Influence of edentulous areas on the accuracy of the maximum intercuspal position recorded by using different intraoral scanners or an artificial intelligence-based program.

Abstract

Statement of problem: Intraoral scans can be articulated in maximum intercuspal position (MIP) by using an artificial intelligence (AI) based program; however, the impact of edentulous areas on the accuracy of the MIP located using this AI-based program is unknown.

Purpose: The purpose of this in vitro study was to assess the impact of edentulous areas (0, 1, 2, 3, and 4 posterior mandibular teeth) on the accuracy of the MIP located using 3 intraoral scanners (IOSs) and an AI-based program.

Material and methods: Stone casts articulated in MIP in an articulator were digitized (T710). Five groups were created: no edentulous area (Group 0) or edentulous area of 1 (Group 1), 2 (Group 2), 3 (Group 3), or 4 (Group 4) posterior mandibular teeth. A maxillary and mandibular scan were obtained from the reference casts with 3 IOSs: Primescan, Aoralscan3, and i700. The nonarticulated scans were duplicated 20 times. Six subgroups were created based on the program used to locate the MIP: 3 IOS subgroups: PrimeScan, AoralScan3, and i700 and 3 subgroups for the AI-based program (Bitefinder) (Primescan-AI-articulated, Aoralscan3-AI articulated, and i700-AI articulated) (n=10). In the Group 0-Primescan subgroup, the 10 duplicated corresponding scans were articulated by recording a bilateral occlusal record. In the Group 0-Primescan-AI articulated subgroup, the 10 duplicated corresponding scans were automatically articulated in MIP by the AI-based program. In the Group 0-Aoralscan3 and Group 0-i700 subgroups, the same procedures were completed as in the Group 0-Primescan. In the Group 0-Aoralscan3-AI articulated and Group 0-i700-AI articulated subgroups, the same procedures were accomplished as in the Group 0- Primescan-AI articulated. For the data acquisition of Groups 1, 2, 3, and 4, the right mandibular posterior teeth were removed sequentially. The same procedures were completed as in Group 0. A program (Geomagic Wrap) was selected to compute interlandmark measurements on the digitized articulated casts (control) and each articulated specimen. Two-way ANOVA and pairwise multiple comparison Tukey tests were used to analyze trueness (α=.05). The Levene and pairwise multiple comparison Wilcoxon rank tests were used to analyze precision (α=.05).

Results: Trueness and precision discrepancies were found between the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P<.001). Groups 0, 1, and 2 obtained the best trueness and precision, while Group 4 demonstrated the worst trueness and precision. Primescan and Aoralscan3 obtained better trueness than the i700. The AI-based program obtained lower MIP trueness and precision when compared with the IOSs tested. The AI-based program revealed the best MIP accuracy when articulating scans recorded by using the i700 and the worst with the Aoralscan3.

Conclusions: Edentulous areas impacted the trueness and precision of the MIP recorded by using the IOSs or AI-based program tested. Edentulous spaces involving 1 or 2 posterior teeth did not impact the MIP accuracy. An edentulous space of 4 teeth revealed the worst accuracy values captured by using the IOSs assessed or AI-based program. The performance of the AI-based program was influenced by the IOS system used to record the nonarticulated digital scans.