Evaluation of laboratory scanner accuracy by a novel calibration block for complete-arch implant rehabilitation

Objectives: To compare the accuracies of 4 laboratory scanners using a new custom-made block for complete-arch implant rehabilitation. Materials and Methods: A block comprised 4 cylinders, with 2 in the anterior (0 degrees angulation) and 2 in the posterior region (45 degrees distal angulation) (Experimental group) and a standard block with 2 parallel cones in 16 degrees taper (ISO group), were fabricated. Both blocks were scanned consecutively for 15 times by 4 laboratory scanners: IScan, Zfx, 3Shape, and KaVo. Measurements were also made by a coordinate measuring machine (CMM) as the reference. Acquired digital models were inspected with a metrology software. Linear and angular distortions were computed evaluation of trueness, precision and expanded uncertainty of scanners. Effects of blocks and scanners on the scanning trueness and precision were analyzed by Two-way ANOVA (alpha = 0.05). Results: The linear trueness and precision of scanners was significantly poorer when the Experimental block instead of ISO block was used. Significant greater distortions were noticed at the 45 degrees sites than the 0 degrees sites and no significant effect of inter-implant distance on the scanning accuracy was found. Zfx, IScan and 3Shape exhibited comparable expanded uncertainties (10.6 similar to 11.8) but KaVo showed the greatest (19.3) in complete-arch implant scans. Conclusion: The ISO block might not be more suitable than the Experimental block for evaluating the accuracy of laboratory scanner for complete-arch implant scanning. All the scanners tested except one demonstrated acceptable accuracy for complete-arch implant digitization. Scanning accuracy was compromised by unfavourable angulation of implants. Clinical significance: It is questionable whether the laboratory scanners validated for tooth-borne cases could also perform well for implant cases. It might be necessary to develop a new calibration object specifically for complete-arch implant scenarios to verify the capability of laboratory scanners in the implant workflow.