Accuracy of Complete-Arch Implant Digital Scans: Effect of Scanning Protocol, Number of Implants, and Scan Body Splinting

Purpose: To determine the effect of scanning protocol, number of implants, and implant splinting on the accuracy of digital scanning in the edentulous arch. Materials and Methods: A resin-based model of an edentulous mandible with six implants was scanned with a coordinate measurement machine as a reference and then with two intraoral scanner (IOS) systems (Trios 3 and Primescan). Ten scans were taken per IOS for three experiments, and each scan was compared to the reference data to evaluate trueness and precision. Analysis involved measurement of linear and angular discrepanices using engineering software. In experiment 1, three scanning protocols were compared (curvilinear, zigzag, and half-arch). In experiment 2, three clinical situations were simulated (6 implants, 4 implants-short arch, and 4 implants-long arch). In experiment 3, the effect of implant splinting with a suture thread was measured. Normal distribution of data was examined with Shapiro-Wilk test. Levene test was used for equality of variance (& alpha; = .05). Statistical differences in distance and angular deviations were analyzed using Student t test or ANOVA with post hoc Tukey test (& alpha; = .05). Results: The best results in terms of trueness and precision were obtained with a linear scanning protocol and six implants. The results were as follows: Trios 3: trueness = 52 pm/0.42 degrees, precision = 40 pm/0.26 degrees; Primescan: trueness = 24 pm/0.28 degrees, precision = 18 pm/0.27 degrees. The scanning protocol did not significantly affect distance or angular deviation accuracy. Trueness and precision significantly decreased with four implants using Primescan and TRIOS 3. Splinting implants negatively affected accuracy with both IOS devices. Conclusion: Both IOS devices achieved clinically satisfying accuracy for distance (< 100 pm) and angular (< 0.5 degrees) deviations with six implants and a linear scanning protocol. With four implants, angular deviations sometimes differed between implants within the same group depending on the IOS and the clinical situation. Int J Prosthodont 2023;36:219-227. doi: 10.11607/ijp.7332