inEos X5 Research Articles

Effect of the scanner type on the marginal gap and internal fit of two monolithic CAD/CAM esthetic crown materials: An in vitro study.

The durability of indirect restorations is significantly influenced by marginal adaptation and internal fit. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) with digital impressions has reduced dental prosthesis fabrication errors, improving the long-term survivability of the restorations. The present study assessed the impact of intraoral and extraoral scanning methods on the marginal adaptation and internal fit of 2 different types of monolithic crowns manufactured using CAD/CAM. A total of 40 three-dimensional (3D) resin-printed dies were randomly assigned to 2 groups based on the type of crown material (n = 20 per group). Each group was divided into 2 subgroups (n = 10 per group) according to the die-scanning technique: subgroup A, scanned using the intraoral scanner (IOS) Primescan; and subgroup B, scanned using the extraoral scanner (EOS) inEos X5. The digitized photos were converted into a 3D virtual crown design using CAD software. The internal discrepancy values, and the marginal gap between the 3D resin-printed die and the crown were assessed using a ×50 digital microscope. The data was checked for normality with the Kolmogorov-Smirnov test, and the Mann-Whitney U test was used to compare the tested groups. The collected data was analyzed at a significance level set at p < 0.05. The different scanning techniques used had a statistically significant effect on the vertical marginal gap and the internal fit [μm] (p < 0.05). As far as the crown materials are concerned, BRILLIANT Crios showed a significantly higher marginal gap as compared to Tetric CAD when scanned with inEos X5 (p = 0.004), whereas the differences were insignificant with regard to the internal fit (p > 0.05).The crown parameters tested with both scanning systems were within the clinically acceptable ranges. Scanning methods and crown materials had an impact on the internal fit and vertical marginal gap of monolithic crowns.

Effect of different storage conditions on dimensional accuracy of 3D-printed dental models.

The objective was to determine the accuracy of 3D-printed dental models subjected to different storage conditions using six different material and printer combinations. Three completely dentate models were designed using dental CAD software (3Shape Dental System). A horseshoe-shaped solid base with a posterior horizontal bar was used. The models were printed in a horizontal direction against the building platform without support. The models were printed using six printers with the corresponding recommended resin material: Carbon M2 (DPR10), HeyGears A2D4K (Model HP UV2.0), Stratasys J5 (MED610), Stratasys Origin One (DM200), Envision One (E-Model LightDLP), and Asiga Pro4K (VeriModel) with a standard layer thickness of 50 μm. All printed models underwent scanning using a laboratory scanner (Sirona inEOS X5) after printing. Subsequently, the models were randomly assigned into three groups of storage conditions, LT: cold environment (4±1°C), HT: hot and dry environment (50±2°C), and RT: room temperature (25±2°C) serving as the control. Each group was kept under the designated condition and was scanned at 1, 2, 3, 4, and 8 weeks. The total number of models (N) was 72, with 6 printers producing 12 models per printer for 3 storage conditions, resulting in 4 models for each storage condition and each printer. The generated STL files were imported into a 3D inspection software for comparison with the original STL files. In-tolerance percentage, the deviation RMS, trueness, and precision were obtained and analyzed with least square mean linear regression using JMP Pro 15 to identify the significant effects (α = 0.05). The in-tolerance percentage as-printed was significantly different among different printers. Significant dimension deviations were observed after the first week of storage at HT and with subsequent weeks of storage. RT and LT did not show significant dimensional changes. Models printed with Carbon M2 showed the highest in-tolerance percentages compared to the other printers. The model deviations were affected by storage conditions and the printer used, with high-temperature storage showed least stability compared to low and room temperatures. No significant difference was observed between low and room temperature storage conditions. The Carbon M2 printer showed the highest accuracy among all printers tested. The region had a significant effect on the deviation measured, with the abutment body showing the least deviation. Among the 3D printers evaluated, A2D4K by HeyGears and Carbon M2 printers demonstrated the highest accuracy in terms of both precision and trueness.

Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction

Aim: This study aims to evaluate and compare the scanning accuracy of various intraoral scanners when taking digital impressions of single-implant-supported prostheses. Methodology: A partially edentulous model with a single implant was produced, and a scan body was fixed on the model. The control model was created by scanning the model using Ineos X5 (CM). The model was also scanned (n = 3) using three different intraoral scanners (IOS) [(Helios (H), TRIOS 3 (T3), Medit (M)]. GOM Inspect software was used for comparison. The data were analyzed with a Shapiro–Wilk test, resulting in a nonnormal distribution, and Kruskal–Wallis test was employed for intergroup parameter comparisons. Results: There were significant differences in the devices’ accuracy values (p &lt; 0.05). Accuracy M (19.1 μm), T3 (25.3 μm), H (33.9 μm) and sensitivity values (M (10 μm), T3 (19.05 μm), H (25 μm)) are similarly listed from high to low as M, T3, and H. Conclusion: IOS can be used to create digital impressions for single-unit implant crowns. Clinicians should be cautious and selective when choosing IOS for more successful and accurate impressions. More comprehensive and clinical studies using different brands are needed on this subject. How to cite this article: Güzelce Sultanoğlu E, Keleş Eroğlu B. Evaluating the accuracy of intraoral scanners used in single-unit implant prosthesis construction. Int Dent Res 2023;13(S1):32-37. https://doi.org/10.5577/idr.2023.vol13.s1.5 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Positional transfer accuracy of titanium base implant abutment provided by two different scan body designs: an invitro study

BackgroundThe variabilities in design and material of scan bodies have a major role in the positional transfer accuracy of implants. The purpose of this invitro study was to compare the 3D transfer accuracy (trueness and precision) of titanium base (TB) abutment position provided by 2 different scan bodies: one-piece scan body (SB) in comparison to two-piece healing abutment and scan peg (HA-SP).MethodsA maxillary model with a dummy implant in the 2nd premolar (Proactive Tapered Implant; Neoss) was 3D printed and TB (Ti Neolink Mono; Neoss) was tightened on the implant and scanned by using a laboratory scanner (inEos X5; Dentsply Sirona) (reference scan). An SB (Elos Medtech) and an HA-SP (Neoss) were subsequently connected to the implant and were scanned 10 times each by using the same scanner (test scans). All the scans were exported as STL files and imported into CAD software where the TBs were formed. Test scans were superimposed on reference scans for transfer accuracy analysis using 3D metrology software (GOM Inspect; GOM GmbH) in terms of angular deviation in vertical and horizontal directions, linear deviation in each XYZ axis of TBs and total linear deviation in all axes. Statistical analysis was done using independent sample t test. When Levene’s test for equality of variances was significant, Welch’s t-test was used. (P value < 0.05)ResultsSignificant differences were found amongst the tested groups in both angular and linear deviation in terms of trueness with less deviation values for the SB group (P < 0.001). For the precision, significant differences were found amongst the tested groups in angular deviation in vertical direction with less deviation value for the SB group compared to HA-SP group (P < 0.001). However, no significant difference was found between the tested groups regarding the angular deviation in horizontal direction (P = 1.000). Moreover, significant differences were found amongst the tested groups in linear deviations with less linear deviations in XYZ axes for SB compared to HA-SP group (P = 0.020, < 0.001, = 0.010 respectively).ConclusionsSB showed less angular and linear deviation values in the 3D positional transfer of TB than HA-SP indicating higher degree of accuracy of SB.

Effect of substrate adjacent to the scan region on the trueness of four intraoral scanners: An in vitro study

ObjectivesThe purpose of this in vitro study was to evaluate the trueness of four commercially available intraoral scanners (IOSs) on scanning different substrates that existed in the adjacent proximal contact area. MethodsFour IOSs (TRIOS 4, TRIOS 3, Primescan, Omnicam) were used for scanning the intact enamel surface of a molar tooth, and six restorative materials (zirconia, lithium disilicate glass-ceramic, composite resin, hybrid ceramic, feldspathic ceramic, metal) that were located at the adjacent proximal contact area of the same tooth. Reference scans were obtained using an extraoral scanner (inEos X5). A 3-dimensional analyzing software (Geomagic Control X) was used to compare the reference and tested scans. The two-way analysis of variance (ANOVA) followed by Bonferroni correction was performed for statistical analyses (α=0.05). ResultsTRIOS 3 and TRIOS 4 showed higher trueness than Primescan, and Primescan showed higher trueness than Omnicam (p<0.001), while there were no differences between TRIOS 3 and TRIOS 4. Metal showed significantly higher Root Mean Square values (0.273 ± 0.24 mm) than other substrates. No difference was found between the scanners’ zirconia, lithium disilicate glass-ceramic, composite, and feldspathic ceramic scans (p > 0.05). For the metal, TRIOS 3 and TRIOS 4 showed higher trueness than Primescan and Omnicam, while Omnicam showed lower trueness among all scanners. For the hybrid ceramic, TRIOS 3 showed higher trueness than Omnicam (p<0.001). For the enamel, TRIOS 3 showed higher trueness than Primescan and Omnicam (p<0.001). ConclusionsThe trueness of IOSs can be affected by the substrates that exist in the proximal contact area. Amongst all, the metal substrate affected most the trueness of the IOSs. Clinical SignificanceThe clinician should decide on the impression system, taking into account that the IOS and the surfaces to be scanned affect the trueness of the digital data. The deviation of the digital impression would be high in the presence of a metal restoration on the adjacent proximal surface.

