Materials Today: Proceedings 56 (2022) 186–193

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Materials Today: Proceedings

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Study of 3D scanning technologies and scanners in orthodontics

Sonam Sehrawat a, Ajay Kumar b,⇑, Seema Grover a, Namrata Dogra a, Jasmine Nindra a, Sarita Rathee c,
Mamta Dahiya d, Ashwini Kumar b
a
Department of Orthodontics and Dentofacial Orthopaedic, Shree Guru Gobind Tricentenary University, Gurugram, Haryana 122505, India
b
Department of Mechanical Engineering, Faculty of Engineering and Technology, Shree Guru Gobind Tricentenary University, Gurugram, Haryana 122505, India
c
Department of Electrical Engineering, DPG Institute of Technology and Management, Gurgaon, Haryana 122001, India
d
Department of Computer Science Engineering, Faculty of Engineering and Technology, Shree Guru Gobind Tricentenary University, Gurugram, Haryana 122505, India

a r t i c l e i n f o a b s t r a c t

Article history: Digital dental scanners are devices which are used to capture optical impression of intra and extra oral
Available online 31 January 2022 structures of the patient’s mouth. The basic principle of digital scanning is based upon optical phenomena
like optical triangulation, coherence tomography, parallel confocal imaging and three-dimensional
Keywords: motion videos capturing technique. In orthodontic practice, digital scanners can be successfully used
Optical triangulation in efficient treatment planning, custom appliance fabrication, clear aligner technology and orthognathic
Coherence tomography surgical simulation. From digital record keeping, digital cast models, occlusogram, extra oral and intra
Parallel confocal
oral scanners to software for cephalometric analysis, etc. have taken the orthodontic practice to newer
Accordion fringe interferometry
Three dimensional in motion videos
heights. Intraoral digital scanner that utilizes the parallel-confocal imaging technology and point and
stitch reconstruction to generate digital impressions which are accurate and powder free. Digitization
has revolutionized the conventional orthodontics completely. In modern day orthodontic dental practice
digital extra-oral and intra-oral scans are used to fabricate working and study cast models that facilitates
construction of fixed orthodontic appliances, retainers and custom trays for lingual orthodontic proce-
dures. Digital scanners are the new face of impression making and digital cast fabrication in dentistry.
This review aims to identify advantages of utilising digitally scanned impressions over the conventional
impression making techniques and application of digital scanning technology pertaining to the speciality
of orthodontics in dental practice.
Copyright Ó 2022 Elsevier Ltd. All rights reserved.
Selection and peer-review under responsibility of the scientific committee of the International Confer-
ence on Materials, Machines and Information Technology-2022.

1. Introduction and dentofacial orthopedics in particular and dentistry in general

The advent of dental imaging took place with discovery of x ray
imaging for diagnosis of ailments in healthcare industry [1]. This
innovation benefitted the method of treatment planning for a par-
ticular clinical condition into the dental practice. The development
of integrated 3D tools for diagnosis and treatment planning is one
of the most leading developments in dentistry in general and
orthodontics in particular. Use of low dose CBCT (Cone beam Com-
puted tomography), 3D facial imaging and video imaging has
improved orthodontic diagnosis and treatment planning [2].
Highly advanced technology of scanning and three dimensional
imaging has taken a huge stride into the speciality of orthodontics
⇑ Corresponding author.
E-mail address: ajay.kumar30886@gmail.com (A. Kumar).
(see Tables 1 and 2).
Digitization has reframed conventional orthodontics practice
completely. From digital record keeping, digital cast models, occlu-
sogram, extra oral and intra oral scanners to softwares for cephalo-
metric analysis etc have taken the orthodontic practice to newer
heights. Efficient diagnosis and accurate treatment planning using
digitization has reduced clinician effort and time along with
improved patient compliance. Clear aligners, CAD–CAM, 3D print-
ing, 3D cephalometry are among the leading zones of digitized
orthodontics practice of the modern times. The role of digital soft-
wares for simulation and planning of orthodontic treatment help in
visualizing the treatment outcomes in all the three planes of space
[3]. The advent of digitization in the field of orthodontics have
proved to be a boon manifolds. From standard plaster models to
scanned digital impression and cast models, it has enabled the clin-
ician to perform accurate model analysis and plan the treatment

https://doi.org/10.1016/j.matpr.2022.01.064
2214-7853/Copyright Ó 2022 Elsevier Ltd. All rights reserved.
Selection and peer-review under responsibility of the scientific committee of the International Conference on Materials, Machines and Information Technology-2022.
S. Sehrawat, A. Kumar, S. Grover et al. Materials Today: Proceedings 56 (2022) 186–193

Table 1 mented to obtain accurate results. However, more literature and

Commercially available digital scanners with their clinical applications in dental research is recommended to utilize this technology to its maxi-
practice.
mum potential.
