Digital intraoral scanner devices: a validation study based on common evaluation criteria.

BACKGROUND: The evolution of intraoral scanners (IOSs) is rapid, and new IOSs appear on the market with different properties depending on the manufacturers. There is no uniform rating system based on a defined set of aspects that has reported in the literature that can be used to compare these devices. This validation study aimed to compare different IOSs based on objective and comprehensive parameters. METHODS: In this study, 12 different IOSs were examined. The IOSs that were tested in this study in order of their delivery included the 3Shape Trios 3 Pod®, Planmeca Emerald®, Straumann DWIO®, GC Aadva®, iTero Element 2®, CEREC Primescan®, Medit i500®, 3Shape Trios 4 Move®, Carestream CS3600®, 3Shape Trios 4 Pod®, Carestream CS3700®, and Planmeca Emerald S®. IOSs were evaluated in four different ways: (a)summary chart, (b)comparative assessment, (c)data based on in vitro measurements and (d)accuracy measurements. A scoring system was created to enable an objective rating of IOSs. RESULTS: The differences among IOSs were demonstrated in point scores (summary chart[max. 10 points] + weight of IOSs[max. 2.5 points] + circumference of IOSs[max. 2.5 points] + in vitro scanning time[max. 2.5 points] + pauses in data capture[max. 2.5 points] + accuracy[max. 10 points] = summary[max. 30 points]). Trios 4 Pod achieved the greatest cumulative score (23.37 points), furthermore it earned the highest points for summary chart and scanning speed. Regarding scanning continuity, the best-performing IOSs, which tied at identical point scores, were the Trios 3 and 4 Pod, Trios 4 Move, iTero Element 2, CS3600 and CS3700. The most accurate IOS was the CEREC Primescan, although it earned the lowest points of the comparative assessment (heaviest IOS). GC Aadva scored 5.73 points of a maximum of 30 points, which was the poorest result in this study. CONCLUSION: The scoring system reflects the differences among IOS devices based on the evaluated objective parameters and can be used to help clinicians select the right IOS device. The new generations of IOSs have more special properties, and their accuracy is higher than the previous versions. Trial registration The permission for this study was granted by University Ethics Committee of Semmelweis University (SE RKEB number:108/2019).

Comparing the effectiveness of shade measurement by intraoral scanner, digital spectrophotometer, and visual shade assessment.

OBJECTIVE: Trios3 (3Shape, Denmark) intraoral scanner is complete with a tooth shade measurement function, but there is limited information about its efficacy. This in vivo study aimed to evaluate this function in relation to visual and spectrophotometric shade determination. MATERIALS AND METHODS: Ten dental students from Semmelweis University determined tooth shade for 10 volunteers using Vita A1-D4 (VC) and Vita Linearguide 3D-Master (LG) guides, Vita Easyshade spectrophotometer (ES) and Trios 3 intraoral scanner (TR). First and last patient was always the same (Patient R). Intrapersonal repeatability was calculated. Four selected shades of each tooth were presented to student, supervisor, and patient to select best match. Selection percentages were calculated. The supervisor's best match was the reference (∆E00 ). RESULTS: Median ∆E00 of Patient R: TR 1.09; VC 1.5; ES 2.35; LG 3.1. The percentages of best match: VC 16.7%.; TR 21.64%; ES 26.58%; LG 34.08%. Median ∆E00 of students' and supervisor's best match: LG 2.73; ES 4.29; TR 4.29; VC 16.35. TR was the most repeatable. The most "best-match shade tabs" were selected using LG. VC shade tabs was the least consistent with the examined teeth. CONCLUSIONS: TR can be used for shade selection with a 3D-Master tooth color system with visual verification. CLINICAL SIGNIFICANCE: Correct tooth shade determination is one of the most important step in making esthetic restorations. New shade matching systems have been developed to surpass the visual method of shade determination. There are new intraoral scanners with built-in shade measurement functions. Digital shade determination methods are more independent from the environmental circumstances, and with intraoral scanners, it is easy to measure the tooth shade by taking a digital impression at the same time. These new devices may be a reliable alternative method for shade selection with visual verification.

