Clinical Applications of Intraoral Scanning in Removable

Prosthodontics: A Literature Review

Hamad S. AlRumaih, BDS, MSD
Substitutive Dental Science Department, College of Dentistry, Imam Abdulrahman Bin Fasial University, Dammam, Saudi Arabia

Keywords Abstract
Chairside CAD/CAM; computerized digital
impression; digital complete denture; digital
Purpose: This review aimed to identify the reported intraoral scanning applications
impression. in fabricating different types of removable prostheses in the field of prosthodontics.
Methods: A comprehensive electronic search was performed using the PubMed and
Correspondence MEDLINE databases. This review included in vitro studies and clinical reports pub-
Hamad S. AlRumaih, BDS, MSD, FACP, lished between January 2013 and March 2021. The main keywords were as follows:
AFAAID, College of Dentistry, Imam intraoral scanning, digital impression, computerized digital impression, removable
Abdulrahman bin Fasial University, Dammam, prosthesis, chairside computer-aided design/computer-assisted manufacturing, digi-
Saudi Arabia. E-mail: hsalrumaih@iau.edu.sa tal complete denture, digital immediate complete denture, digital interim complete
denture, digital removable partial denture, digital removable overdenture, digital ob-
The authors deny any conflicts of interest in turator, digital occlusal splints, and digital maxillofacial prostheses.
regards to the current study. Results: In total, 33 papers (22 clinical reports, 8 papers focused on dental tech-
Accepted May 23, 2021
niques, and 3 clinical studies) were included in the final analysis.
Conclusions: The efficiency of using intraoral scanning in the field of removable
doi: 10.1111/jopr.13395
prosthodontics was documented. However, there is a need for more clinical studies to
identify intraoral scanning-usage protocols and to yield reliable and valid data.

Innovations in digital dentistry have influenced multiple areas IOS accuracy has been reported to be comparable to that
of the prosthodontic field, ranging from the diagnostic phase of conventional means for fabricating various fixed prosthetic
to the execution of the final treatment plan. This has allowed restorations.4 Inlays, onlays, tooth- or implant-supported sin-
the achievement of highly predictable and precise outcomes, gle crowns, and short-span bridges up to 5 units have been pro-
which was not previously possible. The use of intraoral scan- duced using IOS-obtained digital models.5,6 However, IOS for
ning (IOS) technology is the 1st step of digital-based planning long span or full-arch restorations are not as accurate as con-
regardless of whether conventional treatment modalities are ventional impressions.7,8 New generations of IOS are capable
used in subsequent dental therapy stages. IOS involves the use of obtaining full-arch impressions with minimal errors, which
of a 3-dimensional (3D) camera to obtain IOS of the dentogin- has been recently introduced in dental practice.9
gival tissues, dental arches, and implant scanbodies, which are In general, there have been limited and inconsistent stud-
subsequently converted into a virtual 3D model using scanning ies on the accuracy and extent of the IOS use to digitize the
software.1 The digital data are used to design the restoration us- full dental arches and allow the fabrication of removable pros-
ing computer-aided design (CAD) software and the restoration theses. The main limitation is the difficulty in the functional
is developed using computer-assisted manufacturing (CAM) recording of the mucosal tissues.10 Specifically, there are clin-
technology.2 ical challenges associated with complete denture (CD) treat-
The advantages, disadvantages, indications, and contraindi- ment. Therefore, in vitro studies, which focused on the accu-
cations of IOS are well reported in the literature.1,2 IOS has al- racy of full-arch impressions, have recommended the use of
lowed the circumvention of inconveniences associated with the conventional impressions in such cases.11,12
use of elastomeric materials and trays to obtain conventional This review focused on discussing recent clinical studies,
impressions. Furthermore, IOS reduces patients’ discomfort, reports, and techniques regarding the use of IOS for patients
storage requirements, and overall working time; moreover, it requiring a removable prostheses (for example, complete den-
improves communication between the specialist, patient, and tures, immediate complete dentures, removable partial den-
dental technician.3 Conversely, its use also has limitations, in- tures, maxillofacial prostheses, custom trays, occlusion rims,
cluding difficulties in detecting subgingival margins of pre- and occlusal devices) with the aim of providing an up to date
pared teeth and increased initial financial cost for obtaining the overview of the corresponding advances in the field of remov-
equipment.1 able prosthodontics as well as the benefits and shortcoming of
this new technology.

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists 1

Intraoral Scanning in Removable Prosthodontics AlRumaih

Materials and methods using a custom tray. In addition, Goodacre et al18 reported
a successful case of a milled maxillary CD and mandibu-
In this narrative review, a comprehensive electronic search lar implant-assisted complete overdenture involving the use
of PubMed for in vitro studies and clinical reports published of IOS to obtain the mucostatic impression, centric relation,
between January 2013 and March 2021 was performed. More- and existing dentures. The use of combined scans allows the
over, a survey of relevant prosthodontic journals was com- creation of digital records that replicate old denture morphol-
pleted. The initial search was performed using the follow- ogy and teeth position, which, in turn, streamline the clinical
ing keywords: intraoral scanning, digital impression, com- and laboratory steps. Another advantage is that patients with
puterized digital impression, removable prosthesis, chairside flabby ridges yield greater benefits from an IOS mucostatic
CAD/CAM, digital CD, digital immediate CD, digital interim impression.18
CD, digital removable partial denture, digital removable over- Recently, the application of IOS for complete overdenture
denture, digital obturator, digital occlusal device, and digital was reported. Lin et al19 used a combined CAD/CAM proto-
maxillofacial prostheses. col to fabricate a palateless, implant-supported removable CD,
Available abstracts were reviewed and full-text articles of which was supported by a milled bar and an additively man-
the selected abstracts were obtained. Thirty-three manuscripts ufactured friction fit superstructure framework. Using IOS, a
were selected for analysis (22 clinical reports, 8 articles with definitive impression was made to determine the implant posi-
a focus on dental techniques, and 3 clinical studies) and are tions and static tissue morphology. Further, they performed full
discussed thoroughly in this review. retraction and lip and cheek overextension, while capturing the
digital data.
Results Although previous clinical reports have reported the feasi-
bility of complete digitization of edentulous jaws, Darienzo
Complete dentures
et al20 reported significant differences between digital and
Several studies have reported the use of IOS for producing a functional impressions in compressible tissues (i.e., the periph-
removable CD (Table 1). Digitizing edentulous jaws is contro- eral seal zone). They recommended the use of IOS to acquire
versial because of difficulty in acquiring accurate scans of the preliminary impressions for producing custom trays for func-
soft tissue dynamics. Fang et al13 reported that although IOS tional impressions, which could improve the results yielded.
could not functionally record mobile soft tissues, satisfactory Moreover, they recommended the use of contact scanners and
CD results could be achieved using a specialized retractor for exerting selective pressure using tissue probes. However, phys-
fixation and maximum retraction of the vestibular area, lips, ical contact during scanning can produce undesirable tissue al-
and cheeks. This was consistent with the report by Lo Russo terations.
et al14 where a U-shaped retractor was used to stabilize the In 2019, Hack et al21 conducted a comparative study to eval-
soft tissues while scanning the edentulous maxillary arch. The uate the feasibility of digitizing full edentulous arches and
resulting CD allowed satisfactory retention and function. The compared conventional impressions, scanned stone casts, and
use of IOS has been recommended in cases similar to those re- digitized IOS. Notably, they observed that visual evaluation
ported by Kim et al15 where conventional impressions proved showed significant deviation mainly at the peripheral seal zone,
to be difficult, as the available smallest stock tray could not soft palate, sublingual areas, and the vestibule of maxillary and
be inserted into the patient’s mouth because of excessive lip mandibular jaws.
tightness. Consequently, a well-fitting CD was fabricated based
on an IOS, as previously described.13,14 Lin et al16 proposed
Immediate complete dentures
a technique for producing in-office 3D-printed interim CDs
through virtual data acquisition and digital planning. However, An immediate denture is a prosthesis for replacing lost teeth
there is a need for long-term validation of the accuracy and immediately after removal. Conventional impressions for pe-
performance of the CDs before using IOS as an alternative to riodontally compromised teeth could cause stress to the pa-
definitive conventional impressions in specific cases. tient and clinician concerning the risk of unintentional teeth
Goodacre and Goodacre17 examined the feasibility of us- removal during the procedure. Therefore, the IOS use has been
ing IOS to determine the morphology of edentulous maxillary reported to be advantageous for preventing accidental teeth re-
arches for CAD/CAM CD fabrication. A series of 5 IOS were moval (Table 2). Lee and Kim22 reported a clinical case that
captured with the use of different soft tissue additives to en- required immediate maxillary denture of 2 remaining teeth. To
hance the scanning process. There was no difference between conduct the digital scan, they drew connected irregular shapes
the 5 denture bases; moreover, a final CAD/CAM CD with sat- using calcium hydroxide paste on the unmovable soft tissues.
isfactory stability and retention was fabricated based on the This prevented matching errors and reduced the scanning time.
digital scan without the use of additive material. They con- Subsequently, they could obtain a polyvinyl siloxane (PVS) al-
cluded that IOS could be used to fabricate functionally accept- tered cast impression through the guidance of the previously
able maxillary, but not mandibular CD. Even with the use of obtained digital scan and without covering the loose teeth with
pressure indicating paste (PIP) during the scanning process and the impression material. Fang et al23 and Oh et al24 suggested
soft tissue retraction, it is difficult to scan the lingual borders of that denture relining using a tissue conditioning material could
the denture. Consequently, a border molded impression using overcome inaccuracies while scanning the vestibular area. No-
the trial denture base is needed. However, the reline impression tably, all the aforementioned cases22–24 showed suitable den-
required less time than obtaining a conventional impression ture fit and digital workflow, which allowed less fabrication

