning: A systematic review. J Prosthodont Res 2024; 68:237-245. [PMID: 37574273 DOI: 10.2186/jpr.jpr_d_23_00098] [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] [Indexed: 08/15/2023]
Abstract
PURPOSE To systematically assess the influence of ambient light on the accuracy and scanning time of intraoral scanning. STUDY SELECTION The present systematic review (CRD 42022346672) was registered at the International Prospective Register of Systematic Reviews (PROSPERO) and was performed based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Electronic searches were conducted using PubMed, Web of Science, and EMBASE, complemented by gray literature, references, and citations of the included studies. The primary outcome was accuracy, and the scanning time was a secondary outcome. Owing to the high heterogeneity, the pooled data were analyzed descriptively. RESULTS Six in vitro and two in vivo experiments were performed. Three in vitro studies reported both the accuracy and scanning time of the intraoral scans, whereas the remaining studies exclusively evaluated the accuracy. The studies mainly investigated the influence of illumination levels (0-11000 lux) on intraoral scanning. Intraoral scans revealed optimal accuracy at 1000-lux illumination for complete-arch dentition scans, whereas the influence of illumination levels on 4-unit or shorter scans was not clinically significant. The intraoral scans obtained using confocal microscopy were less affected by the illumination levels than those obtained using the active triangulation technique. Furthermore, the scanning time tended to increase with increasing illumination. CONCLUSIONS Evidently from the limited number of studies conducted, ambient light illumination had considerable influence on the accuracy and scanning time of intraoral scanning, which appeared to be related to the scanning range and imaging technology.
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Affiliation(s)
- Yun Ma
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
| | - Yong-Qing Guo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
| | - Mohammed Qasem Saleh
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
| | - Hao Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
- Department of Applied Prosthodontics Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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10
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Rosmaninho A, Vedovato E, Kois JC, Revilla-León M. Altered reverse impression method involving extraoral digitalization of a verification jig for the fabrication of implant-supported prosthesis by using a complete-digital workflow. J ESTHET RESTOR DENT 2024; 36:566-572. [PMID: 37882153 DOI: 10.1111/jerd.13157] [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: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
The reverse impression method involves the extraoral digitalization of the interim implant-supported prostheses and intraoral digitalization of antagonist arch and maxillomandibular relationship. This technique allows the fabrication of implant-supported prostheses by using a complete-digital workflow. The scan analogs make the reverse impression method feasible. However, this method may not be recommended if the interim polymethyl methacrylate prosthesis does not have passive fit. The present manuscript describes an altered reverse impression technique that involves the extraoral digitalization of a conventional verification jig, which has attached scan analogs. With this technique modification, the implant positions captured using the verification jig are used to obtain the virtual definitive implant cast and fabricate the definitive implant-supported prosthesis.
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Affiliation(s)
| | | | - John C Kois
- Founder and Director 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
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Faculty & Director of 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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11
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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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12
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Mittal S, Kaurani P, Goyal R. Comparison of accuracy between single posterior immediate and delayed implants placed using computer guided implant surgery and a digital laser printed surgical guide: A clinical investigation. J Prosthet Dent 2024:S0022-3913(23)00816-8. [PMID: 38218708 DOI: 10.1016/j.prosdent.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 01/15/2024]
Abstract
STATEMENT OF PROBLEM The congruence of surgical implant placement with the preplanned position is important for anatomic and prosthetic precision, minimal complications, and increased longevity. The influence of implant placement timing on the surgical deviations in single posterior implants is unclear. PURPOSE The purpose of this clinical study was to compare deviations between preplanned and single posterior immediate and delayed implants placed using computer-guided digital light processing (DLP) surgical guides fabricated using intraoral scanning and cone beam computed tomography (CBCT). MATERIAL AND METHODS Implant surgery was performed on 24 participants requiring single immediate or delayed implants in the posterior maxillary and mandibular regions, for which the surgical site data were obtained from CBCT and intraoral scanning. Subsequently, virtual implant planning and DLP surgical guides were fabricated. Preimplant and postimplant placement CBCT scans were overlapped, and mean deviations for the immediate and delayed implant groups were calculated. The groups were compared with unpaired t tests (α=.05). RESULTS A total of 24 implants were placed, 12 in each group. In participants who received immediate implant placement, the mean ±standard deviation angular deviation, linear deviation at shoulder, linear deviation at apex, and vertical deviation were 1.03 ±0.70 degrees, 0.26 ±0.30 mm, 0.23 ±0.24 mm, and 0.39 ± 0.34 mm, respectively. In participants who received delayed implant treatment, the deviations were 0.53 ±0.60 degrees, 0.15 ±0.18 mm, 0.25 ±0.33 mm, and 0.17 ±0.10 mm, respectively. Significant differences between the 2 groups were found in the vertical deviation (P<.05). CONCLUSIONS The timing of the single posterior placement was associated with different deviations in the vertical direction. All deviations obtained were below the recommended values. DLP surgical guides fabricated from intraoral and CBCT scans provided accurate implant placement in immediate and delayed single posterior implants.
