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  • Title: Comparing the accuracy of full-arch implant impressions using the conventional technique and digital scans with and without prefabricated landmarks in the mandible: An in vitro study.
    Author: Ke Y, Zhang Y, Wang Y, Chen H, Sun Y.
    Journal: J Dent; 2023 Aug; 135():104561. PubMed ID: 37236297.
    Abstract:
    OBJECTIVES: This study evaluated the accuracy of digital implant impressions with or without prefabricated landmarks compared with the conventional method in the edentulous mandible. METHODS: An edentulous mandibular stone cast with implant abutment analogs and scan bodies in FDI #46, #43, #33, and #36 served as the master model. The scans captured with intraoral scanners (IOS) were divided into four groups: IOS-NT (no landmarks + Trios 4 scanner), IOS-NA (no landmarks + Aoralscan 3 scanner), IOS-YT (landmarks + Trios 4 scanner), and IOS-YA (landmarks + Aoralscan 3 scanner) (n=10). Landmarks were attached to the scan bodies with resin to improve scanning fluency. Conventional open-trayed technique (CNV) was performed with the 3D-printed splinting frameworks (n=10). The master model and conventional castings were scanned using a laboratory scanner, and the former served as the reference model. Overall distance and angle deviations between scan bodies were measured to determine trueness and precision. The ANOVA or Kruskal-Wallis test compared CNV group to scans without landmarks, while a generalized linear model analyzed scan groups with and without landmarks. RESULTS: Compared to the CNV group, the IOS-NA and IOS-NT groups showed higher overall distance trueness (p=0.009), and precision (distance, p<0.001 and angular, p<0.001). With landmarks, the IOS-YA group had higher overall trueness (distance, p<0.001 and angular, p<0.001) than the IOS-NA group, and the IOS-YT group has higher distance trueness (p=0.041) than the IOS-NT group. Moreover, the precision in distance and angle was significantly improved for IOS-YA and IOS-YT groups, compared with the IOS-NA (p<0.001) and IOS-NT (p<0.001) groups separately. CONCLUSIONS: Digital scans were more accurate than conventional splinting open-trayed impressions. Prefabricated landmarks significantly improved the accuracy of full-arch implant digital scans, regardless of the scanner used. CLINICAL SIGNIFICANCE: Prefabricated landmarks can enhance the accuracy of intraoral scanners for full-arch implant rehabilitation, improving scanning efficiency and clinical outcomes.
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