Obtaining more accurate complete arch implant digital scans with the aid of a geometric pattern: A dental technique.

A technique to obtain more accurate complete arch implant digital scans and virtual casts is described. In order to obtain complete arch implant digital scans with greater accuracy, short-span intraoral digital scans are superimposed with the aid of a geometric pattern. Therefore, the technique takes advantage of the accuracy of intraoral scanners to obtain digital scans of reduced spans. Two virtual designs of the geometric pattern have been made available online: one for maxillary arches and one for mandibular arches. From these virtual designs, new virtual designs of geometric patterns of different sizes and shapes can be created to better fit different arch forms and implant positions.

Improving the accuracy of complete arch implant digital scans by using auxiliary clips for intraoral scan bodies: A dental technique.

A technique to improve the accuracy of complete arch implant intraoral digital scans and the accuracy of their virtual casts is described. Obtaining accurate complete arch implant intraoral digital scans with an intraoral scanner is challenging because of the smooth and movable tissues of edentulous areas. The described technique uses auxiliary clips attached to intraoral scan bodies to cover interimplant edentulous spans with immobile tooth-like geometric references that are more favorable for intraoral scanning. The technique is designed to be user friendly and compatible with any intraoral scanner.

Improving the accuracy of complete arch implant intraoral digital scans by using horizontal scan bodies with occlusal geometry: A dental technique.

A technique to improve the accuracy of complete arch implant intraoral digital scans and to obtain more accurate virtual casts with them is described. First, 2 complete arch intraoral digital scans were obtained with an intraoral scanner: a multiunit abutment digital scan and an implant digital scan with reusable horizontal intraoral scan bodies (ISBs) placed on the implants. These were previously created by combining the conventional ISBs compatible with the patient's implants with extensional structures with occlusal geometry. Once the digital scans had been acquired, the position of the implants was obtained by superimposing a virtual design of the conventional ISB onto each horizontal ISB of the complete arch implant digital scan. Finally, the virtual cast was obtained by superimposing the complete arch multiunit abutment digital scan on the complete arch implant digital scan.

Improving the precision of recordings acquired with digital occlusal analyzers: A dental technique.

A technique to improve the precision of recordings acquired with the 2 main digital occlusal analyzers on the market (T-Scan and OccluSense) is presented. This technique consists of using digital occlusal analyzers with a customizable centering tray. The virtual design of the centering tray is available online, together with that of the adapters required for both digital occlusal analyzers. The designs can be downloaded and additively manufactured for clinical use. These parts improve the positioning of the piezoelectric film sensors of the digital occlusal analyzers in the patient's mouth and thus the precision of their records. Improving the precision of the records of the digital occlusal analyzers is especially important for the comparison of records obtained at different stages of rehabilitation treatment.

Repeatability and reproducibility of 2 digital occlusal analyzers for measuring the right- and left-side balance of occlusal contact forces: An in vitro study.

STATEMENT OF PROBLEM: Although different digital occlusal analyzers have been marketed, comparative studies are lacking. PURPOSE: The purpose of this in vitro study was to compare the repeatability and reproducibility of 2 different digital occlusal analyzers (T-Scan and OccluSense) for measuring the right- and left-side balance of occlusal contact forces. MATERIAL AND METHODS: The repeatability and reproducibility of the 2 digital occlusal analyzers for measuring the balance of occlusal contact forces were determined and compared by using the Gauge Repeatability and Reproducibility tests based on the International Organization for Standardization (ISO), ISO 5725-2 and ISO 5725-3 standards. Ten different dental casts were mounted in the maximum intercuspation position on a semi-adjustable articulator. Then, the balance of occlusal contact forces in each of the 10 articulated dental casts was measured 24 times with each of the 2 digital occlusal analyzers. In addition, as the OccluSense, unlike the T-Scan, does not have a centering support for the piezoelectric film sensor, measurements with it were performed without and with a custom-designed and manufactured centering support. Finally, the repeatability and reproducibility of both digital occlusal analyzers were determined and compared using the Gauge Repeatability and Reproducibility tests. RESULTS: The repeatability and reproducibility tests revealed that only 0.8% of the variance of the measurements obtained with the T-Scan was due to repeatability and reproducibility (0.4% repeatability, 0.4% reproducibility). In contrast, 12% of the variance of the measurements obtained with the OccluSense was due to repeatability and reproducibility (2.2% repeatability, 9.8% reproducibility). However, when using OccluSense with the centering support, the variance decreased to 6.4% (2.8% repeatability, 3.6% reproducibility). According to the Automotive Industry Action Group classification, the repeatability and reproducibility of the T-Scan were good, those of the OccluSense poor, and those of the OccluSense with the centering support medium. CONCLUSIONS: The repeatability and reproducibility of the T-Scan were significantly better than those of the OccluSense for measuring the balance of occlusal contact forces. Furthermore, the repeatability and reproducibility of the OccluSense were significantly improved when used with a device to center the piezoelectric film sensor between the incisors. Nevertheless, the repeatability and reproducibility of the T-Scan were better.

