Search Results (31)

This in vitro study aims to compare the trueness of digital impressions obtained using two intraoral scanners (IOS) and one photogrammetry device for full-arch implant-supported rehabilitations. According to the Caramês Classification I, three models were produced with Straumann implants arranged in different spatial distributions: Option A with six implants and Options B and C with four implants each. The three models were scanned using a 12-megapixel scanner to create digital master casts. For each reference model, 30 digital impressions were acquired: 10 with the 3Shape Trios 3 intraoral scanner, 10 with the Medit i500 intraoral scanner, and 10 with the PIC Dental photogrammetry device. Trueness was assessed through best-fit superimpositions between the digital master casts and the corresponding virtual models. The Shapiro–Wilk test was applied to assess the normality of the data distribution, and Levene’s test was used to evaluate the homogeneity of variances. The non-parametric Kruskal–Wallis test was employed to compare group differences, with post hoc adjustments made using the Bonferroni correction. A significance threshold of p = 0.05 was adopted for all statistical tests. Statistically significant differences were observed in the root mean square values among the three devices. The Medit i500 demonstrated the highest trueness, with a median (interquartile range) deviation of 24.45 (18.18) µm, whereas the PIC Dental exhibited the lowest trueness, with a median deviation of 49.45 (9.17) µm. Among the implant distribution, the Option C showed the best trueness, with a median deviation of 19.00 (27.83). Considering the results of this in vitro study, intraoral scanners demonstrated comparable trueness, whereas the photogrammetry-based system exhibited lower trueness values. Additionally, a smaller number of implants and reduced inter-implant distances were associated with improved trueness in digital impressions for full-arch implant rehabilitation. Full article

Background: The increasing adoption of digital workflows in implant dentistry necessitates rigorous assessment of intraoral scanning, particularly for complex full-arch rehabilitations like All-on-Four prostheses, where posterior implant angulation may impact the accuracy of optical data acquisition. Objectives: This in vitro study aimed to assess the accuracy of digital intraoral scanners in scanning All-on-Four implant models with different posterior implant angulations. Methods: Two epoxy resin All-on-Four implant models were fabricated with two posterior implant angulations (30-degree and 45-degree). Both models were digitized to obtain control datasets using a Smart Optics reference scanner (REF). Four intraoral scanners were comparatively assessed: Cerec Omnicam AC (OMN), Trios 4 (TRI), Cerec Primescan AC (PRI), and Medit i700 (MED), with nine scans per each scanner (n = 9). All STL files were exported and analyzed using Geomagic Control X with root mean square (RMS) values computed for trueness and precision assessments. Results: The comparison between IOS types in terms of trueness revealed that with 30° angulation, the MED group showed the statistically significant least deviation (p = 402). With 45° angulation, both PRI and OMN scanners showed the statistically significant highest deviation values (p = 0.047 and 0.007, respectively). MED again showed the statistically significant least deviation (p = 402). For precision evaluation in 30° angulation models, PRI and OMN scanners showed the statistically significant least deviation values (p = 402 and <0.001, respectively). While, in 45° angulation models, no statistically significant inter-scanner differences were observed. Conclusions: While MED, PRI, and OMN scanners demonstrated clinical validity for 30° angled posterior implants, only the MED system achieved sufficient accuracy for 45° tilt. These findings emphasize the critical relationship between scanner selection and extreme implant angulations in full-arch digital workflows. Full article

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication. Full article

Background/purpose: Fiber-reinforced materials are commonly used as biobases beneath indirect restorations, potentially affecting the seating and marginal accuracy of the restorations. This study intended to assess the impact of various biobase techniques on the marginal adaptation of lithium disilicate overlay restorations. Methods: Fifty sound maxillary first premolar teeth of comparable dimensions were prepared using a full-bevel overlay design (3 mm occlusal reduction) and allocated randomly to five groups as follows (n = 10): Group A, delayed dentin sealing; Group B, immediate dentin sealing using Optibond FL; Group C, immediate dentin sealing with a 1 mm flowable composite layer (Clearfil AP-X Flow); Group D, immediate dentin sealing followed by a 1 mm short-fiber-reinforced composite layer (everX Flow); and Group E, immediate dentin sealing coated with a 1 mm flowable composite layer reinforced with polyethylene Ribbond fibers. Digital impressions were obtained using a Medit i700 intraoral scanner, and the overlays were digitally designed via the Sirona inLab CAD software and milled via a four-axis milling machine. The overlays were luted with a preheated composite (Clearfil AP-X). Marginal gap assessments were conducted pre- and post-cementation via a digital microscope at 230× magnification. The data were statistically analyzed using a one-way analysis of variance and paired t-tests. Results: The one-way ANOVA disclosed no significant differences among the groups before or after cementation (p > 0.05). Conclusions: The presence or absence of fiber-reinforced biobases did not impact the marginal adaptation of the restorations; these biobases can be incorporated to optimize the mechanical behavior of indirect restorations without adversely affecting their seating accuracy. These findings suggest that fiber-reinforced and non-reinforced biobase techniques can be safely integrated into clinical adhesive protocols to enhance the mechanical performance of restorations without comprising their marginal adaptation. Full article

