One of the key challenges in intraoral scanning for removable prosthetics—particularly fully edentulous arches—lies in the lack of fixed anatomical landmarks and tissue retraction.1 These factors often lead to errors in image stitching and arch alignment. This is especially problematic when scanning soft, mobile tissue, such as the vestibules, which can easily distort under retraction or patient movement.2,3 However, many of these challenges have been overcome with the introduction of various streamlined scanning strategies and retraction methods, in particular by Lucio Lo Russo, DDS, PhD.4
For partially edentulous patients, additional obstacles include capturing undercut areas and posterior segments with limited access, as well as capturing centric relation in maximum intercuspation (MIP) when significant mobility is present. However, even in patients with mobile teeth, digital intraoral scanning—where each arch is scanned separately and then related in MIP, the digital workflow minimizes distortion and allows for precise alignment of arches in MIP, which is often more reliable than traditional material-based impressions and stone casts.5 Ensuring scan continuity across both existing teeth and edentulous spans further complicates the process.6
Another challenge that is now being increasingly addressed is the reliable capture of reference dentures.7 Earlier generations of intraoral scanners (IOS) often struggled with gloss, translucency, and rounded surfaces of acrylic denture bases and teeth. However, modern scanners, such as 3Shape TRIOS, Medit i700, PrimeScan 2, and iTero Lumina, are significantly more capable of capturing data for removable prosthetic indications. This includes scanning existing dentures used as references for new prostheses or as diagnostic tools for full-arch implant treatments.
The development and validation of the reference denture scan strategy, which I co-developed with 3Shape, was instrumental in expanding the company’s capabilities in scanning dentures.8 This approach—using the patient’s current denture as a scanning guide—established a repeatable and accurate method for capturing negative impressions of soft tissue form, occlusal relationships, and esthetic preferences. It has also become foundational in training clinicians to confidently adopt IOS for digital dentures and immediate workflows.
According to the 2023 Materials & Equipment Survey, 3Shape continues to lead CAD/CAM adoption among North American dental laboratories, while exocad is the second-most-used platform, favored for its open architecture and implant workflow integration.9
Today, many IOS are equipped with artificial intelligence (AI)–driven features, faster frame rates, improved depth perception, and advanced scan path guidance. These innovations have made IOS more effective than ever for removable prosthetic indications.
Overcoming Challenges
To overcome the challenges associated with intraoral scanning for removable prosthetics, at Aspen Dental we implement defined scanning protocols tailored to all restorative indications with an emphasis on edentulous workflows. Additionally, clinician training combined with the use of AI-powered scan tools plays a critical role in ensuring scan integrity and design-ready datasets. Moreover, none of this is possible without our robust training and education programs lead through our collaboration with our learning and development teams at The Aspen Group University (TAG U).
Advancements in Scanner Technology
Advancements in scanner technology have fundamentally transformed the approach we recommend for restorations. Although photogrammetry remains the gold standard for capturing implant positions due to sub-10 µm accuracy, new innovations such as TruAbutment IO Connect, Straumann Exact, Straumann RevX, and Medit’s Smart Scan Filtering have dramatically increased intraoral scan fidelity for full-arch restorations.10,11 These improvements stand to reduce cost barriers and enable the adoption of All-on-X workflows.12
Photogrammetry systems like iCam4D, PIC, Shining 3D still offer the highest precision in passive fit applications, but hybrid workflows now make it feasible for many clinicians to start full-arch cases digitally without dedicated photogrammetry.13,14
Investing in Your First Scanner
When a dental laboratory is taking its first steps into digital workflows, one of the most strategic decisions it will face is choosing between an IOS and a desktop (benchtop) scanner. Each offers unique benefits depending on the lab’s service model, client base, and long-term goals (Table).
Strategic Recommendations
For most dental labs starting out, a desktop scanner is the preferred entry point. It offers a fast, stable, and scalable way to digitize both analog impressions and gypsum models, while supporting a broad array of indications including crowns, bridges, full dentures, implant bars, and hybrid prosthetics.
A desktop scanner ensures consistency and efficiency in a lab-controlled environment. It’s also more feasible for labs serving clients over a broad geographic area, where chairside deployment of an IOS would not be practical.
However, labs aiming to collaborate closely with local clinicians—especially for real-time chairside support, immediate case turnaround, or All-on-X workflows—may benefit from owning an IOS. This can be a powerful differentiator in competitive markets where onsite scanning services and same-day workflows are increasingly demanded.
