Accuracy of impression scan bodies for complete arch fixed implant-supported restorations

Abstract

Statement of problemDespite the extensive studies on and comparisons of different implant impression techniques for completely edentulous patients, studies on novel techniques that combine conventional impression making with digital scanning are lacking. PurposeThe primary aim of this study was to compare the accuracy of the impression scan body technique with conventional impression making and digital scanning for a completely edentulous mandibular arch. The secondary aim was to assess the relationship between different implant angulations and interimplant distances in relation to the recording accuracy. Material and methodsAn edentulous mandibular definitive cast (control) was designed with 5 implants placed at different angles and interimplant distances. Three recording techniques were tested: a conventional impression with splinted copings (conventional) (n=15), an impression scan body technique where impression scan bodies were attached to the splinted impression copings in a conventional elastomeric impression and then digitally scanned with an extraoral scanner (n=15), and an intraoral digital scanning technique (digital) (n=15). For comparison, the definitive cast and the conventional impression stone casts were digitized into standard tessellation language (STL) datasets using the extraoral scanner. The 3-dimensional (3D) deviations between the 3 test groups and the control were calculated by superimposing the STL datasets. The 3D deviations from the control were compared by using the Kruskal-Wallis test followed by the Dunn post hoc test (α=.05). The Mann-Whitney test was used to investigate the effect of implant angulation and interimplant distance on impression accuracy (α=.05). ResultsThe conventional splinted-coping impression technique showed a mean 3D deviation of 0.408 mm. The impression scan body and intraoral digital scan showed similar mean 3D deviations, 0.219 mm and 0.257 mm, respectively (P=.334). Both techniques showed significantly lower 3D deviations than the conventional technique (P<.001). Implants at an angle of 5 degrees and 10 degrees showed a statistically significant difference (P=.010) with mean 3D deviations of 0.340 mm and 0.396 mm, respectively. Implants with 5-mm and 10-mm interimplant distance showed a significant difference (P<.001) with mean 3D deviations of 0.301 mm and 0.423 mm, respectively. ConclusionsThe impression scan body technique is comparable with intraoral digital scanning for a completely edentulous arch. Increased implant angulation and increased interimplant distance significantly reduced the accuracy of implant impression making or scanning.