An In-Vitro Evaluation of Articulation Accuracy for Digitally Milled Models vs. Conventional Gypsum Casts

With the advent of a digital workflow in dentistry, the inter-occlusal articulation of digital models is now possible through various means. The Cadent iTero intraoral scanner uses a buccal scan in maximum intercuspation to record the maxillomandibular relationship. This in-vitro study compares the occlusion derived from conventionally articulated stone casts versus that of digitally articulated quadrant milled models. Thirty sets of stone casts poured from full arch polyvinyl siloxane impressions (Group A) and thirty sets of polyurethane quadrant models milled from digital impressions (Group B) were used for this study. The full arch stone casts were hand-articulated and mounted on semi-adjustable articulators, while the digitally derived models were pre-mounted from the milling center based on the data obtained from the buccal scanning procedure. A T-scan sensor was used to obtain a bite registration from each set of models in both groups. The T-scan data derived from groups A and B were compared to that from the master model to evaluate the reproducibility of the occlusion in the two groups. A statistically significant difference of the contact region surface area was found on #11 of the digitally articulated models compared to the master. An analysis of the force distribution also showed a tendency for a heavier distribution on the more anterior #11 tooth for the digitally articulated models. Within the limitations of this study, the use of a digitally articulated quadrant model system may result in a loss of accuracy, in terms of occlusion, the further anteriorly the tooth to be restored is located. Care must be taken to consider the sources of inaccuracies in the digital workflow to minimize them for a more efficient and effective restorative process.

Accuracy of Master Casts Generated Using Conventional and Digital Impression Modalities: Part 1—The Half-Arch Dimension

Accurate impression-making is considered a vital step in the fabrication of fixed dental prostheses. There is a paucity of studies that compare the casts generated by various impression materials and techniques that are commonly used for the fabrication of provisional and definitive fixed prostheses. The aim of this study is to compare the accuracy of casts obtained using conventional impression and digital impression techniques. Thirty impressions were made for the typodont model (10 impressions each of polyvinyl siloxane, alginate, and alginate alternative materials). Ten digital models were printed from the same model using a TRIOS-3 3Shape intraoral scanner. Accuracy was assessed by measuring four dimensions (horizontal anteroposterior straight, horizontal anteroposterior curved, horizontal cross-arch, and vertical). A one-way ANOVA and Tukey’s test (α = 0.05) were used to analyze data. A statistically significant difference in the four dimensions of the stone casts and digital models was observed among the four groups (exception: between alginate alternative and 2-step putty–light body impression in the horizontal anteroposterior straight, horizontal anteroposterior curved, and horizontal cross-arch dimensions; between alginate and alginate alternative in the horizontal anteroposterior curved dimension; between alginate and 2-step putty–light body impression in the horizontal anteroposterior curved dimension; and between alginate alternative and digital in the vertical dimension). Polyvinyl siloxane had the highest accuracy compared to casts obtained from other impression materials and digital impressions.

Improved accuracy of digital implant impressions with newly designed scan bodies: an in vivo evaluation in beagle dogs

Background The accuracy of digital impressions for fully edentulous cases is currently insufficient for routinely clinical application. To overcome the challenge, a modified scan body was introduced, which demonstrated satisfactory accuracy in vitro. The aim of this study was to evaluate the accuracy of digital impressions using the modified scan bodies with extensional structure versus scan bodies without extensional structure in mandible with two implants in beagle dogs. Methods The unilateral mandibular second premolar to second molar were extracted in four beagle dogs. Twelve weeks later, two implants were placed. Five repeated digital impressions were performed with an intraoral scanner on each dog using each of the two different scan bodies: Group I—scan body without extensional structure (SB); Group II—scan body with extensional structure (SBE). The scans were exported to Standard Tessellation Language (STL) files to serve as test data. The dogs were sacrificed and the dissected mandibles were digitalized with a lab scanner to provide reference data. Linear and angular deviations were calculated in an inspection software for accuracy assessment. Statistical analysis was performed with two-way ANOVA. The level of significance was set at α = 0.05. Results For trueness assessment, the mean of absolute linear/angular deviations were 119.53 μm/0.75 degrees in Group I and 68.89 μm/0.36 degrees in Group II. SBE was more accurate than SB regarding both linear (p = 0.008) and angular (p = 0.049) deviations. For precision assessment, the mean of absolute linear/angular deviations were 63.01 μm/0.47 degrees in Group I and 38.38 μm/0.24 degrees in Group II. No significant difference was found. Conclusions The application of SBE significantly improved the trueness of digital impressions in mandible with two implants compared to SB. No significant difference was found in terms of precision.

