Comparative trueness of complete‐arch implant position acquisition using auxiliary geometric device–aided and noncalibrated scanbody–based intraoral scanning versus smartphone‐based and dedicated extraoral photogrammetry

PURPOSE: To compare the trueness of four techniques for complete-arch implant position acquisition: intraoral implant scanning (IOIS) using auxiliary geometric devices (AGDs), IOIS using horizontally extended noncalibrated scanbodies (NCSBs), smartphone-based extraoral photogrammetry (EPG), and EPG with a dedicated scanner, with the null hypothesis that no significant differences in trueness would be observed among the techniques. MATERIALS AND METHODS: This in vitro study used a mandibular edentulous stone cast with four straight multiunit abutment analogs positioned at sites #19, #22, #27, and #30. Four experimental groups were evaluated: DynamicAbut, using AGD-aided IOIS; TruAbut, using horizontally extended NCSBs; PICApp, using smartphone-based EPG; and MicronMapper, using dedicated EPG. Ten repeated acquisitions were performed per group (n = 10; N = 40). A reference dataset was obtained with a calibrated laboratory scanner. All standard tessellation language (STL) files were imported into computer-aided design software, converted to a uniform multiunit abutment library representation, and analyzed in 3D inspection software after best-fit superimposition to the reference file. Primary outcomes were mean per-implant axis deviation, pooled interimplant distance deviation, and pooled interimplant angulation deviation. Secondary outcomes included pairwise interimplant deviations and short-span versus long-span comparisons. Kruskal-Wallis tests with Dunn post hoc comparisons were used for between-group analyses, and Wilcoxon signed-rank tests were used for within-group span comparisons (α = 0.05). RESULTS: Significant differences were identified among groups for all primary outcomes. DynamicAbut showed the highest mean per-implant axis deviation (0.418 ±0.073), whereas TruAbut showed the lowest deviation (0.122 ±0.018). PICApp (0.204 ±0.044) and MicronMapper (0.239 ±0.030) showed intermediate axis deviations. For pooled interimplant distance deviation, PICApp (22.8 ±7.5 µm) and MicronMapper (22.1 ±2.9 µm) demonstrated significantly lower deviations than DynamicAbut (46.3 ±22.4 µm) and TruAbut (35.3 ±5.9 µm). For pooled interimplant angulation deviation, DynamicAbut showed the greatest deviation (0.343 ±0.175), while TruAbut (0.118 ±0.033) and PICApp (0.133 ±0.012) showed the lowest and statistically comparable deviations; MicronMapper showed intermediate values (0.199 ±0.069). Pairwise analyses showed that no single system was uniformly superior across all implant pairs. Span analysis showed that DynamicAbut had significantly greater long-span angulation deviation than short-span angulation deviation (p = 0.027), whereas PICApp and MicronMapper showed favorable long-span distance deviations. CONCLUSION: The photogrammetric workflows, including both smartphone-based and dedicated systems, provided the most favorable interimplant distance trueness, particularly across long edentulous spans. The horizontally extended NCSB technique provided the lowest per-implant axis deviation, suggesting a potential advantage when precise axis reproduction is critical. The AGD-aided IOIS workflow did not demonstrate a measurable trueness advantage and showed increased long-span angulation deviation. Technique selection should be guided by the geometric demands of the clinical situation, particularly span length and angular tolerance, rather than by assuming universal superiority of a single acquisition method.