Learning curve of digital intraoral scanning - an in vivo study.

BACKGROUND: The spread of digital technology in dentistry poses new challenges and sets new goals for dentists. The aim of the present in vivo study was to determine the learning curve of intraoral scanning described by (1) scanning time and (2) image number (count of images created by intraoral scanner during the scanning process). METHODS: Ten dental students of Semmelweis University took part in the study. Dental students took digital study impressions using a 3Shape Trios 3® (3Shape, Copenhagen, Denmark) intraoral scanning device. Each student took 10 digital impressions on volunteers. Volunteer inclusion criteria included full dentition (except for missing third molars) and no prosthetic/restorative treatment. Digital impression taking was preceded by tuition consisting of both theoretical education and practical training. Digital impressions were taken of the upper and lower arches, and the bite was recorded according to the manufacturer's instructions. Total scanning times and image numbers were recorded. RESULTS: The difference in scanning time between the first and the tenth digital impressions was significant (p = 0.007). The average scanning time for the first impressions was 23 min 9 s; for the tenth impressions, it was 15 min 28 s. The difference between the scanning times of the first and the tenth procedures was 7 min 41 s. The average image count for the first impressions was 1964.5; for the tenth impressions, it was 1468.6. The image count difference between the first and the tenth procedures was 495.9. The image count versus sequential number of measurement curve shows an initial decreasing tendency followed by a trough around the sixth measurement and a final increasing phase. CONCLUSION: Our results indicate an association between the sequential number of measurements and the outcome variables. The drop in scanning time is probably explained by a practice effect of repeated use, i.e. the students learned to move the scanning tip faster. The image count first showed a decreasing tendency, and after the sixth measurement, it increased; there was no consistent decline in mean scan count. Shorter scanning times are associated with poorer coverage quality, with the operator needing to make corrections by adding extra images; this manifests as the time function of image counts taking an increase after the sixth measurement.

Effects of substrate, ceramic thickness, translucency, and cement shade on the color of CAD/CAM lithium-disilicate crowns.

OBJECTIVE: The aim of this in vitro study was to evaluate the effects of substrate colors, different levels of ceramic thickness and translucency, and cement shades on the color difference from a reference color of lithium-disilicate crowns. MATERIALS AND METHODS: A premolar tooth preparation was made on a study model for 1.0 and 1.5 mm thick full-ceramic crowns. Digital impressions were taken (3Shape TRIOS) and crowns designed in a CAD program (DentalDesigner). Shade A1 crowns were milled (Everest, Kavo) from high-translucency (HT) and low-translucency IPS e.max (Ivoclar Vivadent) blocks. Twelve substrates were made of different colors and materials (Natural Die Material, Co-Cr, zirconia, and gold-colored alloy). Three different shades of try-in pastes were used to simulate the effect of cements (Variolink Esthetic try-in paste; Ivoclar). Shade measurement was done three times for each crown by a spectrophotometer (VITA Easyshade Advance); averages were compared to a reference crown (A1, HT, 1.5 mm, ND2 abutment, neutral try-in paste) with ΔE00 (CIEDE2000, according to the CIE latest standard) calculated. RESULTS: All the examined parameters influenced the ΔE00 of the crowns. The weakest effect was exerted by the try-in paste. CONCLUSIONS: All examined parameters influenced the final color of e.max CAD lithium-disilicate ceramic crowns. CLINICAL SIGNIFICANCE: Matching the shade of ceramic crowns to the natural tooth color is a great challenge in dentistry. To meet patients' increasing esthetical expectations, CAD/CAM methods are very popular for full-ceramic crowns. However, several factors such as the shade of the abutment, luting cement color, ceramic thickness, and translucency may influence the final color. Our objective was to measure the optical effect of these factors on the final shade of CAD/CAM lithium-disilicate ceramic crowns.