2 Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

 AlRumaih

Table 1 A literature review on making complete dentures using digital impressions and IOS

Author/s and article Prosthesis IOS type Workflow Notes

type

Fang et al13 Maxillary CD Trios (3Shape A/S; - CAD: Dental system, 3Shape A/S - Using a retractor improved the scanning
(Clinical report) Mandibular RPD – Kennedy 3Shape, - Denture base: milled from PMMA (Trione Z; time. The total scanning time of both
class I Copenhagen, Dio Implants) arches was 3.5 min. Customized denture
Denmark) - Teeth: 5-axis milling from PMMA teeth could be obtained for optimal
occlusion.
Lo Russo and Salamini14 Maxillary CD 3Shape Trios3 Color - CAD: 3Shape dental system for occlusal - The digital workflow of this case report
(Dental technique) records and baseplates. 3D printing was showed high clinical accuracy and
performed using M200 (Zortrax, Olsztyn, effectiveness.
Poland) - Open systems allow improved control of
- The definitive CD base was fabricated using each step.
a reverse engineering software (Netfabb; - A new workflow by 3Shape has been
Autodesk Inc., San Rafael, CA, USA). released for single-arch CD.

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

- Teeth milled (DWX-51D; Roland, Shizuoka,
Japan) from PMMA.
Kim et al15 Maxillary CD Trios; 3Shape - CAD: Exocad; Exocad GmbH were used for -The patient had restricted mouth opening
(Clinical report) generating dental casts followed by dry milling and conventional impression was not
(Trione Z; Dio Implants, Busan, Korea) using feasible.
gypsum blocks.
- CD fabrication was performed conventionally.
Lin et al16 Mandibular interim CD iTero (Align - CAD: Geomagic Freeform; 3D Systems Inc., - The proposed technique reduced the
(Dental technique) Technology Inc., Rock Hill, SC, USA). overall working time with the use of an
San Jose, CA, - In-office DLP 3D printer (MAX; Asiga, in-office printer to fabricate interim CD.
USA) Sydney, Australia) of CD base and teeth from Long-term stability monitoring and
photopolymerization resin prosthesis accuracy were recommended.

(Continued)

3
Intraoral Scanning in Removable Prosthodontics
4
Table 1 (Continued)

Author/s and article Prosthesis IOS type Workflow Notes

type

Lin et al19 Maxillary implant-supported iTero (Align - CAD/CAM (milled bar): Cagenix; AccuFrame - The authors reported that the IOS tip was
(Dental technique) removable CD Technology Inc.) (Cagenix Inc., Memphis, TN, USA). The large, which prevented complete scanning
milled bar is secured through attachments of the deep palatal vault.
(locator bar female Zest anchor) to the milled - Verification of the milled bar was
polyurethane cast. recommended before superstructure
- CAD/CAM of superstructure framework: framework fabrication to avoid causing
- Cast assembly using the scanned bar misfit errors and an extensive remaking
(3Shape lab scanner) followed by framework process.
designing (3Shape dental system 2014) - Open architecture systems allowed
- CAM: SLM (SLM process; BEGO, Bremen, flexible bar and framework designing.
Intraoral Scanning in Removable Prosthodontics

Germany) from Co-Cr alloy.

Goodacre and Maxillary CD series Trios3 3Shape A/G - CAD/CAM: Global Dental Science was used - Five intraoral scans of the maxilla soft
Goodacre17 Maxillary and mandibular to fabricate the milled denture base. tissue were obtained with the following:
(Clinical report) CDs no additives, 4 adhesive radiopaque
markers, scanning spray (3M Corp., Saint
Paul, MN, USA), minimal PIP amount, and
maximal amount of PIP. There was no
clinical difference among the 5 denture
bases.
- IOS using Avadent WTI showed effective
CD fabrication in 3 appointments;
moreover, it allowed validation before
definitive denture fabrication.
- Performing a mandibular scan was
challenging even with the use of PIP. A
traditional reline impression required.
Goodacre et al18 Maxillary CD and mandibular Trios 3, 3Shape A/G - IOS was performed for both arches, centric - Scanned dentures were used to guide the
(Clinical report) implant overdenture relation, and existing dentures. design of new CAD/CAM–dentures.
- CAD/CAM: Global Dental Science. - This pathway allowed condensed
- A maxillary esthetic try-in was ordered and appointments.
verified. It was subsequently used to - The total scanning time for both jaws was
fabricate a definitive fully-milled monolithic 7 min.
denture. Limitations: Technique sensitivity: A small
- Two Locator attachments (Zest Anchors LLC, amount of attached mucosa had a
Carlsbad, CA, USA) were picked up in the negative effect on the ability of the
mandibular denture. scanner to stitch the surfaces together.

