Implant Impressions Research Articles

Direct vs. Indirect Digital Implant Impressions: A Time and Cost Analysis

Background/Objectives: This study aimed to compare the cost and time implications for implant-supported prosthesis comparing three digital impression techniques: digitization with an intraoral scanner, digitization of the conventional impression (without dental casts) and digitization of the stone models. Methods: To assess the time and cost of digital impression techniques on implants, time records on intraoral scans were consulted and three models were created with one, two and six implants to assess extraoral procedures time. Costs were evaluated based on material consumption, time expenditure and operator-related expenses. Time was recorded in three stages: (1) impression-taking, (2) model fabrication and (3) overall workflow completion. Statistical analysis was performed using ANOVA to compare cost and time differences across workflows. Results: Intraoral scanning presented a reduction in chair-side time between 4 and 20% when compared to extraoral techniques. For the three clinical situations evaluated, the intraoral scanning always presented the lowest cost. The extraoral digitization of impressions showed a reduction between 51.9% and 53.6% in laboratory time and between 3.5% and 7.6% in total cost compared to stone models digitization. Conclusions: The findings of this study indicate that intraoral scanning is a more cost-effective and time-efficient alternative to traditional impression methods, providing advantages in terms of reduced material use and shorter procedural durations.

Clinical Working Time and Patient Satisfaction Outcomes: A Crossover Trial Comparing Digital and Conventional Implant Impression Techniques.

Clinical Working Time and Patient Satisfaction Outcomes: A Crossover Trial Comparing Digital and Conventional Implant Impression Techniques.

Stereo-Photogrammetry for Impression of Full-Arch Fixed Dental Prosthesis—An Update of the Reviews

Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and Google Scholar was conducted to find systematic reviews published in the last 10 years. The PICdental® camera (IDITEC NORTH WEST, SL; Torrelodones, Spain) is a stereocamera that records implant positions in the mouth by means of photogrammetry with the objective of registering and obtaining a viable, reliable, and direct digital impression of the positions of the multiple implants. The use of photogrammetry via PiCdental® camera as an alternative to digital impression for multiple implants is an easy and trustworthy technique that permits an adequate fit without prosthetic complications.

In vitro Evaluation of Implant Impression Techniques and Elastomeric Materials: A Comparative Dimensional Accuracy Study

Abstract Context: Dimensional precision in implant impression. Aims: The purpose of this study was to comparatively evaluate the dimensional accuracy of two implant impression techniques with two different variants of vinyl polysiloxane impression material. Material and Methods: The edentulous mandible reference model was fabricated in clear resin. In the anterior region of the mandibular ridge, three dummy implants were placed in a spread-out configuration. Impressions were made using two elastomeric impression materials and two impression techniques using customised impression trays. Finished casts were then divided into four groups having four samples each. The mean centre-to-centre distances between adjacent analogues (in sample casts) and between adjacent implants (in the control cast) were measured with the help of a profile projector. Statistical Analysis Used: Data were analysed using Student’s t-test. Results: The open-tray technique showed more accurate results with a combination of medium body and light body, whereas in the closed tray technique, mono-phase vinyl polysiloxane appeared to be a better option. Amongst all, mono-phase with closed tray provided statistically significant results. P < 0.05 in Group C and other group’s P ≥ 0.05. Conclusions: Within the limitations of this study, both implant impression techniques appeared to be equally accurate depending on clinical conditions, temperature and time of the procedure. However, mono-phase impression material with closed tray provided statistically significant results.

Trueness of Intraoral Scanners in Different Scan Patterns for Full-Arch Digital Implant Impressions.

