In Vitro Accuracy Study of Intraoral Scanning versus CBCT in Evaluating Implant Positioning

doi:10.13701/j.cnki.kqyxyj.2025.07.009

Abstract

Abstract: Objective: To analyze the consistency between intraoral scanning (IOS) and cone-beam computed tomography (CBCT) in evaluating implant positioning through in vitro experiments and to explore the feasibility of replacing CBCT with IOS. Methods: Ten resin models simulating dentition defects were constructed based on missing tooth positions and implant numbers. Postoperative scans were performed using IOS (4 scans per group) and CBCT (1 scan per group). Deviations at the implant neck, apex, depth, and angulation were measured using reverse engineering software, followed by analysis of trueness (n=4) and precision (n=6). Results: Trueness results revealed neck deviation of (0.174±0.080) mm, apex deviation of (0.310±0.098) mm, depth deviation of (0.131±0.077) mm, and angular deviation of (1.311±0.486)°. Except for depth deviation (P>0.05), all other deviations significantly increased with the number of implants (P<0.05). Precision analysis demonstrated significantly higher deviations in the free-end group compared to the non-free-end group (P<0.05). Conclusion: Intraoral scanning may serve as a viable alternative to CBCT for assessing implant positioning accuracy in surgical planning and avoiding postoperative radiation exposure, however, further clinical validation is warranted.

Key words: oral implant, intraoral scanning, CBCT, accuracy

LIN Yuxuan, ZHANG Sihui, CHEN Jiang. In Vitro Accuracy Study of Intraoral Scanning versus CBCT in Evaluating Implant Positioning[J]. Journal of Oral Science Research, 2025, 41(7): 594-600.