3D = 3-dimensional; CAD = computer-aided design; CAM = computer-assisted manufacturing; CD = complete denture; IOS = intraoral scanning; PIP = pressure indicating pate; PMMA = polymethyl methacrylate;
RPD = removable partial denture; SLM = selective laser melting.
AlRumaih

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

 Table 2 A literature review on immediate CDs using digital impressions and IOS
AlRumaih

Author/s and year Prosthesis IOS type Workflow Notes

Lee and Kim22 Maxillary immediate CD TRIOS Color - CAD: Exocad CAD dental software was - Irregular shapes were drawn using
(Clinical report) Pod; 3Shape used to remove the endodontic paste. calcium hydroxide endodontic
- A physical cast was fabricated using an RP medicament on the immobile soft tissue.
machine (Fortus 450mc). - These landmarks reduced the total time
- CAD (framework): SensAble System. for scanning and matching error
- Printed resin pattern (ProJet DP 3000; 3D summation.
Systems) casted in a Co-Cr alloy. - A potential limitation of this technique
- An altered cast impression, was obtained was the initial capital required for
using the framework, except for cases of hardware and software.
mobile teeth.
Fang et al23 Mandibular immediate TRIOS3; 3Shape A/S - CAD: Dental System; 3Shape A/S. - Minimal adjustments were required.
(Clinical report) CD - CAM: 5-axis milling machine (ARUM - Denture relining after 7 days showed
5X-100; Doowon ID, Daejeon, Korea). excellent retention.
- This immediate denture could be
employed as a custom tray if required.
- Among the potential limitations were a
deficient border seal at the vestibule and
the requirement for relining.
Oh et al24 Maxillary and mandibular Trios3, 3Shape - CAD: Exocad DentalCAD, - Digital design allowed virtual removal of
(Clinical report) immediate CDs - Exocad was used to design the trial the existing dentures; moreover, it

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

denture bases and resin occlusal rim. provided a guide for appropriate positions
- CAM: A 3D printer was used (Zenith, La of the occlusal rims and teeth index.
Palma, CA, USA). - Only 2 appointments were required.
- Conventional means were used to - A limitation of this procedure was the
fabricate dental stone casts from the time-consuming removal of resin rims.
printed bases and occlusal rim - Soft tissue alterations should be
assemblies. considered in virtual extraction.
Millet et al25 Maxillary and mandibular TRIOS - CAD: Dental System (3Shape A/S) was - The patient was very young. IOS
(Clinical report) immediate CDs Move; 3Shape A/S used to fabricate the trial base. (PMMA) increased comfort and prevented gag
- 3D printed casts were fabricated (Form 2; reflexes.
Formlabs, Somerville, MA, USA) for teeth - Limitations: Functional borders were
arrangement on the fabricated base. partially captured because of pain. The
- The final dentures were designed and left retromylohyoid space was not
milled using similar software. captured. A 2nd recording was required.
- CDs were border relined during insertion. - Accurate recording of occlusal relation
was impeded by excessive dental
mobility. Conventional methods were
recommended.

3D = 3-dimensional; CAD = computer-aided design; CAM = computer-assisted manufacturing; CD = complete denture; IOS = intraoral scanning; PMMA = polymethyl methacrylate.

5
Intraoral Scanning in Removable Prosthodontics
Intraoral Scanning in Removable Prosthodontics AlRumaih

time. For future definitive CDs, an immediate CD can be used Several materials other than the cobalt-chromium alloy can
as a custom tray for border molding. be used in RPD framework fabrication. Metal-free frameworks
Moreover, IOS seem to be more appropriate for young pa- are beneficial to patients who are allergic to metal; moreover,
tients. Millet et al25 reported the case of a 14-year-old patient they may allow superior esthetics, as they do not require metal
with Papillon-Lefevre syndrome that required immediate den- clasps. Different strategies have shown that IOS-based fabrica-
tures. IOS was difficult to perform because of the pain caused tion can be employed in efficient Zirconia framework produc-
by mobile dentition and tissue retraction. Even with the use of tion for RPDs33,34 with promising results concerning the func-
a retractor, they could not sufficiently scan the vestibular area tion and esthetic. Hu et al35 used IOS and direct 3D printing of
in the mylohyoid or retromylohyoid regions. They suggested a pure titanium framework with satisfactory clinical outcomes.
the use of a dental mirror and PIP to overcome this obstacle. In addition, Sun et al36 described a novel approach of
Therefore, good results can be obtained using an interim soft polyetherketoneketone (PEKK) speech bulb prosthesis and
liner to adjust the borders and improve denture adaptation. RPD framework. The fabrication process involved combined
digital and analog treatment modalities. The digital modality
involved digital scanning, 3D printing of the definitive cast,
and PEKK framework milling while the analog modality in-
Removable partial dentures
volved conventional speech bulb fabrication to restore a surgi-
There have several many clinical reports of CAD/CAM cal soft palate defect. The main advantage of this technique was
fabricated removable partial denture (RPD) frameworks that it allowed the use of lighter-weight material than cobalt-
(Table 3). Computerized IOS is more widely used in the RPD chromium frameworks.
than in the CD field. Tregerman et al26 compared 3 methods for IOS application has been extended to the field of immedi-
producing RPD frameworks: full analog-, combined analog- ate RPD. For the 1st time, Virard et al37 described successful
digital, and full digital pathways. The full digital pathway was IOS-based fabrication of an immediate RPD. They used similar
the only IOS-based method and showed a significantly superior principles of soft tissue retractors to capture the dental and soft
RPD framework fit compared to the analog pathway, regardless tissue structures. Another advantage of IOS and CAD/CAM is
of Kennedy’s classification. that they eliminate distortion and porosity of the denture base
Al-Haj Husain et al27 reported the fabrication of a cast-free associated with conventional means.38
implant-supported mandibular RPD of a clinical case. After
IOS, a CAD-designed framework was developed followed by
Maxillofacial prostheses
selective laser melting to weld the cobalt-chromium alloy. The
framework fit was comparable to those obtained using conven- Digital scanning of maxillectomy defects to manufacture obtu-
tional impressions. When adjustments were required, Mendes rators (Table 4) has shown acceptable treatment outcomes.39–41
et al28 recommended IOS and model superimposition to allow Park et al39 acquired preliminary and final IOS of Aramany
appropriate viewing and adjustment of the relevant areas. class II maxillary defects to generate a master cast and to de-
IOS technology allows more comfort for patients with lim- sign and print a resin pattern framework. A functional impres-
ited mouth opening. Precise RPD frameworks have been ob- sion was obtained using the casted framework and an altered
tained using digital data.29,30 However, the extent of structures cast produced using the printed model. They evaluated the ac-
captured in 1 reported case29 was limited by the narrow mouth curacy of the digital model by overlapping the scanned stone
opening but the final data were enough to design and fabri- model and IOS data. They reported significant differences in
cate the framework and RPD. Further, these patients required the palatal tissues. To compensate for this difference, addi-
multiple scans and more time to complete the scanning of both tional metal components were added to the dentate side.
arches. Other clinical reports have described acceptable results re-
Patients with microstomia have similar challenges in ob- garding the use of IOS for obturators. Murat et al40 pro-
taining accurate impressions that result from restricted mouth posed that superimposing cone beam computed tomography
opening. Adali et al31 used IOS to overcome this issue and fa- (CBCT) imaging data with IOS could improve the creation of
cilitate the manufacturing steps of a maxillary telescopic pros- an accurate virtual defect model. Ye et al41 conducted a sim-
thesis. They obtained combined functional and pick-up impres- ilar study where they produced 1-piece prostheses—RPD and
sions of provisional cemented telescopic crowns, alveolar ridge obturator—for maxillectomy defect restoration. Merging digi-
with concomitant lip and cheek retraction. This technique us- tal data from IOS and CT scans to produce a 3D-prototyped
ing combined analog and IOS protocols allowed for the fabri- cast showed that the final prosthesis had good clinical ef-
cation of an accurately fitting prosthesis. fectiveness. Additionally, Michelinakis et al42 employed IOS
Maryod and Taha32 compared the retention of 20 mandibular and CAD/CAM techniques to produce a definitive implant-
Kennedy class I RPDs fabricated using conventional or digi- supported obturator for a patient undergoing hemimaxillec-
tal methods. The digital frameworks were based on IOS, digi- tomy in 3 appointments. Conventional impressions of facial
tal design, and casting of 3D-printed resin patterns. Although defects cause discomfort and deformation of the facial soft
the authors did not specify the need for adjustments in subse- tissue.43 CT, laser scanning, magnetic resonance imaging, and
quent frameworks, their results showed that digitally fabricated stereophotogrammetry are the traditional tools for acquiring fa-
RPDs had a significantly better retention and fit compared to cial structure data.44 However, IOS has been shown as a safer
the conventional RPDs with tests at different intervals over a option than laser scanning and CT based scan because of the
3-month follow-up period. hazards of laser light and radiation. Liu et al45 successfully