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Affiliation(s)
- Sankalp Mittal
- Head of Department, Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Jaipur, India.
| | - Pragati Kaurani
- Professor, Department of Prosthodontics Crown and Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
| | - Ritika Goyal
- Postgraduate student, Department of Prosthodontics Crown and Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur, India
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13
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Revilla-León M, Gómez-Polo M, Kois JC. A guide for selecting the intraoral scan extension when fabricating tooth- and implant-supported fixed dental prostheses. J ESTHET RESTOR DENT 2024; 36:85-93. [PMID: 37789708 DOI: 10.1111/jerd.13143] [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: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To describe a new classification for intraoral scans based on the scan extension and to introduce a decision guideline to choose the scan extension for fabricating tooth- and implant-supported fixed dental prostheses (FDPs). OVERVIEW Multiple operator- and patient-related factors have been identified that can decrease the scanning accuracy of intraoral scanners (IOSs), including scan extension. However, the decision criteria for selecting scan extension for fabricating tooth- and implant-supported restorations is unclear. Based on the extension of the intraoral digital scans, three types of scans can be defined: half-arch (anterior or posterior), extended half-arch, and complete-arch scan. Variables to consider when choosing the scan extension include the number and location of units being restored, as well as the extension and location of edentulous areas. Additionally, the accuracy of the virtual definitive cast and the accuracy of the maxillomandibular relationship captured by using IOSs should be differentiated. CONCLUSIONS A decision tree for selecting the scan extension is presented. The decision is based on the number and location of units being restored, and the extension and location of edentulous areas. Intraoral scans with reduced scan extension are indicated when fabricating tooth- and implant-supported crowns or short-span fixed prostheses, when the patient does not have more than one missing tooth in the area of the dental arch included in the scan. For the remaining clinical conditions, complete-arch intraoral scans are recommended. CLINICAL SIGNIFICANCE Scan extension is a clinician's decision that should be based on the number and location of units being restored and the extension and location of edentulous areas. Intraoral scans with a reduced scan extension is recommended, when possible.
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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
| | - 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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14
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Schmidt A, Berschin C, Wöstmann B, Schlenz MA. Chairside 3-D printed impression trays: a new approach to increase the accuracy of conventional implant impression taking? An in vitro study. Int J Implant Dent 2023; 9:47. [PMID: 38052992 DOI: 10.1186/s40729-023-00516-9] [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: 07/26/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE A high transfer accuracy of the intraoral implant position to a model is required, to manufacture implant-supported restorations. However, clinically relevant deviations persist between the intraoral implant position and the model obtained, even for the benchmark conventional custom implant impressions with polyether. Thus, new approaches using 3-D printed impression trays may increase the transfer accuracy of implant impressions. The ability to adjust parameters such as the thickness of the layers and the influence of the openings in the impression tray could potentially affect accuracy. METHODS Four different types of impression trays (n = 10 for each group) for the conventional impression technique were investigated: conventional custom impression tray, customized foil tray, chairside 3-D printed impression tray with the SHERA system, and the Primeprint system using an implant master model with four implants in the posterior region and a reference cube. After plaster model casting, all models were measured using a coordinate measuring machine, and the deviation from the reference dataset was determined. A statistical ANOVA analysis was performed (p < 0.05). RESULTS Chairside 3-D printed impression trays showed the best results, followed by conventional custom impression trays. Implant impressions obtained using a customized foil tray exhibited the lowest accuracy. Statistically significant differences were observed between 3-D printed impression trays and conventional custom impression and customized foil trays (p < 0.05). Whereas, the implant position did not have any significant influence on accuracy (p > 0.05). CONCLUSIONS Chairside 3-D printed impression trays significantly increase the transfer accuracy for implant impression taking.
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Affiliation(s)
- Alexander Schmidt
- Department of Prosthodontics, Dental Clinic, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Cara Berschin
- Department of Prosthodontics, Dental Clinic, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics, Dental Clinic, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany
| | - Maximiliane Amelie Schlenz
- Department of Prosthodontics, Dental Clinic, Justus Liebig University, Schlangenzahl 14, 35392, Giessen, Germany.
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15
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Guirao S, Llansana F, Button H, Yilmaz B, Kois JC, Revilla-León M. Additively manufactured devices with varying designs and sizes for acquiring initial intraoral implant scans. J Prosthodont 2023; 32:181-185. [PMID: 37585338 DOI: 10.1111/jopr.13750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023] Open
Abstract
Dental literature has reported greater intraoral scanning accuracy when implant scan bodies (ISBs) are connected compared with non-connected methods. Initial intraoral digital implant scans are required for the fabrication of a custom framework to connect implant scan bodies (IOSFix; IOSFix Dental). This calibrated metal framework is used to acquire definitive intraoral implant scans. However, the acquisition of initial intraoral implant scans can be challenging when ISBs are not connected. This article describes a step-by-step technique for connecting ISBs by using additively manufactured devices to acquire initial intraoral implant scans. This technique aims to facilitate the recording of initial intraoral implant scans, provide different device designs and sizes to connect ISBs, and reduce chairside time.
