Trueness of automatic complete denture segmentation in two implant planning software programs: An in vitro study

To investigate influences of arch location and implant planning software programs on trueness of automatic segmentation and reconstruction of complete dentures.

Ten maxillary (Mx) and ten mandibular (Mn) complete prostheses were attached with fiducial markers and underwent desktop scanning to obtain reference scans. The prostheses were digitized using cone-beam computed tomography before converted into digital imaging and communications in medicine. The dataset was automatically segmented and reconstructed using automatic segmentation of 2 different implant planning software programs (DTX Studio (DTX) and BlueSky Plan (BSP)), resulting in 4 experimental groups: Mx-DTX, Mn-DTX, Mx-BSP, and Mn-BSP (n = 10). Reconstructions were superimposed on the reference scan in 3D inspection software and analyzed for trueness using the root mean square value (RMS). Data were analyzed by two-way ANOVA and Tukey's test (α = 0.05). Trueness was also assessed qualitatively via color mapping.

Arch location and implant planning software significantly affected segmentation trueness (P < .05). Mx exhibited greater deviation than Mn (mean difference = 236 µm; 95 % CI: 80-392 µm), and DTX software produced higher deviation than BSP (mean difference = 541 µm; 95 % CI: 385-698 µm). Mx-DTX demonstrated the highest deviation among all subgroups (P < .001), while no significant difference was found between Mx-BSP and Mn-BSP. Qualitative analysis revealed that DTX-reconstructed denture had an overall enlarged reconstruction, whereas BSP-derived reconstructions were more accurate.

Arch location and implant planning software significantly affected the trueness of denture reconstruction. Maxillary dentures exhibited greater deviation compared to mandibular dentures in DTX, and the BSP yielded lower deviation than DTX for both arches.

The trueness of automatic denture segmentation varies depending on the arch and program used, which may affect the fit and accuracy of mucosa-supported surgical guides and interim implant-supported prostheses, potentially leading to deviations in implant positioning and occlusion.