6 Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

 AlRumaih

Table 3 A literature review on RPD using digital impressions and IOS

Author/s and year Prosthesis IOS type Workflow Notes

26
Tregerman et al Nine RPD frameworks: Trios3; 3Shape - CAD: Dental System 2016 Premium - Authors compared digital- and analog-fabricated
(Clinical research) - Kennedy class I (mandibular (3Shape) was used. RPD. Digital RPD had a significantly superior fit (P <
4) - CAM: SLM from Co-Cr alloy was used. 0.001).
- Kennedy class II (mandibular - Fully digital pathways were used for 7 out of 9
2, maxillary 1) definitive RPDs.
- Kennedy class II (maxillary 2) - Limitations: Critical areas of RPD fitting were
proximal to the hard tissues. There was limited
accuracy when capturing a soft tissue.
Kattadiyil et al51 Maxillary RPD - Kennedy class iTero; Align Technology - CAD: SensAble System was used. - The total number of scans was 81.
(Clinical report) III Inc. - Maxillary and mandibular casts were - The total scanning time was 17 min.
generated using Cadent iTero and milled - The framework had an excellent fit and there was
using polyurethane. favorable patient satisfaction.
- The resin pattern was 3D printed and - Limitations: The stability and feasibility of additive
conventionally casted from Cr-Cb alloy. and subtractive adjustments of the resin pattern
were not evaluated.
Mansour et al55 Maxillary and mandibular RPDs LAVA C.O.S; - An SLA resin model was fabricated. - The patients were highly satisfied with the partial
(Clinical report) – Kennedy Class III 3M ESPE - A cobalt-chromium framework was RDPs.
modification I fabricated using the traditional casting - Kennedy class III modification I patients may have an

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

technique. improved partial RDP fit.
Mendes et al28 Maxillary RPD Kennedy class 3Shape; Trios® - Survey analysis was performed using - Few adjustments were required with a good passive
(Clinical report) III modification 3Shape; 3Shape Dental System 2018 fit and improved patient comfort.
software. - A follow-up examination period >6 months showed
- CAD: 3Shape CAD framework design. excellent results.
- CAM: SLM machine (EOS GmgH, Phibo, - The authors conducted a digital comparison
Barcelona) from Cr-Cb alloy. between the digitized metal structure (CAM) and its
- The digital impressions were sent corresponding design (CAD-file). The observed
electronically to print the physical SLA deviation was ≤100 microns.
resin master model for holding the - There was further comparison between the digitized
framework and teeth arrangement to physical model and the STL file of the digital models.
allow processing. There were deviations on the interproximal faces of
the abutments and the palatal area. There were
greater differences on the mesial surface of tooth
#17, which corresponded to the area that required
adjustment.

(Continued)

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8
Table 3 (Continued)

Author/s and year Prosthesis IOS type Workflow Notes

Wu et al29 Maxillary RPD Kennedy class Cerec Omnicam - Multiple scans were united using Mimics - The patient had severely limited mouth opening.
(Dental technique) III modification I Dentsplay Sirona 17.0 software. - The RPD framework had a good cast and intraoral fit.
- CAD: A 3Shape Dental System (3Shape) - Limitations: Multiple overlapping scans were
was used. required because of limited mouth opening. There
- The polymerized cast was 3D printed. were missing data that could not be recorded.
- CAM: Titanium alloy RPD was fabricated However, the scanned data were adequate for RPD
using SLM (BLT-S200; Solveere, design.
Intraoral Scanning in Removable Prosthodontics

Ogrodzieniec, Poland).
Batisse et al30 Mandibular RPD Kennedy class LyraTM 3ShapeTM Trios - Scanning data were transferred to the - Virtual model recording was completed within 10
(Clinical report) III system (L3shT) lab (3Shape Dental System 2.9.9.3). min.
- CAM: SLM (Prox DMP 200/3D system) - The patient had severe gag reflex and limited mouth
from Cr-Cb alloy. opening.
- The polymide model was 3D printed - Good retention achieved.
(P110 FORMIGA/EOS). - Limitation: There was no available software in the
L3shT for designing the RPD framework.
Al-Haj Husain et al27 Mandibular implant-supported Trios3 basic; 3Shape - Scanning both jaws and occlusal scans - No casts were used. The parts were assembled
(Dental technique) RPD – Kennedy class III (IO relation). using repositioning aids and parallel-walled
- CAD: 3Shape CAD points; 3Shape to framework design.
produce occlusal rims. - The overall fabrication cost was reduced by 25%.
- Definitive IOS of the prepared teeth and - Limitation: The digital devices have a high initial cost.
occlusion rims.
- Connectors, rests, and clasps were
designed using Touch X; 3D Systems
- CAM: framework; rapid prototyping SLM
(M270; EOS) from Cb-Cr.
- Denture base: CAD-CAM milled from
PMMA.
- Attachments (Dalbo System; Cendres
and Métaux SA, Biel, Switzerland).

