Accuracy of Intraoral Digital Impressions for Whole Upper Jaws, Including Full Dentitions and Palatal Soft Tissues

Abstract

Intraoral digital impressions have been stated to meet the clinical requirements for some teeth-supported restorations, though fewer evidences were proposed for larger scanning range. The aim of this study was to compare the accuracy (trueness and precision) of intraoral digital impressions for whole upper jaws, including the full dentitions and palatal soft tissues, as well as to determine the effect of different palatal vault height or arch width on accuracy of intraoral digital impressions. Thirty-two volunteers were divided into three groups according to the palatal vault height or arch width. Each volunteer received three scans with TRIOS intraoral scanner and one conventional impression of whole upper jaw. Three-dimensional (3D) images digitized from conventional gypsum casts by a laboratory scanner were chose as the reference models. All datasets were imported to a specific software program for 3D analysis by "best fit alignment" and "3D compare" process. Color-coded deviation maps showed qualitative visualization of the deviations. For the digital impressions for palatal soft tissues, trueness was (130.54±33.95)μm and precision was (55.26±11.21)μm. For the digital impressions for upper full dentitions, trueness was (80.01±17.78)μm and precision was (59.52±11.29)μm. Larger deviations were found between intraoral digital impressions and conventional impressions in the areas of palatal soft tissues than that in the areas of full dentitions (p<0.001). Precision of digital impressions for palatal soft tissues was slightly better than that for full dentitions (p = 0.049). There was no significant effect of palatal vault height on accuracy of digital impressions for palatal soft tissues (p>0.05), but arch width was found to have a significant effect on precision of intraoral digital impressions for full dentitions (p = 0.016). A linear correlation was found between arch width and precision of digital impressions for whole upper jaws (r = 0.326, p = 0.034 for palatal soft tissues and r = 0.485, p = 0.002 for full dentitions). It was feasible to use the intraoral scanner to obtain digital impressions for whole upper jaws. Wider dental arch contributed to lower precision of an intraoral digital impression. It should be confirmed in further studies that whether accuracy of digital impressions for whole upper jaws is clinically acceptable.

Fig 1. Flow chart.

Fig 2. Measurement method of arch width.

Fig 3. Measurement method of palatal vault height.

Fig 4. Color-coded deviation maps presentation after best fit alignment and 3D compare by Geomagic Qualify 12.

(a) Trueness of digital impression for palatal soft tissues. Left: The top of the palatal vault was in the behind position. Right: The top of the palatal vault was in the front position. (b) Trueness of digital impression for full upper dentitions. (c) Precision of digital impression for palatal soft tissues. (d) Precision of digital impression for full upper dentitions. Color-coded scale unit: millimetre.

Fig 5. Box plot demonstrating accuracy measurement (trueness and precision) for palatal soft tissues and full upper dentitions.

The black dots represent outliers.

Fig 6. A linear correlation was found between arch width and precision of the digital impressions for full upper dentitions (r = 0.485,p = 0.002).

Fig 7. A linear correlation was found between arch width and precision of the digital impressions for palatal soft tissues (r = 0.326,p = 0.034).