ARTICLE IN PRESS European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

EPA Consensus Project Paper:

Accuracy of Photogrammetry
Devices, Intraoral
Scanners, and Conventional
Keywords
Accuracy
Photogrammetry
Edentulous
Intraoral Scanner Techniques for the Full-Arch
Implant Impression

Authors
Implant Impressions: A
Vygandas Rutkūnas *
(Professor, Ph.D.) Systematic Review
Agnė Gedrimienė *
(Assistant Professor, Ph.D.)

Ingrida Mischitz ‡
(Dental Research Assistant)
ABSTRACT
Eitan Mijiritsky § Purpose: The objective of this systematic review was to evaluate and compare the
(Professor) accuracy of digital impression techniques and conventional methods for full-arch im-
plant impressions. Methods: An electronic literature search in the databases Medline
Sandra Huber ‡
(Doctor of Dental Medicine) (Pubmed), Web of Science, and Embase was performed to identify in vitro and in vivo
publications (between 2016 and 2022) directly comparing digital and conventional
Address for Correspondence abutment-level impression techniques. All selected articles passed through the data
extraction procedure according to defined parameters in inclusion and exclusion cri-
Agnė Gedrimienė * teria. Measurements on linear, angular and/or surface deviations were performed in all
Email: [email protected] selected articles. Results: Nine studies met the inclusion criteria and were selected for
this systematic review. 3 articles were clinical studies and 6 studies were in vitro. Accu-
* Department of Prosthodontics, Institute
racy difference mean values of the trueness up to 162+/-77µm between digital and con-
of Odontology, Faculty of Medicine, Vilnius
ventional techniques were reported in the clinical studies and up to 43µm in laboratory
University, Žalgirio g. 115, Vilnius, LITHUANIA
studies. Methodological heterogeneity was observed in both, in vivo and in vitro studies.
‡
Department of Dental Medicine and Oral Health, Conclusions: Intraoral scanning and photogrammetric method showed comparable ac-
Medical University of Graz, Billrothgasse 4, 8010
curacy for registering implant positions in the full-arch edentulous cases. A tolerable
Graz, AUSTRIA
implant prosthesis misfit threshold and objective misfit assessment criteria (for linear
§
Head and Neck Maxillofacial Surgery, Tel-Aviv and angular deviations) should be verified in clinical studies.
Sourasky Medical Center, Department of
Otolaryngology, Sackler Faculty of Medicine,
Tel-Aviv University, Tel-Aviv 699350, ISRAEL
INTRODUCTION
Digital approach has become an alternative to conventional techniques
to restore completely edentulous cases with fixed implant prostheses.
Therefore, full-arch digital impression accuracy is extensively investigated
in clinical1,2 and laboratory studies.3,4

Trueness and precision are well-described standardized measures to

evaluate the accuracy of digital and conventional impressions. While true-
ness represents the test group compared with the true reference, preci-
sion describes the repeatability of a procedure.5 Most commonly trueness
Received: 26.10.2022
Accepted: 18.04.2023
doi: 10.1922/EJPRD_2481Rutkunas12 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • EJPRD
ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023 ARTICLE IN PRESS
and precision are evaluated for linear, angular,3 and surface6 Therefore, the aim of this systematic review was to evalu-
deviations. Reference data can be conveniently obtained in ate the accuracy of the full-arch dental implant impressions
laboratory studies by coordinate measuring machines (CMM),4 taken with intraoral scanners and photogrammetry devices of
industrial3 or laboratory scanners6 with a very high level of ac- the latest generation, by including only studies of high meth-
curacy of up to only a few 4 microns.6–8 For this reason, most odological quality, which investigated clinically relevant sce-
of the studies on implant impression accuracy are mainly narios (abutment-level full-arch impressions from 4 or more
done in vitro, which limits the applicability of the results in implants) and directly compared the accuracy of digital and
clinical practice. Attaining the reference scan in clinical con- conventional impressions (CI).
ditions still remains a major methodological issue.9 There is
a lack of clinical studies with an objective evaluation of the
fit of full-arch implant-supported fixed restorations produced
METHODS
from digital impressions.10 Therefore, open-tray conventional This systematic review was performed according to the PRIS-
implant impressions with splinted impression copings are still MA (Preferred Reporting Items for Systematic Reviews and
the most documented technique in clinical studies and, there- Meta-Analyses) guidelines. The review was registered on the
fore, can be regarded as a reliable positive control.11 PROSPERO register (registration number: CRD42021288679).
There are two main digital techniques to capture the spatial The focused PICOS (Population, Intervention, Comparison,
position of the dental implants for full-arch cases: intraoral Outcome, Study design) question (Table 1) was defined: “What
scanning (IOS) and photogrammetry (PG)12,13 Contradicting re- are the accuracy outcomes of implant position registration in
sults and conclusions have been reported by several systematic full-arch edentulous cases using intraoral scanners and/or pho-
reviews evaluating the accuracy of full-arch digital implant im- togrammetric devices compared to conventional impressions?”
pressions with intraoral scanners.12,14 This can be explained by
the methodological differences of the selected studies. Also, the
accuracy of the intraoral scanners can be affected by multiple
Table 1. Inclusion criteria of studies into systematic review
factors.15 The size of the edentulous area negatively affects the
based on PICOS guides.
accuracy, as the lack of natural reference objects compromises
the quality of stitching of the images. For this, different types
Systematic review
of artificial reference objects have been suggested to improve
the quality of a digital implant impression.16–20 Modern intraoral Patients/ Completely edentulous dental
scanners were found to demonstrate high trueness,21 however, Population arch or replica with implants
intraoral scanning for full-arch implant-supported prostheses
still needs further clinical validation.22 Taking full-arch conventional and digital (IOS
or photogrammetry) implant impressions with
Photogrammetry serves as an alternative to intraoral scan- Intervention
commercially available intraoral scanner or
ning when 3D (Three dimensional) coordinates of implant photogrammetric devices, using scan bodies.
position are captured with a special camera. Instead of multi-
ple registrations as with intraoral scanners, it takes a limited Accuracy (trueness and precision or trueness
number of images of special screw-retained transfers. With only) of digital implant impression directly
Comparison
this technique, only implant positions are registered, while compared to the model produced from
the conventional implant impression
soft tissue surface or bite registrations are done with intraoral
scanners or conventional impression techniques. Many stud-
ies have reported the reliability of photogrammetry, however, Quantitative estimation of accuracy:
Outcomes
others demonstrated poorer accuracy than the conventional linear, angular, or surface deviations
technique.8,23,24

The diversity of the results from different systematic re- Study design In-vivo and in-vitro experimental studies
views, could be explained by the inclusion of less controlled
studies (case series, case reports),25 using different reference
models and techniques to obtain reference data, presence or
absence of the remaining teeth in the dental arch, comparing SEARCH STRATEGY AND SEARCH TERMS
different types of impressions (implant- vs abutment-level),26
A literature search in the electronic databases Medline (Pub-
high variability of number of the implants in the arch, usage of
Med), Web of Science, and Embase was conducted to receive
very limited sample size, different user experience, different
publications from January 1, 2016, to the date of search (Feb-
generations of digital devices, and other factors.12,27 Yet, the
ruary 4, 2022), resulting in a time period of about 6 years. Six
main limitation remains that indirect comparisons between
year period was chosen to include the latest and most rel-
different types of digital devices and conventional techniques
evant hardware and software of the digital devices.
are being made.