Trueness and precision of mandibular complete-arch implant scans when different data acquisition methods are used

ObjectivesTo evaluate the effect of different data acquisition methods on the trueness and precision of mandibular complete-arch implant scans. MethodsAn edentulous polyurethane master mandibular model with 6 implants was digitized by using an industrial-grade blue light scanner (ATOS Core 80 5MP) to obtain a master standard tessellation language (MSTL) file. The master model was also digitized by using either direct digital workflow with a stereoscopic camera (iCam 4D (IM)) or intraoral scanners (CEREC Primescan (PS) and Trios 4 (T4)) or indirect digital workflow with laboratory scanners (inEos X5 (X5) and CARES 7 (S7)) to obtain test-scan STLs (n = 10). All STL files were imported into a metrology-grade analysis software (Geomagic Control X 2020.1) and test-scan STLs were superimposed over MSTL. The root mean square method was used to calculate surface deviations, while angular deviations were also calculated. Kruskal–Wallis and Dunn's tests were used to evaluate measured deviations (surface and angular) for trueness and precision (α = 0.05). ResultsX5 and S7 had the lowest, and IM had the highest surface deviations (P ≤ .036). The angular deviations of PS were lower than those of X5, S7, and IM (P ≤ .008). When surface deviations were considered, T4 had the lowest precision among tested scanners (P ≤ .002), and the scans of IM had higher precision than those of PS (P = .003). Scanner type did not affect the precision of the scans when angular deviations were considered (P = .084). ConclusionsThe data acquisition method affected the trueness (surface and angular deviations) and precision (surface deviations) of mandibular complete-arch implant scans. Clinical significanceTested data acquisition methods may be feasible to digitize mandibular complete-arch implants considering the deviations of the scans, which were in the range of previously reported thresholds, and the high precision of scans. However, the frameworks fabricated with the direct digital workflow that involves the scans of the stereoscopic camera might require more adjustments than those fabricated by using the scans of other tested scanners.

Effect of different intraoral scanners and post-space depths on the trueness of digital impressions.

The trueness of intraoral scanners (IOSs) has been evaluated in many clinical situations. However, the tests of their performance when scanning post-space preparations are still lacking. The aim of the present study was to compare the trueness of the digital impressions of post spaces with different depths, captured by means of different IOSs. Digital impressions of teeth (N = 16) with post spaces of depths of 8 mm and 10 mm were captured. Three IOSs were used, including Primescan AC, Medit i500 and CS 3600. The STL files were compared to the files obtained from the traditional impression scanning performed with an InEos X5 desktop scanner. Then, reverse engineering software measured the trueness values, which were analyzed using the two-way analysis of variance (ANOVA), followed by Tukey's post-hoc test. The significance level was set at p < 0.05. Significant differences were found between the scanners in terms of root mean square (RMS) values (p < 0.001). The highest RMS value was found for CS 3600 (0.30 ±0.11 mm), followed by Primescan AC (0.26 ±0.09 mm), while the lowest value was found for Medit i500 (0.18 ±0.05 mm). The 8-millimeter-deep post spaces had a significantly higher RMS value than the 10-millimeter-deep ones (0.28 ±0.10 mm and 0.21 ±0.09 mm, respectively) (p = 0.009). The Medit i500 scanner showed the highest post-space digital impression trueness as compared to Primescan AC and CS 3600. In the digital impressions captured with CS 3600, the 10 mm postspace depth had higher trueness than the 8 mm depth. Moreover, CS 3600 was less able to capture the full length of both the 8 mm and 10 mm post-space depths than Primescan AC and Medit i500.