Accuracy of photogrammetry, intraoral scanning, and conventional impression techniques for complete-arch implant rehabilitation: an in vitro comparative study

Background To compare the accuracy of photogrammetry, intraoral scanning and conventional impression techniques for complete-arch implant rehabilitation. Methods A master cast containing 6 implant abutment replicas was fabricated. Group PG: digital impressions were taken 10 times using a photogrammetry system; Group IOS: intraoral scanning was performed to fabricate 10 digital impressions; Group CNV: splinted open-tray impression technique was used to fabricate 10 definitive casts. The master cast and conventional definitive casts were digitized with a laboratory reference scanner. For all STL files obtained, scan bodies were converted to implant abutment replicas using a digital library. The accuracy of a digitizer was defined by 2 main parameters, trueness and precision. "Trueness" was used to describe the deviation between test files and reference file, and "precision" was used to describe the closeness between test files. Then, the trueness and precision of three impression techniques were evaluated and statistically compared (α = 0.05). Results The median trueness was 24.45, 43.45 and 28.70 μm for group PG, IOS and CNV; Group PG gave more accurate trueness than group IOS (P < 0.001) and group CNV (P = 0.033), group CNV showed more accurate trueness than group IOS (P = 0.033). The median precision was 2.00, 36.00 and 29.40 μm for group PG, IOS and CNV; Group PG gave more accurate precision than group IOS (P < 0.001) and group CNV (P < 0.001), group CNV showed more accurate precision than IOS (P = 0.002). Conclusions For complete-arch implant rehabilitation, the photogrammetry system showed the best accuracy of all the impression techniques evaluated, followed by the conventional impression technique, and the intraoral scanner provided the least accuracy.

Effect of assistive devices on the precision of digital impressions for implants placed in edentulous maxilla: an in vitro study

Purpose To examine the effect of assistive devices on the precision of digital impression for multiple implants placed in the edentulous maxilla. Methods A reference model representing an edentulous maxilla with four implants was developed. The digital impression group included three settings: Type 0, without an assistive device; Type 1, with an assistive device connecting only neighboring implants; and Type 2, with an assistive device connecting not only neighboring implants but also the two posterior implants, with perpendicular branches from this bar towards the anterior implants. Digital impressions were made five times for each type using three intraoral scanners (IOSs). For conventional method, silicone impressions and verification jigs were prepared; fabricated plaster models were scanned using a laboratory scanner/industrial 3D scanner. In analysis 1, two-way ANOVA analyzed the effect of IOSs and assistive devices on the precision of digital impressions. In analysis 2, one-way ANOVA compared the silicone impressions, the verification jigs, and the most precise group of digital impressions from analysis 1. Results In analysis 1, the IOS and assistive device type (F = 25.22, p < .0001) effects and the interaction between these two factors (F = 5.64, p = .0005) were statistically significant. In analysis 2, CON, VJ, and digital impression with Type 2 devices (most precise devices in analysis 1) were compared; better precision was obtained by digital impression with Type 2 device than by CON and VJ (F = 30.08, p < .0001). Conclusions For implants placed in an edentulous maxilla, digital impressions with assistive devices can provide better precision compared to silicone impressions and verification jigs.

Accuracy in marginal and/or internal adaptation of full-coverage fixed prostheses made with digital versus conventional impressions: an overview of systematic reviews and meta-analysis

Review question / Objective: Is the accuracy (marginal adaptation and / or internal adaptation) of fixed full coverage prostheses made with digital impressions better than conventional impressions? Eligibility criteria: Inclusion criteria• Systematic reviews and / or meta-analyzes that evaluated the precision (marginal adaptation and / or internal adaptation) of full coverage fixed prostheses on natural teeth in clinical studies and on tooth replicas in in vitro studies.• Systematic reviews and / or meta-analyzes comparing digital impressions with an intraoral scanner versus conventional impressions taken with any impression material.• Systematic reviews and / or meta-analyzes of randomized clinical trials (RCTs), prospective comparative and in vitro and non-randomized clinical trials.Exclusion criteria:• Systematic literature reviews, case reports, pilot studies• Studies evaluating the seating of crowns on implants and partial restorations• Studies with no response from the author to the requested information query.