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Affiliation(s)
| | | | | | - 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
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Marta Revilla-León
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
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16
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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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17
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Schwärzler A, Nemec M, Lettner S, Rank C, Schedle A, Jonke E. 3D printed indirect bonding trays: Transfer accuracy of hard versus soft resin material in a prospective, randomized, single-blinded clinical study. Dent Mater 2023; 39:1058-1065. [PMID: 37806794 DOI: 10.1016/j.dental.2023.09.011] [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: 09/08/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This prospective clinical study aimed to compare transfer accuracy and immediate loss rate of hard versus soft transfer trays utilizing a CAD/CAM workflow. METHODS We performed virtual bracket placement on intraoral scans of adolescent patients to create individual indirect bonding trays. Orthodontic software (Appliance Designer, 3Shape, Copenhagen, Denmark) was used to design the trays, which were then produced using 3D printing technology. Patients were randomly assigned to the hard or soft resin groups with a 1:1 allocation. Subgroups were determined based on the Little's Irregularity Index and distributed equally. RESULTS 552 brackets were bonded onto adolescent patients using 46 CAD/CAM indirect bonding trays. The linear mean transfer errors ranged from -0.011 mm (soft) to -0.162 mm (hard) and angularly -0.255° (hard) and -0.243° (soft). No statistically significant differences were found between the subgroups or soft and hard resin groups. However, the transfer accuracy of molar brackets was significantly lower in the transversal and horizontal directions. All mean transfer errors were within the limits of clinical acceptability. The loss rate was 2.4 % in the hard resin group and 2.3 % in the soft resin group. The Intra Observer Correlation was excellent. SIGNIFICANCE CAD/CAM technology for indirect bracket bonding has been proven reliable in a randomized clinical trial. Both hard and soft resin showed a low rate of immediate loss compared to the current literature. Soft resin was more favorable than hard resin in terms of accuracy and usability. However, the indirect bonding of molar brackets is significantly less accurate than incisor brackets.
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Affiliation(s)
- Alexander Schwärzler
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Michael Nemec
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Stefan Lettner
- Core Facility Hard Tissue and Biomaterials Research, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Christiane Rank
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Andreas Schedle
- Competence Center for Dental Materials, University Clinic of Dentistry, Medical University of Vienna, Austria.
| | - Erwin Jonke
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
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18
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Abdelaziz MS, Ayad MW, Tella EAESAEM. Fabrication of a reverse-engineered custom scan body as a digital solution for recording implant position: A dental technique. J Prosthet Dent 2023:S0022-3913(23)00635-2. [PMID: 37891041 DOI: 10.1016/j.prosdent.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 10/29/2023]
Abstract
A technique for the reverse engineering of the implant-abutment connection to fabricate a custom scan body is described. The implant-abutment connection was designed using the exocad software program, the scan body with screw channel was designed with the Blender software program, and the file was either 3-dimensionally printed in definitive tooth-colored resin with ceramic filler material or milled in polyetheretherketone (PEEK). This technique offers an accurate, cost-effective digital solution for implant optical scanning that can replace prefabricated scan bodies that may not be available for all implants. (J Prosthet Dent xxxx;xxx:xxx-xxx).
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Affiliation(s)
- Medhat Sameh Abdelaziz
- Assistant Lecturer, Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt.
| | - Mohamed Wael Ayad
- Specialist, Oral and Maxillofacial, Dental College, Najran University, Saudi Arabia
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19
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Ma Y, Guo YQ, Jiang L, Yu H. Influence of intraoral conditions on the accuracy of digital and conventional implant impression techniques for two-implant-supported fixed dental prostheses. J Prosthodont Res 2023; 67:633-640. [PMID: 36804246 DOI: 10.2186/jpr.jpr_d_22_00242] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
PURPOSE To compare the trueness and precision of different impression techniques for two-implant-supported fixed dental prostheses between extraoral and intraoral conditions at different locations. METHODS Six volunteers participated in this study. A resin block with two parallel analogs was fabricated as an implant site simulator (ISS). The ISS was bonded to a molded ethylene vinyl acetate sheet to create a reference model. For each participant, four reference models were prepared based on the locations of the ISSs: maxillary posterior/anterior region (MaxP/MaxA) and mandibular posterior/anterior region (ManP/ManA). Five impressions were taken extraorally using the open-tray (conventional implant impression technique, CIT) and intraoral scanning (digital implant impression technique, DIT) techniques. The reference models were positioned in the participants' mouths, and impressions were obtained intraorally using the CIT and DIT. The interanalog distance (d) and angulation (θ) were measured to calculate trueness (Δd, Δθ) and precision (dP, θP). Two-way ANOVA and t tests were performed (α=0.05). RESULTS For the DIT, under intraoral conditions, the Δd and Δθ in MaxP and Δθ in ManP were significantly higher than those under extraoral conditions. For the CIT, under intraoral conditions, the Δd and Δθ in ManA and ManP and Δθ in MaxP were significantly lower than those under extraoral conditions. No significant differences in the dP and θP of either DIT or CIT were observed between the two conditions. CONCLUSIONS Intraoral conditions affected the trueness of DIT and CIT in different regions but had no influence on precision.
