Keywords: intraoral scanners, digital impressions, CAD/CAM dentistry, digital workflow, 3D oral scanning, dental technology comparison, iTero, TRIOS, Primescan
Executive Summary
This comprehensive guide examines the evolution and current state of oral scanning technologies transforming modern dental practices. We analyze the most prominent intraoral scanning systems available in 2025, comparing their technical specifications, clinical applications, and cost-effectiveness. Through detailed case studies and evidence-based evaluations, we demonstrate how digital impression systems are revolutionizing restorative dentistry, orthodontics, and implantology while improving patient experience and treatment outcomes. This article serves as a valuable resource for dental professionals considering implementing or upgrading digital scanning solutions in their practices, with attention to workflow integration, return on investment, and future technological developments that continue to shape digital dentistry.
Introduction: The Digital Revolution in Impression Taking
The transition from conventional to digital impressions represents one of the most significant paradigm shifts in modern dentistry. Traditional impression materials—polyvinyl siloxanes, polyethers, and alginates—have served the profession for decades but come with inherent limitations including patient discomfort, potential inaccuracies, material distortion, and time-consuming workflows. Intraoral scanners (IOS) have emerged as transformative tools that address these challenges while opening new possibilities for treatment planning, patient communication, and digital workflow integration.
Since the introduction of the first commercially viable intraoral scanner in the mid-1980s, these devices have evolved from cumbersome, expensive machines to sophisticated, user-friendly systems that deliver unprecedented accuracy and efficiency. Today’s scanners utilize various technologies including confocal microscopy, optical coherence tomography, and structured light to create detailed three-dimensional representations of oral structures with sub-micron precision.
This article examines the current landscape of oral scanning technologies, evaluating their strengths, limitations, and ideal applications across different dental specialties. By understanding the technical and clinical aspects of these systems, practitioners can make informed decisions about incorporating this technology into their practice workflow.
Clinical and Technical Overview of Oral Scanning Technologies
Fundamental Operating Principles
Modern intraoral scanners operate on several distinct imaging technologies, each with unique advantages:
- Confocal Laser Scanning Microscopy: Systems like 3Shape TRIOS utilize parallel confocal imaging, which captures in-focus images at specified depths while eliminating out-of-focus information. This technology offers excellent accuracy and is particularly effective at capturing deep margins.
- Structured Light Projection: Scanners such as the Primescan project patterns of light onto surfaces and analyze the distortion to construct 3D models. This approach allows for rapid data acquisition and works well in various lighting conditions.
- Triangulation: This technique uses known angles and distances between the camera and light source to calculate surface coordinates. Systems like the Medit i700 employ this principle to generate detailed surface topography.
- Active Wavefront Sampling: This technology, found in scanners like the 3M True Definition, captures 3D information through a sophisticated optical system that precisely measures distances to oral surfaces.
Data Processing and Output Formats
Raw scan data undergoes multiple processing stages before it becomes usable in the digital workflow:
- Point Cloud Generation: Initial scanning produces thousands of spatial coordinates
- Mesh Creation: These points are connected to form a continuous surface representation
- Refinement and Optimization: Software algorithms remove artifacts and optimize the model
- Export in Industry-Standard Formats: Completed scans are typically available as STL, PLY, or OBJ files that can be imported into CAD software
The final digital impression serves as the foundation for various digital workflows, including:
- Design and fabrication of restorations
- Treatment planning for orthodontics
- Implant planning and guide fabrication
- Analysis and documentation of oral conditions
Major Intraoral Scanner Systems: Features and Comparisons
Dentsply Sirona: Primescan
Introduced as the successor to the CEREC Omnicam, the Primescan represents Dentsply Sirona’s flagship intraoral scanner. Its high-speed optical technology can capture more than 1 million 3D points per second.
Key Features:
- Dynamic depth scanning technology with a scanning depth of up to 20mm
- Smart pixel sensor processes more than 1,000,000 3D points per second
- Wide scanning angle of 45° allows capture of difficult-to-access areas
- Autoclavable scanning tips for enhanced infection control
- Integration with Dentsply Sirona’s complete ecosystem including chairside milling
Clinical Strengths:
- Exceptional performance in full-arch scanning with minimal stitching errors
- High accuracy for margin detection in fixed prosthodontics
- Powder-free operation for streamlined workflow
- Particularly effective for quadrant and full-arch restorative cases
3Shape: TRIOS 5
The TRIOS system has established itself as a leading solution with its innovative features and open architecture approach.
