Effect of intraoral scanner and fixed partial denture situation on the scan accuracy of multiple implants: An in vitro study.

Abstract

Accuracy of intraoral implant scans may be affected by the region of the implant and the type of the intraoral scanner (IOSs). However, there is limited knowledge on the scan accuracy of multiple implants placed for an implant-supported fixed partial denture (FPD) in different partially edentulous situations when digitized by using different IOSs. To investigate the effect of IOS and FPD situation on the scan accuracy of two implants when partial-arch scans were performed. Tissue level implants were placed in 3 maxillary models with implant spaces either at right first premolar and right first molar sites (Model 1, 3-unit FPD), at right canine and right first molar sites (Model 2, 4-unit FPD), or at lateral incisor sites (Model 3, 4-unit FPD). Reference standard tessellation language (STL) files of the models were generated by using an optical scanner (ATOS Capsule 200MV120). Two IOSs (CEREC Primescan [CP] and TRIOS 3 [TR]) were used to perform partial-arch scans (test-scans) of each model (n=14), which were exported in STL format. A metrology-grade analysis software (GOM Inspect 2018) was used to superimpose test-scan STLs over the reference STL to calculate 3D distance, inter-implant distance, and angular (mesiodistal and buccopalatal) deviations. Trueness and precision analyses were performed by using bootstrap analysis of variance followed by Welch tests with Holm correction (α=0.05). Trueness of the scans was affected by IOS and FPD situation when 3D distance deviations were considered, while inter-implant distance, mesiodistal angular, and buccopalatal angular deviations were only affected by the FPD situation (p < 0.001). Scan precision was affected by the interaction between the IOSs and the FPD situation when 3D distance and buccopalatal angular deviations were concerned, while IOSs and FPD situation were effective when all deviations were concerned (p≤ 0.001). When 3D distance deviations were considered, CP scans had higher accuracy TR scans in Models 1 and 3 (p ≤ 0.002), and the Model 1 scans had the highest accuracy (p < 0.001). When inter-implant distance deviations were considered, Model 1 scans had the highest accuracy with CP and higher accuracy than Model 2 when TR was used (p ≤ 0.030). When mesiodistal angular deviations were considered, Model 1 scans had the highest accuracy (p ≤ 0.040). When buccopalatal angular deviations were considered, Model 1 scans had the highest accuracy among models when CP was used (p ≤ 0.020). Posterior 3-unit fixed partial denture implant scans, CP scans, and combination of these two factors had accuracy either similar to or better than their tested counterparts.