Purpose: To update data on the transfer accuracy of digital implant impressions by using a coordinate-based analysis, latest intraoral scanners (IOSs) were investigated in an established clinical close model set-up. Materials and Methods: An implant master model (IMM) of the maxilla with four implants in the posterior area (#14/#24 and #16/#26) and a reference cube was scanned with four different IOS (i700 (Medit), Primescan (Dentsply Sirona), Trios 4 and Trios 5 (3Shape) ten times each. Datasets were compared with a reference dataset of IMM that was generated with x-ray computed tomography in advance. 3D deviations for the implant-abutment-interface points (IAIPs) were calculated. Statistical analysis was performed by multifactorial ANOVA (p < .05). Results: Overall deviations for trueness (mean) ± precision (SD) of the IAIPs ranged from 88±47 μm for the Primescan, followed by 112±57 μm for the i700, 121±42 μm for the Trios 4 and 124±43 μm for the Trios 5 with decreasing accuracy along the scan path. For trueness, one significant difference between the Primescan and the T4 was detected for one implant position. For precision, no significant differences were noticed. Conclusions: Although the latest IOS showed a significant improvement in transfer accuracy, the accumulating deviation along the scan path is not yet resolved. Considering the Trios system, the innovation seems to be limited as no improvement could be detected between Trios 4 and 5.

Die Bindegewebetransplantation zählt heute zu den Standardverfahren zur Kompensation von Volumendefiziten bei Sofortimplantation. Neue Biomaterialien wie azelluläre Matrices könnten die Gewinnung autogenen Gewebes auf ein absolut notwendiges Minimum reduzieren und damit die Häufigkeit und das Ausmaß postoperativer Beschwerden verringern. Die vorliegende randomisierte Studie verglich die klinischen Therapieergebnisse von Sofortimplantationen in der Oberkieferfront, bei denen sowohl eine knöcherne Augmentation als auch eine Weichgewebeverdickung durchgeführt wurde. Neben anorganischem bovinem Knochenmaterial (ABBM) kam entweder ein Bindegewebeersatz aus porciner Dermis, eine azelluläre dermale Matrix (ADM) oder ein autogenes Bindegewebetransplantat (BGT) zum Einsatz. An der Studie nahmen 20 Patienten (11 Männer, 9 Frauen) mit einem Durchschnittsalter von 48,9 Jahren (21−72 Jahre) teil. Die Zuordnung der Studienteilnehmer zu der Test- (ADM) bzw. Kontrollgruppe (BGT) geschah nach dem Zufallsprinzip. Der Zahnextraktion folgte die sofortige Implantatinsertion. Der bukkale Knochen wurde mit ABBM augmentiert. Eine ADM oder ein BGT diente zur Verdickung des bukkalen Weichgewebes und somit zur Kompensation des erwarteten Verlustes von bukkalem Volumen. Die klinische und volumetrische Nachuntersuchung fand 12 Monate nach Implantatinsertion statt. Bei allen Implantaten hatte eine Osseointegration stattgefunden und die prothetische Versorgung befand sich in situ. Ein Jahr postoperativ betrug die durchschnittliche, linear gemessene Volumenveränderung −0,55 ± 0,32 mm (ADM) bzw. −0,60 ± 0,49 mm (BGT). Patienten der ADM-Gruppe beklagten signifikant weniger postoperative Beschwerden. Bei Sofortimplantation mit Augmentation von Hart- und Weichgewebe führten Ersatzmaterialien und autogene Bindegewebetransplantate zu ähnlichen klinischen Ergebnissen hinsichtlich der gemessenen Volumenveränderungen. Die Anwendung von Ersatzmaterial führte zu signifikant weniger postoperativer Morbidität. Manuskripteingang: 07.01.2021, Annahme: 14.04.2021 Keywords: Sofortimplantation, Weichgewebeverdickung, Bindegewebetransplantat, azelluläre dermale Matrix, anorganisches bovines Knochenmaterial

