Pilot study on accuracy and dimensional stability of impression materials using industrial CT technology

Comparative Analysis between 3D-Printed Models Designed with Generic and Dental-Specific Software

With the great demand in the market for new dental software, the need has been seen to carry out a precision study for applications in digital dentistry, for which there is no comparative study, and there is a general ignorance regarding their applications. The purpose of this study was to investigate the accuracy differences between digital impressions obtained using generic G-CAD (general CAD) and D-CAD (CAD dental) software. Today, there is a difference between the design software used in dentistry and these in common use. Thus, it is necessary to make a comparison of precision software for specific and generic dental use. We hypothesized that there is no significant difference between the software for specific and general dental use.

METHODS

A typodont was digitized with an intraoral scanner and the models obtained were exported in STL format to four different softwares (Autodesk MeshMixer 3.5, Exocad Dental, Blender for dental, and InLAB). The STL files obtained by each software were materialized using a 3D printer. The printed models were scanned and exported in STL files, with which six pairs of groups were formed. The groups were compared using analysis software (3D Geomagic Control X) by superimposing them in the initial alignment order and using the best fit method.

RESULTS

There were no significant differences between the four analyzed software types; however, group 4, composed of the combination of D-CAD (Blender-InLAB), obtained the highest average (-0.0324 SD = 0.0456), with a higher accuracy compared to the group with the lowest average (group 5, composed of the combination of the Meshmixer and Blender models), a generic software and a specific software (0.1024 SD = 0.0819).

CONCLUSION

Although no evidence of significant difference was found regarding the accuracy of 3D models produced by G-CAD and D-CAD, combinations of groups where specific dental design software was present showed higher accuracy (precision and trueness). The comparison of the 3D graphics obtained with the superimposition of the digital meshes of the printed models performed with the help of the analysis software using the best fit method, replicating the same five reference points for the six groups formed, evidenced a greater tolerance in the groups using D-CAD.

Accuracy of 14 intraoral scanners for the All-on-4 treatment concept: a comparative in vitro study

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.

Analysis of the mesh resolution of an .STL exported from an intraoral scanner file

OBJECTIVES

This study aimed to provide information on the accuracy of exported digital files with the different resolutions available in the CEREC 4.6.2 software obtained by means of an intraoral scanner (IOS), in addition to establishing differences between materialized models with different exported resolutions, and how these different exported files can influence finite element analysis (FEA) simulations.

MATERIALS AND METHODS

The upper complete arch of 10 patients was scanned through an IOS (CEREC Omnicam 1.0/Dentsply Sirona). Files of three resolution meshes digitalized by a CAD software (Cerec SW, 4.6.2) high, medium and low (IOSH, IOSM, and IOSL) were exported. Each file was evaluated by a software (NETFABB) about the number of triangles obtained and compared with the number announced by the manufacturer. Also, with a superimposition with a specialized software (GEOMAGIC X), the digital models were compared. The files of each resolution were printed (Sprintray 3D Printer), and the printed models were scanned with IOS (Omnicam 1.0) and compared with the control group (intraoral scanned high-resolution file, IOSH). FEA simulations were imported into COMSOL and analyzed under different loading conditions.

RESULTS

The number of exported triangles coincided with that reported by the manufacturer. The digital models from files of different resolution did not show significant differences (less than 1.5 um) between each other. Models printed (H, M, L) from files of the same resolution mesh (H, M, L) did not show significant differences between them either in partial measures of the arch and neither in the complete arch. FEA showed significant differences in stress concentration between different exported models.

CLINICAL SIGNIFICANCE

Digital models can be exported and printed in three resolutions of the mesh, without differences clinically significative. On the other hand, for future FEA applications further research should be performed in order to determine the optimal number of triangles.

Effect of posterior span length on the trueness and precision of 3 intraoral digital scanners: A comparative 3-dimensional in vitro study

Purpose

This in vitro study measured and compared 3 intraoral scanners' accuracy (trueness and precision) with different span lengths.

