Digital Alignment Accuracy of Zirconia Abutments on Incompletely Captured Implant Impressions: A Laboratory Study
Abstract
Objectives
This in vitro study aimed to evaluate the feasibility and accuracy of digitally aligning zirconia customized abutment library files onto incomplete abutment scan datasets. Superimposition was compared to the conventional “Close holes” reconstruction function in CAD software.
Materials and Methods
A dental model with a single implant was used. A zirconia customized abutment was scanned to generate a library file. Complete scans of the abutment and adjacent teeth served as the control group (C). Two experimental datasets were created by deleting marginal regions and proximal surfaces from the complete scan (NC2, NC3). The “Close holes” function in exocad software was applied to defective scans to form the reconstruction group (CH). All datasets were digitally superimposed with the zirconia abutment library file. Trueness was assessed using root mean square (RMS) error and point-based deviation analysis in Geomagic Control X. One-way ANOVA and Tukey HSD tests were used for statistical analysis.
Results
Superimposition significantly improved trueness compared to unprocessed scans. RMS values decreased from 39.11 ± 0.98 μm in the IOS group to 35.41–37.59 μm across C, NC2, NC3, and S datasets (p < .001). No significant differences were found among the superimposed groups (p > .05). The CH group showed higher deviations than all superimposition groups (p < .001). Point-based analysis confirmed lower deviations after superimposition (p < .05), except at the marginal ridge regions (p > .05). The hole-filling function did not improve trueness (p > .05).
Conclusions
Digital superimposition of zirconia abutment library data onto incomplete scans enhances trueness and geometric reliability. This method is superior to conventional reconstruction tools for restoring incomplete implant impressions.
Keywords
Zirkonyum Diş protezi implant destekli diş ölçü tekniği Bilgisayar yardımlı tasarım protez tasarımı.
References
- 1. Kihara H, Hatakeyama W, Komine F, Takafuji K, Takahashi T, Yokota J, et al. Accuracy and practicality of intraoral scanner in dentistry: a literature review. J Prosthodont Res 2020;64:109-113.
- 2. Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health 2017;17:149.
- 3. Han X, Li Y, Liu X. Modification and evaluation of a custom impression technique for soft tissue around dental implant. Chinese J Oral Implantol 2021;26:159-163.
- 4. Derksen W, Tahmaseb A, Wismeijer D. A randomized clinical trial comparing the clinical fit of CAD/CAM monolithic zirconia fixed dental prostheses on Ti-base abutments based on digital or conventional impression techniques: 1-year follow-up. Int J Prosthodont 2021;34:441-449.
- 5. Mejía JBC, Wakabayashi K, Nakamura T, Yatani H. Influence of abutment tooth geometry on the accuracy of conventional and digital methods of obtaining dental impressions. J Prosthet Dent 2017;118:392-399.
- 6. Medina-Sotomayor P, Pascual-Moscardó A, Camps I. Influence of scanning strategy on the accuracy of zirconia crowns fabricated by a digital workflow. J Prosthodont 2019;28:e536–e541.
- 7. Revilla-León M, Özcan M. The influence of material translucency and scanning distance on the accuracy of intraoral scanners. J Prosthodont 2020;29:785-793.
- 8. Kaushik K, Bhatt S, Gupta RY, Patadiya HH, Luthra A, Rao KA. Intraoral scanner in dentistry: a comprehensive review. J Adv Med Dent Scie Res 2025;13:57-61.
- 9. Zhu H, Zhou Y, Jiang J, Wang Y, He F. Accuracy and margin quality of advanced 3D printed monolithic zirconia crowns. J Prosthet Dent 2025;133:1284-1292.
- 10. Rudolph H, Salmen H, Moldan M, Kuhn K, Sichwardt V, Wöstmann B, et al. Accuracy of intraoral and extraoral digital data acquisition for dental restorations. J Appl Oral Sci 2016;24:85-94.
- 11. Zeller S, Guichet D, Kontogiorgos E, Nagy WW. Accuracy of three digital workflows for implant abutment and crown fabrication using a digital measuring technique. J Prosthet Dent 2019;121:276-284.
- 12. Bertolini MdM, Kempen J, Lourenço EJV, de Moraes Telles D. The use of CAD/CAM technology to fabricate a custom ceramic implant abutment: a clinical report. J Prosthet Dent 2014;111:362-366.
- 13. Kim JH, Jang Y, Jeon JH, Park JM. Effect of translucency of CAD-CAM ceramic restorative materials and scanning-aid conditions on the accuracy of intraoral scans. J Dent Sci 2023;18:1212-1218.
- 14. Cho JH, Jang Y, Jeon JH, Kim CM, Park JM. Effects of scanning-aid materials and CAD-CAM restorative materials on the accuracy and time efficiency of intraoral scans. J Prosthet Dent 2024;132:548-555.