Connective tissue grafts have become a standard for compensating horizontal volume loss in immediate implant placement. The use of new biomaterials like acellular matrices may avoid the need to harvest autogenous grafts, yielding less postoperative morbidity. This randomized comparative study evaluated the clinical outcomes following extraction and immediate implant placement in conjunction with anorganic bovine bone mineral (ABBM) and the use of a porcine acellular dermal matrix (ADM) vs an autogenous connective tissue graft (CTG) in the anterior maxilla. Twenty patients (11 men, 9 women) with a mean age of 48.9 years (range: 21 to 72 years) were included in the study and randomly assigned to either the test (ADM) or control (CTG) group. They underwent tooth extraction and immediate implant placement together with ABBM for socket grafting and either ADM or CTG for soft tissue augmentation. Twelve months after implant placement, the cases were evaluated clinically and volumetrically. All implants achieved osseointegration and were restored. The average horizontal change of the ridge dimension at 1 year postsurgery was -0.55 ± 0.32 mm for the ADM group and -0.60 ± 0.49 mm for the CTG group. Patients of the ADM group reported significantly less postoperative pain. Using xenografts for hard and soft tissue augmentation in conjunction with immediate implant placement showed no difference in the volume change in comparison to an autogenous soft tissue graft, and showed significantly less postoperative morbidity.

Purpose: To evaluate the accuracy (trueness and precision) achievable with four intraoral scanners (IOSs) and different preparation geometries. Materials and methods: A model of a maxillary arch with different preparation geometries (onlay, inlay, veneer, full-crown) served as the reference master model (RMM). The RMM was scanned 10 times using four commonly used IOSs (Trios 2 [TR], 3Shape; Omnicam [OC], Dentsply Sirona; True-Definition [TD], 3M ESPE; and Primescan [PS], Dentsply Sirona). Scans were matched using a 3D measurement software (Inspect 2019, GOM) and a best-fit algorithm, and the accuracy (trueness and precision) of the preparation types of the scanning data was evaluated for positive and negative deviations separately. All data were subjected to univariate analysis of variance using SPSS version 24 (IBM). Results: Mean (± SD) positive deviations ranged from 4.6 ± 0.7 μm (TR, veneer) to 25.9 ± 2.4μm (OC, full crown). Mean negative deviations ranged from -7.2 ± 0.6 μm (TR, veneer) to -26.4 ± 3.8 μm (OC, full crown). There were significant differences (P < .05) in terms of trueness and precision among the different IOSs and preparation geometries. Conclusion: The transfer accuracy of simple geometries was significantly more accurate than those of the more complex prosthetic geometries. Overall, however, the IOSs used in this study yielded results that were clinically useful for the investigated preparation types, and the mean positive and negative deviations were in clinically acceptable ranges.

Insbesondere in der Implantologie eröffnet der intraorale Scan, neben der alleinigen Funktion einer Abformung, die Möglichkeit zur Implementierung neuer Behandlungskonzepte. Bereits in der Beratungs- und Planungsphase können so in Verbindung mit dreidimensionalen Röntgendaten Möglichkeiten, Grenzen und Risiken der Implantatversorgung erläutert und in einem prothetisch-chirurgischen Behandlungskonzept festgelegt werden, welches zu vorhersagbareren Behandlungsergebnissen führt. Jedoch müssen die heute noch bestehenden Limitationen der Ganzkieferversorgungen in Bezug auf die dreidimensionale Übertragung der Implantatposition von der Mundhöhle auf ein Modell beachtet werden, weshalb indikationsabhängig auch kombiniert digital-analoge Versorgungskonzepte in Betracht gezogen werden sollten. Durch die kontinuierliche Weiterentwicklung der Scansysteme ist jedoch zukünftig damit zu rechnen, dass auch hier die digitale Abformung die etablierten analogen Behandlungsverfahren ersetzen wird. Manuskripteingang: 18.06.2021, Annahme: 11.08.2021 Keywords: digitale Abformung, Implantatabformung, konventionelle Abformung, intraorale Scanner, Abformgenauigkeit, digitale Implantatplanung

