Impact of Scannable Healing Abutment Type on the Accuracy of Implant Impression

초록

Objectives The objectives of this study are to determine whether scannable healing abutment (SHA) geometry affects implant-impression accuracy compared with conventional scan bodies (SBs) and to assess the effect of a detachable cap on SHA accuracy. Methods Three partially edentulous mandibular models were fabricated, each with two implants at the right second premolar and first molar, corresponding to three implant systems: IS-III active (Neobiotech), TS-III (Osstem), and Bright tissue level (Dentium). For each system, scans were obtained with SBs and SHAs; in the Bright system, a detachable-cap SHA (SHAC-B) was additionally tested. The seven groups were SB-I, SB-T, SB-B, SHA-I, SHA-T, SHA-B, and SHAC-B (n = 10 scans per group). Reference datasets were acquired with a laboratory scanner (inEos X5), and intraoral scans were obtained with an intraoral scanner (Primescan, Dentsply Sirona). Implants were reconstructed in exocad Dental CAD 2.2 and analyzed in Geomagic Control X after best fit alignment to adjacent teeth. Outcomes were 3D linear and implant angular deviations. Wilcoxon signed-rank tests compared SBs with SHAs within each system and SHA-B with SHAC-B; differences among SHA-I, SHA-T, and SHA-B were assessed with Kruskal-Wallis tests and Bonferroni-adjusted pairwise comparisons (alpha = 0.05). Results 3D linear deviations were < 70 mu m for all groups except SHAC-B. For 3D linear deviation, p values (second premolar, first molar) were 0.017, 0.139 (SB-I vs. SHA-I); 0.005, 0.013 (SB-T vs. SHA-T); and 0.241, 0.169 (SB-B vs. SHA-B). Corresponding angular p values were 0.005, 0.005; 0.005, 0.005; and 0.074, 0.017, respectively. In the Bright system, adding a cap (SHA-B vs. SHAC-B) reduced accuracy (linear 0.009, 0.037; angular 0.005, 0.005). Among SHA groups, differences occurred only at the second premolar, where SHA-B differed from SHA-I and SHA-T; no differences were observed at the first molar. Conclusions SHA geometry influenced implant-impression accuracy, yet deviations were generally within clinically acceptable ranges. Cap application reduced accuracy, highlighting the need to optimize cap design and connection.

키워드