P2 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Accuracy of Implant Impressions: A Systematic Review...

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 ARTICLE IN PRESS European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

English- and German- language articles were selected us- Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.28
ing the following search terms: implant* AND (impression* Meta-analysis was not conducted due to the methodological
OR scan* OR IOS OR digital impression* OR photogramme- differences of the selected studies.
try [MesH Term] OR photogrammetric OR optical OR intraoral
scan* OR stereophotogrammetry [MesH Term] OR stereopho-
togrammetric) AND (full arch OR edentulous OR edentate OR
RESULTS
complete arch) AND (trueness OR precision OR accuracy). A total of 805 studies were identified after the initial litera-
The decision criteria for including or excluding the studies ture search in the databases. Removal of duplicates and title
are shown in Table 2. revision resulted in 117 abstracts for screening. Twenty-five
full-text articles were considered to be eligible. After the ex-
clusion of sixteen full-text articles with reason, nine studies
fulfilled the inclusion criteria and were selected for further
Table 2. Inclusion and exclusion criteria.
synthesis. (Figure 1)
Inclusion criteria Exclusion criteria The main findings of the systematic review are presented
in Table 3.
Articles reporting on
impression accuracy
English and German literature
for tooth-supported or STUDY TYPE
removable prostheses
The majority of the selected articles were in vitro stud-
At least 4 implants Partially edentulous situations, ies.4,6–8,24,29 All of them were assessed with a low risk of bias
per dental arch implant-level impressions (Table 4). Three studies were done in an in vivo setting.1,2,22
Two of them showed a high risk of bias, whereas the risk was
Only qualitative evaluation
Minimum sample size: 5 of impression or/and rated as unclear for the study by Carneiro Pereira et al.
model accuracy
STUDY GROUPS AND CONTROLS
Peer-reviewed in vitro Digital impression device is
and in vivo articles not commercially available or All analyzed articles were characterized by the presence of a
published from 2016 not available on the market “conventional impression group”(positive group).
Digital and conventional Four studies compared the accuracy of conventional impres-
Expert opinions, case
impression groups sions and digital impressions gained from different intraoral
reports, reviews
available in the study
scanners.2,4,6,22 In the four publications a single intraoral scan-
ner was tested.2,4,6,22 Two studies evaluated the accuracy of
the conventional impression technique in comparison with
DATA EXTRACTION the impressions captured by photogrammetric imaging de-
Three reviewers (S.H., I.M, A.G.) conducted the primary lit- vices.1,24 In the remaining three articles all three impression
erature search in the databases and independently screened groups were investigated and analyzed against each other,
the titles for abstract revision. There was only one disagree- namely conventional methods vs. digital impressions from
ment, that was resolved by discussion. The selected abstracts IOS vs. PG.7,8,29 In one of these studies two different intraoral
had been revised independently for further full-text screening scanners were applied.8
according to the inclusion and exclusion criteria (Table 2). The In regard to the clinical studies, two of them compared the
full texts had been selected and the final consensus for inclu- accuracy of conventional impressions and IOS impressions,2,22
sion was reached by all the authors. The extracted data was ar- while one study evaluated conventional impressions and im-
ranged in an online spreadsheet (Google Sheets, Google LLC), plant position registrations obtained by photogrammetry.1
according to the following categories: identification of the
Concerning the control group, in the clinical studies casts
article (year, authors); study type (in vitro, in vivo), implants
obtained from conventional impression methods were con-
(system, number, angulation, connection type), location (man-
sidered as controls for the accuracy measurements.1,2,22 In all
dible, maxilla), study groups (impression type, material, and
in vitro settings control reference models were produced with
device, reference group), number of samples or performed
coordinate measuring machines or scanned with industrial
interventions, accuracy assessment (assessment methods, re-
optical or laboratory scanners.4,6–8,24,29
sults, outcomes). There was one disagreement regarding the
number of implants used in the study. After discussion, the The number of scans per examined group varied from 1
decision to exclude the article was taken, as it was clarified scan1,2,22 to 104,6–8,24 or 15 scans29 per group. (Table 3)
that less than 4 implants per arch were used for the meas-
urements. An assessment of the quality and risk of bias for
the included studies was performed according to the Quality

EJPRD • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • P3

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023 ARTICLE IN PRESS

Figure 1: Search strategy.

e.g. open-tray splinted and non-splinted and additionally the

SAMPLE SIZE AND IMPLANT PARAMETERS closed-tray approach.4 Carneiro-Pereira et al., however, used
Majority of publications presented full-arch situations with no trays for impressions but splinted the impression copings
4 - 6 implants or implant replicas for accuracy measurements. intraorally with acrylic resin and poured it directly into the
In one clinical study, the number of implants varied among dental stone.2
the patient cases from 4 to 7.1
Regarding the impression material in three studies polyvinyl
Five studies were related to the maxilla,7,8,22,24,29 two to the siloxane (PVS) was utilized,1,6,22 in three studies polyether (PE) was
mandible.2,6 In one study the implants were distributed over the material of choice7,8,24 and in one article impression plaster
both jaws1 and one study used a simplified cast for the refer- (type I) was used for the conventional impressions.29 Menini et al.
ence model. 4 performed the impressions with polyether and plaster material
and as already mentioned previously, in the study of Carneiro-
Among the included studies, four integrated tilted implants
Pereira et al. no impression material was used.2,4
in their study-set up,7,8,22,29 in one article only parallel implants
were used6 and in the remaining 4 studies no statement re- A variety of different intraoral scanners were chosen for
garding implant angulation was made.1,2,4,24 performing digital impressions. The most frequently used
IOS was the TRIOS 3(3Shape, Copenhagen, Denmark)2,6–8,29 fol-
Implant abutment replicas were chosen for the implant po-
lowed by the True Definition scanner (3M, Saint Paul, Mine-
sition measurements by four authors,4,7,8,24 while in the other
sota, USA).4,22 An exact list of all intraoral scanners is shown in
five studies internal connection implants fitted with multi-unit
Table 3. For obtaining digital impressions by photogrammetric
abutments were investigated.1,2,6,22,29
imaging in three articles the Icam4D system (Imetric4D Imag-
ing Sàrl, Courgenay, Switzerland) was selected,1,7,8 while in the
IMPRESSION DETAILS
other two studies the PIC camera (PIC Dental, Madrid, Spain)
In regards to the impression level, in all analyzed studies im- was applied.24,29
pressions and measurements were performed at the abutment
Apart from the study of Huang et al., where custom CAD/
level, which was in accordance with the inclusion criteria.
CAM scan bodies were fabricated in addition, in all other arti-
The majority of studies conducted the splinted open-tray cles the original scan bodies were used for the abutment level
impression technique for producing conventional stone assessments.
casts.1,6–8,24 In two articles the conventional impressions were
done with the open-tray non-splinted method.22,29 Menini
et al. analyzed various conventional impression techniques

P4 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Accuracy of Implant Impressions: A Systematic Review...