(Continued)
AlRumaih

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

 AlRumaih

Table 3 (Continued)

Author/s and year Prosthesis IOS type Workflow Notes

Adali et al31 Maxillary RPD retained by Trios 3Shape - Telescopic crowns were designed and - The patient had microstomia. IOS improved dental
(Clinical report) telescopic crowns on the milled using CAD-CAM. ridge recording.
remaining teeth (n=2) - Combined pick-up and functional - Crowns had high precision of fit.
impression were obtained. - Limitations: Combined impressions showed limits
- A light-curing resin model was additively on the palate. There was a need to reline the final
obtained (VisiJet DP200, 3D Systems). prosthesis.
- The fabrication process for telescopic - Satisfactory results were yielded in the 3-year
prosthesis was completed follow-up period.
conventionally. - This method reduced the chair time.
Maryod and Taha32 Twenty mandibular Kennedy Trios3, 3Shape - RPD was designed using a CAD software - Compared to the conventional-fabricated RPDs,
(Clinical research) class I RPD patients (Dental System 2.9.9.3, 3Shape). digital-fabricated RPDs had significantly higher
- Each patient received 2 RPD - Digital surveying and 3D printing (Rapid retention evaluated after 0, 1, and 3 months using
sets: a conventional and a full shape D30) of resin pattern framework the digital force gauge by pulling the denture from its
digital RPD and polyamide models was performed. geographic center.
- The resin pattern was casted from Cb-Cr - Less human intervention was required and the
alloy. processing improved the final retention, given the

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

elimination of inherent shrinkage/expansion
associated with material manipulation.
Nishiyama et al33 Maxillary Kennedy class III Trios2, 3Shape - CAD: Dental system D-810 Framework - Fully digital RPD showed satisfactory results over a
(Clinical research) RPD (IOS) - Lab scanner: dental and artificial teeth. 6-month follow-up period with no clinical
Mandibular Kennedy class I system D-180, 3Shape - CAM: milled (CORiTEC 250i, imes-icore) complications.
RPD (digitized cast) from ceria stable zirconia and alumina - No metal was used, which improved esthetics and
composite blanks (connectors), PEEK reduced allergy.
(clasps), and composite resin.
- Denture base: CAD, Freeform 3D
system; CAM, 3D printed system (D30,
Rapidshape, Heimsheim, Germany).
- All the parts were assembled on the 3D
printed model using adhesive material
(Super-Bond).

(Continued)

9
Intraoral Scanning in Removable Prosthodontics
10
Table 3 (Continued)

Author/s and year Prosthesis IOS type Workflow Notes

Hamanaka et al34 Mandibular Kennedy class IV CEREC Omnicam; - CAD: inLab SW 15.1; Dentsplay Sirona - A 3D printed model (Varseo, BEGO) was used to
(Clinical report) RPD Dentsplay Sirona was used to design resin-bonded fixed assess the final RPD.
RPD. The STL file was imported to - The RPD was completed within 2 appointments.
another CAD software (Geomagic - A replacement RPD can be easily fabricated from
Freeform Plus; 3D System Inc.) to stored data.
modify and prepare the resin FPD into a - Limitation: Polyester can be easily scratched.
nonmetal clasp denture.
- CAM: RPD milled as 2 parts;
Intraoral Scanning in Removable Prosthodontics

gingiva-colored polyester (labial side) and

zirconia (lingual side and artificial teeth)
by 5-axis machine (Belleza 5x milling
machine).
Hu et al35 Maxillary Kennedy class I RPD Trios; 3Shape - CAD: Dental System (3Shape) was used. - The total scan counts of both arches were 655 and
(Clinical report) - CAM: SLM by a 3D printer (EOSINT M the total time of the procedure was 6 min
280; EOS) from pure titanium was used. - An excellent fit was achieved with minor
- The master resin model was also 3D adjustments.
printed. - Limitation: It was difficult to obtain the virtual
framework outline on the virtual cast.
Sun et al36 Maxillary RPD with speech 3Shape Trios; 3Shape - CAD: A 3Shape Dental System (3Shape - Favorable retention and stability findings were
(Clinical report) bulb A/S A/S) was used. observed.
- CAM: milled (Zenotec Select Hybrid; - No complications were observed within the 6-month
Wieland Dental, Pforzheim, Germany) follow-up period.
from PEKK. - The PEKK weighed 37.1% lesser than the metal
- Resin cast: A 3D-printed model was RPD.
used (Envision TEC Vida). - Limitations: There was lower PEKK strength, which
- The framework with the baseplate required more bulky clasps.
border molded and used to take - It was difficult to polish, which leaded to plaque
impression of edentulous and defect accumulation concerns.
areas.
- Resin model sectioned and the acquired
impression was assembled to obtain a
definitive cast.

(Continued)
AlRumaih

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

AlRumaih Intraoral Scanning in Removable Prosthodontics

designed and fabricated an orbital prosthesis using IOS com-

3D = 3-dimensional; CAD = computer-aided design; CAM = computer-assisted manufacturing; FPD = fixed partial denture; IOS = intraoral scanning; PEKK = polyetherketoneketone; PMMA = polymethyl
adherence than those obtained through conventional
- No complications were observed on the follow-up
bined with facial system topography (Table 4). However, it

- The milled denture had lower porosity and fungal

- Limitations: Tooth translucency was inadequate

remains challenging to reconstruct facial topography realign-
ment using current dental CAD software once it is lost.
Ballo et al46 reported that IOS could efficiently directly scan
the unaffected ear and quickly produce a fast dataset for auric-
ular prosthesis fabrication.
- No corrections were required.

Custom trays, occlusion rims, and occlusal

devices
A combination of the digital-analog workflow has been shown
(ivory disk). to improve the quality of conventional CD fabrication methods
(Table 5). Kanazawa et al47 produced CAD/CAM custom trays
means.

using data obtained by scanning the edentulous arches. How-

period.
Notes

ever, they cited that the scanning findings could not be used as a
definitive impression, as tissue mobility could not be recorded.
Nonetheless, replacing stock trays and hydrocolloid materials
tooth were milled using a 5-axis machine
- CAM: The denture base and the artificial

with digital data enhances the overall CD production. Lo Russo

the printed model (ProJet 3500 HD; 3D
- CAD: DentalCAD (Exocad, Darmstadt,

metal clasps were manually added on

- The tooth and base were bonded and

et al48 reported a technique for direct alignment of partially

methacrylate; RPD = removable partial denture; SLA = stereolithography; SLM = selective laser melting; STL = standard tessellation language.
Germany) was used for virtual tooth

or completely edentulous arches using a CAD software. IOS

was obtained and used to design and print baseplates. More-
- CAD: Freeform, 3D Systems,

over, subsequent rim scans could be used to correctly align the

(DWX 52 DC) and PMMA.

former scans of both arches and contribute toward managing

the teeth arrangement process. Additionally, Fang et al49 de-
scribed a method for obtaining IOS and virtual bite registration
using a specialized flexible retractor. The acquired digital data
allowed denture outline determination. Munk et al50 reported a
Systems).
removal.
Workflow

successful fabrication for an occlusal device through IOS for a

bruxer patient with limited mouth opening where conventional
impression was not possible to achieve.

Discussion
IOS and digital dentistry integration in clinical practice could
Trios2; 3Shape

be more valuable when managing difficult cases, including pa-

tients with limited mouth opening, severe gag reflex, and lip
IOS type

tightness.15,25,30 In these patients, conventional pathways can

increase the risk of errors caused by the dental practitioner
and the technician.30 Digital capturing of hard and soft tissues
improves the comfort of patients and reduces complications as-
sociated with laboratory analog procedures.35 Regarding eden-
Immediate maxillary RPD –

tulous arch scanning, IOS could be used to fabricate func-

Single tooth trauma case

tionally acceptable maxillary CD. However, it cannot be used

for mandibular CD, especially the lingual border, because of
Kennedy class III

tongue movement and movable mucosa proximal to the ridge

crest. However, reline impressions required less time than con-
Prosthesis

ventional impressions obtained using custom trays.17 Although

a proof of concept has been established, faulty assembly of the
scanning data is still possible given the lack of reference points
and edentulous region smoothness.16 Capturing the vestibular
area in one pass has been recommended to minimize changes
in the reflected tissue position induced by the back-and-forth
Table 3 (Continued)

movement. A specific scanning pathway starts with the resid-

Author/s and year

ual ridge crest of both jaws, covers the palatal area, and ends in
(Clinical report)
37

the buccal and labial vestibules of the maxilla. The mandibular

Virard et al

arch pathway starts from the ridge crest to the vestibules and
ends on the lingual borders.18 It is challenging to capture the
peripheral seal area and the compressible tissue in the posterior

