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SolidWorks Akcelik. Additive v PreScan v8. Afterwards, the pattern was placed and fixed in replica of an upper jaw for their subsequent scans 10 times using 3 intraoral scanners, namely iTero Element1, Trios 3, and True Definition. Trueness and precision were assessed for each IOS: trueness, as the deviation of the measures from the control ones, while precision, as the dispersion of measurements in each reference parameter.
These measurements were carried out using software for analyzing 3-dimensional data. Trueness analysis in angle measurements, as well as precision analysis, did not show conclusive results. Importantly, the proposed methodology is considered reliable for analyzing accuracy in any dental arch length and valid for assessing both trueness and precision in an in vivo study.
Original Article. The Journal of Advanced Prosthodontics ; 11 6 : Published online: 18 December A new method to measure the accuracy of intraoral scanners along the complete dental arch: A pilot study. This article has been cited by other articles in ScienceCentral. Abstract PURPOSE The purpose of this study is to assess the accuracy of three intraoral scanners along the complete dental arch and evaluate the feasibility of the assessment methodology for further in vivo analysis.
Accuracy is a requirement in any dental specialty, although it is certain that in some particular cases, the maximum allowable deviations are more restrictive. Prosthodontics is one of these specialties in which accuracy requirements are most demanding. This means that restorations fabricated from digital impressions must fit without causing any long-term clinical complications, i. In dental implants, regardless of these limits, implant-supported reconstructions typically require a greater level of fit than teeth-supported reconstructions.
For that purpose, IOS must provide a reliable replica that will fit passively in the patient’s mouth. The development of IOS sought to overcome the challenges related to conventionally taken dental impressions, such as volumetric changes of impression materials, expansion of plaster models, or others related to the impression-taking process, such as improper tray selection, separation of impression material from the tray, or problems arising from the storage of impressions for the potential remaking of models.
However, the practice of conventional impressions still persists. The validity of restorations made using IOS has been questioned from the beginning and many studies have been carried out to analyze their accuracy. Some have tried to directly assess the accuracy of IOS by performing studies in vitro. All these studies have been performed using different methodologies, in varying lengths of arch, considering different conditions of the patient, such as edentulous or toothed, and even with different versions of the same IOS.
However, there is clearly a lack of accuracy studies performed in vivo. In this sense, when determining the accuracy of digital impressions, it is necessary to measure their trueness.
The measurement of trueness has been the main obstacle in performing accuracy studies in vivo , even to the point of considering it impossible because of the difficulty to obtain references for trueness measurements. The aim of this research was to design a new methodology that enables the study of the accuracy of digital impressions in vivo – a methodology based on the use of a pattern that allows the assessment of both trueness and precision in distance and angle measurements.
Simultaneously, this methodology allows analysis of the accuracy in different lengths of dental arch. For this purpose, the methodology has been tested to assess the accuracy, in terms of trueness and precision, of three different IOS. This pattern was previously measured in a coordinate measuring machine CMM to obtain control distances and angles. The pattern design had to meet three requirements: 1 the size and shape had to be suitable for replicating the study in different arch models; 2 the pattern had to be valid for measuring distance and angle errors along the complete arch; 3 the material had to be dimensionally stable and biocompatible to enable in vivo replication of the study if the methodology used was validated.
To fulfill the size and shape requirement, digital impressions of five upper jaws were used. The goal was to design a pattern that would fit in as many jaws as possible without interfering with dentition. From this digitization, five digital impressions in standard tessellation language STL were achieved.
The jaws were completely dentate and without any diagnosed pathology. The five digital impressions of the upper jaws were aligned and overlapped using reverse engineering software Geomagic Design X with Then, the structure of the pattern was designed and five cylinders were digitally placed along the pattern in order to obtain useful geometries for both distance measurements and, using their axes, angle measurements. A reference plane was also machined as a base geometry for further measurements The position of each cylinder corresponded approximately depending on the characteristics of each jaw to those of the maxillary right third molar, maxillary right canine, central maxillary incisors, maxillary left canine, and maxillary left third molar.
Placing these reference cylinders along the pattern allowed the measurement of the distance and angle error along the complete arch. Then, the reference pattern was designed and fabricated in stainless steel Fig.
The surface of the pattern was shot-blasted to avoid glare and reflections that can interfere with the scanning process. Accuracy was evaluated in terms of trueness and precision. Trueness was assessed as the deviation of measured parameters distance and angle in IOS digital impressions from control ones and precision, as the deviation of each measurement of reference parameters in these digital impressions.
In all scans, the complete arch was digitized together with the five cylinders of the pattern Fig. All the scans were performed according to the IOS manufacturer’s scanning protocols for complete arch. When the scans were performed with the iTero or Trios3, the scanning began in the maxillary right first molar, and when performed with the True Definition, the scanning began in the maxillary right canine. The first scans were performed using the iTero and Trios3.
The measurements were performed using 3D inspection and mesh processing software for dimensional analysis GOM Inspect with software version , following a specifically-designed measuring protocol. To measure the 4 reference distances, 5 points were created in each cylinder of all STL files as the intersection between a cylinder axis and a plane. The cylinders were created on each part of the mesh resembling a cylinder according to the Gaussian best-fit method.
