Differences in maxillomandibular relationship recorded at centric relation when using a conventional method, four intraoral scanners, and a jaw tracking system: A clinical study

Marta Revilla-León; Rubén Agustín-Panadero; Jonathan M Zeitler; Abdul B Barmak; Burak Yilmaz; John C Kois; Jorge Alonso Pérez-Barquero

doi:10.1016/j.prosdent.2022.12.007

Differences in maxillomandibular relationship recorded at centric relation when using a conventional method, four intraoral scanners, and a jaw tracking system: A clinical study

J Prosthet Dent. 2023 Jan 20:S0022-3913(22)00795-8. doi: 10.1016/j.prosdent.2022.12.007. Online ahead of print.

Authors

Marta Revilla-León¹, Rubén Agustín-Panadero², Jonathan M Zeitler³, Abdul B Barmak⁴, Burak Yilmaz⁵, John C Kois⁶, Jorge Alonso Pérez-Barquero⁷

Affiliations

¹ Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, Scool of Dental Medicine, Tufts University, Boston, MA. Electronic address: marta.revilla.leon@gmail.com.
² Adjunct Professor, Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
³ Director IT, Kois Center, Seattle, Wash.
⁴ Assistant Professor, Clinical Research and Biostatistics, Department of Dentistry, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY.
⁵ Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio.
⁶ Private practice, Kois Center, Seattle, Wash; Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.
⁷ Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.

PMID: 36682896
DOI: 10.1016/j.prosdent.2022.12.007

Abstract

Statement of problem: Digital systems including intraoral scanners (IOSs) and optical jaw tracking systems can be used to acquire the maxillomandibular relationship at the centric relation (CR). However, the discrepancy of the maxillomandibular relationship recorded at the CR position when using digital methods remains uncertain.

Purpose: The purpose of this clinical study was to compare the accuracy of the maxillomandibular relationship recorded at the CR position using a conventional procedure, 4 different IOSs, and an optical jaw tracking system.

Material and methods: A completely dentate volunteer was selected. A Kois deprogrammer (KD) was fabricated. Six groups were created based on the technique used to obtain diagnostic casts and record the maxillomandibular relationship at the CR position: conventional procedures (CNV group), 4 IOS groups: TRIOS4 (TRIOS4 group), iTero Element 5D (iTero group), i700 wireless (i700 group), Primescan (Primescan group), and a jaw tracking system (Modjaw) (Modjaw group) (n=10). In the CNV group, conventional diagnostic stone casts were obtained. A facebow record was used to mount the maxillary cast on an articulator (Panadent). The KD was used to obtain a CR record for mounting the mandibular cast, and the mounted casts were digitized by using a scanner (T710) to acquire the reference scans. In the TRIOS group, intraoral scans were obtained and duplicated 10 times. The KD was used to obtain a bilateral virtual occlusal record at the CR position. To acquire the specimens of the iTero, i700, and Primescan groups, the procedures in the TRIOS4 group were followed, but with the corresponding IOS. In the Modjaw group, the KD was used to record and export the maxillomandibular relationship at the CR position. Articulated virtual casts of each group were exported. Thirty-six interlandmark linear measurements were computed on both the reference and experimental scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The data were analyzed by using 1-way ANOVA followed by the pairwise comparison Tukey tests (α=.05).

Results: The trueness and precision of the maxillomandibular relationship record were significantly affected by the technique used (P<.001). The maxillomandibular relationship trueness values from high to low were iTero (0.14 ±0.09 mm), followed by the Modjaw (0.20 ±0.04 mm) and the TRIOS4 (0.22 ±0.09 mm) groups. However, the iTero, Modjaw, and TRIOS4 groups were not significantly different from each other (P>.05). The i700 group obtained the lowest trueness and precision values (0.40 ±0.22 mm) of all groups tested, followed by the Primescan grop (0.26±0.13 mm); however, the i700 and Primescan groups had significantly lower trueness and precision than only the iTero group (P<.05).

Conclusions: The trueness and precision of the maxillomandibular relationship recorded at the CR position were influenced by the different digital techniques tested.