Materials and Methods

Three master casts were prepared to simulate 3 different span lengths (fixed partial dentures with 3, 4, and 5 units). Each master cast was scanned once with an E3 lab scanner and 10 times with each of the 3 intraoral scanners (Trios 3, Planmeca Emerald, and Primescan AC). Data were stored as Standard Tessellation Language (STL) files. The differences between measurements were compared 3-dimensionally using metrology software. Data were analyzed using 1-way analysis of variance with post hoc analysis by the Tukey honest significant difference test for trueness and precision. Statistical significance was set at P<0.05.

Results

A statistically significant difference was found between the 3 intraoral scanners in trueness and precision (P<0.05). Primescan AC showed the lowest trueness and precision values (36.8 µm and 42.0 µm; (39.4 µm and 51.2 µm; and 54.9 µm and 52.7 µm) followed by Trios 3 (38.9 µm and 53.5 µm; 49.9 µm and 59.1 µm; and 58.1 µm and 64.5 µm) and Planmeca Emerald (60.4 µm and 63.6 µm; 61.3 µm and 69.0 µm; and 70.8 µm and 74.3 µm) for the 3-unit, 4-unit, and 5-unit fixed partial dentures, respectively.

Conclusion

Primescan AC had the best trueness and precision, followed by Trios 3 and Planmeca Emerald. Increasing span length reduced the trueness and precession of the 3 scanners; however, their values were within the accepted successful ranges.

Influence of Liquid on the Tooth Surface on the Accuracy of Intraoral Scanners: An In Vitro Study

PURPOSE

To assess the influence of liquid attached on the tooth surfaces on the accuracy (trueness and precision) of intraoral scanners and the effectiveness of the drying method (using compression air) to exclude the influence of liquid on the scanning results.

MATERIALS AND METHODS

A mandibular jaw model was scanned using an industrial computed tomography scanner to obtain a reference model. A scanning platform was designed to simulate three specific tooth surface states (dry, wet, blow-dry). Two kinds of liquids (ultra-pure water and artificial saliva) were used for the test. Two intraoral scanners (Trios 3 and Primescan) were used to scan the mandibular jaw model 10 times under each condition. All scanning data were processed and analyzed using dedicated software (Geomagic Control 2015). Trueness and precision comparison were conducted within the 12 groups of 3D models divided based on different intraoral scanners and liquids used under each condition. The root mean square (RMS) value was used to indicate the difference between the aligned virtual models. The color maps were used to evaluate and observe the deviation distribution patterns. The 3-way ANOVA (condition, intraoral scanner, liquid) followed by the Tukey test were used to assess precision and trueness. The level of significance was set at 0.05.

RESULTS

The mean RMS values obtained from wet condition were significantly higher than those of the dry and blow-dry condition (p < 0.001, F = 64.033 for trueness and F = 54.866 for precision), which indicates less accurate trueness and precision for wet condition. For two different types of liquids, the mean RMS value was not significantly different on trueness and precision. The deviations caused by liquid were positive and mainly distributed in the pits and fissures of the occlusal surface of posterior teeth, the interproximal area of the teeth, and the margin of the abutments.

CONCLUSIONS

Liquid on the tooth surface could affect intraoral scanning accuracy. Blow-drying with a three-way syringe can reduce scanning errors.

Clinical Evaluation of Time Efficiency and Fit Accuracy of Lithium Disilicate Single Crowns between Conventional and Digital Impression