Positional influence of center of masticatory forces on occlusal contact forces using a digital occlusal analyzer.

STATEMENT OF PROBLEM: Digital occlusal analyzers allow the recording of dental contact forces. Some authors assume a unique location for the center of contact forces at the position of maximum intercuspation, while others indicate variations in dental contact forces when recorded at different times of the day. Which approach is more appropriate is unclear. PURPOSE: The purpose of this in vitro study was to analyze whether a change in the balance of masticatory forces influences the location of the center of contact forces and its magnitude. MATERIAL AND METHODS: Three different dental casts, selected under dental criteria, were mounted in maximum intercuspation on a semiadjustable articulator equipped with a pattern indicating 9 different force application points (intersection point between 3 longitudinal rows and 3 transverse columns). A force of constant magnitude (169 N) was applied 10 times at each of the application points, and occlusal forces were recorded with a digital occlusal analyzer. Then, two variables were studied: the location of the center of contact forces and its magnitude. Each force application position (9 positions × 3 dental casts=27 in total) was repeated 10 times, and measured data were statistically analyzed with 2-way repeated measures ANOVA (α=.05) test. RESULTS: The repeatability of the method indicated that the coefficient of variation mean was 0.37% in the location of the center of contact forces and that its magnitude was 3.70%. The 2-way repeated measures ANOVA test revealed statistically significant variations in the location of the center of contact forces and its magnitude, revealing that longitudinal changes of the application point of masticatory forces affected the magnitude of contact forces and that longitudinal and transverse changes of the application point of masticatory forces affected the location of the center of contact forces. CONCLUSIONS: The location of the center of contact force and its magnitude provided by a digital occlusal analyzer at the position of maximum intercuspation are not necessarily unique to each articulated dental cast. Even if the intensity of the masticatory force remains unchanged, changes in its lateral or longitudinal balance also influence the result of the occlusion forces.

Analysis of the impact of the facial scanning method on the precision of a virtual facebow record technique: An in vivo study.

STATEMENT OF PROBLEM: Virtual facebow record techniques typically record the relationship of a maxillary digital scan to facial landmarks by aligning it to a 3-dimensional face scan. Three-dimensional face scans can be acquired with different facial scanning methods, but the impact of the facial scanning method on the accuracy (trueness and precision) of a virtual facebow record technique remains unclear. PURPOSE: The purpose of this in vivo study was to assess the impact of the facial scanning method on the precision under the repeatability conditions (repeatability) of a virtual facebow record technique. MATERIAL AND METHODS: Repeatability of the virtual facebow record technique with the following 3 clinical-grade facial scanning methods was determined and compared: a professional handheld scanner based on structured blue light scanning technology (PHS method); an attachment-type 3-dimensional sensor camera connected to a tablet and controlled with a mobile application (3DSC-T method); and a smartphone with an integrated 3-dimensional sensor camera controlled with a mobile application (3DSC-S method). To determine the repeatability of the virtual facebow record technique with each facial scanning method, 8 virtual facebow records of a completely dentate adult with class I occlusion and mesoprosopic facial form were obtained (8×3=24 in total); with these, 8 locations of a maxillary digital scan with respect to a common 3-dimensional face scan were obtained. Repeatability was determined in terms of deviations between located maxillary digital scans, determined, in turn, by calculating the distances between corresponding vertices for each of the possible nonrepeating combinations of pairs of located maxillary digital scans (8C2=28). Finally, the repeatability of the virtual facebow record technique with the different facial scanning methods was compared by using the Welch ANOVA test and the post hoc Games-Howell test (both α=.05). RESULTS: The repeatability of the virtual facebow record technique with PHS, 3DSC-T, and 3DSC-S facial scanning methods resulted in 0.243 ±0.094 mm, 0.437 ±0.171 mm, and 1.023 ±0.399 mm, respectively. Comparison of these results revealed that the facial scanning method had a statistically significant effect on the repeatability of the virtual facebow record technique (P<.001) and that its repeatability was statistically significantly greater with the PHS facial scanning method than with the 3DSC-T and 3DSC-S facial scanning methods and greater with the 3DSC-T facial scanning method than with the 3DSC-S facial scanning method (P<.001 for all pairwise comparisons). CONCLUSIONS: This study found that the facial scanning method had a great impact on the repeatability of the virtual facebow record technique and that the virtual facebow record technique was more repeatable with more accurate facial scanning methods.

