Effect of angulation on the 3D trueness of conventional and digital implant impressions for multi-unit restorations

J Adv Prosthodont. 2023 Dec;15(6):290-301. doi: 10.4047/jap.2023.15.6.290. Epub 2023 Dec 18.

Abstract

Purpose: The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies.

Materials and methods: As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed.

Results: Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively.

Conclusion: Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.

Keywords: Angulated implants; Closed tray; Intraoral scanners; Scan path; Splinted open tray.