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Affiliation(s)
- Yun Ma
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yong-Qing Guo
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
| | - Lei Jiang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
| | - Hao Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Prosthodontics & Research Center of Dental Esthetics and Biomechanics, Fujian Medical University, Fuzhou, China
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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20
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Ramadan RE, Razek MKA, Mohamed FS, Fahmy RA, Abd-Ellah ME. Positional transfer accuracy of titanium base implant abutment provided by two different scan body designs: an invitro study. BMC Oral Health 2023; 23:746. [PMID: 37821890 PMCID: PMC10568787 DOI: 10.1186/s12903-023-03399-9] [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: 03/31/2023] [Accepted: 09/09/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The variabilities in design and material of scan bodies have a major role in the positional transfer accuracy of implants. The purpose of this invitro study was to compare the 3D transfer accuracy (trueness and precision) of titanium base (TB) abutment position provided by 2 different scan bodies: one-piece scan body (SB) in comparison to two-piece healing abutment and scan peg (HA-SP). METHODS A maxillary model with a dummy implant in the 2nd premolar (Proactive Tapered Implant; Neoss) was 3D printed and TB (Ti Neolink Mono; Neoss) was tightened on the implant and scanned by using a laboratory scanner (inEos X5; Dentsply Sirona) (reference scan). An SB (Elos Medtech) and an HA-SP (Neoss) were subsequently connected to the implant and were scanned 10 times each by using the same scanner (test scans). All the scans were exported as STL files and imported into CAD software where the TBs were formed. Test scans were superimposed on reference scans for transfer accuracy analysis using 3D metrology software (GOM Inspect; GOM GmbH) in terms of angular deviation in vertical and horizontal directions, linear deviation in each XYZ axis of TBs and total linear deviation in all axes. Statistical analysis was done using independent sample t test. When Levene's test for equality of variances was significant, Welch's t-test was used. (P value < 0.05) RESULTS: Significant differences were found amongst the tested groups in both angular and linear deviation in terms of trueness with less deviation values for the SB group (P < 0.001). For the precision, significant differences were found amongst the tested groups in angular deviation in vertical direction with less deviation value for the SB group compared to HA-SP group (P < 0.001). However, no significant difference was found between the tested groups regarding the angular deviation in horizontal direction (P = 1.000). Moreover, significant differences were found amongst the tested groups in linear deviations with less linear deviations in XYZ axes for SB compared to HA-SP group (P = 0.020, < 0.001, = 0.010 respectively). CONCLUSIONS SB showed less angular and linear deviation values in the 3D positional transfer of TB than HA-SP indicating higher degree of accuracy of SB.
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Affiliation(s)
- Rania E Ramadan
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | | | - Faten S Mohamed
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania A Fahmy
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mervat E Abd-Ellah
- Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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21
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2023; 130:453-532. [PMID: 37453884 DOI: 10.1016/j.prosdent.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | - Frederick Eichmiller
- Vice President and Science Officer (Emeritus), Delta Dental of Wisconsin, Stevens Point, Wis
| | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md
| | - Matthias Troeltzsch
- Private practice, Oral, Maxillofacial, and Facial Plastic Surgery, Ansbach, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
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22
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Uzel SM, Guncu MB, Aktas G, Arikan H, Reiss N, Turkyilmaz I. Influence of the implant scan body modifications on trueness of digital impressions. J Dent Sci 2023; 18:1771-1777. [PMID: 37799878 PMCID: PMC10547997 DOI: 10.1016/j.jds.2023.04.004] [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: 04/07/2023] [Revised: 04/08/2023] [Indexed: 10/07/2023] Open
Abstract
Background/purpose Effects of implant angulation on digital impression accuracy remain controversial. The purpose of this study was to assess the relationship between the alteration of implant scan bodies and the trueness of digital impressions. Materials and methods A maxillary typodont without the right premolars and first molar was scanned with a laboratory scanner and saved as a standard triangular language (STL) file. A model from the STL file was fabricated with a 3-dimensional printer. Two implants were placed into the first premolar and first molar sites of the model, followed by the insertion of two scan bodies onto the implants. These scan bodies were divided into four test groups, based on the surface modifications. A digital impression of each typodont was made with three different intraoral scanners. An abutment was digitally seated on each implant. 120 STL files (30 for each group) of the typodont with two implants and two corresponding abutments were used for statistical analysis. Results A total of 240 values (two implants for each typodont) were obtained after each sample (4 groups) was scanned 10 times by utilizing three intraoral scanners. The overall linear and angular discrepancies were analyzed. Group 1 showed the lowest linear discrepancy of 14.9 ± 5.4 μm while Group 4 reported the highest linear discrepancy of 137.5 ± 41.7 μm, yielding a statistical significance (P < 0.05). Conclusion It has been concluded that the more adjustments made to the scan bodies, the greater the linear and angular deviations occur, compromising the trueness of the digital implant impression.