Creating three-dimensional virtual patients by superimposing intraoral and facial digital scans guided with an aligner system: A dental technique.

A technique for creating 3-dimensional virtual patients (3DVPs) by superimposing intraoral and facial digital scans guided with a novel aligner system is described. This aligner system supports design modifications to adapt to different facial scanning methods (FSMs) and reduce the impact of FSMs on the accuracy of 3DVPs. Two different designs of the aligner system are described: one for use with less-accurate FSMs and another for use with more-accurate FSMs. These virtual designs are available for download and use.

Evaluation of repeatability of different alignment methods to obtain digital interocclusal records: An in vitro study.

STATEMENT OF PROBLEM: The alignment of the maxillary and mandibular digital scans obtained with an intraoral scanner (IOS) generates digital interocclusal records. Although the accuracy of maxillary and mandibular digital scans obtained from an IOS is widely studied, the accuracy of digital interocclusal records obtained with them is not; even less studied is the accuracy (trueness and precision) of the alignment methods that are available to obtain them. PURPOSE: The purpose of this in vitro study was to assess the precision under repeatability conditions (repeatability) of the different alignment methods used to obtain digital interocclusal records. MATERIAL AND METHODS: Digital scans of maxillary and mandibular casts of a dentate healthy adult were acquired with an IOS. Casts were then mounted in maximum intercuspal position in a semi-adjustable mechanical articulator (1801 AR Model PSH Articulator), and left and right occlusal digital scans were acquired with the IOS. Occlusal digital scans were repeated 7 times under repeatability conditions. After obtaining each pair of occlusal digital scans, the software program of the IOS automatically aligned the maxillary and mandibular digital scans with occlusal digital scans (TRI method), resulting in 7 digital interocclusal records composed of aligned maxillary and mandibular digital scans and occlusal digital scans. All 7 sets of aligned digital scans were exported and realigned in a dental computer-aided design software program by means of global and reference alignment methods (EXO-B and EXO-R methods, respectively). To assess the repeatability, the 7 aligned digital scan sets of each group were repositioned in the common coordinate system by aligning maxillary digital scans, and repeatability was calculated in terms of the distance between the vertices of the mandibular digital scans for each of the possible nonrepeating combinations of pairs (7C2=21). The repeatability was tested by using the Kruskal-Wallis test for nonparametric distribution followed by the Mann-Whitney U test and Bonferroni correction for pairwise comparisons (α=.05). RESULTS: The median with interquartile range for the TRI alignment method was 47 (27) µm for the EXO-B method 41 (25) µm and 16 (5) µm for EXO-R. The Kruskal-Wallis test showed statistical difference between test groups (P<.05). The post hoc Dunn test with Bonferroni adjustment detected significant statistical differences between the EXO-R-TRI (P<.001) and EXO-R-EXO-B (P<.001) alignment methods. CONCLUSIONS: This study found that the alignment method could influence the repeatability of digital interocclusal records. The reference best-fit alignment method (EXO-R) provided better repeatability.

Analysis of the influence of the facial scanning method on the transfer accuracy of a maxillary digital scan to a 3D face scan for a virtual facebow technique: An in vitro study.

