Intraoral scanning for implant-supported complete-arch fixed dental prostheses (ISCFDPs): Four clinical reports.

Although there are difficulties with using intraoral scans for implant-supported complete-arch fixed dental prostheses (ISCFDPs), several commercially available systems have become helpful in simplifying the treatment process in the prosthetic phase. These systems help patients move from interim ISCFDPs to receiving definitive prostheses in just three clinical visits. This clinical report summarizes the indications, benefits, and limitations of the four systems. The information provided in this report about the digital prosthetic workflow of ISCFDPs aims to help clinicians make well-informed choices and improve treatment results. With digital technologies advancing, refining these tools and protocols, and validating research is crucial for continued evolution in the field.

Effect of scanning strategies on trueness and time efficiency of digital impression on paediatric models.

BACKGROUND: Various scanning methods aim to reduce intraoral scanner errors, yet no specific approach targets paediatric patients. AIM: Evaluate continuous (C) and noncontinuous (NC) scanning patterns' impact on the trueness and duration of paediatric digital impressions. DESIGN: A standard pedodontic typodont model was scanned with a Trios 4 Move+ IOS using four scanning strategies. C1 and C2 followed continuous scanning from the right molars, with different directions. NC1 scanned noncontinuously from the right molar, with breaks every four teeth. NC2 began at the right primary incisor, with breaks after every three teeth. Each scan, performed five times by one researcher, was timed. Industrial scanning provided reference data. Deviations were analyzed using the MIXED procedure. RESULTS: NC1 had higher deviations in the lower jaw, whereas C1 and NC1 showed higher deviations in the upper jaw (p < .001). C1 had significantly higher deviations in the upper jaw than the lower jaw (p = .041). NC2 had the longest scanning time in both upper and lower jaws (p = .002). CONCLUSION: Paediatric digital impressions benefit from starting at the anterior and incorporating breaks, although this increases scanning time.

Comparison of Direct Intraoral Scan and Traditional Impression for CAD/CAM Mandibular Overdenture Base: RCT on Peri-implant Marginal Bone Changes.

AIM: This study aimed to evaluate the impact of digital vs traditional impression techniques on peri-implant vertical bone resorption in the creation of mandibular overdenture bases supported by four implants using CAD/CAM technology. MATERIALS AND METHODS: Twenty edentulous patients were placed in four mandibular implants and randomly divided into groups: (A) the control group (CIG) (n = 10); patients obtained CAD/CAM denture base using conventional impression technique and group (B) the study (DIG) group (n = 10); patients obtained CAD/CAM denture base using digital impression technique. Peri-implant vertical bone height was measured immediately (T0), 6 (T6), and 12 (T12) months after insertion. Peri-implant vertical bone loss (VBL) was calculated first 6 months (T1), the second 6 months (T2), and 1 year (T3) after insertion. RESULTS: For both groups, the survival rates of inserted implants were 100%. The amount of VBL in the first year in both groups was within normal ranges. In both groups, VBL significantly decreased over time. The control group recorded significantly higher VBL than (DIG) group at T2 (p = 0.006) and at T3 (p = 0.005). CONCLUSION: Digital intraoral scanning technique may be considered a more beneficial registration method than traditional impression technique for the construction of CAD/CAM 4-implant-assisted overdenture base regarding the preservation of vertical bone levels. CLINICAL SIGNIFICANCE: Both digital intraoral scanners and conventional impression techniques can be used for the construction of CAD/CAM-implant-assisted overdenture bases regarding the preservation of peri-implant vertical bone resorption. How to cite this article: Seifeldeen AR, Aboelez MA, Gebreel AA, et al. Comparison of Direct Intraoral Scan and Traditional Impression for CAD/CAM Mandibular Overdenture Base: RCT on Peri-implant Marginal Bone Changes. J Contemp Dent Pract 2024;25(6):527-534.

Impact of scanning strategies on the accuracy of virtual interocclusal records in partially edentulous arch using intraoral scanner: an in vitro study.