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Affiliation(s)
- Sema Merve Uzel
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mustafa Baris Guncu
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Guliz Aktas
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Hale Arikan
- Department of Prosthodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Natalia Reiss
- New York University College of Dentistry, New York, NY, USA
| | - Ilser Turkyilmaz
- Department of Prosthodontics, New York University College of Dentistry, New York, NY, USA
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23
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Pullishery F, Huraib W, Alruhaymi AS, Alharandah WA, AlDara EW, Benten MM, Alassaf DM, Babatin WMA, Mohsen NMM. Intraoral Scan Accuracy and Time Efficiency in Implant-Supported Fixed Partial Dentures: A Systematic Review. Cureus 2023; 15:e48027. [PMID: 38034200 PMCID: PMC10688193 DOI: 10.7759/cureus.48027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
The digital implant impression technique (DIT) and conventional implant impression technique (CIT) workflows in implant-supported fixed partial dentures (FPDs) have not been extensively compared in prior studies. Moreover, there is no agreement on the more accurate method that entails less time in the laboratory and during the clinical phases of fabrication and delivery of the prosthesis, respectively. This review aimed to assess the precision of the imaging procedure and overall fabrication time of the DIT and CIT for the implant-supported FPDs. An electronic search was performed using PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases through EBSCO for relevant studies from January 2014 to April 2023. Following the preliminary screening, the studies that met the inclusion criteria underwent full-text review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cochrane Collaboration risk of bias appraisal tool and Newcastle-Ottawa scale were applied to assess the quality of randomized controlled trials (RCTs) and non-randomized prospective clinical studies, respectively. The initial search yielded 332 studies, and after excluding duplicates, 241 papers were available for screening. Titles and abstracts were reviewed, and 97 articles were chosen for full-text review by two authors independently. Furthermore, 89 articles were excluded in compliance with the PICOS question, and eight studies were chosen for qualitative analysis. Hence, the review comprised two RCTs and six prospective clinical studies. The time efficiency of the implant-supported FPDs was examined in four investigations, three of which used the Trios 3 scanner and one used the Intero scanner. The three-dimensional accuracy of DIT and CIT was compared in six clinical comparative studies. One of the RCTs was rated to have a high risk of bias and the other with a moderate quality of evidence. The six prospective studies were rated to have high-quality of evidence. The findings of this review indicate the prospective applicability of future intraoral scanning systems. The DIT was reported to be outstanding in terms of patient preferences and total fabrication time efficiency. Additional in vivo studies are needed to establish the therapeutic usefulness and time efficiency of integrating DIT in more comprehensive settings.
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Affiliation(s)
- Fawaz Pullishery
- Community Dentistry and Research, Batterjee Medical College, Jeddah, SAU
| | - Wayel Huraib
- Fixed Prosthodontics, Dentistry Program, Batterjee Medical College, Jeddah, SAU
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24
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Guo YQ, Ma Y, Cai SN, Yu H. Optimal impression materials for implant-supported fixed complete dentures: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00433-X. [PMID: 37599185 DOI: 10.1016/j.prosdent.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 08/22/2023]
Abstract
STATEMENT OF PROBLEM Although polyvinyl siloxane (PVS) materials and polyether (PE) materials have been the recommended materials for making impressions for implant-supported fixed complete dentures (IFCDs), a consensus regarding the optimal impression materials has yet to be established. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the effect of impression materials on the accuracy of conventional impressions for IFCDs and to provide guidance for selecting the optimal impression material. MATERIAL AND METHODS The PubMed, Web of Science, and Embase databases were searched and supplemented via hand searches. Studies comparing the accuracy of conventional impressions for IFCDs by using PVS and PE materials with either direct (open-tray) or indirect (closed-tray) techniques were included. Linear distance deviations and angular deviations between adjacent implants were evaluated. The mean difference (MD) with a 95% confidence interval (CI) was calculated for continuous data. A subgroup analysis was conducted to evaluate the impact of implant angulation (α=.05). RESULTS Among the 597 publications identified, 27 in vitro studies were included for qualitative analysis, and 12 were included for quantitative analysis. The general analysis revealed no significant differences in linear distance and angular deviations between the 2 impression materials with the direct or indirect technique. The subgroup analysis found that a statistically significant difference in linear distance deviations was found when implants were placed at an angle greater than 15 degrees, favoring PE materials when using the direct technique (P=.010, MD: 32.54 µm; 95% CI: 6.83 to 58.24) and indirect technique (P=.020, MD: 138.15 µm, 95% CI: 19.17 to 257.13). However, only 2 relevant studies assessed the indirect technique. CONCLUSIONS When providing IFCDs, conventional impressions obtained by using PVS and PE materials were found to have similar accuracy in most scenarios. PE materials yielded better outcomes when implants were placed at an angle greater than 15 degrees.
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Affiliation(s)
- Yong-Qing Guo
- Postgraduate student, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Yun Ma
- PhD Candidate, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Shu-Ning Cai
- Postgraduate student, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, PR China
| | - Hao Yu
- Associate Professor and Associate Dean, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, PR China; and Adjunct Associate Professor, Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan..
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25
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Caggiano M, D’Ambrosio F, Acerra A, Giudice D, Giordano F. Biomechanical Implications of Mandibular Flexion on Implant-Supported Full-Arch Rehabilitations: A Systematic Literature Review. J Clin Med 2023; 12:5302. [PMID: 37629344 PMCID: PMC10455661 DOI: 10.3390/jcm12165302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and it can have numerous clinical effects. The deformation of the lower jaw caused by mandibular flexion is generally very small, and it is often overlooked and considered irrelevant from a clinical point of view by many authors; however, it should be important to remember that median mandibular flexure (MMF) has a multifactorial aetiology. The main aim of the current systematic review is to highlight the different factors that can increase MF in order to help clinicians identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyse the preventive measures and suitable techniques to be adopted to minimise the negative effects of this phenomenon on oral fixed rehabilitations. METHODS The review, which was carried out in accordance with the "Preferred Reporting Items for Systematic reviews and Meta-Analyses" (PRISMA) flowchart, was recorded in the "International Prospective Register of Systematic Reviews" (PROSPERO). As research questions, "Patient/Population, Intervention, Comparison and Outcomes" (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomised clinical studies was evaluated. RESULTS The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression taking, and fixed rehabilitations were obtained. CONCLUSIONS The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length; small gonial angle; and less density, length, and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium-, and long-term consequences of MF.
