• Imaging Science in Dentistry
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• v.53 no.1
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• pp.21-26
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• 2023

Purpose: A fully digital approach to oral prosthodontic rehabilitation requires the possibility of combining (i.e., registering) digital documentation from different sources. This becomes more complex in an edentulous jaw, as fixed dental markers to perform reliable registration are lacking. This validation study aimed to evaluate the reproducibility of 1) intraoral scanning and 2) soft tissue-based registration of an intraoral scan with a cone-beam computed tomography (CBCT) scan for a fully edentulous upper jaw. Materials and Methods: Two observers independently performed intraoral scans of the upper jaw in 14 fully edentulous patients. The palatal vault of both surface models was aligned, and the inter-observer variability was assessed by calculating the mean inter-surface distance at the level of the alveolar crest. Additionally, a CBCT scan of all patients was obtained and a soft tissue surface model was generated using patient-specific gray values. This CBCT soft tissue model was registered with the intraoral scans of both observers, and the intraclass correlation coefficient(ICC) was calculated to evaluate the reproducibility of the registration method. Results: The mean inter-observer deviation when performing an intraoral scan of the fully edentulous upper jaw was 0.10±0.09 mm. The inter-observer agreement for the soft tissue-based registration method was excellent(ICC=0.94; 95% confidence interval, 0.81-0.98). Conclusion: Even when teeth are lacking, intraoral scanning of the jaw and soft tissue-based registration of an intraoral scan with a CBCT scan can be performed with a high degree of precision.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.245-256
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• 2023

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

• The korean journal of orthodontics
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• v.51 no.2
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• pp.95-104
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• 2021

Objective: To evaluate the trueness and precision of full-arch scans acquired using five intraoral scanners and investigate the factors associated with the dimensional accuracy of the intraoral scan data. Methods: Nine adult participants (mean age, 34.3 ± 8.3 years) were recruited. Four zirconium spheres (Ø 6 mm) were bonded to the canines and the molars. Following acquisition of reference scans using an industrial-grade scanner, five intraoral scanners, namely i500, CS3600, Trios 3, iTero, and CEREC Omnicam, were used to scan the arches. Linear distances between the four reference spheres were automatically calculated, and linear mixed model analysis was performed to compare the trueness and precision of the intraoral scan data among the different scanners. Results: The absolute mean trueness and precision values for all intraoral scanners were 76.6 ± 79.3 and 56.6 ± 52.4 ㎛, respectively. The type of scanner and the measured linear distances had significant effects on the accuracy of the intraoral scan data. With regard to trueness, errors in the intermolar dimension and the distance from the canine to the contralateral molar were greater with Omnicam than with the other scanners. With regard to precision, the error in the linear distance from the canine to the molar in the same quadrant was greater with Omnicam and CS3600 than with the other scanners. Conclusions: The dimensional accuracy of intraoral scan data may differ significantly according to the type of scanner, with the amount of error in terms of trueness being clinically significant.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.425-431
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• 2019

This clinical case report describes the digital workflow that combines a face scan, cone beam computed tomography and an intraoral scan to visualize the outcome of prosthodontic treatment in the anterior region. This approach improves communication between clinic, laboratory and patients. A patient with healthy general condition came for a restorative treatment to treat post-traumatic central incisors of maxilla. A virtual patient replica was made by incorporating a face scan, cone beam computed tomography and an intraoral scan. Design mockup of definitive restorations was shown to the patient and modified according to the patient's desire. This digital workflow facilitates the fabrication of optimal esthetic restorations, and enhances the predictability of outcome of restorations.

• The Journal of the Korean dental association
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• v.57 no.9
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• pp.524-528
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• 2019

With the advances of CAD-CAM (computer-aided design and computer-aided manufacturing) technology, the field of modern clinical dentistry has been dramatically changed. The first step in the digital workflow for tooth-supported dental prosthesis is a data acquisition with intraoral digital or conventional impression techniques. For the accuracy of intraoral digital impression data, the basic principles of conventional impression should be applied. It is necessary to obtain a good visibility with properly-dried field and well-exposed margin of the prepared abutment. Currently, the equi- or supra-gingival finish line can be recommended as an indication for intraoral digital impression. The scan data are generally exported to '.stl' file format, which has only morphological information of black and whitem while '.obj' file format can store data on color and texture.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.1
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• pp.57-64
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• 2022

Additional dentition images are needed because the dentitions are distorted in cone-beam computed tomography (CBCT) due to streak artifacts and non-uniformity of the x-ray beam. The purpose of this study is to evaluate the feasibility of improving the dentition image of CBCT scan with intraoral scanner instead of plaster models. Maxilla images from plaster models, two intraoral scanners, and CBCT of 20 patients aged 12 to 18 were used in this study. With one of the intraoral scanners, the full arch was scanned by three segments and combined into a complete full arch. Virtual skull-dentition hybrid images from intraoral scanners were superimposed with the images from plaster models to evaluate the coordinate value difference and distance at reference points. The results showed that the coordinate value difference and distance were smallest with segmented intraoral scan, which showed only 2 ㎛ distance. Intraoral scan may provide good dentition images for virtual skull-dentition images.

