Building on the foundational concepts introduced in Part 1 (published in the March 2025 issue of Dentistry Today), this article delves into practical applications of intraoral scanning (IOS) and intraoral photogrammetry (IPG) for full-arch implant workflows. By leveraging a streamlined digital process, clinicians can achieve unparalleled accuracy in implant positioning, optimize prosthetic design, and improve overall treatment efficiency.
Through a series of case demonstrations, we explore the integration of IOS and IPG in both dentate and edentulous arches, highlighting how these technologies simplify data acquisition, enhance scan matching, and eliminate common challenges in full-arch restorations. Additionally, we discuss the impact of IPG on surgical workflows, its advantages over traditional scanning techniques, and how it sets a new standard for digital implant dentistry. This second installment provides a deeper understanding of how IOS and IPG work in real-world scenarios, showcasing their potential to improve predictability, efficiency, and patient outcomes.
Case Demonstration: Dentate Arches
For healed ridges after implant placement, a simplified workflow is employed by leveraging both IOS and IPG technologies. If a provisional prosthesis is present, an initial intraoral scan of the prosthesis, opposing arch, and occlusion is conducted (Figure 1). Once this is captured, the provisional is removed, and a subsequent intraoral scan is performed to document the multiple-unit abutments in relation to the soft tissue (Figure 2). Following this, high-accuracy coded scan bodies are installed onto the abutments (Figure 3). The IPG camera is then utilized for a quick photogrammetric capture of these scan bodies, ensuring that the acquisition overlaps the horizontal scan bodies relative to one another for enhanced precision. Increasing the number of overlapping images obtained allows for faster and more accurate registration of each scan body within the software.
Next, the workflow transitions back to the IOS camera, which is used for scan matching (Figure 4). To optimize results, capturing at least 2 sides of the arch is recommended. The scan bodies and soft-tissue data will automatically merge, providing a comprehensive virtual digital model. At this stage, the coded scan bodies can be digitally converted (Figure 5) into the preferred scan body type (by manufacturer), as the software supports an extensive library of options. Once complete, the final file is exported or transmitted via the cloud to the laboratory of the clinician’s choice for further processing and prosthetic fabrication.
The most intriguing application of the combined IOS/IPG device is in the realm of surgical interventions. A major challenge when using photogrammetry in surgical cases has been the maintenance or adjustment of the vertical dimension of occlusion (VDO). Traditionally, EPG systems have relied on fiducial markers, which can be effective but present difficulties in accurately matching in third-party software post-surgery. This can often necessitate the use of pre- and post-surgical CBCT scans with radiopaque markers to determine VDO and bone reduction. However, this method introduces additional radiation exposure and presents challenges in acquiring clean images, particularly after prolonged surgical procedures.
The scan-matching capabilities of IPG have proven to be highly beneficial in overcoming these challenges. For dentate surgical cases, preserving a few strategic teeth before extractions (Figure 6) can greatly simplify the matching process for the scan bodies. Initial scans are taken with the remaining teeth, capturing the opposing arch and occlusion. After nonessential teeth are extracted, bone reduction, if necessary, can be performed, implants placed, and multi-unit abutments (MUAs) installed. Once the abutments are in place, scan bodies are inserted and captured using the IPG camera. The IOS system then matches these scan bodies to the remaining teeth, ensuring a seamless alignment. After this step, the remaining teeth can be removed, grafting can be performed as needed, and a final tissue scan can be captured, providing data for the emergence profile and pontic site design. An all-in-one project file can then be utilized for prosthetic design.
If the preserved teeth are not ideally positioned or interfere with the surgical procedure, alternative fiducial markers (Figure 7a) can be used to facilitate scan matching (Figure 7b). Bone screws, surgical bars, or other stable reference points can be employed, as the software is capable of recognizing any device that remains consistently present from the initial scan through the duration of the surgery (Figure 8). These markers or remaining natural teeth help maintain the VDO throughout the entire surgical and design process, ensuring accuracy and predictability for the final restorative outcome.