The purpose of this study was to demonstrate the time-efficiency and the clinical effectiveness of chairside-fabricated lithium disilicate single crowns by digital impressions compared to the conventional method. Thirteen patients requiring a single crown on the maxillary or mandibular premolar or first molar were assigned as study subjects. The impressions were obtained using the conventional method and two digital methods with intraoral scanners: AEGIS.PO (Digital Dentistry Solution, Seoul, Korea) and CEREC Omnicam (Sirona, Bensheim, Germany). Two types of lithium disilicate single crowns were obtained; a reference crown (by conventional workflow) and a chairside crown (by digital workflow). The total time taken for fabricating the chairside crown was recorded. The replica technique was performed to compare the marginal and internal fit of the two types of crowns. In addition, accuracy of the intraoral scanners was evaluated by the best-fit alignment method. The difference between the groups was analyzed using the two-tailed paired t-test or one-way ANOVA, followed by the Student–Newman–Keuls test for multiple comparisons. Statistical significance was accepted at p < 0.05 for all statistical tests. The time required to obtain the impressions by the AEGIS (7:16 ± 1:50 min:s) and CEREC (7:29 ± 2:03 min:s) intraoral scans was significantly lower than the conventional method (12:41 ± 1:16 min:s; p < 0.001). There was no significant difference between the intraoral scanners. The total working time to fabricate the chairside crown averaged 30:58 ± 4:40 min:s. The average marginal gap was not significantly different between the reference (107.86 ± 42.45 µm) and chairside (115.52 ± 38.22 µm) crowns (p > 0.05), based on results of replica measurement. The average internal gaps were not significantly different. The average value of the root mean square between the AEGIS (31.7 ± 12.3 µm) and CEREC (32.4 ± 9.7 µm) scans was not significantly different (p > 0.05). Intraoral scans required a significantly shorter impression time than the conventional method, and it was possible to fabricate a lithium disilicate crown in a single visit. There were no statistically significant differences in the fit of the restorations and accuracy of the intraoral scanners compared to the conventional workflow.

Impression material accuracy for palatal orthodontic miniscrews

Purpose

This study investigates the accuracy of abutment transfer with current impression materials and provides a concise overview, including other relevant factors, in order to enable clinicians to make an informed decision about the optimal impression for this treatment procedure.

Methods

In all, 96 impressions of a cadaver head with two orthodontic miniscrews in place were taken with four common impression materials by two observers and using two methods of application. After pouring with a standard type IV stone and abutment transfer, all models and the upper jaw (which had been separated from the head) were scanned in a standard model scanner (Zirkonzahn® [Zirkohnzahn GmbH, Gais, Italy] S600 ARTI) and evaluated using a computer-aided design (CAD) program (GOM-Inspect [Gesellschaft für optische Messtechnik m.b.H., Braunschweig, Germany]). The deviations were measured at six points per screw and statistically evaluated with SPSS® (IBM, Chicago, IL, USA).

Results

Optimal values were obtained with biphasic polyvinylsiloxane, while monophasic polyvinylsiloxane, alginate and polyether also resulted in acceptable accuracy. Observer experience showed no effect and the method of application had only a minor effect on accuracy.

Conclusions

Within the limitations of this study, it seems that all impression materials are suitable for miniscrew abutment transfer, provided that methods of intraoral adaptation of the orthodontic appliance can be employed. If higher accuracy is needed or for clinicians with less experienced, a biphasic polyvinylsiloxane impression with the putty-wash technique should be used as this combination reduces setting time. The most cost-effective version, alginate, can be used if the consequences of greater deviations can be handled. Caution is advised with polyether if undercuts are present.

Comparison and evaluation of the morphology of crowns generated by biogeneric design technique with CEREC chairside system

Objectives

To better guide clinicians to choose the appropriate chairside system, we compared and evaluated the morphology of crowns generated by three different biogeneric design modes (biogeneric copy (BC), biogeneric individual (BI), and biogeneric reference (BR)) of the CEREC software.

Methods

Maxillary and mandibular casts were obtained from twelve volunteers and digital impressions were acquired. All ceramic crown preparations of all right maxillary central incisors were prepared and digital impressions were taken. Then, crowns were automatically designed under BC, BI and BR modes separately and their morphologies were evaluated by six doctors. The “optimal fitting alignment” and “3D analysis” functions of the Geomagic Qualify software were carried out between original teeth and auto-generated full crowns. The auto-generated crowns were modified by a technician according to clinical criteria and the adjustment time was recorded. The discrepancies between technician modified crowns and the auto-generated full crowns were evaluated with the same functions in the Geomagic Qualify software.

