Clinical studies on TRIOS®

Clinical studies on TRIOS® November 2015

Accuracy• 9 articles• 4 Posters

Shade measurement• 1 article

Technology comparison• 1 article

Shade Measurement – Validation and Verification

TRIOS® shade measurement more reliable than the human eye

”3Shape TRIOS® Color had the best agreement of all included methods for the color chroma and hue”...”whereas the conventional visual, subjective method demonstrated a moderate agreement for the color value and a fair agreement for the color hue”

“The TRIOS® intraoral scanner was easy to handle and more convenient to the patient than the MHT SpectroShadeTM”

Gotredsen et al, Int J Oral Dent Health, 2015, p. 25.

Figure 1 TRIOS® Color Figure 2 SpectroShadeTM Figure 3 Vita 3D-Master®

TRIOS® shade measurement as accurate as the human eye

“The effectiveness of the new digital scanning and computer software system for color determination was as good as an earlier tested and validated digital colorimetric system and as the conventional, visual method for color determination of teeth.”

“The results support the use of a scanning and color measuring computer-based system in dentistry.”

Gotredsen et al, Int J Oral Dent Health, 2015

Best shade match by comparing 3Shape TRIOS® Color with traditional Visual method and SpectroShadeTM with traditional Visual method

Accuracy – Clinical research overview

What is Accuracy?

Accuracy terminology

Accuracy Deviation of one measurement compared to golden standard

Trueness Deviation of average of multiple measurements compared to golden standard

Precision (repeatibility)Average deviation of measurements compared to the average of those multiple measurements

Real tooth Golden standard (high accuracy digitalization)*

Digital Impression of

tooth

*High accuracy digitalization of Real tooth (in vivo) is commonly obtained through digitalisation of a conventional impression in a lab scanner. A model (in vitro) is commonly digitalized directly in a lab scanner

Published papers on TRIOS® vs. Conventional

Digital impressions with TRIOS® are at least as accurate as conventional impression accross indications“Digital impressions with TRIOS are of good precision and up to the clinical standard” 1

There is no significant difference between intraoral impressions with TRIOS®, extra oral scanning of a plaster model with TRIOS® and model scanning with D7002

“Digital implant impressions are as accurate as conventional implant impressions” 3

”Accuracy of digital impressions is often more precise than traditional silicone impressions of implants independent of implant connection type, scanners and number of implants.” 4

TRIOS full arch scans are significantly more accurate than conventional impressions using standard perforated metal trays with alginate5

TRIOS quadrant scans are significantly more accurate than conventional impressions using tripple tray with Identium6

1Yang et al, Beijing Da Xue Xue Bao, 2015 Feb 18

2 Atia et al, Biometrics & Biostatics International Journal 2015 April 6

3 Papaspyridakos et al, Clin Oral Implants Res 2015 Feb 13

4 Khachatryan et al, The 14th Congress of the European Academy of Dento-Maxillofacial Radiology. Cluj-Napoca, Romania, 25-28 June 2014

5 Ender et al, J Prosthet Dent. Nov 6 2015 E-pub

6 Ender et al, Clin Oral Investig. Nov 7 2015 E-pub

Published papers on TRIOS® vs. Competitors

TRIOS® the most accurate Digital Impression System– for single units, quadrants and full arch impressions

TRIOS® is the most accurate IOS scanner for single crowns and significantly more accurate than CEREC Omnicam and PlanScan1

TRIOS® is significantly more accurate than LavaCos, Itero and CEREC Omnicam on quadrant impressions2

TRIOS® the most accurate IOS for full arch impressions – compared to CEREC Bluecam, CEREC Omnicam, Lava COS, True Definition, Itero3

TRIOS® is significantly more accurate than CEREC Omnicam4

TRIOS® is significantly more accurate than Lava COS and CEREC Bluecam5

1Hack and Patzelt, 2015 Issues of the ADA Professional Product Review, Volume 10 Issue 4, September 25, 2015

