Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner
01 Sep 2013-American Journal of Orthodontics and Dentofacial Orthopedics (Am J Orthod Dentofacial Orthop)-Vol. 144, Iss: 3, pp 471-478
TL;DR: Intraoral and extraoral scanning with the iTero resulted in deviations at the facial surfaces of the anterior teeth and the buccal molar surfaces, suggesting that the intraoral conditions (saliva, limited spacing) contribute to the inaccuracy of a scan.
About: This article is published in American Journal of Orthodontics and Dentofacial Orthopedics.The article was published on 2013-09-01. It has received 379 citations till now. The article focuses on the topics: Dental impression material.
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TL;DR: Optical impressions reduce patient discomfort; IOS are time-efficient and simplify clinical procedures for the dentist, eliminating plaster models and allowing better communication with the dental technician and with patients; however, with IOS, it can be difficult to detect deep margin lines in prepared teeth and in case of bleeding, there is a learning curve, and there are purchasing and managing costs.
Abstract: Intraoral scanners (IOS) are devices for capturing direct optical impressions in dentistry. The purpose of this narrative review on the use of IOS was to: (1) identify the advantages/disadvantages of using optical impressions compared to conventional impressions; (2) investigate if optical impressions are as accurate as conventional impressions; (3) evaluate the differences between the IOS currently available commercially; (4) determine the current clinical applications/limitations in the use of IOS. Electronic database searches were performed using specific keywords and MeSH terms. The searches were confined to full-text articles written in English and published in peer-reviewed journals between January 2007 and June 2017. One hundred thirty-two studies were included in the present review; among them, 20 were previous literature reviews, 78 were in vivo clinical studies (6 randomized controlled/crossover trials, 31 controlled/comparative studies; 24 cohort studies/case series; 17 case reports) and 34 were in vitro comparative studies. Optical impressions reduce patient discomfort; IOS are time-efficient and simplify clinical procedures for the dentist, eliminating plaster models and allowing better communication with the dental technician and with patients; however, with IOS, it can be difficult to detect deep margin lines in prepared teeth and/or in case of bleeding, there is a learning curve, and there are purchasing and managing costs. The current IOS are sufficiently accurate for capturing impressions for fabricating a whole series of prosthetic restorations (inlays/onlays, copings and frameworks, single crowns and fixed partial dentures) on both natural teeth and implants; in addition, they can be used for smile design, and to fabricate posts and cores, removable partial prostheses and obturators. The literature to date does not support the use of IOS in long-span restorations with natural teeth or implants. Finally, IOS can be integrated in implant dentistry for guided surgery and in orthodontics for fabricating aligners and custom-made devices.
376 citations
TL;DR: A comprehensive review of the current published literature investigating the various methods and techniques for scanning, designing, and fabrication of CAD/CAM generated restorations along with detailing the new classifications of CAD-CAM technology is presented.
359 citations
Cites background from "Precision of intraoral digital dent..."
...An extended scanning protocol can improve the scanning results in some regions [38]....
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...[38] reported that scanning with the intra-oral...
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...[38] Flügge TV, Schlager S, Nelson K, Nahles S, Metzger MC....
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TL;DR: Based on this study, the conventional impression technique is still recommended for full-arch impressions and digital impression techniques are a clinically acceptable alternative to conventional impression methods in fabrication of crowns and short FDPs.
Abstract: Purpose To conduct a systematic review to evaluate the evidence of possible benefits and accuracy of digital impression techniques vs. conventional impression techniques. Materials and methods Reports of digital impression techniques versus conventional impression techniques were systematically searched for in the following databases: Cochrane Central Register of Controlled Trials, PubMed, and Web of Science. A combination of controlled vocabulary, free-text words, and well-defined inclusion and exclusion criteria guided the search. Results Digital impression accuracy is at the same level as conventional impression methods in fabrication of crowns and short fixed dental prostheses (FDPs). For fabrication of implant-supported crowns and FDPs, digital impression accuracy is clinically acceptable. In full-arch impressions, conventional impression methods resulted in better accuracy compared to digital impressions. Conclusions Digital impression techniques are a clinically acceptable alternative to conventional impression methods in fabrication of crowns and short FDPs. For fabrication of implant-supported crowns and FDPs, digital impression systems also result in clinically acceptable fit. Digital impression techniques are faster and can shorten the operation time. Based on this study, the conventional impression technique is still recommended for full-arch impressions.