• Journal of Korean society of Dental Hygiene
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• v.24 no.4
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• pp.271-280
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• 2024

Objectives: This study aimed to test whether the digital competence of dental hygienists can affect their intraoral scanning potential in terms of scan time and error. Methods: Dental hygienists and dental hygiene students who had never used an intraoral scanner were surveyed to determine their digital competence. Individual data collected using an intraoral scanner was compared with reference data collected using a model scanner to identify scanning errors, and participants' scanning times were measured. Results: A significant decrease in scanning time was observed as the overall level of digital competence increased. The increase in digital skills and digital knowledge led to a decrease in scanning time by 3.73 and 3.98 minutes, respectively. Conclusions: This study found that digital competence was associated with reduced scan times, but less so with scan errors. This may be due to recent advances in scanning software, and future studies may need to develop a digital competence assessment tool that is more appropriate for the dental field.

• The Journal of Advanced Prosthodontics
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• v.15 no.4
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• pp.179-188
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• 2023

PURPOSE. This in vitro study aimed to evaluate the performance of digital intraoral scanners in a completely edentulous patient with angled and parallel implants. MATERIALS AND METHODS. A total of 6 implants were placed at angulations of 0°, 5°, 0°, 0°, 15°, and 0° in regions #36, #34, #32, #42, #44, and #46, respectively, in a completely edentulous mandibular polyurethane model. Then, the study model created by connecting a scan body on the implants was scanned using a model scanner, and a 3D reference model was obtained. Three different intraoral scanners were used for digital impressions (PS group, TR group, and CS group, n = 10 in each group). The distances and angles between the scan bodies in these measurement groups were measured. RESULTS. While the Primescan (PS) impression group had the highest accuracy with 38 ㎛, the values of 104 ㎛ and 171 ㎛ were obtained with Trios 4 IOSs (TR) and Carestream 3600 (CS), respectively (P = .001). The CS scanner constituted the impression group with the highest deviation in terms of accuracy. In terms of dimensional differences in the angle parameter, a statistically significant difference was revealed among the mean deviation angle values according to the scanners (P < .001). While the lowest angular deviation was obtained with the PS impression group with 0.185°, the values of 0.499° and 1.250° were obtained with TR and CS, respectively. No statistically significant difference was detected among the impression groups in terms of precision values (P > .05). CONCLUSION. A statistically significant difference was found among the three digital impression groups upon comparing the impression accuracy. Implant angulation affected the impression accuracy of the digital impression groups. The most accurate impressions in terms of both distance and angle deviation were obtained with the PS impression group.

• The Journal of Advanced Prosthodontics
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• v.14 no.5
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• pp.294-304
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• 2022

PURPOSE. The purpose of this study was to evaluate the influence of different palatal vault configurations on the accuracy and scan speed of intraoral scans (IO) of completely edentulous arches. MATERIALS AND METHODS. Three different virtual models of a completely edentulous maxillary arch with different palatal vault heights- Cl I moderate (U-shaped), Cl II deep (steep) and Cl III shallow (flat)-were digitally designed using CAD software (Meshmixer; Autodesk, USA) and 3D-printed using SLA-based 3D-printer (XFAB; DWS, Italy) (n = 30; 10 specimens per group). Each model was scanned using intraoral scanner (Trios 3; 3Shape^TM, Denmark). Scanning time was recorded for all samples. Scanning accuracy (trueness and precision) were evaluated using digital subtraction technique using Geomagic Control X v2020 (Geomagic; 3DSystems, USA). One-way analysis of variance (ANOVA) test was used to detect differences in scanning time, trueness and precision among the test groups. Statistical significance was set at α = .05. RESULTS. The scan process could not be completed for Class II group and manufacturer's recommended technique had to be modified. ANOVA revealed no statistically significant difference in trueness and precision values among the test groups (P=.959 and P=.658, respectively). Deep palatal vault (Cl II) showed significantly longer scan time compared to Cl I and III. CONCLUSION. The selection of scan protocol in complex cases such as deep palatal vault is of utmost importance. The modified, adopted longer path scan protocol of deep vault cases resulted in increased scan time when compared to the other two groups.

• The Journal of Advanced Prosthodontics
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• v.16 no.4
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• pp.201-211
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• 2024

PURPOSE. The aim of this prospective clinical study was to compare the influence of palatal vault forms on accuracy and speed of intraoral (IO) scans in completely edentulous cases. MATERIALS AND METHODS. Based on the palatal vault form, participants were divided into three equal groups (n = 10 each); Class I: moderate; Class II: deep; Class III: flat palatal vault. A reference model was created for each patient using polyvinylsiloxane impression material. The poured models were digitized using an extraoral scanner. The resultant data were imported as a solid CAD file into 3D analysis software (GOM Inspect 2018; Gom GmbH, Braunschweig, Germany) and aligned using the software's coordinate system to determine its X, Y, and Z axes. Five digital impressions (DIs) of maxilla were captured for each patient using an intraoral scanner (TRIOS; 3Shape A/S, Copenhagen, Denmark) and the resultant Standard Tessellation Language (STL) scan files served as test models. Trueness was evaluated by calculating arithmetic mean deviation (AMD) of the vault area between reference and test files while precision was evaluated by calculating AMD between captured scans to measure repeatability of scan acquisition. The scan time taken for each participant was also recorded. RESULTS. There was no significant difference in trueness and precision among the groups (P = .806 and .950, respectively). Average scan time for Class I and III palatal vaults was 1 min 13 seconds and 1 min 37 seconds, respectively, while class II deep palatal vaults showed the highest scan time of 5 mins. CONCLUSION. Palatal vault form in edentulous cases has an influence on scan time. However, it does not have a substantial impact on the accuracy of the acquired scans.