Smart fusion vs. double scan: a comparison between two data-matching protocols for a computer guided implant planning

Aim: To make a comparison between two different approaches of data matching during the preparation of a computer guided implant planning. Material and methods: Electronic and manual literature searches were performed to collect information about the double-scan protocol and the smart fusion protocol. The two systems were then tested to identify or confirm their advantages and disadvantages. Results: The double scan protocol is a reliable and well-known process to obtain a fusion between the anatomical data (CBCT) and the prosthetic data (radiographic template). It is possible to use this protocol both in dentate and edentulous patients. The newly developed smart fusion technique offers the possibility to superimpose the anatomical data (CBCT) onto the prosthetic data (cast + wax-up scan) without the production of a radiographic template. This system is still being tested by the clinicians even though dental manufacturers already consider it as the best solution for the dentate patients selected for a static computer guided implant surgery. Conclusions: Smart fusion protocol offers a reasonable time and cost reduction even though its application is limited to dentate patients. A noticeable drawback of the workflow is the matching step: often a manual intervention is necessary to obtain a correct alignment of the CBCT data with the lab scan of the cast. This issue is partially due to the use of non-volume stable materials during the preparation of the cast. Future improvements could be made by combining CBCT data with direct optical scans of patient dental arches in order to create the so-called 'virtual patient'.