Evaluation the Scanning Accuracy of Blue-Light Laboratory Scanners in Complete Edentulous Maxilla with Multiple Implants with Titanium Scan Bodies

To evaluate the accuracy of complete arch scanning with multiple implant titanium scan bodies using laboratory scanners. A master model of an edentulous maxillary arch with 6 implants was fabricated. Titanium scan bodies were inserted into the model. Three laboratory scanners were used: D2000 (3Shape), Vinyl High Resolution (Smart Optics), and inEos X5 (Dentsply Sirona). The master model was consecutively scanned ten times using dental laboratory scanners (LS) without detaching and repositioning the scan bodies. Linear and angular accuracy between adjacent implants was measured using inspection software (Control X, Geomagic). The accuracy of the complete arch scans was calculated. Implant regions were defined as; parallel (R1: #24-26 and #16-14), angled (R2: #22-24 and #14-12), angled to occlusal plane (R3: #12-22), and cross-arch (R4: #16-26). The effect of LS and implant region on accuracy was compared using two-Way ANOVA (α=0.05). Significant greater linear distortion was noted in R4 (61.2±17.9µm) compared to R1 (23.4±15.5µm) and R2 (26±17.7µm) (p&lt;0.01). Greater linear distortions were noted in R4 with D2000 (0.07±0.016 degrees) and Vinyl High Resolution (0.067±0.02 degrees) than inEos X5 (0.032±0.021 degrees) (p&gt;0.05). Greater mean linear precisions were noted in R1 (9±8µm) and R3 (9.3±8.3µm) than R4 (12.6±10.3µm) (p&lt;0.05). The highest linear precision was noted in D2000 (7.2±7.6µm) (p&lt;0.05). The angular precision of D2000 (0.02±0.015 degrees) was the highest (p&lt;0.01). The angular precision of R4 (0.036±0.018 degrees) was the lowest (p&lt;0.01). This study revealed that the trueness was affected by the implant region and the precision was affected by both LS and implant region.

Accuracy, Precision, and Efficiency of Three-Dimensional (3D) Dental Lab Scanners: A Comparative Study of Two Systems

Purpose: To compare the accuracy, repeatability, reproducibility, and time efficiency between two digital lab scanners (inEos X5 Sirona and KaVo SMD ARCTICA CAD/CAM Scanners) by the traditional method using a digital caliper. Methods: Pair of dental casts (upper and lower) were duplicated using an elastic putty mold to make ten copies of each. Following that, a total of twenty models were scanned in each scanner (Sirona and KaVo) separately by three different calibrated operators. Each operator repeated the scan at an interval of 48 hours. Fifteen measurements for each model were obtained in three different planes (vertical, horizontal, and transfers) following the same protocol. Measurements were obtained manually using a Boley gauge and digitally by the scanner company software. The two scanners that were assessed were; Sirona and KaVo indirect lab Scanners. Results: The coefficient of variations was between 1%- 8%, although statistically significant in some groups, but clinically the differences were insignificant and within the accepted range. Correlations between the inter and Intra operator reliability were assessed using the Intraclass Correlation Coefficient in Tables 5-6. The reliability of the increased distance of the measurement seems more consistent. The variations of Correlations among operators increased as the distance measured decreased, even though all operators were calibrated respectively. Operators’ feedback was that KaVo was easier to learn. However, timewise Sirona seemed more efficient. The average time for the Sirona scanner was less than half a minute with average scanner time (4.3 and 3.8 minutes). Based on various parameters recorded, both scanners proved to be accurate with no clinically significant differences detected between the groups. Conclusion: Both scanners proved to be accurate with no clinically significant differences detected between the groups. These two scanners were reliable tools to scan and reproduce digital dental records. The inEos X5 Sirona Scanner seemed to be more efficient time-wise than the KaVo SMD ARCTICA CAD/CAM Scanners.

An evaluation of concordance between linear measurements obtained from conventional, digital and reconstructed three-dimensional printed orthodontic models: An in vitro study

Abstract Objective: To evaluate the potential use of digital and reconstructed three-dimensional printed models as an alternative to conventional plaster models by assessing the accuracy of their linear measurements. Methodology: Pre-treatment plaster models of 45 patients were selected from the archives of the Department of Orthodontics. Each physical plaster model was scanned and digitized using a three-dimensional (3D) laser surface scanning system (inEOS X5, Dentsply Sirona, Bensheim, Germany). The scanned STL files were later used to reconstruct models by 3D printing using Figure4® standalone 3D printer (3D systems, Rock Hill, South Carolina). Measurements of teeth 11 and 16, the transverse width of the upper jaw between the first molars (MM - intermolar width) and canines (CC - intercanine width) were done manually using a digital vernier caliper (Mitutoyo, Kawasaki, Japan), and the CAD Assistant software (Open cascade, Guyancourt, France). Intra examiner data, Intraobserver variability, and measurement accuracy were evaluated using Intraclass Correlation Coefficient (ICC) analysis was done using SPSS 20.0. Results: The intraclass correlation coefficients were &gt;0.8 indicating high reproducibility and reliability. Significant differences were found between the physical and the digital models but to a small proportion which were deemed not clinically relevant. Conclusion: Both the digital models and reconstructed three-dimensional printed models using Figure4® technology were clinically permissible in terms of accuracy and reproducibility. The digital storage, transmission, and treatment planning in an environmentally friendly manner should promote digital over conventional records.