STATEMENT OF PROBLEM: With the emergence of virtual articulators, virtual facebow techniques have been developed for mounting maxillary digital scans to virtual articulators. Different scanning methods can be used to obtain 3D face scans, but the influence that these methods have on the accuracy with which a maxillary digital scan is transferred to a 3D face scan is unknown. PURPOSE: The purpose of this in vitro study was to analyze the influence of the facial scanning method on the accuracy with which a maxillary digital scan is transferred to a 3D face scan in a virtual facebow technique. MATERIAL AND METHODS: According to a virtual facebow technique, a maxillary digital scan was transferred to a standard virtual patient-who had the maxillary digital scan in its real location-guided by an intraoral transfer element by using different 3D face scans with the intraoral transfer element in place (reference 3D face scans) obtained with 2 different scanning methods: 10 obtained with an accurate scanning method based on structured white light technology and 10 obtained with a less accurate scanning method based on structure-from-motion technology. For each situation, deviation between the maxillary digital scan at the location obtained via the virtual facebow technique and at its real location was obtained in terms of distance by using a novel methodology. From these distances, the accuracy was assessed in terms of trueness and precision, according to the International Organization for Standardization (ISO) 5725-1. The Student t test with Welch correction was used to determine if the accuracy with which the maxillary digital scan was transferred to the standard virtual patient was influenced by the facial scanning method used to obtain the reference 3D face scans (α=.05). RESULTS: Significant differences (P<.05) were found among the trueness values obtained when using the different facial scanning methods, with a very large effect size. A trueness of 0.138 mm and a precision of 0.022 mm were obtained by using the structured white light scanning method, and a trueness of 0.416 mm and a precision of 0.095 mm were acquired when using the structure-from-motion scanning method. CONCLUSIONS: The accuracy with which a maxillary digital scan is located with respect to a 3D face scan in a virtual facebow technique is strongly influenced by the facial scanning method used.

Use of measuring gauges for in vivo accuracy analysis of intraoral scanners: a pilot study.

PURPOSE: The purpose of this study is to present a methodology to evaluate the accuracy of intraoral scanners (IOS) used in vivo. MATERIALS AND METHODS: A specific feature-based gauge was designed, manufactured, and measured in a coordinate measuring machine (CMM), obtaining reference distances and angles. Then, 10 scans were taken by an IOS with the gauge in the patient's mouth and from the obtained stereolithography (STL) files, a total of 40 distances and 150 angles were measured and compared with the gauge's reference values. In order to provide a comparison, there were defined distance and angle groups in accordance with the increasing scanning area: from a short span area to a complete-arch scanning extension. Data was analyzed using software for statistical analysis. RESULTS: Deviations in measured distances showed that accuracy worsened as the scanning area increased: trueness varied from 0.018 ± 0.021 mm in a distance equivalent to the space spanning a four-unit bridge to 0.106 ± 0.08 mm in a space equivalent to a complete arch. Precision ranged from 0.015 ± 0.03 mm to 0.077 ± 0.073 mm in the same two areas. When analyzing angles, deviations did not show such a worsening pattern. In addition, deviations in angle measurement values were low and there were no calculated significant differences among angle groups. CONCLUSION: Currently, there is no standardized procedure to assess the accuracy of IOS in vivo, and the results show that the proposed methodology can contribute to this purpose. The deviations measured in the study show a worsening accuracy when increasing the length of the scanning area.

Accuracy of digitization obtained from scannable and nonscannable elastomeric impression materials.

STATEMENT OF PROBLEM: Elastomeric impression materials have been marketed for optimizing direct digital acquisition without requiring a stone cast. The trueness and precision of the digitization of these new elastomeric impression materials are unclear. PURPOSE: The purpose of this in vitro study was to compare the trueness and precision of digital dental casts obtained from the direct digitization of 2 types of vinylsiloxanether (VSXE) impression materials by using a laboratory laser scanner. MATERIAL AND METHODS: Thirty-eight elastomeric impressions were made of a master die with a similar morphology to a premolar crown preparation. The impression materials were Identium (IDE) and Identium Scan (SCAN), designed for direct digitalization. Each impression was digitalized by using an optical scanner to create digital casts. A computer-aided design (CAD) reference model of trueness (CRM) was created and aligned to each digital cast for digital 3-dimensional discrepancy analysis. RESULTS: The mean ±standard deviation global trueness of IDE was 53 ±16 µm and that of SCAN was 46 ±3 µm. SCAN digital casts showed higher precision (58 ±5 µm) than IDE (69 ±18 µm) (P<.05). At the margin of the preparation and at the axial surfaces, SCAN models showed higher trueness (3 ±6 µm and 1 ±5 µm) than IDE (15 ±10 µm and 2 ±37 µm), respectively. CONCLUSIONS: Scannable impressions could be digitalized with higher global precision than conventional elastomeric materials. Higher trueness could be achieved in specific impression locations such as gingival areas or axial walls of preparations, where the light emitted by the scanner was not blocked.

