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Journal of Peking University(Health Sciences) ›› 2020, Vol. 52 ›› Issue (1): 129-137. doi: 10.19723/j.issn.1671-167X.2020.01.021

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Accuracy of three intraoral scans for primary impressions of edentulous jaws

Yue CAO,Jun-kai CHEN,Ke-hui DENG,Yong WANG,Yu-chun SUN(),Yi-jiao ZHAO()   

  1. Center of Digital Dentistry, Faculty of Prosthodontics, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China
  • Received:2019-10-08 Online:2020-02-18 Published:2020-02-20
  • Contact: Yu-chun SUN,Yi-jiao ZHAO E-mail:kqsyc@bjmu.edu.cn;kqcadcs@bjmu.edu.cn
  • Supported by:
    Supported by the National Key R&D Program of China(2018YFB1106900);Capital’s Funds for Health Improvement and Research(2018-2-41031);Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-18G01);Joint Fund of Ministry of Education of China for Equipment(6141A020226XX);Key R&D Program of Ningxia Hui Autonomous Region(2018BEG02012)

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Abstract:

Objective: To provide a reference for using intraoral scanners for making clinical diagnostic dentures of edentulous jaws by comparing the accuracy of three intraoral scanners for primary impression and jaw relation record of edentulous jaws. Methods: This study contained 6 primary impressions of the edentulous patients. Each of the impressions consisted of the maxillary primary impression, the mandibular primary impression and the jaw relation record. For each of them, a dental cast scanner (Dentscan Y500) was used to obtain stereolithography(STL)data as reference scan, and then three intraoral scanners including i500, Trios 3 and CEREC Primescan were used for three times to obtain STL data as experiment groups. In Geomagic Studio 2013 software, trueness was obtained by comparing experiment groups with the reference scan, and the precision was obtained from intragroup comparisons. Registered maxillary data of the intraoral scan with reference scan, the morphological error of jaw relation record was obtained by comparing jaw relation record of the intraoral scan with the reference scan. Registered mandibular data with jaw relation record of intraoral scan and the displacement of the jaw position were evaluated. Independent samples t test and Mann-Whitney U test in the SPSS 20.0 statistical software were used to statistically analyze the trueness, precision and morphological error of jaw relation record of three intraoral scanners. The Bland-Altman diagram was used to evaluate the consistency of the jaw relationship measured by the three intraoral scanners. Results: The trueness of i500, Trios 3 and CEREC Primescan scanners was (182.34±101.21) μm, (145.21±71.73) μm, and (78.34±34.79) μm for maxilla; (106.42±21.63) μm, and 95.08 (63.08) μm, (78.45±42.77) μm for mandible. There was no significant difference in trueness of the three scanners when scanning the maxilla and mandible(P>0.05). The precision of the three scanners was 147.65 (156.30) μm, (147.54±83.33) μm, and 40.30 (32.80) μm for maxilla; (90.96±30.77) μm, (53.73±23.56) μm, and 37.60 (93.93) μm for mandible. The precision of CEREC Primescan scanner was significantly better than that of the other two scanners for maxilla(P<0.05). Trios 3 and CEREC Primescan scanners were significantly better than i500 scanner for mandible(P<0.05). The precision of the i500 and Trios 3 scanners for mandible was superior to maxilla(P<0.05). The upper limit of 95% confidence intervals of trueness and precision of three scanners for both maxilla and mandible were within ±300 μm which was clinically accepted. The morphological error of jaw relation record of the three scanners was (337.68±128.54) μm, (342.89±195.41) μm, and (168.62±88.35) μm. The 95% confidence intervals of i500 and Trios 3 scanners were over 300 μm. CEREC Primescan scanner was significantly superior to i500 scanner(P<0.05).The displacement of the jaw position of the three scanners was (0.83±0.56) mm, (0.80±0.45) mm, and (0.91±0.75) mm for vertical dimension; (0.79±0.58) mm, (0.62±0.18) mm, and (0.53±0.53) mm for anterior and posterior directions; (0.95±0.59) mm, (0.69±0.45) mm, and (0.60±0.22) mm for left and right directions. The displacement of the jaw position of the three scanners in vertical dimension, anterior and posterior directions and the left and right directions were within the 95% consistency limit. Conclusion: Three intraoral scanners showed good trueness and precision. The i500 and Trios 3 scanners had more errors in jaw relation record, but they were used as primary jaw relation record. It is suggested that three intraoral scanners can be used for obtaining digital data to make diagnostic dentures and individual trays, reducing possible deforming or crack when sending impressions from clinic to laboratory.