A comparison of trueness and precision of 12 3D printers used in dentistry

IntroductionJudging the dimensional accuracy of the resulting printed part requires comparison and conformity between the 3D printed model and its virtual counterpart. The resolution and accuracy of 3D model samples are determined by a wide array of factors depending on the technology used and related factors such as the print head/laser spot size/screen resolution, build orientation, materials, geometric features, and their topology.AimsThe aim of this manuscript is to present a literature review on 12 3D printers, namely the Ackuretta Sol, Anycubic Photon and Photon S, Asiga Max UV, Elegoo Mars, Envisiontec Vida HD, Envisiontec One, Envisiontec D4K Pro, Formlabs Form 2 and Form 3, Nextdent 5100, and Planmeca Creo, studying the accuracy of these printers that are of a wide variety of budgets.DesignThe present study involves some of the recently released 3D printers that have not yet been studied for their accuracy. Since these new printers will replace current models that may have been included in the previous studies in the literature, it is important to study whether they are statistically more or less accurate and to discuss whether these results are clinically relevant. For the purposes of this study, the use of a standardised printable object was used to measure the accuracy of these recent 3D printers.Materials and methodsIn total, 12 3D printers produced test blocks. All test blocks were printed using the same settings with 100 micron Z layer thickness and the print time set to standard where applicable. To measure the resulting blocks a digital measurement was taken using a Dentsply Sirona Ineos X5 lab scanner to measure the XYZ dimensions of each block produced on each printer using CloudCompare to measure the deviation compared to the Master STL. Each measurement was taken from the central axis of that dimension.ResultsWhen grouped into homogenous subsets, the cheapest 3D printers in the group, namely the Anycubic printers and the Elegoo Mars, are statistically not dissimilar to the higher priced Asiga Max UV or even the mid-priced Formlabs printers in the X and Z dimensions. However, the Envisiontec One and D4K Pro, Ackuretta Sol and Asiga Max UV were statistically superior in terms of consistently accurate Y dimension. Although these printers use different technologies to print, no specific type of printer technology is more accurate than the others.DiscussionThe null hypothesis was proved to be true, in that no significant differences were found among the various technologies of 3D printing regarding trueness and precision. The evolution of 3D printers that leads to budget printers being as statistically accurate, for at least two of the dimensions of data recorded, as expensive printers is remarkable. Whilst clear differences in the mean error between the printers were found, the performance of these printers is considered exceptional. Albeit, the Envision One, Envision D4K, Ackuretta Sol and Asiga Max UV printers performed the best with overall trueness under 35 μm.ConclusionThis study shows that the current range of 3D printers can produce clinically acceptable levels of accuracy. The present study also shows that there is no statistical difference in the results of budget printers and more expensive printers for the X and Z dimensions but this was not the case for the measurements in the Y dimension. This study confirms that all of the 3D printers can produce a reliable, reproducible model.

Accuracy of different laboratory scanners for scanning of implant‐supported full arch fixed prosthesis

