Related Experiment Video
Updated: Jan 15, 2026
Accuracy in Dental Medicine, A New Way to Measure Trueness and Precision
Published on: April 29, 2014
Clinical accuracy of three intraoral scanners for determining an increased vertical dimension of occlusion: A pilot
Álvaro Ferrando Cascales1, Maria José Martínez Ballester2, Javier Fernández-Navarro3
1Department of Biomaterials Engineering, Faculty of Medicine, UCAM, Universidad Católica de Murcia, Campus Los Jerónimos, 135 Guadalupe, 30107 Murcia, Spain.
Statement Of Problem:
The accuracy of maxillomandibular relationships captured by intraoral scanners (IOSs) has been previously evaluated under in vitro conditions; however, the accuracy of different IOSs in registering an increased vertical dimension of occlusion under clinical conditions remains unclear.
Purpose:
The purpose of this in vivo study was to assess the accuracy of maxillomandibular relationship records at an increased vertical dimension of occlusion using different IOSs.
Material And Methods:
A participant dentition was digitized using an IOS (PrimeScan) to obtain a reference standard tessellation language (STL) file and design and 3-dimensionally (3D) print an anterior device to increase the vertical dimension of occlusion. A reference cone beam computed tomography (CBCT) scan (CS9600; Carestream) was then acquired with the device in place. The STL and CBCT files were aligned using a computer-aided design (CAD) software program (NemoScan) to generate the control reference dataset (CTRLr). Subsequently, the participant was scanned with 3 different IOSs: i900 (Medit Corp), iTero Lumina (Align Technology), and TRIOS 5 (3Shape A/S) (n=10). STL files from both the CTRLr and experimental groups were segmented using an artificial intelligence algorithm (MovumStudio). Reference key points were manually annotated on each tooth in the CTRLr group, and pairwise Euclidean distances between corresponding key points were calculated to obtain the reference distances. The same key points were automatically detected in the experimental groups and corresponding interarch Euclidean distances were computed. All measurements were categorized by anatomic location (anterior or posterior). Statistical analysis was performed using 1-way ANOVA (α=.05), followed by Bonferroni post hoc tests for pairwise comparisons. Additionally, paired t tests and the Levene test were applied to evaluate differences between anterior and posterior sectors within each scanner group. All analyses were conducted using a statistical software program (IBM SPSS Statistics, v25; IBM Corp) (α=.05).
Results:
The i900 and TR5 groups had significantly higher accuracy and precision compared with the iTero group (P<.001), with no statistically significant differences between i900 (P=.130) and TRIOS (P=.426). No significant differences were observed between anterior and posterior sectors in either the i900 or TR5 groups (P>.05). In contrast, the iTero group showed a significant difference in trueness between anterior and posterior sectors (P<.001), while precision was statistically similar (P=.188). A 2-way ANOVA confirmed a significant scanner effect and a significant interaction effect (P<.001), indicating that accuracy outcomes were influenced by the IOS used.
Conclusions:
The IOS selected impacted the virtual occlusal registrations at an increased vertical dimension. The i900 and TRIOS 5 scanners had the highest trueness and precision, whereas the iTero Lumina had the lowest performance among the scanners evaluated.