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 Table 3. The main findings of this systematic review.

EJPRD
Number Types of Conventional IOS/ Type of scan body
Study Impression Results Results Outcome /
Author of impressions impression photogrammetry (height, original,
type material Trueness Precision Conclusion
implants compared technique device custom made)

Statistically significant
differences were
1. OT, PE 1; 2. OT
reported between
ARTICLE IN PRESS

splinted PE 1; 3. IOS: distance

Menini IOS and CI both for
CT PE 1; 4. OT PE 1. PE 1; 2. PE True Definition Createch Medical (Createch error: - 12 ± 26
in vitro 4 IOS vs CI NA distance and angle
et al, 2018 2; 5. OT splinted 2; 3. Plaster (3M ESPE) Medical S.L.); 8mm μm; angle error:
errors. IOS showed
PE 2; 6. CT PE 2; 0.257±0.242°
better reproducibility
7. OT Plaster
than conventional
techniques.

Overall 3D deviation
3D deviations
between virtual casts
for 4 implants:
and CI casts was
Chochlidakis mean 139±56
4, 5, 6 (16 True Definition CARES Mono scan 162±77μm. Positive,
in vivo IOS vs CI OT, nonsplinted PVS μm; 5 implants: -
et al, 2020 cases) (3M ESPE) bodies (Straumann) but not significant
mean 146±90
correlation between
μm; 6 implants:
implant number

ejprd.org - Published by Dennis Barber Journals.

185±81 μm.
and 3D deviation.

IOS 1: Original scan

bodies (Straumann) 9
The median of The median
mm height; IOS 2: CAD/
trueness of 3D of precision Design of the
CAM scan bodies (Gialloy
Huang surface for IOS of 3D surface extensional structure of
Ti-5; SRL Dental GmbH),
in vitro 4 IOS vs CI OT, splinted PVS TRIOS 3 (3Shape) varied from for IOS varied SB improved scanning
et al, 2020 9 mm height; IOS 3: CAD/
28.45 μm to 35.8 from 27.3 to accuracy; CI were more
CAM scan bodies (Gialloy
μm and 25.55 48.9 μm and accurate than IOS.
Ti-5; SRL Dental GmbH),
μm for CI. 19 μm for CI.
9 mm height; 20 mm
extensional structure

Total linear 3D
displacements
Carneiro Splinted impression Neodent (Straumann); varied from 2.28 Scanning device
copings poured Splint with scanning device: μm to 4.39 μm. improved trueness
Pereira in vivo 4 (10 cases) IOS vs CI Trios (3Shape) -
into dental stone acrylic resin with patented CAD Median angular of linear and angular
et al, 2021 without tray software program displacements displacements.
varied from
-4.48° to 6.37°.

Trueness values
OT, splinted

Copyright ©2023 by Dennis Barber Ltd. All rights reserved.

3D discrepancy were similar,
Revilla-Leon (additively 3D discrepancy for
for CI 6.81μm, precision varied. CI
in vitro 6 CI vs PG manufactured Co-Cr PE PIC camera (PIC dental) PIC Transfer (PIC Dental) CI 18.4 μm, for PG
et al, 2021 for PG system showed significantly
framework splinted system 20.15 μm.

• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
25.41μm. higher accuracy
with copings)
values than PG.
European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

Table 3 continued overleaf...

P5
 P6
Table 3. The main findings of this systematic review - continued....

Number Types of Conventional IOS/ Type of scan body

Study Impression Results Results Outcome /
Author of impressions impression photogrammetry (height, original,
type material Trueness Precision Conclusion
implants compared technique device custom made)

For PG: custom scan PG positive correlation

PG overall linear
bodies ICamBody of distance deviations
Zhang OT, splinted (metal distance deviation
4, 5, 6, 7 ICam4D (Imetric4D (Imetric4D Imaging Sarl). with interimplant
in vivo CI vs PG bars splinted with PVS 70±57 μm, NA
et al, 2021 (14 cases) Imaging Sarl) For digitization of verified distance, but no
impression copings) angular deviation
casts: desktop scan bodies angular deviation
0.43±0.35°
IO 2C-A (Nobel Biocare) correlation.

The PG system
obtained the lowest
Median 3D discrepancy in
Median trueness
precision of terms of trueness
PG: ICamBody (Imetric4D, of 3D surface
ICam4D (Imetric4D 3D surface and precision for the
Imaging Sarl); IOS: deviations: PG:
Ma et al, 2021 in vitro 6 IOS vs CI vs PG OT, splinted PE Imaging Sàrl), deviations: implant abutment
CARES Mono scan 24.45 μm; IOS:
TRIOS 3 (3Shape) PG: 2 μm; positions. The IOS
bodies (Straumann) 43.45 μm; CI:
IOS: 36 μm; tested represented the
28.7 μm;
CI: 29.4 μm. least accuracy among
the three impression

ejprd.org - Published by Dennis Barber Journals.

techniques tested.
European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

• • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Linear precision
for CI group
The median linear varied from
trueness for CI 4.6 to 17.9 μm,
varied from 1.8 to for IOS 1group CI demonstrated the
OT, splinted For PG: optical marker
ICam4D (Imetric4D 8.9 μm, for IOS 1 varied from lowest 3D discrepancy,
Revilla-Leon (additively ICamBody (Imetric4D
Imaging Sarl), iTero varied from -4.1 to 16.6 to 48.9 IOS showed the
in vitro 6 IOS vs CI vs PG manufactured Co-Cr PE Imaging Sarl). IOS:
et al, 2021 Element (Cadent), 17.5 μm, for IOS μm, for IOS 2 most stable results.
framework splinted CARES Mono scan
Trios 3 (3Shape) 2 varied from -4.9 group varied PG system was the
with copings) body (Straumann)
to 18 μm. For PG from 20.7 to least accurate.
group varied from 54.9 μm. For PG
-4.7 to 73.7 μm. group varied
from 27.2 to
308.7 μm

The PG technique
Global whole scan Global whole
demonstrated the
body 3D surface scan body 3D
highest accuracy in
Tohme deviation for CI deviation for CI
Trios 3 (3Shape); PIC CARES Mono scan terms of trueness
in vitro 4 IOS vs CI vs PG OT, nonsplinted Plaster group 120 μm, group 103 μm,
et al, 2021 camera (PIC dental) body (Straumann) and precision for
for IOS group for IOS group
the intraoral scan
150 μm, for PG 63 μm, for PG
bodies of all the
group 90 μm group 2 μm.