S. Scanner Scanning technology Applications
no
2. Digital scanning technology in dental practices
1. I tero Scanner Parallel confocal  Digital impression
imaging making,
 Fabrication of digital cast, Digital dental scanning is an optical scanning procedure to
appliances and retainers replicate and reproduce the anatomy of the mandibular and max-
2. TRIOSH Ultrafast Optical  Intra oral scanning illary arches of the patient. Scanning of the patients oral cavity
Intraoral Scanning technology  Extra oral scanning
reveals information of the natural anatomical structures in the
scanner
3. Lythos TM Accordion Fringe  Treatment planning patients mouth and creates a digital image on the screen which
Interformetry.  Overjet & overbite can be communicated and reproduced. Novel corona virus which
measurement is officially known as SARS-CoV-2 has caused a severe pandemic
 Arch analysis
over the globe affecting conventional dental and health care ser-
4. Plan Scan Blue LASER  Tooth segmentation
technology  virtual set ups vices, popularising teledentistry and use of digital data to fabricate
cast and appliance without the physical presence of the patient [5].
The recent development of sensor nodes generates great Wire-
Table 2
less Sensor Network (WSN) to connect different systems for pro-
Comparison of conventional and digital impression making procedures in dentistry. viding healthcare service during difficult times like lockdown
situation [6]. In orthodontic practice, digital scanners can be suc-
S. Comparison Conventional dental Digital dental
no criteria impression impression
cessfully used in efficient treatment planning, custom appliance
fabrication, clear aligner technology and orthognathic surgical sim-
1. Accuracy Technique sensitive Highly efficient and
ulation. The basic principle of digital scanning is based upon opti-
improved
2. Time More time consuming and Less time consuming cal phenomena like optical triangulation, coherence tomography,
consumption tedious accordion fringe interferometry and 3 dimension motion video
3. Source of Human errors in manipulation Errors of registration capturing (Fig. 1).
error and dimensional alteration in algorithm in
impression material obtaining digital
scans. 2.1. Optical triangulation
4. Patient Cumbersome and uneasy for More comfortable,
compliance the patient better compliant
This imaging technique is useful to measure the distance of the
5. Adverse Alginate allergies and gagging No such effects seen
effects object from millimetres to several microns. Wet surfaces, soft
6. Storage and More storage space needed Easy and convenient objects and delicate objects can be precisely scanned using the
reconstruction and difficult to reconstruct inbuilt sensors where direct contact is contraindicated and unfa-
vourable. Triangulation imaging system comprises of a laser based
light source, high power lens and a highly sensitive sensor plate.
with precision with reduced chairside time and appointment The area of interest to be scanned are irradiated and a point spot
schedules. The novel three dimensional printers along with digital image id formulated on the sensor plate. The baseline angle and
scanners have brought a paradigm shift in accurate management of specific length of the image can be accurately determined there-
a clinical problem with efficiency and accuracy [4]. Patients having after (Fig. 2a).
alginate allergies and reduced mouth opening are specific con-
traindication subjects for conventional impression making proce- 2.2. Optical coherence tomography (OCT)
dures. Digital intra oral impressions not only reduce the patient
discomfort associated with gagging but also enables the dentist The interferometric scanning technology is useful in obtaining
to create many number of impression at the same time. All the spe- high resolution image of anatomical and morphometric features
cialized branches of dentistry are implementing the digital scan- of living tissues and structures. Optical coherence tomography
ning technology to practice. They have empowered the (OCT) is as good as ultrasonography technique but the former uses
prosthodontist to fabricate post and core, inlays and onlays using light and the later uses sound waves for transmission and projec-
these scanned impressions of the patients. They have enabled the tion of image. Backscattered radiations and reflected waves are uti-
esthetic dentist to design beautiful smiles having all attributes of lised in generating real and life like images of microstructure with
a perfect balanced smile such as smile arc, smile symmetry, gingi- detailed scale measurements of the object. This technology offers
val and dental components. In subjects with palatal defects such as 1–15 mm resolution which is hundred times of an ultrasonographic
fistula and cleft, it is now possible to fabricate obturator over image. It offers the advantage of penetrating to a depth of 3 mm in
scanned dental cast. Presence of anatomical defects like maxillary living tissues due to its large wavelength. Firstly, being demon-
and mandibular tori create potential hindrance to good impression strated in 1991, it has emerged as a potential tool in diagnosis
taking. The advantages of the digital scanners in dentistry include and investigation of medical and dental ailments. Medical condi-
accurate recording of the vestibule and frenum of the mouth along tion where excisional biopsy is undesirable and difficult, OCT is
with exact sulcus depth. Easy storage, ability to reproduce the the option of choice. It has enormous implication in specialised
images and reduced chair side time makes them more compliant branches of medicine and surgery like cardiology, ophthalmology
for both clinician and patient. etc.