PURPOSE: To evaluate the scanning strategies affecting the accuracy of virtual interocclusal records (VIR) in partially edentulous arches using an intraoral scanner in vitro. METHODS: A reference model of a partially edentulous arch with implant analogs in positions 45,46 and 47 was constructed. Six pairs of 1-mm diameter metal beads were placed on the gingival tissue as markers for measurement. Four scanning strategies were tested: Quadrant-arch Scan (group 1), Quadrant-arch Scan with Auxiliary occlusal devices (AOD) (group 2), Full-arch Scan (group 3), Full-arch Scan with AOD (group 4). The model was digitalized with a lab scanner as a reference and 15 scans were obtained for each group. The accuracy of VIR was assessed by comparing the experiment data to the reference digital model. RESULTS: The mean surface deviations of VIR for Groups 1-4 were 89.4 ± 105.2 µm,95.6 ± 132.8 µm,152.3 ± 159.7 µm and 107.6 ± 138.2 µm respectively. Quadrant-arch scans resulted in lower errors of VIR than full-arch scan (P < 0.001). There was a significant interaction between the AOD and scanning span (P = 0.017). The Quadrant-arch scan with AOD　(group 2) produced the least error in the distally extended edentulous area. CONCLUSIONS: Quadrant-arch scans showed better accuracy of VIR than full-arch scans across all tooth positions. The combination of AOD and quadrant-arch scan further enhances VIR accuracy in distally extended edentulous areas.

An Evaluation of the Accuracy of Digital Models-An In Vitro Study.

BACKGROUND: Intraoral scanning technology has opened new perspectives in dental practice, and combined with CAD/CAM technology, contributes significantly to fabricating high-quality prosthetic restorations. Our in vitro study aims to assess the accuracy of digital models obtained from one laboratory and two less commonly used intraoral scanners by conducting 3D measurements on the digital models obtained. METHODS: An articulated simulator cast was used. Forty-eight scans were performed before and after tooth preparation with each scanner. The Zeiss Inspect software (Version: 2023.3.0.969) was used for measurements in sagittal and transversal planes. The obtained values were compared to reference values resulting from manual measurements. RESULTS: Digital impressions provided discrepancies compared to the reference model. The lowest differences at the A2-L2 (the diagonal dimension of the models from the distal fossa of the second right maxillary molar and the maximum oral convexity of the artificial gingiva at the first left premolar) and the A1-B1 (transversal dimension of the model in the posterior area, from the right second molar's occlusal central fossa to the left second molar central fossa) distances were obtained for the upper models, and at the a1-b1 distance for all the lower models, except the non-prepared models scanned with the intraoral scanners (the discrepancies were not statistically significant). The discrepancies increased with the distance from the starting point of the scan. CONCLUSION: The number and position of prepared teeth can influence the accuracy of the scans. Distortions can appear in the case of multiple preparations. The scanning protocol and calibration must be optimized for the highest accuracy. Furthermore, in vivo studies are necessary to evaluate the clinical applicability of these findings.

Fabrication of three implant-supported crowns using a digital workflow: a case report.

Accurate working impression is an essential requirement for the fabrication of implant prosthesis, and digital impressions have recently become more popular. In this case report, a completely digital workflow is introduced for the fabrication of three single-unit screw-retained implant crowns on the posterior maxilla by a dental student, under supervision. This approach involved the use of an intraoral scanner to capture a digital impression of the three implants and their surrounding mucosa, the opposing arch, and occlusion. The use of intraoral scanners and digital impressions illustrated an efficient and patient-friendly method of capturing the necessary data to fabricate a well-fitted prothesis. The aim of this case report is to examine a fully digital approach in the production of multiple single-unit implant crowns.

Accuracy of implant abutment level digital impressions using stereophotogrammetry in edentulous jaws: an in vitro pilot study.