Copyright ©2023 by Dennis Barber Ltd. All rights reserved.

techniques evaluated.

IOS – intraoral scanning, CI – conventional impression, OT – open tray, CT – closed tray, PE – polyether, PVS – polyvinylsiloxane, NA – not available
ARTICLE IN PRESS

Accuracy of Implant Impressions: A Systematic Review...

 ARTICLE IN PRESS European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

Table 4. Risk of bias evaluation according to Quadas-2 domains.

Risk Of Bias
Study
Patient Selection Index Test Reference Standard Flow And Timing

Menini et al + + + +

Caneiro Pereira et al ? ? ? +

Chochlidakis et al - - - ?

Huang et al + + + +

Ma et al + + + +

Revilla-Leon et al + + + +

Revilla-Leon et al + + + +

Tohme et al + + + +

Zhang et al - - - -

+ Low Risk; - High Risk; ? Unclear Risk

In the clinical study of Carneiro Pereira et al. an additional best-fit algorithm was assessed by five studies.2,6,7,22,29 In three
digital experimental group was examined, where the scanning articles the 3D surface deviations were measured as root
process was conducted with a CAD/CAM produced scanning mean squares.6,7,22 Tohme et al. additionally presented means
device that was attached over the scan bodies, and therefore a of global angular deviations, whereas Carneiro Pereira et al.
splinting of the scan bodies was obtained. A similar procedure calculated the median of absolute values and 3D total linear
was reported in the article of Huang et al. They used CAD/CAM displacements. In two articles linear, angular (mean values
scan bodies with extensional structures as an auxiliary device and median values respectively), and 3D deviations (median)
for the scanning procedure. Chochlidakis et al. performed the were measured. (8,24) Additionally, Menini et al. measured
IOS scanning with palatal fiducial markers. the framework fit under the stereomicroscope using the Shef-
field test. (Table 3)
There was no information available about the number of
operators and their experience in the three articles.22,24,29 In
five studies a single operator conducted all digital impres- OUTCOME ASSESSMENT
sions,1,2,6–8 while the operator number was three in the study of Four articles compared the accuracy of intraoral scanners
Menini et al. Regarding the operator experience, four studies and conventional impressions.2,4,6,22 Menini et al. reported in-
reported that they had operators with a long experience,1,2,7,8 traoral scanner superiority to conventional impressions with
while in two studies un-experienced operators performed the statistically significant results in linear and angular measure-
scannings.4,6 No inter- and intra-observer reliability had been ments.4 The clinical study of Carneiro Pereira et al. showed
reported in the selected studies. similar results for conventional impressions and intraoral
scanning with the scanning device, however, a longer me-
ASSESSMENT METHODOLOGY dian distance and a higher angular variation were found for
the group with scan bodies alone.2 A comparative prospec-
Articles that measured accuracy in terms of trueness were
tive study by Chochlidakis et al. reported the clinical feasibil-
selected for the systematic review. Precision, the second pa-
ity of the digital workflow for the fixed complete dentures in
rameter of accuracy, was evaluated in the majority of in vitro
the maxilla, as the 3D deviation levels (162±77 µm) of digital
studies.6–8,24,29
scanning lied within the clinically acceptable threshold (<200
Distance and angular deviations of the scan bodies were µm).22 However, Huang et al.stated the opposite to the previ-
measured and calculated in two studies:1,4 Menini et al. and ously mentioned findings, reporting better accuracy param-
Zhang et al. expressed the data for distance and angle param- eters of conventional splinted open-tray impressions, but
eters in mean values, Zhang et al.provided additional informa- noted that the design of the extensional structure of the scan
tion on minimum and maximum values. Three-dimensional bodies improved scanning accuracy.6
discrepancy using the superimposition of the STL files and the

EJPRD • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • P7

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023 ARTICLE IN PRESS
Two articles compared the accuracy of photogrammetric use multi-unit abutments for the full-arch implant-supported
and conventional methods.14,24 A clinical study by Zhang et al. fixed restoration fabrication, the studies which investigated
classified photogrammetric imaging as a clinically acceptable full-arch implant-level impressions were excluded.
method with a distance deviation less than 150 µm, however,
The majority of the studies were in vitro studies, which used
28,6% of measurements showed deviations higher than 150
reference data obtained by CMM or optical scanners. Due to
µm.1 Revilla-Leon et al. reported higher accuracy values for
the availability of the reference data, the mean trueness was
conventional impressions than photogrammetric imaging in a
assessed in these studies and ranged from 28 to 26322 µm in
laboratory setting.24
linear deviations. However, the reference data cannot be reli-
Three articles presented accuracy data from conventional ably obtained in the clinical studies and only a comparison
impressions, intraoral scanning, and photogrammetric imag- between conventional and digital techniques could be made,
ing with varying results.7,8,29 Ma et al. evaluated the lowest 3D taking the conventional method as a positive control. The find-
discrepancy in terms of trueness and precision for the im- ings from the 2 included in vivo studies have indicated that
plant abutment positions in the photogrammetric imaging IOS had mean linear deviation values of 2-185 µm as com-
group followed by the conventional impression technique. pared with CI.2,19 One in vivo study has shown that this charac-
Both methods showed better accuracy results in compari- teristic for PG was 70 µm.14 The standardization of the impres-
son to the intraoral scanner, representing the least accuracy sion procedure is more difficult in clinical studies, therefore,
among the three tested impression techniques.7 In contrast, the risk of bias was higher as compared to the in vitro studies.
Revilla-Leon et al. reported that the photogrammetric imag-
Overall, the majority of studies have rated digital techniques
ing system was the least accurate method, while the conven-
as accurate enough for the full-arch edentulous cases.1,2,4,7,22,29
tional procedure revealed the lowest 3D discrepancy. The two
However, high variability in ranking of the included impres-
intraoral scanners showed no significant differences in linear
sion techniques was observed. Three included studies report-
deviations compared to the conventional impressions and
ed that CI was the most accurate technique,6,8,24 3 indicated
hence were regarded as a reliable digitizing procedure.8 For
that accuracy was similar1,2,22 and the rest of the studies pre-
precision assessment in the study of Tohme et al. the smallest
ferred DI over CI.4,7,29
deviation values were observed for the photogrammetric im-
aging group followed by the IOS technique. The conventional One group of studies (n=4) compared the accuracy of IOS
group showed the highest precision deviations. In this study and CI techniques. Huang et al. have reported better accuracy
in terms of trueness, all results were superior for the photo- parameters of conventional splinted open-tray impressions,
grammetric method except the flat angled surface region of but noted that the design of the extensional structure of the
the scan body, where higher trueness was detected with the scan bodies improved scanning accuracy. These results can be
IOS technique.29 (Table 3) explained by the use of parallel implants in the study model,
large interimplant distances (up to 28 mm), and less experi-