Background: Cheiloscopy, a forensic technique based on the uniqueness of labial traces, has traditionally relied on analog methods. While simple, these methods present significant limitations in terms of precision and reproducibility. The introduction of 3D technology, specifically high-resolution optical scanners, represents a pivotal advancement in overcoming these challenges. Objective: This pilot study aimed to explore the feasibility and potential advantages of 3D cheiloscopy in forensic science by analyzing its precision and repeatability compared to traditional analog methods. Methods: Two participants were selected as a pilot sample, and their lip impressions were captured using both analog techniques and a high-resolution intraoral scanner (Medit i700). A total of 40 samples were collected, equally distributed among operators with varying levels of experience. Surface deviation analysis was performed to compare the methods. Results: The 3D models demonstrated greater uniformity and resolution compared to the analog impressions, which were more prone to errors caused by material quality or operator pressure. Surface deviation analysis showed an average similarity of 70%, with a standard deviation of 0.229 mm. The digital methods also significantly reduced operator-dependent variability. Conclusions: This pilot study highlights the potential of 3D cheiloscopy to improve precision and standardization in forensic applications. While the small sample size limits the generalizability of the findings, the results provide a foundation for further research with larger and more diverse datasets. Future studies should explore the capability of 3D cheiloscopy to accurately match individuals and further validate its applicability in forensic and clinical contexts. Full article

The objective of this in vitro study is to evaluate and compare the precision of digital impressions obtained using intraoral scanners and photogrammetry devices for full-arch implant-supported oral rehabilitation. Three reference models were created with various spatial distributions of Straumann implants, according to the Caramês I Classification: (i) option A with six implants; (ii) option B with four implants; and (iii) option C with four implants. Thirty digital impressions were taken for each of the reference models: ten with the Intraoral 3Shape Trios 3 scanner, ten with the Medit i500 intraoral scanner, and ten with the PIC Dental photogrammetry device. Intra-group best-fit overlaps were performed between the virtual models obtained, and accuracy was evaluated using root mean square (RMS) values. A significance level of p = 0.05 was defined. Mean values were statistically analyzed using the Kruskal–Wallis test. All scanners studied showed high precision, with RMS values similar for each implant distribution. The PIC Dental photogrammetry device demonstrated the best results for the CCI A and B distributions, with mean values of 11.28 µm and 14.44 µm, respectively. For the CCI C distribution, the 3Shape Trios 3 scanner achieved the best result, with a mean value of 5.96 µm. Among all devices, the implant distribution showing the highest RMS values was the CCI B, with mean values between 14.44 µm and 16.96 µm. The PIC Dental device was the only method that did not exhibit statistically significant differences in RMS values across the different distributions studied, indicating that its performance is unaffected by distribution variations. No statistically significant differences (p < 0.05) were observed in the RMS values among the three types of scanners. Overall, a smaller number of implants and closer distribution between them resulted in improved precision for digital impressions in full-arch implant rehabilitation. Full article

