How the iTero Scanner Replaces Messy Impressions

A small wand is moved slowly over the teeth and gums, capturing thousands of frames per second. Software stitches them together in real time into a full-colour three-dimensional model that appears on screen as it is built.

Because the model is being constructed live, gaps are obvious immediately and can be filled by passing over the area again. Compare that with a physical impression, where a flaw is often discovered only after the material has set — or worse, after the lab has received it.

The finished scan is a digital file. It does not shrink, warp, or degrade, it can be duplicated infinitely, and it can be sent to a laboratory or a planning workstation instantly rather than couriered as a box of plaster.

Digital scans have been shown to be as accurate as, and in many contexts more accurate than, conventional impressions — particularly for the fine marginal detail that determines whether a restoration seals properly.

The reason is elimination of cumulative error. A physical workflow stacks distortion at every stage: material setting, tray removal, disinfection, stone pouring, and curing. A digital workflow has one capture, and everything downstream is a mathematical operation on that same data.

There is also the matter of the retake. When a physical impression fails, the patient returns and the whole process repeats. When a scan has a deficiency, it is corrected in seconds while the patient is still in the chair.

This is the part that matters most in an oral surgery practice, and it is the reason scanning is not merely a comfort upgrade.

The iTero scan captures the surface of the teeth and gums with high precision. The CBCT scan captures the bone, nerves, and sinuses beneath. Merging the two produces a single model containing both — and implant planning requires exactly that, because an implant has to be positioned correctly relative to the bone that will hold it and the teeth it has to function with.

From that merged model, the 3D-printed surgical guide is designed. The guide seats on the tooth or tissue surfaces captured by the iTero scan, and it directs the drill along the trajectory planned in the CBCT volume. If the surface scan is inaccurate, the guide does not seat correctly and the accuracy of the whole plan is lost. Precision at this step is not cosmetic.

The same data drives occlusal splint fabrication for TMJ patients, bite analysis, provisional and definitive prosthesis design for full-arch cases, and surgical stents for grafting.

No trays, no putty, no setting time, and no gagging. The wand is small and the scan is performed in short passes with breaks whenever you want one, which makes it manageable for patients with strong gag reflexes who could not tolerate impressions at all.

It is faster — a full-arch scan takes a few minutes rather than multiple sets of impressions across a longer appointment.

And you see it. The model appears on screen in colour and can be rotated, magnified, and annotated while your treatment is explained. Patients understand a recommendation about a fractured cusp or a recession defect far better when looking at their own tooth in three dimensions than when listening to a description of it.

Scans are also archived, so a scan taken today can be overlaid on one taken in two years to show wear, recession, or tooth movement objectively rather than from memory.

Digital scanning has replaced the great majority of impressions in this practice, but honesty requires noting the exceptions. Some complete denture workflows still benefit from a physical impression that captures the functional movement of the soft tissue borders, because that information comes from tissue in motion rather than tissue at rest.

Very deep subgingival margins in a bleeding field can also defeat an optical scanner, since the camera cannot record a surface it cannot see. Tissue management or a hybrid approach solves that, and the decision is made at the appointment rather than assumed in advance.

For everything relevant to surgical planning — implant sites, full-arch cases, splints, guides, and bite records — the digital scan is both the more accurate and the more comfortable option, which is why it is the default at Diamond Arch.