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Vag J, Romanszky L, Sersli G, DeFee M, Renne W, Mangano F, Borbola D. Application of the virtual-fit method for fixed complete denture cases designed on intraoral scans: Effect of cement spacing. J Dent 2024; 141:104780. [PMID: 37981046 DOI: 10.1016/j.jdent.2023.104780] [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: 06/17/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To validate the virtual-fit alignment, analyze the impact of cement spacing on internal/marginal gaps, and correlate results with conventional trueness measures. METHODS Four dental abutment models were scanned using an industrial reference scanner (one time each), Emerald S (three times each), and Medit i700 (three times each) intraoral scanners (IOS). On each IOS scan (n = 24), three complete-arch fixed frameworks were designed with 70 or 140 µm cement space with no marginal space (groups 70 and 140) and 70 µm with an additional 20 µm space, including the margin (group 70+20). Two types of alignment were performed by GOM Inspect software. The reference and IOS scans were aligned through a conventional iterative closest point algorithm (ICP) where the penetration of the two scans was permitted into each other (conventional trueness method). Second, the computer-aided designs were superimposed with the reference scan also using an ICP, but preventing the design from virtual penetration into the model (virtual-fit method). The virtual-fit algorithm was validated by non-penetration alignment of the designs with the IOS scans. Internal and marginal gap was measured between the design and the abutments. The difference between spacing groups was compared by Friedman's test. A statistical correlation (Spearman's Rho Test) was computed between the measured gaps and the conventional trueness method. A significant difference was accepted at p<0.05 after the Bonferroni correction. RESULTS The gaps deviated from the set cement space by 3-13 µm on IOS scans (validation of virtual-fit algorithm). The internal gap of the design on the reference scan was not affected by cement spacing (Emerald S, p = 0.779; Medit i700, p = 0.205). The marginal gap in groups 70 and 70+20 was significantly lower than in group 140 in Emerald S (p<0.05). In Medit i700, it was lower in the 70+20 group than in the group 70 (p<0.01) and in the group 140 (p<0.05). Some Medit i700 scans exhibited high marginal gaps within group 70 but not in groups 70 and 140. The measured gaps correlated significantly (r = 0.51-0.81, p<0.05-0.001) with the conventional trueness but were 2.6-4.6 times higher (p<0.001). CONCLUSION Virtual-fit alignment can simulate restoration seating. A 20 µm marginal and 90 µm internal spacing could compensate for scan errors up to several hundred micrometers. However, 140 µm internal spacing is counterproductive. The conventional trueness method could only partially predict framework misfit. CLINICAL SIGNIFICANCE The virtual-fit method can provide clinically interpretable data for intraoral scanners. Emerald S and Medit i700 intraoral scanners are suitable for fabricating complete-arch fixed tooth-supported prostheses. In addition, a slight elevation of spacing at the margin could compensate for moderate inaccuracies in a scan.
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Affiliation(s)
- Janos Vag
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary.
| | - Laszlo Romanszky
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Gyorgy Sersli
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Michael DeFee
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Walter Renne
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Francesco Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation
| | - Daniel Borbola
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary
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Gómez-Polo M, Donmez MB, Çakmak G, Yilmaz B, Revilla-León M. Influence of implant scan body design (height, diameter, geometry, material, and retention system) on intraoral scanning accuracy: A systematic review. J Prosthodont 2023; 32:165-180. [PMID: 37771200 DOI: 10.1111/jopr.13774] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE To evaluate the influence of implant scan body (ISB) design (height, diameter, geometry, material, and retention system) on the accuracy of digital implant scans. MATERIAL AND METHODS A literature search was completed in five databases: PubMed/Medline, Scopus, Embase, World of Science, and Cochrane. A manual search was also conducted. Studies reporting the evaluation of ISB design on the accuracy of digital scans obtained by using IOSs were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. Articles were classified based on the ISB features of height, geometry, material, and retention system. RESULTS Twenty articles were included. Among the reviewed studies, 11 investigations analyzed the influence of different ISB geometries, 1 study assessed the impact of ISB diameter, 4 studies investigated the effect of ISB splinting, 2 articles evaluated ISB height, and 2 studies focused on the effect of ISB material on scan accuracy. In addition, 8 studies involved ISBs fabricated with different materials (1- and 2-piece polyetheretherketone and 1-piece titanium ISBs), and all of the reviewed articles tested screw-retained ISBs, except for 3 in vitro studies. CONCLUSIONS The findings did not enable concrete conclusions regarding the optimal ISB design, whether there is a relationship between IOS technology and a specific ISB design, or the clinical condition that maximizes intraoral scanning accuracy. Research efforts are needed to identify the optimal ISB design and its possible relationship with the IOS selected for acquiring intraoral digital implant scans.