Results

The subjective evaluation results of BC group were significantly better than those of BI and BR group (p < 0.05). Compared with the original teeth and modified crowns, auto-generated crowns in BC group all had the smallest differences, followed by BR and BI group (p < 0.05). BC group needed the shortest adjustment time than BI and BR group (p < 0.05).

Conclusions

Using crowns generated by BC mode is more aesthetic and suitable in clinics use than those generated by BI and BR modes and can reduce clinic adjustment time.

The digital factory in both the modern dental lab and clinic

OBJECTIVE

Significant technological advances are occurring in the dental industry that are complementary to the introduction of monolithic restorative materials. Glidewell Laboratories has been at the forefront of innovation of these developments and these internal developments may be instructive of future trends in dentistry.

METHODS

This paper examines internal Glidewell data from 2010 to 2019 about zirconia-related technology and provides context for some technological advancements at Glidewell Laboratories.

RESULTS

The trend towards increased use of monolithic zirconia in both, posterior and anterior regions continues to grow. With the advent of intraoral scanners and chairside CAD/CAM technologies, more and more dentists are able to provide same day dentistry. Despite the many clinicians that have made the leap to digital dentistry the low rate of growth in ownership and utilization means PVS impression will be common place long into the future. Glidewell Laboratories has an advanced, automated impression scanning, AI crown design, automated milling and glazing system extending the advantages of digital dentistry to all dentists and pushing the bounds of the technology further.

SIGNIFICANCE

This paper describes the first use of AI GAN to design dental crowns and also shows the strong path monolithic zirconia restorations are paving into the future. Supporting technologies will continue to evolve around zirconia and this paper provides a snapshot of those that exist and a few that are in development.

Dimensional accuracy of cone beam CT with varying angulation of the jaw to the X-ray beam

OBJECTIVES

Cone beam CT (CBCT) machines do not always allow for patients to be scanned in the ideal position for image acquisition. This study aimed to investigate the influence of the position/angulation of the mandible relative to the X-ray beam of a CBCT machine.

METHODS

Five sequential CBCT scans were captured of a human mandible at each angulation of 10°, 20°, 30°, and 40° using a coronal and sagittal positioning. Inspection software utilized a best-fit alignment to automatically calculate the three-dimensional variation at 15 standardized points of interest.

RESULTS

Statistically significant differences were found between the dimensional accuracy of CBCT scans taken at 10° (26.3 µm) of coronal angulation, as well as those taken at 20° (-17.3 mm) and 30° (35.2 mm) of sagittal angulations (p < 0.001, 0.016, and <0.001, respectively). The largest deviations in accuracy included an overall maximum deviation of 490 mm.

CONCLUSIONS

The position of the mandible with respect to the X-ray beam has a clinically insignificant effect on dimensional accuracy, up to the maximum angle of 40° assessed.

Optical 3D scans for orthodontic diagnostics performed on full-arch impressions. Completeness of surface structure representation

OBJECTIVE

The purpose of this work was to evaluate the completeness of surface structure representation offered by full-arch impression scans in different situations of tooth (mal)alignment and whether this completeness could be improved by performing rescans on the same impressions reduced sequentially to different levels of gingival height and by adding extra single scans to the number of single scans recommended by the manufacturer.

METHODS

Three pairs of full-arch resin models were used as reference, characterized either by normal occlusion, by anterior diastematic protrusion (and edentulous spaces in the lower posterior segments), or by anterior crowding. An alginate impression of each arch was taken and digitized with a structured-light scanner, followed by three rescans with the impression cut back to 10, 5, and 1 mm of gingival height. Both the initial scan and the rescans were performed both with 19 basic single scans and with 10 extra single scans. Each impression scan was analyzed for quantitative completeness relative to its homologous direct scan of the original resin model. In addition, the topography of voids in the resultant digital model was assessed by visual inspection.

