Aim: This systematic review and meta‐analysis were conducted to assess and compare the accuracy of conventional and digital implant impressions. The review was registered on the PROSPERO register (registration number: CRD42016050730).Material and Methods: A systematic literature search was conducted adhering to PRISMA guidelines to identify studies on implant impressions published between 2012 and 2017. Experimental and clinical studies at all levels of evidence published in peer‐reviewed journals were included, excluding expert opinions. Data extraction was performed along defined parameters for studied specimens, digital and conventional impression specifications and outcome assessment.Results: Seventy‐nine studies were included for the systematic review, thereof 77 experimental studies, one RCT and one retrospective study. The study setting was in vitro for most of the included studies (75 studies) and in vivo for four studies. Accuracy of conventional impressions was examined in 59 studies, whereas digital impressions were examined in 11 studies. Nine studies compared the accuracy of conventional and digital implant impressions. Reported measurements for the accuracy include the following: (a) linear and angular deviations between reference models and test models fabricated with each impression technique; (b) three‐dimensional deviations between impression posts and scan bodies respectively; and (c) fit of implant‐supported frameworks, assessed by measuring marginal discrepancy along implant abutments.) Meta‐analysis was performed of 62 studies. The results of conventional and digital implant impressions exhibited high values for heterogeneity.Conclusions: The available data for accuracy of digital and conventional implant impressions have a low evidence level and do not include sufficient data on in vivo application to derive clinical recommendations.

Objectives: Guided implant surgery (GIS) is performed with drilling guides that are produced on the virtual tooth model using CAD/CAM technology. The prerequisite for this workflow is the alignment of patients cone beam computed tomography CBCT and surface scan (registration). Dental restorations may cause deteriorating imaging artifacts in CBCT data, which in turn can have an impact on the registration process. The influence of the user and the preprocessing of data and of image artifacts on the registration accuracy were examined.Material and Methods: CBCT data and intraoral surface scans of 36 patients were used for virtual implant planning in coDiagnostiX (Dentalwings, Montreal, Canada). CBCT data were reconstructed to a three‐dimensional anatomical model with the default settings provided by the software and also manually by four different examiners. Subsequently, the CBCT and intraoral surface models were registered by each examiner with the help of anatomical landmarks. Patients' data were subdivided into four groups (A–D) according to the number of metallic restorations: A = 0–2 restorations, B = 3–5 restorations, C = 6–8 restorations and D > 8 restorations. After registration, the distances between CBCT and dental surface models were measured. Linear regression models were used to assess the influence of the segmentation, the examiner and to the number of restorations (P < 0.05).Results: The deviations between surface scan and CBCT models accounted to 0.54 mm (mean). The mean deviations were 0.69 mm (max. 24.8 mm) and 0.4 mm (max. 9.1 mm) for default and manual segmentation, respectively. Mean deviations of 0.36 mm (Group A), 0.43 mm (Group B), 0.67 mm (Group C) and 1.01 mm (Group D) were recorded.The segmentation (P = 0.000), the user (P = 0.0052) and the number of restorations (P = 0.0337) had a significant influence on the registration accuracy.Conclusions: The deviation between CBCT and surface scan model resulting from inaccurate registration is transferred to the surgical field and results in a deviation between the planned and actual implant position. The registration accuracy in commercial virtual implant planning software is significantly influenced by the preprocessing of imported data, by the user and by the number of restorations resulting in clinically non‐acceptable deviations encoded in drilling guides.

Tabea V. Fl?gge, DMD/Wael Att, DMD/Marc C. Metzger, MD, DDS/Katja Nelson, DDS: Purpose: The digitization of scanbodies on dental implants is required to use computer-aided design/computer-assisted manufacture processes for implant prosthetics. Little is known about the accuracy of scanbody digitization with intraoral scanners and dental lab scanners. This study aimed to examine the precision of different intraoral digital impression systems as well as a dental lab scanner using commercially available implant scanbodies. Materials and Methods: Two study models with a different number and distribution of dental implant scanbodies were produced from conventional implant impressions. The study models were scanned using three different intraoral scanners (iTero, Cadent; Trios, 3Shape; and True Definition, 3M ESPE) and a dental lab scanner (D250, 3Shape). For each study model, 10 scans were performed per scanner to produce repeated measurements for the calculation of precision. The distance and angulation between the respective scanbodies were measured. The results of each scanning system were compared using analysis of variance, and post hoc Tukey test was conducted for a pairwise comparison of scanning devices. Results: The precision values of the scanbodies varied according to the distance between the scanbodies and the scanning device. A distance of a single tooth space and a jaw-traversing distance between scanbodies produced significantly different results for distance and angle measurements between the scanning systems (P < .05). Conclusion: The precision of intraoral scanners and the dental lab scanner was significantly different. The precision of intraoral scanners decreased with an increasing distance between the scanbodies, whereas the precision of the dental lab scanner was independent of the distance between the scanbodies.

Objectives: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer‐aided implant surgery (s‐CAIS) and patient‐related outcome measurements when using s‐CAIS were addressed.Materials and methods: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted.Results: Static computer‐aided surgery (s‐CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s‐CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent.Conclusions: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s‐CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s‐CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care.