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Affiliation(s)
- Miguel Gómez-Polo
- Department of Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye Univeristy, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Akl MA, Daifallah K, Pérez-Barquero JA, Barmak AB, Wee AG, Revilla-León M. Influence of interdental spaces and the palate on the accuracy of maxillary scans acquired using different intraoral scanners. J Prosthodont 2023; 32:125-134. [PMID: 37591814 DOI: 10.1111/jopr.13748] [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: 05/15/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023] Open
Abstract
PURPOSE To assess the influence of interdental spaces and scanning the palate on the accuracy of maxillary scans acquired using three intraoral scanners (IOSs). MATERIALS AND METHODS A virtual completely dentate maxillary cast without interdental spaces was obtained and modified to create 1, 2, and 3 mm of interdental spacing between the anterior teeth. These three files (reference standard tessellation language files) were used to print three reference casts. The reference casts were scanned using three IOSs: TRIOS4, iTero Element 5D, and Aoralscan2. Three groups were created based on the interdental spaces: 0, 1, 2, and 3 mm (n = 10). The groups were subdivided into two subgroups: no palate (NP subgroup) and palate (P subgroup). The reference STL files were used to measure the discrepancy with the experimental scans by calculating the root mean square (RMS) error. Three-way analysis of variance (ANOVA) and post hoc Tukey pairwise comparison tests were used to analyze trueness. The Levene test was used to analyze precision (α = 0.05). RESULTS Trueness ranged from 91 to 139 μm and precision ranged from 5 to 23 μm among the subgroups tested. A significant correlation was found between IOS*group (p<0.001) and IOS*subgroup ( p<0.001). Tukey test showed significant trueness differences among the interdental spaces tested (p<0.001). The 1- and 2-mm groups obtained better trueness than the 0- and 3-mm groups (p<0.001). An 11 μm mean trueness discrepancy was measured among the different interdental space groups tested. The P subgroups demonstrated significantly higher trueness when compared to the NP subgroups (p<0.001). The discrepancy between the maxillary scans with and without the palate was 4 μm. Significant precision discrepancies were found (p = 0.008), with the iTero group showing the lowest precision. CONCLUSION Interdental spaces and incorporation of the palate on maxillary intraoral scans influenced trueness and precision of the three IOSs tested. However, the scanning discrepancy measured may be of no clinical relevance.
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Affiliation(s)
- Mohammed A Akl
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
| | - Khaled Daifallah
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Alvin G Wee
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - 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
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Alkadi L. A Comprehensive Review of Factors That Influence the Accuracy of Intraoral Scanners. Diagnostics (Basel) 2023; 13:3291. [PMID: 37958187 PMCID: PMC10650453 DOI: 10.3390/diagnostics13213291] [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: 09/28/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
Intraoral scanners (IOSs) have become increasingly popular in the field of dentistry for capturing accurate digital impressions of patients' teeth and oral structures. This study investigates the various factors influencing their accuracy. An extensive search of scholarly literature was carried out via PubMed, utilizing appropriate keywords. Factors evaluated in the included studies were categorized into three primary divisions: those related to the operator, the patient, and the IOS itself. The analysis demonstrated that the accuracy of intraoral scanning is influenced by various factors such as scanner selection, operator skill, calibration, patient's oral anatomy, ambient conditions, and scanning aids. Maintaining updated software and understanding factors beyond scanner resolution are crucial for optimal accuracy. Conversely, smaller IOS tips, fast scanning speeds, and specific scanning patterns compromise the accuracy and precision. By understanding these factors, dental professionals can make more informed decisions and enhance the accuracy of IOSs, leading to improved final dental restorations.
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Affiliation(s)
- Lubna Alkadi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
- King Abdullah International Medical Research Center, National Guard Health Affairs, Riyadh 11481, Saudi Arabia
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