Comparison of Intraoral Scanning and Cone-Beam Computed Tomography for Implant Position in Edentulous Patterns

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OBJECTIVE: This study aimed to assess the accuracy of intraoral scanning (IOS) for postoperative implant position evaluation in comparison with cone-beam computed tomography (CBCT) across different partially edentulous patterns. MATERIALS AND METHODS: We retrospectively analysed 172 patients who underwent implant placement between January 2020 and January 2025. Patients were classified into six clinical subgroups according to edentulous configuration. Nonfree-end patterns were defined as tooth-bounded edentulous spaces with remaining teeth on both sides, whereas free-end patterns lacked a distal tooth-supported reference. IOS- and CBCT-derived postoperative implant positions were compared using shoulder and apical deviations, buccolingual, mesiodistal, and vertical components, and angular deviations. RESULTS: A total of 172 patients with 278 implants were included. The within-group analysis indicated no statistically significant difference between IOS and CBCT measurements in the single tooth and nonfree-end subgroup (Group A). Conversely, the free-end subgroups (Groups B, C, and F) exhibited greater deviations, particularly the unilateral multiple-tooth free-end subgroup (Group C), which demonstrated a significantly different buccal-lingual angular deviation (P < .05). Between-group comparisons confirmed greater discrepancies in free-end than in nonfree-end patterns. Vertical and apical deviations contributed most prominently to subgroup differentiation. The findings from linear discriminant analysis and leave-one-out cross-validation indicated that there was overlap in the deviation performance across edentulous patterns. Nevertheless, vertical displacement, particularly apical deviation, emerged as the most significant indicator for differentiating the characteristic deviations associated with each group. CONCLUSION: IOS showed better concordance with CBCT in nonfree-end edentulous patterns than in free-end patterns. However, greater variability in free-end cases, particularly in apical and angular measurements, indicates that IOS-based postoperative assessment should be interpreted according to the clinical edentulous pattern. These findings suggest a promising but indication-dependent clinical application of IOS for postoperative implant position assessment.

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