Optimal Use of Physical Centric Relation Records for Digital Workflows.

Correctly articulated dental casts are essential for certain dental treatment. Articulation can be traditional: using a physical articulator; digital: using a physical articulator followed by 3D scanning, or virtual: using 3D scanning and software to articulate scans without initial physical articulation. This study compared the precision of traditional articulation, using physical centric relation records and an articulator and virtually, by digitally aligning scans of the casts and record. Articulated casts and centric relation records were obtained. 12 record pairs were recorded from the articulated casts. Virtual method: all records were scanned, unclamped, in a custom laboratory scanner. The casts were aligned to each scanned record to create virtual articulations. Traditional method: each record was used to physically articulate the casts. Each articulation was recorded using an intraoral scanner. The mean inter-arch separation between three key-points on each cast-pair were used to determine differences in occlusal separation in three anatomical directions, and precision of methods. Traditional articulations: standard deviations in key-point distance never exceeded 0.102mm. The virtual equivalent was 0.059mm. Statistically significant differences (p⟨0.05) between all anteroposterior separation distances were found between the methods, and in three of six lateral/vertical separations. Virtual articulation was significantly more precise than traditional articulation.