Accuracy of intraoral data acquisition in comparison to the conventional impression

The achievable accuracy is a decisive parameter for the comparison of direct intraoral digitization with the conventional impression. The objective of the study was therefore to compare the accuracy of the reproduction of a model situation by intraoral digitization vs. the conventional procedure consisting of impression taking, model production, and extraoral digitization. Proceeding from a die model with a prepared tooth 16, the reference data set of the teeth 15, 16 and 17 was produced with an established procedure by means ofextraoral digitization. For the simulated intraoral data acquisition of the master model (Cerec 3D camera, Sirona, Bensheim), the camera was fastened on a stand for the measurement and the teeth digitized seven times each in defined views (occlusal, and in each case inclined by 20 degrees, from the mesio-proximal, disto-proximal, vestibular and oral aspect). Matching was automated (comparative data sets B1-B5). A clinically perfect one-step putty-and-wash impression was taken from the starting model. The model produced under defined conditions was digitized extraorally five times (digi-SCAN, comparative data sets C1-C5). The data sets B1-B5 and C1-C5 were assigned to the reference data set by means of best-fit matching and the root of the mean quadratic deviation (RMS; root mean square) calculated. The deviations were visualized, and mean positive, negative and absolute deviations calculated. The mean RMS was 27.9 microm (B1-B5) or 18.8 microm (C1-C5). The mean deviations for the prepared tooth were 18 microm/-17 microm (B1-B5) and 9 microm /-9 microm (C1-C5). For tooth 15, the mean deviations were 22 microm/-19 microm (B1-B5) and 15 microm/-16 microm (C1-C5). The intraoral method showed good results with deviations from the CAD starting model of approx. 17 microm, related to the prepared tooth 16. On the whole, in this in-vitro study, extraoral digitization with impression taking and model production showed higher accuracy than intraoral digitization. Since the inaccuracies in the conventional impression under real clinical conditions may be higher than the values determined above, a comparison under clinical conditions should be performed subsequently.

Design and production of dental prosthetic restorations: basic research on dental CAD/CAM technology

Dental prosthetic restorations (crowns and FPDs) are currently produced mainly by conventional dental technology methods. The automation of the production process can be achieved by the use of CAD/CAM techniques. In addition, it has become possible to use materials that previously could not be processed for technical reasons or could not be processed economically, especially high-performance ceramics. Although CAD/CAM methods for producing fixed restorations are of increasing interest, little information has been published about their mode of operation and functionality. To date, studies have focused mostly on special systems. However, basic studies are lacking. Basic research on the most important aspects of CAD/CAM fixed dental restorations from the viewpoint of production, information technology, and dentistry/dental technology are the subject of a current research project. The aim of this study is the presentation of preliminary results. The CAD/CAM process for fixed restorations was analyzed and broken down into single steps. In order to examine the influence of the single steps in the process chain, a computer test model with the teeth of the maxilla and mandible in static occlusion was developed and reverse engineered. While producing the test model, fundamental knowledge regarding the manufacturing of dental restorations with functional occlusal surfaces was gained. The intersection of the maxillary and mandibulary occlusal surfaces allows the qualitative analysis of occlusal contacts analogous to the conventional technique. Furthermore, a quantitative assessment of the size of the occlusal contacts and the measurement of intersection is possible.

Matching point clouds: limits and possibilities

In computer-aided production of fixed dental restorations, the process chain always starts with digitizing, independent of the type of further (data) processing, the material used, and the kind of restoration to be produced. The quality of the digitized data, followed by the influences of further data processing and the production parameters, decisively influence the fitting accuracy of the dental restoration to be fabricated. The accuracy with which individually measured 3D data sets in the form of point clouds can be matched for further processing in one common system of coordinates was the object of the present study. Casts of the maxilla and mandible were digitized in several partial measurements comprising two to three teeth in each case, using an optical three-coordinate measuring system. The individual segments were sequentially aligned to surfaces that were created on the basis of partial point clouds. The mean deviation between surfaces and point clouds was between 1.90 microns and 18.24 microns. The accuracy of the alignment was determined by the RMS (root mean square) error, and was on average 14.2 microns (SD 7 microns) for the maxilla and 17.2 microns (SD 9.4 microns) for the mandible. Combining a larger number of smaller segments did not improve the result, since the errors of the individual registrations are summed in sequential matching. In this study, the errors arising in matching are not negligible and can possibly negatively influence the quality (fitting accuracy) of the restoration produced on the basis of the matched data records.