The presentation gives you an overview of the digital impression as well as intraoral scanners. Trios 3 of 3Shape was specifically discussed in the presentation.

1. Dr. Van Thai Nguyen

2. Aims
After this lecture, you are able to:
• Contrast the advantages and
disadvantages between conventional
and digital impression
• Describe the steps of performing
digital impression

3. Outline
• Conventional impression
• Digital impression/Intraoral scanners
• 3Shape TRIOS® intraoral scanner

4. Disadvantages
Conventional impression

5. Loss or damage
Errors in tray selection
Inadequate adhesive application
Storage space constraints
Gag reflexShort working time
Tearing and deformation
Required disinfection

6. The concept of intraoral scanning
Duret F. (1973) Empreinte optique
“The optical
impression is a
fundamental
step in the
dental
CAD/CAM
since it only
allows to
break the
chain of
inaccuracies”

7. Alginate impression
Bite registration
Plaster cast model Digital 3D models
CAD/CAM technology
Peluso MJ et al. (2004) Digital Models: An Introduction

8. The first digital oral scanner with CAD/CAM system for
restorative dentistry (1984)
Dr. Werner Mőrmann and Marco Brandestini
CEREC
Chairside Economical Restoration
of Esthetic Ceramics,
or
CEramic REConstruction

9. The first orthodontic scanning system:
OrthoCAD, Cadent (1999)
Martin CG et al. (2005)
Orthodontic scanners: what’s available

10. Peluso MJ et al. (2004) Digital Models: An Introduction

12. Intraoral scanners

13. Components
Component
• a wireless mobile
workstation
• a computer monitor
• a handheld camera
wand
Function
• to support data entry
• to enter prescriptions,
approve scans, and
review digital files
• to collect the scan data
in the patient’s mouth
Baheti MJ et al. (2015) Intra-oral Scanners: A New eye in Dentistry

14. Types of scanner
LED
• optical scanners
depending on a
reflective surface
• require a contrasting
medium or powder to
acquire a
representation of the
tooth morphology
Laser technology
• scan and measure
distances from the
tooth surface to
acquire the image
• do not require
powder.

15. Systems
• Closed systems
– a pathway predetermined by the system
being used
– Ex: CEREC scans went directly to the
CEREC milling system

16. Systems
• Selective open systems
– it was a scanner and not a complete
milling system, so it required partners
– Ex: 3M partnered with
Straumann (Etkon) and Authorized Lava
Milling Centers.

17. Systems
• Mostly/Completely open systems
– you can send files to almost any service
that can receive them
– Ex: Trios 3 (3Shape)

18. Advantages
Elimination of the shortcomings
associated with traditional,
technique-sensitive impression taking
• Material
• Presence of undercuts
• Material shrinkage
• Time to casting
• Impression storage
• Temperature sensitivity
• Mixing of impression material

19. Advantages
For orthodontists
• Improved diagnosis and
treatment planning
• Faster records submission
• Fewer retakes
• Reduced chair time
• Standardization of office
procedures
• Reduced storage requirements
• Faster laboratory return
• Improved appliance accuracy
• Enhanced workflow
For patients
• Improved case
presentation and a better
orthodontic experience
with more comfort and
less anxiety
• Reduced chair time
• Easier refabrication of
lost or broken appliances
• Reduced treatment time.

20. Intraoral Digital Impression Technique Compared to
Conventional Impression Technique
- A Randomized Clinical Trial
Gjelvold B et al. (2015)
Digital
impression
(TRIOS)
Conventional
impression
(SS tray + polyether)
Mean total procedure times * 14:33 ± 5.27 20:42 ± 5.42
Mean impression times * 7:33 ± 3.37 11:33 ± 1.56
Mean VAS for dentist’s difficulty * 24.00 ± 18.02 48.02 ± 21.21
Mean VAS for patient’s
discomfort *
6.50 ± 5.87 44.86 ±27.13
*: p < 0.0001

21. Current intraoral scanners
Scanner Company
Lauched
year
Contrast
media
Color Weight
LythosTM Ormco 2013 Yes No 317
3M™ True
definition
3M ESPE 2012 Yes No 280
IOS FastScan™ IOS Technologies Inc. 2012 Yes Yes *
Planmeca Planscan E4D Technologies 2014 No No *
iTero® Align Technology Inc. 2013 No Yes *
Trios® 3Shape 2010 No Yes 950

22. What aspects to consider
• Size of the nozzle
– Wider nozzle: scan broader surface at each image
– High nozzle: difficult to insert the tip into the molar areas
• Weight of the handpiece and grip
• Screen
– Easy-to-clean
– Functional tactile
• Usage of powder
• Price

24. Videos
• Unbox
https://www.youtube.com/watch?v=w7
VAB09dv7g
• Pod Connection
https://www.youtube.com/watch?v=Jz
H08TUuSQM

25. TRIOS® scanner can be
used with …
• OrthoAnalyzerTM
• Appliance DesignerTM
• IncognitoTM

26. Indications
Crowns and
Bridges
Post and core
Abutments, implant
bridges and bars
Implant planning and
surgical guides
Orthodontics and
Splints
Removable
partial
dentures
Temporary crowns
and virtual
diagnostic wax-ups
Veneers,
inlays and
onlays

27. Steps
Please read
the manual!

28. Steps
What scanner and configuration are
suitable for you?

30. Touch screen laptop

31. Steps
Wait for the heating process
Foggy images on the screen

33. Steps
Dry the teeth slightly (optional)

34. Steps
• Wait for 5 clicks before moving
A good beginning makes a good ending

35. Bad start
Hit clear
Start again

36. Lower arch Upper arch
Bite scan
Recommended sequence of scanning

37. MORE

38. Patients need to open wide enough to
assess the scanning area
NOT necessary too wide

39. When to hit the “start” button?
When the scanner is inside the mouth,
in the scanning area

40. Where to start?
Start from the preparation
or molar area

41. Recommened distance between the tip
and the teeth
0 – 5 mm

42. Soft tissues should be relaxed
Soft tissues,
get out of the way!
The scanner
is coming!

43. Using

44. Or
• Ask the patient to hold their lips and cheek
away from the scanner
• Hold the tongue back without interfering
the scanner when scanning the lingual
surfaces

45. You can select the area where you want to
continue scanning

46. Steps
Keep on track of the scanning process

47. If you make a color scan
Do not point the dentist chair lamp
directly in to the patient’s mouth

48. Check the virtual model
Scan to fill in unscanned areas

49. Steps
Trimming
• All patches
• Undo
• Redo

50. How to
Change the arch
Change the position of the scanner tip

51. How to
Scan the front teeth ?
– Move the tip a little slower
– Wiggle the tip over the teeth

52. How to
Pass an area with no teeth ?
• Tilt the scanner to the side of the teeth
-> scan gingiva and the area of missing teeth

53. Videos
• Full arch scan strategy
https://www.youtube.com/watch?v=5_j
q-vyvYew
https://www.youtube.com/watch?v=4R
ykxq3_ojU

54. LIFE IS NOT A MODEL