BACKGROUND: In edentulous jaws, factors such as the number of implants, cross-arch distribution, and the angle among implants may affect the accuracy of the implant impression. This study explored factors influencing the accuracy of implant abutment-level digital impressions using stereophotogrammetry in edentulous jaws. METHODS: Two standard all-on-4 and all-on-6 models of edentulous jaws were constructed in vitro. In the stereophotogrammetry group (PG), the implant digital impression was made using stereophotogrammetry and saved as an STL file. In the conventional group (CNV), the impression was made using the open-tray splint impression technique. An electronic and optical 3D measuring instrument was used to scan the standard model and the conventional plaster model to obtain STL files. Using 3D data processing software (GOM Inspect Pro, Zeiss), the distance and angle between the abutments in the CNV impression and the PG impression were measured and compared with the data from the standard model. RESULTS: The distance deviation in the PG and the CNV was 145 ± 196 µm and 96 ± 150 µm, respectively, with a significant difference (P < 0.001). The angle deviation in the PG and the CNV was 0.82 ± 0.88° and 0.74 ± 0.62°, respectively, with no significant difference (P = 0.267). In the PG, the distance deviation was negatively correlated with the distance between implants (r = -0.145, P = 0.028) and positively correlated with the angle of implants (r = 0.205, P = 0.002). The angle deviation was negatively correlated with the distance between implants (r = -0.198, P = 0.003) and positively correlated with the angle of implants (r = 0.172, P = 0.009). In the CNV, the effect of inter-implant distance on impression accuracy was also shown by Spearman correlation analysis: r = 0.347 (P < 0.001) for distance deviation and r = -0.012 (P = 0.859) for angle deviation. The effect of inter-implant angulation on impression accuracy deviation was r = -0.026 (P = 0.698) for distance deviation and r = 0.056 (P = 0.399) for angle deviation. CONCLUSIONS: The CNV method is closer to the real value of the original model. The distance between implants and the distribution angle had a weak correlation with the accuracy of digital impressions but no significant correlation with the accuracy of traditional impressions.

Effect of soft tissue thickness on accuracy of conventional and digital implant impression techniques.

BACKGROUND: Placing implants deep sub-gingivally may affect the accuracy of implant impression techniques and the fit of final restoration. PURPOSE: The aim of this in-vitro study was to evaluate the effect of soft tissue thickness on accuracy of conventional and digital implant impression techniques. METHODS: Four parallel implant analogues (A, B, C, D) placed in each of two epoxy resin models representing edentulous mandible covered by flexible polyurethane material with two different thickness two mm and four mm. A total of sixty impressions performed, thirty impressions for each model divided into four groups (n = 15 per group) GI (C2mm) open tray impression with two mm implant depth, GII (C4mm) open tray impression with four mm implant depth, GIII (D2mm) digital impression with two mm implant depth, GIV (D 4 mm) digital impression with four mm implant depth. Impressions from open tray technique were poured to get stone casts while impressions from digital scanning technique were printed as three-dimensional printed casts. The six inter-implant distances between analogues were measured using Co-ordinate measuring machine, deviations compared to reference models were calculated. Data was collected, tabulated and statistically analyzed using One-way ANOVA test to detect significances between groups. RESULTS: For conventional impressions there was significant difference between C2mm/C4mm (P < 0.001) regarding interimplant distance, while in digital impressions there was no significant difference between D2mm/D4mm AB(p = 0.110), BC(p = 0.066), CD(p = 0.710), AD(p = 0.084), AC(p = 0.067) and BD(p = 0.072). There was significant difference between conventional and digital impression techniques C2mm/D2mm, C4mm/D4mm (P < 0.001). CONCLUSION: Within the limitations of this in-vitro study digital impressions provide more accurate outcomes with implants placed deeper subgingivally than conventional impressions. TRIAL REGISTRATION: Retrospectively registered.

Influence of impression method and shoulder design on the marginal adaptation of CAD/CAM nanoceramic resin onlay restorations.

Objective: This in-vitro study investigates the influence of two different impression techniques and two shoulder designs on the marginal adaptation of computer-aided design/computer-aided manufacturing restorations. Methods: Forty mandibular first premolars were cast into dental arch models for this in vitro study. Fragile cusps and concavities on the mesial-buccal-occlusal surfaces were treated, with 2 mm of the occlusal surface removed. Teeth were categorised into two groups based on shoulder preparation. Digital scanning using a 3Shape 3D scanner identified them further for allocation into conventional and digital impression subgroups. The restorations were created from nanoceramic resin blocks using prescribed guidelines. Microscopic evaluation assessed the restoration's marginal adaptation, with data analysed using SPSS 27.0. The level of significance was set at p ≤ 0.05. Results: Digital intraoral scanning consistently demonstrated smaller marginal gaps than the traditional impression method, regardless of shoulder preparation, with the differences being statistically significant (p < 0.05). Furthermore, shoulder preparation significantly reduced the marginal gaps in both the digital and traditional impression groups (p < 0.05). Conclusions: The onlay preparation design with a shoulder led to restorations with improved marginal adaptation compared with the design with no shoulder. Direct digital impression techniques produced restorations within a better marginal discrepancy than traditional impressions.

