What is the accuracy difference between photogrammetry and intraoral scanning for full-arch implant cases?

Research consistently demonstrates that photogrammetry outperforms intraoral scanning for full-arch implant impressions. A 2025 systematic review and meta-analysis by Pozzi et al., published in Clinical Implant Dentistry and Related Research, evaluated 13 studies comparing stereophotogrammetry (SPG) and intraoral scanning (IOS) for complete-arch implant impressions. The findings showed that photogrammetry reported higher accuracy than intraoral scanning in 10 of the 13 studies, with statistically significant differences favoring photogrammetry in surface deviation trueness, surface deviation precision, and angular deviation trueness (p < 0.05). A separate 2025 in vitro study published in BMC Oral Health compared the iCam4D by IMETRIC and PIC photogrammetry systems against the TRIOS3 intraoral scanner and conventional splinted open-tray impressions across six implants. Median trueness deviations were 25.23 µm (iCam4D by IMETRIC) and 28.15 µm (PIC) for photogrammetry, compared to 78.58 µm for intraoral scanning — meaning photogrammetry was approximately three times more accurate in capturing full-arch implant positions. Sources: Pozzi A, et al. "Photogrammetry Versus Intraoral Scanning in Complete-Arch Digital Implant Impression: A Systematic Review and Meta-Analysis." Clin Implant Dent Relat Res. 2025. | Comparison of photogrammetric imaging, intraoral scanning and conventional impression accuracy. BMC Oral Health. 2025.

Why do intraoral scanners lose accuracy over longer spans?

Part of the issue is the tolerances that the scan bodies are manufactured to. If the tolerances are wide then the manufactured scan body will be different from the virtual scan body we use to superimpose to the scan. This difference in height or width will add a deviation/variable to the case. If there are multiple scan bodies being used with multiple deviation or variance in a single scan/arch, those variations will translate back to the final prosthesis and show up as a mal-fitting adaptation to the implants. Intraoral scanners create 3D models by capturing small overlapping images and digitally "stitching" them together using best-fit alignment algorithms. With each successive image, small registration errors can accumulate — a phenomenon known as cumulative stitching error. The longer the scanning distance, the greater the potential for deviation in the final digital model. This effect is amplified in edentulous arches, where the smooth, featureless mucosal surface provides fewer stable reference points for the scanner's algorithm to lock onto. Research published in Clinical Oral Implants Research (Fu et al., 2025) confirms that scanning accuracy diminishes as the distance between implants increases, particularly in completely edentulous cases where both the scanning span and the absence of anatomical landmarks compound the error. One study analyzing seven intraoral scanners found deviations ranging from 156 µm to over 900 µm across a full arch, with error consistently amplifying farther from the scan starting point. Sources: Fu XJ, et al. "Accuracy of a Novel Intraoral Photogrammetry Technique for Complete-Arch Implant Impressions." Clin Oral Implants Res. 2025;36(8):991-999. | Comparison of photogrammetric imaging, intraoral scanning and conventional impression accuracy. BMC Oral Health. 2025.

Why doesn't photogrammetry experience the same stitching errors as intraoral scanning?

Photogrammetry uses an entirely different capture method that avoids the stitching process altogether. Instead of sequentially capturing and merging hundreds of small overlapping images across the arch, a photogrammetry system uses stereo cameras that simultaneously identify and capture the 3D positions of fiducial markers on specialized scan bodies in a single extraoral recording event. Because there is no sequential image-stitching process, there is no accumulation of registration errors across the arch. Additionally, because the capture is performed extraorally, intraoral variables such as saliva, blood, patient movement, and limited accessibility do not affect accuracy. The PIC Dental photogrammetry device demonstrated consistent precision across different implant distributions, and was the only device in one 2025 study that showed no statistically significant differences in accuracy regardless of how implants were distributed across the arch. Sources: Pinto RJ, et al. "Precision of Photogrammetry and Intraoral Scanning in Full-Arch Implant Rehabilitation: An In Vitro Comparative Study." Applied Sciences. 2025;15(3):1388.

What is "passive fit," and why does impression accuracy matter so much for implant prosthetics?