Accuracy of digital impressions for implant-supported complete-arch prosthesis, using an auxiliary geometry part-An in vitro study.

OBJECTIVES: The aim of this study was to evaluate the accuracy of complete-arch digital impressions for fabrication of an implant-supported prosthesis in the edentulous maxilla using an auxiliary geometry part. MATERIALS AND METHODS: A replica of the upper jaw of an edentulous patient with four scannable impression copings was fabricated in stainless steel. This model was scanned with an industrial non-contact 3D structured blue light 3D scanner, and the measurements of three reference distances were established as reference values. Subsequently, the model was scanned in two different scenarios (with or without an auxiliary geometry part put in place and fixed to the model) using three intraoral scanners. Measurements were taken with 3D inspection software, and a digital impression of the complete arch was built with mesh processing software by combining 2 STL files obtained with an intraoral scanner. RESULTS: All measurements with the auxiliary geometry part gave significantly more accurate results (p < .05). Trueness improved in the three reference distances, reaching values of 8 ± 6 µm at D12 reference distance, 20 ± 11 µm at D13 and 35 ± 22 µm at D14. Precision also improved significantly with the use of the auxiliary geometry part placed on the model (p < .05). The best precision results at reference distances D13 and D14 were obtained with the True Definition Scanner. CONCLUSIONS: The proposed methodology significantly improves the accuracy of complete-arch digital impressions in edentulous patients obtained in vitro, regardless of which scanner is used.

A new method to measure the accuracy of intraoral scanners along the complete dental arch: A pilot study.

PURPOSE: The purpose of this study is to assess the accuracy of three intraoral scanners along the complete dental arch and evaluate the feasibility of the assessment methodology for further in vivo analysis. MATERIALS AND METHODS: A specific measurement pattern was fabricated and measured using a coordinate measuring machine for the assessment of control distances and angles. Afterwards, the pattern was placed and fixed in replica of an upper jaw for their subsequent scans (10 times) using 3 intraoral scanners, namely iTero Element1, Trios 3, and True Definition. 4 reference distances and 5 angles were measured and compared with the controls. Trueness and precision were assessed for each IOS: trueness, as the deviation of the measures from the control ones, while precision, as the dispersion of measurements in each reference parameter. These measurements were carried out using software for analyzing 3-dimensional data. Data analysis software was used for statistical and measurements analysis (α=.05). RESULTS: Significant differences (P<.05) were found depending on the intraoral scanner used. Best trueness values were achieved with iTero Element1 (mean from 10 ± 7 µm to 91 ± 63 µm) while the worst values were obtained with Trios3 (mean from 42 ± 23 µm to 174 ± 77 µm). Trueness analysis in angle measurements, as well as precision analysis, did not show conclusive results. CONCLUSION: iTero Element1 was more accurate than the current versions of Trios3 and True Definition. Importantly, the proposed methodology is considered reliable for analyzing accuracy in any dental arch length and valid for assessing both trueness and precision in an in vivo study.

Obtaining reliable intraoral digital scans for an implant-supported complete-arch prosthesis: A dental technique.

This article describes a technique for obtaining an accurate complete-arch digital scan for an edentulous patient. To achieve this, an auxiliary polymeric device that simulates a denture is designed, fabricated, and placed in the mouth. This device, having the geometry of a typical dental arch, facilitates the digitalization of the edentulous complete arch. This is because the change in radius of the curvature (change of geometry) enables the scanner to perform a more accurate alignment. Initially, the necessary location of the implants is acquired, and then the soft tissue is added. This technique can achieve accurate complete-arch digital scans. Distances between implants are closer to the gold standard when using this auxiliary geometry piece than those obtained without using it.

Accuracy analysis of complete-arch digital scans in edentulous arches when using an auxiliary geometric device.