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Affiliation(s)
- Mario Caggiano
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Allende, Baronissi, 84081 Salerno, Italy; (F.D.); (D.G.); (F.G.)
| | | | - Alfonso Acerra
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via Allende, Baronissi, 84081 Salerno, Italy; (F.D.); (D.G.); (F.G.)
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26
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Silvestri F, Maille G, Mansuy C, Graillon N, Mense C. Prosthetic rehabilitation of a completely edentulous maxilla with a sectioned implant-supported screw-retained prosthesis in a multiamputee patient with microstomia: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00411-0. [PMID: 37442751 DOI: 10.1016/j.prosdent.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 07/15/2023]
Abstract
Providing fixed implant-supported prostheses for edentulous patients with microstomia or limited mouth opening is challenging. The clinical treatment of a patient who was a multiple amputee with microstomia and a complete loss of lips elasticity is described. A custom half-sectioned prosthesis was fabricated to resolve numerous difficulties. A screw-retained complete implant-supported prosthesis was developed from a monolithic zirconia framework supported by 4 implants and with digital scanning and computer-aided design and computer-aided manufacturing of the prosthesis. The protocol achieved a complete screw-retained implant-supported prosthesis and offered a solution for a patient with microstomia and limited mouth opening, leading to improved quality of life.
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Affiliation(s)
- Frédéric Silvestri
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France.
| | - Gérald Maille
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Charlotte Mansuy
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Nicolas Graillon
- Assistant Professor, School of Medicine, Aix-Marseille University, Marseille, France; and Assistant Professor, Department of Maxillofacial and Oral Surgery, Conception Hospital, Marseille, France
| | - Chloë Mense
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
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27
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Iwamoto M, Atsuta W, Kaneko Y, Ito J, Kanno T, Murakami T, Tanaka J. Investigating the implant position reproducibility of optical impressions obtained using an intraoral scanner and 3D-printed models fabricated using an intraoral scanner. Int J Implant Dent 2023; 9:14. [PMID: 37341929 DOI: 10.1186/s40729-023-00481-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
PURPOSE This study aims to examine the effect of the size of the intraoral scanning area on implant position reproducibility and compare the implant position reproducibility of plaster models fabricated using the silicone impression technique, the digital model of an intraoral scanner, and three-dimensional (3D)-printed models fabricated using an intraoral scanner. METHODS Scanbodies were attached to an edentulous model with six implants (master model) and were scanned using a dental laboratory scanner to obtain basic data. The plaster model was fabricated using the open-tray method (IMPM; n = 5). The master model was then scanned in various implant areas using an intraoral scanner to obtain data (IOSM; n = 5); the scanning data of six scanbodies were used to fabricate the 3D-printed models (3DPM; n = 5) using a 3D printer. Scanbodies were attached to the implant analogs of the IMPM and 3DPM models and data were obtained using a dental laboratory scanner. The basic data and IMPM, IOSM, and 3DPM data were superimposed to calculate the concordance rate of the scanbodies. RESULTS The concordance rate of intraoral scanning decreased as the number of scanbodies increased. Significant differences were observed between the IMPM and IOSM data, and between the IOSM and 3DPM data; however, the IMPM and 3DPM data did not differ significantly. CONCLUSIONS The implant position reproducibility of the intraoral scanner decreased with an increase in the scanning area. However, ISOM and 3DPM may provide higher implant position reproducibility than plaster models fabricated using IMPM.
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Affiliation(s)
- Maya Iwamoto
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
| | - Wataru Atsuta
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
| | - Yasuhide Kaneko
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
| | - Junnosuke Ito
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
| | - Takeshi Kanno
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
| | - Takahiro Murakami
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan.
