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In Vivo Accuracy and Precision in Prosthodontics
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: There has been a dramatic increase in commercially available intraoral scanners (IOS) in the last decade, offering to replace indirect digitization of models (MOD) fabricated from impressions (IMPR). IOS has benefits of less patient discomfort and a faster workflow to fabricate fixed dental prosthesis (FDP), and implant-supported prostheses (IFD). However, in vivo evidence is lacking not only for IOS, but also for MOD, FDP and IFD fit.

Aims: Paper I: to evaluate in vitro finish line distinction and accuracy in seven IOS and one MOD. To assess parameters of resolution, tessellation, topography, and color. Paper II: to evaluate a method of acquiring an in vivo reference measurement in dentate subjects and analyse accuracy and precision of IOS and MOD. Paper III: to evaluate an in vivo reference-measurement method in fully edentulous maxillae with full-arch implant treatments and to analyse accuracy of MOD and fit of existing IFD. Paper IV: to analyse precision and accuracy of IOS using different acquisition protocols compared to the reference-measurement in Paper III.

Material and Methods: Paper I: A model with a crown preparation was reference-scanned with an industrial scanner, (ATOS), scanned with seven IOS and the MOD of an IMPR was digitized. Best-fit Alignment and 3D Compare Analysis was followed by descriptive analysis. Paper II: A reference-scan was acquired with ATOS. Subjects were scanned with IOS and one MOD of an IMPR was digitized. Accuracy and precision were evaluated after Best-Fit Alignment and 3D Compare Analysis. Paper III: A reference-measurement of implant positions was acquired with ATOS. MOD from IMPR was digitized and IFD scanned. Datum and Relative Point System Alignment was followed by accuracy and precision analysis. Paper IV: Subjects in Paper III were scanned with IOS using three different protocols, followed by accuracy and precision analysis.

Results: Paper I: There were considerable differences between IOS depiction of finish line and finish line accuracy. Paper II: IOS presented varying results for impressions in up to ten units. No differences were found for MOD. Paper III: IFD was significantly less accurate than MOD. Paper IV: Differences were found between scanning protocols. Compared to Paper III, IFD was less accurate. No differences were found for MOD.

Conclusion: There are relevant differences between IOS when scanning subgingival preparations. Some IOS are better suited for long-span scans. Some IOS can be used for full-arch impressions for IFD in the maxilla, however, adequate soft-tissue management is crucial.  

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. , p. 51
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1625
Keywords [en]
accuracy, precision, in vivo, digital impression, intraoral scanner, polyether impression, implant impression, framework misfit, fully edentulous
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery; Oral and Maxillofacial Surgery
Identifiers
URN: urn:nbn:se:uu:diva-399689ISBN: 978-91-513-0840-1 (print)OAI: oai:DiVA.org:uu-399689DiVA, id: diva2:1379976
Public defence
2020-02-14, Gunnesalen, Psykiatrins Hus, Akademiska Sjukhuset, Ingång 10, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2020-01-24 Created: 2019-12-18 Last updated: 2020-03-05
List of papers
1. Finish line distinctness and accuracy in 7 intraoral scanners versus conventional impression: an in vitro descriptive comparison
Open this publication in new window or tab >>Finish line distinctness and accuracy in 7 intraoral scanners versus conventional impression: an in vitro descriptive comparison
2018 (English)In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 18, article id 27Article in journal (Refereed) Published
National Category
Surgery Medical Image Processing
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-348983 (URN)10.1186/s12903-018-0489-3 (DOI)000426323900001 ()29471825 (PubMedID)
Available from: 2018-02-23 Created: 2018-04-26 Last updated: 2019-12-18Bibliographically approved
2. Accuracy and precision of 3 intraoral scanners and accuracy of conventional impressions: A novel in vivo analysis method
Open this publication in new window or tab >>Accuracy and precision of 3 intraoral scanners and accuracy of conventional impressions: A novel in vivo analysis method
Show others...
2018 (English)In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 69, p. 110-118Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate a novel methodology using industrial scanners as a reference, and assess in vivo accuracy of 3 intraoral scanners (IOS) and conventional impressions. Further, to evaluate IOS precision in vivo.

Methods: Four reference-bodies were bonded to the buccal surfaces of upper premolars and incisors in five subjects. After three reference-scans, ATOS Core 80 (ATOS), subjects were scanned three times with three IOS systems: 3M True Definition (3M), CEREC Omnicam (OMNI) and Trios 3 (TRIOS). One conventional impression (IMPR) was taken, 3M Impregum Penta Soft, and poured models were digitized with laboratory scanner 3shape D1000 (D1000). Best-fit alignment of reference-bodies and 3D Compare Analysis was performed. Precision of ATOS and D1000 was assessed for quantitative evaluation and comparison. Accuracy of IOS and IMPR were analyzed using ATOS as reference. Precision of IOS was evaluated through intra-system comparison.

Results: Precision of ATOS reference scanner (mean 0.6 mu m) and D1000 (mean 0.5 mu m) was high. Pairwise multiple comparisons of reference-bodies located in different tooth positions displayed a statistically significant difference of accuracy between two scanner-groups: 3M and TRIOS, over OMNI (p value range 0.0001 to 0.0006). IMPR did not show any statistically significant difference to IOS. However, deviations of IOS and IMPR were within a similar magnitude. No statistical difference was found for IOS precision.

Conclusion: The methodology can be used for assessing accuracy of IOS and IMPR in vivo in up to five units bilaterally from midline. 3M and TRIOS had a higher accuracy than OMNI. IMPR overlapped both groups. Clinical significance: Intraoral scanners can be used as a replacement for conventional impressions when restoring up to ten units without extended edentulous spans.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2018
Keywords
Digital impression, Intraoral scanner, Polyether impression, Accuracy, Precision, In vivo
National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-349829 (URN)10.1016/j.jdent.2017.12.006 (DOI)000425888000014 ()29246490 (PubMedID)
Available from: 2018-05-07 Created: 2018-05-07 Last updated: 2019-12-18Bibliographically approved
3. In vivo accuracy and precision of full-arch implant-supported restorative workflow. Part 1: impression, models and restorations
Open this publication in new window or tab >>In vivo accuracy and precision of full-arch implant-supported restorative workflow. Part 1: impression, models and restorations
Show others...
(English)In: Article in journal (Refereed) Submitted
Keywords
accuracy, precision, in vivo digital impression, intraoral scanner, polyether impression
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-399686 (URN)
Available from: 2019-12-15 Created: 2019-12-15 Last updated: 2020-02-17Bibliographically approved
4. In vivo accuracy and precision of full-arch implant-supported restorative workflow. Part 2: Intraoral scanning using different protocols
Open this publication in new window or tab >>In vivo accuracy and precision of full-arch implant-supported restorative workflow. Part 2: Intraoral scanning using different protocols
Show others...
(English)In: Article in journal (Refereed) Submitted
Keywords
accuracy, precision, in vivo, intraoral scanner, digital impressions, implant impressions, fully edentulous, framework misfit
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-399688 (URN)
Available from: 2019-12-15 Created: 2019-12-15 Last updated: 2020-02-17Bibliographically approved

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