AbstractObjectiveThis study evaluated the accuracy of different laboratory scanners (LS) for scanning of implant‐supported full arch fixed prosthesis with different implant angulations.Materials and MethodsTwo maxillary models that are designed to receive an all‐on‐four implant retained prosthesis were fabricated then scanned using five different LS. The models were divided into two groups according to the angulation of the posterior implant (Group 1; 30° and group 2; 45°). Each group was then subdivided into five subgroups according to the type of LS, subgroup T; Medit T710, subgroup I; IneosX5, subgroup E; 3ShapeE4, subgroup A; Autoscan DS‐Mix, and subgroup M; Ceramill Map600. An industrial 3D scanner was used as reference scanner, then each model was scanned with 5 LS 10 times. Trueness and precision were analyzed using Geomagic 3D analysis software.ResultsBoth scanner type and implant angle had a significant effect on the trueness (p &lt; 0.001). Significant interaction was found between the scanner type and implant angle (p &lt; 0.001). For scanner type tukeys post hoc test revealed highest trueness with the 3Shape E4 (21.3 ± 2.1) and the medit T710 (22.6 ± 2.1) and least trueness with the shining 3D autoscan ds‐mix (33.8 ± 3.0). Significantly better trueness was observed with the 30° than the 45° angle. Regarding precision, two‐way ANOVA revealed significant effect of the scanner type only (p &lt; 0.001). There were no significant differences between the 3Shape E4, medit T710, Ineos X5, and the Ceramill map600. However, all showed significantly higher precision values when compared to shining 3D autoscan ds‐mix.ConclusionsAll tested scanners showed results within the clinically acceptable range with 3ShapeE4 and Medit T710 showing the highest accuracy.Clinical significanceTested scanners can be used for scanning of All‐on‐four implant supported prosthesis.

Evaluation of trueness and precision of two intraoral scanners and a conventional impression: an in vivo clinical study.

To evaluate, in vivo, trueness and precision of two intraoral scanners, CEREC Omnicam (OMNI) and CEREC Primescan (PRIM), compared to a conventional impression serving as a master model. Impressions were performed for seven participants. For each participant, conventional polyvinylsiloxane impression and digital impressions using two intraoral scanners, OMNI (software 4.6; CEREC ORTHO Protocol) and PRIM (10 digital impressions per participant, per scanner), were made. Conventional impression was digitized with a laboratory scanner (INEOS X5), and used as reference model. .STL files were superimposed with software (Geomagic Control X) using the tools Initial Alignment and Best Fit Alignment, and trueness and precision were evaluated. Statistical evaluation was performed with Shapiro-Wilk and Mann-Whitney tests (P < .05). Total mean trueness for the OMNI system was 56.45 ± 7.80 µm, and 47.29 ± 5.47 µm for the PRIM system. Regarding precision, values from the OMNI system were 42.47 ± 6.91 µm and from the PRIM system 21.86 ± 4.40 µm. PRIM presented better results for both trueness (P = .000) and precision (P = .000) when compared to OMNI. PRIM provided a better combination of trueness and precision than its predecessor OMNI. However, both PRIM and OMNI performed acceptably when performing indirect restorations, according to the current acceptable thresholds, considering both trueness and precision. Full-arch impressions with Primescan presented more precision and trueness than Omnicam; however, compared to previous reported values of conventional impressions, they still presented lower accuracy.

Effect of span length on the trueness of an intraoral scanner. (An in-vitro study)

Abstract Statement of the problem: Digital scanning has been widely used nowadays, however its accuracy in relation to the bridge span length needs further investigations. Objective: The aim of this study was to determine the effect of span length on the trueness of an intra-oral scanner. Materials and methods: On a typodont (Nissin Dental Model, Japan) preparations for two bridge span lengths were made. One resembling missing upper second premolar representing short straight span length (SS) while the second resembling missing upper first and second premolars representing long curved span (LS). Then typodont was scanned by a laboratory scanner (InEos X5 scanner) (Sirona Dental System, Bensheim, Germany) to act as a reference model scan to compare measurements for trueness. Then for each group five scans were taken for the typodont by Medit intraoral scanner (iScan version 1.2.0.1; Medit, Seoul, Korea) to be compared with the reference scan. Then data set from the scans were transferred to STL format and then exported to exocad (exocad version 2.3 Matera exocad GmbH,Darmstadt, Germany) software to get the measurements to determine the trueness. Results: Results of this study showed that in the comparison between short and long span bridges, the long span bridge scans showed statistically significant higher root mean square (RMS) mean value (0.23±0.10 mm), lower trueness than short span bridge scans (0.06±0.04 mm). Conclusions: Long span fixed bridge had an adverse effect on the scanning accuracy. Trueness of intraoral scanner may be affected by the complexity and length of the scanning area.