2 Ender et al, Clin Oral Investig. Nov 7 2015 E-pub

3 Ender et al, J Prosthet Dent. Nov 6 2015 E-pub

4 Boeddinghaus et al, Clin Oral Investig, 2015

5 Schaefer et al, J Dent 2014 Jun E-pub 2014 Feb 6

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Hack and Patzelt, 2015 Issues of the ADA Professional Product Review Volume 10 Issue 4, September 25, 2015

The smallest deviations for both the trueness and the precision measurements (± standard deviation) between the reference dataset and the various intraoral scanner datasets were obtained from the TRIOS®

TRIOS® is significantly more accurate than CEREC Omnicam and PlanScan

TRIOS® #1 in Evaluation of the Accuracy of Six IOS Devices

TRIOS® significantly more accurate than other IOS systems in terms of quadrant impressions

TRIOS Color and TRIOS Standard significantly more accurate than LavaCos, Itero and Omnicam

”Digital intraoral impression of small parts of the dental arch in cases of individual tooth restoration is a fast procedure compared to conventional impression taking”… “Combined with a direct digital workflow, immediate restoration production is possible”

Ender et al, Clin Oral Investig. Nov 7 2015 E-pub

TRIOS® the most accurate IOS for full arch impressions

“The precision of complete-arch scans approaches or exceeds that of some conventional impression materials (POE, ALG).”

Patients report greater comfort when digital impression systems are used, and for some indications, the time expenditure is lower than for conventional impression techniques. This shows the potential of digital intraoral impression systems as an equivalent or better alternative to traditional conventional impression procedures.

Fig. Precision of digital complete arch impression in vivo (µm)

Table. Precision of digital complete arch impression in vivo (µm)

Ender et al, J Prosthet Dent. Nov 6 2015 E-pub

TRIOS® significantly more accurate than Cerec Omnicam

”Zirconia copings for single-tooth restorations based on intraoral scans and conventional impressions in combination with laboratory scans – with the exception of Cerec Omnicam – are comparable to one another with regard to their marginal fit.”

”Only TRIOS and Omnicam were used in randomized order. True Definition was always used as the third intraoral scanner because of the necessary powder application”...”Considering the clinical conditions, a longer stay of the cords in the sulcus often improves the local conditions for the impression.”

Boeddinghaus et al, Clin Oral Investig, 2015

Summarized results for the marginal gap. Same letters denote significant differences (p<0.05) in between the groups.

“It can be argued that powdering or dusting to achieve an anti-reflective coating of hard tissue structures compromise accuracy, as it seems intuitive that over-application of the powder layer may negatively influence marginal or internal adaptation. Furthermore, any of these coatings are difficult to handle clinically, especially in a moist environment. Although the present study used aerosol sprays with mean particle size of 5 µm to avoid a thick-layer formation, powdering affected both marginal and internal adaption.”

Schaefer et al, J Dent 2014 Jun E-pub 2014 Feb 6

“Itero and TRIOS® impressions required no preliminary powdering or dusting and performed significantly better than Lava COS and CEREC Bluecam, that needed such coating procedures”

Color-coded difference images for qualitative deviation analysis of internal (upper row) and marginal surfaces (lower row). Sample images that contribute best to the authors’ findings were selected for each impression technique.

Non-powder digital impression systems perform significantly better than digital impressions requiring powder

TRIOS® vs. Manual shade measurement and Validated digital system

Overall conclusion – TRIOS® is (at least) as accurate as conventional shade matching (3D Master) and Validated digital system (SpectroShade)

Reference Key findings Study type Control

Gotfredsen et al 2015 TRIOS® shade measurement more reliable than the human eye

TRIOS® shade measurement as accurate as the human eye and as an earlier tested and validated digital colormetric system.

The newly developed color determination scanner used in the present study was easy to handle and more convenient to the patient than the colorimetric camera system used.

