Influence of scanning system and dentist's level of training in the accuracy of digital impressions

Background: The principal aim of our study was to evaluate digital impressions, taken with spray powder and powderfree scan systems, in order to determine the influence of the dentist’s commitment to training as a critical factor regarding quality. Material and method: Two digital intraoral impression systems from the same manufacture (Sirona) : Apollo DI and CEREC Omnicam, were used to scan 16 crown preparations on teeth on a typodont maxillary model. Because an Apollo Di intraoral camera is a powder system, an adhesive was applied before using the powder spray. Three groups were used to scan the crown preparations in order to determine coating thickness homogeneity. One group consisted of senior year dental students, a second consisted of prosthodontics residents, and the third consisted of prosthodontics specialists. The same procedure was applied with a CEREC Omnicam intraoral camera, which is a powder-free system. By using the two systems software parameters we were able to determine the scanning precision. Results: Homogeneity scores for Apollo Di regarding the spray layer was significantly thinner for all dental surfaces in the first group, while the second group had thinner coatings for buccal and distal surfaces. For the third group, the crown preparations were coated more homogeneously than the first two groups. The powder-free system CEREC Omnicam can, to a degree, mask the lack of experience in direct optical impressions by avoiding the poor quality coating, which can lead to defective marginal adaptation of definitive restoration. Conclusions: The dentist’s lack of experience can be mitigated, and partially avoided, by using powder-free systems. At the same time, the dentist can give more time towards learning how to integrate computerized fabricated restoration into the practice. The commitment to training is a critical factor in the successful integration of the technology. In addition, scanning marginal preparation details needs time in order to develop technical and manual skills.