- 15. Mitchell HL, Koch I, Chadwick RG. Linear interpolation error in measured surfaces in a dental erosion study. Med Biol Eng Comput 2004;42:100-105.
- 16. Târtea DA, Ionescu M, Manolea HO, Mercuț V, Obădan E, Amărăscu MO, et al. Comparative study of dental custom CAD-CAM implant abutments and dental implant stock abutments. J Clin Med 2023;12:2128.
- 17. Revilla-León M, Quesada-Olmo N, Gómez-Polo M, Sicilia E, Farjas-Abadia M, Kois JC. Influence of rescanning of mesh holes on the accuracy of an intraoral scanner: an in vivo study. J Dent 2021;115:103851.
- 18. Joda T, Braegger U, Gallucci G. Systematic literature review of digital three-dimensional superimposition techniques to create virtual dental patients. Int J Oral Maxillofac Implants 2015;30:126-134.
- 19. Rudolph H, Salmen H, Moldan M, Kuhn K, Sichwardt V, Wöstmann B, et al. Accuracy of intraoral and extraoral digital data acquisition for dental restorations. J Appl Oral Sci 2016;24:85-94.
- 20. Borbola D, Berkei G, Simon B, Romanszky L, Sersli G, DeFee M, et al. In vitro comparison of five desktop scanners and an industrial scanner in the evaluation of an intraoral scanner accuracy. J Dent 2023;129:104391.
- 21. Al Assadi F. Influence of gingival retraction on the accuracy of an intraoral scanner for subgingival finish lines. University of British Columbia; 2023.
- 22. Zhang ZC, Li PL, Chu FT, Shen G. Influence of the three-dimensional printing technique and printing layer thickness on model accuracy. J Orofac Orthop 2019;80:194-204.
- 23. Boitelle P, Tapie L, Mawussi B, Fromentin O. Evaluation of the marginal fit of CAD-CAM zirconia copings: comparison of 2D and 3D measurement methods. J Prosthet Dent 2018;119:75-81.
- 24. Rhee YK, Huh YH, Cho LR, Park CJ. Comparison of intraoral scanning and conventional impression techniques using 3-dimensional superimposition. J Adv Prosthodont 2015;7:460-467.
- 25. 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;124:379.e1-379.e6.
- 26. Nam NE, Shin SH, Lim JH, Lee B, Shim JS, Kim JE. Accuracy of implant position reproduction according to exposed length of the scan body during optical scanning: an in vitro study. Appl Sci 2021;11:1689.
- 27. Oh HS, Lim YJ, Kim B, Kim MJ, Kwon HB, Baek YW. Influence of scanning-aid materials on the accuracy and time efficiency of intraoral scanners for full-arch digital scanning: an in vitro study. Materials 2021;14:2340.
- 28. Fratila AM, Saceleanu A, Arcas VC, Fratila N, Earar K. Enhancing intraoral scanning accuracy: From the influencing factors to a procedural guideline. J Clin Med 2025;14:3562.
- 29. Oh HS, Lim YJ, Kim B, Kim MJ, Kwon HB, Baek YW. Effect of scanning-aid agents on the scanning accuracy in specially designed metallic models: a laboratory study. PLoS One 2022;17:e0267742.
- 30. Kurz M, Attin T, Mehl A. Influence of material surface on the scanning error of a powder-free 3D measuring system. Clin Oral Investig 2015;19:2035-2043.
- 31. Li H, Lyu P, Wang Y, Sun Y. Influence of object translucency on the scanning accuracy of a powder-free intraoral scanner: a laboratory study. J Prosthet Dent 2017;117:93-101.
- 32. Park TM, Jung CM, Yoon MJ, Huh JB, Lee SH, Sailer I, et al. Accuracy of customized abutment data superimposition according to the extent of scanning area. Int J Prosthodont 2021;34:390-394.
- 33. Lee B, Nam NE, Shin SH, Lim JH, Shim JS, Kim JE. Evaluation of the trueness of digital implant impressions according to the implant scan body orientation and scanning method. Appl Sci 2021;11:3027.
- 34. Pérez E, Salamanca S, Merchán P, Adán A. A comparison of hole-filling methods in 3D. Int J Appl Math Comput Sci 2016;26(4):885-903.
Eksik Dijital İmplant Ölçülerinde Zirkonya Abutmentlerin Kütüphane Verisi ile Dijital Eşleştirme Doğruluğu: İn Vitro Çalışma
Abstract
Amaç
Bu in vitro çalışmanın amacı, kenar veya proksimal bölgelerinde bilinçli olarak eksik veri bulunan taranmış zirkonya abutment modelleri üzerine, dijital olarak kütüphane dosyalarının hizalanabilirliğini ve bu yöntemin doğruluğunu değerlendirmektir. Süperimpozisyon yöntemi, CAD yazılımının geleneksel “boşluk doldurma” fonksiyonu ile karşılaştırılmıştır.