Adaptation and Biomechanical Performance of Custom-Fit Mouthguards Produced Using Conventional and Digital Workflows: A Comparative In Vitro Strain Analysis.

BACKGROUND/OBJECTIVES: The use of different models for the fabrication of custom-fit mouthguards (MTGs) can affect their final thickness, adaptation, and shock-absorption properties. This study aimed to evaluate the adaptation, thickness, and shock absorption of ethylene-vinyl acetate (EVA) thermoplastic MTGs produced using conventional plaster or three-dimensional (3D) printed models. MATERIALS AND METHODS: A typical model with simulated soft gum tissue was used as the reference model to produce MTGs with the following two different protocols: plast-MTG using a conventional impression and plaster model (n = 10) and 3DPr-MTG using a digital scanning and 3D printed model (n = 10). A custom-fit MTG was fabricated using EVA sheets (Bioart) plasticized over different models. The MTG thickness (mm), internal adaptation (mm) to the typodontic model, and voids in the area (mm2) between the two EVA layers were measured using cone-beam computed tomography images and Mimics software (Materialize). The shock absorption of the MTG was measured using a strain-gauge test with a pendulum impact at 30° with a steel ball over the typodont model with and without MTGs. Data were analyzed using one-way analysis of variance with repeated measurements, followed by Tukey's post hoc tests. RESULTS: The 3DPr-MTG showed better adaptation than that of the Plast-MTG at the incisal/occlusal and lingual tooth surfaces (p < 0.001). The 3DPr-MTG showed a thickness similar to that of the Plast-MTG, irrespective of the measured location. MTGs produced using both model types significantly reduced the strain values during horizontal impact (3DPr-MTG 86.2% and Plast-MTG 87.0%) compared with the control group without MTG (p < 0.001). CONCLUSION: The MTGs showed the required standards regarding thickness, adaptation, and biomechanical performance, suggesting that the number and volume of voids had no significant impact on their functionality. Three-dimensional printed models are a viable alternative for MTG production, providing better adaptation than the Plast-MTG at the incisal/occlusal and lingual tooth surfaces and similar performance as the MTG produced with the conventional protocol.

Effect of cut-out rescanning protocol on the accuracy of digital impressions in convergent implants positioned at varying depths: An in vitro study.

BACKGROUND: This study aimed to assess the effect of the "cut-out rescan" strategy on the accuracy of intraoral digital scans from 25° convergent implants positioned at two distinct depths. MATERIAL AND METHODS: Two customized models were fabricated, each designated to receive two posterior converged implant fixtures: one at a depth of 1 mm and the other at a depth of 4 mm. Initially, the models were scanned as reference casts using a lab scanner. The test group was involved in scanning the 1-mm and 4-mm implant models using an intraoral scanner in the following order: (1) scanning the 1-mm (T1; n = 10) and (2) 4-mm (T4; n = 10) implant groups with scan bodies connected to both fixtures in each model; (3) cut-out rescan (COR) in the 1-mm (COR1; n = 10) and (4) 4-mm (COR4; n = 10) models, leading to 40 digital files in standard tessellation language format. The mean absolute deviation (MAD), in terms of trueness and precision, between the experimental and control scans was assessed through the alignment of their respective datasets using three-dimensional analysis software. Two-way analysis of variance (ANOVA) and Levene's tests were used to analyze the data. RESULTS: The COR4 group exhibited the highest MAD, indicative of both trueness and precision (Mean ±SD: 55.659 ±34.802). In contrast, the T1 group demonstrated the lowest MAD (Mean ±SD: 43.225 ±19.237). However, the ANOVA analysis showed no significant influence of depth (P = 0.506) or type of scan (P = 0.442) on the MAD. Precision also did not differ significantly across groups (P = 0.071). CONCLUSIONS: The cut-out rescan approach demonstrated an accuracy comparable to that of the one-time scan method. CLINICAL SIGNIFICANCE: Digital intraoral scanning provides clinicians with a range of tools to navigate challenging conditions in which conventional methods may prove difficult, such as cases involving angled adjacent implants. In these scenarios, the cut-out rescan tool serves as a valuable resource, aiding clinicians in overcoming the challenges associated with impression-making owing to the convergence of placed implants.