References

[1] Brånemark PI, Adell R, Breine U, et al. Intra-osseous anchorage of dental prostheses. Ⅰ. Experimental studies [J]. Scand J Plast Reconstr Surg, 1969, 3(2): 81-100.
[2] Brånemark PI. Osseointegration and its experimental background [J]. J Prosthet Dent, 1983, 50(3):300-410.
[3] 冯希平.中国居民口腔健康状况——第四次中国口腔健康流行病学调查报告[C].2018年中华口腔医学会第十八次口腔预防医学学术年会论文汇编,2018:23-31.
[4] Mcdermott NE, Chuang SK, Woo VV, et al. Complications of dental implants: identification, frequency, and associated risk factors [J]. Int J Oral Maxillofac Implants, 2003, 18(6):848-855.
[5] 汤春波,褚壮壮.种植体位置异常相关并发症及处理方式探讨[J].口腔医学,2023,43(1):28-34.
[6] ISO-5725-1. Accuracy (trueness and precision) of measurement methods and results-Part 1: general principles and definitions [S]. International Organization for Standardization, 1994.
[7] Yeung M, Abdulmajeed A, Carrico CK, et al. Accuracy and precision of 3D-printed implant surgical guides with different implant systems: An in vitro study [J]. J Prosthet Dent, 2020, 123(6): 821-828.
[8] Block MS, Emery RW, Cullum DR, et al. Implant placement is more accurate using dynamic navigation [J]. J Oral Maxillofac Surg, 2017, 75(7): 1377-1386.
[9] Sawicki P, Zawadzki PJ, Regulski P. The impact of cone-beam computed tomography exposure parameters on peri-implant artifacts: A literature review [J]. Cureus, 2022, 14(3): e23035.
[10] Abboud M, Calvo-Guirado JL, Orentlicher G, et al. Comparison of the accuracy of cone beam computed tomography and medical computed tomography: implications for clinical diagnostics with guided surgery [J]. Int J Oral Maxillofac Implants, 2013, 28(2): 536-542.
[11] Al-Ekrish AA, Ekram M. A comparative study of the accuracy and reliability of multidetector computed tomography and cone beam computed tomography in the assessment of dental implant site dimensions [J]. Dentomaxillofac Radiol, 2011, 40(2):67-75.
[12] Joda T, Brägger U. Patient-centered outcomes comparing digital and conventional implant impression procedures: a randomized crossover trial [J]. Clin Oral Implants Res, 2016, 27(12): e185-e189.
[13] Basaki K, Alkumru H, De Souza G, et al. Accuracy of digital vs conventional implant impression approach: A three-dimensional comparative in vitro analysis [J]. Int J Oral Maxillofac Implants, 2017, 32(4): 792-799.
[14] Mizumoto RM, Yilmaz B. Intraoral scan bodies in implant dentistry: A systematic review [J]. J Prosthet Dent, 2018, 120(3):343-352.
[15] Wismeijer D, Joda T, Flügge T, et al. Group 5 ITI consensus report: Digital technologies [J]. Clin Oral Implants Res, 2018, 29 Suppl 16:436-442.
[16] El Kholy K, Lazarin R, Janner SFM, et al. Influence of surgical guide support and implant site location on accuracy of static computer-assisted implant surgery [J]. Clin Oral Implants Res, 2019, 30(11):1067-1075.
[17] Derksen W, Wismeijer D, Flügge T, et al. The accuracy of computer-guided implant surgery with tooth-supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study [J]. Clin Oral Implants Res, 2019, 30(10):1005-1015.
[18] Brandt J, Brenner M, Lauer HC, et al. Accuracy of a template-guided implant surgery system with a CAD/CAM-based measurement method: An in vitro study [J]. Int J Oral Maxillofac Implants, 2018, 33(2):328-334.
[19] 宫苹.口腔种植学[M].北京:人民卫生出版社, 2020.
[20] Müller P, Ender A, Joda T, et al. Impact of digital intraoral scan strategies on the impression accuracy using the TRIOS Pod scanner [J]. Quintessence Int, 2016, 47(4):343-349.
[21] Miyoshi K, Tanaka S, Yokoyama S, et al. Effects of different types of intraoral scanners and scanning ranges on the precision of digital implant impressions in edentulous maxilla: An in vitro study [J]. Clin Oral Implants Res, 2020, 31(1):74-83.
[22] 陈泉林,许胜,周文娟,等.计算机辅助动态导航技术在种植手术中的临床精度影响因素分析[J].中国口腔种植学杂志,2021,26(2):85-90.
[23] 陶宝鑫,王凤,沈意涵,等.动态导航技术辅助双侧双颧种植的精度分析及临床效果评估[J].中华口腔医学杂志,2020,55(11):845-850.
[24] 白石柱,任楠,冯志宏,等.自主式口腔种植机器人手术系统动物体内种植精度的研究[J].中华口腔医学杂志,2021,56(2):170-174.
[25] Dreiseidler T, Neugebauer J, Ritter L, et al. Accuracy of a newly developed integrated system for dental implant planning [J]. Clin Oral Implants Res, 2009, 20(11):1191-1199.
[26] Al-Harbi SA, Sun AY. Implant placement accuracy when using stereolithographic template as a surgical guide: preliminary results [J]. Implant Dent, 2009, 18(1):46-56.
[27] Beach DA. CBCT use in endodontic diagnosis [J]. Dent Today, 2016, 35(2):80-83.
[28] Cristache CM, Gurbanescu S. Accuracy evaluation of a stereolithographic surgical template for dental implant insertion using 3D superimposition protocol [J]. Int J Dent, 2017, 2017:4292081.
[29] Ajioka H, Kihara H, Odaira C, et al. Influence of scan body design on the accuracy of intraoral scanning for implant-supported prostheses [J]. Clin Oral Implants Res, 2023, 34(2):178-187.
[30] Revilla-León M, Jiang P, Sadeghpour M, et al. Intraoral digital scans-Part 1: Influence of ambient scanning light conditions on the accuracy of different intraoral scanners [J]. J Prosthodont, 2022, 31(5):402-410.
[31] Papaspyridakos P, De Souza A, Vazouras K, et al. Digital vs conventional full-arch implant impressions: A systematic review and meta-analysis [J]. J Prosthet Dent, 2021, 126(1):15-22.
[32] Van Assche N, Vercruyssen M, Coucke W, et al. Accuracy of computer-aided implant placement [J]. Clin Oral Implants Res, 2012, 23 Suppl 6:112-123.
[33] Bover-Ramos F, Viña-Almunia J, Cervera-Ballester J, et al. Accuracy of implant placement with computer-guided surgery: A systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies [J]. Int J Oral Maxillofac Implants, 2018, 33(1):101-115.