In vivo (29 patients)

SpectroShade, MHT

TRIOS® accuracy vs. Conventional Impressions

Reference Key findings Indication Study type Control

Yang X et al 2015

Digital impressions with TRIOS® are of good precision and up to the clinical standardAccuracy of TRIOS® digital impressions less than 10 µm

Single crown In vitro (n=10) Silicone rubber impression poured with type IV plaster and digitalized with 3Shape D700

Atia et al 2015 There is no significant difference between intraoral impressions with TRIOS®, extra oral scanning of a plaster model with TRIOS® and model scanning with D700

Full arch (ortho) In vivo (40 patients)

Plaster models scanned with D700

Papaspyridikos et al 2015

TRIOS® implant impressions are as accurate as conventional implant impressions

Edentulous In vitro (n=10) Stone cast with 5 implants

Ender et al, J Prosthet Dent. Nov 6 2015 E-pub

TRIOS full arch scans are significantly more accurate than conventional impressions using standard perforated metal trays with alginate5

Full arch In vivo (n=15) 3 impressions on 5 participants

Conventional impressions poured with type iV plaster and digitalized with iSeries; Dental Wings)

Ender et al, Clin Oral Investig. Nov 7 2015 E-pub

TRIOS quadrant scans are significantly more accurate than conventional impressions using tripple tray with Identium6

Quadrant In vivo (n=15) 3 impressions on 5 participants

Conventional impressions poured with type iV plaster and digitalized with inEOS X5, Sirona Dental Systems)

Overall conclusion – TRIOS® is (at least as) accurate as conventional impression accross indications

TRIOS® accuracy vs. other Intraoral scanners

Reference Key findings Indication

Study type Intra Oral Scanners compared

Control

Hack and Patzelt, 2015

TRIOS® is the most accurate IOS and significantly more accurate than CEREC Omnicam and PlanScan

Single crown

In vitro (n=19) CEREC Omnicam and PlanScan, iTero, CS3500 TrueDefinition

Acrylic replica of a typodont dental model – digitalized with ATOS Blue Light Triple Scan III

Ender et al, 2015

TRIOS® is significantly more accurate than LavaCos, Itero and CEREC Omnicam on quadrant impressions

Quadrant In vivo (n=15) 3 impressions on 5 participants

LavaCos, Itero and CEREC Omnicam, CEREC Bluecam, True-Definition

Conventional impressions poured with type iV plaster and digitalized with inEOS X5, Sirona Dental Systems)

Ender et al, 2015

TRIOS® the most accurate IOS for full arch impressions – compared to CEREC Bluecam, CEREC Omnicam, Lava COS, True Definition, Itero

Full arch In vivo (n=15) 3 impressions on 5 participants

CEREC Bluecam, CEREC Omnicam, Lava COS, True Definition, Itero

Conventional impressions poured with type iV plaster and digitalized with iSeries; Dental Wings)

Boeddinghaus et al 2015

TRIOS® is significantly more accurate than CEREC Omnicam

Single crown

In vivo (24 patients)

Heraeus Cara TRIOSSirona CEREC AC Omnicam3M Lava True Definition

Control gypsum model based on conventional impression

Schaeffer et al 2014

TRIOS® is significantly more accurate than Lava COS and CEREC Bluecam

Itero and TRIOS® impressions required no preliminary powdering or dusting and performed significantly better than Lava COS and CEREC Bluecam, that needed such coating procedures

Single crown

In vitro (n=5) iTeroCara TRIOSCEREC AC BlueCamLava COS

Gypsum model scanned in a D700 scanner

Yang X et al 2015

Digital impressions showed better internal fitness. Fitness of single crowns based on digital impressions was up to clinical standard. Digital impressions could be an alternative method for single crown manufacturing

Single crown

In vitro (n=10) TRIOSMHT

Stone cast based on conventional impression

Overall conclusion – TRIOS® is (at least) as accurate as competitor scanners accross indications