Aim: Dental research involves variations between actual and reference datasets of master models to determine the metric accuracy through transfer accuracy tests. Various methods of measurement are used to analyze the results, which are often subjected to direct comparisons. Hence, the aim of the present study was to analyze the influence and effect on results of different methods of digital data analysis, being coordinate-based analysis (CBA) and best-fit superimposition analysis. Materials and methods: A model with four implants and a reference cuboid was digitized through computed tomography (CT), which served as the master model. Ten implant impressions were made using a Trios (3Shape) intraoral scanner, and three different scan bodies (nt-trading, Kulzer, and Medentika) were used. The deviations between the master model and the digital impressions were analyzed using CBA and best-fit superimposition analysis. Statistical analysis was performed using SPSS 25. Results: The deviations in the CBA and best-fit superimposition analysis ranged from 0.088 ± 0.012 mm (mean ± SE; Medentika, 14) to 0.199 ± 0.021 mm (Kulzer, 26), and from 0.042 ± 0.010 mm (Medentika, 16) to 0.074 ± 0.006 mm (Kulzer, 16), respectively. Significant differences were observed between the implant positions in the CBA and the digital measurements at each implant position, whereas the best-fit analysis showed no significant difference between the scan bodies and implant positions. Conclusion: CBA displays an advantage over best-fit superimposition analysis in the detection of possible influencing factors for primarily scientific purposes. However, a global analysis and visualization of angles and torsions is difficult, for which a best-fit evaluation is needed. However, a best-fit analysis better represents the clinical try-in. It is associated with the risk that possible disturbing factors and resulting errors might be leveled out and their identification camouflaged. Keywords: dimensional measurement accuracy, accuracy, trueness, precision, intraoral scanner, digital dentistry, implant impression, best-fit analysis

Purpose: To assess the absolute linear distances of three different intraoral scan bodies (ISBs) using an intraoral scanner compared to a conventional impression in a common clinical model setup with a gap and a free-end situation in the maxilla. Materials and methods: An implant master model with a reference cube was digitized using x-ray computed tomography and served as the reference file. Digital impressions (TRIOS, 3Shape) were taken using three different ISB manufacturers: NT Trading, Kulzer, and Medentika (n = 10 per group). Conventional implant impressions were taken for comparison (n = 10). The conventional models were digitized, and all models (digital and conventional) were superimposed with the reference file to obtain the 3D deviations for the implant-abutment-interface points (IAIPs). Results for linear deviation (trueness and precision) were analyzed using pairwise comparisons (P < .05; SPSS version 25). For precision, a two-way factorial mixed ANOVA was used. Results: The deviations for trueness (mean) ± precision (SD) of the IAIPs ranged as follows: FDI region 14 = 0.106 ± 0.050 mm (Medentika) to 0.134 ± .026 mm (NT Trading); region 16 = 0.108 ± 0.046 mm (conventional) to 0.164 ± 0.032 mm (NT Trading); region 24 = 0.111 ± 0.050 mm (conventional) to 0.191 ± 0.052 mm (Medentika); region 26 = 0.086 ± 0.040 mm (conventional) to 0.199 ± 0.066 mm (Kulzer). There were significant differences for trueness between all digital and conventional impression techniques. For precision, only two significant differences in two implant regions (14, 24) were observed. Conclusion: Longer scanning paths resulted in higher deviations of the implant position in digital impressions. Due to algorithms implemented in the software, errors resulting from the different scan bodies may be reduced during the alignment process of the IOS in clinical practice.

Objectives: The aim of this retrospective pilot study was to analyze the clinical performance of computer-engineered complete dentures (CECDs) in edentulous patients regarding survival and maintenance. Method and materials: For this retrospective analysis, data from 10 patients who received CECD treatment in each arch (Digital Denture, Ivoclar Vivadent) between 2015 and 2016 were analyzed. The following aspects were assessed: number of appointments required for treatment, number of interventions during the initial (≤ 4 weeks after insertion) and functional periods (> 4 weeks after insertion), and survival. Additionally, whether these aspects were influenced by function or esthetics, the arch, or recall participation was assessed. Poisson regression models were used for the statistical analysis (P .05). Results: All CECDs survived the observation period of 2.54 ± 0.48 years. More than four appointments were required for treatment (mean ± standard deviation, 4.6 ± 0.7), mainly for esthetic concerns. An average of 1.7 ± 0.05 appointments during the initial period and 2.07 ± 0.32 during the functional period were noted as a consequence of functional concerns. During both periods, the major reason for intervention was removal of pressure spots. Relining was required in 40% of the CECDs, and fracture of the denture base occurred in two CECDs. Conclusions: Within the limitations of this retrospective pilot study, the CECDs showed acceptable clinical performance in terms of survival and maintenance. Nevertheless, transferring more information about the patient from the dental practice to the dental laboratory might reduce the number of appointments for treatment and avoid technical complications such as fractures of the denture base. Keywords: CAD/CAM complete denture, computer-engineered complete dentures, maintenance, survival