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Intraoral scanning Limassol: what is it and how it is revolutionizing dentistry

By Dr. Eleni Siamplettou | Lead Dentist & Laser Specialist at Dentall Clinic 

The intraoral scanner is one of the latest additions to our dental routine in recent years, and it has improved our work, most importantly, patient satisfaction with intraoral scanning. Nowadays, technology is becoming part of daily dental practice, transforming previously uncomfortable experiences into more pleasant ones. At DentAll clinic, we prioritize patient comfort, so it’s our goal to provide the best available treatment options.

This scanner is a tool used in dentistry to produce a digital image (direct optical impression), allowing us to design, visualize, and ultimately fabricate any prosthetic restoration, such as crowns, veneers, and bridges.

intraoral scanning by dr. Eleni Siamplettou

What is intraoral scanning?

It involves acquiring a series of images, subsequently processed by specific software, which reproduce all the elements of the oral cavity, maintaining consistency with its real characteristics and minimizing the margin of error. It’s fast, clean, and very precise, allowing the dentist to produce fine work. It has the ability to save images, repeat the process, and reproduce the desired end result as many times as needed.

What is the principle of intraoral scanning and how does it work?

This type of scanning utilizes optical technology to capture the shape and dimensions of three-dimensional (3D) geometry of oral tissues using optical technologies and converting that information into a precise digital 3D model. 

1. Optical Triangulation or Confocal Microscopy:

  • Optical Triangulation:
    • This is a common method. The scanner projects a light pattern (e.g., laser or structured light) onto the teeth and gums. 
       
       
    • A sensor within the scanner captures the reflected light from different angles.  
       
    • By calculating the angles and distances of the reflected light, the scanner’s software determines the 3D coordinates of the scanned surfaces.  
       
  • Confocal Microscopy:
    • Some scanners use this technique. It involves focusing a laser beam onto a specific point of the tissue.  
       
    • Only the light reflected from that focused point is captured, eliminating out-of-focus light. 
       
    • By scanning point by point and compiling the data, a 3D image is generated.

2. Image Acquisition and Data Processing:

  • As the scanner moves within the oral cavity, it rapidly captures numerous 2D images.
  • The scanner’s software then processes these images, stitching them together to create a continuous 3D digital model.  
     
  • This process involves sophisticated algorithms that account for movement, variations in surface texture, and other factors.  
     

3. 3D Model Construction:

  • The processed data is used to generate a 3D digital representation of the teeth and gums.
  • This model can be displayed on a screen in real-time, allowing the dentist to visualize the scanned area.  
     
  • The digital model can then be exported in standard file formats (e.g., STL) for use in CAD/CAM systems

This eliminates the need for traditional, physical impressions. It’s fast, clean and very precise allowing the dentist to produce a fine work. It has the ability to save the images, repeat the process and reproduced as many times as the dentist desires the end result.

Scientific research about intraoral scanning

A 2017 study by Mangano et al.  examined whether  dental scanning impressions (IOS) are as accurate as traditional ones. They looked at different types of intraoral scanners available on the market to understand how IOS are currently used in dentistry and their limitations. They found that IOS are more comfortable for patients and saves time for both dentists and dental technicians. Moreover, it eliminates the need for messy plaster models and helps improve communication between dentists, technicians, and patients.

However, they also found a few challenges. Capturing deep margin lines (edges of prepared teeth) can be difficult, and impressions may be affected by bleeding. Additionally, dentists need time to learn how to use them properly. Moreover, the scanners are expensive to buy and maintain. Importantly, IOS are accurate enough for making most dental restorations, such as crowns, bridges, and implants. Moreover, they are useful for smile design and making aligners, dentures, and surgical guides. However, they are not yet reliable for very long restorations that involve multiple teeth

Reference: Mangano, Francesco; Gandolfi, Andrea; Luongo, Giuseppe & Logazzo,Silvia (2017). Intraoral scanners in dentistry: a review of the current literature. National Library of Medicine. PMCID: PMC5727697  PMID: 29233132

A study by Nelwan et al. (2024) wanted to see if intraoral scanning are accurate enough even for kids’ teeth, specifically when they have a mix of baby and adult teeth (mixed dentition). They scanned the teeth of 34 kids with mixed dentition using a Medit i500 scanner. They also made traditional plaster models of the same kids’ teeth. They measured the widths of the dental arches on both the digital scans and the plaster models. They found no significant difference between the measurements taken from the digital scans and the plaster models.

This means the digital scans were just as accurate as the traditional models. This is amazing because digital scans are more comfortable devices than the traditional impressions.

Reference: Nelwan, Sindy: Karuniadewi, Anak; Nowwarote, Nunthawan, Dewi, Ardiani and Prayogo, Rosiana (2014) National Library of Medicine, Accuracy of Digital Intraoral Scans Three-dimensional Surface Analysis Compared with Plaster Models Dental Measurement in Mixed Dentition. Dec;17(12):1363–1369. doi: 10.5005/jp-journals-10005-3013

So what are the benefits of intraorals scanning?

After a lot of literature review and our personal experience, it is safe to acknowledge that intraoral scanning offers numerous benefits compared to traditional dental impression methods.