Background and Objectives: The present study aims to assess and compare the accuracy of post-space impressions captured by three different intraoral scanners (IOS) using various canal diameters. Methods: Three extracted natural maxillary central incisors were selected and prepared for a 1 mm wide margin and a 3 mm ferrule. All steps required for the endodontic procedure were performed, and the post space was prepared using post drills. The post length was kept constant at 12 mm, whereas the width was varied (Group 1: 1.4 mm, Group 2: 1.6 mm, and Group 3: 1.8 mm). Three IOSs (Trios3, iTero2, and Medit i700) were used to acquire a digital impression of the prepared post space. Each tooth was scanned 10 times by each scanner. So, in the end, 90 digital images were recorded, and the STL files were stored. GC Pattern resin was used to fabricate resin post and core patterns, which were scanned using an extraoral scanner (EOS). The STL file obtained was used as the reference file. To evaluate the trueness of the tested IOSs, each three-dimensional scan from an IOS was superimposed on the reference scan with the help of the Medit Design software 2.1.4. The software generates color plots and gives numerical values as deviations in the Root mean square (RMS) for the variance between the two superimposed scans. The data collected was tabulated for statistical analysis. One Way ANOVA was used to test the significance difference between three different IOSs, followed by Bonferroni Post-hoc test pairwise test to identify the differences between every two different IOS. Statistical significance was set at p < 0.05. Results: The mean deviation for trueness in post space impression values recorded by the Medit i700 was highest among groups 1, 2, and 3 [0.825 (±0.071), 0.673 (±0.042) and 0.516 (±0.039), respectively], followed by iTero2 [0.738 (±0.081), 0.569 (±0.043) and 0.470 (±0.037), respectively] and Trios3 [0.714 (±0.062), 0.530 (±0.040) and 0.418 (±0.024), respectively]. Significant differences were found between the groups for all three IOSs (Trios3: p-value < 0.0001; iTero2: p-value < 0.0001; Medit i700: p-value < 0.0001). Conclusions: Within the limitations of this study, it can be concluded that Trios3 IOS has higher accuracy (as it exhibited minimal deviation for trueness) in recording post space, followed by iTero2 and Mediti700 IOS. As the diameter of the post space is increased, the accuracy of recording by IOS increases. For all the tested IOSs (except for Trios3 and iTero2, when used to record post space with 1.8 mm canal diameter), the deviations in trueness were higher than the clinically acceptable limits. Thus, IOSs should be used cautiously when recording impressions of post spaces. Full article

Background/Objectives: This study aimed to investigate the prevalence and characteristics of positional anomalies in second permanent molars among Romanian patients. These molars play a crucial role in occlusion but can exhibit positional issues such as tilting, rotation, infraocclusion, and impaction. Methods: This retrospective study examined the digital models of 103 patients aged 12–40, which were obtained by using the Medit i500 intraoral scanner. Positional anomalies were categorized by tilting, rotation, infraocclusion, and impaction. Results: The results showed a high prevalence of anomalies, particularly infraocclusion and buccal tilting in upper molars and oral tilting and mesio-buccal rotations in lower molars. The significant symmetry of anomalies within the same dental arch was noted. Gender and malocclusion type did not significantly influence anomaly frequency. Conclusions: The findings emphasize the need for the vigilant monitoring of second permanent molars to maintain functional occlusion and suggest potential common etiological factors within dental arches. Despite this study’s limitations, including sample size and retrospective design, this study underscores the clinical importance of the early detection and management of molar anomalies. Future research should expand on these findings, considering genetic and environmental influences on dental development. Full article

Background: This retrospective in vivo study evaluated the trueness and precision of two digital intraoral scanners—Dentsply Sirona Primescan and Medit i900—, both with and without two variants of the novel Scan Ladder aids, and compared their performance to a new intraoral photogrammetry scanner (Shining 3D Elite). Methods: Data from ten edentulous patients, previously collected during routine clinical treatment, were analyzed using a master STL generated from traditional impression casts as the reference. A custom positional change calculator and comprehensive statistical analysis were used to assess scanner accuracy. Results: The findings demonstrated that the use of the Scan Ladder significantly enhanced the overall accuracy of both intraoral scanners, showing no statistically significant differences when compared to the intraoral photogrammetry system. Conclusions: These results indicate that the Scan Ladder improves the performance of conventional intraoral scanners and suggests that the Shining 3D Elite intraoral photogrammetry scanner is a reliable alternative to extraoral photogrammetry for edentulous cases. Further research, with a larger and more diverse cohort, is warranted to validate and expand upon these findings. Full article

