Feasibility of using a prosthetic-based impression template to improve the trueness and precision of a complete arch digital impression on four and six implants: An in vitro study

Background: Intraoral scanners (IOSs) in implantology represent a viable approach for single teeth or partial arches. However, when used for complete edentulous arches or long-span edentulous areas, it has been demonstrated that there is a need for improvement of IOS-related techniques. Therefore, the aim of this in vitro study was to assess the trueness and precision of a complete arch digital impression on four and six implants taken with or without a customized, prosthetic-based impression template. Materials and Methods: Two experimental models were prepared, representative of a complete edentulous mandible restored with four and six implants with built-in scan abutments. Models were scanned with (test group, TG) or without (control group, CG) the prosthetic-based impression template. Eight scans were taken for each model. The time needed to take impressions, error, trueness, and precision were evaluated. A statistical analysis was performed. Results: In the case of four implants, the time needed for the impression was 128.7 ± 55.3 s in the TG and 81.0 ± 23.5 s in the CG (p = 0.0416). With six scan abutments, the time was 197.5 ± 26.8 and 110.6 ± 25.2 s in the TG and CG, respectively (p = 0.0000). In the TG, no errors were experienced, while in the CG, 13 impressions were retaken due to incorrect stitching processes. In the four-implant impression, the mean angle deviation was 0.252 ± 0.068° (95% CI 0.021-0.115°) in the CG and 0.134 ± 0.053° (95% CI 0.016-0.090°) in the TG. The difference was statistically significant (p = 0.002). In the six-implant impression, the mean angle deviation was 0.373 ± 0.117° (95% CI 0.036-0.198°) in the CG and 0.100 ± 0.029° (95% CI 0.009-0.049°) in the TG (p = 0.000). In the TG, there were no statistically significant differences in the mean angle deviation within the group (p > 0.05), but there were in the CG. A colorimetric analysis showed higher deviations from the original model for the six-implant impression without a prosthetic template. Conclusions: Although all of the impressions exhibited deviation from the original model in the range of clinical acceptability, the prosthetic-based impression template significantly improved the trueness and precision of complete edentulous arches rehabilitated with four or six implants, making the complete arch digital impression more predictable.