The optimal scan pattern for full-arch digital implant impressions remains to be determined. This study aimed to analyze the effects of different scan patterns on the trueness of intraoral scanners for full-arch digital implant impressions. A maxillary plaster model with 4 implant analogs was employed as the master model. Scan bodies were attached to the master model and scanned with a laboratory scanner to obtain reference data. Test scans were obtained using 3 different scan patterns with Cerec Primescan and Trios 3. Each test datum was superimposed onto the reference data. The trueness was assessed by determining the 3D distance and angular deviations between the test and reference data. Significant differences in 3D distance deviation were detected among the scan patterns for both scanners. Significant differences in angle deviation were detected among the scan patterns for the Cerec Primescan, whereas it was not substantial for the Trios 3. Cerec Primescan exhibited superior trueness across all scan patterns compared with Trios 3. The zigzag pattern resulted in more accurate scans for the Cerec Primescan, whereas both the zigzag and occlusal-palatal-buccal patterns showed higher accuracy for the Trios 3.

Comparison of Intraoral Scanning Modes in Three Distinct Full- Arch Digital Implant Impression Scenarios: An In Vitro Study.

The purpose of this study was to analyze the effect of scanning modes on the accuracy of the Trios for full-arch digital implant impressions. The trueness and precision of the intraoral scanning mode (IOSM) and the intraoral edentulous scanning mode (IOEM) of the Trios were evaluated in three edentulous models, each featuring 4, 6, and 8 implant analogues. Reference scanning data were obtained by scanning each model with a desktop scanner. Each model was scanned 10 times using the IOSM and IOEM modes of the Trios to establish the test groups. The scan bodies in the test and reference scans were isolated and exported in the reverse engineering program. The scan bodies in each group were superimposed with the corresponding reference scan (trueness) or with each other (precision). The overall 3D deviation between the aligned scan bodies was computed by the root-meansquare (RMS) values. As a result of the trueness and precision evaluation, no significant difference was found between scanning modes in any of the models. When comparing models, the 8-implant model showed significantly lower trueness than the 4-implant model. However, it also exhibited significantly higher precision when compared to both the 4-implant and 6-implant models. There were no significant differences in other pairwise comparisons between the models. Trueness and precision values were similar between the IOSM and IOEM groups across all the models. An increase in the number of implants in complete edentulous arches may have a negative impact on digital impression accuracy.

Evaluation of Implant Impression Accuracy Using Different Trays and Techniques with a 3D Superimposition Method.

To evaluate the dimensional accuracy of implant impressions obtained using five different tray types and two techniques. A partially dentate maxillary Kennedy Class II model was created as a reference model through 3D printing. Then, implant analogs 4.3 mm in diameter were placed at the first premolar, first molar, and second molar sites. Five types of trays were used to create impressions: (1) metal stock trays, (2) plastic stock trays, (3) custom trays fabricated using liquid crystal display (LCD), (4) custom trays fabricated using fused deposition modeling (FDM), and (5) custom trays fabricated using urethane dimethacrylate (UDMA) resin. Open and closed tray techniques were also compared. In total, 150 impressions were obtained. The reference model and impressions were scanned using a laboratory scanner. Additionally, the positional and angular deviations of implants with different tray types and techniques were evaluated using the superimposition method. There was no statistically significant difference (P > .05) between the impression accuracy with the different tray types and impression techniques. The angular deviations with plastic and UDMA trays were greater than those with metal, FDM, and LCD trays. Angular deviation at the second molar was greater when using closed plastic trays compared to open plastic trays. The highest and lowest positional deviations were observed at the first molar implant with an open plastic tray impression (mean ± SD of 62.46 ± 28.54 mm) and a closed LCD tray impression (36.59 ± 29.93 mm). The greatest angular deviation was observed with an open FDM tray impression at the first premolar implant (0.067 ± 0.024 degree), and the lowest angular deviation was observed with a closed metal stock tray impression at the second molar implant (0.039 ± 0.025 degree). Statistical differences were detected using the Mann-Whitney U test for paired groups and the Kruskal-Wallis test for groups with more than three comparisons (P > .05). Plastic and metal stock trays or conventional and 3D-printed custom trays can be used to obtain implant impressions for maxillary partially edentulous arches with similar dimensional accuracy. The five tray types and two techniques may be safely used to obtain impressions of partially edentulous maxillary arches with three implants.

Update on the Accuracy of Digital Implant Impressions in 2023: A Coordinate-Based Analysis.