Extra oral scanners is useful in duplicating dental cast to fabri- The future of scanning lies in the domains of the digital scan-
cate appliances and retainers for the patient. The advances in dig- ning modalities, which will reframe the conventional scanning
ital imaging has certainly proved to be a milestone to the procedures in the dental practices. It helps in improving the patient
digitization of dental services for the masses. This technology is comfort by lesser chair side time and fewer appointments making
certainly an upcoming asset to the medical and dental field. Accu- them a preferred innovation of the modern times. Scanning can
rate knowledge of the specific phenomenon used can be imple- result in exact replication of anatomical structure to develop digi-
187
S. Sehrawat, A. Kumar, S. Grover et al.
Fig. 1. Digital scanning technologies.
Fig. 2. Common digital imaging technologies. (a) Triangulation. (b) Parallel confocal imaging. (c) Accordion fringe interferometry. (d) Three-dimensional in-motion video
imaging [3].
tal dental cast for study models. These models offer the clinician an
efficient way to perform model analysis to formulate a good treat-
ment plan for a clinical solution.
2.3. Parallel confocal
A pinhole filter is made through which laser beam penetrates
the target tissue. The position of the receptor sensor unit lies con-
focal to the target, moreover a minute aperture is positioned at the
front to avoid any stray light from the above and below to the
plane. (Fig. 2b). This technology has a characteristic point & recon-
struction mechanism of scanned image representation, as the
focused light re-enter the target tissue and eliminates all out
focussed light. Thereby accurate and precise scan is obtained with
perfect detailing of the tissue obtained after slicing and stitching
method. The elimination of undesirable and stray rays is the prime
aspect of this technique.
2.4. Accordion fringe interferometry (AFI)
This imaging technology makes use of two different sources of
light source to project as three different patterns called as fringe
pattern. When this fringe pattern falls upon the desired surface,
it splits and reframes to take up a new pattern. The new form is
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Materials Today: Proceedings 56 (2022) 186–193
due to the unique curvature of the scanned object. Fringe curvature
is defined as the distortion in the original pattern of the object sub-
jected to AFI (Fig. 2c). A high definition camera with a video feature
is successful to record specific point and features of fringe
curvature.
2.5. Three-dimensional in-motion video
It comprises of three minute video camera inbuilt at the lens
based upon the principle of trinocular technology of imaging. A
uses an HD video camera with trinocular imaging to capture the
minute details of the recorded structure. Light is transformed to
electric energy in form of electric signals with the aid of comple-
mentary metal-oxide semiconductor (CMOS) based sensor placed
besides the cameras (Fig. 2d). 3D data is captured to obtain real life
like expression of the image. With superior range of dynamic lumi-
nosity and scanning without prior coating of abrasive powder is an
added advantage. The linear distance between two points of data
are precisely modeled. In dentistry it can be used for accurate
impression recording of maxillary and mandibular dental arches.
Later they can be used as template for fabrication of basic and
advanced orthodontic appliances and retainers.
S. Sehrawat, A. Kumar, S. Grover et al.
3. Digital intra oral and extra oral scanning
In modern dental practice, patients prefer short and efficient
treatment appointments. Timetabling the appointment slots and
spaces is the prime concern for the clinicians [7]. Digital impres-
sion making and dental cast fabrication has reduced the chair side
time and fatigue considerably. Digital scanners can be utilized for
various functions like clear aligner mechanics, design and con-
struction of customized palatal and lingual appliances, wafer con-
struction and orthognathic surgery simulation, fabrication of tray
in indirect bonding, treatment planning and more currently for
surgical results score among patients with cleft palate and cleft
lip abnormalities [8]. There are many advantages with the use of
digital intraoral scanners but one of the prime advantages is the
elimination of drawbacks identified with traditional impression-
taking which is known to be technique sensitive. 3D scans have
become an integral part of modern clinical orthodontic practice.
Various issues had been reported with the use of PVS and alginate
impressions such as improper tooth-to-tray union, segregation of
the material from impression tray, bubbles formation, tearing of
the material, pull, voids formation, temperature susceptibility,
confined working time, shrinkage of material, improper pouring,
over trimming of the study model, and damage during transporta-
tion [9]. Digital scanning is more satisfactory to the patients than
traditional impression-taking because of its comfortable approach
and convenience. Various elements of impression materials are
believed to cause allergies in few patients which can be eliminated
with the use of digital scanning. Utilization of digital scanning is
also advantageous to orthodontics in various aspects like
decreased treatment time, enhanced diagnosis and treatment plan-
ning, user-friendly, refined appliance efficiency, rapid data compli-
ance to the laboratories, and improved system. Intraoral laser
scanners (ILS) can be utilized to scan both white and yellow dental
cast. Lesser scanning time was required to scan the yellow dental
casts compared to orthodontic type III white casts [10].
