Accuracy of Complete-Arch Digital Implant Impressions with and Without Modular E-Chain Splinting: An in vitro Study
Y. P. Parikeerthan *
Department of Prosthodontics and Crown and Bridge, Bapuji Dental College and Hospital, Davangere, India.
Sunitha N. Shamnur
Department of Prosthodontics and Crown and Bridge, Bapuji Dental College and Hospital, Davangere, India.
K. R. Pavankumar
Department of Prosthodontics and Crown and Bridge, Bapuji Dental College and Hospital, Davangere, India.
D. B. Nandeeshwar
Department of Prosthodontics and Crown and Bridge, Bapuji Dental College and Hospital, Davangere, India.
*Author to whom correspondence should be addressed.
Abstract
Background and Objectives: The long-term success of full-arch implant-supported restorations depends on the precision of the impression-making process. Intraoral scanners (IOS) offer clinical advantages, yet capturing accurate complete-arch impressions in edentulous patients remains challenging due to cumulative stitching errors and limited stable landmarks. This study evaluated a novel stabilization method—the modular E-chain splinting technique—for improving digital impression accuracy.
Materials and Methods: A prospective in vitro study was conducted using a standardized PMMA mandibular edentulous model in an “All-on-Four” configuration with four Noris implants (3.75×10 mm). Intraoral scan bodies (Noris C9010) were attached and 15 digital scans were acquired using Dentsply Sirona Primescan, both with and without modular E-chain splinting. STL files were compared against a laboratory reference scan (Dentsply Sirona inEos X5) using Geomagic Studio 12. Linear (x, y, z axes), angular, and distance deviations were measured. Statistical analysis was performed using IBM SPSS v25 (independent student t-test, p < 0.05).
Results: Modular E-chain splinting significantly improved all measured accuracy parameters (p < 0.001). Mean linear deviations were reduced along all three axes (x: 1.12 vs. 1.19 μm; y: 2.15 vs. 2.24 μm; z: 2.55 vs. 2.61 μm). Angular deviation improved from 0.33° to 0.32°. Distance deviation decreased from 1.49 to 1.39 μm, and the global measure of linear absolute error (GMLAE) reduced from 2.01 to 1.94 μm.
Conclusions: Modular E-chain splinting significantly enhances the accuracy of complete-arch digital implant impressions. This technique is time-efficient, passive, and clinically adaptable. Further in vivo studies are warranted to validate these findings in oral conditions.
Keywords: Intraoral scanner, digital implant impression, E-chain splinting, complete arch, scan body, accuracy, All-on-Four, edentulous