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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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Önöral Ö, Kurtulmus-Yilmaz S, Toksoy D, Ozan O. Effect of angulation on the 3D trueness of conventional and digital implant impressions for multi-unit restorations. J Adv Prosthodont 2023; 15:290-301. [PMID: 38205122 PMCID: PMC10774637 DOI: 10.4047/jap.2023.15.6.290] [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: 08/28/2023] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies. MATERIALS AND METHODS As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed. RESULTS Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively. CONCLUSION Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.
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Affiliation(s)
- Özay Önöral
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | | | - Dilem Toksoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | - Oguz Ozan
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
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Revilla-León M, Lanis A, Yilmaz B, Kois JC, Gallucci GO. Intraoral digital implant scans: Parameters to improve accuracy. J Prosthodont 2023; 32:150-164. [PMID: 37586762 DOI: 10.1111/jopr.13749] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE To report the means to maximize the predictability and accuracy of intraoral digital implant scans through the evaluation of operator and patient-related factors. MATERIALS AND METHODS A search of published articles related to factors that can decrease the scanning accuracy of intraoral digital implant scans was completed in four data sources:MEDLINE, EMBASE, EBSCO, and Web of Science. All studies related to variables that can influence the accuracy of intraoral digital implant scans obtained by using intraoral scanners (IOSs) were considered. These variables included ambient lighting, scanning pattern, implant scan body (ISB) design, techniques for splinting ISBs, arch location, implant position, and inter-implant distance. RESULTS Among operator-related factors, ambient lighting conditions, scanning pattern, and ISB design (material, geometry, and retention design) can impact the accuracy of intraoral digital implant scans. The optimal ISB for maximizing IOS accuracy is unclear; however, polymer ISB can wear with multiple reuse and sterilization methods. Among patient-related factors, additional variables should be considered, namely arch (maxillary vs. mandibular arch), implant position in the arch, inter-implant distance, implant depth, and angulation. CONCLUSIONS Ambient lighting conditions should be established based on the IOS selected to optimize the accuracy of intraoral digital implant scans. The optimal scanning pattern may vary based on the IOS, clinical situation, and the number of implants. The optimal ISB design may vary depending on the IOS used. Metallic implant scan bodies are preferred over polymer ISB designs to minimize wear due to multiple use and sterilization distortion. Among patient-related factors, additional variables should be considered namely the arch scanned, implant position in the arch, inter-implant distance, implant depth, and angulation. The impact of these factors may vary depending on the IOS selected.
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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
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - 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
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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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: 5] [Impact Index Per Article: 5.0] [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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Wu HK, Chen G, Huang X, Deng F, Li Y. Accuracy of single-implant digital impression with various scanbody exposure levels at anterior and posterior regions. J Dent 2023; 138:104641. [PMID: 37516339 DOI: 10.1016/j.jdent.2023.104641] [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: 05/12/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 07/31/2023] Open
Abstract
OBJECTIVES This in vitro study aimed to evaluate the effect of the exposure heights of the scanbody on the accuracy of digital implant impressions at different positions. METHODS Four maxillary master models with one analog at the anterior and posterior region were fabricated by a 3-dimensional (3D) printer. The analogs were submerged from the gingival margin to ensure four exposure heights of the scanbody: 10, 8, 6, and 4 mm. . The master models were then scanned with D2000 dental laboratory scanner as the reference models. An intraoral scanner obtained ten test models for each group. After aligning the scanbody library file, the related files were imported into inspection software for superimposition by a local fit algorithm based on the adjacent teeth. RESULTS 3D trueness was significantly decreased at 6 and 4 mm scanbody exposure at the anterior region. In comparison, a significant decrease was only seen at 4 mm scanbody exposure at the posterior region. 3D precision was significantly decreased at 4 mm scanbody exposure at both anterior and posterior regions. CONCLUSION The exposure height of the scanbody influenced the accuracy of the digital implant impression, according to the implant positions. Scanbody exposure of less than 6 mm at the anterior region and 4 mm scanbody exposure at the posterior region could lead to increased deviations, but still in the tolerance range. CLINICAL SIGNIFICANCE The scanbody exposure height less than 6 mm at the anterior region and 4 mm scanbody exposure height at the posterior region could lead to significantly increased deviations. Though these deviations may be still in the clinically acceptable range, caution should be taken.