| | - Jyoji Tanaka
- Clinical Implant Society of Japan, 1-43-9, Komagome, Toshima-ku, Tokyo, 170-0003, Japan
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28
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Todaro C, Cerri M, Rodriguez Y Baena R, Lupi SM. Full-Arch Guided Restoration and Bone Regeneration: A Complete Digital Workflow Case Report. Healthcare (Basel) 2023; 11:healthcare11091301. [PMID: 37174843 PMCID: PMC10177883 DOI: 10.3390/healthcare11091301] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE complex rehabilitations present multiple difficulties, regarding both the planification of the surgery and the design of the prothesis. A digital approach can support the workflow, as well as the degree of intraoperative precision, and improve the long-term prognosis. METHODS A surgical guide was designed for implant placement. An extensive regeneration of the upper jaw was performed with contextual implant insertion, and a delayed load rehabilitation was chosen. After four months, a second surgery and a simultaneous soft tissue augmentation was performed, and a 3D-printed temporary restoration was placed. After another two months, new dental and facial scans, smile design, and facial bite registrations were obtained. Upper and lower dentures were built using an exclusively digital workflow. Both metal substructures were passivated and cemented in one session; in the following appointment, the aesthetic and occlusal checks were carried out. During the third visit, both prostheses were delivered. RESULTS Careful case planning and the surgical guide made it possible to achieve primary stability and acceptable emergence profiles in an extremely reabsorbed upper jaw. Leukocyte-Platelet Rich Fibrin (L-PRF) made the extensive bone regeneration more approachable and lowered the post-operative pain and swelling, while speeding up the soft tissue healing process. During the re-entry surgery, the volumes of soft tissues were increased to improve aesthetics, and the amount of keratinized gingiva around the six implants was also increased. Smile design and facial scans have provided the means to create acceptable aesthetics and function in a few sessions with minimal patient discomfort. CONCLUSIONS Computer-assisted implantology is a safe and precise method of performing dental implant surgery. Preliminary studies have a high degree of accuracy, but further studies are needed to arrive at a fully digital clinical protocol at all stages.
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Affiliation(s)
- Claudia Todaro
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Ruggero Rodriguez Y Baena
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Saturnino Marco Lupi
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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29
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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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30
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Beck F, Lettner S, Zupancic Cepic L, Schedle A. Comparison of Virtual Intersection and Occlusal Contacts between Intraoral and Laboratory Scans: An In-Vivo Study. J Clin Med 2023; 12:996. [PMID: 36769645 PMCID: PMC9917590 DOI: 10.3390/jcm12030996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The inaccurate maxillomandibular relationship of virtual casts following alignment by the vestibular scan may result in intersection (intermesh penetration) between opposing dental arch surfaces. Intersection occurs at short interocclusal distances in the occlusal contact area (OCA) and may result in infra-occluded definitive restorations. The purpose of this clinical study was to compare initial (by the proprietary scanner software) and new alignments (by a standalone 3D software) of virtual casts regarding OCA and intersection failure. New alignments aimed to rectify intersections by refinement of occlusal contacts. MATERIAL AND METHODS The virtual casts of 30 patients following digital and conventional impression-taking were analyzed, which were acquired for single implant restoration in the posterior site. Digital impressions were performed by both IOS 1 (3M True Definition) and IOS 2 (TRIOS 3), either as complete- or partial-arch scans, respectively. Mounted gypsum casts were digitized as complete-arch by a laboratory scanner (LS) in enabled and disabled mode to avoid intersection [LS (+)/LS (-)]. All virtual casts were newly aligned by a 3D software. The difference of the OCA and the area of intersection were calculated for initial and new alignments, using interocclusal distance ranges of 0-100 μm, 0-10 μm or <0 μm (=intersection). The difference of the OCA was compared using a linear mixed model. The distribution of occlusal contact points per modality and alignment was assessed independently by three observers and estimated by inter- and intraclass correlation (ICC) coefficients. RESULTS Virtual casts following initial alignment demonstrated intersections irrespective of the modality. The mean area of the intersection was most for IOS 2 (79.23 mm2), followed by IOS 1 (48.28 mm2), LS (-) (2.77 mm2), and LS (+) (2.01 mm2) in partial-arch scans. Complete-arch scans demonstrated an area of intersection of 70.63 mm2 for IOS 1 followed by 65.52 mm2 (IOS 2), 6.13 mm2 [LS (-)] and 2.76 mm2 [LS (+)]. Newly aligned scans showed no intersections. The overall distribution of occlusal contact points demonstrated moderate reliability (ICC 0.63). Good reliability could be observed (ICC 0.9) for LS (-) scans. CONCLUSIONS Intersections in the area of occlusal contact points are a phenomenon restricted to virtual casts, which should be considered in CAD/CAM. Initial alignments of LS are less affected by this virtual phenomenon, and contact points may be more distinct according to their anatomic region compared to IOS. Furthermore, intersections can be rectified in a 3D software by adjustment of the maxillomandibular relationship.