Trueness of extra-oral scanner in relation to two span lengths. An in-vitro study

Statement of the problem: Extraoral scanners have been used widely nowadays however there are certain conditions that could affect their accuracy which will subsequently affect the success of the final restoration. Objective: The aim of this study was to determine the accuracy of extraoral scanner in relation to two span lengths. Materials and methods: A typodont (Nissin Dental, Kyoto Japan) was used and two bridges with different span lengths were prepared, the first one with missing upper left second premolar (short straight span (GS)) and the other with missing upper left first and second premolars (long curved span (GL)). Indentations were made on each abutment to be taken as a reference for measurements. For both groups reference scan was taken by inEos X5 extra-oral scanner. Then five physical impression was taken for each group using vinylpolysiloxane impression material (Honigum, Germany) and then poured into type IV dental stone. Casts of each group were scanned using DOF extraoral scanner (DOF Company, Korea). Measurements were made from the indentations on the reference scan and the sample scans, compared with each-other and root mean square value (RMS) was obtained to evaluate the trueness. Results: Comparison between short and long span bridges revealed that there was no statistically significant difference between trueness values of short and long span bridges. Where RMS mean for the short span was 0.0727 mm and that for the long span was 0.1069 mm. Conclusions: Different span lengths do not seem to affect the trueness of the extra-oral scanner tested.

A Comparison of Full Arch Trueness and Precision of Nine Intra-Oral Digital Scanners and Four Lab Digital Scanners.

(1) Background: The purpose of this study is to evaluate the full arch scan accuracy (precision and trueness) of nine digital intra-oral scanners and four lab scanners. Previous studies have compared the accuracy of some intra-oral scanners, but as this is a field of quickly developing technologies, a more up-to-date study was needed to assess the capabilities of currently available models. (2) Methods: The present in vitro study compared nine different intra-oral scanners (Omnicam 4.6; Omnicam 5.1; Primescan; CS 3600; Trios 3; Trios 4; Runyes; i500; and DL206) as well as four lab light scanners (Einscan SE; 300e; E2; and Ineos X5) to investigate the accuracy of each scanner by examining the overall trueness and precision. Ten aligned and cut scans from each of the intra-oral and lab scanners in the in vitro study were brought into CloudCompare. A comparison was made with the master STL using the CloudCompare 3D analysis best-fit algorithm. The results were recorded along with individual standard deviation and a colorimetric map of the deviation across the surface of the STL mesh; a comparison was made to the master STL, quantified at specific points. (3) Results: In the present study, the Primescan had the best overall trueness (17.3 ± 4.9), followed by (in order of increasing deviation) the Trios 4 (20.8 ± 6.2), i500 (25.2 ± 7.3), CS3600 (26.9 ± 15.9), Trios 3 (27.7 ± 6.8), Runyes (47.2 ± 5.4), Omnicam 5.1 (55.1 ± 9.5), Omnicam 4.6 (57.5 ± 3.2), and Launca DL206 (58.5 ± 22.0). Regarding the lab light scanners, the Ineos X5 had the best overall trueness with (0.0 ± 1.9), followed by (in order of increasing deviation) the 3Shape E2 (3.6 ± 2.2), Up3D 300E (12.8 ± 2.7), and Einscan SE (14.9 ± 9.5). (4) Conclusions: This study confirms that all current generations of intra-oral digital scanners can capture a reliable, reproducible full arch scan in dentate patients. Out of the intra-oral scanners tested, no scanner produced results significantly similar in trueness to the Ineos X5. However, the Primescan was the only one to be statistically of a similar level of trueness to the 3Shape E2 lab scanner. All scanners in the study had mean trueness of under 60-micron deviation. While this study can compare the scanning accuracy of this sample in a dentate arch, the scanning of a fully edentulous arch is more challenging. The accuracy of these scanners in edentulous cases should be examined in further studies.

Micro-CT Evaluation of the Marginal and Internal Fit of Crown and Inlay Restorations Fabricated Via Different Digital Scanners belonging to the Same CAD-CAM System.

To evaluate the marginal and internal adaptation of all-ceramic crowns and inlays fabricated by different scanners of the same CAD/CAM system. All-ceramic crown preparations were performed on typodont maxillary first premolars, and mandibular first molars were prepared for ceramic Class II mesio-occlusal inlays. Two intraoral scanners (CEREC Bluecam and Omnicam, Dentsply Sirona) and one model scanner (CEREC inEos X5, Dentsply Sirona) were used to scan the preparations. All restorations were fabricated by milling single-feldspathic ceramic blocks (CEREC Blocks). The marginal and internal discrepancies of restorations were evaluated via micro-CT analyses. For linear crown measurements, the marginal gaps were 63.75 μm, 88.24 μm, and 90.89 μm for Bluecam, Omnicam, and inEos X5, respectively. For crowns at central groove areas, the maximum values for Bluecam, Omnicam, and inEos X5 were found to be 144.78 μm, 165.19 μm, and 129.49 μm, respectively. For inlays, the highest range at the midpoint of the axiopulpal line angle for Bluecam, Omnicam, and inEos X5 were determined as 138.57 μm, 184.33 μm, and 179.71 μm, respectively. In volumetric measurements, inEos X5 showed lower gap for both crowns (11.47 mm3) and inlays (5.65 mm3) compared to both intraoral scanners. These results are within a clinically acceptable range. When all-ceramic crowns were evaluated, there were generally no significant differences found between scanners for the regional linear measurements, but more gaps occurred in restorations obtained with intraoral scanners for volumetric measurements. On the other hand, when the inlay restorations were evaluated, significant differences were found between groups except for the midpoint of the axio-pulpal line angle and the midpoint of the mesio-gingival margin. However, marginal and internal gaps of both crowns and inlays presented mean values less than 150 μm in many surfaces, which could be considered clinically acceptable.

