Although studies have evaluated the accuracy of data obtained by intraoral scanners (IOSs), studies on the precision of interocclusal registrations made with IOSs are lacking.
The purpose of this ...clinical study was to compare the precision of IOS interocclusal registration with that of conventional methods with a silicone impression material and a gypsum cast.
Eight participants with complete natural dentitions were enrolled. Images of their maxillary and mandibular quadrant arches and their interocclusal relationship were scanned with 2 IOSs: the 3M True Definition Scanner and the TRIOS Scanner 3. In the conventional method, impressions of complete-arch dentition and quadrant-arch dentition were made with a silicone impression material, and gypsum casts were fabricated, mounted on a dental articulator related with a silicone interocclusal record, and scanned with a 3D laboratory scanner. These procedures were repeated 4 times, and 4 sets of interocclusal registration data in standard tessellation language (STL) format were generated for each condition. Interocclusal registration precision was evaluated by determining the discrepancy of the STL data between repeated measurements by using the best-fit-algorithm method.
The average discrepancies for all participants were 25 ±12 μm for the True Definition, 31 ±7 μm for the TRIOS 3, 154 ±59 μm for the complete arch, and 128 ±33 μm for the quadrant arch. The Kruskal-Wallis test revealed that the effect of the impression methods on the discrepancy was statistically significant (P<.001). The Steel-Dwass test showed that both digital scan methods exhibited significantly smaller discrepancies than the 2 conventional methods (P=.005).
These results suggest that the intermaxillary relationship captured by the digital scan method by using IOSs had better precision than that obtained by the conventional method.
Objective
This study aimed to evaluate the precision of digital implant impressions in comparison with conventional impressions and assess the impact of the scanning range on precision.
Materials and ...Methods
An edentulous maxilla model with six implants was scanned with four intraoral scanners (IOSs) and a dental laboratory scanner five times each, and stereolithography (STL) data were generated. A conventional silicone impression was made, and a model was fabricated, which was scanned using the laboratory scanner. This procedure was also repeated five times. Nine different ranges of interest (ROIs) were defined, and the average discrepancies of the measurement points between each pair of STL images out of five for each ROI were calculated. The effects of “impression method” and “ROI” on precision, as evaluated by the averaged discrepancy, were tested by two‐way analysis of variance (p < .05).
Results
The effects of “impression methods” and “ROI” and their interactions were statistically significant. The discrepancies in the scanned datasets of the dental laboratory scanner were significantly lower than those in the other impression methods. The discrepancies of the IOSs were comparable with those of the laboratory scanner when the ROI was limited, however; the discrepancies deteriorated when the ROI expanded across the arch, while those of the laboratory scanner remained stable irrespective of the ROI.
Conclusions
Within the limitation of this in vitro study, digital implant impressions by IOSs may show clinically acceptable precision when the scan range is limited, such as in 3‐unit superstructure supported by two implants.
Background
With the development of intraoral scanners, their trueness and precision have been evaluated in various studies. Through these studies, the amount of accuracy that can be expected from ...intraoral scanners has gradually been disclosed, at the same time, it was difficult to integrate the results of individual studies due to differences in evaluation methods between studies. The purpose of this article was to review the currently available evidence, summarise what is currently known about IOS, analyse the evaluation methods of each study, and list points to note when interpreting the results.
Main text
Most of the studies were conducted in vitro. The accuracy is evaluated in situations such as single missing teeth, partially edentulous ridges with multiple missing teeth, and fully edentulous jaws. To evaluate the accuracy, direct measurement of distance or angle by coordinate measuring machines and calculation of surface deviation by superimposing surface data were predominantly performed. The influence of parameters such as the number of implants, distance between implants, angle between implants, and experience of the operator was evaluated. Many studies have shown that trueness tends to decrease as the distance between the implants and the scan range increases. It was agreed that the implant angle did not affect either trueness or precision. Regarding other factors, the results varied among studies. Therefore, the effects of these parameters are not clear.
Conclusions
Heterogeneity in the research methodology was prevalent among the studies considered in this review. Therefore, we cannot make a decisive statement regarding the trueness and precision of digital implant impressions by IOSs. So far, the comparison of the numerical values of error between studies has yet to elucidate any clear answers, despite small methodological differences.
This technical procedure report introduces a newly developed method for removable partial denture (RPD) fabrication using computer-aided design and computer-aided manufacturing (CAD/CAM) and rapid ...prototyping (RP) technologies.
Full-arch digital impressions of the partially edentulous jaw were made by an IOS or the conventional method. The denture framework, artificial teeth, and denture base were designed by commercially available CAD software. Each of the denture components including connectors, clasps, and artificial teeth and the denture bases were fabricated separately by the CAM machine or the three-dimensional (3D) printer, and then assembled using an adhesive material.
RPDs were successfully fabricated using fully digital workflow and delivered to the patient, and no clinical complications were reported. Within the limitations of this report, the newly developed RPD fabrication techniques have the potential to change clinical and laboratory workflow from analog to digital.
