In vitro evaluation of six intraoral scanners for cone beam computed tomography data registration in robotic-assisted implant surgery: impact of scanning experience.

Objectives: This study evaluated the accuracy of intraoral scanning (IOS) and cone beam computed tomography (CBCT) data registration (ICR) in robotic computer-assisted implant surgery (r-CAIS) using six different intraoral scanners, considering the impact of surgeon experience.

Methods: A total of 112 standardized mandibular partially edentulous models were assigned to six experimental groups and one control group based on the intraoral scanner used. In the control group, preoperative CBCT data were registered with CBCT data from a model containing an optical tracking marker (OT-Marker). In the experimental groups, IOS data from models with OT-Markers were registered with preoperative CBCT data. Each experimental group was further divided based on the surgeon's experience: one subgroup had a surgeon with over 5 years of IOS experience, while the other had a novice surgeon. Following registration, two implants were placed in each model using r-CAIS. Postoperative CBCT images were analyzed to measure and compare three-dimensional (3D) and two-dimensional (2D) deviations of implant positioning.

Results: No significant differences were observed in angular, entry level, or apical deviations among the ICR methods using the six intraoral scanners (P>0.05). However, different scanners found substantial variations in entry, apical, entry depth, and apical depth deviations (P<0.05). Furthermore, no considerable differences were found in implant deviation indices between surgeons with different levels of scanning experience (P>0.05).

Conclusion: The ICR method demonstrates high accuracy across six intraoral scanners, regardless of the surgeon's IOS experience. However, accuracy varies among scanners.

Clinical Significance: This in vitro study provides valuable insights for surgeons in selecting an appropriate intraoral scanner for the ICR method. Moreover, it confirms that the method's accuracy is independent of the surgeon's experience, supporting its broader clinical adoption.