Overview: This article provides standardized procedures and technical requirements for performing high-quality intraoral scans across various dental workflows, including crown and bridge, dentures, and sleep apnea appliances.
Clear Aligner and Retainer Scanning
Effective scanning for clear aligners requires specific patient positioning and accurate posterior data capture.
Patient Positioning
Have the patient close their mouth halfway. Closing the mouth halfway creates necessary space for the scanner in the posterior regions of the mouth.
Scan Paths
Upper Jaw: Scan the Occlusal surface, then the Buccal surface, followed by the Palatal surface.
Lower Jaw: Scan the Occlusal surface, then the Lingual surface, followed by the Buccal surface.
Gingival Margin: Ensure the scan extends 3-5mm beyond the gingival margin.
Bite Scans: Capture bite scans from the molar to the premolar. Do not exceed the canine teeth during bite scans.
Crown and Bridge Scanning
Crown and bridge workflows require a minimum of a full quadrant scan to ensure accurate digital fabrication.
Preparation and Retraction
Preparations: Use shoulder or chamfer preps for the most predictable results. Knife and feather edge preps are not recommended for digital workflows.
Isolation: Place cotton rolls in the vestibular region or use cheek pads to retract soft tissue. Ensure edentulous tissue is completely dry before beginning the scan.
Retraction: Use the double cord technique for optimal tissue displacement and margin visibility.
Scanning Sequence
Upper Jaw: Occlusal → Buccal → Palatal.
Lower Jaw: Occlusal → Lingual → Buccal.
Gingival Margin: Scan 3-5mm beyond the gingival margin.
Denture Scanning
Denture scanning includes procedures for wax rims and copy dentures to capture accurate intaglio and cameo data.
Wax Rim Procedures
Border Molding: Periphery border mold the wax rim using compound or heavy body PVS material while the patient performs functional movements.
Wash Impression: Apply a light body wash and have the patient repeat functional movements.
Markings: Use clear markings on the wax rim for smile lines, canine lines, and the midline.
Extraoral Scan: Perform a 360-degree extraoral scan while holding the wax rim in your hand.
Copy Denture and Try-in Scanning
Ensure the denture fits properly before applying a light body wash to the intaglio. Perform the scan following this path: Intaglio → Border → Occlusal → Cameo → Bite.
Edentulous Scanning
When scanning edentulous areas, move the scanner significantly slower over soft tissue to maintain tracking.
Lower Arch Technique
Start the scan on the occlusal surface of the second molar. Rock the scanner labial/lingual in the anterior region. Capture the alveolar ridge using a twisting motion to record undercuts.
Upper Arch Technique
Start at the second molar occlusal surface. Roll the scanner lingually toward the midline. Use a back-and-forth sweeping motion to capture the palate and connect the data to the previous scan path.
Partial Denture Scanning
Focus on abutment teeth and proper tissue extension for partial dentures.
- Abutment Capture: Ensure abutment teeth are completely and accurately captured.
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Recommended Scanning:
- Upper jaw: Occlusal → Buccal → Palatal
- Lower jaw: Occlusal → Lingual → Buccal
- Bite scans should be molar to premolar, not exceeding canines
- Tilt the scanner on both sides of the arch to capture at least 5 mm of the lingual and buccal gum tissue.
Implant Scanning
The implant workflow requires an emergence profile scan and a separate scan with the scan body hand-tightened.
Emergence Profile
The implant site without the healing cap or scan body placed. This is our main design file and allows us to capture the interproximal contacts, reveals discrepancies with the scan body being fully seated, and is responsible for how the emergence of the restoration is designed
Scan Body Management
Hand-tighten the scan body but do not apply torque. Always remove the scan body before performing bite scans to ensure accurate jaw registration.
Manage Improperly Seated Implant Scan Bodies
Bite Scans
Always remove the scan body before performing bite scans.
Chairside Implant Crown Workflow
Night Guard and Splint Scanning
Capture the entire palate for upper jaw scans and both retromolar pads for lower jaw scans to ensure the fit of the appliance.
- Upper jaw: Occlusal → Buccal → Palatal The entire palate must be captured
- Lower jaw: Occlusal → Lingual → Buccal, ensuring both retromolar pads are captured.
- Scan 3-5mm beyond gingival margin
- Bite scans should be molar to premolar, not exceeding canines
Sleep Apnea Scanning
Sleep apnea appliances require a therapeutic bite position and specific vertical and anterior clearances.
Position and Clearance Requirements
Positioning: Use a bite gauge (such as a George Gauge) to maintain a therapeutic bite at 40-50% of maximum mandibular protrusion.
Vertical Clearance: Maintain a minimum of 3mm of space between arches.
Anterior Clearance: Maintain a minimum of 5mm of space between front teeth.
Quality Control Checklist
Verify the following criteria before submitting any case:
[ ] All posterior tooth surfaces are captured.
[ ] Both retromolar pads are included in the scan.
[ ] The scan is free of holes, voids, layering, or distortions.
[ ] The entire palate is visible for splint or night guard cases.
[ ] The bite scan is an accurate representation of the patient's jaw relationship.