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.

Conventional beat the Trios in Hussein 2018 J Pros article. Gao JPD 2022 finds that impression scanning is the most accurate method to create a digital cast of a full arch preparation.

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

Older studies

2018 has a lot of studies that are not making omnicam look good Renne 2017  Nedelcu 2018

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

Interocclusal registration

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. Revilla-León JPD 2023 However, we have seen dentists complain about this study on facebook. Another example is the ICam 4D by Imetric4D. Photogrammetry and Grammetry from Roe uses Optisplint.

Another method is Instarisa 3D which is a facial scanner but can pick up implant positions similar to photogrammetry.

Facial scanner

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.