To update data on the transfer accuracy of digital implant impressions by using a coordinate-based analysis, latest intraoral scanners (IOSs) were investigated in an established clinical close model set-up. An implant master model (IMM) of the maxilla with four implants in the posterior area (#14/#24 and #16/#26) and a reference cube was scanned with four different IOS (i700 (Medit), Primescan (Dentsply Sirona), Trios 4 and Trios 5 (3Shape) ten times each. Datasets were compared with a reference dataset of IMM that was generated with x-ray computed tomography in advance. 3D deviations for the implant-abutment-interface points (IAIPs) were calculated. Statistical analysis was performed by multifactorial ANOVA (p < .05). Overall deviations for trueness (mean) ± precision (SD) of the IAIPs ranged from 88±47 μm for the Primescan, followed by 112±57 μm for the i700, 121±42 μm for the Trios 4 and 124±43 μm for the Trios 5 with decreasing accuracy along the scan path. For trueness, one significant difference between the Primescan and the T4 was detected for one implant position. For precision, no significant differences were noticed. Although the latest IOS showed a significant improvement in transfer accuracy, the accumulating deviation along the scan path is not yet resolved. Considering the Trios system, the innovation seems to be limited as no improvement could be detected between Trios 4 and 5.

Effect of a Novel ‘Scan Body’ on the In Vitro Scanning Accuracy of Full-Arch Implant Impressions

ObjectiveThis in vitro study aimed to determine whether a newly designed arcuate scan body can improve intraoral scanning accuracy for implant rehabilitation of edentulous jaws. Material and methodsA master model containing 4 implant abutment replicas was fabricated and digitized with different scan bodies using an intraoral scanner. Four types of scan bodies were evaluated: original scan bodies (group OS), computer-aided design and computer-aided manufacturing (CAD/CAM) scan bodies without extension (group CS), CAD/CAM scan bodies with straight extension (group CSS), and CAD/CAM scan bodies with arcuate extension (group CSA). Conventional splinted open-tray impressions (group CI) were used as controls. The master model and the poured casts were digitized using a laboratory scanner. Impressions were repeated 10 times each in 5 groups. Scans in standard tessellation language format were exported to reverse engineering software and root mean square (RMS) values were used for trueness and precision assessments. In each group, 45 RMS values were acquired for precision evaluation and 10 RMS values were obtained for trueness assessment. Statistical evaluation was performed with the Kruskal–Wallis test and Dunn–Bonferroni test (α = 0.05). ResultsThe median trueness values were 41.40, 55.95, 39.80, 39.75, and 22.30 μm for group OS, CS, CSS, CSA, and CI, respectively. CI showed better trueness than OS (P = .020), CS (P < .001), and CSS (P = .035). The median precisions for group OS, CS, CSS, CSA, and CI were 47.40, 51.50, 43.90, 25.20, and 24.60 μm. respectively. The precision of CSA and CI were higher than OS (P < .001), CS (P < .001), and CSS (P < .001). Between CI and CSA, there was no significant difference (P = 1.000). ConclusionsFor full-arch implant rehabilitation, the scan body with arcuate extension could improve the intraoral scanning precision and showed similar 3-dimensional discrepancy compared to conventional splinted open-tray impressions.

Transfer of Guided Emergence Profile Developed Using Customized Provisional Implant Restoration and Cementation Using an Abutment Replica Technique: A Case Report.

The long-term success of dental implants depends not only upon implant osseointegration, but also on the surrounding soft tissue health and profile. An ideal emergence profile contributes to the aesthetics of an implant restoration. It maintains long-term implant health by preventing potential food accumulation and forming a barrier against bacterial ingress. This article describes a method for obtaining an impression of implants that will capture the custom guided peri-implant soft tissue contours accurately, thus contributing to a final restoration with favorable aesthetics. We also describe a technique for reducing excess cement in a cement retained implant crown, thereby contributing to the health of the peri-implant tissues.