DISCUSSION
enced operators.6 Menini et al. have found that a more re-
producible outcome of IOS compared to CI was achieved, al-
Digital technologies are helping to continuously improve though 3 inexperienced operators were involved in the study.
clinical and research aspects of implant dentistry. Accuracy It shows that CI can be more technique sensitive with a steep-
of the clinical and laboratory procedures is of paramount im- er learning curve. However, the rest of the studies from this
portance, as it influences the treatment effectiveness, safety, group (both in vivo), have stated that the results with IOS were
and patient comfort.15 Besides the advances in CAD/CAM and comparable to CI and detected deviations were in the range
3D printing technologies, capturing the exact implant posi- of clinically acceptable threshold (200 µm). Carneiro Pereira et
tions using conventional and digital tools still remains a chal- al. reported improved accuracy with a scanning device com-
lenge.12,26,30 Whereas, digital techniques are considered reli- pared to the situation when only the scan bodies were used
able for the short-span fixed implant-supported prosthesis, without additional device. These findings can be specific to the
their accuracy for full-arch cases is still debated. IOS and PG study, as in the CI group impression dental stone was used.
devices have become the most popular for digital registration Chochlidakis et al. involved patients with edentulous maxilla
of implant positions. Few systematic reviews summarized the and mandible with 4-6 implants. The results can be partially
accuracy of IOS15,31,32 and PG23 techniques for the full-arch im- explained by the non-splinted CI technique and fiducial mark-
plant impressions. However, the conclusions and clinical rec- ers used in the palatal area.
ommendations of these reviews are contradicting due to the Another group of studies (n=2) has compared PG and CI for
methodological differences of the included studies and lack the full-arch implant impressions. Revilla-Leon et al. in vitro
of inclusion of the conventional groups.12,23,26,27,33 This system- study reported that CI was more accurate than PG. This can
atic review aimed at the analysis of the studies which directly be explained by the favorable in vitro conditions for the con-
compared the current and commercially available digital and ventional impression making (absence of saliva and mobile
conventional techniques using the clinically relevant mod- soft tissues) and the use of the additively manufactured cus-
els and patient populations. As it is widely recommended to tom tray and metal framework which was used for splinting of

P8 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Accuracy of Implant Impressions: A Systematic Review...

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 ARTICLE IN PRESS European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

the impression copings. However, the statistically significant of images obtained.8,22,24 Majority of the studies reported on
trueness difference of 1.8 µm and a precision difference of the number and experience of the operators. Among those
18.6 µm between both systems is of very limited clinical sig- reporting the experience of the operator, impressions in 4
nificance. In vivo study by Zhang et al. indicated that the linear studies were taken by an experienced dentist.1,2,7,8
measurement difference between CI and PG was up to 127
All of the included studies had conventional impression
µm and angular - up to 0.78 degrees. While linear deviation
groups as a positive control (in vitro studies) or as the best
falls in the range of clinically acceptable limits, the angular
available reference (in vivo studies). As digital and conventional
deviation can be outside of these limits.34 Yet, due to the ab-
techniques are compared between each other, it is important
sence of a reliable true reference in clinical studies, it is diffi-
to highlight the variety of the conventional impression groups
cult to state which of the impression techniques, conventional
in different studies. The majority of studies (n=8) have used
or digital, had better overall trueness.
splinting of the impression copings, however, different splint-
In the third group of studies (n=3) all techniques (PG, IOS, ing techniques were employed. Using prefabricated splinting
and CI) were compared. All studies were in vitro studies, as to structures could lead to better accuracy results,8,24,40 compared
do a comparison between 3 impression techniques in a clini- to the splinting with acrylic resin without cutting and rejoin-
cal setting would be problematic. In two studies, the CI with ing.4 Only two studies (Chochlidakis et al and Tohme et al) of
splinted impression transfers were used, while Tohme et al. this systematic review claimed using non-splinted conventional
did not use the splinting. impression copings. 3D accuracy in non-splinted conventional
impression group varied from 115 to 162 µm, when in splinted
Ma et al. reported better accuracy for PG than CI and IOS.
group it varied from 12 to 30 µm. While splinted group demon-
This is in contrast to the results of Revilla et al. study, where
strated better results than non-splinted, both were lower than
CI was rated as the most accurate, followed by IOS and PG.7,8
recommended 200 µm clinical threshold.
Both studies have used the same PG device (iCAM4D, Voxel-
dental, Magnolia, Texas, USA) on the maxillary model with 6 Similarly, digital impressions can be affected by various fac-
implants. In one study the true reference data was obtained tors. The properties of different scan bodies (geometry, mate-
using the laboratory dental scanner and CMM in another. It rial, optical properties, and machining tolerances) can have a
can be argued that due to the size and shape of the spherical significant impact on the proper registration of the implant
probe of CMM, it is more challenging to detect complex and positions.27 Higher than 10 degrees41 or 15 degrees12 between
undercut areas.7,8,24 Therefore, using the laboratory scanner implants significantly affects the accuracy of digital implant
could have some advantages for acquiring reference data. impression and the fit of the final prosthesis. Repositioning
These statements need to be investigated further and are accuracy of the scan bodies can negatively affect the digital
of significant importance in accuracy studies. Tohme et al. impressions.42 Majority of studies have not declared if the
have used a maxillary model with 4 implants, a PIC camera scan bodies were removed and repositioned between each
(PG group), and impression plaster for the CI technique. Due digital registration of the implant positions.
to the methodological differences results can not be directly
It is also important to discuss different measurement meth-
compared to the previous two studies. The PG was found to
odologies used in the studies. Some studies have used CAD
have the best trueness, followed by the CI and IOS for true-
libraries1,6,8,29 of the scan bodies and others used meshes ob-
ness, as well as for precision, followed by IOS and CI.
tained after the intraoral scanning to define the planes and
Though only the studies with high methodological qual- axes for the measurements.2,4,7,22,24 Also, different geometries
ity and direct comparison between digital and conventional of the scan bodies dictated the choice of the different planes
impressions were included in this systematic review, due to and axes. The selection of the points for the linear measure-
the high variability of the patient population, types of study ments can significantly influence the measurement results
models, impression techniques and measurement strategies, and should be standardized in future studies. Different thresh-
comparison of the results and providing clinical recommenda- olds for the clinically acceptable deviations were mentioned in
tions is problematic. Many factors can influence the accuracy the studies, ranging up to 200 µm.43 The 0.4 degree angular
of the conventional and digital impressions that were used deviation threshold is widely used in the studies investigating
in the included studies. The distance and angulation between predominantly implant-level impression accuracy.34 However,
implants are one of the most critical factors influencing the this value is not very well validated and could be significantly
accuracy of the impressions. A positive correlation between different for the abutment-level impressions.
inter-implant distance and deviations was reported in a few
Perimucositis and periimplantitis are common biological
studies.1,22,35 Also, the use of scan bodies with extensions, aux-
complications of osseointegrated implants. Inaccurate fixed
iliary scanning devices, and fiducial markers showed the ten-
implant restoration can be one of the reasons inducing the
dency to increase the accuracy of intraoral scanners.2,6,20,22 It
inflammation of periimplant tissues. Improper design of the
was shown that the scanning strategy might significantly affect
prosthesis such as bulky crowns or blocked gingival embra-
the IOS accuracy.18,36–39 However, the majority of studies have
sures prevents good oral hygiene and causes plaque accumu-
not specified the details of the scanning strategy or the number
lation. Presence of gap at the implant – abutment interface

