Reliability of mixed dentition space analysis using a digital model obtained from an optical impression: a preliminary study

OBJECTIVE

While mixed dentition space analysis is a common practice in pediatric dentistry, digital models created using an intraoral scanner are not as widely used in clinical settings. This preliminary study used a very small sample size with one reference model and aimed to (1) compare the accuracy of mixed dentition space analysis using a digital model obtained from an optical impression with that of conventional plaster model-based analysis and (2) assess inter-examiner differences.

RESULTS

The space required for the mandibular permanent canine and premolars and arch length discrepancy were calculated using each model. The largest significant difference between plaster- and digital model-based analyses was identified when the right arch length discrepancy was considered (-0.49 mm; 95% confidence interval: -0.95-0.03); however, the value was considered clinically insignificant. Significant inter-examiner differences were observed for six items of the plaster model; however, no such differences were observed when using the digital model. In conclusion, digital model space analysis may have the same level of accuracy as conventional plaster model analysis and likely results in smaller inter-examiner differences than plaster model analysis.

The effect of scanning pathways on trueness and precision in full-arch optical impression

BACKGROUND

In this study, we investigated the effects of differences in scanning pathways during optical impression on the trueness and precision of full-arch impressions.

METHODS

Reference data were obtained using a laboratory scanner. All optical impressions were measured across the dental arch using TRIOS® 3 in four different pathways. The reference and optical impression data were superimposed using the best-fit method. The criteria for superimposition were based on the starting side of the dental arch (partial arch best-fit method, PB) and based on the full arch (full arch best-fit method, FB). The data were compared between the left and right molars (starting and ending sides). The scan deviations for trueness (n = 5) and precision (n = 10) were obtained for each group by calculating the root mean square (RMS) of the deviation at each measurement point. Visual observations using superimposed color map images revealed variations in trueness.

RESULTS

There were no significant differences in scanning time or amount of scan data between the four scanning pathways. Trueness did not differ significantly among the four pathways with respect to the starting and ending sides, regardless of the superimposition criteria. Precision with PB was significantly different between scanning pathways A and B, and pathways B and C for the starting sides, and between scanning pathways A and B, and pathways A and D for the ending sides. In contrast, there was no significant difference between the starting and ending side in pathways for FB. Regarding PB, color map images showed a large error range in the direction toward the molar radius for the occlusal surface and cervical regions on the ending sides.

CONCLUSION

Differences in the scanning pathways did not affect trueness, regardless of the superimposition criteria. On the other hand, differences in the scanning pathways affected the precision of the starting and ending sides with PB. Scanning pathways B and D were more precise on the starting and ending sides, respectively.

Maxillary Obturator Prosthesis Made with Polyetherketoneketone Using Optical Impression and CAD/CAM System

This report describes the case of a 68-year-old man who visited our department complaining of poor denture retention and difficulty masticating due to damage to the retainer of a maxillary obturator. The patient had never been satisfied with the fit of this prosthesis, which had been placed two years earlier. The obturator and the mucosal surface of the denture base were incompatible, which had caused the retainer to detach. The maxillary defect was categorized as H3S0D0T0 according to the HS classification. The diagnosis was a masticatory disorder due to a damaged retainer and an incompatible denture base. Optical impressions and occlusal records were taken and a maxillary obturator fabricated using a CAD/CAM system. Dental CAD software was used to design and complete the tooth arrangement. The CAM system was used to mill a polyetherketoneketone disc based on the obtained data and composite resin used to face the teeth and gingiva. The maxillary obturator was placed after only three visits, spanning from impression taking to denture completion. The use of digital data allowed the time to denture completion to be shortened in addition to the number of hospital visits to be reduced. Compared to conventional impression taking, optical impressions also prevent discomfort, decreasing stress for the patient.

Effect of defect size and tooth anatomy in the measurements of a 3D patient monitoring tool

Purpose

To assess the influence of defect size and tooth anatomy on the measurements performed by a 3D patient monitoring tool.

Methods

A fully dentate model was scanned to obtain a master digital file. Virtual duplicates received defects created in molars (16, 18, 28) and incisors (11, 12, 22), according to different depths (60, 80, 120 microns) and sizes (small, medium, large) totaling 180 conditions. The surface changes measured by the 3D Patient Monitoring Tool (3Shape TRIOS Patient Monitoring [TPM]) were compared with the reference by 2 calibrated operators. False Positives (FP), and False Negatives (FN) defect were registered. Pearson chi-square test, Multivariate binary logistic regression and Spearman rank correlation were used to evaluate the data (α = 0.05).

Results

A significant association was found between the area and the presence of FP and FN (P < .01). Larger defects had higher chances to present FP or an FN respectively. There was a significant association between the tooth and the presence of a FP value (FP, P = .02; FN, P = .005) specially in molars. No significant association was found between the defect depth and the presence of a FP value. Spearman rank correlation showed a strong association between the presence of an FP and an FN (r = 0.858, P < .01).

Conclusions

The defect size and tooth anatomy significantly affected the virtual follow-up, whereas defect depth did not. Small defects were correctly detected in all cases. An incorrect measurement on one side of the tooth simultaneously resulted in incorrect measurement on the opposite side.