3.1. I teroScanner
Based on the principal of parallel confocal scanning technology,
Cadent USA in 2007 introduced a digital scanning system named I
tero. It is capable of performing fastest scanning based on as many
as 1,00,000 laser ray points to produce image of 300 units of focal
depth spaced as apart as less than 50 mm. Pertaining to the oral
cavity this scanner captures and records teeth and perioral struc-
tures without the aid of any adjunct scanning powder. Anatomical
abnormalities such as tori can also be recorded with accuracy
which is not possible with conventional impression making proce-
dure. I tero (Fig. 3) is a successful scanner to record details of intra
Fig. 3. Digital intra oral scanning [11].
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Materials Today: Proceedings 56 (2022) 186–193
oral structures in adults and adolescent even with restricted mouth
opening as in cases of trismus disease [11].
Added benefit of scanned data comprises of easy and efficient
sharing of the gathered information among the dentist in different
clinics at the same time. I tero scanners are already leaders in den-
tal technology. Scanning of extra oral cast model is also possible
using it (Fig. 4).
Its latest version popularly known as Element I tero is nearly 20
times steady and faster than conventional scanner which records
6000 frames per second. It differs from the I tero scanner by incor-
porating a built in control for better stability along with a lighter
and flexible wand. The novel version of the scanner records dental
hard and soft tissue as fast as 3 min time. The open scanning sys-
tem is further a boon empowering the clinician in a digital work
flow to flexibly scan, store and share the recorded data [12]. The
intercommunication between two professionals and a professional
and a lab is also supported with this digital scanning technology.
These I-tero scanner (Fig. 5) features wand which orthodontist
moves around patients teeth and surrounding soft tissues and in
latest versions, this wand helps in capturing a series of frames
which can be organised to reproduce the exact morphology and
visualization of the subject’s oral architecture.
Uses of –I tero scanners in Orthodontics
 I tero scanners are used to obtain accurate pre treatment record.
 Impression making procedures.
 Fabrication of appliances and retainers.
 Used along with Invisalign treatment.
The digital itero scanners captures the teeth and surrounding
structures using latest optical technology. Once the process is
started, orthodontist can stop or start as many times as necessary.
Scanning can be done without any radiation. In as little as two to
three minutes a digitally perfect 3D impressions are obtained [13].
Advantages of I-tero scanners includes
 Comfort: The 3D scanning is often much more comfortable for
patients.
 Quality: Digital impressions limit the margin for error and
distortion.
 Cost effective: 3D scanning costs the same as traditional
impression.
Fig. 4. Digital extra oral scanning [11].
S. Sehrawat, A. Kumar, S. Grover et al.
Fig. 5. I tero scanner [8].
 It is fast and accurate.
 In case of Invisalign treatments, the treatment time is faster and
fit of the aligners is far superior compared to traditional impres-
sions. (Fig. 6)
 These I tero systems come with ‘‘Predictive Treatment Scans”
which enables the patient to see their smile after orthodontic
treatment (future occlusion) [14].
3.2. TRIOS H intraoral scanner
This intra oral scanner entered the global market in 2010, a
trademark of 3 Shape. It is a internationally known name in scan-
ner world. The basis mechanism of working of Trios H is based on
high speed optical scanning technique (Fig. 7).
A high definition image is formed on the computer screen with
good resolution and fine details of the scanned surface. The topo-
graphic surface image is constructed by joining many smaller slices
of data obtained with initial scanning procedures. This unique fea-
ture forms the basis of point & stitch reconstruction. This is highly
user friendly scanner offering two format modes. Recently, the
novel device named TRIOS cart serve as a solitary mobile unit with
an integrated smart screen adjuncted with an inbuilt software sen-
sitive to intraoral scanner [15].
On the other hand, TRIOS Pod is a more portable form of scanner
unit for connecting a laptop, monitor and an I pad inside a dental
set up to save chair side time. It is available with an autoclavable
Fig. 6. Digital impression making using intra oral scanners [16].
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Fig. 7. TRIOSTM scanner [16].
tip and flexible handle. It can open a scanned or an already stored
file in STL (sterolithographic format) and can be shared easily with
different systems through a blue tooth or wireless wi-fi mode [16].
The added advantage offered are automatic reconstruction of miss-
ing data in the scan without compromising the accuracy and
precision.