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists 11

12
Table 4 Literature review on applications of IOS for maxillofacial prostheses

Author/s and year Prosthesis IOS type Workflow Notes

Park et al39 Maxillary Obturator - Trios3, 3Shape CAD: Digital design (LAPtools; SensAble - They evaluated the trueness of the IOS
(Clinical report) Aramani Class II Technologies, Woburn, MA, USA) was used. impression compared to that of the
defect - The resin pattern framework was obtained conventional impression. The stone
conventionally. model showed a greater difference in
- The polyurethane cast was 3D printed. the palatal tissues. This was
- A functional impression was performed using compensated by adding an additional
a metal framework to produce altered casts. clasp and rest for support.
Intraoral Scanning in Removable Prosthodontics

Murat et al40 Maxillary obturator - Cerec Omnicam, - CBCT and IOS data were independently - No capturing of the defect area was
(Clinical report) Aramany Class II (Dentsplay Sirona; York, processed using Mimics software and performed.
defect PA, USA) geometrically superimposed. The merged - The total scanning time for the entire
- CBCT scan (Promax 3D data were imported to Materialize 3-Matic maxilla was 7 min.
max; Planmeca, Helsinki, software to compose the virtual model. - There was excellent sealing.
Finland) - Model; SLA 3D printed (Forml1abs form 2). - The performance was verified through
- The framework was fabricated on resin speech and absence of nasal leakage.
positive mold using conventional means. - Limitations: There was scatter from the
- The obturator was hollowed using the metallic restorations, which took time to
open-top design. be manually removed.
Ye et al41 Twelve patients with TRIOS; 3Shape - The CT and IOS scans were fused to form 3D - Three participants were selected to test
(Clinical research) partial maxillectomy .- Spiral computed digital casts of the defect cavity, maxillary the clinical applicability of the digital
defects of Aramany tomography (CT; Optima dentition, and palate. casts.
CT520Pro; GE Healthcare - The DICOM file was imported into the Mimics - The digital casts had a similar accuracy
class I (n=4), class II Corp., Chicago, IL, USA) Research v17.0 software. to the corresponding of the
(n=4), and - Resin cast: A rapid prototype machine (Objet conventional stone casts (P>0.05).
class IV (n=4) 30 Pro; Stratasys Ltd, Rehovot, Israel) was - Limitations: There were few
used to fabricate the metal framework and measurement points and no
definitive base. quantitative comparisons between the
- Conventional casts were formed using casts and the oral cavity.
conventional impressions. - There were small numbers of clinical
treatments.

(Continued)
AlRumaih

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

 AlRumaih

Table 4 (Continued)

Author/s and year Prosthesis IOS type Workflow Notes

Michelinakis et al42 Implant-supported Trios, 3Shape - CAD: Dental wings productivity package - The patient had trismus: TRIOS scanner
(Clinical report) maxillary - The total scans were (Dental Wings Inc., Montreal, Canada) was was used to successfully obtain a digital
obturator <1500 for each jaw used. impression of the remaining maxilla,
- The resin model of the resected maxilla and teeth, peripheries, and borders of the
intact mandible were 3D printed (Projet 6000, oncology defect.
3D Systems) - Obturator was completed in three
- CAM: The framework was constructed using appointments.
the SLM machine (PRO100 DMP, 3D System) - Trial placement is necessary to ensure
from Co-Cr alloy. the patient’s satisfaction and
- The trial obturator portion of the RPD was predictable outcomes.
milled using a resin blank.
- The permanent obturator was milled using a
pink resin blank (Coritec 250i; Imes-icore,
Eiterfeld, Germany) and assembled using the
base on the resin master cast.
- Locator attachments (Zest Anchors) were
picked up with resin.

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

Liu et al45 Orbital prostheses TRIOS2.0; 3Shape face - CAD: Geomagic Studio 2014 (3D Systems) - The use of a custom ocular prosthesis
(Dental technique) using a facial scanner was used instead of stock, could allow better
- CAM: Negative mold using a polyamide esthetics in case of digital orbital
(PA2200; EOS) using a 3D printer (EOS P500; prosthesis fabrication.
EOS) was performed.
Ballo et al46 Auricular prosthesis Trios3; 3Shape - CAD: Meshmixer v2.1 (Autodesk) was used. - The main advantage of performing this
(Dental technique) - CAM: A 3D-printing machine or molds approach was the shortened process of
designed for fabricating the prosthesis was fabricating an auricular prosthesis
used. without unnecessary additional
radiation.
- Limitation: There are limited color
choices. Moreover, it is not currently
possible to print esthetic prostheses for
patients.

3D, 3-dimensional; CAD, computer-aided design; CAM, computer-assisted manufacturing; CBCT, cone beam computed tomography CT, computed tomography; IOS, intraoral scanning; RPD, removable partial
denture; SLA, stereolithography; SLM, selective laser melting.

13
Intraoral Scanning in Removable Prosthodontics
Intraoral Scanning in Removable Prosthodontics AlRumaih

palatal seal area in patients receiving CD.17,20 D’arienzo et al20

- The external shape of the trays should be

- Border molding can be skipped when the

- The splint was very smooth and precise

recommended the use of IOS to obtain primary impressions to

- The patient had limited mouth opening.

fabricate custom trays for conventional impression. The area

and no adjustments were required.

and depth of the posterior palatal seal should be intraorally

trays are appropriately designed.

similar to the external CD form.

palpated; moreover, the seal can be virtually added to the fi-
nal denture base.17 The estimated IOS time ranges between 3.5
and 17 min for both arches.13,18,40,51
Clinicians should be aware that scanning strategies influ-
ence the precision and trueness of the digital scans.52 Improper
scanning techniques could cause deformation and stitching er-
rors. Lee53 reported that drawing irregular landmarks over the
residual ridge connected on the hard palate improved digital
Notes

recording and reduced stitching summation errors. However,

Fang et al54 tested this technique by drawing a bold X-shape
over the palate and reported scanning difficulties in patients
with broad palatal vaults. In contrast, they used flowable com-
posite to draw 6 distinct half spheres on the palatal tissues
- CAM: 3D printing; CamBridge 2.655
- CAM: Rapid prototyping 3D printer

to obtain a complete edentulous maxilla scan. Placing trace-

by BEGO Verseo 3D device with
Objet Eden250 (Stratasys) was
- CAD: Freeform Geomagic (3D

able marks on smooth surfaces, including the palate, allowed

- CAD: Ortho System 2016 (3D

3D = 3-dimensional; CAD = computer-aided design; CAM = computer-assisted manufacturing; CD = complete denture IOS = intraoral scanning.

easier acquisition of direct impressions. For immediate CD,

other works have24,25 proposed relining the dentures using a
Systems) was used.