Gereç ve Yöntemler
Tek implant içeren bir dental model kullanıldı. Zirkonya kişiye özel abutment, 3Shape laboratuvar tarayıcısıyla taranarak kütüphane dosyası oluşturuldu. Tam tarama verileri kontrol grubu (C) olarak referans kabul edildi. Marjinal alanların ve proksimal yüzeylerin silinmesiyle oluşturulan NC2, NC3 veri setleri, eksik taramaları simüle etti. Ayrıca, eksik alanlara “Close holes” fonksiyonu uygulanan CH grubu oluşturuldu. Tüm veriler, kütüphane abutment modeli ile dijital olarak hizalandı. Her bir veri seti, Geomagic Control X yazılımında RMS hata değerleri ve nokta bazlı sapma analizi ile değerlendirildi. İstatistiksel analizde tek yönlü ANOVA ve Tukey HSD post hoc testi kullanıldı.
Bulgular
Zirkonya abutment kütüphane verisinin süperimpozisyonu, işlenmemiş taramalara göre anlamlı düzeyde daha yüksek doğruluk sağladı (RMS: 39.11 ± 0.98 μm → 35.41–37.59 μm; p < .001). C, NC2, NC3 ve S grupları arasında anlamlı fark gözlenmedi (p > .05). CH grubundaki sapmalar tüm süperimpozisyon gruplarından anlamlı olarak daha yüksekti (p < .001). Nokta bazlı analizde, marjinal sırtlar hariç tüm bölgelerde sapmalar azaldı (p < .05).
Sonuçlar
Zirkonya abutment kütüphane verisinin eksik taramalara dijital olarak hizalanması, geometrik doğruluğu artırmakta ve boşluk doldurma algoritmalarına göre üstün performans göstermektedir.
References
- 1. Kihara H, Hatakeyama W, Komine F, Takafuji K, Takahashi T, Yokota J, et al. Accuracy and practicality of intraoral scanner in dentistry: a literature review. J Prosthodont Res 2020;64:109-113.
- 2. Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health 2017;17:149.
- 3. Han X, Li Y, Liu X. Modification and evaluation of a custom impression technique for soft tissue around dental implant. Chinese J Oral Implantol 2021;26:159-163.
- 4. Derksen W, Tahmaseb A, Wismeijer D. A randomized clinical trial comparing the clinical fit of CAD/CAM monolithic zirconia fixed dental prostheses on Ti-base abutments based on digital or conventional impression techniques: 1-year follow-up. Int J Prosthodont 2021;34:441-449.
- 5. Mejía JBC, Wakabayashi K, Nakamura T, Yatani H. Influence of abutment tooth geometry on the accuracy of conventional and digital methods of obtaining dental impressions. J Prosthet Dent 2017;118:392-399.
- 6. Medina-Sotomayor P, Pascual-Moscardó A, Camps I. Influence of scanning strategy on the accuracy of zirconia crowns fabricated by a digital workflow. J Prosthodont 2019;28:e536–e541.
- 7. Revilla-León M, Özcan M. The influence of material translucency and scanning distance on the accuracy of intraoral scanners. J Prosthodont 2020;29:785-793.
- 8. Kaushik K, Bhatt S, Gupta RY, Patadiya HH, Luthra A, Rao KA. Intraoral scanner in dentistry: a comprehensive review. J Adv Med Dent Scie Res 2025;13:57-61.
- 9. Zhu H, Zhou Y, Jiang J, Wang Y, He F. Accuracy and margin quality of advanced 3D printed monolithic zirconia crowns. J Prosthet Dent 2025;133:1284-1292.
- 10. Rudolph H, Salmen H, Moldan M, Kuhn K, Sichwardt V, Wöstmann B, et al. Accuracy of intraoral and extraoral digital data acquisition for dental restorations. J Appl Oral Sci 2016;24:85-94.
- 11. Zeller S, Guichet D, Kontogiorgos E, Nagy WW. Accuracy of three digital workflows for implant abutment and crown fabrication using a digital measuring technique. J Prosthet Dent 2019;121:276-284.
- 12. Bertolini MdM, Kempen J, Lourenço EJV, de Moraes Telles D. The use of CAD/CAM technology to fabricate a custom ceramic implant abutment: a clinical report. J Prosthet Dent 2014;111:362-366.
- 13. Kim JH, Jang Y, Jeon JH, Park JM. Effect of translucency of CAD-CAM ceramic restorative materials and scanning-aid conditions on the accuracy of intraoral scans. J Dent Sci 2023;18:1212-1218.
- 14. Cho JH, Jang Y, Jeon JH, Kim CM, Park JM. Effects of scanning-aid materials and CAD-CAM restorative materials on the accuracy and time efficiency of intraoral scans. J Prosthet Dent 2024;132:548-555.
