Purpose: To assess the influence of the number of teeth (2, 3, or 4) and location (molars, molar and premolar, or premolars and canines) of the bilateral virtual occlusal record on the accuracy of the virtual maxillo-mandibular relationship acquired by an intraoral scanner (IOS).
Material and methods: Diagnostic casts mounted on a semi-adjustable articulator were obtained. Four markers were adhered on the facial surfaces of the first molars and canines. The mounted casts were digitized using an extraoral scanner. Maxillary and mandibular intraoral digital scans were obtained using an intraoral scanner (TRIOS 4). The maxillary and mandibular digital scans were duplicated 105 times and divided into 7 groups based on the number of teeth (2, 3, or 4) and location (molar, molar and premolar, or premolars and canines) of the bilateral virtual occlusal records (n = 15). The alignment of the scans was automatically performed after the acquisition of the corresponding occlusal records by the IOS program. Eight linear distances between the gauge balls were computed on the reference scan and on the 105 digital scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The Shapiro-Wilk test showed that the data was normally distributed. The trueness and precision data were analyzed using 2-way ANOVA followed by pairwise comparison Tukey tests (α = 0.05).
Results: Two-way ANOVA showed that the number of teeth (p < 0.001) and the position of the virtual occlusal record (p < 0.001) were significant factors on the accuracy of the maxillo-mandibular relationship. Tukey test showed significant overall mean differences between the different groups tested: the 4-teeth group obtained the highest trueness, and the 2-teeth group showed the lowest trueness values (p < 0.001). Tukey test showed significant trueness differences between the virtual occlusal record locations. The 2-teeth record located more posteriorly obtained the lowest trueness. Significant differences in precision values were found among the subgroups tested (p < 0.001). The 2-teeth group obtained significantly more precision values than the 3- and 4-teeth groups. Additionally, there was a significant difference in precision values between the subgroup tested in which the first molar and second premolar location had the highest precision, while the first and second premolar's location obtained the lowest precision.
Conclusions: The number of teeth and the location of the bilateral virtual occlusal record influenced the accuracy of the virtual maxillo-mandibular relationship obtained by the intraoral scanner tested. The more teeth included in the bilateral virtual occlusal record, the higher the accuracy of the maxillo-mandibular relationship. Additionally, the more anteriorly located the virtual bilateral occlusal record involving 2 or 3 teeth was, the higher the accuracy mean value.
Keywords: Intraoral digital scan; virtual articulator; virtual occlusal records; virtual patient.
© 2022 by the American College of Prosthodontists.