3D Accuracy of a Conventional Method Versus Three Digital Scanning Strategies for Completely Edentulous Maxillary Implant Impressions

3D Accuracy of a Conventional Method Versus Three Digital Scanning Strategies for Completely Edentulous Maxillary Implant Impressions

Evaluating the Impact of Scan Body Angulation and Geometric Attachments on the Accuracy of Complete-Arch Digital Implant Impressions: A Comparison of Two Intraoral Scanners.

To investigate the effects of scan body (SB) angulation and geometric attachments on the deviations of complete-arch digital implant impressions obtained using intraoral scanners (IOSs), in relation to the gold-standard desktop scanner. Two intraoral scanners (iTero and Omnicam), two scan body angulations (0 degrees and 30 degrees), and geometric attachments (GAs) for the SBs were investigated. SBs were attached to an edentulous maxillary cast with the following implant analogs: parallel 0-degree at positions #13, #23, and #26, and 30-degree posteriorly tilted at position #16. The cast was digitized using a reference desktop scanner, followed by ten consecutive digital scans using each IOS (five scans with GAs and five without GAs, n = 20). Meshes obtained from the IOS scans were superimposed on the master reference mesh. Linear distance and 3D surface deviations from the reference mesh were calculated. A three-way multivariate analysis of variance (MANOVA) was employed to assess the effects of angulation, IOS type, and GAs on the combined dependent variables (α = 0.05). No significant three-way interaction was observed between IOS type, SB angulation, and GAs for combined deviations from the reference scan (p = 0.56). Simple main effect analysis revealed that iTero exhibited significantly lower mean 3D surface and linear deviations than Omnicam (p<0.05). Additionally, the use of GAs significantly reduced deviations (p<0.001), with mean deviation reductions for both scanners ranging from 26-33 micrometers (μm) for 3D deviations and 15-21μm for linear distance deviations. No differences were found between angled and parallel SBs regarding 3D surface and linear distance deviations (p≥0.05). iTero demonstrated significantly smaller deviations, and the use of GAs led to significantly reduced distance and 3D surface deviations. SB angulations did not impact scan deviations. This article is protected by copyright. All rights reserved.

Chairside 3-D printed impression trays: a new approach to increase the accuracy of conventional implant impression taking? An in vitro study

PurposeA high transfer accuracy of the intraoral implant position to a model is required, to manufacture implant-supported restorations. However, clinically relevant deviations persist between the intraoral implant position and the model obtained, even for the benchmark conventional custom implant impressions with polyether. Thus, new approaches using 3-D printed impression trays may increase the transfer accuracy of implant impressions. The ability to adjust parameters such as the thickness of the layers and the influence of the openings in the impression tray could potentially affect accuracy.MethodsFour different types of impression trays (n = 10 for each group) for the conventional impression technique were investigated: conventional custom impression tray, customized foil tray, chairside 3-D printed impression tray with the SHERA system, and the Primeprint system using an implant master model with four implants in the posterior region and a reference cube. After plaster model casting, all models were measured using a coordinate measuring machine, and the deviation from the reference dataset was determined. A statistical ANOVA analysis was performed (p < 0.05).ResultsChairside 3-D printed impression trays showed the best results, followed by conventional custom impression trays. Implant impressions obtained using a customized foil tray exhibited the lowest accuracy. Statistically significant differences were observed between 3-D printed impression trays and conventional custom impression and customized foil trays (p < 0.05). Whereas, the implant position did not have any significant influence on accuracy (p > 0.05).ConclusionsChairside 3-D printed impression trays significantly increase the transfer accuracy for implant impression taking.Graphical

A digital approach to create a virtual implant preliminary cast for the fabrication of a splinted framework and custom open tray for multiple implants impression making: A dental technique.