RESULTS

Compared to the homologous reference scans of the original resin models, completeness of the original impression scans--in the absence of both gingival cutback and extra single scans--was 97.23 ± 0.066% in the maxilla or 95.72 ± 0.070% in the mandible with normal occlusion, 91.11 ± 0.132% or 96.07 ± 0.109% in the arches with anterior diastematic protrusion, and 98.24 ± 0.085% or 93.39 ± 0.146% in those with anterior crowding. Gingival cutback and extra single scans were found to improve these values up to 100.35 ± 0.066% or 99.53 ± 0.070% in the arches with normal occlusion, 91.77 ± 0.132% or 97.95 ± 0.109% in those with anterior diastematic protrusion, and 98.59 ± 0.085% or 98.96 ± 0.146% in those with anterior crowding.

CONCLUSION

In strictly quantitative terms, the impression scans did capture relatively large percentages of the total surface. However, the topographic examinations revealed that regions essential for orthodontic model analysis were missing. The malocclusion models were particularly affected. Thus, impression scans performed with structured-light scanners cannot replace scans of positive casts for diagnostic use in orthodontics.

Dimensional accuracy of jaw scans performed on alginate impressions or stone models: A practice-oriented study

OBJECTIVES

Digital jaw models offer more extensive possibilities for analysis than casts and make it easier to share and archive relevant information. The aim of this study was to compare the dimensional accuracy of scans performed on alginate impressions and on stone models to reference scans performed on underlying resin models.

METHODS

Precision spheres 5 mm in diameter were occlusally fitted to the sites of the first premolars and first molars on a pair of jaw models fabricated from resin. A structured-light scanner was used for digitization. Once the two reference models had been scanned, alginate impressions were taken and scanned after no later than 1 h. A third series of scans was performed on type III stone models derived from the impressions. All scans were analyzed by performing five repeated measurements to determine the distances between the various sphere centers.

RESULTS

Compared to the reference scans, the stone-model scans were larger by a mean of 73.6 µm (maxilla) or 65.2 µm (mandible). The impression scans were only larger by 7.7 µm (maxilla) or smaller by 0.7 µm (mandible). Median standard deviations over the five repeated measurements of 1.0 µm for the reference scans, 2.35 µm for the impression scans, and 2.0 µm for the stone-model scans indicate that the values measured in this study were adequately reproducible.

CONCLUSION

Alginate impressions can be suitably digitized by structured-light scanning and offer considerably better dimensional accuracy than stone models. Apparently, however, both impression scans and stone-model scans can offer adequate precision for orthodontic purposes. The main issue of impression scans (which is incomplete representation of model surfaces) is being systematically explored in a follow-up study.

Comparison of repeatability between intraoral digital scanner and extraoral digital scanner: An in-vitro study

PURPOSE

The aim of this study was to compare the repeatability of intraoral digital impression scanning with the repeatability of extraoral scanning by using Geomagic Qualify 12 as the software of analysis.

METHODS

One Nissin Dental Study Model (upper jaw) with prepared abutments were designed to form 5 set of arrangements according to the layout of prepared abutments (arrangement 1: single prepared maxillary central incisor; arrangement 2: single prepared maxillary first molar; arrangement 3: prepared central incisor and canine with the lateral incisor absent; arrangement 4: half of upper arch with 7 prepared teeth; arrangement 5: entire upper arch with 14 prepared teeth). Each arrangement of Nissin Dental Study Model was scanned by TRIOS intraoral digital scanner (experimental group) and D800 extraoral scanner (control group) for 10 times exporting 100 STL files in total. The data were processed and analyzed using Geomagic Qualify 12 software to evaluate the repeatability of intraoral digital scanning.

RESULTS

3D standard deviations were 13.33, 7.0, 16.33, 41.56, 88.44 μm for arrangements 1-5 respectively in experimental group and 14.89, 8.67, 24.33, 14.22, 12.67 μm for arrangements 1-5 respectively in the control group. Mann-Whitney test revealed a significant difference between the 2 groups with regard to arrangements 2-5 (p<0.05).

