Techniques to improve the accuracy of complete arch implant intraoral digital scans: A systematic review

Abstract

Statement of problem: The best method of optimizing the accuracy of complete arch intraoral digital scans is still unclear. For instance, the location of the scan bodies can be significantly distorted with respect to their actual positions, which would lead to a nonpassive fit of the definitive prosthesis.

Purpose: The purpose of this systematic review was to analyze available techniques for improving the accuracy of digital scans in implant-supported complete arch fixed prostheses.

Material and methods: Three databases (Medline, Embase, and Google Scholar) were searched, and the results obtained were supplemented by a hand search. Specific descriptors identified techniques whose objective were to increase the accuracy of digital scans in implant-supported complete arch fixed prostheses. Titles and abstracts were screened by 2 independent reviewers, and unclear results were discussed with a third independent reviewer. A qualitative analysis based on procedural parameters was used. The interexaminer agreements of both were assessed by the Cohen kappa statistic, and the Risk of Bias Tool was used to assess the risk of bias across the studies.

Results: A total of 17 techniques matching the inclusion criteria were evaluated. Higher accuracy but also differences regarding the need for supplementary devices, number of intraoral scans, and time consumption of clinical and software program steps were observed compared with the conventional digital scanning protocol. The use of a splinting device was common to most of the studies. The outcome variables for the evaluation of the effectiveness of these protocols were heterogeneous.

Conclusions: The use of additional techniques during intraoral scanning can improve accuracy in implant-supported complete arch fixed prostheses. However, higher complexity for those procedures should be expected.