Evaluation of hypermobile teeth deviation during impression taking in a partially edentulous dental arch: An in vitro study comparing digital and conventional impression techniques.

PURPOSE: This study aimed to compare the deviation of hypermobile teeth in partially edentulous dental arches during impression taking using digital and conventional techniques. METHODS: A partially edentulous mandibular model with three target hypermobile teeth (including the left first premolar, #34; left second molar, #37; and right first premolar, #44), was used as the simulation model. After reference data were acquired using a desktop scanner, impressions of the simulation model were obtained using a digital intraoral scanner (IOS) and two conventional techniques (hydrocolloid material with a stock tray and silicone material with a custom tray as impression data (n=12/group). The three-dimensional accuracy (root mean square value) and two-dimensional accuracy (mesiodistal and buccolingual displacements) of the target teeth in each impression dataset were calculated based on the reference data. The comparison among three impression techniques was statistically performed using the Kruskal-Wallis test (α=0.05). RESULTS: For #34 and #44, the three- and two-dimensional accuracies of the impressions fabricated through data acquired through digital scanning (digital impression) were significantly superior to those of the hydrocolloid impression (P < 0.05), whereas no significant difference was found between the digital and silicone impressions. For #37, no significant difference in the accuracy of the impression data for the target teeth was observed among the three impression techniques. CONCLUSIONS: Digital impression acquiring using an IOS is recommended over using a conventional hydrocolloid impression to prevent the deviation of hypermobile teeth in partially edentulous dental arches. Hypermobile tooth deviation in digital impression data depends on the tooth location.

Influence of scanning pattern on accuracy, time, and number of photograms of complete-arch implant scans: A clinical study.

OBJECTIVES: To measure the influence of scanning pattern on the accuracy, time, and number of photograms of complete-arch intraoral implant scans. METHODS: A maxillary edentulous patient with 7 implants was selected. The reference implant cast was obtained using conventional methods (7Series Scanner). Four groups were created based on the scanning pattern used to acquire the complete-arch implant scans by using an intraoral scanner (IOS) (Trios4): manufacturer's recommended (Occlusal-Buccal-Lingual (OBL)), zig-zag (Zig-zag), circumferential (Circumf), and novel pattern that included locking an initial occlusal scan (O-Lock group) (n = 15). Scanning time and number of photograms were recorded. The linear and angular measurements were used to assess scanning accuracy. One-way ANOVA and Tukey tests were used to analyze trueness, scanning time, and number of photograms. The Levene test was selected to assess precision (α=0.05). RESULTS: Statistically significant differences in trueness were detected among OBL, Zig-zag, Circumf, and O-Lock regarding linear discrepancy (P<0.01), angular discrepancy (P<0.01), scanning time (P<0.01), and number of photograms (P<0.01). The O-Lock (63 ± 20 µm) showed the best linear trueness with statistically significant differences (P < 0.01) with Circumferential (86 ± 16 µm) and OBL (87 ± 19 µm) groups. The O-Lock (93.5 ± 13.4 s, 1080 ± 104 photograms) and Circumf groups (102.9 ± 15.1 s, 1112 ± 179 photograms) obtained lower scanning times (P < 0.01) and number of photograms (P < 0.01) than OBL (130.3 ± 19.4 s, 1293 ± 161 photograms) and Zig-zag (125.7 ± 22.1 s, 1316 ± 160 photograms) groups. CONCLUSIONS: The scanning patterns tested influenced scanning accuracy, time, and number of photograms of the complete-arch scans obtained by using the IOS tested. The zig-zag and O-Lock scanning patterns are recommended to obtain complete-arch implant scans when using the selected IOS.

Perfect digital impression of natural abutment teeth without using retraction cords.

