Is Intraoral Scanning Accurate to Evaluate Dental Implant Position? An In-Vitro Study

Author(s)

Bergamaschi, Isabela Polesi ; Cortellazzi, Karine Laura ; Sverzut, Alexander Tadeu

• Document type: Journal article
• Source: JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY; v. 81, n. 4, p. 15-pg., 2023-04-01.

Abstract

Purpose: The position of dental implants is generally verified through imaging exams, even though its use exposes patients to radiation. Intraoral scanning (IOS) may be a suitable alternative to using radio-graphic imaging to verify implant position. Using polyurethane jaw models, the purpose of this in-vitro study was to measure and compare implant positions determined by IOS and cone-bean computed tomog-raphy (CBCT). Methods: One hundred twenty implants were installed in 30 edentulous polyurethane jaws, 4 dental implants in each prototype. Four scanbodies were attached to the implants, and a scanning of each mandible was acquired using an intraoral scanner (CS 3600). All prototypes were also submitted to CBCT. Then, the 3D scan files in STL (Standard Tessellation Language) format were superimposed on the DICOM (Digital Imaging and Communications in Medicine) images of the tomographic mandibles. The accuracy of IOS was evaluated by the metric analyses of deviations between the position of the im-plants projected by the IOS versus the detected tomographically, in which CBCT served as the gold stan-dard, using a free software for digital planning (Bluesky 4 -Grayslake, IL, USA). The following measures were analyzed: radial deviations at the shoulder (Xc) and at the apex of the implants (Xa), height deviation (Xh) and axial deviation. Bland-Altman and a paired t-test were applied to verify the reproducibility be-tween measurements and a t-test for a mean was applied to compare the measurements with zero value. Results: The results showed Xc and Xa deviation means of 0.14 +/- 0.09 mm and 0.12 +/- 0.12 mm, respec-tively. The Xh mean was 0.2 +/- 0.12 mm and the axial deviation mean was 0.71 degrees +/- 0.66 degrees. T-test showed a statistically significant difference when the 4 means were compared to zero value, represented by the CBCT (P < .0001). Conclusions: There was a statistically significant difference IN the scanned measures compared to CBCT as the standard, but the differences may not be clinically significant. The IOS utilization to evaluate the po-sition of dental implants is a radiation-free and reproducible method, with the advantage of not generating metal artifacts. Further clinical studies are needed to validate this new method of postoperative evaluation. (c) 2022 American Association of Oral and Maxillofacial Surgeons (AU)

• FAPESP's process: 18/18663-0 - Accuracy of the osseointegrated dental implants placement by a new method for obtaining surgical template for flapless guided surgery - in vitro study
• Grantee: Alexander Tadeu Sverzut
• Support Opportunities: Regular Research Grants