Background: As the demand for digital dentistry constantly increases, digital devices are gradually replacing conventional methods of recording occlusal contacts. The study aimed to assess the inter-rater reliability of occlusal contact point detection using 40 μm articulating paper, Medit i700, and OccluSense and to compare the distribution of occlusal contacts using the articulating paper and intraoral scanner. Material and Methods: The study included 25 participants aged 20 to 30 (13 women and 12 men). Photographs of contact points were taken and marked in maximum intercuspal position (MIP), in protrusive and laterotrusive movements, on working and non-working sides using 40 μm articulating paper and digital devices. The Cohen’s Kappa coefficient assessed the inter-rater reliability. The Wilcoxon signed-rank test was used to compare dependent groups, articulating paper, and Medit i700. Results: The Cohen’s Kappa index showed that almost perfect agreement was achieved with 40 μm articulating paper. Compared to Medit i700, the 40 μm articulating paper showed an increased mean number of contacts per tooth, except for the third molars. Conclusions: The 40 μm articulating paper has detected more overall contacts than the digital devices, particularly in the posterior areas. An ideal method for registering occlusal contacts has not been established yet. Full article

Introduction: Dental occlusion refers to the static and dynamic relationships that are established between the teeth of the two arches and is an important factor in the homeostasis of the dento-maxillary system. The objective of the present study was to compare two digital occlusal analysis systems: the T-Scan III system and the Medit I600 intraoral scanner. Materials and Methods: The study was carried out on 20 students from the Faculty of Dental Medicine Craiova, whose dental occlusion was assessed with the T-Scan III system and with the Medit I600 intraoral scanner. Dental occlusion was assessed in the maximum intercuspation position, the edge-to-edge protrusion position, and the edge-to-edge position in right and left laterotrusion. The images of the 2D occlusal contact areas obtained by both methods were converted to .jpeg format and then transferred to Adobe Photoshop CS6 2021 (Adobe Systems, San Jose, CA, USA) for comparison. The recorded data were statistically processed. Results: Analyzing the data provided by the two digital occlusal analysis systems, it was found that the T-Scan III system provided data related to the amplitude of the occlusal forces, the surface on which they were distributed (the contact surface), the dynamics of the occlusal contacts, and the proportion in which they were distributed at the level of the two hemiarches, and the Medit I600 intraoral scanner performed an evaluation of the occlusal interface of the two arches, highlighting the extent of the contact areas with the degree of overlapping of the occlusal components. Although both methods of occlusal analysis recorded the highest values for the maximum intercuspation position, the results could not be compared. Conclusions: The two digital systems provide different data in occlusal analysis. As the T-Scan III system is considered the gold standard for occlusal analysis, more studies are needed to understand the data provided by the Medit I600 intraoral scanner and their significance. Full article

(1) Background: Intraoral scanners undergo rapid advancements in hardware and software, prompting frequent updates by manufacturers. (2) Aim: This study aimed to quantitatively assess the precision of full dental arch digital impressions obtained from four different intraoral scanners: Trios 5—3SHAPE, Copenhagen, Denmark, CEREC Primescan— Dentsply Sirona, New York, NY, USA, Planmeca Emerald S—Planmeca Oy, Helsinki, Finland, and Medit i700—Medit Corp, Seoul, Republic of Korea. (3) Methods: A maxillary virtual dental model (digital master model) was created in accordance with ISO standard 20896-1. Subsequently, a 3D-printed model was obtained from the master model’s STL file and scanned 15 times consecutively with each scanner. STL files were aligned with the master model’s STL using Medit Link—Medit Design software v.3.1.0. The accuracy was evaluated by measuring deviations in micrometers between each scanner’s scans and the master model. (4) Results: The study revealed variations in accuracy ranging from 23 to 32 µm across scans of the same dental arch, irrespective of the scanner used and scanning strategy employed. The anterior regions exhibited higher precision (Mean Absolute Deviation of 112 µm) compared to the posterior regions (Mean Absolute Deviation of 127 µm). Trios 5 demonstrated the smallest deviation (average 112 µm), indicating superior accuracy among the scanners tested. Emerald S and Medit i700 exhibited balanced performance (average 117 µm and 114 µm, respectively), while Primescan consistently displayed high deviation (average 127 µm). (5) Conclusions: Based on clinically accepted thresholds for accuracy in intraoral scanning, which are typically 200 µm for full arch scans, Trios 5 surpasses these benchmarks with its average deviation falling within the 200 µm range. Emerald S and Medit i700 also meet these standards, while Primescan, although showing high overall deviation, approaches the upper limit of clinical acceptability. Considering the limitations of an in vitro investigation, the findings demonstrate that each intraoral scanner under evaluation is capable of reliably and consistently capturing a full arch scan for dentate patients. Full article

