Resident, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Clinical Professor, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
J Prosthet Dent. 2024 Jul;132(1):190.e1-190.e7. doi: 10.1016/j.prosdent.2024.04.008. Epub 2024 Apr 30.
Axial displacement is inevitable when connecting scan bodies to implants for digital scans using intraoral scanners, and axial displacement may reduce implant position accuracy in digital casts. However, studies assessing scan body type and accuracy are lacking.
The purpose of this in vitro study was to assess the linear and angular displacements of implants in digital casts using 2 scan body types with or without a vertical stop to minimize the axial displacement and 2 internal conical connection implants (ICCIs) with different internal conical angles.
Two identical reference casts were fabricated from epoxy resin by duplicating a partially edentulous mandibular dentiform. Each cast received 3 implants in the left first premolar, first molar, and second molar regions. One cast received an ICCI with a 7-degree internal conical angle (7-degree ICCI), and the other received an ICCI with an 11-degree internal conical angle (11-degree ICCI). A 10-mm polyetheretherketone (PEEK) cube was attached to the buccal area of the mandibular second premolar of each reference cast. A vertical stop was used in the experimental scan bodies to minimize the axial displacement, and conventional scan bodies were hand tightened to the implants in the reference casts. An intraoral scanner was used to fabricate 4 digital cast groups (2 implant types and 2 scan body types; each group had 10 casts). A coordinate measuring machine and digital inspection software program were used to measure the implant platform centroids (x, y, z) and projection angles (θXY, θYZ, θZX) of implant long axes in the reference and digital casts, respectively. One-way analysis of variance (ANOVA) and linear mixed model both with Tukey post hoc and 2-way ANOVA tests were performed to assess the significance of linear and angular displacements between groups (α=.05).
Significant differences were noted in all linear displacement variables among the 4 digital cast groups, except for Δx in the left first premolar implant. For the 7-degree ICCI, the linear displacement was statistically similar in the experimental and conventional scan bodies. However, for the 11-degree ICCIs, the experimental scan body group resulted in significantly smaller Δy, Δz, and Δd (Δd=Δx+Δy+Δz) than the conventional scan body group (P<.05). Overall, the 11-degree ICCIs demonstrated a significantly greater linear displacement than the 7-degree ICCI, regardless of the scan body type (P<.05). Significant differences between the test groups were observed for 10 of the 12 angular displacement variables (P<.05).
The 11-degree ICCIs demonstrated significantly greater linear displacements in Δy, Δz, and Δr than the 7-degree ICCIs. The experimental scan bodies with a vertical stop demonstrated significantly smaller linear displacements in the 11-degree ICCIs.
使用口内扫描仪对植入物进行数字扫描时,扫描体与植入物相连不可避免会发生轴向位移,而轴向位移可能会降低数字印模中的植入物位置精度。然而,评估扫描体类型和准确性的研究还很缺乏。
本体外研究的目的是评估使用 2 种扫描体类型(带或不带垂直止动件以最小化轴向位移)和 2 种内部锥形连接植入物(ICCIs)(具有不同内部锥形角度)的数字印模中植入物的线性和角度位移。
通过复制部分无牙下颌齿形,用环氧树脂制作了 2 个相同的参考模型。每个模型在左侧第一前磨牙、第一磨牙和第二磨牙区域接收 3 个植入物。一个模型接收具有 7 度内部锥形角度的 ICCI(7 度 ICCI),另一个模型接收具有 11 度内部锥形角度的 ICCI(11 度 ICCI)。在每个参考模型的下颌第二前磨牙的颊侧区域附着一个 10 毫米的聚醚醚酮(PEEK)立方体。在实验扫描体中使用垂直止动件以最小化轴向位移,并且将常规扫描体手动拧紧到参考模型中的植入物上。使用口内扫描仪制作 4 个数字印模组(2 种植入物类型和 2 种扫描体类型;每个组有 10 个印模)。使用坐标测量机和数字检测软件程序分别测量参考和数字印模中植入物平台质心(x、y、z)和植入物长轴的投影角(θXY、θYZ、θZX)。使用单向方差分析(ANOVA)和线性混合模型(均带有 Tukey 事后检验和 2 向 ANOVA 检验)评估组间线性和角度位移的显著性(α=.05)。
4 个数字印模组的所有线性位移变量均存在显著差异,除了左侧第一前磨牙植入物的 Δx。对于 7 度 ICCI,实验扫描体和常规扫描体的线性位移在统计学上相似。然而,对于 11 度 ICCI,实验扫描体组的 Δy、Δz 和 Δd(Δd=Δx+Δy+Δz)明显小于常规扫描体组(P<.05)。总体而言,无论扫描体类型如何,11 度 ICCI 的线性位移均明显大于 7 度 ICCI(P<.05)。12 个角度位移变量中的 10 个在实验组之间存在显著差异(P<.05)。
11 度 ICCI 的 Δy、Δz 和 Δr 线性位移明显大于 7 度 ICCI。带垂直止动件的实验扫描体在 11 度 ICCI 中表现出明显较小的线性位移。