Tek Kronlar İçin Farklı İmplant Derinliklerinde Dijital ve Konvansiyonel Ölçülerin Doğruluğunun İn Vitro Değerlendirilmesi

Öz

Amaç: Bu in vitro çalışmanın amacı, tek implantlı restorasyonlarda implantın dikey konumunun dijital ve konvansiyonel ölçü tekniklerinin doğruluğu üzerindeki etkisini üç boyutlu süperimpozisyon analizleri kullanarak değerlendirmektir. Gereç ve Yöntemler: Mandibular birinci molar bölgesinde yer alan bir implant analogu, üç farklı gingival derinlikte (2 mm, 4 mm, 6 mm) olacak şekilde ana modele yerleştirildi. Dijital ölçüler Trios 3Shape ve Cerec Omnicam tarayıcılarıyla, konvansiyonel ölçüler ise polivinilsiloksan (PVS) ve kondenzasyon tipi silikon (C-silikon) ile alındı. Toplam 96 test modeli (her grup için n=8) oluşturuldu. Tüm modeller dijitalize edilerek referans STL modeliyle karşılaştırıldı ve 3D sapma analizleri Rapidform yazılımı ile gerçekleştirildi. İstatistiksel değerlendirmede Kruskal-Wallis ve Mann-Whitney U testleri kullanıldı (α=0,05). Bulgular: Dijital ölçü grupları arasında anlamlı bir fark saptanmadı (p>0,05). Konvansiyonel yöntemlerde C-silikonla alınan ölçüler, PVS grubuna kıyasla anlamlı derecede daha yüksek sapma gösterdi (p<0,05). Gingival derinlik arttıkça tüm eksenlerde, özellikle 6 mm derinlikte y- ve z-ekseni sapmalarında belirgin artış gözlendi (p<0,05). Sonuç: İmplantın dikey gingival derinliği ölçü doğruluğunu anlamlı düzeyde etkilemektedir. Dijital ölçü teknikleri farklı derinliklerde yüksek doğruluğu korurken, konvansiyonel yöntemler—özellikle C-silikon—daha derin implant konumlarında belirgin doğruluk kaybı göstermektedir.

Anahtar Kelimeler

• Dijital ölçü
• konvansiyonel ölçü
• implant derinliği
• doğruluk
• in vitro çalışma

IN VITRO EVALUATION OF ACCURACY OF DIGITAL IMPRESSIONS VERSUS CONVENTİONAL IMPRESSIONS AT VARYING IMPLANT DEPTHS FOR SINGLE CROWNS

Öz

Objective: This in vitro study aimed to evaluate the effect of implant vertical positioning on the accuracy of digital and conventional impressions for single implants using three-dimensional superimposition analysis. Material and Methods: A master model with a single implant analog (Biohorizons, 5.7 mm) was prepared at three different gingival depths (2 mm, 4 mm, and 6 mm) in the mandibular first molar region. Digital impressions were obtained using two intraoral scanners (Trios 3Shape and Cerec Omnicam), while conventional impressions were taken using polyvinylsiloxane (PVS) and condensation silicone (Type C silicone). In total, 96 test models (n=8 per group) were generated. All models were digitized and compared to the reference STL model using reverse-engineering software (Rapidform) for 3D deviation analysis. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests (α=0.05). Results: No statistically significant differences were observed between the digital impression groups (p>0.05). Among conventional techniques, the group using C-silicone showed significantly higher deviations than the PVS group (p<0.05). Increasing gingival depth resulted in significantly greater deviation values in all axes, especially in the y- and z-axes at 6 mm depth (p<0.05). Conclusion: The vertical gingival depth has a significant influence on impression accuracy. Digital techniques maintain higher accuracy across varying depths, whereas conventional techniques, particularly those using C-silicone, exhibit reduced performance at deeper levels.

Anahtar Kelimeler

• Digital impression
• conventional impression
• implant depth
• accuracy
• in vitro study

Kaynakça

1. Karl M, Rosch S, Graef F, Taylor TD, Heckmann SM. Static implant loading caused by as-cast metal and ceramic-veneered superstructures. J Prosthet Dent. 2005;93(4):324-330.
2. Del’Acqua MA, Chávez AM, Compagnoni MA, Molo F de A. Accuracy of impression techniques for an implant-supported prosthesis. Int J Oral Maxillofac Implants. 2010;25(4):715–721.
3. Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: Clinical guidelines with biomechanical rationale. Clinical Oral Implants research, 2005;(1):26-35.
4. Papaspyridakos P, Chen CJ, Gallucci G, Doukoudakis A, Weber HP, Chronopoulos V. Accuracy of implant impressions for partially and completely edentulous patients: A systematic review. Int J Oral Maxillofac Implants. 2014;29(4):836–845.
5. Kim JH, Kim KR, Kim S. Critical appraisal of implant impression accuracies: A systematic review. Journal of Prosthetic Dentistry. 2015;114(2):185-192.
6. Wee AG. Comparison of impression materials for direct multi-implant impressions. J Prosthet Dent. 2000; 83(3):323-331.
7. Lee SJ, Betensky RA, Gianneschi GE, Gallucci GO. Accuracy of digital versus conventional implant impressions. Clin Oral Implants Res. 2015; 26(6):715-719.
8. Chochlidakis KM, Papaspyridakos P, Geminiani A, Chen CJ, Feng IJ, Ercoli C. Digital versus conventional impressions for fixed prosthodontics: A systematic review and meta-analysis. Journal of Prosthetic Dentistry. 2016;116(2):184-190.