It is important to recognize that virtually all dental laboratories are capable of accepting intraoral scans from clinicians—provided the scans are properly captured and exported according to the lab’s preferred protocols and digital workflow requirements.
Key Features
When evaluating IOS—regardless of scanner type—there are several key features that dental laboratories should prioritize. Open-system compatibility with platforms like exocad and 3Shape ensures seamless integration into existing digital workflows.15,16 Scanners that capture color and texture are essential for accurately recording soft tissue, shade tabs, and clinical markings. High trueness and precision (≤10 µm for fixed; ≤20µm for removable) are critical. Automated workflows for scanning dies, full arches, and occlusion records can significantly streamline lab processes. Finally, scan speed and ease of use directly impact technician efficiency, making these factors vital for high-throughput environments.
Closing Comments
As digital dentistry continues to evolve, so too does our ability to manage the complexities of scanning edentulous and partially edentulous arches with greater confidence. Although analog methods still have their place, the integration of IOS, advanced file formats like .DCM, and AI-driven software tools have significantly enhanced what is possible—both clinically and operationally.
At Aspen Dental, we are committed to the unique needs of every case, patient, and practice. That’s why we approach digital workflows not as a one-size-fits-all solution, but as a growing toolkit that empowers clinicians and lab teams to choose the best path forward for each situation.
Eric Kukucka, DD
VP, Clinical Removable Prosthetics and Design Technologies
Aspen Dental
Chicago, Illinois
References
1. Kontis P, Güth JF, Schubert O, Keul C. Accuracy of intraoral scans of edentulous jaws with different generations of intraoral scanners compared to laboratory scans. J Adv Prosthodont. 2021;13(5):316-326.
2. Ender A, Mehl A. Accuracy of complete-arch dental impressions: a new method of measuring trueness and precision. J Prosthet Dent. 2013;109(2):121-128.
3. Papaspyridakos P, Chen CJ, Gallucci GO, et al. Accuracy of implant impressions for partially and completely edentulous patients: a systematic review. Int J Oral Maxillofac Implants. 2014;29(4):836-845.
4. Lo Russo L, Sorrentino R, Esperouz F, et al. Assessment of distortion of intraoral scans of edentulous mandibular arch made with a 2-step scanning strategy: a clinical study. J Prosthet Dent. 2025;134(1):151-159.
5. Ender A, Zimmermann M, Mehl A. Accuracy of complete- and partial-arch impressions of actual intraoral scanning systems in vitro. Int J Comput Dent. 2019;22(1):11-19.
6. Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017;17:149.
7. Kukucka E. Reference denture scanning: a predictable digital pathway for immediate dentures. In: Cortes ARG, ed. Digital Dentistry: A Step-by-Step Guide and Case Atlas. Wiley; 2020.
8. Kukucka E. The Reference Denture Protocol. 3Shape; 2021. https://www.3shape.com/en/ebooks/digital-dentures-reference-protocol. Accessed June 27, 2025.
9. 2023 Materials and Equipment Survey. National Association of Dental Laboratories. https://nadlonlinestore.payscapecommerce.com/2023-Materials-and-Equipment-Survey-Full-Survey-Including-Executive-Summary-p646352260. December 2023. Accessed June 27, 2025.
10. IO Connect system overview. TruAbutment. 2024. https://truabutment.com/io-connect. Accessed June 27, 2025.
11. Straumann Exact Workflow brochure. Straumann. 2023. https://www.straumann.com/en/dental-professionals/products-and-solutions/exact-workflow.html. Accessed June 27, 2025.
12. Papaspyridakos P, Chochlidakis K, Kang K, et al. Digital workflow for implant rehabilitation with double full-arch monolithic zirconia prostheses. J Prosthodont. 202;29(6):460-465.
13. Papaspyridakos P, Gallucci GO, Chen CJ, et al. Digital versus conventional implant impressions for edentulous patients: accuracy outcomes. Clin Oral Implants Res. 2016;27(4):465-472.
14. Papaspyridakos P, Bedrossian A, Kudara Y, et al. Reverse scan body: A complete digital workflow for prosthesis prototype fabrication. J Prosthodont. 2023;32(5):452-457.
15. Lab Scanner Portfolio Overview. 3Shape. 2023. https://www.3shape.com/en/lab-scanners. Accessed June 27, 2025.
16. exocad Insights Global Adoption. Exocad. 2023. https://www.exocad.com/insights/global-adoption. Accessed June 27, 2025.
Figures and Images
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