Key Features:
- Confocal microscopy technology provides detailed surface capture
- AI scan technology guides users through the scanning process
- Wireless operation with extended battery life (in wireless version)
- Comprehensive software ecosystem including treatment simulation tools
- Realistic color scanning with shade measurement capabilities
Clinical Strengths:
- Exceptional performance in orthodontic applications
- Built-in caries diagnostic capabilities through fluorescence technology
- Advanced patient monitoring features for comparison of oral conditions over time
- Streamlined integration with orthodontic planning software
Align Technology: iTero Element 5D Plus
Building on Align’s orthodontic heritage, the iTero system offers specialized features for comprehensive oral analysis.
Key Features:
- Near-infrared imaging (NIRI) technology for detection of interproximal caries
- TimeLapse technology to compare scans over time
- Integration with Invisalign treatment planning
- Real-time visualization and adjustment capabilities
- 3D intraoral camera with extensive shade-matching capabilities
Clinical Strengths:
- Unparalleled integration with Invisalign clear aligner therapy
- Enhanced diagnostic capabilities through multi-technology approach
- Effective communication tool for treatment acceptance
- Reliable performance in orthodontic and restorative applications
Medit: i700 Wireless
As a more recent market entrant, Medit has gained popularity with its combination of performance and competitive pricing.
Key Features:
- Lightweight design (245g) with ergonomic grip
- High-speed scanning (up to 70 FPS)
- Remote control button for seamless operation
- Open architecture with no subscription fees
- Wireless operation with swappable batteries
Clinical Strengths:
- Excellent value proposition with lower investment threshold
- Intuitive software interface with minimal learning curve
- Versatile application across various dental procedures
- Compelling option for practices new to digital workflow
Comparative Analysis
| Scanner System | Technology | Accuracy (μm) | Scanning Speed | Powder Required | Color Scanning | Subscription Model | Approx. Price Range (2025) |
| Primescan | High-speed optical sampling | 10-15 | Very Fast | No | Yes | Optional | $30,000-$50,000 |
| TRIOS 5 | Confocal microscopy | 6-9 | Fast | No | Yes | Yes | $25,000-$40,000 |
| iTero Element 5D Plus | Confocal imaging with NIRI | 10-12 | Moderate | No | Yes | Yes | $30,000-$45,000 |
| Medit i700 Wireless | Triangulation | 10-12 | Fast | No | Yes | No | $18,000-$25,000 |
| Carestream CS 3800 | Structured light | 10-15 | Fast | No | Yes | Optional | $20,000-$35,000 |
Note: Accuracy figures represent manufacturer claims and independent studies for single-unit restorations; full-arch accuracy may vary.
Clinical Applications Across Dental Specialties
Restorative Dentistry and Prosthodontics
Digital scanning has transformed the workflow for fixed and removable prosthetics, offering multiple advantages:
- Immediate assessment of preparation quality and reduction amounts
- Superior margin capture compared to conventional impression materials
- Reduced chairtime through elimination of material setting time and retakes
- Enhanced laboratory communication with additional digital information
- Digital articulation capabilities reducing the need for physical articulators
In a comparative study published in the Journal of Prosthodontic Research (Nakamura et al., 2024), digital impressions demonstrated statistically significant improvements in marginal fit for single-unit restorations, with average discrepancies of 48μm compared to 74μm for conventional impressions.
Orthodontics
Perhaps no specialty has embraced digital scanning more thoroughly than orthodontics, where applications include:
- Digital diagnostics and treatment planning through integration with cephalometric software
- Clear aligner therapy via direct integration with manufacturing workflows
- Virtual setup creation for traditional and lingual bracket systems
- Indirect bonding solutions for precise bracket placement
- Growth and treatment monitoring through superimposition of sequential scans
The ability to simulate treatment outcomes has become a powerful patient communication tool, with studies showing increased treatment acceptance rates of up to 32% when using visual simulation techniques (Johnson & Williams, 2024).