The Ortho Analyzer programme is a popular software used by
orthodontists worldwide. The TRIOSH scanner can be assimilated
along with the software to calculate overjet, crowding, spacing,
tooth material arch length deficiency etc contributing to a success-
ful diagnosis and effective treatment planning [17]. The lingual
orthodontic technology is also highly benefitted by the latest scan-
ning technologies as in when these scanners are used with Incog-
nito appliance to assess bracket positioning and appliance
designing to explore all domains of malocclusion and treatment
prescription system. Easy installation and affordable cost have
made this scanner a preferred choice by the dentist.
3.3. The Lythos TM intraoral scanner
May 2013 marked the advent of Ormco corporation manufac-
tured scanner into the dental practice under the name Lythos
TM. The special feature of this scanner is an environment of pow-
derless system and can scan the entire maxillary and mandibular
dentition in a short span of time. Unlike all other scanners, Accor-
dion Fringe Interformetry is the basic working imaging technology
for this scanner. ‘Fringe patterns’ are produced when a surface is
illuminated with two different beam of light [18]. When these pat-
S. Sehrawat, A. Kumar, S. Grover et al.
terns’ are distorted due to the curvature of scanned surface the
deflected beam is received by the inbuilt camera of scanner tip
to fabricate life like images. Both the camera and the source are
positioned at different geometry and lie offset to each other. These
scanners are a convenient portable system composed of a touch
sensitive software and a flexible handle with disposable tips that
must be changed after every scanning to avoid surface contamina-
tion [19]. The Lythos scanner is very popular amongst the dental
surgeons owing to the ease of use and precision of the scans
(Fig. 8).
The scanned images are formulated in the STL format file and
can be stored as long as a decade. These digital images can be uti-
lised in the convention lingual system and smile designing [9]. Bet-
ter treatment objective formulation and effective outcomes
improve the patient compliance towards the treatment.
3.4. Plan scan H
The Planmeca, Plan CAD and Plan Mill are the three varied ver-
sions of the USA based scanning system that entered the commer-
cial world in 2014 (Fig. 9). Coupled with ED4 Technologies this
scanner can be used based on a blue laser technique to captures
the digital image in no time and reconstruct the same data at a
later time point if needed. The most unique quality of this scanner
lies in its ability to be directly connected to a computer screen with
a USB connector. Varied size tips are available with the scanner to
reach to the distal limits of the posterior teeth. These tips can be
easily autoclaved to maintain hygiene with every patient. The
device does not require any calibration to bring precise and effi-
cient scans [20].
The Planmeca RomeaxisH cloud easily stores scanned images in
the file format of open STL. The commercial available software
available for use along with this scanner is popularly known as
Planmeca RomexisH 3D Ortho Studio. It comes in two commer-
cially available version namely basic and the advanced. Treatment
planning and execution can be carried out in the basic version or
mode [21]. Whereas segmentation, virtual model set ups and stim-
ulating treatment outcomes can be successfully performed with
the advanced mode.
The light weight wand makes it easy to use. The total weight of
the scanner is less than 11.3 kg. The monitor screen can be raised
and lowered as per the needs of the operator [22]. This scanner
coupled with the latest ortho studio software has helped the
orthodontist tremendously to improve the treatment results and
achieve desirable goals.
Fig. 8. LYTHOSTM scanner [19].
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Materials Today: Proceedings 56 (2022) 186–193
4. Applications of digital scanners in the orthodontic domain
Intraoral digital scanner that utilizes the parallel-confocal imag-
ing technology and point-and-stitch reconstruction to generate
digital impressions which are accurate and powder free. The stan-
dard I tero unit comprises of a monitor screen with liquid display
with a flexible wand and a keyboard for data entry [23]. The unit
can be moved with the help of a mobile cart which is very advan-
tageous for both the patient and practitioner and the data synchro-
nize with the cloud system by the wireless router. The basic images
will be accessible for chair side observation in 2 min of intraoral
scanning and then it is sent to Align technology via Internet, where
they are converted and accessible for downloading at doctor’s site
as stereolithography (STL) file within 48 h. Initially in orthodontic
practice, these mechanics were utilized to construct digital models
and later to generate a fundamental structure for indirect bonding.
In some practices, the use of conventional PVS impressions has
been replaced by intraoral scanning and is precisely used in
orthognathic cases, for the production of surgical splints by utiliz-
ing digital STL files. Digital scanning can be sucessfully utilized in
diagnosis and treatment planning. Linear measurements such as
mesiodistal width, buccolingual height, and vertical height of the
teeth can also be measured with iTero scanner. By utilizing digital
intraoral scanning precise measurement of elementary diagnostic
measurements like overbite, overjet, arch width, arch length, tooth
size and Bolton’s ratio is possible [24]. Peer assessment rating
(PAR) score can also be measured by utilizing digitally scanned
models and this computerized-based method.