EJPRD • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • P9

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023 ARTICLE IN PRESS
leads to microleakage and accumulation of bacteria which can
affect the surrounding soft and hard tissue around implants. CONCLUSIONS
Single unit implant prosthesis can reach minimal gap of dis-
Within the limitation of this systematic review it can be con-
crepancy: a gap of 10 μm was presented by external connec-
cluded, that:
tion implant – abutment interface and Morse taper implants
demonstrated results with a gap of 2-3 μm in in vitro condi- 1. Intraoral scanning and photogrammetry are reported
tions.44 For screw - retained bridge type restoration marginal as having similar accuracy for registering implant posi-
gap discrepancy from 25 to 50 microns45 is also evaluated as tions in the full-arch edentulous situations;
accurate fit. Differently, full - arch restorations usually are 2. Mean values of the linear deviations were of from 2.28
fixated at abutment level, so the tolerance of micro gap for up to 162 µm in the clinical studies and from 4.1 up to
passive restoration varies from less than 50 to 100 microns.45 43 µm in laboratory studies were found comparing digi-
Additional technical issues can also induce periimplant tis- tal and conventional impression techniques.
sue inflammation such as unstable prosthesis and abutment
connection,46 and non-passive prosthesis structure, which 3. A wide variety of research methodology (study set-up,
can cause tension at implant surrounding bone and its re- reference data collection, scanning, and measurement
sorption.47,48 It has been reported, however, that non-passive strategy) compromise comparison of the study results;
restoration of implants seems to have no negative impact on there is a need to standardize future studies on implant
marginal bone, because of a possible bone adaptation mecha- impression accuracy. Minimization of the risks of bias
nism.49 The amount of attached tissue around implants also by controlling the patient selection, inclusion of the in-
has an impact to long term implant survival success, despite dex test and reference standard should be applied in
contrasting data in the literature.50,51 The recent systematic the future studies.
reviews claimed that the lack of keratinized gingival tissue 4. There is a lack of information about digital bite registra-
around implants is associated with higher values of inflamma- tion accuracy, strategies of model, and prosthesis pro-
tion, plaque accumulation and patients discomfort perform- duction, in order to comprehensively assess the error
ing oral hygiene.52–54 propagation of a specific workflow;
The included studies and current systematic review have 5. Various clinically relevant thresholds for the linear (up
certain limitations. Though only studies reporting on the to 200 µm) and angular deviations (up to 0.4 degrees)
modern digital devices currently widely used in the clinical are used in the studies. These values should be validat-
practice were included, new hardware and software for IOS ed in the clinical studies and objective misfit assessment
and PG devices were released from the onset of this review. criteria adopted for clinical use.
The accuracy of full-arch implant impression is of key impor-
tance and prerequisite to achieving the final prosthesis with
a clinically acceptable misfit. Nonetheless, error propagation
REFERENCES
of the workflow can occur at the latter clinical and laboratory 1. Zhang, Y.J., Qian, S.J., Lai, H.C. and Shi, J.Y. Accuracy of photogrammet-
steps.55 For the effective treatment, not only accurate digital ric imaging versus conventional impressions for complete-arch im-
impressions but also reliable bite registrations are needed. plant-supported fixed dental prostheses: A comparative clinical study.
There is a lack of studies, reporting the accuracy of digital bite J Prosthet Dent. 2021; S0022-3913(21)00567-9.

registration techniques. Although the CAM techniques are re- 2. Carneiro Pereira, A.L., Carvalho Porto de Freitas, R.F., de Fatima Trin-
ported as very accurate and predictable, the 3D printing of dade Pinto Campos, M., Soares Paiva Torres, A.C., Bezerra de Medeiros,
A.K. and da Fonte Porto Carreiro, A. Trueness of a device for intraoral
the final prostheses still lacks validation in clinical practice.56
scanning to capture the angle and distance between implants in eden-
Furthermore, having accurate registrations of implant posi-
tulous mandibular arches. J Prosthet Dent. 2021;128:1310-1317.
tions in 3D space is not enough, as for the finalization of the
3. Albayrak, B., Sukotjo, C., Wee, A.G., Korkmaz, I.H. and Bayindir, F.
prosthesis the master model is still recommended. Finally, the
Three-Dimensional Accuracy of Conventional Versus Digital Complete
clinically acceptable misfit should be more investigated in fu-
Arch Implant Impressions. J Prosthod. 2021; 30:163–170.
ture research, for the objective evaluation of the fit of the final
4. Menini, M., Setti, P., Pera, F., Pera, P. and Pesce P. Accuracy of multi-unit
implant- and abutment-level prostheses produced from dif-
implant impression: traditional techniques versus a digital procedure.
ferent digital and conventional impressions.57 Only one study4
Clin Oral Investig. 2018; 22:1253–1262.
investigated the fit of the framework on the model produced
5. ISO 5725-1:1994 [Internet]. www.iso.org. [cited 2020 Dec 6]. Available
from the conventional impressions, however, future studies
from: https://www.iso.org/cms/render/live/en/sites/isoorg/contents/
should evaluate the clinical and laboratory fit of the full-arch data/standard/01/18/11833.html
prostheses fabricated using digital impression data.41
6. Huang, R., Liu, Y., Huang, B., Zhang, C., Chen, Z. and Li, Z. Improved
scanning accuracy with newly designed scan bodies: An in vitro study
comparing digital versus conventional impression techniques for
complete-arch implant rehabilitation. Clin Oral Implants Res. 2020;
31:625-633.

P10 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Accuracy of Implant Impressions: A Systematic Review...