A digital approach is described for fabricating a splinted framework and custom open tray for the impression of multiple implants based on a virtually created implant cast with the digital prediction of the future impression coping positions. In this technique, impression copings to be used in the definitive impression-making process were digitally scanned and aligned to a preliminary cast using installed protective caps of screw-retained abutments as references, which resulted in a virtual cast that offers information both about the impression coping positions and their surrounding tissues and could allow a splinted framework and custom open tray to be digitally designed and fabricated. Creation of a virtual cast through digital technologies eliminates the traditional manual splinted framework and custom tray fabrication procedures. Additionally, only one set of impression copings and analogs is needed in this technique, thereby reducing treatment time and cost. It alsooffers a splinted framework and custom open tray with consistent quality.

Influence of Implant ScanBody Material and Intraoral Scanners on the Accuracy of Complete-Arch Digital Implant Impressions.

To evaluate the accuracy of complete-arch digital implant impressions using different intraoral scan body (ISB) materials and intraoral scanners (IOSs). The mandibular dental cast of an edentulous patient with six tissue-level dental implants was used as the master cast. Two types of ISBs-polyether ether ketone (PEEK) and plasma-coated medical titanium-were used with five IOSs: TRIOS 4 (T4), Virtuo Vivo (VV), Medit i700 (Mi700), iTero 5D (i5D), and Primescan (PS). To assess accuracy, digital impressions (n &#61; 10) with each IOS and ISB were compared to two reference models obtained by digitizing the master cast with each ISB type using a desktop scanner (IScan4D LS3i) and importing the scan data into metrology software (Geomagic Control X). Root mean square (RMS) error was employed to evaluate overall deviation values (trueness), while precision was determined using the SD of RMS values. Statistical significance was set at P < .05. Kruskal-Wallis test was used, followed by the pairwise comparison method with Bonferroni correction (α &#61; .05). An interaction between ISB material and IOS was found (P &#61; .001). Plasma-coated medical titanium ISBs demonstrated significantly higher trueness and precision compared to PEEK ISBs with T4 (P &#61; .001), Mi700 (P &#61; .001; P &#61; .004), and i5D (P &#61; .001). Conversely, VV exhibited higher trueness and precision values with PEEK ISBs (P &#61; .005; P &#61; .003). PS provided the highest trueness and precision regardless of the ISB material (P &#61; .912). T4 showed the lowest accuracy for PEEK ISBs, and VV showed the lowest accuracy for plasma-coated medical titanium ISBs. Except for PS, all IOSs showed significant differences between ISB materials. PS demonstrated the highest accuracy with both ISB materials, whereas T4 had the lowest accuracy for PEEK ISBs, and VV showed the lowest accuracy for plasma-coated medical titanium ISBs.

Implant impression technique preferences – survey study among dental practitioners

Implant impression technique preferences – survey study among dental practitioners

Trueness evaluation of latest generation intraoral scanners on complete arch implant impressions.

To evaluate the trueness of five intraoral scanners for a fully edentulous model with seven implants. The study model was created from gypsum with seven implant analogs that were placed with 2-mm gingival height and 0-degree angle at tooth sites 47, 45, 43, 31, 33, 35, and 37. The study model was scanned 10 times (n = 10) with five intraoral scanners (CS3600, Emerald S, Primescan, TRIOS 3, TRIOS 4). The study model was digitized with a high-resolution industrial desktop scanner, and the data were imported into a software (Geomagic Studio 2012) as the reference model. The trueness assessment was made digitally with superimposition using the software. Linear measurements were calculated by the differences between the centers of the scan bodies on the study vs the reference model. Volumetric deviations were calculated with root mean square values. Data obtained in the study were analyzed statistically. One-way analysis of variance and Tukey tests were used to evaluate significant interactions. A value of P < .05 was accepted as statistically significant. In linear measurements, TRIOS 4 showed the best trueness results, followed by TRIOS 3, Emerald S, Primescan, and CS3600. TRIOS 4 showed statistically truer results than CS3600 (P = .029). However, no statistically significant difference was found between groups in volumetric measurements (P < .05). All of the intraoral scanners used in the study showed favorable deviation values in an edentulous model with seven implants. TRIOS 4 showed the best trueness values. The latest generation of intraoral scanners can be used in full-arch implant impressions.