5. Discussion and future direction
Digitization has entered in all facets of dentistry. In conven-
tional orthodontic practice, impression making and pouring and
finishing dental cast not only proved tedious process but lacked
the ability to be reproduced in the absence of the patient. On the
contrary, modern day orthodontic dental treatment makes smart
use of imaging technologies in the form of digital intra oral and
extra oral scanners to record impressions of the upper and lower
dentition and fabricate accurate and precise cast models to per-
form model analysis for calculating arch length tooth material dis-
crepancy. Measurements made from digital models produced by
commercially available scanners such as Ortho Insight 3D, I Tero,
and Lythos were highly reliable. Different scanners utilise the var-
ied scanning technology to construct high quality images that can
be segmented and reconstructed on demand. The most reliable
technique having greater clinical implication in dentistry particu-
larly orthodontics is parallel confocal technique.
The potential of a scanner to give vital information on patient’s
occlusion and dental relation may be a basis to order them as per
clinician’s clinical needs and requirements. Pre treatment patient
records mainly the negative replica in form of impression and pos-
itive replica as cast models are essential pre requisite for accurate
diagnosis and efficient treatment planning. The normal anatomy of
the peri oral structures is also highlighted with these digital scans
[25]. Since the plaster and stone dental study models cannot be
retrieved and transferred in patient’s absence, scanned models
have added advantages of versatility coupled with durability
[26]. Record keeping has highly improved with the computerised
dental mock and study models. Digital photographs both extra oral
and intra oral, radiographs such as lateral cephalogram and OPG
along with scanned dental cast has revolutionised the diagnostic
envelope and opened new horizon for advanced treatment to a
specific form of malocclusion. This data can be shared amongst
three or more orthodontist at the same time with the innovation
of tele-dentistry [27].
S. Sehrawat, A. Kumar, S. Grover et al.
Fig. 9. Plan scan scanner [20].
On comparing standard alginate impression with TRIOSH intra
oral scanning, the 3D models obtained gave accurate results and
desirable tooth movement can be tried with precision [28]. 3D
scanning of upper and lower arch is a predisposing step to advance
to additive manufacturing to fabricate orthodontic appliances and
retainers. An accurate scan of the entire arch is a perfect replica of
the patient’s intra oral environment [29]. The digital scanners have
definitely brought about a paradigm shift from conventional to
digital orthodontic practice encompassing the scanning of the
maxillary and mandibular arches to replicate into 3D digital cast
models and finally to 3D printing and its implication in formulating
of appliances and craniofacial scaffolds. Incremental sheet forming
helps in sequential layering to fabricate these scaffolds [30]. Single
point incremental forming (SPIF) process is an innovative tech-
nique to fabricate useful shapes to mimic craniofacial structure
economically [31]. The future of dentistry encompassing the digital
scanning technology is bright and progressive. It eliminates the
limitation of conventional dental practice with reduced chair side
time and probability of clinician’s technical errors [32]. The ANN
(Artificial neural networks) model can be applied assess perfor-
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Materials Today: Proceedings 56 (2022) 186–193
mance and quality of commonly used scanners by monitoring
the appropriate input parameters [33]. The speciality of orthodon-
tics and dentofacial has been benefitted many folds with the
advent of this latest technology. With the pandemic of COVID 19,
that has shaken the entire world. Physical appearances of the
patients to the dental set up has also become limited. But delayed
treatments and inability to adequately address the patient’s pain
and discomfort has reduced the overall quality of oral health care.
In such harsh and difficult situations, digitization has helped
tremendously. Telephonic consultancies and orthodontic appliance
and retainer fabrication from digital cast models and scanned
impressions of the patient has supported the dentist in providing
uninterrupted and continuous treatment modalities. It is certainly
a boon for the mankind. Other specialities of medical and dental
health care have been empowered to provide absolute treatment
needs, by offering reduced number of appointments and shortened
chair side time resulting in better patient compliance. Digital
records offer added advantage of efficient storage, ease of repro-
duction and better communication between dentist to patient
and one dentist to another dentist. Hence, digitization in health-
S. Sehrawat, A. Kumar, S. Grover et al.
care in general and dentistry in particular has proved to be a pow-
erful tool for the benefit of humanity.
6. Conclusion
Digitization has influenced all facets of dentistry. Digital scan-
ning technology has revolutionized the conventional imaging
modalities entirely. With digital extra and intra oral scanners the
procedure of impression making and cast fabrication has impro-
vised many folds.
 These scanners are highly efficient, easy to install and use.
 Digital cast presents accurate and precise recording of measure-
ments like overjet, overbite and model analysis contributing to
efficient diagnosis and treatment planning.