CONCLUSIONS

Precision decreases with the increased scanning scope. Precision was clinically acceptable when scanning scope was less than half arch. Precision of extraoral scanning was acceptable in scanning any scope of arch region.

Accuracy of Digital Impressions and Fitness of Single Crowns Based on Digital Impressions

In this study, the accuracy (precision and trueness) of digital impressions and the fitness of single crowns manufactured based on digital impressions were evaluated. #14-17 epoxy resin dentitions were made, while full-crown preparations of extracted natural teeth were embedded at #16. (1) To assess precision, deviations among repeated scan models made by intraoral scanner TRIOS and MHT and model scanner D700 and inEos were calculated through best-fit algorithm and three-dimensional (3D) comparison. Root mean square (RMS) and color-coded difference images were offered. (2) To assess trueness, micro computed tomography (micro-CT) was used to get the reference model (REF). Deviations between REF and repeated scan models (from (1)) were calculated. (3) To assess fitness, single crowns were manufactured based on TRIOS, MHT, D700 and inEos scan models. The adhesive gaps were evaluated under stereomicroscope after cross-sectioned. Digital impressions showed lower precision and better trueness. Except for MHT, the means of RMS for precision were lower than 10 μm. Digital impressions showed better internal fitness. Fitness of single crowns based on digital impressions was up to clinical standard. Digital impressions could be an alternative method for single crowns manufacturing.

Fit of 4-unit FDPs made of zirconia and CoCr-alloy after chairside and labside digitalization--a laboratory study

OBJECTIVES

To analyse the marginal fit of 4-unit fixed dental prostheses (FDPs) and the accuracy of three-dimensional cast-datasets using both approaches to Computer Aided Design (CAD)/Computer Aided Manufacturing (CAM): direct and indirect digitalization.

METHODS

A titanium model of a 4-unit FDP was digitized by an intraoral scanning device (iTero, Align Technology, Carlstadt, US; DD, n=12). Additionally 12 conventional impressions were taken and referring master casts were digitized by a laboratory scanner (CS2, Straumann, Basel, Switzerland; ID, n=12). Frameworks were fabricated (CARES CADCAM GmbH, Straumann, Markkleeberg, Germany) from base metal alloy (coron, Straumann; DD-C: n=12; ID-C: n=12) and zirconia (zerion, Straumann; DD-Z: n=12; ID-Z: n=12) from the same datasets. The marginal fit of the resulting frameworks and the accuracy of the underlying datasets from DD and ID were evaluated. Data were analyzed by unpaired two sample Student's t-test with Levene-test (p<0.05).

RESULTS

Frameworks from group DD-C showed significantly better marginal fit than ID-C (DD-C: 56.90±27.37 μm, ID-C: 90.64±90.81 μm). For zirconia frameworks no differences between both digitalization methods (DD-Z: 127.23±66.87 μm, ID-Z: 141.08±193.17 μm) could be observed. Base metal alloy frameworks exhibited significantly better marginal fit than zirconia frameworks (DD: p<0.001; ID: p=0.022). Regarding the accuracy group DD showed significantly higher "trueness" than ID.

SIGNIFICANCE

Direct and indirect digitalization lead to clinically acceptable marginal fit of 4-unit FDPs from base metal alloy and zirconia. Higher accuracy of datasets from DD leads to better marginal fit of frameworks from base metal alloy but not for ones from zirconia.

Management of orocutaneous fistulas using a vacuum-assisted closure system

BACKGROUND

The vacuum-assisted closure (VAC) system has been used to manage complicated wounds. The purpose of this study was to describe a novel technique in using the VAC system for orocutaneous fistulas.

METHODS

A retrospective study was performed on 10 patients treated at the National Cancer Centre, Singapore, who developed postoperative orocutaneous fistulas. Hydrogum dental paste was used as a sealant together with the VAC system to close the fistulas. We used either the RENASYS or VAC ATS system with 50 mm Hg to 125 mm Hg continuous suction.