Digital technologies are gradually gaining ground in dentistry. In particular, taking impressions with intraoral scanners is becoming routine; however, even this must often be preceded by the use of retraction cords. This article presents an innovative technique to record digital impressions of natural tooth abutments using interim restorations relined with impression material instead of retraction cords. In the laboratory, using computer-aided design, the technician can segment the internal surface of the interim restoration and use it to replace the abutment of the intraoral scan, thus obtaining an accurate coping that yields more detailed information about the supragingival and intrasulcular surface of the preparation.

Complete-arch accuracy of seven intraoral scanners measured by the virtual-fit method.

OBJECTIVES: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method. METHODS: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE). RESULTS: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap. CONCLUSION: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit. CLINICAL SIGNIFICANCE: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration.

Comparative Analysis of Four Different Intraoral Scanners: An In Vitro Study.

(1) Background: Intraoral scanners undergo rapid advancements in hardware and software, prompting frequent updates by manufacturers. (2) Aim: This study aimed to quantitatively assess the precision of full dental arch digital impressions obtained from four different intraoral scanners: Trios 5-3SHAPE, Copenhagen, Denmark, CEREC Primescan- Dentsply Sirona, New York, NY, USA, Planmeca Emerald S-Planmeca Oy, Helsinki, Finland, and Medit i700-Medit Corp, Seoul, Republic of Korea. (3) Methods: A maxillary virtual dental model (digital master model) was created in accordance with ISO standard 20896-1. Subsequently, a 3D-printed model was obtained from the master model's STL file and scanned 15 times consecutively with each scanner. STL files were aligned with the master model's STL using Medit Link-Medit Design software v.3.1.0. The accuracy was evaluated by measuring deviations in micrometers between each scanner's scans and the master model. (4) Results: The study revealed variations in accuracy ranging from 23 to 32 µm across scans of the same dental arch, irrespective of the scanner used and scanning strategy employed. The anterior regions exhibited higher precision (Mean Absolute Deviation of 112 µm) compared to the posterior regions (Mean Absolute Deviation of 127 µm). Trios 5 demonstrated the smallest deviation (average 112 µm), indicating superior accuracy among the scanners tested. Emerald S and Medit i700 exhibited balanced performance (average 117 µm and 114 µm, respectively), while Primescan consistently displayed high deviation (average 127 µm). (5) Conclusions: Based on clinically accepted thresholds for accuracy in intraoral scanning, which are typically 200 µm for full arch scans, Trios 5 surpasses these benchmarks with its average deviation falling within the 200 µm range. Emerald S and Medit i700 also meet these standards, while Primescan, although showing high overall deviation, approaches the upper limit of clinical acceptability. Considering the limitations of an in vitro investigation, the findings demonstrate that each intraoral scanner under evaluation is capable of reliably and consistently capturing a full arch scan for dentate patients.

In vitro evaluation of the impact of intraoral scanner, scanning aids, and the scanned arch on the scan accuracy of edentulous arches.

PURPOSE: To assess the accuracy of complete maxillary and mandibular edentulous arch scans obtained using two different intraoral scanners (IOSs), with and without scanning aids, and to compare these results to those obtained using conventional impression methods. MATERIALS AND METHODS: Two IOSs were used (TRIOS 4 [TRI] and Emerald S [EMR]) to scan maxillary and mandibular typodonts. The typodonts were scanned without scanning aids [TRI_WSA and EMR_WSA groups] (n = 10). The typodonts were then scanned under four scanning aid conditions (n = 10): composite markers [TRI_MRK and EMR_MRK groups], scanning spray [TRI_SPR and EMR_SPR groups], pressure indicating paste [TRI_PIP and EMR_PIP groups], and liquid-type scanning aid [TRI_LQD and EMR_LQD groups]. Conventional impressions of both arches were also made using irreversible hydrocolloids in stock trays [IHC] and using polyvinyl siloxane (PVS) impression material in custom trays (n = 10) which were digitized using a laboratory scanner. Using a metrology software program, all scans were compared to a reference scan in order to assess trueness and to each other to assess precision. Trueness and precision were expressed as the root mean square (RMS) of the absolute deviation values and the statistical analysis was modeled on a logarithmic scale using fixed-effects models to meet model assumptions (α = 0.05). RESULTS: The main effect of arch (p = 0.004), scanner (p < 0.001), scanning aid (p = 0.041), and the interaction between scanner and scanning aid (p = 0.027) had a significant effect on mean RMS values of trueness. The arch (p = 0.015) and scanner (p < 0.001) had a significant effect on the mean RMS values of precision. The maxillary arch had better accuracy compared to the mandible. The TRIOS 4 scanner had better accuracy than both the Emerald S scanner and conventional impressions. The Emerald S had better precision than conventional impressions. The scanning spray and liquid-type scanning aids produced the best trueness with the TRIOS 4 scanner, while the liquid-type scanning aid and composite markers produced the best trueness for the Emerald S scanner. CONCLUSION: The scanned arch and the type of scanner had a significant effect on the accuracy of digital scans of completely edentulous arches. The scanning aid had a significant effect on the trueness of digital scans of completely edentulous arches which varied depending on the scanner used.