Case Demonstration: Edentulous Arches
For patients with edentulous arches, utilizing a well-fitting denture can greatly enhance the efficiency and accuracy of data acquisition (Figure 9). One conventional method involves applying a denture wash impression to capture the healing caps, which provides a stable reference for matching IPG scans (Figure 10). This technique is similar to extraoral photogrammetry, where a 360° scan of the denture wash is performed to capture comprehensive data. Alternatively, small openings can be created within the denture to accommodate fiducial markers, establishing reliable reference points relative to the removable prosthesis. These markers enable precise alignment of the IPG scans with IOS data, ensuring that the VDO remains consistent throughout the procedure. Once this alignment is verified, a detailed soft-tissue scan is performed to capture essential data for pontic site design, which can then be integrated into an all-in-one project file for streamlined prosthetic planning and fabrication.
These advanced techniques highlight the versatility and precision of the integrated IOS/IPG workflow, offering a robust solution for both routine and complex implant cases. By leveraging the strengths of photogrammetry and intraoral scanning, clinicians can achieve higher levels of accuracy, minimize chair time, and help in delivering highly precise transitional prosthetics faster without the need for a conversion prosthesis. This increases confidence in delivering interim transitional screw-retained prostheses or final monolithic full-arch prosthetics and, ultimately, improves patient outcomes. This integration sets a new standard for digital workflows in implant dentistry, paving the way for more predictable and efficient management of complex restorative procedures.
DISCUSSION
The Benefits of IPG
IPG technology presents numerous benefits that make it an appealing option for clinicians working on complex implant cases. First, the system offers enhanced accuracy when compared to traditional intraoral scanners that often struggle to maintain precision over larger areas, leading to distortions and poorly fitting restorations. IPG overcomes these challenges by utilizing coded markers that establish a stable reference throughout the scanning process, ensuring high precision even in full-arch cases. Recent trials have indicated that IPG can achieve positional accuracy of less than 20 µm in multi-implant scenarios, making it one of the most precise digital methods available today. One of the key advantages of IPG technology is its streamlined workflow, which simplifies the digital process by capturing all necessary data in a single scan and efficiently converting the files. This eliminates the need for multiple scans or manual alignment of data points, enabling clinicians to transition seamlessly from scanning to designing and fabricating the restoration. The integration of fiducial markers within the workflow further ensures precision by maintaining consistent alignment throughout the entire surgical procedure. In complex cases where preserving some natural teeth is necessary, utilizing fiducial markers—such as bone screws or foundation bars—up until scans are completed allows for continuous and accurate software alignment without interruptions.
In addition to improved accuracy and workflow efficiency, IPG significantly reduces chair time. By capturing both implant positions and surrounding soft tissue in a single pass, the overall time required for impression-taking is substantially minimized. This leads to shorter patient appointments, fewer retakes, and an overall enhancement of the clinical workflow. The simplified, all-in-one device configuration of IPG has demonstrated the potential to considerably reduce chair time compared to traditional impression techniques, offering a substantial time-saving advantage for clinicians and patients. The minimization of errors is another critical benefit of IPG technology. The implementation of coded markers ensures precise recording of all implant positions, significantly lowering the risk of alignment discrepancies that are often observed with conventional intraoral scanning methods. This heightened accuracy results in a more predictable outcome and a superior fit for the final prosthetic, thereby decreasing the likelihood of adjustments or costly remakes. Additionally, these markers can be converted into scan bodies, allowing them to be exported as unified project files, which helps mitigate technical errors during subsequent CAD software processing.
Lastly, IPG allows for comprehensive data capture. The ability to capture hard and soft tissues in a single scan, results in a digital model that is a more complete and accurate representation of the patient’s oral anatomy. This comprehensive capture leads to better-fitting prosthetics, fewer adjustments during the restorative phase, and an overall more efficient treatment process. With all these advantages, IPG is setting new standards for accuracy, workflow efficiency, and patient satisfaction in complex implant dentistry (Table 1).
The Future of IPG Technology
As with any emerging technology, the true potential of IPG is still being explored. Future advancements include the integration of artificial intelligence (AI) driven software that can further enhance accuracy by automatically detecting and correcting minor errors during the scanning process. AI has the potential to refine the scanning process by identifying and addressing inconsistencies in real-time, providing immediate feedback to clinicians, and reducing the risk of inaccuracies. Another area of potential growth is the development of multi-modal imaging systems that combine IPG with other imaging technologies, such as CBCT and facial scanning. This integration enables clinicians to create a comprehensive digital model or dental avatar that includes intraoral and extraoral structures, providing a more holistic view of the patient’s anatomy. Multi-modal systems can help clinicians better understand the relationship between implants, facial structure, and contours, improving treatment planning and outcomes.