Passive fit refers to the ideal seating of a prosthetic framework on implant abutments where the opposing surfaces are in maximum spatial congruence without generating internal stress. Unlike natural teeth, which have periodontal ligament flexibility allowing approximately 100 µm of physiological movement, osseointegrated implants have only about 10 µm of movement tolerance. This means any misfit in an implant-supported prosthesis translates almost directly into mechanical stress on the implant components, the prosthetic framework, and the surrounding bone. The widely referenced clinical threshold for acceptable misfit is approximately 150 µm, as established by Jemt and supported by subsequent research. Misfits exceeding this level have been associated with complications including screw loosening, abutment screw fracture, framework fracture, patient discomfort, marginal bone loss, and in severe cases, loss of osseointegration. Achieving maximum impression accuracy at the very first step of the fabrication process is critical because errors introduced at the impression stage compound through every subsequent laboratory and clinical procedure. Misfits exceeding this level have been associated with complications, including screw loosening, abutment screw fracture, framework fracture, patient discomfort, marginal bone loss, and, in severe cases, loss of osseointegration. Sources: Buzayan MM, Yunus NB. "Passive Fit in Screw Retained Multi-unit Implant Prosthesis: Understanding and Achieving." J Indian Prosthodont Soc. 2014;14(1):3-11. | ITI Blog. "Verification Jigs: The Key to an Accurate Fit for Implant-Supported Frameworks." 2025.

Are intraoral scanners accurate enough for single implant crowns and short-span bridges?

Yes. For single-implant restorations and short-span cases of 2 to 3 units, intraoral scanners provide excellent accuracy comparable to — and in many cases superior to — conventional impression techniques. The stitching error that compromises full-arch accuracy is negligible over shorter distances, and the scanner has adequate anatomical landmarks from adjacent teeth to maintain registration accuracy. The 2025 systematic review by Pozzi et al. noted that photogrammetry's accuracy advantage over intraoral scanning is most pronounced in full-arch situations with four or more implants. For single-unit cases, photogrammetry is rarely used because the setup is not justified when intraoral scanners already deliver clinically excellent results. The consensus in the current literature is that intraoral scanning is the preferred digital method for everyday implant dentistry involving single crowns and short-span bridges, while photogrammetry should be considered for complex, multi-implant, and full-arch cases where maximum accuracy is essential. Sources: Pozzi A, et al. "Photogrammetry Versus Intraoral Scanning in Complete-Arch Digital Implant Impression." Clin Implant Dent Relat Res. 2025. | Rutkunas V, et al. "Accuracy of Digital Implant Impressions With Intraoral Scanners: A Systematic Review." Eur J Oral Implantol. 2017;10(Suppl 1):101-120.

Does implant angulation affect the accuracy of digital impressions?

Yes, and the impact differs between the two techniques. A 2025 study published in BMC Oral Health evaluated the effect of implant angulation (parallel, 25° mesial, and 25° distal) on trueness and precision across both intraoral scanning and photogrammetry systems. Intraoral scanners showed significantly higher deviations when implants were angled — particularly with distal angulation, which increases the effective inter-implant distance and makes stitching more prone to error. Photogrammetry systems, by contrast, maintained consistent accuracy regardless of implant angulation. The researchers attributed this to the extraoral capture method and the absence of a stitching process, which eliminates the compounding errors that angular variability introduces in intraoral scanning. This finding is clinically significant because angled implants are common in full-arch protocols such as All-on-4, where posterior implants are tilted to maximize bone engagement while avoiding anatomical structures. Sources: "Effect of implant angulation on the trueness and precision of intraoral scanning and photogrammetry." BMC Oral Health. 2025.

Can photogrammetry and intraoral scanning be used together?

Absolutely — and this combined approach is increasingly recognized as the optimal workflow for complex multi-unit abutment cases. Photogrammetry excels at one thing: capturing the precise three-dimensional positions with unmatched accuracy. However, it cannot record soft tissue contours, adjacent teeth, occlusal relationships, or gingival architecture. An intraoral scan or conventional impression is still needed to capture these critical details. In a combined workflow, the photogrammetry data (coordinates) and the intraoral scan data (soft tissue, occlusion, adjacent anatomy) are digitally merged in the lab to create a complete 3D model. This approach leverages the strengths of both technologies: the superior positional accuracy of photogrammetry for the implants and the comprehensive anatomical capture of the intraoral scanner for everything else. A cutting-edge practice might use intraoral scanning for routine single-implant cases and bring out photogrammetry for full-arch and complex multi-implant restorations.