The software GOM Inspect squares the deviations of the selected polygons with the possible fitting element and adds the quadratic deviations. To create the intersection plane, firstly, the surface of the mesh corresponding to the horizontal plane of the pattern was selected taking into account only the mathematically useful surface of this horizontal area. The intersection plane was created as a 3 mm parallel plane to the previously created one.
Angles were measured using the axes of the created cylinders. The real angle between these axes and the plane created on the horizontal surface of the pattern was also measured.
Deviations were calculated as differences between the control reference distance and angles measured using the CMM and these reference parameters measured in digital impressions obtained with IOS. Error in distance and angle measurements was measured in each of the reference parameters reference distances and angles and the mean and standard deviation of these errors were calculated.
These calculations were repeated for each reference parameter and with each of the 3 IOS used. In order to apply this technique, the Levene test was previously used to check the homogeneity of the variances. In order to discern the influence of each scanner, the scanners were compared in pairs, and results showed that these differences occurred especially when the Trios3 was involved. In D12, D13, and D15 reference distances, best mean deviation values were achieved with iTero while the larger mean deviation values were achieved in all cases using Trios3.
Table 1 summarizes deviation values obtained with each IOS in each reference distance. Table 2 summarizes precision values obtained with each IOS in each reference distance.
Contrasting the scanners in pairs, in general, significant differences were found in each measured angle. With regard to the measured angular deviations, it was found that while distance analysis clearly showed higher deviations as the scanning length increased, angle measurement analysis did not show the same evolution so clearly Fig.
Minimum mean deviation values were measured in A1 reference angle 0. All angle deviation values are shown in Table 3. In line with angle trueness, precision measurements did not worsen as the scanning length increased Fig. Best precision values were obtained in A3 reference angle assessed on 0.
The distribution of trueness and precision data showed that distance error increased when the scanning area increased and that best results were achieved with iTero and True Definition Fig. Angle measurements did not show any conclusive data associated with the scanned arch length. The study was carried out following a new methodology and proved using in vitro tests. The results obtained, similar to those obtained in previous studies, suggest that it is an applicable methodology for in vivo studies.
This methodology was designed to measure the accuracy of scanners and to analyze the validity of results in certain clinical practices such as the fabrication of complete or partial restorations. Many studies calculated the accuracy of IOS by superim-posing meshes obtained from these scanners, or with meshes obtained from industrial or desktop scanners.
The results, obtained following these functions, provide important knowledge on the subject, especially for the manufacturers of scanners, although the use of scanners may present serious limitations in clinical practice when rehabilitations cover arch lengths longer than a dental piece. The best fit functions align the meshes in order to achieve the minimum error; thus, this error is distributed as homogeneously as possible throughout the whole mesh.
When the whole mesh represents a reduced space of the dental arch from one to two teeth , as in the case of an impression to prepare a crown, the measurements of the resultant distributed error can be useful to establish whether or not the dental digital impressions are accurate enough.
Measured error using best fit alignment functions could resemble marginal fit errors. However, in rehabilitations with implant restorations, it is preferable to know the error between fixation points rather than the homogeneously distributed error.
According to this criterion, mesh alignments should be performed aiming for zero error at the first fixation point and measuring the accumulated error at other fixation points, instead of using best fit alignment processes that distribute the error and minimizes it in all the extension of the mesh.
Some studies of IOS accuracy have followed these criteria of assessing distance or angulation errors between previously determined points. The present study shows a methodology to assess the trueness and precision of digitally-acquired dental impressions using a measurement pattern. On the other hand, many published IOS accuracy studies compared results achieved using IOS with results obtained by conventional procedures.
Impression materials can shrink, expand, or warp during or after removal from the mouth, resulting in inaccuracies. In addition, as in any type of process, each of the sub-processes carried out during conventional dental impressions can increase errors. Thus, this methodology can be easily replicated in an in vivo study. Some studies have proposed similar methodologies based on the use of a pattern or externally-measured landmarks 30 37 However, the proposed methodology is valid for assessing the accuracy in different scanning lengths by measuring a once defined pattern.
Thus, the deviation increase can be evaluated as the scanning length increases. It is important to note that the proposed methodology has its limitations.
The aim was to design a pattern that would fit in different mouths for later in vivo studies; for this, 5 volunteer arches were used.
However, it is reasonable to assume that the pattern is not valid for all mouths and that in other cases the distances between the cylindrical abutments might not resemble implant or tooth positions.
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Google Analytics Error – December 6, , am. Table 2 Precision in each reference distance and with each IOS.
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The five digital impressions of the upper jaws were aligned and overlapped using reverse engineering software (Geomagic Design X with software. Geomagic Design X. Geomagic Design X. GIGE DVR. 1.X Microsoft Windows 7 Professional, Multiprocessor Free. 7.x JetBrains CLion geomagic control x tutorial.
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Clinical evaluation of all-ceramic crowns fabricated from intraoral digital impressions based on the principle of active wavefront sampling. Accuracy of complete-arch dental impressions: a new method of measuring trueness and precision. The results obtained, similar to those obtained in previous studies, suggest that it is an applicable methodology for in vivo studies. WatPro v4.