Accuracy and Precision Evaluation of International Standard Spherical Model by Digital Dental Scanners

An overview of three-dimensional imaging devices in dentistry

OBJECTIVE

To review four types of three-dimensional imaging devices: intraoral scanners, extraoral scanners, cone-beam computed tomography (CBCT), and facial scanners, in terms of their development, technologies, advantages, disadvantages, accuracy, influencing factors, and applications in dentistry.

METHODS

PubMed (National Library of Medicine) and Google Scholar databases were searched. Additionally, the scanner manufacturers' websites were accessed to obtain relevant data. Four authors independently selected the articles, books, and websites. To exclude duplicates and scrutinize the data, they were uploaded to Mendeley Data. In total, 135 articles, two books, and 17 websites were included.

RESULTS

Research and clinical practice have shown that oral and facial scanners and CBCT can be used widely in various areas of dentistry with high accuracy.

CONCLUSION

Although further advancement of these devices is desirable, there is no doubt that digital technology represents the future of dentistry. Furthermore, the combined use of different devices may bring dentistry into a new era. These four devices will play a significant role in clinical utility with high accuracy. The combined use of these devices should be explored further.

CLINICAL SIGNIFICANCE

The four devices will play a significant role in clinical use with high accuracy. The combined use of these devices should be explored further.

Evaluation of the impact of reference tooth morphology and alignment on model measurement accuracy

Background

The development of personalized and high-precision dental treatment is inseparable from the accurate measurement and analysis of the model. Compared with traditional plaster models, digital models allow dentists to obtain richer and more detailed inspection results. However, the measurement of digital models in clinical practice usually ignores the influence of the overall three-dimensional (3D) structure of teeth and tooth arrangement on the measurement results. The purpose of this study was to evaluate the effect of calibrated tooth axis and tooth arrangement on tooth width and arch length.

Methods

A total of 110 digital models from 80 participants were used to measure teeth width and dental arch length using the following methods: Method A, simple positioning of the proximal and distal of teeth; Method B: calibration of the clinical crown axis; and Method C: calibration of the overall 3D axis of the teeth. The Measurand model included pre- and post-orthodontic models of the same patients to assess the impact of tooth alignment on outcomes.

Results

In the aligned dentition, whether the tooth axis was calibrated had no effect on the measurement results. On unaligned dentitions, calibrating the pinion allowed for more accurate measurements, with Method C the closest to the true size. Furthermore, the arrangement of teeth affected the measurement, but there was no continuous linear correlation with arch length discrepancy (ALD).

Conclusions

Clinicians should choose appropriate measurement methods according to actual needs when performing model measurement, and should pay attention to the influence of tooth axis, tooth shape, and arrangement on the measurement results.

Bias Evaluation of the Accuracy of Two Extraoral Scanners and an Intraoral Scanner Based on ADA Standards

The spread and application of computer-aided design/computer-aided manufacturing (CAD/CAM) technology have contributed to the rapid development of digitalization in dentistry. The accuracy of scan results is closely related to the devising subsequent treatment plans and outcomes. Professional standards for evaluating scanners are specified in the American National Standard/American Dental Association Standard 132 (ANSI/ADA No. 132). The aims of this study were to use the three samples mentioned in ANSI/ADA No. 132 and evaluate the accuracy and reproducibility of two extraoral scanners and an intraoral scanner based on the inspection standards recommended by ANSI/ADA No. 132. In this study, two trained operators used two extraoral scanners (E4, 3Shape, Denmark & SHINING DS100+, Shining, China) and an intraoral scanner (TRIOS SERIES3, 3Shape, Denmark) to perform 30 scans of each of the three samples at a temperature of 25 ± 2°C and export standard tessellation language files and used reverse engineering software to perform measurements and iterative nearest point matching experiments. The measured values obtained were compared with the reference values measured by a coordinate measuring machine (NC8107, Leader Metrology, USA). We performed a normal distribution test (Shapiro-Wilk test), the nonparametric Kruskal-Wallis test, and an independent-samples t-test to analyze the reproducibility of each scan for different models. The experimental results indicate that the trueness and precision of the two extraoral scanners and the intraoral scanner had a slight mean deviation. The trueness and precision of the three scanners on the curved surface and groove areas are poor. The accuracy and reproducibility of E4 outperformed SHINING and TRIOS. The iterative closest point matching experiment also showed good matching results. The two extraoral scanners and the intraoral scanner in this study can meet the basic clinical requirements in terms of accuracy, and we hope that digital technology will be more widely used in dentistry in the future.

Design of a Single-Tooth Model and Its Application in Oral Scan System Assessment

Intraoral scanners have been widely used in the application of dentistry. Accuracy includes trueness and precision; they have an important position in the assessment of intraoral scanners. The existing standard models are divided into the inlay and the crown, but the operation is relatively complicated. In this study, in order to simplify the current standard model, we designed a new integration model to compare the accuracy of two intraoral scanners (CEREC and TRIOS) and an extraoral scanner (SHINING). The coordinate measuring machine measured value is the gold standard. Values of the length and angle were analyzed by converting the scanned digital impressions into an STL (standard triangulation language) format to evaluate the accuracy of the intraoral scanner and to verify the feasibility of the designed model. The result shows that the integration model can be successfully scanned and imaged. In the case of the powder-free integration model, intraoral scanner precision, trueness, 3D fitting, and imaging are better than the extraoral scanner. It can be seen straightly from the measurement result and the 3D fitting result that the intraoral scanner can acquire the shape of the standard model integrally with good repeatability. Therefore, it can be concluded that TRIOS is superior to CEREC and SHINING in accuracy, and the integration model is feasible as a reference in the examination of intraoral scanners. The performance of the newly designed integration model that can be scanned is clinically significant, suggesting that this model can be used as a standard reference model.