Accuracy of full-arch scans using intraoral and extraoral scanners: an in vitro study using a new method of evaluation

The aim of this study was to compare the accuracy of six intraoral scanners as regards clinically relevant distances using a new method of evaluation. An additional objective was to compare intraoral scanners with the indirect digitization of model scanners. A resin master model was created by 3D printing and drilled in five places to reflect the following distances: intermolar width (IMW), intercanine width (ICW), and arch length (AL). To determine a gold standard, the distances were measured with a coordinate measuring instrument (Zeiss O-Inspect 422). The master model was scanned 37 times with the following intraoral scanners: Apollo DI (Sirona), CS 3500 (Carestream Dental), iTero (Cadent), PlanScan (Planmeca), Trios (3Shape), and True Definition (3M Espe), and indirectly digitized with the OrthoX Scan (Dentaurum). The digital models were then measured, and deviations from the gold standard calculated. Significant differences were found between the devices. Among the intraoral scanners, Trios and iTero showed the most accurate results, although CS 3500, True Definition, and Apollo DI achieved comparable results. PlanScan demonstrated the highest deviations from the gold standard, and presented a high standard deviation (SD). Direct digitization revealed comparable (and, in fact, slightly higher) accuracy than indirect digitization. Both indirect digitization and most of the intraoral scanners were therefore demonstrated to be suitable for use in the orthodontic office, with the exception of PlanScan, which did not meet the demands of individual orthodontic treatment. Keywords: intraoral scanner, indirect digitization, full-arch scan, digital impression, CAD/CAM, accuracy