Systems) was used.

tissue conditioning material to compensate for potential inac-

BEGO Verso wax.

curacies in vestibular area scanning,22–24 Regarding RPD, pre-

vious studies29,51,55 have reported that IOS and occlusal records
performed.

allow for Kennedy class III RPD production characterized by

Workflow

good adaptation, improved passive fit, minimal adjustments,

and favorable patient response. Maryod and Taha32 reported
that digitally fabricated RPDs had greater retention and fit than
those obtained using conventional methods in 20 mandibular
Kennedy class I RPD patients. Regarding maxillofacial pros-
ESPE with a scanner spray

thesis, merging digital IOS and CT data to produce a 3D pro-

True Definition Scanner, 3M;

totype cast has shown good clinical effectiveness of the final

prosthesis.50,51 For extraoral prosthesis, IOS could efficiently
scan the unaffected side46 and is a safer option than laser scan-
ning and CT.45 However, it is difficult to combine digital im-
Trios 3Shape

ages because of the lack of clear soft tissue landmarks.45,46 Re-

cent systematic reviews indicate that the accuracy of IOS for
IOS type

(3M)

edentulous ridges is comparable to those of conventional meth-

ods, even though it is not yet considered an effective alternative
to conventional methods unless for preliminary impressions.56
A clinical study compared the three-dimensional differences
between IOS and conventional impressions of the maxilla and
mandible in 10 patients, and reported that superimposition of
Michigan occlusal
Table 5 A literature review of other IOS applications

the scans showed that the differences between the two methods
Custom tray

were not statistically significant.57 Jung et al58 also obtained

Prosthesis

similar results by comparing conventional and IOS of support-

splint

ing edentulous areas. Another study by Chebib et al59 com-

pared groups of conventional impressions obtained using dif-
ferent materials with those by IOS, and found that PVS, PVS
modified with zinc oxide eugenol (ZOE) and IOS have simi-
lar deviations and provide clinically acceptable results. Using
artificial markers like alumina in partially edentulous jaws im-
proved the trueness and precision of the scanning. Kim et al60
conducted a laboratory study on partially edentulous casts and
(Dental technique)
Author/s and year
47

scanned them using 3 IOS methods with and without artificial

(Clinical report)
Kanazawa et al

Munk et al50

markers. They found that mean trueness for IOS ranged from
36.1 to 38.8 µm without artificial markers and 26.7 to 31.8 µm
using artificial markers. Mean precision ranged from 13.0 to
43.6 µm without artificial markers and 9.2 to 12.4 µm when

14 Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists

AlRumaih Intraoral Scanning in Removable Prosthodontics

artificial markers were used. Using artificial markers also re- 13. Fang J, An X, Jeong S, et al: Development of complete dentures
duced the scanning time and improved scan reproducibility.60 based on digital intraoral impressions-Case report. J Prosthodont
Scanner head size was also found to affect IOS accuracy; Res 2018;62:116-120
Hayama et al61 found that a larger scanner head size improved 14. Lo Russo L, Salamini A: Single-arch digital removable
the accuracy of scans of partially edentulous Kennedy class I complete denture: a workflow that starts from the intraoral scan.
J Prosthet Dent 2018;120:20-24
and III arches.
15. Kim JE, Kim NH, Shim JS: Fabrication of a complete,
removable dental prosthesis from a digital intraoral impression
Conclusion for a patient with an excessively tight reconstructed lip after oral
cancer treatment: a clinical report. J Prosthet Dent
The manuscripts discussed in this review suggest that IOS is a 2017;117:205-208
viable option for reducing clinical visits and laboratory work, 16. Lin WS, Harris BT, Pellerito J, et al: Fabrication of an interim
relieving patients’ anxiety, and improving comfort. To date, complete removable dental prosthesis with an in-office digital
there is increasing promising evidence regarding the integrated light processing three-dimensional printer: a proof-of-concept
use of IOS to produce various removable prostheses. However, technique. J Prosthet Dent 2018;120:331-334
there is a need for further clinical studies on the use of IOS 17. Goodacre BJ, Goodacre CJ: Using intraoral scanning to
to develop reliable and valid data before completely replacing fabricate complete dentures: first experiences. Int J Prosthodont
conventional impression techniques. 2018;31:166-170
18. Goodacre BJ, Goodacre CJ, Baba NZ: Using intraoral scanning
to capture complete denture impressions, tooth positions, and
centric relation records. Int J Prosthodont 2018;31:377-381
References 19. Lin WS, Chou JC, Metz MJ, et al: Use of intraoral digital
1. Mangano F, Gandolfi A, Luongo G, et al: Intraoral scanners in scanning for a CAD/CAM-fabricated milled bar and
dentistry: a review of the current literature. BMC Oral Health superstructure framework for an implant-supported, removable
2017;17:1-11 complete dental prosthesis. J Prosthet Dent 2015;113:509-515
2. Ting-shu S, Jian S: Intraoral digital impression technique: a 20. D’Arienzo LF, D’Arienzo A, Borracchini A: Comparison of the
review. J Prosthodont 2015;24:313-321 suitability of intra-oral scanning with conventional impression
3. Abad-Coronel C, Valdiviezo OP, Naranjo OB: Intraoral of edentulous maxilla in vivo. A preliminary study.
scanning devices applied in fixed prosthodontics. Acta Sci Dent J Osseointegration 2018;10:115-120
Sci 2019;3:44-51 21. Hack G, Liberman L, Vach K, et al: Computerized optical
4. Gjelvold B, Chrcanovic BR, Korduner EK, et al: Intraoral digital impression making of edentulous jaws—an in vivo feasibility
impression technique compared to conventional impression study. J Prosthodont Res 2020;64:444-453
technique. A randomized clinical trial. J Prosthodont 22. Lee JH, Kim HG: A digital approach to a definitive immediate
2016;25:282-287 denture: a clinical report. J Korean Dent Sci 2016;9:74-80
5. Seelbach P, Brueckel C, Wöstmann B: Accuracy of digital and 23. Fang JH, An X, Jeong SM, et al: Digital immediate denture: a
conventional impression techniques and workflow. Clin Oral clinical report. J Prosthet Dent 2018;119:698-701
Investig 2013;17:1759-1764 24. Oh KC, Kim JH, Moon HS: Two-visit placement of immediate
6. Almeida e Silva JS, Erdelt K, Edelhoff D, et al: Marginal and dentures with the aid of digital technologies. J Am Dent Assoc
internal fit of four-unit zirconia fixed dental prostheses based on 2019;150:618-623
digital and conventional impression techniques. Clin Oral 25. Millet C, Virard F, Lienhart G, et al: Digital prosthodontic
Investig 2014;18:515-523 management of a young patient with Papillon-Lefèvre
7. Ender A, Attin T, Mehl A: In vivo precision of conventional and syndrome: a clinical report. J Prosthet Dent 2020;123:548-552
digital methods of obtaining complete-arch dental impressions. 26. Tregerman I, Renne W, Kelly A, et al: Evaluation of removable
J Prosthet Dent 2016;115:313-320 partial denture frameworks fabricated using 3 different
8. Ender A, Mehl A: Accuracy of complete-arch dental techniques. J Prosthet Dent 2019;122:390-395
impressions: a new method of measuring trueness and precision. 27. Al-Haj Husain N, Özcan M, Schimmel M, et al: A digital
J Prosthet Dent 2013;109:121-128 cast-free clinical workflow for oral rehabilitation with
9. Imburgia M, Logozzo S, Hauschild U, et al: Accuracy of four removable partial dentures: a dental technique. J Prosthet Dent
intraoral scanners in oral implantology: a comparative in vitro 2020;123:680-685
study. BMC Oral Health 2017;17:92 28. Mendes T, Marques D, Lopes L, et al: Total digital workflow in
10. Asaka A, Uekubo Y, Mitsui T, et al: Applying intraoral scanner the fabrication of a partial removable dental prostheses: a case
to residual ridge in edentulous regions: in vitro evaluation of report. SAGE Open Med Case Rep 2019;7:2050313(1987113
inter-operator validity to confirm trueness. BMC Oral Health 29. Wu J, Li Y, Zhang Y: Use of intraoral scanning and
2019;19:264 3-dimensional printing in the fabrication of a removable partial
11. Ender A, Mehl A: In-vitro evaluation of the accuracy of denture for a patient with limited mouth opening. J Am Dent
conventional and digital methods of obtaining full-arch dental Assoc 2017;148:338-341
impressions. Quintessence Int 2015;46:9-17 30. Batisse C, Bonnet G, Bongert P, et al: Optical impression and
12. Papaspyridakos P, Chen CJ, Gallucci GO, et al: Accuracy of removable partial denture: an accurate and actual solution? Int J
implant impressions for partially and completely edentulous Oral Dent Health 2017;3:1-4
patients: a systematic review. Int J Oral Maxillofac Implants 31. Adali U, Schober S, Beuer F, et al: Digital impression-taking
2014;29:836-845 facilitates prosthetic rehabilitation of microstomia patients: a
case history report. Int J Prosthodont 2019;32:110-112

