Studies comparing different 3D intraoral scanners to traditional
Cleaing the scanner
A tip from a doc to clean the wand is to use a Mr. Clean Magic Eraser which works great for lipstick.
Intraoral scanner = Worse
3M scanner v. alginate impression. accuracy about same. chair time alginate much faster but operator did not have much experience 20 min v 7:30 min. Pt preferred alginate 73% of time but usually because “faster” or “easier”. Grunheid 2014
3M v VSE (arguably better than PE or PVS) in custom tray 3m lost but not by numbers I consider clinically significant and not in all categories Cho Schaefer 2015 April J Pros Dent
iTero vs impression shows impression slightly better Kim 2013 Int J Pros
Full arch impressions PE and VSE better than all tested Ender 2016 JPD
Bone level implants conventional beats digital and of digital tested Trios Color beats True Def and iTero Chew IJOMI 2017
Intraoral scanner = Better
Lava COS and iTero beat tradional PVS impression in measuring gap of crown made. Abdel-Azim 2015 JPD
Lava COS better traditional in margin fit Ng Syrek
Lava better PE for bridge Silva 2014 Clin Oral Investig
Lava better than traditional impression Guth 2013 Clin Oral Investig
Cerec Omnicam beats traditional in patient preference and time Luthardt
iTero, Lava, and Cerec better than traditional in precision Henkel, Ender and Mehl 2013 Inside Dentistry
Cerec omnicam better than PE in time and patient preference Schepke JPD 2015 Sept
iTero vs. PE for better implants showed more time-efficeint for both lab and doctor Joda 2015 JOMI
Intraoral scanner = Same
Similar accuracy. 3M, Cerec, iTero and PVS Seelbach 2013 COI
Digital versus conventional implant impressions
I have heard several lectures that are very into digital admit they still take conventional impressions for implants. Conventional splinting open-tray techniques do show better trueness for multiple implants. Lyu 2022 JPD
Marghalani JPD 2017 found True Def beat conventional and Omnicam for implants.
A meta-analysis by Gaikwad JOMI 2022 finds that for 3 or less implants digital are better but the full arch is not satisfactory.
Trueness v Precision definitions
The trueness (some call this accuracy but maybe mean accuracy is better term) of the impressions was
- 55 +/- 21.8 microm = conventional impression group
- Cerec Bluecam = 49 +/- 14.2 microm
- Lava COS 40.3 +/- 14.1 microm
The precision (repeatability) was
- 61.3 +/- 17.9 microm for conventional impression with Impregum
- 30.9 +/- 7.1 microm for Cerec Bluecam and
- 60.1 +/- 31.3 microm for Lava COS.
These in-vitro results show that accuracy of the digital impression is similar to that of the conventional impression. Ender 2011 Int J Comput Dent. 2011
Specificity is negative are negative. Sensitivity is how many sick are correctly found.