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With the rapid development of implant techniques and digital technology, intraoral digital impressions have become a commonly used impression method in implant restoration. At present, the accuracy of intraoral digital impressions directly applied to implant-supported prostheses in edentulous jaw remains inadequate. This is due to the high accuracy requirement of full-arch implant impressions, while there are still technical challenges in intraoral digital impressions about recognition and stitching. In this regard, scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scans, including mucosal modifications, auxiliary devices and novel scan bodies. At the same time, as a new digital impression technique, stereo photogrammetry has been developing steadily and exhibits promising accuracy. This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions thus providing a reference for clinical application.

Accuracy of digital and conventional implant-level impression techniques for maxillary full-arch screw-retained prosthesis: A crossover randomized trial.

OBJECTIVES: This study aimed to compare the accuracy of implant-level conventional and digital impressions for atrophied maxillary ridges. MATERIALS AND METHODS: Twelve participants with atrophied edentulous maxillary ridges received six implants. Six months later and after soft tissue maturation around healing abutments, a control cast was constructed using the final passive restoration for each patient. Two types of implant-level impression techniques were carried out for each patient: (1) conventional (splinted open-tray) impression technique and (2) digital impression technique. For both techniques, scan bodies were labeled from the most distal implant on the left side (A, B, C, D, E, and F) and scanning was made. Accuracy of both techniques was measured using in vitro (two-dimensional and three-dimensional) and in vivo (clinical) methods. Two-dimensional methods include measurement of the difference in linear distances AB, AC AD, AE, and AF. Geomagic software was used to assess the three-dimensional deviation between the two impression techniques using the superimposition of standard tessellation language files. The incidence and percentage of nonpassive frameworks and framework misfits of final restorations for both types of impression techniques were assessed using the single screw test. RESULTS: For all distances, digital impressions recorded significantly higher deviation from control measurements than conventional impressions. The highest two-dimensional linear deviation was noted for AF distance and the lowest difference was noted for AB distance. For all scan bodies, digital impressions recorded significantly higher three-dimensional deviation than conventional impressions. The highest three-dimensional deviation was noted with scan bodies C and D. Digital impressions recorded a significantly higher incidence of nonpassive frameworks and framework misfits than conventional impressions. [Correction added on 11 June 2024, after first online publication: In the preceding sentence, "digital impressions" was changed to "conventional impressions" in this version.] CONCLUSION: Within the limitations of this study, it could be concluded that the conventional implant-level impression technique showed greater in vitro and in vivo accuracy than the digital impression technique when used for full-arch maxillary fixed restorations on inclined implants.

Maxillary interim obturator prosthesis fabrication for a patient with limited mouth opening with a digital approach: A clinical report.

Squamous cell carcinoma is a common malignant condition affecting the oral cavity and may involve the surrounding maxillofacial regions. Treatment commonly involves resection of the tumor, followed by prosthetic rehabilitation of the resection defect. This clinical report presents a 62-year-old Asian male patient who had previously undergone surgical resection, resulting in a post-surgical Aramany Class II maxillary defect. The patient's medical history included severe trismus, characterized by restricted mouth opening, as well as a diagnosis of maxillary sinus verrucous squamous cell carcinoma. This report provides a comprehensive account of the rapid fabrication of an interim obturator using digitally assisted dentistry techniques.