9. Amin S, Weber HP, Finkelman M, El Rafie K, Kudara Y, Papaspyridakos P. Digital vs. conventional full-arch implant impressions: a comparative study. Clin Oral Implants Res. 2017;28(11):1360-1367.
10. Seelbach P, Brueckel C, Wöstmann B. Accuracy of digital and conventional impression techniques and workflow. Clin Oral Investig. 2013;17(7):1759–1764.
11. Roig E, Garza LC, Álvarez-Maldonado N, et al. In vitro comparison of the accuracy of four intraoral scanners and three conventional impression methods for two neighboring implants. PLoS One. 2020;15(2):e0228266.
12. Ribeiro P, Herrero-Climent M, Díaz-Castro C, et al. Accuracy of implant casts generated with conventional and digital impressions: An in vitro study. Int J Environ Res Public Health. 2018;15(8):1599.
13. Alikhasi M, Alsharbaty MHM, Moharrami M. Digital implant impression technique accuracy: a systematic review. Implant Dent. 2017;26(6):929–935.
14. Linkevicius T, Svediene O, Vindasiute E, Puisys A, Linkeviciene L. The influence of implant placement depth and impression material on the stability of an open tray impression coping. J Prosthet Dent. 2012;108(4):238-243.
15. Lee H, Ercoli C, Funkenbusch PD, Feng C. Effect of subgingival depth of implant placement on the dimensional accuracy of the implant impression: An in vitro study. J Prosthet Dent. 2008;99(2):107-113.
16. Flügge T, van der Meer WJ, Gonzalez BG, Vach K, Wismeijer D, Wang P. The accuracy of different dental impression techniques for implant-supported dental prostheses: A systematic review and meta-analysis. Clinical Oral Implants Research. 2018;29(1):374-392.
17. Sequeira V, Harper MT, Lilly CL, Bryington MS. Accuracy of digital impressions at varying implant depths: An in vitro study. J Prosthodont. 2023;32(1):54–61.
18. Choi YD, Lee KE, Mai HN, Lee DH. Effects of scan body exposure and operator on the accuracy of image matching of implant impressions with scan bodies. J Prosthet Dent. 2020;124(3):379:e1-e6.
19. Park SW, Choi Y Do, Lee DH. The effect of the improperly scanned scan body images on the accuracy of virtual implant positioning in computer-aided design software. J Adv Prosthodont. 2020;12(3):107–113.
20. Abduo J, Palamara JEA. Accuracy of digital impressions versus conventional impressions for 2 implants: an in vitro study evaluating the effect of implant angulation. Int J Implant Dent. 2021;7(1):75.
21. Awad EM, ElSheikh MM, El-Segai AA et al. Effect of soft tissue thickness on accuracy of conventional and digital implant impression techniques. BMC Oral Health. 2024;24(1):1318.
22. Giménez B, Özcan M, Martínez-Rus F, Pradíes G. Accuracy of a digital impression system based on active wavefront sampling technology for implants considering operator experience, implant angulation, and depth. Clin Implant Dent Relat Res. 2015;17(1):e54-e64.
23. Laohverapanich K, Luangchana P, Anunmana C, Pornprasertsuk-Damrongsri S. Different Implant subgingival depth affects the trueness and precision of the 3D dental implant position: a comparative in vitro study among five digital scanners and a conventional technique. Int J Oral Maxillofac Implants. 2021;36(6):1111-1120.
24. Balamurugan T, Manimaran P. Evaluation of accuracy of direct transfer snapon impression coping closed tray impression technique and direct transfer open tray impression technique: An in vitro study. J Indian Prosthodont Soc. 2013;13(3):226-232.
25. Sabouhi M, Bajoghli F, Dakhilalian M, Beygi A, Abolhasani M. Effects of impression coping design, impression technique, and dental undercuts on the accuracy of implant impressions assessed by 3-dimensional optical scanning: An in vitro study. Implant Dent. 2016;25(2):238-246.
26. Schmidt A, Wöstmann B, Schlenz MA. Accuracy of digital implant impressions in clinical studies: A systematic review. Clin Oral Implants Res. 2022;33(6):573–585.
27. Abdel-Azim T, Zandinejad A, Elathamna E, Lin W, Morton D. The influence of digital fabrication options on the accuracy of dental implant–based single units and complete-arch frameworks. Int J Oral Maxillofac Implants. 2014;29(6):1281-1288.
28. Berrendero S, Salido MP, Valverde A, Ferreiroa A, Pradíes G. Influence of conventional and digital intraoral impressions on the fit of CAD/CAM-fabricated all-ceramic crowns. Clin Oral Investig. 2016; 20(9):2403-2410.
29. Assuncao WG, Gennari Filho H, Zaniqueili O. Evaluation of transfer impressions for osseointegrated implants at various angulations. Implant Dent. 2004;13(4):358–366.
30. Akalin ZF, Ozkan YK, Ekerim A. Effects of implant angulation, impression material, and variation in arch curvature width on implant transfer model accuracy. Int J Oral Maxillofac Implants. 2013;28(1):149–157.
31. Wu HK, Chen G, Huang X, Deng F, Li Y. Accuracy of single-implant digital impression with various scanbody exposure levels at anterior and posterior regions. J Dent. 2023;138:104641.
32. Fluegge T, Att W, Metzger M, Nelson K. A Novel Method to evaluate precision of optical implant impressions with commercial scan bodies: An experimental approach. J Prosthodont. 2017;26(1):34-41.
33. Gimenez‐Gonzalez B, Hassan B, Özcan M, Pradíes G. An in vitro study of factors influencing the performance of digital intraoral impressions operating on active wavefront sampling technology with multiple implants in the edentulous maxilla. J Prosthodont. 2017;26(8):650–655.