Studies on Technique of 3D intraoral scanner
iTero 50 µm deviation in the mouth (Intraoral iTero worse than extraoral iTero by 2 fold deviation). “Intraoral scanning with the iTero is less accurate than model scanning with the iTero, suggesting that the intraoral conditions (saliva, limited spacing) contribute to the inaccuracy of a scan.” Deviation is not necessarily accuracy though. Flugge 2013 AJO-DO
PVS with press better > 3M with press = 3M w/ milling on E4D = PVS w/ milling on E4D Anadioti 2014
PVS/Press=PVS/CAD=3M/CAD>3M/Press Anadioti 2015 April JPD
Along same lines as above. Study kind of dumb. 3M direct scan better than PE impression and scan. Guth 2013
Interesting that new users were MORE accurate than experienced users. Believed due to experienced users ability to easily rotate camera. Cerec Bluecam Gimenez Oct 2015 ID
Distance of scan impacts accuracy Gimenez 2014 Int J Oral Max Implants
Different 3D intraoral scanners – Trios is best but for the price 3M really good
Top 3 intraoral scanner models 2017 = Omnicam, Trios 3, and 3M
Cerec Redcam 2000 Cerec Redcam 3D 2003 Cerec Bluecam 2009 Cerec omniscan 2012 Cerec primescan 2019
Trios 3 2015 Trios 4 2019
Medit i500 2018 Medit i700 2021
Itero element 2015 2018 Itero 5D 2019 Itero 5D plus 2021
CS3600 Itero 5D TRIOS 3 Primescan beat Omnicam Medit i500 Emerald and Planscan. Dupagne JPD 2022
Trios beats everyone in partially edentulous scans. Diker Int J pros 2021
Trios beats Omnicam for complete arch Resende JPD 2021
Trios beats 4 others JPD Park 2020
Trios Color best in terms of trueness and precision AND speed. Compare to Omnicam, Bluecam, and Carestream, the Bluecam. Treesh JPD 2018
Trios beats iTero Lim JPD 2018
Planmeca, Planscan Trios, True def and Itero all beat Omnicam 2018 Mennito
Precision CS 3500, the Trios, the True Definition, the iTero > CEREC Omnicam and the PlanScan Hack ADA product Review 2015
Omnicam, Truedef, and 3Shape>Bluecam, iTero, and Lava COS Ender 2016 JPD
List but wont say best. Outdated already though Logozzo
Cerec introral and extraoral same da Costa
Lava>iTero and Cerec Blue cam van der Meer
Lava>Cerec AC Brawek
Lava>iTero>>Cerec Bluecam Patzelt COI 2014
Lava>iTero Cerec AC/Bluecam and E4D Nedelcu JPD 2014
Lava Oral scanner and Cadent’s iTero – The mean value for the marginal measuring points of the control was 170 μm, and the values for all the evaluated crowns ranged from 107 to 128 μm.
Extraoral iTero v 3Shape = 3Shape much better
Hsuan reviews 12 systems at IDS 2017 but it is a very subjective review. He is relying on information from reps which can be hit or miss and I am assuming has a heavy omnicam bias since it’s on a cerec website. The information is probably usable for the easy of use analysis though.
Full arch scan intraoral scan
Accuracy of multiple implants is not satisfactory in this meta-analysis. Gaikwad JOMI 2022
Not accurate enough for full arch. Trios>True Def>Omnicam Kernen JPD 2022
TRIOS – Time to scan is less with digital but more rescans needed. Gherlone 2016 JOMI
TRIOS is the best for full arch scans but Braian JPD 2019 shows edentulous in particular can be an issue.
Conventional impressions are better in precision and accuracy in comparison to best two digital Trios and Omnicam which are both about the same. Malik 2019 IJP
Park JPD 2019 found scans is not sufficient for complete arch prostheses.
Powder systems do better in long spans, for instance, True Def was better than TRIOS, iTero, and Omnicam according to Medina-Sotomayor JPD 2019
Trios color>Omnicam>3M True Def is the order for accuracy of interocclusal records. JP 2017 Wong
Iwauchi JPD 2022 shows True Def and Trios 3 much better than conventional for bite registration.
Scan pattern impact on accuracy and time
It is ios wand dependent and probably user dependent as well, since time has a correlation to precision. Omnicam did the worst and the other 3 were very similar. For the Trios 3, which we use, method 2 and 4 are about the same and the best methods to use. However, mostly that is due to the shorter amount of time. Latham JPD 2020
New types of scanning devices – Photogrammetry
Implant intraoral scanners such as PiC Camera are more accurate for implant impressions typically in full mouth impressions. Sallorenzo JPD 2022. Although not every study finds this to be the case. However, we have seen dentists complain about this study on facebook. Another example is the ICam 4D by Imetric4D. Photogrammetry and JPD 2023Grammetry from Roe uses Optisplint.
Another method is Instarisa 3D which is a facial scanner but can pick up implant positions similar to photogrammetry.
There are several expensive ones and several apps that are free. The integration is the tricky part but will be there soon. Magiscan is a free app that works well.