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Feasibility of digitizing multiple tissue-level implants without scan bodies for fixed dental prostheses
Stefano Pieralli1, Ahmad Amro Baradee2, Benedikt C Spies2
1Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie, Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, Berlin, 14197, Germany.
Objective:
This in vitro study evaluated the feasibility of intraoral scanning of two tissue-level implants for a three-unit fixed dental prosthesis (FDP) without using scan bodies, with the aim of potentially improving clinical cost efficiency.
Methods:
A mandibular typodont model with two tissue-level implants - a regular-platform (RP) implant in the premolar region and a wide-platform (WP) implant in the molar region - was digitized. Three intraoral scanners (TRIOS 5, Primescan, DCS Scan) and one laboratory scanner (E4; reference scanner) were used to acquire 16 scans each, with and without scan bodies. Linear deviations at the implant shoulder and apex, as well as angular deviations, were analyzed. Statistical analysis included one-way ANOVA, Scheffé's post hoc test, and unpaired t-tests (α = 0.05).
Results:
Linear deviations were generally smaller at the implant shoulder than at the apex for all scanners and both implants. For the RP implant, mean deviations without scan bodies remained predominantly within 100 µm at the shoulder region and were comparable to those obtained with scan bodies. In contrast, the WP implant exhibited greater mean deviations of >110 µm at the shoulder. Angular deviations between implants were similar with and without scan bodies, with a maximum deviation of 0.34 ° compared with the reference scans.
Conclusions:
In this in vitro study, scan body-free digital impressions of tissue-level implants showed variable accuracy. Differences in accuracy may be associated with implant position and scanning strategy rather than implant geometry alone. The observed linear deviations, currently limit the applicability of scan body-free digitization for FDP restorations.
Clinical Significance:
Eliminating scan bodies could simplify clinical workflows and reduce material costs and chair time. However, the findings indicate that scan body-free intraoral scanning of tissue-level implants may not yet provide sufficient accuracy for multi-unit FDPs, particularly in posterior regions, and should therefore be used with caution in clinical practice.