The integration of these technologies not only provides a more detailed digital representation of the patient’s anatomy but also allows for better communication and collaboration among dental professionals. For example, orthodontists, oral surgeons, and prosthodontists could work together using a single, unified digital model to plan and execute complex treatments more effectively. This collaborative approach leads to more predictable results and a higher standard of care for patients. The adoption of IPG technology in full-arch implant procedures has the potential to significantly impact clinical outcomes and patient satisfaction. One of the most important benefits of IPG is its ability to provide a more accurate digital model without the need for a verification index or physical model, which is faster, less invasive for the patient, and provides better-fitting restorations. A well-fitting prosthetic not only enhances the patient’s comfort and function but also reduces the risk of complications such as peri-implantitis, bone loss, and prosthetic or even implant failure. Additionally, IPG technology allows for the expedited creation of digital mockups and simulations that can be used to educate patients about their treatment options. By visualizing the potential final outcome before the procedure is completed, patients can have a clearer understanding of the treatment process and what to expect. This transparency can help build trust and improve patient compliance, as they feel more involved in the decision-making process. Moreover, IPG enables a more streamlined workflow, reducing the time required for impression-taking and prosthetic fabrication, using only one device instead of 2. This efficiency translates into shorter treatment times, fewer appointments, and less time spent in the dental chair for patients. For individuals undergoing complex full-arch restorations, this reduction in treatment time can significantly improve their overall experience and satisfaction. In desired cases when timing is essential and with a fully equipped dental office, it is possible to (1) surgically place implants; (2) scan the patient with IPG technology; and (3) send off the files to the lab technician, who can immediately design a full-arch, screw-retained prosthesis. The lab technician sends the STL file back to the office where it is 3D printed, stained, glazed, and delivered to the patient on the same day.
The Path Forward: Integrating IPG Into Routine Practice
The journey to integrating IPG into routine practice begins with understanding its role in enhancing the accuracy and predictability of full-arch implant procedures. Successful integration requires not only investing in technology but also investing in training and support. Dental professionals must be adequately trained to handle the nuances of photogrammetry, from fiducial marker placement to data interpretation, to leverage the full potential of IPG systems.
Implementing IPG also requires a shift in mindset, from a traditional IOS or impression-taking approach to a more sophisticated, data-driven process. Practices must consider how IPG fits into their current workflows and are willing to adjust as needed to accommodate the new technology. This may involve upgrading existing equipment, revising digital workflows, and adopting new protocols for capturing and analyzing implant positions. Collaboration with technology providers and ongoing professional education will be key to making this transition successful.
As digital technologies continue to evolve and become more accessible, the boundaries of what is possible in dental implantology will continue to expand. Intraoral photogrammetry is just one example of how innovation is reshaping the field, offering clinicians new tools to enhance precision, streamline workflows, and improve patient outcomes. By embracing these advancements, dental professionals can stay at the forefront of their field and continue to provide the highest standard of care.
CONCLUSION
IPG represents a new standard in digital dentistry for full-arch implant capture. By combining the precision of photogrammetry with the convenience of intraoral scanning, IPG offers a streamlined, accurate, and patient-friendly solution that addresses many of the challenges associated with full-arch restorations. As technology continues to evolve with new devices and supporting software applications, its adoption is likely to grow, paving the way for even more sophisticated and efficient digital workflows in implant dentistry. For clinicians and patients alike, IPG offers a glimpse into the future of digital dentistry, one where precision, efficiency, and patient comfort are no longer mutually exclusive. With its ability to transform how full-arch cases are approached and completed, IPG is poised to become a cornerstone technology in the ever-advancing field of digital dental implantology.