Bone grafting is widely used to treat large bone defects. A porous composite of a bioactive octacalcium phosphate material with gelatin sponge (OCP/Gel) has been shown to biodegrade promptly and be ...replaced with new bone both in animal models of a membranous bone defect and a long bone defect. However, it is unclear whether OCP/Gel can regenerate bone in more severe bone defects, such as a critical-size transcortical defect.
Using an in vivo rat femur model of a standardized, transcortical, critical-size bone defect, we asked: Compared with a Gel control, does OCP/Gel result in more newly formed bone as determined by (1) micro-CT evaluation, (2) histologic and histomorphometric measures, and (3) osteocalcin staining and tartrate-resistant acid phosphatase staining?
Thirty-four 12-week-old male Sprague-Dawley rats (weight 356 ± 25.6 g) were used. Gel and OCP/Gel composites were prepared in our laboratory. Porous cylinders 3 mm in diameter and 4 mm in height were manufactured from both materials. The OCP/Gel and Gel cylinders were implanted into a 3-mm-diameter transcortical critical-size bone defect model in the left rat femur. The OCP/Gel and Gel were randomly assigned, and the cylinders were implanted. The biological responses of the defect regions were evaluated radiologically and histologically. At 4 and 8 weeks after implantation, CT evaluation, histological examination of decalcified samples, and immunostaining were quantitatively performed to evaluate new bone formation and remaining bone graft substitutes and activity of osteoblasts and osteoclast-like cells (n = 24). Qualitative histological evaluation was performed on undecalcified samples at 3 weeks postimplantation (n = 10). CT and decalcified tissue analysis was not performed blinded, but an analysis of undecalcified specimens was performed under blinded conditions.
Radiologic analysis revealed that the OCP/Gel group showed radiopaque regions around the OCP granules and at the edge of the defect margin 4 weeks after implantation, suggesting that new bone formation occurred in two ways. In contrast, the rat femurs in the Gel group had a limited radiopaque zone at the edge of the defect region. The amount of new bone volume analyzed by micro-CT was higher in the OCP/Gel group than in the Gel group at 4 and 8 weeks after implantation (4 weeks after implantation: OCP/Gel versus Gel: 6.1 ± 1.6 mm 3 versus 3.4 ± 0.7 mm 3 , mean difference 2.7 95% confidence interval (CI) 0.9 to 4.5; p = 0.002; intraclass correlation coefficient ICC 0.72 95% CI 0.29 to 0.91; 8 weeks after implantation: OCP/Gel versus Gel: 3.9 ± 0.7 mm 3 versus 1.4 ± 1.1 mm 3 , mean difference 2.5 95% CI 0.8 to 4.3; p = 0.004; ICC 0.81 95% CI 0.47 to 0.94). Histologic evaluation also showed there was a higher percentage of new bone formation in the OCP/Gel group at 4 and 8 weeks after implantation (4 weeks after implantation: OCP/Gel versus Gel: 31.2% ± 5.3% versus 13.6% ± 4.0%, mean difference 17.6% 95% CI 14.2% to 29.2%; p < 0.001; ICC 0.83 95% CI 0.53 to 0.95; 8 weeks after implantation: OCP/Gel versus Gel: 28.3% ± 6.2% versus 9.5% ± 1.9%, mean difference 18.8% 95% CI 11.3% to 26.3%; p < 0.001; ICC 0.90 95% CI 0.69 to 0.97). Bridging of the defect area started earlier in the OCP/Gel group than in the Gel group at 4 weeks after implantation. Osteocalcin immunostaining showed that the number of mature osteoblasts was higher in the OCP/Gel group than in the Gel group at 4 weeks (OCP/Gel versus Gel: 42.1 ± 6.5/mm 2 versus 17.4 ± 5.4/mm 2 , mean difference 24.7 95% CI 16.2 to 33.2; p < 0.001; ICC 0.99 95% CI 0.97 to 0.99). At 4 weeks, the number of osteoclast-like cells was higher in the OCP/Gel composite group than in the Gel group (OCP/Gel versus Gel: 3.2 ± 0.6/mm 2 versus 0.9 ± 0.4/mm 2 , mean difference 2.3 95% CI 1.3 to 3.5; p < 0.001; ICC 0.79 95% CI 0.35 to 0.94).
OCP/Gel composites induced early bone remodeling and cortical bone repair in less time than did the Gel control in a rat critical-size, transcortical femoral defect, suggesting that OCP/Gel could be used as a bone replacement material to treat severe bone defects.
In a transcortical bone defect model of critical size in the rat femur, the OCP/Gel composite demonstrated successful bone regeneration. Several future studies are needed to evaluate the clinical application of this interesting bone graft substitute, including bone formation capacity in refractory fracture and spinal fusion models and the comparison of bone strength after repair with OCP/Gel composite to that of autologous bone.