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 ARTICLE IN PRESS European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023

7. Ma, B., Yue, X., Sun, Y., Peng, L. and Geng, W. Accuracy of photogram- 22. Chochlidakis, K., Papaspyridakos, P., Tsigarida, A., Romeo, D., Chen,
metry, intraoral scanning, and conventional impression techniques for Y.W., Natto, Z., et al. Digital Versus Conventional Full-Arch Implant Im-
complete-arch implant rehabilitation: an in vitro comparative study. pressions: A Prospective Study on 16 Edentulous Maxillae. J Prostho-
BMC Oral Health. 2021; 21:636. dont. 2020; 29:281–286.
8. Revilla-León, M., Att, W., Özcan, M. and Rubenstein, J. Comparison of 23. Hussein, M.O. Photogrammetry technology in implant dentistry: A sys-
conventional, photogrammetry, and intraoral scanning accuracy of tematic review. J Prosthet Dent. 2021; S0022391321005163.
complete-arch implant impression procedures evaluated with a coor- 24. Revilla-León, M., Rubenstein, J., Methani, M.M., Piedra-Cascón, W., Öz-
dinate measuring machine. J Prosthet Dent. 2021; 125:470–478. can M. and Att, W. Trueness and precision of complete-arch photo-
9. Nedelcu, R., Olsson, P., Nyström, I., Rydén, J. and Thor, A. Accuracy and grammetry implant scanning assessed with a coordinate-measuring
precision of 3 intraoral scanners and accuracy of conventional impres- machine. J Prosthet Dent. 2021; S0022391321002808.
sions: A novel in vivo analysis method. J Dent. 2018; 69:110–118. 25. García-Gil, I., Cortés-Bretón-Brinkmann, J., Jiménez-García, J., Peláez-
10. Cappare, P., Sannino, G., Minoli, M., Montemezzi, P. and Ferrini, F. Rico, J. and Suárez-García, M.J. Precision and practical usefulness of
Conventional versus Digital Impressions for Full Arch Screw-Retained intraoral scanners in implant dentistry: A systematic literature review.
Maxillary Rehabilitations: A Randomized Clinical Trial. Int J Environ Res J Clin Exp Dent. 2020; 12:e784–93.
Public Health. 2019; 16:E829. 26. Alikhasi, M., Alsharbaty, M.H.M. and Moharrami, M. Digital Implant
11. Moreira, A.H.J., Rodrigues, N.F., Pinho, A.C.M., Fonseca, J.C. and Vilaça, Impression Technique Accuracy: A Systematic Review. Implant Dent.
J.L. Accuracy Comparison of Implant Impression Techniques: A Sys- 2017; 26:929–935.
tematic Review: Accuracy of Implant Impression Techniques. Clin Im- 27. Marques, S., Ribeiro, P., Falcao, C., Lemos, B.F., Rios-Carrasco, B., Rios-
plant Dent Relat Res. 2015; 17:e751–764. Santos, J.V., et al. Digital Impressions in Implant Dentistry: A Literature
12. Carneiro Pereira, A.L., Medeiros, V.R. and da Fonte Porto Carreiro, A. Review. Int J Environ Res Public Health. 2021; 18:1020.
Influence of implant position on the accuracy of intraoral scanning in 28. Whiting, P.F. QUADAS-2: A Revised Tool for the Quality Assessment of
fully edentulous arches: A systematic review. J Prosthet Dent. 2021; Diagnostic Accuracy Studies. Ann Intern Med. 2011; 155:529.
126:749–755.
29. Tohme, H., Lawand, G., Chmielewska, M. and Makhzoume, J. Compari-
13. Sánchez-Monescillo, A., Sánchez-Turrión, A., Vellon-Domarco, E., Sali- son between stereophotogrammetric, digital, and conventional im-
nas-Goodier, C. and Prados-Frutos, J. Photogrammetry Impression pression techniques in implant-supported fixed complete arch pros-
Technique: A Case History Report. Int J Prosthodont. 2016; 29:71–73. theses: An in vitro study. J Prosthet Dent. 2021;S0022391321002699.
14. Zhang, Y.J., Shi, J.Y., Qian, S.J., Qiao, S.C. and Lai, H.C. Accuracy of full- 30. Wulfman, C., Naveau, A. and Rignon-Bret, C. Digital scanning for com-
arch digital implant impressions taken using intraoral scanners and plete-arch implant-supported restorations: A systematic review. J Pros-
related variables: A systematic review. Int J Oral Implantol (Berl). 2021; thet Dent. 2019; 124:161-167
14:157–179.
31. Sanda, M., Miyoshi, K. and Baba, K. Trueness and precision of digital
15. Rutkūnas, V., Gečiauskaitė, A., Jegelevičius, D. and Vaitiekūnas, M. Ac- implant impressions by intraoral scanners: a literature review. Int J Im-
curacy of digital implant impressions with intraoral scanners. A sys- plant Dent. 2021; 7:97.
tematic review. Eur J Oral Implantol. 2017; 10:101–120.
32. Papaspyridakos, P., Vazouras, K., Chen, Y., Kotina, E., Natto, Z., Kang,
16. Iturrate, M., Eguiraun, H., Etxaniz, O. and Solaberrieta, E. Accuracy K., et al. Digital vs Conventional Implant Impressions: A Systematic Re-
analysis of complete-arch digital scans in edentulous arches when us- view and Meta-Analysis. J Prosthodont. 2020; 29:660–678.
ing an auxiliary geometric device. J Prosthet Dent. 2019; 121:447–454.
33. Paratelli, A., Vania, S., Gómez-Polo, C., Ortega, R., Revilla-León, M. and
17. Rutkūnas, V., Gedrimienė, A., Al-Haj Husain, N., Pletkus, J., Barauskis, Gómez-Polo, M. Techniques to improve the accuracy of complete-arch
D., Jegelevičius, D., et al. Effect of additional reference objects on ac- implant intraoral digital scans: A systematic review. J Prosthet Dent.
curacy of five intraoral scanners in partially and completely edentulous 2021; S0022-3913(21)00486-8.
jaws: An in vitro study. J Prosthet Dent. 2021;S0022-3913(21)00560-6.
34. Andriessen, F.S., Rijkens, D.R., van der Meer, W.J. and Wismeijer, D.W.
18. Kanjanasavitree, P., Thammajaruk, P. and Guazzato, M. Comparison of Applicability and accuracy of an intraoral scanner for scanning multi-
different artificial landmarks and scanning patterns on the complete- ple implants in edentulous mandibles: a pilot study. J Prosthet Dent.
arch implant intraoral digital scans. J Dent. 2022; 125:104266. 2014; 111:186–194.
19. Tallarico, M., Galiffi, D., Scrascia, R., Gualandri, M., Zadrożny, Ł., Cza- 35. Gómez-Polo, M., Ortega, R., Sallorenzo, A., Agustín-Panadero, R., Bar-
jkowska, M., et al. Digital Workflow for Prosthetically Driven Implants mak, A.B., Kois, J.C., et al. Influence of the surface humidity, implant
Placement and Digital Cross Mounting: A Retrospective Case Series. angulation, and interimplant distance on the accuracy and scanning
Prosthesis. 2022; 4:353–368. time of complete-arch implant scans. J Dent. 2022; 127:104307.
20. García-Martínez, I., Zarauz, C., Morejón, B., Ferreiroa, A. and Pradíes, 36. Ender, A. and Mehl, A. Influence of scanning strategies on the accuracy
G. Influence of customized over-scan body rings on the intraoral scan- of digital intraoral scanning systems. Int J Comput Dent. 2013; 16:11–21.
ning effectiveness of a multiple implant edentulous mandibular mod-
37. Medina-Sotomayor, P., Pascual, M.A. and Camps, A.I. Accuracy of four
el. J Dent. 2022; 122:104095.
digital scanners according to scanning strategy in complete-arch im-
21. Mangano, F.G., Admakin, O., Bonacina, M., Lerner, H., Rutkunas, V. pressions. PLoS One 2018; 13: e0202916.
and Mangano, C. Trueness of 12 intraoral scanners in the full-arch im-
38. Muller, P., Ender, A., Joda, T. and Katsoulis, J. Impact of digital intraoral
plant impression: a comparative in vitro study. BMC Oral Health. 2020;
scan strategies on the impression accuracy using the TRIOS Pod scan-
20:263.
ner. Quintessence International. 2016; 47:343–349.