Key words: Intraoral scanner, Edentulous jaws, Digital impression, Accuracy

CLC Number: 

  • R783.6

Figure 1

Maxillary and mandibular primary impressions and primary jaw relation record A, maxillary primary impression; B, mandibular primary impression; C, front view of primary jaw relation record; D, vertical view of primary jaw relation record."

Table 1

Characteristics of three intraoral scanners and dental cast scanner"

System Manufacture Software Country Acquisition technology
i500 MEDIT 2.0.3 Korea Triangulation
Trios 3 3 SHAPE 1.4.7.5 Denmark Confocal measurement
CEREC Primescan Sirona 5.0.1.16682 Germany Triangulation
Dentscan Y500 Nanjing Geosmart 3D China Blue grating

Figure 2

Flow-chart of scans with DentscanY500 and three intraoral scanners for maxillary impression (Model U), jaw relation record(Model O) and mandibular impression(Model L). Use reference (Ref), for trueness test and cross-comparison for precision. Multiple intraoral scans are denoted by S1, S2 and S3"

Figure 3

Color difference map of Model U and Model L A, i500 scanner; B, Trios 3 scanner; C, CEREC Primescan scanner."

Figure 4

Color difference map of Model A, i500 scanner; B, Trios 3 scanner; C, CEREC Primescan scanner."

Figure 5

Set up coordinate system Ref in Model L Ref A, frontal view of coordinate system; B, lateral view of coordinate system."

Figure 6

Analyze the displacement of jaw relationship A, copy the coordinate system Ref to the Model L Exp;B, register the Model L Exp to the Model U Exp based on Model O Exp; C, analyze the deviation between the coordinate system Ref and the coordinate system Exp."

Table 2

Trueness of three intraoral scanners"

Items Model U Model L
MD TR PS MD TR PS
Trueness/μm,
x?±s/Median (IQR)		 182.34±101.21 145.21±71.73 78.34±34.79 106.42±21.63 95.08(63.08) 78.45±42.77
95%CI (76.13,288.55) (69.94,220.49) (41.83,114.86) (83.72,129.12) (55.28,175.36) (33.56,123.34)

Table 3

Statistical magnitude of trueness"

Items Model U Model L Model U versus Model L
MD-TRa TR-PSa MD-PSa MD-TRb TR-PSb MD-PSa MDa TRb PSa
Difference value 0.733 2.055 2.380 0.320 1.363 1.430 1.793 0.801 0.005
P value 0.480 0.067 0.054 0.749 0.173 0.183 0.127 0.423 0.996

Table 4

Precision of three intraoral scanners"

Items Model U Model L
MD TR PS MD TR PS
Precision/(μm),
x?±s/Median (IQR)		 147.65(156.30) 147.54±83.33 40.30(32.80) 90.69±30.77 53.73±23.56 37.60(93.93)
95%CI (120.90,243.77) (106.11,188.98) (57.39,105.99) (75.39,105.99) (42.01,65.44) (37.28,94.57)

Table 5

Statistical magnitude of precision"

Items Model U Model L Model U versus Model L
MD-TRb TR-PSb MD-PSb MD-TRa TR-PSb MD-PSb MDb TRa PSb
Difference value 0.601 4.176 4.651 4.046 1.155 2.247 2.816 4.597 0.174
P value 0.548 0.000* 0.000* 0.000* 0.248 0.025* 0.005* 0.000* 0.862

Table 6

Morphological error of jaw relation record of three intraoral scanners"

Items MD TR PS
Morphological error of jaw relation record/μm, x?±s 337.68±128.54 342.89±195.41 168.62±88.35
95%CI (202.78,472.57) (137.82,547.96) (75.90,261.34)

Table 7

Statistical magnitude of morphological error of jaw relation record"

Items MD-TR TR-PS MD-PS
Difference value 0.055 1.991 2.655
P value 0.958 0.075 0.024*

Table 8

Displacement of jaw relationship"

Items Group z y x
Displacement of jaw relationship/mm, x?±s MD 0.83±0.56 0.79±0.58 0.95±0.59
TR 0.80±0.45 0.62±0.18 0.69±0.45
PS 0.91±0.75 0.53±0.53 0.60±0.22
95%CI MD (0.24,1.41) (0.18,1.39) (0.33,1.57)
TR (0.34,1.27) (0.44,0.81) (0.22,1.16)
PS (0.38,1.69) (-0.30,1.09) (0.38,0.83)

Figure 7

Bland-Altman diagrams of deviation of jaw relationship MD, i500 scanner; TR, Trios 3 scanner; PS, CEREC Primescan scanner; z, vertical dimension; y, displacement in anterior and posterior; x, displacement in left and right; SD, standard deviation. The unit of x, y, z is mm."

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