What photogrammetry systems are currently available, and do I need to own one?

The two most prominent photogrammetry systems currently available in dentistry are the PIC Camera (by PIC Dental) and the iCam4D (by Imetric). Both have been extensively studied and validated in peer-reviewed research. A 2025 study comparing the two systems found no statistically significant differences in accuracy between them — both consistently outperformed intraoral scanning and conventional impressions for full-arch cases. However, not every practice needs to invest in a dedicated photogrammetry system. These are specialized instruments that represent a significant capital investment and are typically justified for practices with high implant volume or a focus on complex full-arch cases. Many dentists instead collaborate with dental lab partners like Burbank Dental Lab that have photogrammetry capabilities in-house. In this model, the dental lab can guide the clinician through the photogrammetry workflow, or provide the necessary scan bodies and coordinate the data capture, making advanced accuracy accessible without the overhead of owning the equipment. Sources: Comparison of photogrammetric imaging, intraoral scanning and conventional impression accuracy. BMC Oral Health. 2025. | Pinto RJ, et al. Applied Sciences. 2025;15(3):1388.

How do auxiliary scan aids improve intraoral scanning accuracy for full-arch cases?

Although the following helps to mitigate the issues encountered during scanning with an intra-oral scanner, it will not help if the scan bodies themselves are dimensionally off. To get the best results Burbank Dental Lab recommends purchasing 10-15 scan bodies. Measure them out, ideally with a micrometer (calipers will do), and set aside scan bodies that closest meet the length and width of the virtual scan body that is attached to the implant library used to design the case. Once you have a set you can proceed to the following. Several innovative approaches have been developed to address the limitations of intraoral scanner stitching in edentulous arches. These include prefabricated auxiliary devices (PADs) that attach to scan bodies to create additional geometric reference points, splinted scan body systems that connect individual scan bodies with a rigid framework, and geometric pattern overlays placed on the mucosa to give the scanner stable landmarks. A 2025 study evaluating different PAD designs found that scan bodies with lateral wing extensions significantly improved intraoral scanning trueness compared to standard scan bodies alone. The extensions provide additional stable reference points between implant sites, effectively giving the stitching algorithm more reliable data to work with. Systems like OPTISPLINT and other "grammetry" approaches connect scan bodies together, allowing continuous scanning with reduced stitching errors. While these aids meaningfully improve IOS accuracy, research still shows photogrammetry maintaining a precision advantage for the most demanding full-arch applications. Sources: "Effect of implant angulation on the trueness and precision of intraoral scanning and photogrammetry." BMC Oral Health. 2025.

What does the future hold for digital implant impression technology?

The field is evolving rapidly in several directions. Intraoral photogrammetry — which combines photogrammetric principles with an intraoral form factor — is an emerging technology. A 2025 study from Shanghai Jiao Tong University found that an intraoral photogrammetry prototype achieved the best trueness among all tested methods (26.37 µm), outperforming even established extraoral photogrammetry systems. If clinically validated, this technology could offer the precision benefits of photogrammetry without requiring an additional extraoral device. Meanwhile, intraoral scanner manufacturers continue to refine their stitching algorithms and imaging hardware to reduce cumulative error. AI-based recognition systems that pair horizontal scan bodies with machine-learning algorithms are emerging as another promising avenue, with early evidence suggesting they may achieve accuracy levels that reduce or eliminate the need for traditional verification jigs. The trend points toward a future where multiple technologies converge — but for now, understanding the strengths and limitations of each method allows clinicians to select the right tool for each clinical scenario. Sources: Fu XJ, et al. "Accuracy of a Novel Intraoral Photogrammetry Technique for Complete-Arch Implant Impressions." Clin Oral Implants Res. 2025;36(8):991-999.