The aim of this study was to evaluate and compare the inter-operator reproducibility of three-dimensional (3D) images of teeth captured by a digital impression technique to a conventional impression ...technique in vivo.
Twelve participants with complete natural dentition were included in this study. A digital impression of the mandibular molars of these participants was made by two operators with different levels of clinical experience, 3 or 16 years, using an intra-oral scanner (Lava COS, 3M ESPE). A silicone impression also was made by the same operators using the double mix impression technique (Imprint3, 3M ESPE). Stereolithography (STL) data were directly exported from the Lava COS system, while STL data of a plaster model made from silicone impression were captured by a three-dimensional (3D) laboratory scanner (D810, 3shape). The STL datasets recorded by two different operators were compared using 3D evaluation software and superimposed using the best-fit-algorithm method (least-squares method, PolyWorks, InnovMetric Software) for each impression technique. Inter-operator reproducibility as evaluated by average discrepancies of corresponding 3D data was compared between the two techniques (Wilcoxon signed-rank test).
The visual inspection of superimposed datasets revealed that discrepancies between repeated digital impression were smaller than observed with silicone impression. Confirmation was forthcoming from statistical analysis revealing significantly smaller average inter-operator reproducibility using a digital impression technique (0.014± 0.02 mm) than when using a conventional impression technique (0.023 ± 0.01 mm).
The results of this in vivo study suggest that inter-operator reproducibility with a digital impression technique may be better than that of a conventional impression technique and is independent of the clinical experience of the operator.
Ceria-stabilized zirconia-alumina nanocomposite (Ce-TZP-Al2O3) has properties that may be suitable for partial denture frameworks. However, studies on its adhesion strength and durability with ...denture base resin are lacking.
The purpose of this in vitro study was to determine the optimal surface treatment for Ce-TZP-Al2O3 to secure a durable bond with an acrylic resin.
The surface of Ce-TZP-Al2O3 test specimens was alumina airborne-particle abraded (Group APA) and then treated with 10-methacryloyloxydecyl dihydrogen phosphate (MDP) (Group MDP) and 2 silica coating methods: the flame spraying method (Group SLP) and the tribochemical treatment (110 μm: Group TRB-P, 30 μm: Group TRB-S). TRB-P and TBR-S were further treated by MDP (Group CBT-P and CBT-S). Autopolymerizing acrylic resin was bonded to the specimens, and the shear bond strength was tested after thermocycling (5 °C and 60 °C, 10 000 cycles). The area of the resin remaining on the fractured surfaces was also measured. To evaluate the effect of the surface treatment condition on shear bond strength and the resin remaining, 1-way analysis of variance (ANOVA) was conducted, followed by the Tukey multiple comparison post hoc test. Additionally, the effect of thermocycling on the specimens was evaluated by the Student t test.
After placement in deionized water for 24 hours, the shear bond strengths of Group MDP and 2 types of combination treatment (Groups CBT-P and CBT-S) were significantly higher than those of Groups SLP, TRB-P, and TRB-S (P<.05). Moreover, the fractured surface of all the treatment conditions except Group APA showed cohesive failure. The shear bond strength as a result of all treatment conditions decreased significantly after thermocycling (P<.05). Group CBT-S showed the highest shear bond strength; however, no significant differences were found between Groups CBT-S and MDP (P=.908). In particular, the area of resin remaining on the fractured surfaces of Group CBT-S was 100% (cohesive failure).
The combined surface treatment of alumina airborne-particle abrasion and tribochemical treatment, along with primer treatment using silane coupling and an MDP monomer, improved the adhesion strength and adhesion durability between base resins and Ce-TZP-Al2O3.
Purpose: The effect of scan range and the number of scanned images on the precision of in vivo intermaxillary relationship reproduction was evaluated using digital scans acquired with an intraoral ...scanner.Methods: The study involved 15 participants with normal occlusion. Two different interocclusal recording settings were employed using the intraoral scanner (TRIOS 4): 'MIN,' focusing on the minimal scan range of the first molar region, and 'MAX,' including the scan range from the right first premolar to the right second molar. These settings were combined with three different image counts, resulting in six experimental conditions. Interocclusal recordings were performed four times for each condition. Dimensional discrepancies between datasets were analyzed using three-dimensional morphometric software and compared using two-way analysis of variance.Results: Median dimensional discrepancies (interquartile range; IQR) of 39.2 (30.7-49.4), 42.2 (32.6-49.3), 30.3 (26.8-44.1), 20.1 (16.0-34.8), 21.8 (19.0-25.1), and 26.6 (19.9-34.5) µm were found for MIN/200, MIN/400, MIN/600, MAX/200, MAX/400, and MAX/600, respectively. Significant differences in dimensional discrepancies according to scan range were found. Wilcoxon signed-rank test showed significant differences between MAX and MIN (P < 0.01).Conclusion: Scan range may affect the precision of intermaxillary relationship reproduction. Thus, scanning of the most extensive region practically achievable is recommended.
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