- 15. Mitchell HL, Koch I, Chadwick RG. Linear interpolation error in measured surfaces in a dental erosion study. Med Biol Eng Comput 2004;42:100-105.
- 16. Târtea DA, Ionescu M, Manolea HO, Mercuț V, Obădan E, Amărăscu MO, et al. Comparative study of dental custom CAD-CAM implant abutments and dental implant stock abutments. J Clin Med 2023;12:2128.
- 17. Revilla-León M, Quesada-Olmo N, Gómez-Polo M, Sicilia E, Farjas-Abadia M, Kois JC. Influence of rescanning of mesh holes on the accuracy of an intraoral scanner: an in vivo study. J Dent 2021;115:103851.
- 18. Joda T, Braegger U, Gallucci G. Systematic literature review of digital three-dimensional superimposition techniques to create virtual dental patients. Int J Oral Maxillofac Implants 2015;30:126-134.
- 19. Rudolph H, Salmen H, Moldan M, Kuhn K, Sichwardt V, Wöstmann B, et al. Accuracy of intraoral and extraoral digital data acquisition for dental restorations. J Appl Oral Sci 2016;24:85-94.
- 20. Borbola D, Berkei G, Simon B, Romanszky L, Sersli G, DeFee M, et al. In vitro comparison of five desktop scanners and an industrial scanner in the evaluation of an intraoral scanner accuracy. J Dent 2023;129:104391.
- 21. Al Assadi F. Influence of gingival retraction on the accuracy of an intraoral scanner for subgingival finish lines. University of British Columbia; 2023.
- 22. Zhang ZC, Li PL, Chu FT, Shen G. Influence of the three-dimensional printing technique and printing layer thickness on model accuracy. J Orofac Orthop 2019;80:194-204.
- 23. Boitelle P, Tapie L, Mawussi B, Fromentin O. Evaluation of the marginal fit of CAD-CAM zirconia copings: comparison of 2D and 3D measurement methods. J Prosthet Dent 2018;119:75-81.
- 24. Rhee YK, Huh YH, Cho LR, Park CJ. Comparison of intraoral scanning and conventional impression techniques using 3-dimensional superimposition. J Adv Prosthodont 2015;7:460-467.
- 25. 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;124:379.e1-379.e6.
- 26. Nam NE, Shin SH, Lim JH, Lee B, Shim JS, Kim JE. Accuracy of implant position reproduction according to exposed length of the scan body during optical scanning: an in vitro study. Appl Sci 2021;11:1689.
- 27. Oh HS, Lim YJ, Kim B, Kim MJ, Kwon HB, Baek YW. Influence of scanning-aid materials on the accuracy and time efficiency of intraoral scanners for full-arch digital scanning: an in vitro study. Materials 2021;14:2340.
- 28. Fratila AM, Saceleanu A, Arcas VC, Fratila N, Earar K. Enhancing intraoral scanning accuracy: From the influencing factors to a procedural guideline. J Clin Med 2025;14:3562.
- 29. Oh HS, Lim YJ, Kim B, Kim MJ, Kwon HB, Baek YW. Effect of scanning-aid agents on the scanning accuracy in specially designed metallic models: a laboratory study. PLoS One 2022;17:e0267742.
- 30. Kurz M, Attin T, Mehl A. Influence of material surface on the scanning error of a powder-free 3D measuring system. Clin Oral Investig 2015;19:2035-2043.
- 31. Li H, Lyu P, Wang Y, Sun Y. Influence of object translucency on the scanning accuracy of a powder-free intraoral scanner: a laboratory study. J Prosthet Dent 2017;117:93-101.
- 32. Park TM, Jung CM, Yoon MJ, Huh JB, Lee SH, Sailer I, et al. Accuracy of customized abutment data superimposition according to the extent of scanning area. Int J Prosthodont 2021;34:390-394.
- 33. Lee B, Nam NE, Shin SH, Lim JH, Shim JS, Kim JE. Evaluation of the trueness of digital implant impressions according to the implant scan body orientation and scanning method. Appl Sci 2021;11:3027.
- 34. Pérez E, Salamanca S, Merchán P, Adán A. A comparison of hole-filling methods in 3D. Int J Appl Math Comput Sci 2016;26(4):885-903.
Details
| Primary Language | English |
|---|---|
| Subjects | Prosthodontics, Dental Materials |
| Journal Section | Research Article |
| Authors | |
| Submission Date | August 5, 2025 |
| Acceptance Date | December 2, 2025 |
| Publication Date | December 29, 2025 |
| DOI | https://doi.org/10.7126/cumudj.1758867 |
| IZ | https://izlik.org/JA96UY42ZG |
| Published in Issue | Year 2025 Volume: 28 Issue: 4 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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