  • Let’s talk first about discomfort. It is known that one of the reasons people avoid going to the dentist is because dentistry is associated with at least a level of discomfort, and in most cases, pain.
  • Digital scanners provide amazing accuracy.
  • No more gypsum models. Think about those plaster molds dentists used to make of your teeth. They took up space. With digital scanning, dentists skip that whole step. They don’t need to make those molds anymore, which saves them time. Plus, they don’t have to buy all that plaster stuff, so it saves them money too.
  • With digital scanning, you definitely need fewer visits, so it is more time-efficient.
  • Easier for the dental technician to work with. With digital scanning, the dentist and the lab can check the tooth scan right away, like looking at a photo. If the lab sees something wrong, they can tell the dentist to re-scan it immediately. This saves time and avoids having to bring the patient back for another appointment. It also makes it much easier for the dentist and lab to talk to each other.
  • Better communication with the patients. Digital tooth scans are great for showing patients exactly what’s going on. When patients see their teeth on a screen, they understand their treatment better and are more likely to take care of their teeth.
  • Plus, people think the technology is cool and tell their friends, which brings more patients to dental offices that have it. These scans help dentists explain things better and also act like free advertising

What are the disadvantages of intraoral scanning?

Basically, we looked at 71 research papers about this topic. These papers came out over 10 years, from 2010 to 2024, and they were all different. Some were reviews of other studies, some were tests on real people or animals, and some were lab experiments. However the majority agreed on two disadvantages:

  1. Difficulty detecting deep marginal lines of prepared teeth. Sometimes, digital scanners struggle to see the very edge of a prepared tooth, especially if it’s deep under the gum or if there’s bleeding. It’s like trying to take a picture in a dark or messy spot. Unlike the old-fashioned putty, the scanner’s light can’t push the gum aside. But, if the dentist works quickly, uses special tools to move the gum, and keeps things clean, they can usually get a good scan. And, for implants, there’s a special part that makes scanning easy. Overall, good scans depend on well-prepared teeth and healthy gums, just like the old way.
  2. Purchansing and managing costs. Digital scanners for teeth cost a lot, anywhere from 15,000 to 35,000 euros. While new models are coming out, hopefully lowering prices, you need to use them a lot to make it worth it. Also, the software that makes the scans into 3D models might need updates that cost extra. And some scanners only work with certain software, which could mean more fees. So, before buying, dentists need to know all the extra costs.

However, when it comes to the former, they all agreed that there is a learning curve. In relation to the cost, one must assess what is paid compared to what one gets. We must all agree that the advantages outweigh the disadvantages.

How to choose the best intraoral scanner for your clinic?

We think that the Imburgia et al. (2017) case study will be a great way to make you understand the importance of knowing how to choose the best intraoral scanner for your clinic. Their study compared how well four different intraoral scanners (IOS) capture accurate impressions of dental implants in two different cases: First, a partially edentulous model (PEM) – a model with three implants (some missing teeth) and second, a fully edentulous model (FEM) – a model with six implants (all teeth missing).

The goal was to check trueness (how close the scan is to the actual model) and precision (how consistent the scans are when repeated). Their findings are eye-opening regarding how we need to assess which intraoral scanner is best for our clinic’s needs.

Regarding accuracy, they found that CS3600® had the best accuracy for PEM (3 implants), and CS3600® was still the most accurate for FEM (6 implants), while TrueDefinition® had the lowest accuracy. All scanners performed better with PEM than FEM, meaning they are more reliable when scanning fewer implants. However, regarding precision in repeated scans, TrueDefinition® was the most consistent for PEM, and Trios3® performed best for FEM. Precision was generally better with PEM than FEM, meaning scanners give more reliable results when scanning fewer implants.

To conclude, different scanners have different levels of accuracy, and scanning a full set of implants (FEM) is more challenging than scanning just a few implants (PEM). These results are important for dentists choosing the best scanner for dental implant procedure. 

Reference: Imburgia, Mario; Logozzo, Silvia; Hauschild, Uli; Veronesi, Giovanni; Mangano, Carlo & Mangano, Francesco (2017) Accuracy of four intraoral scanners in oral implantology: a comparative in vitro study. BMC Oral Health, Volume 17, article number 92.

Another study by Costa et al. (2022) comparing the accuracy of iTero®, Medit®, and Planmeca® intraoral scanners, found that the Medit scanner was the most consistent (best “precision,” meaning it gave similar results each time). The Planmeca scanner was the least accurate and consistent. However, all scanners were more accurate when scanning smaller areas (fewer implants)

Reference: Vitoria Costa, António Sérgio Silva, Rosana Costa, Pedro Barreiros, Joana Mendes, José Manuel Mendes (2022). In Vitro Comparison of Three Intraoral Scanners for Implant – Supported Dental Prostheses. National Library of Medicine. PMCID: PMC9221835 DOI: 10.3390/dj10060112

One of the latest study in 2024 by Bhatia & Pandian compared how accurate three different digital tooth scanners are at capturing a full set of teeth, compared to the traditional “putty” impressions. They wanted to see how well three intraoral scanners (Medit, CEREC Primescan, and 3Shape Trios) capture the whole arch of teeth compared to traditional alginate impressions. They took putty impressions from 50 people and made plaster models from those impressions. They also scanned the same people’s teeth with the three digital scanners. They compared the digital scans to the plaster models using computer software. They also measured how long it took to do each scan. They found that all three scanners were pretty much as accurate, but one scanner (Trios) was faster than the others.

Reference: Niharika Bhatia & Srirengalakshmi Muthuswamy Pandian (2024). Evaluation of the accuracy of full-arch impressions between three different intraoral scanners and conventional impressions: A prospective in vivo study. National Library of Medicine, PMC11179144  PMID: 38881640

Intraoral scanner Medit i500

Best Intraoral Scanners

Best on research, it is safe to acknowledge the following inraoral scanner as the best ones in the industry:

  1. Medit i500 ; Medit i700
  2. 3Shape Trios
  3. Itero
  4. Cerec Primescan
  5. Planmeca

So forget the discomfortable old impression techniques that used to use materials that smell and caused unpleasant feelings like gag reflex. Nowadays intraoral scanning technique became a fast accurate and comfortable life experience.

Read more about Digital Dental Scanning vs. Conventional Impression Technique

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