Intraoral scanners can be used as a replacement for conventional impressions when restoring up to ten units without extended edentulous spans.

BackgroundSeveral studies have evaluated accuracy of intraoral scanners (IOS), but data is lacking regarding variations between IOS systems in the depiction of the critical finish line and the finish line accuracy. The aim of this study was to analyze the level of finish line distinctness (FLD), and finish line accuracy (FLA), in 7 intraoral scanners (IOS) and one conventional impression (IMPR). Furthermore, to assess parameters of resolution, tessellation, topography, and color.MethodsA dental model with a crown preparation including supra and subgingival finish line was reference-scanned with an industrial scanner (ATOS), and scanned with seven IOS: 3M, CS3500 and CS3600, DWIO, Omnicam, Planscan and Trios. An IMPR was taken and poured, and the model was scanned with a laboratory scanner. The ATOS scan was cropped at finish line and best-fit aligned for 3D Compare Analysis (Geomagic). Accuracy was visualized, and descriptive analysis was performed.ResultsAll IOS, except Planscan, had comparable overall accuracy, however, FLD and FLA varied substantially. Trios presented the highest FLD, and with CS3600, the highest FLA. 3M, and DWIO had low overall FLD and low FLA in subgingival areas, whilst Planscan had overall low FLD and FLA, as well as lower general accuracy. IMPR presented high FLD, except in subgingival areas, and high FLA.Trios had the highest resolution by factor 1.6 to 3.1 among IOS, followed by IMPR, DWIO, Omnicam, CS3500, 3M, CS3600 and Planscan. Tessellation was found to be non-uniform except in 3M and DWIO. Topographic variation was found for 3M and Trios, with deviations below +/− 25 μm for Trios. Inclusion of color enhanced the identification of the finish line in Trios, Omnicam and CS3600, but not in Planscan.ConclusionsThere were sizeable variations between IOS with both higher and lower FLD and FLA than IMPR. High FLD was more related to high localized finish line resolution and non-uniform tessellation, than to high overall resolution. Topography variations were low. Color improved finish line identification in some IOS.It is imperative that clinicians critically evaluate the digital impression, being aware of varying technical limitations among IOS, in particular when challenging subgingival conditions apply.

Purpose   Cranio-maxillofacial (CMF) surgery to restore normal skeletal anatomy in patients with serious trauma to the face can be both complex and time-consuming. But it is generally accepted that careful pre-operative planning leads to a better outcome with a higher degree of function and reduced morbidity in addition to reduced time in the operating room. However, today’s surgery planning systems are primitive, relying mostly on the user’s ability to plan complex tasks with a two-dimensional graphical interface. Methods   A system for planning the restoration of skeletal anatomy in facial trauma patients using a virtual model derived from patient-specific CT data. The system combines stereo visualization with six degrees-of-freedom, high-fidelity haptic feedback that enables analysis, planning, and preoperative testing of alternative solutions for restoring bone fragments to their proper positions. The stereo display provides accurate visual spatial perception, and the haptics system provides intuitive haptic feedback when bone fragments are in contact as well as six degrees-of-freedom attraction forces for precise bone fragment alignment. Results   A senior surgeon without prior experience of the system received 45 min of system training. Following the training session, he completed a virtual reconstruction in 22 min of a complex mandibular fracture with an adequately reduced result. Conclusion   Preliminary testing with one surgeon indicates that our surgery planning system, which combines stereo visualization with sophisticated haptics, has the potential to become a powerful tool for CMF surgery planning. With little training, it allows a surgeon to complete a complex plan in a short amount of time.

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