EJPRD • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • P11

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.
 European Journal of Prosthodontics and Restorative Dentistry Jun 13 2023 ARTICLE IN PRESS
39. Ochoa-López, G., Cascos, R., Antonaya-Martín, J.L., Revilla-León, M. and 49. Karl, M. and Taylor, T.D. Bone Adaptation Induced by Non-Passively
Gómez-Polo, M. Influence of ambient light conditions on the accuracy Fitting Implant Superstructures: A Randomized Clinical Trial. Int J Oral
and scanning time of seven intraoral scanners in complete-arch im- Maxillofac Implants. 2016; 31:369–375.
plant scans. J Dent. 2022; 121:104138. 50. Thoma, D.S., Gil, A., Hämmerle, C.H.F. and Jung, R.E. Management and
40. Rutkunas, V., Bilius, V., Simonaitis, T., Auskalnis, L., Jurgilevicius, J. and prevention of soft tissue complications in implant dentistry. Periodon-
Akulauskas, M. The effect of different implant impression splinting tology 2000. 2022; 88:116–129.
techniques and time on the dimensional accuracy: An in vitro study. 51. Hussain, R.A., Miloro, M. and Cohen, J.B. An Update on the Treatment
J Dent. 2022; 126:104267. of Periimplantitis. Dent Clin North Am. 2021; 65:43–56.
41. Rutkunas, V., Larsson, C., Vult von Steyern, P., Mangano, F. and Gedrim- 52. Brito, C., Tenenbaum, H.C., Wong, B.K.C., Schmitt, C. and Nogueira-
iene, A. Clinical and laboratory passive fit assessment of implant-sup- Filho, G. Is keratinized mucosa indispensable to maintain peri-implant
ported zirconia restorations fabricated using conventional and digital health? A systematic review of the literature. J Biomed Mater Res B
workflow. Clin Implant Dent Relat Res. 2020; 22:237–245. Appl Biomater. 2014; 102:643–650.
42. Stimmelmayr, M., Güth, J.F., Erdelt, K., Edelhoff, D. and Beuer, F. Digital 53. Souza, A.B., Tormena, M., Matarazzo, F. and Araújo, M.G. The influence
evaluation of the reproducibility of implant scanbody fit—an in vitro of peri-implant keratinized mucosa on brushing discomfort and peri-
study. Clin Oral Invest. 2012; 16:851–856. implant tissue health. Clin Oral Implants Res. 2016; 27:650–655.
43. Jemt, T. Failures and complications in 391 consecutively inserted fixed 54. Gobbato, L., Avila-Ortiz, G., Sohrabi, K., Wang, C.W. and Karimbux, N.
prostheses supported by Brånemark implants in edentulous jaws: a The effect of keratinized mucosa width on peri-implant health: a sys-
study of treatment from the time of prosthesis placement to the first tematic review. Int J Oral Maxillofac Implants. 2013; 28:1536–1545.
annual checkup. Int J Oral Maxillofac Implants. 1991; 6:270–276.
55. Auškalnis, L., Akulauskas, M., Jegelevičius, D., Simonaitis, T. and
44. Larrucea Verdugo, C., Jaramillo Núñez, G., Acevedo Avila, A. and Lar- Rutkūnas, V. Error propagation from intraoral scanning to additive
rucea San Martín, C. Microleakage of the prosthetic abutment/implant manufacturing of complete-arch dentate models: An in vitro study. J
interface with internal and external connection: In vitro study. Clin Dent. 2022; 121:104136.
Oral Implants Res. 2014; 25:1078–1083.
56. Rutkūnas, V., Gedrimienė, A., Auškalnis, L., Admakin, O. and Mangano,
45. Katsoulis, J., Takeichi, T., Sol Gaviria, A., Peter, L. and Katsoulis, K. Misfit F. Accuracy of Fixed Implant-Supported Dental Prostheses Additively
of implant prostheses and its impact on clinical outcomes. Definition, Manufactured by Metal, Ceramic, or Polymer: A Systematic Review. J
assessment and a systematic review of the literature. Eur J Oral Im- Prosthodont. 2022; 31:70–87.
plantol. 2017; 10:121–138.
57. Rutkunas, V., Dirse, J., Kules, D. and Simonaitis, T. Misfit simulation on
46. Koutouzis, T. Implant-abutment connection as contributing factor to implant prostheses with different combinations of engaging and non-
peri-implant diseases. Periodontology 2000. 2019; 81:152–166. engaging titanium bases. Part 1: Stereomicroscopic assessment of the
47. Lee, H., So, J.S., Hochstedler, J.L. and Ercoli, C. The accuracy of implant active and passive fit. J Prosthet Dent. 2022; S0022-3913(22)00229-3.
impressions: A systematic review. J Prosthet Dent. 2008; 100:285–291.
48. Goodacre, C.J., Bernal, G., Rungcharassaeng, K. and Kan, J.Y.K. Clinical
complications with implants and implant prostheses. J Prosthet Dent.
2003; 90:121–132.

P12 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Accuracy of Implant Impressions: A Systematic Review...

ejprd.org - Published by Dennis Barber Journals. Copyright ©2023 by Dennis Barber Ltd. All rights reserved.