RESULTS

The 10 patients developed 11 fistulas. The median age of this cohort was 67 years (range, 33-80 years). Nine patients had successful closure of their fistulas with VAC therapy whereas 1 patient had unsuccessful VAC therapy and required flap reconstruction. The median time to fistula closure was 19 days (range, 6-36 days). The median time to radiotherapy after surgery was 46 days (range, 26-62 days).

CONCLUSION

VAC therapy is an effective treatment option for orocutaneous fistulas.

Dimensional changes of extended-pour alginate impression materials

INTRODUCTION

Recently, manufacturers have marketed alginate impression materials, claiming dimensional stability for up to 100 hours to allow shipping to a dental laboratory for digital model fabrication. The purpose of this study was to evaluate the dimensional changes of these newer materials after storage at different temperatures and times.

METHODS

Two extended-pour alginates (claiming 100 hours of accuracy) (Kromopan; Lascod, Florence, Italy; and Triphasix; Parkell, Edgewood, NY), 2 traditional alginates (Jeltrate; Dentsply-Caulk, York, Pa; and Kromatica; Matech, Sylmar, Calif), and 1 vinyl polysiloxane (VP Mix; Henry Schein, Melville, NY) were used to impress a scored aluminum die. The distance between the score lines was measured on the impressions at 10 minutes, 24 hours, and 100 hours after mix, and the percentages of dimensional change were calculated. Temperature effects were studied by storage at cold (-9°C), room (22°C), or hot (46°C) temperatures for 8 hours.

RESULTS

All alginates had statistically significant dimensional changes at 24 and 100 hours (0.69%-6.13%). VP Mix exhibited no statistically significant changes for any storage condition. The Kromopan (100 hour) and Kromatica (traditional) alginates were the most stable (0.85%-2.22% at 100 hours). Triphasix (100 hour) and Jeltrate (traditional) were the least stable (1.53%-4.73% at 100 hours). Cold-temperature storage resulted in the most dimensional changes (1.96%-4.73% at 100 hours). Room-temperature storage resulted in the least dimensional changes (0.97%-1.53% at 100 hours).

CONCLUSIONS

All alginate impression materials in the study had significant changes at 24 and 100 hours in all storage conditions tested.

Accuracy of digital models obtained by direct and indirect data capturing

OBJECTIVES

With direct and indirect digitalisation, two access points to CAD/CAM-generated restorations are available. The aim of this study was to compare the accuracy of the single steps of both approaches by comparing construction datasets using a new methodology.

MATERIAL AND METHOD

Twelve test datasets were generated in vitro (1) with the Lava Chairside Oral Scanner (COS) (2) by digitizing polyether impressions (IMP) and (3) by scanning the referring gypsum cast by the Lava Scan ST laboratory scanner (ST) at a time. Using an inspection software, these datasets were superimposed by a best fit algorithm with the reference dataset (REF), gained from industrial computed tomography, and divergences were analysed.

RESULTS

On the basis of average positive and negative deviations between test- and REF datasets, it could be shown that direct digitalisation accomplished the most accurate results (COS, 17 μm/-13 μm; SD ± 19 μm), followed by digitized polyether impression (IMP, 23 μm/-22 μm; SD ± 31 μm) and indirect digitalisation (ST, 36 μm/-35 μm; SD ± 52 μm). The mean absolute values of Euclidean distances showed the least values for COS (15 μm; SD ± 6 μm), followed by IMP (23 μm; SD ± 9 μm) and ST (36 μm; SD ± 7 μm). The mean negative and mean absolute values of all groups were significantly different. Comparing the mean positive values of the groups, IMP and COS (p = 0.082) showed no significant difference, whereas ST and COS, and ST and IMP exhibited statistically significant differences.

CONCLUSIONS

Within the limitations of this in vitro study, the direct digitalisation with Lava C.O.S. showed statistically significantly higher accuracy compared to the conventional procedure of impression taking and indirect digitalisation.

CLINICAL RELEVANCE

Within the limitations of this study, the method of direct digitalisation seems to have the potential to improve the accuracy of impressions for four-unit FDPs.