Three-dimensional technology using personal data records has been explored for human identification. The present study aimed to explore two methodologies, photography and orofacial scanning, for assessing orofacial records in forensic scenarios, highlighting their impact on human identification. A pilot and quasi-experimental study was performed using Canon 5D-Full Frame equipment (Tokyo, Japan) and an i700 scanner (Medit, Lusobionic, Portugal) (Seoul, Republic of Korea) with Medit Scan for Clinics (MSC) and Smile Design software (V3.3.2). The sample included living patients (n = 10) and individuals in forensic cases (n = 10). The study was divided into two complementary phases: (i) data collection using 2D and 3D technologies and (ii) visual comparison by superimposition procedures, 3D dental images with 3D facial records (3D–3D), and 2D photography with screen printing of 3D facial records (2D-3S). Statistical analyses were performed using descriptive procedures (Likert scale) and the Mann–Whitney U test. The Mann–Whitney U test comparing the data (n = 220 records) from living individuals and those in forensic cases identified statistically significant differences in the performance of the photographic methods for evaluating intraoral mineralisation (p = 0.004), intraoral soft tissues (p = 0.016), intraoral distortion (p = 0.005) and the scan methods for intraoral extra devices (p = 0.003) and extraoral soft tissues (p = 0.005). A visual comparison (n = 40) allowed 3D–3D superimposition. Additionally, 2D-3S superimposition qualitatively identified the middle third of the face as the corporal area within the anatomical features required for successful surgery. In conclusion, the present study presented evidence-based data suggesting that the IO scan method, as an emergent technology, should be explored as a valuable tool in forensic facial identification in real-world scenarios. Full article

This study aimed to analyze the effect of the height of the proximal axial wall of the prepared tooth and the distance between the adjacent tooth and the prepared tooth on the scan accuracy of intraoral scanners. Ten working casts with maxillary first molars prepared to receive zirconia crowns were randomly obtained from a dental clinic. Each of the 10 casts was scanned using two intraoral scanners (i700; MEDIT and CS3600; Carestream; computer-aided design [CAD] test model, CTM; N = 15 per working cast) 15 times per scanner. Individual dies of the prepared teeth were fabricated, and high-precision scan data were acquired using a laboratory scanner (CAD reference model, CRM; N = 1). CTMs were aligned relative to the prepared tooth of CRMs by using three-dimensional inspection software (Ver 2018.1.0; Control X; 3D Systems). Data were statistically analyzed using an independent t-test and one-way analysis of variance for between-group comparisons (α = 0.05). The inaccuracy in the proximal regions (mesial or distal) of the prepared tooth was higher than that in the buccal and lingual regions (p < 0.05). The scan accuracy was not correlated with the variables when the distance between the adjacent tooth and the prepared tooth was ≥2.0 mm and the height of the proximal axial wall of the prepared tooth was <3.0 mm (p > 0.05). Therefore, an excellent scan accuracy can be obtained using an intraoral scanner when the distance between the adjacent tooth and the prepared tooth is ≥2.0 mm and the proximal axial wall height of the prepared tooth is <3.0 mm. Full article

Background and Objectives: Dental caries is a preventable, reversible disease in its early stages. This study evaluated the intra-rater agreement of International Caries Assessment and Detection System (ICDAS) scores with Medit i500^® and Omnicam^® scanners versus traditional clinical examinations and the inter-rater agreement using the Omnicam^® among senior dentists and dental students and between these two groups. Materials and Methods: A total of 24 patients aged between 21 and 34 years, randomly selected from dental students and interns, underwent four examinations (three intraoral scans and one clinical examination), and the corresponding ICDAS scores were recorded by a randomly selected rater out of the 31 available examiners. The examination team consisted of dental students, dentists with less than 3 years, and dentists with more than 5 years of clinical experience. The following inter- and intra-rater agreement tests for the ordinal data were chosen: Fleiss’ kappa coefficient, Cohen’s weighted kappa, and inter-class correlations. Results: For all examination techniques, there was statistically significant agreement for the experienced raters (p < 0.05). The highest positive interclass correlation was obtained for inter-rater agreement tests of 288 observations recorded by senior dentists: ICC = 0.969 (95% CI 0.949–0.981). Conclusions: Intra-rater reliability was excellent for Omnicam compared to clinical exams conducted by senior dentists but moderate for Medit i500. Although inter-rater agreement using Omnicam was poor between students and between senior dentists and students, it was excellent among senior dentists. Full article