295 citations
TL;DR: For sextant scanning, the Planscan was found to be the most precise and true scanner and the 3Shape Trios was foundto have the best balance of speed and accuracy.
Abstract: Statement of problem As digital impressions become more common and more digital impression systems are released onto the market, it is essential to systematically and objectively evaluate their accuracy. Purpose The purpose of this in vitro study was to evaluate and compare the trueness and precision of 6 intraoral scanners and 1 laboratory scanner in both sextant and complete-arch scenarios. Furthermore, time of scanning was evaluated and correlated with trueness and precision. Material and methods A custom complete-arch model was fabricated with a refractive index similar to that of tooth structure. Seven digital impression systems were used to scan the custom model for both posterior sextant and complete arch scenarios. Analysis was performed using 3-dimensional metrology software to measure discrepancies between the master model and experimental casts. Results Of the intraoral scanners, the Planscan was found to have the best trueness and precision while the 3Shape Trios was found to have the poorest for sextant scanning ( P iTero >3Shape TRIOS 3 >Carestream 3500 >Planscan >CEREC Omnicam >CEREC Bluecam. The order of precision for complete-arch scanning was as follows: CS3500 >iTero >3Shape D800 >3Shape TRIOS 3 >CEREC Omnicam >Planscan >CEREC Bluecam. For the secondary outcome evaluating the effect time has on trueness and precision, the complete- arch scan time was highly correlated with both trueness (r=0.771) and precision (r=0.771). Conclusions For sextant scanning, the Planscan was found to be the most precise and true scanner. For complete-arch scanning, the 3Shape Trios was found to have the best balance of speed and accuracy.
276 citations
Cites methods or result from "Precision of intraoral digital dent..."
...The IT scanner uses a proven parallel confocal imaging technology with red laser light beams to capture images of dental tissues.(25,29-33) The ST scanner is based on confocal microscopy capturing multiple images in a very short time....
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...Although a direct comparison with published results is difficult because of variations in study design, the results of this study are in agreement with values reported in the literature for trueness and precision of intraoral impression systems.(22-33) Hack et al(25) found the ST to be the truest scanner when evaluating a single tooth....
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TL;DR: The Lava COS was found not suitable for taking implant impressions for a cross-arch bridge in the edentulous jaw and the 3M True Definition and Trios scanner demonstrated the highest accuracy.
Abstract: Introduction
Studies demonstrated that the accuracy of intra-oral scanners can be compared with conventional impressions for most indications. However, little is known about their applicability to take impressions of multiple implants.
Aim
The aim of this study was to evaluate the accuracy of four intra-oral scanners when applied for implant impressions in the edentulous jaw.
Material and methods
An acrylic mandibular cast containing six external connection implants (region 36, 34, 32, 42, 44 and 46) with PEEK scanbodies was scanned using four intra-oral scanners: the Lava C.O.S. and the 3M True Definition, Cerec Omnicam and 3Shape Trios. Each model was scanned 10 times with every intra-oral scanner. As a reference, a highly accurate laboratory scanner (104i, Imetric, Courgenay, Switzerland) was used. The scans were imported into metrology software (Geomagic Qualify 12) for analyses. Accuracy was measured in terms of trueness (comparing test and reference) and precision (determining the deviation between different test scans). Mann–Whitney U-test and Wilcoxon signed rank test were used to detect statistically significant differences in trueness and precision respectively.
Results
The mean trueness was 0.112 mm for Lava COS, 0.035 mm for 3M TrueDef, 0.028 mm for Trios and 0.061 mm for Cerec Omnicam. There was no statistically significant difference between 3M TrueDef and Trios (P = 0.262). Cerec Omnicam was less accurate than 3M TrueDef (P = 0.013) and Trios (P = 0.005), but more accurate compared to Lava COS (P = 0.007). Lava COS was also less accurate compared to 3M TrueDef (P = 0.005) and Trios (P = 0.005).
The mean precision was 0.066 mm for Lava COS, 0.030 mm for 3M TrueDef, 0.033 mm for Trios and 0.059 mm for Cerec Omnicam. There was no statistically significant difference between 3M TrueDef and Trios (P = 0.119). Cerec Omnicam was less accurate compared to 3M TrueDef (P < 0.001) and Trios (P < 0.001), but no difference was found with Lava COS (P = 0.169). Lava COS was also less accurate compared to 3M TrueDef (P < 0.001) and Trios (P < 0.001).