Accuracy of Models Obtained from Digital Impressions Versus Scanning of Conventional Impressions

The full text of this preprint has been withdrawn, as it was submitted in error. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.

Digital Denture Fabrication: A Technical Note

Fabricating a complete denture in a conventional manner may be complicated and difficult. The purpose of this article was to describe the benefits of a fully digital workflow and fabrication procedure of complete dentures based on digital impressions of edentulous jaws. The digital data for the workflow were acquired using an intraoral scanner and were then used to design the denture base and teeth. The resulting data were exported to a 3D printer or a milling machine for denture fabrication.

Accuracy of Models Obtained from Digital Impressions Versus Scanning of Conventional Impressions

Background Digital workflow has invaded the different dental specialities. It includes some steps, the first of them is the scan process and dental modelling. Many methods are available for digital model fabrication. Therefore, the aim of this in vivo study to assess and compare the accuracy of 3-dimensional (3D) digital dental models obtained from scanning of conventional impressions versus models from digital impressions. Materials and Methods Three-dimensional digital model files were obtained in vivo from three different methods including scanning of impressions by both Cone beam computed tomography (CBCT) machine (Veraview x800, JMorita) and desktop scanner (Smart optics, Vinyl Open Air). The same volunteers have received digital impressions by an intraoral scanner (CS3600). Six linear measurements were measured in each Stereolithography (STL) model and compared with direct calliper measurements. Additionally, STL files from the three systems were paired and superimposed using a best-fit algorithm in a 3D modelling software. Mean deviations between the STL shells were calculated by the software and color maps were obtained for visual analysis. Intra-class correlation coefficient (ICC) was calculated to determine the intra-examiner reliability. Paired t-test, ANOVA with repeated measures and Post Hoc test (Bonferroni adjusted) were used in the statistical analysis. Significance of the obtained results was judged at the 5% level. Results The linear measurements and 3D deviation analysis revealed significant differences in some measurements but were considered clinically accepted. Digital models obtained from laser scanning of the impressions revealed the least mean differences from the gold standard ranging from (-0.24 to 0.01 mm), while CBCT scanning of the impressions mean differences ranged from (0.16 to -0.04 mm). IOS revealed the highest mean differences ranging from (0.11 to 0.33 mm). Conclusion Scanning the impression with a desktop scanner provided the highest accuracy in full arch scans followed by scanning with CBCT but with decreased surface texture of the 3D mesh. While intraoral scanners showed the least accuracy for full arch scans up till now and need further improvement in their technology. All techniques can be applied in clinical practice providing the use of high quality machines.

DIGITAL METHOD OF COMPARATIVE EVALUATION OF THE RIGIDITY BETWEEN THE CUSTOM MADE BY THE AUTHORS IMPLANT IMPRESSION TRAYS AND STOCK IMPLANT IMPRESSION TRAYS WITH REMOVABLE PARTS

Impression taking procedure from prosthetic area in case of constructing implant supported prostheses is one of the most important steps in the process of patient rehabilitation especially in producing long span structures. Quality of the impression could affect the precision and passive fit of the prosthesis to the implants therefore the overall quality of the work. Obtaining digital impressions of edentulous jaws with a different number of implants using intraoral devices is still an unresolved problem in full. The ergonomics of the process of obtaining an impression is not easy due to the need to place both scan abutments in the oral cavity and manipulate the working part of the intraoral scanner around them. The accuracy of digital impressions obtained from edentulous jaws for obtaining full-arch implant supported prostheses does not exceed that when obtaining a classic impression, and according to a number of researchers, it is even lower. The aim of this study was to construct implant impression convertible trays with increased to the optimum levels of rigidity, with simple disassemble process and having an easy access to the adapters, and also to digitally compare the rigidity of the author’s impression trays. The method of assessment was digital technology of analysing structural resistance and inherent stresses and deformations using SolidWorks software. We performed analysis of the resistance of the structure to external loads. We have developed and created the customised copyrighted versions of the upper and lower impression trays made of rigid titanium alloy by 3D printing using DMLM technology on a Concept Laser device made of titanium Ti6-Al4-V. Modeling was carried out in the Mimics Medical 21 program (Materialize, Germany) along the contours on the data of cone-beam computed tomography. Performed digital tests reveal the underlying advantages of the designed by authors impression trays.