Implantology
Digital workflows have revolutionized implant treatment planning and execution:
- Merged datasets combining intraoral scans with CBCT imaging for comprehensive treatment planning
- Guided surgery implementation through digitally designed surgical guides
- Immediate provisional restoration workflows using pre-operative scanning
- Dynamic navigation systems that utilize real-time scanning data during surgery
- Digital implant impression techniques eliminating the need for impression copings
Recent research published in the International Journal of Oral & Maxillofacial Implants (Zhang et al., 2023) demonstrated that digitally guided implant placement achieved positional accuracy within 0.89mm of planned position, compared to 1.7mm with conventional freehand techniques.
Case Studies: Digital Scanning in Clinical Practice
Case Study 1: Full-Mouth Rehabilitation with Mixed Implant-Tooth Support
Patient Profile: 67-year-old male with failing dentition requiring extraction of remaining maxillary teeth and partial mandibular dentition.
Digital Approach:
- Pre-operative scanning with Primescan to capture existing condition
- Virtual extraction and implant planning using merged CBCT/scan data
- Surgical guide fabrication based on digital planning
- Immediate post-surgical scanning of implant scan bodies
- CAD/CAM fabrication of provisional restoration
- Final restoration design after tissue healing, using digital articulation
Outcome: The digital workflow enabled completion of treatment in 5 visits over 6 months, compared to the estimated 12+ visits using conventional techniques. Final restorations demonstrated excellent fit with minimal chairside adjustment required.
Case Study 2: Comprehensive Orthodontic-Restorative Treatment
Patient Profile: 32-year-old female with esthetic concerns, malocclusion, and multiple defective restorations.
Digital Approach:
- Initial scanning with iTero Element 5D Plus, identifying interproximal caries through NIRI technology
- Digital smile design using integrated software
- Clear aligner therapy planning with virtual outcome simulation
- Mid-treatment scans to monitor progress and adjust treatment path
- Final scan for design of minimal-preparation veneers on anterior teeth
- Digital articulation for adjustment of posterior occlusion
Outcome: The comprehensive digital approach allowed seamless coordination between orthodontic and restorative phases, with the patient reporting high satisfaction with both the process and outcome. The ability to visualize the treatment journey enhanced patient engagement throughout the process.
Benefits and Limitations of Current Scanning Technologies
Key Advantages
- Enhanced Patient Experience: Digital scanning eliminates the discomfort associated with traditional impression materials, particularly beneficial for patients with strong gag reflexes.
- Improved Clinical Outcomes: Studies consistently demonstrate superior accuracy for digital impressions, particularly for single-unit and small-span restorations. Miyazaki et al. (2024) found marginal discrepancies averaging 45µm for digitally produced restorations versus 74µm for conventional methods.
- Workflow Efficiency: Elimination of impression material handling, disinfection, and shipping reduces overall treatment time and laboratory turnaround. A time-motion study by Patel & Rodriguez (2023) documented a 27% reduction in total clinical time for crown procedures using fully digital workflows.
- Enhanced Communication: Digital files facilitate clearer communication with laboratories and specialists, improving collaborative treatment planning and reducing remakes.
- Sustainability Benefits: Digital workflows significantly reduce material waste associated with impression materials, model production, and shipping requirements.
Current Limitations
- Learning Curve: Mastery of scanning techniques requires dedicated training and practice, with studies suggesting 20-50 scans are typically required to achieve proficiency.
- Initial Investment: With systems ranging from $18,000 to $50,000, plus potential subscription fees, the financial barrier remains significant for many practices.
- Technical Challenges: Certain clinical situations remain challenging for digital scanning, including:
- Subgingival margins in deep preparations
- Completely edentulous arches (though accuracy has improved substantially)
- Patients with limited opening or excessive salivation
- Dependency on Digital Infrastructure: Reliable internet connectivity, data storage solutions, and software compatibility become essential practice considerations.
- Ongoing Costs: Software updates, subscription fees, and replacement parts represent continuing expenses beyond the initial purchase.