Journal of Prosthodontics 0 (2021) 1–16 © 2021 by the American College of Prosthodontists 15

Intraoral Scanning in Removable Prosthodontics AlRumaih

32. Maryod WH, Taha ER: Comparison of the retention of 46. Ballo AM, Nguyen CT, Lee VSK: Digital workflow of auricular
conventional versus digitally fabricated removable partial rehabilitation: a technical report using an intraoral scanner. J
dentures. A cross over study. Int J Dent Oral Health Prosthodont 2019;28:596-600
2019;5:13-19 47. Kanazawa M, Iwaki M, Arakida T, et al: Digital impression and
33. Nishiyama H, Taniguchi A, Tanaka S, et al: Novel fully digital jaw relation record for the fabrication of CAD/CAM custom
workflow for removable partial denture fabrication. tray. J Prosthodont Res 2018;62:509-513
J Prosthodont Res 2019;64:98-103 48. Lo Russo L, Caradonna G, Salamini A, et al: Intraoral scans of
34. Hamanaka I, Isshi K, Takahashi Y: Fabrication of a nonmetal edentulous arches for denture design in a single procedure. J
clasp denture supported by an intraoral scanner and CAD-CAM. Prosthet Dent 2020;123:215-219
J Prosthet Dent 2018;120:9-12 49. Fang Y, Fang JH, Jeong SM, et al: A technique for digital
35. Hu F, Pei Z, Wen Y: Using intraoral scanning technology for impression and bite registration for a single edentulous arch. J
three-dimensional printing of Kennedy Class I removable partial Prosthodont 2019;28:e519-e523
denture metal framework: a clinical report. J Prosthodont 50. Munk J, Nitecka-Buchta A, Dudkowski M, et al: Digital
2019;28:e473-e476 impression in patients with limited mouth opening—a new
36. Sun F, Shen X, Zhou N, et al: A speech bulb prosthesis for a soft approach for occlusal splint manufacturing. Protet Stomatol
palate defect with a polyetherketoneketone (PEKK) framework 2018;68:267-278
fabricated by multiple digital techniques: a clinical report. J 51. Kattadiyil MT, Mursic Z, AlRumaih H, et al: Intraoral scanning
Prosthet Dent 2019;24:495-499 of hard and soft tissues for partial removable dental prosthesis
37. Virard F, Venet L, Richert R, et al: Manufacturing of an fabrication. J Prosthet Dent 2014;112:444-448
immediate removable partial denture with an intraoral scanner 52. Müller P, Ender A, Joda T, et al: Impact of digital intraoral scan
and CAD-CAM technology: a case report. BMC Oral Health strategies on the impression accuracy using the TRIOS Pod
2018;18:120 scanner. Quintessence Int 2016;47:343-349
38. Bidra AS, Taylor TD, Agar JR: Computer-aided technology for 53. Lee JH: Improved digital impressions of edentulous areas.
fabricating complete dentures: systematic review of historical J Prosthet Dent 2017;117:448-449
background, current status, and future perspectives. J Prosthet 54. Fang JH, An X, Jeong SM, et al: Digital intraoral scanning
Dent 2013;109:361-366 technique for edentulous jaws. J Prosthet Dent
39. Park JH, Lee KS, Lee JY, et al: Fabricating a maxillary 2018;119:733-735
obturator using an intraoral digital impression: a case history 55. Mansour M, Sanchez E, Machado C: The use of digital
report. Int J Prosthodont 2017;30:266-268 impressions to fabricate tooth-supported partial removable
40. Murat S, Gürbüz A, Kamburoğlu K: Fabrication of obturator dental prostheses: a clinical report. J Prosthodont
prosthesis by fusing CBCT and digital impression data. Int J 2016;25:495-497
Comput Dent 2018;21:335-344 56. Rasaie V, Abduo J, Hashemi S: Accuracy of intraoral scanners
41. Ye H, Ma Q, Hou Y, et al: Generation and evaluation of 3D for recording the denture bearing areas: a systematic review.
digital casts of maxillary defects based on multisource data J Prosthodont 2021, Feb 8, https://doi.org/10.1111/jopr.13345
registration: a pilot clinical study. J Prosthet Dent 57. Russo LL, Caradonna G, Troiano G, et al: Three-dimensional
2017;118:790-795 differences between intraoral scans and conventional
42. Michelinakis G, Pavlakis M, Igoumenakis D: Rehabilitation of a impressions of edentulous jaws: a clinical study. J Prosthet Dent
maxillectomy patient using intraoral scanning impression 2020;123:264-268
technology and a computer-aided design/computer-aided 58. Jung S, Park C, Yang HS, et al: Comparison of different
manufacturing fabricated obturator prosthesis: a clinical report. J impression techniques for edentulous jaws using
Indian Prosthodont Soc 2018;18:282-287 three-dimensional analysis. J Adv Prosthodont 2019;11:179-
43. Runte C, Dirksen D, Deleré H, et al: Optical data acquisition for 186
computer-assisted design of facial prostheses. Int J Prosthodont 59. Chebib N, Kalberer N, Srinivasan M, et al: Edentulous jaw
2002;15:129-132 impression techniques: an in vivo comparison of trueness.
44. Farook TH, Jamayet NB, Abdullah JY, et al: A systematic J Prosthet Dent 2019;121:623-630
review of the computerized tools and digital techniques applied 60. Kim JE, Amelya A, Shin Y, et al: Accuracy of intraoral digital
to fabricate nasal, auricular, orbital and ocular prostheses for impressions using an artificial landmark. J Prosthet Dent
facial defect rehabilitation. J Stomatol Oral Maxillofac Surg 2017;117:755-761
2020;121:268-277 61. Hayama H, Fueki K, Wadachi J, et al: Trueness and precision of
45. Liu H, Bai S, Yu X, et al: Combined use of a facial scanner and digital impressions obtained using an intraoral scanner with
an intraoral scanner to acquire a digital scan for the fabrication different head size in the partially edentulous mandible.
of an orbital prosthesis. J Prosthet Dent 2019;121:531-534 J Prosthodont Res 2018;62:347-352

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