Clinical relevance

The clinician should be aware that different factors related to the characteristics of the defects could affect the quality of the full-arch digital follow-up. Therefore, caution is needed when interpreting the models comparison in cases that a larger area of a tooth has been modified.

Development of a new evaluation method for orthodontic forces generated in individual patients

Numerous experimental studies have examined how much orthodontic force is needed to move teeth more smoothly; however, no reports have examined this clinically in individual, living subjects. We aimed to develop a method for quantifying the force exerted on individual teeth by an orthodontic wire to measure how loads placed on crowded teeth change dynamically over time. Accordingly, we fabricated a series of dental casts of patients undergoing orthodontic treatment (using optical impressions and a three-dimensional printer), fitted these models with nickel-titanium wire, and subjected them to bending load tests. During leveling, nickel-titanium wire is generally considered to exert a weak force due to its low elastic modulus, with a weak orthodontic force applied over a long period of time due to its superelasticity; however, we found that the actual energy exerted by nickel-titanium wire is also largely affected by other factors (e.g., amount of crowding).

Applying intraoral scanner to residual ridge in edentulous regions: in vitro evaluation of inter-operator validity to confirm trueness

Background

The purpose of this study was to investigate the trueness of intraoral scanning of residual ridge in edentulous regions during in vitro evaluation of inter-operator validity.

Methods

Both edentulous maxillary and partially edentulous mandibular models were selected as a simulation model. As reference data, scanning of two models was performed using a dental laboratory scanner (D900, 3Shape A/S). Five dentists used an intraoral scanner (TRIOS 2, 3Shape A/S) five times to capture intraoral scanner data, and the “zig-zag” scanning technique was used. They did not have experience with using intraoral scanners in clinical treatment. The intraoral scanner data was overlapped with the reference data (Dental System, 3Shape A/S). Regarding differences that occurred between the reference and intraoral scanner data, the vertical maximum distance of the difference and the integral value obtained by integrating the total distance were analyzed.

Results

In terms of the maximum distances of the difference on the maxillary model, the means of five operators were as follows: premolar region, 0.30 mm; molar region, 0.18 mm; and midline region, 0.18 mm. The integral values were as follows: premolar region, 4.17 mm²; molar region, 6.82 mm²; and midline region, 4.70 mm². Significant inter-operator differences were observed with regard to the integral values of the distance in the premolar and midline regions and with regard to the maximum distance in the premolar region, respectively. The maximum distances of the difference in the free end saddles on mandibular model were as follows: right side, 0.05 mm; and left side, 0.08 mm. The areas were as follows: right side, 0.78 mm²; and left side, 1.60 mm². No significant inter-operator differences were observed in either region.

Conclusions

The present study demonstrated satisfactory trueness of intraoral scanning of the residual ridge in edentulous regions during in vitro evaluation of inter-operator validity.

Adaptation of zirconia crowns created by conventional versus optical impression: in vitro study

PURPOSE

The aim of this study was to compare the precision of optical impression (Trios, 3Shape) versus that of conventional impression (Imprint IV, 3M-ESPE) with three different margins (shoulder, chamfer, and knife-edge) on Frasaco teeth.

MATERIALS AND METHODS

The sample comprised of 60 zirconia half-crowns, divided into six groups according to the type of impression and margin. Scanning electron microscopy enabled us to analyze the gap between the zirconia crowns and the Frasaco teeth, using ImageJ software, based on eight reproducible and standardized measuring points.

RESULTS

No statistically significant difference was found between conventional impressions and optical impressions, except for two of the eight points. A statistically significant difference was observed between the three margin types; the chamfer and knife-edge finishing lines appeared to offer better adaptation results than the shoulder margin.

CONCLUSION

Zirconia crowns created from optical impression and those created from conventional impression present similar adaptation. While offering identical results, the former have many advantages. In view of our findings, we believe the chamfer margin should be favored.

Investigation of accuracy and reproducibility of abutment position by intraoral scanners

PURPOSE

We examined the accuracy, including trueness and precision, of the intraoral scanners comparing with laboratory scanner to reveal the error level of intraoral scanners.

METHODS

Measurements were performed using a computer numerical control coordinate measuring machine (CNCCMM) of the reference models as a control. Subsequently, intraoral scanners and a laboratory scanner were used for measurements of the reference trueness and precision of the distance were evaluated by image analyzing software.

RESULTS

With regard to reference model, there was a significant difference between in the trueness measured by C.O.S. (COS) and that measured by the other scanners. The trueness measured by the second-generation 3M™ true definition scanner (TDS2) and third-generation 3M™ true definition scanner (TDS3) was bigger than the one by TRIOS (TR) and KaVo (KA). With regard to reference model "B," error of the trueness measured by COS was significantly bigger, compared with the one measured by the other scanners. However, error range of intraoral scanners, except for COS, was considerably small and it should be covered with cement space.

CONCLUSIONS

The results of this study indicated that an optical impression method with an intraoral scanner could be applied to the implant therapy for multiple teeth missing.