STATEMENT OF PROBLEM: Obtaining reliable digital scans of edentulous patients is challenging because of the absence of anatomic landmarks/geometric variations along the dental arch. Whether adding an auxiliary geometric device (AGD) will improve scanning is unclear. PURPOSE: The purpose of this in vitro study was to analyze the accuracy of complete-arch digital scans of completely edentulous arches by placing a consumable AGD. MATERIAL AND METHODS: A stainless-steel model of the maxilla of a completely edentulous arch with 4 implants was built. The model was scanned using a reference industrial scanner as the control and using 3 intraoral scanners (True Definition [3M ESPE], TRIOS 3 [3Shape A/S], and iTero [Align Technology, Inc]). Each intraoral scanner was used 10 times without the AGD in place and 10 more times with the AGD fixed on the model. Accuracy in terms of trueness and precision was established by comparing 5 reference distances with or without the AGD in place. A software program for analyzing 3D data was used to measure these 5 distances, and a data analysis software program was used for statistical and measurements analysis (α=.05). RESULTS: Significant differences (P<.05) were found in all reference distances for trueness and in 4 of the 5 reference distances for precision depending on whether the AGD had been used or not. Without the AGD in place, trueness ranged from 21 ±16 µm in the shortest reference distance to 125 ±80 µm in the largest reference distance. With the AGD in place, trueness ranged from 11 ±8 µm in the shortest reference distance to 64 ±51 µm in the largest reference distance. Precision ranged from 18 ±14 µm in the shortest reference distance to 84 ±74 µm in the largest reference distance without the AGD and from 7 ±7 µm in the shortest to 63 ±46 µm in the largest with it. CONCLUSIONS: Complete-arch digital scans of edentulous jaws are more accurate when an AGD is used to resolve the lack of anatomic landmarks. An additional advantage is that the use of the AGD allows for a more fluent scanning process.

Intraoral versus extraoral digital occlusal records: a pilot study.

The aim of the present pilot study was to analyze the reliability of interocclusal contact records generated with an intraoral scanner (TRIOS Standard) and an extraoral scanner (Zfx Evolution). Ten patients were selected. The number of occlusal contacts was first determined with the conventional method using 8-µm articulating paper (gold standard) (control). These conventional records were then compared with the intra- and extraoral digital records. Diagnostics tests (sensitivity, specificity, predictive values for positives and negatives), receiver operating characteristic (ROC) curve, and Cohen's kappa coefficient were performed to analyze the data. The kappa index of the extraoral scanner (40.7%) was considered to be 'moderate,' and better than that of the intraoral scanner (26.1%), which was considered to be 'low.' The extraoral scanner showed better results in the diagnostic test and in the ROC curve. The first results suggest that the extraoral scanner is more reliable for recording occlusal contacts than the intraoral scanner.

Evaluation of the Accuracy of a System to Align Occlusal Dynamic Data on 3D Digital Casts.

In recent years the T-Scan system has introduced the possibility of importing digitization of dental arches to its registrations. This is a remarkable advance, which allows an intuitive display of the location of the gathered dynamic data on the denture. Nevertheless, today's usual method of manually positioning the arch in relation to the T-Scan's force registration gives rise to the possibility of human error. In order to guarantee a good alignment between the dynamic registration and 3D digital casts, a specific method was developed. The aim of this study is to evaluate the accuracy of this alignment method. For this purpose, it was compared with the most common procedure for detecting occlusal contacts, the articulating paper method. The comparison comprised overlapping digital models of both methods. Contacts of casts of 11 adults were registered, both with articulating paper and the T-Scan system. For one method, articulating paper marks were scanned in color; for the second method, the previously mentioned alignment was carried out with the T-Scan registrations. The results of both methods were overlapped in 3D digital casts, quantifying occlusal data matches. Statistical analyses were made to measure the quality of this alignment method. The study revealed a mean matching percentage of 79.02%, confirming the high reliability of the method.

Customized procedure to display T-Scan occlusal contacts.

The virtual technique described in this article integrates reverse engineering and mandibular dynamics into dental computer-aided design and computer-aided manufacturing (CAD-CAM) systems. This technique aims to provide more objective information to the dental technician for the diagnosis, planning, and treatment phases. In order to carry out this protocol, the following devices, currently available in many practices, are necessary: an intraoral scanner, a T-Scan system, and some specific open reverse engineering software. By means of a virtual procedure, the T-Scan system detects the occlusal contacts, and the occlusal surfaces are obtained using an intraoral scanner. Once the alignment between the 3-dimensional occlusal surface and the T-Scan registration is carried out, the resulting contacts are projected onto the patient's occlusal surfaces; in this way, occlusal forces are obtained over time. The results obtained with this procedure demonstrate the feasibility of integrating different tools and software and the full integration of this procedure into a dental digital workflow.