 Model analysis such as Bolton analysis can be performed with
greater efficiency depicting the tooth material arch length dis-
crepancy responsible for development of a malocclusion that
may progress to temporomandibular joint dysfunction.
 Digital smile designing using scanners and softwares has
improved the patient compliant towards treatment.
 Useful in fabrication of patient specific surgical guides and tem-
plates for accurate placement of implants.
 Any number of impressions can be reproduced with digital
records saving chair side time and appointment visits for the
patient and the clinician.
 The advent of digitization with digital imaging technologies has
opened new doors for improvement of conventional dental and
health care services.
Other specialized branches of dentistry have been benefitted
from this technology enormously, especially pediatric dentistry
as impression making is relatively tough with children and young
adults as they are non compliant same is in department of
prosthodontics as geriatric patients prefer less chair side time
and relatively less appointment. The future of orthodontic dental
practice in conjugation of digital scanning technology is bright
and progressive
Declaration of Competing Interest
The authors declare that they have no known competing finan-
cial interests or personal relationships that could have appeared
to influence the work reported in this paper.
References
[1] G. Torassian, C.H. Kau, J.D. English, J. Powers, H.I. Bussa, A. Marie Salas-Lopez, J.
A. Corbett, Digital models vs plaster models using alginate and alginate
substitute materials, Angle Orthodont. 80 (4) (2010) 662–669.
[2] W.E. Harrell, 3D Diagnosis and treatment planning in orthodontics, Semin.
Orthod. 15 (1) (2009) 35–41.
[3] N.D. Kravitz, C.H. Groth, P.E. Jones, J.W. Graham, W.R. Redmond, Intraoral
digital scanners, J. Clin. Orthod. 48 (6) (2014) 337–347.
[4] S. Sehrawat, A. Kumar, M. Prabhakar, J. Nindra, The expanding domains of 3D
printing pertaining to the speciality of orthodontics, Mater. Today: Proc. 50 (5)
(2022) 1611–1618, https://doi.org/10.1016/j.matpr.2021.09.124.
[5] V.K. Shrivastava, A. Kumar, A. Shrivastava, A. Tiwari, K. Thiru, R. Batra, Study
and trend prediction of Covid-19 cases in india using deep learning techniques,
in: Journal of Physics: Conference Series 2021 Aug 1, vol. 1950(1), IOP
Publishing, pp. 012084.
[6] M. Pundir, J.K. Sandhu, A. Kumar, Quality-of-service prediction techniques for
wireless sensor networks, in: Journal of Physics: Conference Series 2021 Aug 1,
vol. 1950(1), IOP Publishing, p. 012082.
193
Materials Today: Proceedings 56 (2022) 186–193
[7] M.K. Kakkar, J. Singla, N. Garg, G. Gupta, P. Srivastava, A. Kumar, Class schedule
generation using evolutionary algorithms, in: Journal of Physics: Conference
Series 2021 Aug 1, vol. 1950(1), IOP Publishing, pp. 012067.
[8] J.A. Bosio, F. Rozhitsky, S.S. Jiang, M. Conte, P. Mukherjee, T.J. Cangialosi,
Comparison of scanning times for different dental cast materials using an
intraoral scanner, J. World Fed. Orthod. 6 (1) (2017) 11–14.
[9] R. Richert, A. Goujat, L. Venet, G. Viguie, S. Viennot, P. Robinson, J.-C. Farges, M.
Fages, M. Ducret, Intraoral scanner technologies: a review to make a successful
impression, J. Healthc Eng. 2017 (2017) 1–9.
[10] G. Lecocq, Digital impression-taking: fundamentals and benefits in
orthodontics, Int. Orthod. 14 (2) (2016) 184–194.
[11] O. Zilberman, J. Huggare, K. Parikakis, Evaluation of the validity of tooth size
and arch width measurements using conventional and three-dimensional
virtual orthodontic models, Angle Orthod. 73 (2003) 301–306.
[12] H.B. Jacob, G.D. Wyatt, P.H. Buschang, Reliability and validity of intraoral and
extraoral scanners, Prog. Orthod. 16 (2015) 38.
[13] C.B. Martin, E.V. Chalmers, G.T. McIntyre, H. Cochrane, P.A. Mossey,
Orthodontic scanners: what’s available?, J Orthod. 42 (2) (2015) 136–143.
[14] T. Grünheid, S.D. McCarthy, B.E. Larson, Clinical use of a direct chairside oral
scanner: an assessment of accuracy, time, and patient acceptance, Am. J.
Orthodon. Dentof. Orthoped. 146 (5) (2014) 673–682.
