Digital impressions in dentistry-accuracy of impression digitalisation by desktop scanners

Abstract

Objectives: To test if the partially digital workflow by digitalisation of the impression reveals a comparable accuracy as the indirect digitalisation of the gypsum cast for 4-unit fixed dental prostheses (FDPs).

Materials and methods: A titanium model with a tapered full veneer preparation of a molar and premolar was used as analysis model. To receive a virtual three-dimensional reference dataset (REF), it was digitised by industrial computed tomography. Three impression materials were used with individual impression trays (N = 36, n/material = 12): (1) PE (Impregum Penta), (2) PVS-I (Imprint 4 Penta: Super Quick Heavy plus Super Quick Light), and (3) PVS-D (Dimension Penta: H Quick plus L). For partially digital workflow (group IMP), two desktop scanners were used: (1) D810 (3Shape D810) and (2) ZZ (Zirkonzahn S600ARTI). For indirect digitalisation (group CAST), gypsum master casts were manufactured and digitalised using the same desktop scanners. Virtual datasets were superimposed by best fit algorithm, and accuracy was analysed by calculating the Euclidean distances (ED) to the REF (Geomagic Qualify). Statistic was determined (Kruskal-Wallis H test, Mann-Whitney U post hoc analysis, two-sample Kolmogorov-Smirnov test, p < 0.05).

Results: ZZ showed for positive deviations superior accuracy for IMP than for CAST. PE and PVS-I showed superior accuracy than PVS-D. D810 showed partially significant better performance with PVS-I and PVS-D than ZZ.

Conclusions: The partially digital workflow by digitalisation of the impression can be used for clinical indications of small-span fixed dental prostheses. However, for this indication, the impression material and the desktop scanner are more decisive for the accuracy of virtual model datasets.

Clinical relevance: Despite the rapid advancement of the computer-aided technology for dental therapy purposes, the implementation of this technique is not as fast as the technical development. In order to combine the well-established procedure to use elastomeric materials for a conventional impression and to avoid the drawbacks of casting it by gypsum, the digitalisation of the impression itself by a desktop scanner may be a logical procedure as an access point to the digital workflow. However, there is only limited information about the accuracy of this partially digital workflow by the digitalisation of modern impression materials in comparison to the well-known process of indirect digitalisation of gypsum casts.

Keywords: Accuracy; Cast scan; Digital impression; Impression material; Impression scan.