When You Should Use Digital Impression Scanners and When You Shouldn’t

With constant evolutions in dental technology, it can be challenging to decide which inventions to try in your practice and which to pass. One hot-topic technology advancement is intraoral scanners (IOS), also known as digital impression scanners.

Continue reading to understand when it’s appropriate to use a digital scanner and when it’s not.

First: What exactly is digital impression technology?

Digital impressions, or 3D intraoral scanners, are a wand-like tool that connects to a computer with advanced software to create a virtual model of the hard and soft tissues in the mouth.

In many cases, these are more accurate than traditional impressions and mold and are more versatile. Once the scan is complete, the digital impressions can be sent to a dental lab where they create a custom denture, bridge, crown, or retainer for the patient.

Generally speaking, intraoral scanners are devices that can (1) capture an image of the mouth with light and sensors, (2) process said image with scanning software, and (3) produce a 3D virtual model of the patient’s teeth or mouth. Even though intraoral scanners are considered a more comfortable way to take impressions, they are not ideal for every scenario.

For patients, digital impressions eliminate the need for messy mold material and the uncomfortable experience of making the mold. This improves the patient experience, especially for those who have sensitive teeth or a severe gag reflex.

Here’s when you should and shouldn’t use digital impressions:

1. Frequent Oral Scans and X-Rays

While some healthy patients only require dental x-rays every few years, others with a higher risk of dental problems may need more frequent x-rays. This population constitutes:

  • Children and adolescents 
  • People who have periodontal disease
  • People who suffer from dry mouth
  • Adults with extensive restorative work
  • People who smoke and use tobacco products
  • People who consume ample amounts of sugar

Compared to x-rays, a significant advantage of intraoral scanners is that they use NIRI (Near-Infrared Imaging) instead of radiation to visualize internal structures.

As reported by the American Cancer Society, long-term overexposure to radiation is linked to both short-term and long-term side effects, including radiation sickness, bone-related disorders, and infertility. When patients require more x-rays than usual, a digital scanner can be a helpful tool.

2. Instant Access and Real-Time Knowledge

A perk of digital scanners is that they are excellent patient education tools. Patients enjoy the instant gratification of immediately seeing a 3D image of the current state of their mouths and seeing the potential of their smiles.

3. Fabricating Dental Prosthetics

In prosthodontics, a dentist can use an intraoral scanner to capture the 3D position of the existing teeth and take impressions for manufacturing:

  • Inlays
  • Onlays
  • Crowns
  • Bridges
  • Dentures
  • Implant-supported restorations

However, according to a review published by the University of Florence, researchers concluded that conventional impressions show greater accuracy than digital impressions.

From time to time, it can be difficult to detect deep margin lines accurately (especially if the mouth is bleeding). Therefore, digital scanners are inferior to traditional impressions when creating dental prosthetics.

4. Creating Clear Aligners for Orthodontic Treatment

Despite the fact that digital scanning technology is constantly updating, dentists and orthodontists should skip scanners during the initial step of clear aligner treatment. Why? Simply, digital scans are not as accurate as conventional impressions. 

In a recent study published by The Journal of Prosthetic Dentistry, clinical researchers concluded that intraoral and extraoral scanners decrease the accuracy of complete-arch scans (required for clear aligner therapy). In this study, intraoral full arch precision ranged from 90-198μm, and intraoral full arch trueness went from 118-581μm. Researchers concluded that clinical IOS full arch scanning did not achieve clinically acceptable accuracy.

Orthosnap uses PVS impressions to create perfectly fitting aligners that use accurate movement instead of attachments and rubber bands to move teeth into their desired position.

By using PVS impressions, we can:

  • Handle more complex cases
  • Prescribe shorter treatment times

In conclusion, digital scanners have some advantages (such as increased patient comfort and instant access). However, the pros of digital scanners do not outweigh one major con: inaccuracy.

Without accuracy, orthodontic treatment cannot be performed efficiently or safely.

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