Does the available interocclusal space influence the accuracy of the maxillomandibular relationship captured with an intraoral scanner?

Marta Revilla-León; Miguel Gómez-Polo; Jonathan M Zeitler; Abdul B Barmak; John C Kois; Jorge Alonso Pérez-Barquero

doi:10.1016/j.prosdent.2022.09.004

Does the available interocclusal space influence the accuracy of the maxillomandibular relationship captured with an intraoral scanner?

J Prosthet Dent. 2022 Oct 27:S0022-3913(22)00564-9. doi: 10.1016/j.prosdent.2022.09.004. Online ahead of print.

Authors

Marta Revilla-León¹, Miguel Gómez-Polo², Jonathan M Zeitler³, Abdul B Barmak⁴, John C Kois⁵, Jorge Alonso Pérez-Barquero⁶

Affiliations

¹ Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass. Electronic address: marta.revilla.leon@gmail.com.
² Associate Professor and Program Director of Graduate in Advanced Implant Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
³ Director IT, Kois Center, Seattle, Wash.
⁴ Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY.
⁵ Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate in Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash.
⁶ Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.

PMID: 36349566
DOI: 10.1016/j.prosdent.2022.09.004

Abstract

Statement of problem: The accuracy of a maxillomandibular relationship acquired by intraoral scanners (IOSs) has been previously analyzed; however, the impact of the interocclusal space on the accuracy of the maxillomandibular relationship remains unknown.

Purpose: The purpose of this in vitro investigation was to evaluate the influence of the interocclusal space (0, 1, 2, 3, or 4 degrees of incisal opening in the articulator) on the accuracy of the maxillomandibular relationship captured with an IOS.

Material and methods: Markers were attached to the first molars and canines of maxillary and mandibular diagnostic casts, which were mounted on a semi-adjustable articulator, and digital scans were acquired (TRIOS 4). Both digital scans were duplicated 100 times and distributed into 5 groups depending on the incisal pin opening in the articulator (n=20): 0 (Group 0), 1 (Group 1), 2 (Group 2), 3 (Group 3), and 4 degrees (Group 4). In Group 0 (control), the casts were maintained in maximum intercuspation (MIP) with the incisal pin of the articulator set at 0 degrees. Then, a bilateral virtual occlusal record was acquired and automatically processed by using the IOS software program. A laboratory scanner (Medit T500) was used to digitize the mounted casts. The same procedures were completed in Groups 1, 2, 3, and 4 but with the incisal pin set at 1, 2, 3, and 4 degrees respectively. The interlandmark distances were used to calculate the discrepancies between the control and groups tested. One-way analysis of variance (ANOVA) and pairwise comparison Tukey HSD tests were used to inspect the data (α=.05).

Results: The interocclusal space available when capturing the occlusal records affected the trueness of the maxillomandibular virtual relationship measured (P<.001). Group 0 (135 μm) obtained the highest distortion, while Group 3 (73 μm) and Group 4 (71 μm) showed the lowest distortion. Additionally, the interocclusal space available (P<.001) impacted the precision of the maxillomandibular virtual relationship measured. Group 0 (111 μm) obtained the highest distortion, while Group 4 (precision mean value of 59 μm) had the lowest distortion among the groups tested.

Conclusions: The interocclusal space available when acquiring virtual bilateral occlusal records using the IOS tested impacted the accuracy of the maxillomandibular relationship. The smallest available interocclusal space tested (maximum intercuspation) showed the worst trueness and precision mean values, while the group with the largest interocclusal space available had the highest trueness and precision mean values among the groups studied.