Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi Street 47, Budapest 1088, Hungary.
Downtown Tulsa Dental, Tulsa, OK, USA.
J Dent. 2023 Dec;139:104764. doi: 10.1016/j.jdent.2023.104764. Epub 2023 Oct 26.
The study aimed to compare the trueness and precision of five intraoral scanners (Emerald S, iTero Element 5D, Medit i700, Primescan, and Trios 4) and two indirect digitization techniques for both teeth and soft tissues on fresh mandibular and maxillary cadaver jaws.
The maxilla and mandible of a fully dentate cadaver were scanned by the ATOS industrial scanner to create a master model. Then, the specimens were scanned eight times by each intraoral scanner (IOS). In addition, 8 polyvinylsiloxane (PVS) impressions were made and digitized with a Medit T710 desktop scanner. Stone models were then poured and again scanned with the desktop scanner. All IOS, PVS, and stone models were compared to the master model to calculate the mean absolute surface deviation for mandibular teeth, maxillary teeth, and palate.
For mandibular teeth, the PVS trueness was only significantly better than the Medit i700 (p < 0.001) and Primescan (p < 0.05). In maxillary teeth, the PVS trueness was significantly better than all IOSs (p < 0.05-0.001); the stone trueness was significantly better than Emerald S (p < 0.01), Medit i700 (p < 0.001) and Primescan (p < 0.01). In the palate, PVS and stone trueness were significantly lower than the iTero Element 5D (p < 0.01) and Trios 4 (p < p < 0.01). Stone trueness was significantly lower than the Medit i700 (p < 0.05). The precision in the palate was significantly lower for PVS and stone than for Emerald S (p < 0.01, p < 0.05), iTero Element 5D (p < 0.01, p < 0.01), Primescan (p < 0.001, p < 0.001), and Trios 4 (p < 0.001, p < 0.01). Significant differences in trueness between the IOSs were observed only in the mandibular teeth. The Medit i700 performed worse than Emerald S (p < 0.01) and iTero Element 5D (p < 0.01). For mandibular teeth, the Medit i700 was significantly more precise than Primescan (p < 0.01) and the Emerald S (p < 0.05). The Trios 4 was significantly less precise than Emerald S (p < 0.05). The precision of Medit i700 was significantly worse than iTero Element 5D (p < 0.01) for maxillary teeth, as well as the Primescan (p < 0.01) and Trios 4 (p < 0.05) for the palate.
In general, indirectly digitized models from PVS impressions had higher trueness than IOS for maxillary teeth; precision between the two methods was similar. IOS was more accurate for palatal tissues. The differences in trueness and precision for mandibular teeth between the various techniques were negligible.
All investigated IOSs and indirect digitization could be used for complete arch scanning in mandibular and maxillary dentate arches. However, direct optical digitization is preferable for the palate due to the low accuracy of physical impression techniques for soft tissues.
本研究旨在比较五种口内扫描仪（Emerald S、iTero Element 5D、Medit i700、Primescan 和 Trios 4）和两种间接数字化技术在新鲜下颌和上颌尸体颌骨上的牙齿和软组织的准确性和精密度。
使用 ATOS 工业扫描仪对一具完全有牙的尸体的上颌和下颌进行扫描，以创建主模型。然后，使用每种口内扫描仪（IOS）对标本进行八次扫描。此外，还制作了 8 个聚硅氧烷（PVS）印模，并使用 Medit T710 台式扫描仪进行数字化。然后用石模型进行浇铸并再次用台式扫描仪进行扫描。将所有 IOS、PVS 和石模型与主模型进行比较，计算下颌牙齿、上颌牙齿和腭的平均绝对表面偏差。
对于下颌牙齿，PVS 的准确性仅明显优于 Medit i700（p<0.001）和 Primescan（p<0.05）。在上颌牙齿中，PVS 的准确性明显优于所有 IOS（p<0.05-0.001）；石模型的准确性明显优于 Emerald S（p<0.01）、Medit i700（p<0.001）和 Primescan（p<0.01）。在上腭，PVS 和石模型的准确性明显低于 iTero Element 5D（p<0.01）和 Trios 4（p<0.01）。石模型的准确性明显低于 Medit i700（p<0.05）。在上腭，PVS 和石模型的精密度明显低于 Emerald S（p<0.01，p<0.05）、iTero Element 5D（p<0.01，p<0.01）、Primescan（p<0.001，p<0.001）和 Trios 4（p<0.001，p<0.01）。仅在下颌牙齿中观察到 IOS 之间的准确性有显著差异。Medit i700 的性能明显劣于 Emerald S（p<0.01）和 iTero Element 5D（p<0.01）。对于下颌牙齿，Medit i700 的精密度明显优于 Primescan（p<0.01）和 Emerald S（p<0.05）。Trios 4 的精密度明显低于 Emerald S（p<0.05）。Medit i700 的精密度明显劣于 iTero Element 5D（p<0.01）在上颌牙齿，以及 Primescan（p<0.01）和 Trios 4（p<0.05）在上腭。
一般来说，PVS 印模的间接数字化模型在上颌牙齿的准确性方面高于 IOS；两种方法的精度相似。IOS 在上腭组织的准确性方面更高。各种技术之间下颌牙齿的准确性和精密度差异可以忽略不计。
所有研究的 IOS 和间接数字化技术都可用于有牙的下颌和上颌全牙弓扫描。然而，由于物理印模技术对软组织的准确性较低，直接光学数字化更适合上腭。