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Affiliation(s)
- Florian Beck
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Lettner
- Core Facility Hard Tissue Research and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Lana Zupancic Cepic
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Schedle
- Competence Center Dental Materials, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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31
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Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans. Part 1: Operator factors. J ESTHET RESTOR DENT 2023; 35:230-240. [PMID: 36479807 DOI: 10.1111/jerd.12985] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe the factors related to the operator skills and decisions that influence the scanning accuracy of intraoral scanners (IOSs). A new classification for these factors is proposed to facilitate dental professionals' decision making when using IOSs and maximize the accuracy and reliability of intraoral digital scans. OVERVIEW Each IOS system is limited by the hardware and software characteristics of the selected device. The operator decisions that can influence the accuracy of IOSs include the scanning technology and system selection, scanning head size, calibration, scanning distance, exposure of the IOS to ambient temperature changes, ambient humidity, ambient lighting conditions, operator experience, scanning pattern, extension of the scan, cutting off, rescanning, and overlapping procedures. CONCLUSIONS The knowledge and understanding of the operator factors that impact scanning accuracy of IOSs is a fundamental element for maximizing the accuracy of IOSs and for successfully integrating IOSs in daily practices. CLINICAL SIGNIFICANCE Operator skills and clinical decisions significantly impact intraoral scanning accuracy. Dental professionals must know and understand these influencing operator factors for maximizing the accuracy of IOSs.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Dean E Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA.,Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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32
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Arikan H, Muhtarogullari M, Uzel SM, Guncu MB, Aktas G, Marshall LS, Turkyilmaz I. Accuracy of digital impressions for implant-supported complete-arch prosthesis when using an auxiliary geometry device. J Dent Sci 2023; 18:808-813. [PMID: 37021239 PMCID: PMC10068489 DOI: 10.1016/j.jds.2023.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
Background/purpose Digital impressions using intraoral scanners have recently gained popularity. The aim of the present study was to evaluate the fit of full-arch screw-retained cobalt-chromium frameworks fabricated via two different digital impression methods. Materials and methods An edentulous resin master model with four dental implants was fabricated. Forty cobalt-chromium superstructures were fabricated and evaluated according to four groups. In Group 1, the superstructures were evaluated using an intraoral scanner to generate digital impressions. Group 2 relied on the help of an auxiliary geometric appliance in generation of digital impressions via intraoral scanner. The traditional method of splinted open-tray conventional impressions was designated for Group 3. Finally, the control group (Group 4) relied on scanning of the master model directly with a laboratory scanner. Vertical marginal discrepancy was evaluated, and data obtained were statistically analyzed. Results The highest mean vertical marginal gap value (80.86 ± 50.06 μm) was observed for Group 1 and statistically higher than Group 2, 3, and 4 (P < 0.05). The lowest mean vertical marginal gap value (41.98 ± 26.33 μm) was measured from Group 4 and statistically similar to Group 2 and 3 (P > 0.05). Conclusion It has been suggested that the use of auxiliary geometric appliances yields increased scanning accuracy. Frameworks fabricated using the traditional splinted open-tray technique were more reliable compared to those frameworks from digital impressions.
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Kaya G, Bilmenoglu C. Accuracy of 14 intraoral scanners for the All-on-4 treatment concept: a comparative in vitro study. J Adv Prosthodont 2022; 14:388-398. [PMID: 36685788 PMCID: PMC9832143 DOI: 10.4047/jap.2022.14.6.388] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/28/2022] Open
Abstract
PURPOSE This in vitro study aimed to evaluate the accuracy of 14 different intraoral scanners for the All-on-4 treatment concept. MATERIALS AND METHODS Four implants were placed in regions 13, 16, 23, and 26 of an edentulous maxillary model that was poured with scannable Type 4 gypsum to imitate the All-on-4 concept. The cast was scanned 10 times for each of 14 intraoral scanners (Primescan, iTero 2, iTero 5D, Virtuo Vivo, Trios 3, Trios 4, CS3600, CS3700, Emerald, Emerald S, Medit i500, BenQ BIS-I, Heron IOS, and Aadva IOS 100P) after the polyether ether ketone scanbody was placed. For the control group, the gypsum model was scanned 10 times with an industrial scanner. The first of the 10 virtual models obtained from the industrial model was chosen as the reference model. For trueness, the data of the 14 dental scanners were superimposed with the reference model; for precision, the data of all 14 scanners were superimposed within the groups. Statistical analyses were performed using the Kolmogorov-Smirnov, Shapiro-Wilks, and Dunn's tests. RESULTS Primescan showed the highest trueness and precision values (P < .005), followed by the iTero 5D scanner (P < .005). CONCLUSION Some of these digital scanners can be used to make impressions within the All-on-4 concept. However, the possibility of data loss due to artifacts, reflections, and the inability to combine the data should be considered.
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Affiliation(s)
- Gözde Kaya
- Department of Prosthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Caglar Bilmenoglu
- Department of Prosthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
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Evaluation of Deviations between Computer-Planned Implant Position and In Vivo Placement through 3D-Printed Guide: A CBCT Scan Analysis on Implant Inserted in Esthetic Area. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115461] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Implant rehabilitation in cases of monoedentulism in the esthetic area is a challenge for the clinician. The aim of our study was to test the diagnostic–therapeutic accuracy of computer-guided implant placement in the esthetic area. Methods: Postimplant surgery cone beam computed tomography (CBCT) scans were retrospectively analyzed to assess the accuracy of computer-guided implant placement compared to the preoperative computer-digital planned implant position. We selectively enrolled CBCT scans of patients who underwent immediate or delayed implant placement of a single maxillary incisor, treated with computer-guided implant surgery through a tooth-supported digitally designed 3D printed guide. Our analysis consisted of three digital measurements: the mean deviation of the implant axis, and the mean mesiodistal implant deviation measured both at the apex and at the head of the implant. Results: A total of 95 implants were placed in 95 patients (60 Males, 35 Females; age from 27 to 45-year-old). Congruence analysis showed a mean deviation of implant axis of 1.04° ± 0.56° in sagittal projection, a mean mesiodistal implant deviation between adjacent teeth of 0.14 mm ± 0.07 mm at implant head level and 0.8 mm ± 0.3 mm at the apex in axial projection. Conclusions: computer-guided implant placement through a tooth-supported guide was extremely accurate in the esthetic area because the deviations between the real implant position and the preoperative planning was not clinically relevant.
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