Korean J Orthod.  2023 Jul;53(4):254-263. 10.4041/kjod22.199.

A novel method for testing accuracy of bite registration using intraoral scanners

• Kakali L
• Halazonetis DJ

• KMID: 2545041
• DOI: http://doi.org/10.4041/kjod22.199

Abstract

Objective
The evidence on the accuracy of bite registration using intraoral scanners is sparse. This study aimed to develop a new method for evaluating bite registration accuracy using intraoral scanners.
Methods
Two different types of models were used; 10 stone models and 10 with acrylic resin teeth. A triangular frame with cylindrical posts at each apex (one anterior and two posteriors) was digitally designed and manufactured using three-dimensional (3D) printing. Such a structure was fitted in the lingual space of each maxillary and mandibular model so that, in occlusion, the posts would contact their opposing counterparts, enforcing a small interocclusal gap between the two arches. This ensured no tooth interference and full contact between opposing posts. Bite registration accuracy was evaluated by measuring the distance between opposing posts, with small values indicating high-accuracy. Three intraoral scanners were used: Medit i500, Primescan, and Trios 4. Viewbox software was used to measure the distance between opposing posts and compute roll and pitch.
Results
The average maximum error in interocclusal registration exceeded 50 μm. Roll and pitch orientation errors ranged above 0.1 degrees, implying an additional interocclusal error of around 40 μm or more. The models with acrylic teeth exhibited higher errors.
Conclusions
A method that avoids the need for reference hardware and the imprecision of locating reference points on tooth surfaces, and offers simplicity in the assessment of bite registration with an intraoral scanner, was developed. These results suggest that intraoral scanners may exhibit clinically significant errors in reproducing the interocclusal relationships.

Keyword

3D scanners; Bite registration; Occlusion; Digital models

Figure

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  Figure 1 Schematic and three-dimensional renderings of the triangular frames used for aligning and occluding the models; occlusal view and frames in ‘occlusion.’

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  Figure 2 A, Digital models with frames in lingual and palatal space. B, Models in ‘occlusion’ showing interocclusal space.

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  Figure 3 Acrylic teeth on pink wax dental bases.

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  Figure 4 Posterior view of digital models, as aligned by intraoral scanner software. Inset shows space between the upper and lower posts (here approximately 0.2 mm), even though the posts were in full contact during scanning.

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  Figure 5 Measuring procedure. Ten points (orange) were digitized on the occluding surface of each post. The calculated average of these points (light and dark purple) was used to measure the inter-post distance, along a direction perpendicular to the plane of the 10 landmarks.

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  Figure 6 Roll and pitch. Arrows show positive direction.

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  Figure 7 Univariate plots of A, roll, B, pitch, C, AveErr, and D, MaxErr. Group A: stone models; Group B: acrylic teeth on wax bases. Scanning of the acrylic teeth on wax bases (Group B) was not possible with the Medit (MEDIT Co., Seoul, Korea) scanner. AveErr, the average of the three post measurements of each model; MaxErr, the maximum absolute value of the three measurements of each model.

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