UNIVERS I T Y O F MO SUL

CO L L EG E O F DENT IST RY

Digital impression 2022

By:
Assist. Prof. Dr.Emad Farhan Alkhalidi
Department of
PhD conservative dentistry
Conservative
Dentistry
 UNIVE R SIT Y OF M OSUL

COLLEG E OF DENT IST RY

Introduction
Today ,digital technology controls almost every aspect of our life, and dentistry is one of
these aspects.
Millions of impressions are taken every year for the production of crowns, bridges, and
partial dentures.
Making impressions with elastomeric impression material is an every day procedure in
almost every general dental practice.
A new way to dispense trays and impression materials is now available that create digital
impressions of a patient’s teeth.
The digital impression concept is emerging rapidly on the horizon and it is believed that
digital impressions will solve the challenges and difficulties of the conventional impressions.
Back-ground of Current Impression
Materials
• The history of today’s traditional impression
materials began in the mid-1930’s with the
introduction of reversible hydrocolloids.
• This was the first material that made the
impression of under cuts possible.
• By the 1955,polysulphides were
introduced and for the first time an
elastomeric impression material was
used.
• There was a great improvement in
reproducing the characteristics of prepared
teeth, but still there were inherent problems
like volumetric changes of impression
materials and expansion of dental stone and
thus the process requires the services of an
excellent dental laboratory.
• In 1966, further improvements in
impression materials occurred with the
introduction of polyether. This material
proved to be far superior to the
hydrocolloid followed by silicones in 1976.
• Though they are hydrophobic by nature but
even in the presence of a moist
environment, they are highly dimensional
stable resulting in a superior elastic
recovery.
• With the advancement of time and
technology improvements are made to
these materials to reduce tearing, chair
time and enhance the patient comfort.
DISADVANTAGES OF CURRENT
IMPRESSION TECHNIQUES
Errors in tray selection.
Limitations in the impression material’s flow and
hydrophilicity.
Short working time.
Patient movement .
Tearing and deformation of the impression during
removal.
Dimensional stability of the set impression.
Required disinfection.
Inadequate wetting and voids when pouring the cast.
time taking.
Discomfort to patient.
Evolution of Digital Impressions
Dr. Duret first introduced the CAD/CAM concept to dentistry in 1973 in
Lyon, France.
The concept of CAD/CAM systems was further developed by Dr.Mormann,
a Swiss Dentist, and Mr. Brandestini, who was an electrical engineer.
The first commercially available digital impression system for use in the
field of dentistry was introduced in 1980 pioneered by PROCERA and
CEREC.
Over the last 10 years, systems like 3M Lava C.O.S., Cadent iTero, E4D
Dentist, and 3Shape Trios have been introduced.
To date, various CAD/CAM systems are now available for dental
applications. Each employs a specific, distinct technique for making
impressions.
• increasing diagnostic
capabilities and the
accuracy of the
treatments

evaluate the
preparation from every
viewpoint
 Intraoral scanners are used to create a digital image of the patient’s
teeth The need for traditional impression materials eliminated.
Using either a laser or video, an image is acquired with a digital
scanning device. Patient’s dentition and bite relationship optically
recorded. Light is projected from the tip of the scanner , and a camera
collects data, Manipulation done to produce a digital model of the
patient’s dentition.
virtual copy for the hard and soft
tissues using a computer-
designed copy for the oral cavity

easy and comfortable

way in comparison
with the conventional
impression technique.
 BENEFITS OF DIGITAL IMPRESSION

• Accuracy of impressions
• Opportunity to view, adjust and rescan impressions
• No physical impression for patient
• Saves time and one visit for in-office systems
• Opportunity to view occlusion
• Accurate restorations created on digital models
• Accurate, wear- and chip-resistant physical CAD/CAM derived models
• No layering/baking errors
• No casting/soldering errors
• Cross-infection control
• Patient is comfortable
Limitations and disadvantages of
digital impression

Digital equipment is
very expensive.

Continuous staff
training and
updating
• Good and up-to- date
laboratory support is
required.

patients with small

mouths may have
difficulty with this
procedure.
Technology of digital impression systems

• Intraoral scanning systems use different

imaging technologies either a laser or a video to
capture their 3D images. Some systems such as
CEREC base its imaging on triangulation a
technique in which a light source is reflected off
an object. Light triangulation limits accuracy
when scanning curved surfaces especially those
that do not reflect light evenly, such as teeth
with amalgam restorations. Therefore some
systems require the use of titanium dioxide
powder as a contrast medium to correct the
problem of light triangulation where as others
do not.
• Current systems use different light source
technologies, including laser, structured ( striped)
light or LED illumination.
• Digital impression data transfer systems using IOS can
be classified in different ways. If the IOS allows the
digital impression to be sent directly via export of
source files such as STL ( standard Tessellation
Language or send to lab) PLY (polygon File Format)
and OBJ ( object file format) to different laboratory
units giving the desired flexibility it is known as an
open system and if not it is a closed system.
Open system allows practitioners to work with different
laboratories and maximize the potential of their investment
with options.
The STL file format is simple and small, thus making its
processing faster, but without representation of color or
texture. On the other hand OBJ and PLY formats can store
properties such as color and texture and benefit from
improved 3D printers.
• In a closed system the digital impressions are sent
to the manufacturing company at a fee. The
advantage is that since the configuration, collection,
and manipulation of the data is by the same
manufacturer, it provides security and single place
for delivery.
• Some scanners allow only acquisition of data, which
is then sent to the laboratory for further processing
and manufacturing.
• On the other hand there are scanners that besides
acquisition are able to mill or print same day there
by allowing the patient to have a dental restoration
in a single sitting.
• Data collection methods transfer of images
strategies for tracking and size of scanner head may
vary between different types of scanners but each
procedure produces a digital model of the patients
dentition.
• Clinical indications and contraindications of digital impressions and
IOS
• Can be used to design and mill single tooth crowns, endodontic
crowns, resin onlay and inlays, veneers, fixed partial dentures,
removable partial denture frameworks, implant brides post and cores,
temporary restorations and digital smile design. Its important to
control bleeding prior to scanning to obtain an access image.
• With the numerous advantages of digital impressions over
traditional impressions and the ability to benefit from digital
impression taking and/or CAD/CAM, more and more dentists are
purchasing digital impression systems.
• It will likely be a routine procedure in most dental offices in the near
future, as dentists, laboratory technicians, and patients all reap the
benefits.