In-vitro evaluation of marginal and internal fit of 3-unit monolithic zirconia restorations fabricated using digital scanning technologies

PURPOSEThis study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners.MATERIALS AND METHODSFor the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in µm) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05).RESULTSIn terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 µm) and axial (92.4 ± 14.8 µm), and T4 had the lowest axio-occlusal (89.4 ± 15.6 µm) and occlusal (89.1 ± 13.9 µm) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner.CONCLUSIONWithin the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 µm), except D900L.

Accuracy of intraoral scans of edentulous jaws with different generations of intraoral scanners compared to laboratory scans.

PURPOSEPurpose of this in vitro study was to determine the accuracy of different intraoral scans versus laboratory scans of impressions and casts for the digitization of an edentulous maxilla.MATERIALS AND METHODSA PEEK model of an edentulous maxilla, featuring four hemispheres on the alveolar ridges in region 13, 17, 23 and 27, was industrially digitized to obtain a reference dataset (REF). Intraoral scans using Cerec Primescan AC (PRI) and Cerec AC Omnicam (OMN), as well as conventional impressions (scannable polyvinyl siloxane) were carried out (n = 25). Conventional impressions (E5I) and referring plaster casts were scanned with the inEOS X5 (E5M). All datasets were exported in STL and analyzed (Geomagic Qualify). Linear and angular differences were evaluated by virtually constructed measurement points in the centers of the hemispheres (P13, P17, P23, P27) and lines between the points (P17–P13, P17–P23, P17–P27). Kolmogorov-Smirnov test and Shapiro-Wilk test were performed to test for normal distribution, Kruskal-Wallis-H test, and Mann-Whitney-U test to detect significant differences in trueness, followed by 2-sample Kolmogorov-Smirnov test to detect significant differences in precision (P < .008).RESULTSGroup PRI showed the highest trueness in linear and angular parameters (P < .001), while group E5I showed the highest precision (P < .001).CONCLUSIONIntraoral scan data obtained using Primescan showed the highest trueness while the indirect digitization of impressions showed the highest precision. To enhance the workflow, indirect digitization of the impression itself appears to be a reasonable technique, as it combines fast access to the digital workflow with the possibility of functional impression of mucosal areas.

THE IMPACT OF A HIGH MAGNIFICATION APPROACH FOR TEETH PREPARATIONS ON THE MARGINAL FIT OF CAD/CAM MONOLITHIC LITHIUM DISILICATE CROWNS (IN VITRO STUDY)

Introduction: Marginal integrity is a challenging goal revealing an accurate restoration with definite marginal adaptation thus inflammation of gingival tissues and bone destruction correlate directly with a poor marginal property of the restoration. These days improved vision is essential in dentistry upgrading exactness and flawlessness. Objectives: To assess the impact of amplification on the marginal adaptation of CAD/CAM monolithic lithium disilicate crowns. Materials and Methods: In-vitro study using 16 upper right cuspid typodont teeth; divided into two entities according to tooth preparation approach (n=8). Group I teeth preparation without magnification (control group), Group II teeth preparation utilizing the dental operating microscope (DOM) under magnification of 16x. Optical impressions were taken through scanning by Sirona inEOS X5 extra-oral scanner where full anatomical crowns were structured, processed, Sintered and glazed. CBCT was utilized to quantify the minimal gapes before and after cementation/aging. Results: Marginal gaps were significantly increased after cementation and aging in both groups yet still inside the worthy minimal gap values. Group II demonstrated recognizable less marginal gaps. Conclusions: Operating microscopy OM is a significant supplement to the armamentarium of present-day dentistry. It helps set the bar of greatness and flawlessness at the most elevated level including every dental field.