Conclusions
Based on the findings of this in vitro study, the 3M True Definition and Trios scanner demonstrated the highest accuracy. The Lava COS was found not suitable for taking implant impressions for a cross-arch bridge in the edentulous jaw.
162 citations
Cites background from "Precision of intraoral digital dent..."
...Scanning in the mouth may doubles the error compared to scanning a model due to the different environment (Flugge et al. 2013)....
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References
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Journal Article•
TL;DR: Copyright (©) 1999–2012 R Foundation for Statistical Computing; permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and permission notice are preserved on all copies.
Abstract: Copyright (©) 1999–2012 R Foundation for Statistical Computing. Permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and this permission notice are preserved on all copies. Permission is granted to copy and distribute modified versions of this manual under the conditions for verbatim copying, provided that the entire resulting derived work is distributed under the terms of a permission notice identical to this one. Permission is granted to copy and distribute translations of this manual into another language, under the above conditions for modified versions, except that this permission notice may be stated in a translation approved by the R Core Team.
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TL;DR: An overview of CAD/CAM-technologies and systems available for dentistry today is given, which enable the access to new, almost defect-free, industrially prefabricated and controlled materials and an improvement in precision and planning, as well as an increase in efficiency.
Abstract: As in many other industries, production stages are increasingly becoming automated in dental technology. As the price of dental laboratory work has become a major factor in treatment planning and therapy, automation could enable more competitive production in high-wage areas like Western Europe and the USA. Advances in computer technology now enable cost-effective production of individual pieces. Dental restorations produced with computer assistance have become more common in recent years. Most dental companies have access to CAD/CAM procedures, either in the dental practice, the dental laboratory or in the form of production centres. The many benefits associated with CAD/CAM generated dental restorations include: the access to new, almost defect-free, industrially prefabricated and controlled materials; an increase in quality and reproducibility and also data storage commensurate with a standardised chain of production; an improvement in precision and planning, as well as an increase in efficiency. As a result of continual developments in computer hardware and software, new methods of production and new treatment concepts are to be expected, which will enable an additional reduction in costs. Dentists, who will be confronted with these techniques in the future, require certain basic knowledge if they are to benefit from these new procedures. This article gives an overview of CAD/CAM-technologies and systems available for dentistry today.
720 citations
TL;DR: In-vitro results show that accuracy of the digital impression is similar to that of the conventional impression, which will have to be confirmed in further clinical studies.
Abstract: The digital intraoral impression has become a central part of the CAD/CAM technique The objective of the present study was to compare the accuracy (trueness and precision) of digital impressions of the full arch with that of conventional impressions on the in-vitro model For this purpose, a master model was acquired with a new reference scanning process, the measuring trueness of which was +/- 41 microm and the precision +/- 25 microm On the one hand, conventional impressions and then plaster models (n = 5) were produced from this master model, and on the other hand, digital impressions were made with the Cerec AC Bluecam and the Lava COS system (each n = 5) The plaster models were also scanned with the reference scanner The available data records were superimposed and the differences determined The deviation from the master model defines the trueness of the impression method The deviations of the models among one another demonstrate the precision of the method The trueness of the impressions was 55 +/- 218 microm in the conventional impression group, for digital impressions with Cerec Bluecam it was 49 +/- 142 microm and for digital impressions with Lava COS 403 +/- 141 microm The precision was 613 +/- 179 microm for conventional impression with Impregum, 309 +/- 71 microm for digital impression with the Cerec Bluecam and 601 +/- 313 microm for digital impression with Lava COS These in-vitro results show that accuracy of the digital impression is similar to that of the conventional impression These results will have to be confirmed in further clinical studies
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TL;DR: Preliminary results did not indicate that digital models would cause an orthodontist to make a different diagnosis of malocclusion compared with plaster models; digital models are not a compromised choice for treatment planning or diagnosis.
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TL;DR: The background, general concepts, available techniques and the clinical applications of recording external craniofacial morphology in three dimensions and the different 3D techniques of imaging the dental arches are described.
Abstract: Part I of this paper describes the background, general concepts, available techniques and the clinical applications of recording external craniofacial morphology in three dimensions. Part II explores the different 3D techniques of imaging the dental arches, and their possible uses in orthodontic diagnosis and treatment.
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