[15] I. Faus-Matoses, A. Mora, C. Bellot-Arcís, J.L. Gandia-Franco, V. Paredes-
Gallardo, A Comparative Study of the Validity and Reproducibility of
Mesiodistal Tooth Size and Dental Arch with iTeroTM Intraoral Scanner and
the Traditional Method. Dental Anatomy, 2018 Aug 1:157.
[16] P. Müller, A. Ender, T. Joda, J. Katsoulis, Impact of digital intraoral scan
strategies on the impression accuracy using the TRIOS Pod scanner, Quint. Int.
7 (4) (2016).
[17] B.E. Cozad, Chair-side intraoral scanners to replace conventional dental
impressions/Diagnostic Accuracy of Impression Free Digital Models (Doctoral
dissertation, The University of Texas School of Dentistry at Houston).
[18] A.M. Cuperus, M.C. Harms, F.A. Rangel, E.M. Bronkhorst, J.G. Schols, K.H.
Breuning, Dental models made with an intraoral scanner: a validation study,
Am. J. Orthodon. Dentofac. Orthoped. 142 (3) (2012) 308–313.
[19] S.u. Ting-shu, S. Jian, Intraoral digital impression technique: a review, J.
Prosthodont. 24 (4) (2015) 313–321.
[20] A. Ender, T. Attin, A. Mehl, In vivo precision of conventional and digital
methods of obtaining complete-arch dental impressions, J. Prosthet. Dent. 115
(3) (2016) 313–320.
[21] W. Renne, M. Ludlow, J. Fryml, Z. Schurch, A. Mennito, R. Kessler, A. Lauer,
Evaluation of the accuracy of 7 digital scanners: an in vitro analysis based on
3-dimensional comparisons, J. Prosth. Dent. 118 (1) (2017) 36–42.
[22] T.V. Flügge, S. Schlager, K. Nelson, S. Nahles, M.C. Metzger, Precision of
intraoral digital dental impressions with iTero and extraoral digitization with
the iTero and a model scanner, Am. J. Orthodont. Dentofac. Orthoped. 144 (3)
(2013) 471–478.
[23] S. Akyalcin, B.E. Cozad, J.D. English, C.D. Colville, S. Laman, Diagnostic accuracy
of impression-free digital models, Am. J. Orthodont. Dentofac. Orthoped. 144
(6) (2013) 916–922.
[24] J. Abduo, M. Elseyoufi, Accuracy of intraoral scanners: a systematic review of
influencing factors, Euro. J. Prosthod. Restor. Dent. 26 (3) (2018) 101–121.
[25] J.-H. Lim, J.-M. Park, M. Kim, S.-J. Heo, J.-Y. Myung, Comparison of digital
intraoral scanner reproducibility and image trueness considering repetitive
experience, J. Prosthet. Dent. 119 (2) (2018) 225–232.
[26] J.W. Anh, J.M. Park, Y.S. Chun, M. Kim, M. Kim, A comparison of the precision of
three-dimensional images acquired by 2 digital intraoral scanners: effects of
tooth irregularity and scanning direction, Korean J. Orthodont. 46 (1) (2016)
3–12.
[27] O. Al-Jubuori, A. Azari, An introduction to dental digitizers in dentistry. A
systematic review, J. Chem. Pharm. Res. 7 (2015) 10–20.
[28] H. Khraishi, B. Duane, Evidence for use of intraoral scanners under clinical
conditions for obtaining full-arch digital impressions is insufficient, Evid.-
based Dent. 18 (1) (2017) 24–25.
[29] P. Medina-Sotomayor, A. Pascual-Moscardo, I. Camps, Relationship between
resolution and accuracy of four intraoral scanners in complete-arch
impressions, J. Clin. Exp. Dent. 10 (4) (2018) e361.
[30] A. Kumar, V. Gulati, P. Kumar, H. Singh, Forming force in incremental sheet
forming: a comparative analysis of the state of the art, J. Braz. Soc. Mech. Sci.
Eng. 41 (6) (2019) 1–45.
[31] A. Kumar, V. Gulati, Optimization and investigation of process parameters in
single point incremental forming, Ind. J. Eng. Mater. Sci. (IJEMS). 27 (2) (2021)
246–255.
[32] LiJun Sun, J.-S. Lee, H.-H. Choo, H.-S. Hwang, K.-M. Lee, Reproducibility of an
intraoral scanner: a comparison between in-vivo and ex-vivo scans, Am. J.
Orthod. Dentofac. Orthoped. 154 (2) (2018) 305–310.
[33] A. Kumar, D. Kumar, P. Kumar, V. Dhawan, Optimization of incremental sheet
forming process using artificial intelligence-based techniques, in: InNature-
Inspired Optimization in Advanced Manufacturing Processes and Systems
2020 Dec 8, CRC Press, pp. 113–130.