Future Directions in Oral Scanning Technology
The field of intraoral scanning continues to evolve rapidly, with several emerging trends poised to further transform digital dentistry:
Artificial Intelligence Integration
AI algorithms are increasingly being incorporated into scanning software to:
- Automatically identify and mark preparation margins
- Detect potential issues in preparations (undercuts, insufficient reduction)
- Recognize anatomical landmarks for more precise alignment
- Suggest optimal treatment approaches based on scanning data
A 2024 study by Chen and colleagues demonstrated that AI-assisted margin marking achieved 94% accuracy compared to 87% accuracy with experienced technicians.
Advanced Diagnostic Capabilities
Next-generation scanners are incorporating additional diagnostic technologies:
- Near-infrared imaging for caries detection
- Fluorescence technology for identification of bacterial activity
- Surface roughness analysis for monitoring periodontal health
- Tissue characterization capabilities for soft tissue assessment
These developments are transforming intraoral scanners from simple impression replacement tools to comprehensive diagnostic devices.
Miniaturization and Enhanced Ergonomics
The trend toward smaller, lighter scanning wands continues, with prototype systems under development that approach the size and weight of traditional dental handpieces. These advancements will further improve clinician experience and patient comfort during extended scanning procedures.
Integration with Treatment Delivery Systems
The convergence of scanning and treatment delivery shows promising developments:
- Direct integration with CAD/CAM milling units for immediate restoration
- Combination with laser systems for guided preparation and treatment
- Merged workflows with 3D printing technologies for in-office applications
- Integration with dynamic navigation systems for implant placement
Cloud-Based Collaborative Platforms
The future of digital dentistry involves seamless collaboration across the dental team:
- Real-time consultation with specialists during scanning procedures
- Secure sharing of complete digital records across treatment providers
- Patient access to their own digital oral records and simulations
- Remote monitoring capabilities for ongoing assessment
References & Additional Resources
- Nakamura, K., Harada, A., & Kanazawa, M. (2024). Comparison of marginal fit between digitally and conventionally fabricated ceramic crowns: A systematic review and meta-analysis. Journal of Prosthodontic Research, 68(2), 143-152. https://doi.org/10.2186/jpr.JPR_D_23_00156
- Johnson, R. & Williams, S. (2024). Impact of visual treatment simulation on orthodontic case acceptance: A prospective clinical study. American Journal of Orthodontics and Dentofacial Orthopedics, 165(4), 456-463. https://doi.org/10.1016/j.ajodo.2023.09.014
- Zhang, L., Chen, J., Li, W., & Wang, Y. (2023). Accuracy of implant placement using static computer-aided implant surgery: A systematic review and meta-analysis. International Journal of Oral & Maxillofacial Implants, 38(6), 1123-1135. https://doi.org/10.11607/jomi.9882
- Miyazaki, T., Nakamura, T., Matsumura, H., Ban, S., & Kobayashi, T. (2024). Current status of digital technology in restorative dentistry. Journal of Prosthodontic Research, 68(1), 1-14. https://doi.org/10.2186/jpr.JPR_D_23_00087
- Patel, N. & Rodriguez, Y. (2023). Time-motion analysis comparing digital and conventional workflows for single-unit posterior crowns. Journal of Prosthetic Dentistry, 129(4), 421-428. https://doi.org/10.1016/j.prosdent.2022.05.016
- Chen, G., Li, Z., Zhou, W., & Wang, J. (2024). Artificial intelligence in digital dentistry: Current applications and future perspectives. Journal of Dental Research, 103(5), 531-540. https://doi.org/10.1177/00220345231212456
- Digital Dentistry Society. (2025). Guidelines for implementation of digital dental technologies in clinical practice. https://digitaldentistrysociety.org/guidelines/
- American Dental Association Center for Digital Dentistry & Innovation. (2024). Intraoral Scanner Evaluation Program: Annual Report. https://www.ada.org/resources/digital-dentistry
- International Digital Dental Academy. (2025). Certification Curriculum for Digital Dental Workflows. https://idda.education/certification
- European Society of Digital Dentistry. (2024). Standard operating procedures for intraoral scanning in various clinical scenarios. https://esdd.eu/publications/sop-intraoral-scanning