EPA Consensus Project Paper: Accuracy of Photogrammetry Devices, Intraoral Scanners, and Conventional Techniques for the Full-Arch Implant Impressions: A Systematic Review.

The objective of this systematic review was to evaluate and compare the accuracy of digital impression techniques and conventional methods for full-arch implant impressions. An electronic literature search in the databases Medline (Pubmed), Web of Science, and Embase was performed to identify in vitro and in vivo publications (between 2016 and 2022) directly comparing digital and conventional abutment-level impression techniques. All selected articles passed through the data extraction procedure according to defined parameters in inclusion and exclusion criteria. Measurements on linear, angular and/or surface deviations were performed in all selected articles. Nine studies met the inclusion criteria and were selected for this systematic review. 3 articles were clinical studies and 6 studies were in vitro. Accuracy difference mean values of the trueness up to 162+/-77μm between digital and conventional techniques were reported in the clinical studies and up to 43μm in laboratory studies. Methodological heterogeneity was observed in both, in vivo and in vitro studies. Intraoral scanning and photogrammetric method showed comparable accuracy for registering implant positions in the full-arch edentulous cases. A tolerable implant prosthesis misfit threshold and objective misfit assessment criteria (for linear and angular deviations) should be verified in clinical studies.

Comparative Analysis of Different Implant Impression Techniques: An In vitro Study

Introduction: Dental implants have emerged as the treatment of choice for restoring missing teeth in situations that require functional and aesthetic replacements. The aim of the study was to assess the dimensional accuracy of (1) the resultant casts made from different impression techniques for implants, (2) implant impressions using two types of splinting material for open tray technique, auto-polymerising acrylic resin and light-cure acrylic resin and impression techniques, including non-sectioning and sectioning and rejoining with the same splinting material. Materials and Methods: The present study was conducted to compare the accuracy of direct splinted implant impression techniques. There were four impression techniques selected: (1) direct impression technique with autopolymerising acrylic resin splint, (2) direct impression technique with autopolymerising acrylic resin splint sectioned 17 min after setting and welded with the same resin, (3) direct impression technique with light-cure acrylic resin splint and (4) direct impression technique with light-cure acrylic resin splint sectioned and welded with the same resin. Results: Comparison within the four impression groups with respect to distances X and Y with a master model by Tukey’s post-hoc procedures shows a statistically significant difference only for Group 1, showing P &lt; 0.05. Conclusion: There is a significant difference in the accuracy of the direct splinted implant impression technique with auto-polymerising acrylic resin without sectioning. Sectioning the auto-polymerising acrylic resin splint after 17 min and rejoining before impression making markedly increase the accuracy of implant impression. Splinting with light-cure acrylic resin shows a more accurate impression than the splint with auto-polymerising acrylic resin.

Effect of Plastic Impression-Transfer Copings on the Dimensional Accuracy of Implant Impressions

Purpose: The purpose of this in vitro study was to evaluate the effect of plastic impression transfer copings on the dimensional accuracy of close tray implant impressions. Methods: A master model was constructed using autopolymerizing acrylic resin. Five parallel holes were drilled for implant analogs. Custom impression trays were made with autopolymerizing polymethyl methacrylate resin. The study consisted of 2 groups (n=5): (group 1) Impression was obtained with using plastic impression transfer coping (group 2) Impression was obtained without using plastic impression transfer coping. Vinylpolysiloxane impression material was used for both groups. After the impression were obtained, casts were made by type IV dental stone. Casts were scanned with the lab-type scanner and transferred to the measurement program. Measurements were made from a specific reference corner for each analog to ensure standardization. Data were saved as millimeters and pairwise comparisons were made with Welch's t-test analysis. Results: The effect of plastic caps was evaluated by applying the t-test to each distance. For all distances, the distortion seen in the measurements taken without the cap is higher than the measurements taken with the cap, but no significant differences were found (p&amp;gt;0.05). Conclusions: In the anterior-posterior distances, the distortions were found compression type, in the right-left distances the distortions were found as expansion-type. There is a dimensional change in the measurements taken without a cap, but no clinically significant differences were found.