Soft tissue-preserving computer-aided impression: a novel concept using ultrasonic 3D-scanning

Subgingival preparations are often affected by blood and saliva during impression taking, regardless of whether one is using compound impression techniques or intraoral digital scanning methods. The latter are currently based on optical principles and therefore also need clean and dry surfaces. In contrast, ultrasonic waves are able to non-invasively penetrate gingiva, saliva, and blood, leading to decisive advantages, as cleaning and drying of the oral cavity becomes unnecessary. In addition, the application of ultrasound may facilitate the detection of subgingival structures without invasive manipulation, thereby reducing the risk of secondary infection and treatment time, and increasing patient comfort. Ultrasound devices commonly available for medical application and for the testing of materials are only suitable to a limited extent, as their resolution, precision, and design do not fulfill the requirements for intraoral scanning. The aim of this article is to describe the development of a novel ultrasound technology that enables soft tissue-preserving digital impressions of preparations for the CAD/CAM-based production of dental prostheses. The concept and development of the high-resolution ultrasound technique and the corresponding intraoral scanning system, as well as the integration into the CAD/CAM process chain, is presented.