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Affiliation(s)
- Hio Kuan Wu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Guanhui Chen
- Department of Stomatology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong 518107, China
| | - Xiaoqiong Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
| | - Yiming Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
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Petchmedyai P, Thanasrisuebwong P. Optimizing digital implant impressions: Evaluating the significance of scan body image deficiency and alignment under varied scan body exposures. PLoS One 2023; 18:e0291831. [PMID: 37733766 PMCID: PMC10513296 DOI: 10.1371/journal.pone.0291831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
In implant dentistry, the advent of intraoral scanning technology has revolutionized traditional clinical processes by streamlining procedures and ensuring predictable treatment outcomes. However, achieving accurate virtual implant positions using intraoral scanners and scan bodies can be influenced by various clinical and laboratory factors. This study aims to investigate the impact of scan body image capture deficiency and scan body alignment methods in computer-aided design (CAD) software on the accuracy of virtual implant positions, particularly in different implant depths. Three stereolithographic half-arch implant models with different implant depths were prepared, representing three scenarios of scan body exposure: full exposed scan body, 2/3 exposed scan body, and 1/3 exposed scan body. The scan body image capture deficiency and alignment methods were simulated using CAD software. The deviation of virtual implant positions obtained from different scenarios were evaluated using 3D analysis software. The highest angular and linear deviation (0.237±0.059 degrees, 0.084±0.068 mm) were found in the 1/4 upper and lower part scan body deficiency using the 1-point alignment method in the 1/3 exposed scan body. Two-way ANOVA analysis revealed significant effects of scan deficiency on virtual implant position deviations across all scan body exposures, except for the linear deviation when the scan body was exposed 2/3 of its length. Furthermore, scan deficiencies in the 1/4 upper and lower parts of the scan body significantly affected implant angular deviation regardless of scan body exposure, while implant linear deviation was specifically affected when the scan body was exposed to only 1/3 of its total length. Deficiencies in scan body acquisition, particularly in deep soft tissue situations, can lead to deviations in both angular and linear positioning of virtual implants. Employing appropriate scan body alignment methods such as a 3-point alignment approach demonstrates better accuracy compared to a 1-point alignment.
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Affiliation(s)
- Pobploy Petchmedyai
- Dental Implant Centre, Faculty of Dentistry, Mahidol University, Salaya, Thailand
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Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans: Part 2-Patient factors. J ESTHET RESTOR DENT 2023; 35:241-249. [PMID: 36639916 DOI: 10.1111/jerd.12993] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/31/2022] [Accepted: 11/14/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To describe the factors related to patient intraoral conditions that impact the scanning accuracy of intraoral scanners (IOSs). A new classification for these influencing factors is proposed to facilitate dental professionals' decision-making and maximize the accuracy and reliability of intraoral digital scans. OVERVIEW Variables related to intraoral conditions of the patient that can influence the scanning accuracy of IOSs include tooth type, presence of interdental spaces, arch width variations, palate characteristics, wetness, existing restorations, characteristics of the surface being digitized, edentulous areas, interimplant distance, position, angulation, and depth of existing implants, and implant scan body selection. CONCLUSIONS The knowledge and understanding of the patient's intraoral conditions that can impact the scanning accuracy of IOSs is a fundamental element for maximizing the accuracy of IOSs. CLINICAL SIGNIFICANCE The patient's intraoral conditions, or patient factors, can significantly impact intraoral scanning accuracy. Dental professionals must know and understand these influencing patient factors to maximize 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.,Research and Digital Dentistry, 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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