In conclusion, intraoral photogrammetry is more than just a new technology. It represents a paradigm shift in how full-arch implant cases are approached and executed. As it becomes more widely adopted, its impact on the field of digital dentistry will only grow, setting the stage for a future in which digital workflows are not just an option but the standard of care for complex restorative and implant procedures. For clinicians and patients, this evolution promises a future of precise, faster, and more predictable treatment outcomes. As digital workflows continue to evolve, the adoption of intraoral photogrammetry is expected to become the new gold standard in full-arch dental implantology.
ABOUT THE AUTHORS
Dr. Tawil received his DDS degree from the New York University College of Dentistry and has a Master’s degree in biology from Long Island University. He is co-director of Advanced Implant Education (AIE). He is a Diplomate of the International Academy of Dental Implantology as well as a Fellow of the International Congress of Oral Implantologists (ICOI) and the Advanced Dental Implant Academy. He also received recognition for outstanding achievement in dental implants from the Advanced Dental Implant Academy. He maintains a general private practice in Brooklyn, NY, where he focuses on implant therapy. He can be reached at tawildental@gmail.com.
Dr. Ganz has published in many scientific journals for more than 5 decades and contributed to 22 professional textbooks. He presents nationally and internationally on the prosthetic and surgical phases of implant dentistry. Dr. Ganz is a Fellow and Diplomate of the Academy of Osseointegration (AO), Fellow of International College of Dentists, and co-director of AIE. Dr. Ganz has been past president of the NJ section of the American College of Prosthodontists; past board of director of Digital Dentistry Society (DDS) and the ICOI; past president of the CAI Academy; and is currently on the board of directors of the Clean Implant Foundation. Dr. Ganz maintains a practice in Fort Lee, NJ, and is director of full-arch implant reconstruction in the heart of Manhattan, NY. He was recently honored for his lifetime achievements in implant and digital dentistry by the American Academy of Implant Dentistry and the DDS. He can be reached at drganz@drganz.com.
Dr. Pozzi has been in practice since 1997, specializing in oral surgery, orthodontics, and TMJ dysfunctions. He is licensed by the Italian General Dental Council of Rome and by the UK General Dental Council of London. He is a clinical researcher and professor at University of Rome Tor Vergata, adjunct associate professor at Goldstein Center for Esthetics and Implant Dentistry, Augusta University, August, Ga; adjunct clinical professor department of periodontics and oral medicine at the University of Michigan School of Dentistry; and lecturer at Harvard School of Dental Medicine, department of restorative and biomaterials sciences. He is a Fellow of AO. Dr. Pozzi is widely published and an international awards winner for his clinical research. He is the founder of the Pozzi Institute in Rome, where he has been training colleagues from all over the world. He is recognized as a global expert in digital implant dentistry and advanced technologies. He can be reached at his Instagram handle @profpozzi and his Facebook handle @alessando.pozzi.
Disclosure: Dr. Ganz receives lecture honoraria from and is a key opinion leader for SHINING 3D Dental. Dr. Tawil is clinical director of SHINING 3D. Dr. Pozzi reports no disclosures.
This article was first published online in the International Magazine of Digital Dentistry and is reprinted with permission by Dental Tribune International.
There will be a FREE CE WEBINAR that will act as a companion to this article.
It will take place on June 5 at 7 PM (Eastern Time).
Join leading experts Drs. Tawil, Ganz, and Pozzi for a cutting-edge webinar that explores the transformative power of intraoral photogrammetry (IPG) and intraoral scanning (IOS) in full-arch implant workflows. Building on foundational concepts, this session dives into real-world applications, showcasing how a fully digital approach streamlines clinical procedures, improves implant accuracy, and elevates patient outcomes.
Attendees will gain practical insights through detailed case demonstrations in both dentate and edentulous arches. Learn how to optimize prosthetic design, eliminate traditional workflow inefficiencies, and leverage scan-matching techniques for surgical precision.
Key topics include:
Seamless integration of IOS and IPG for full-arch restorations
Advantages of IPG over traditional scanning and photogrammetry methods
Real-time digital workflows for immediate prosthetic delivery
Using fiducial markers and coded scan bodies for enhanced scan accuracy
Future-forward technologies including AI integration and multi-modal imaging
Whether you’re a seasoned implantologist or embracing digital dentistry, this webinar will equip you with tools to enhance precision, efficiency, and patient satisfaction in your implant practice. Register now to stay ahead in the rapidly evolving landscape of digital implantology.