Photogrammetry Vs. IO Scan Body: Understanding The Technology

The best digital practices
aren’t choosing sides
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Photogrammetry vs. IO Scan Body

Modern dentistry is rapidly embracing digital workflows, especially in dental implantology, where precision is critical to case success. Two methods for capturing implant positions digitally are Photogrammetry and the IO scan body technique.

Photogrammetry uses photographic images to pinpoint implant locations with high accuracy, while the IO scan body method employs intraoral scanners and specialized scan bodies to digitally record implant positions. Both approaches aim to replace or enhance traditional impressions, offering dentists improved accuracy, efficiency, and patient comfort.

What is Photogrammetry in dentistry?

Photogrammetry in dentistry is a digital impression technique that captures the three-dimensional positions of implants using photographs. In a photogrammetry workflow, special markers or scan abutments (often called photogrammetry scan bodies) are attached to multi-unit abutments. A specialized camera then takes multiple images from different angles, and software triangulates the exact spatial coordinates of each of the positions. Through this process of stitching 2D images together, a precise 3D representation of the implant positions is created.

Photogrammetry vs. IO Scan Body: Understanding the Technology - Burbank Dental Lab

Photogrammetry essentially treats each implant’s location as a “target” to be measured. Unlike conventional intraoral scanning, the photogrammetric capture is done extraorally – the camera records the scan markers from outside the mouth. This extraoral capture means factors such as saliva, bleeding, or patient movement have minimal impact on accuracy. As long as the camera can see the white dots on the markers clearly, it will record the positions.

Saliva, bleeding, and patient movement? Photogrammetry doesn’t care.

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“I’ve been using Burbank Dental Lab for all my dental cases, and they’ve been fantastic to work with. The quality of their work is always consistent — everything fits great and looks beautiful, which makes my life a lot easier.”

Full-arch accuracy isn’t just about the technology — it’s about choosing the right technology for the case.

Benefits of Photogrammetry

Unparalleled accuracy – Photogrammetry provides the highest level of precision for multi-implant, multi-unit abutment cases, ensuring a passive fit and reducing stress on implants.
Fast data capture – Captures positions in seconds, making it a quick, efficient process for full-arch restorations.
Minimally affected by intraoral conditions – Saliva, bleeding, and patient movement do not impact the accuracy of the photogrammetry process.
Improved fit of the final prosthesis – Reduces the need for adjustments, ensuring better long-term outcomes and minimizing chair time for both the patient and the dentist.
Ideal for full-arch and multi-implant cases – Especially beneficial for edentulous patients and full-arch restorations such as All-On-4 or All-On-X.
Enhanced patient comfort – Does not require bulky intraoral scanning or traditional impression trays, making the process more comfortable.
Increased confidence in results – Eliminates the risk of inaccuracies commonly associated with intraoral scanning of multiple implants.

What is the photogrammetry workflow?

Photogrammetry focuses solely on capturing implant positions. It does not capture the surrounding soft tissue or any detailed anatomy of the gums and teeth. Therefore, the process is as follows:

Scan Bodies – Special scan bodies are screwed to the multi-unit abutments. These scan bodies measure the position and orientation of the multi-unit abutments in the mouth.
Record Data – After the scan bodies are placed a special camera is used extraorally that picks up the location of the scan bodies and records the data.
Reference Body – The scan bodies are removed, and a reference body is placed. These reference bodies provide a fixed reference point to allow for accurate alignment. It calculates the exact 3D positions of the multi-unit abutments, enabling a highly accurate passive-fit prosthetic.
Soft-Tissue Scan – The Photogrammetry system does not record the soft-tissue profile, occlusion, or teeth. An intraoral scan (without the photogrammetry markers) or a traditional impression must be taken to record the gingiva and other details
Reconciliation of Data – Next, implant position data and soft tissue records are digitally merged to create a complete 3D model of the patient’s arch.
Fabrication – The information is used by Burbank Dental Lab to design and fabricate the final prosthesis.

Current prominent photogrammetry systems on the market include iCam4D (iMetric) and the PIC Camera (PIC Dental), among others.

You don’t need to invest in a photogrammetry system —
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ICam4D: Providing Accuracy in Multi-Unit Implant Cases - Dr. Diana Sedler - Cutting Edge Periodontist, Burbank, CA

One method captures everything in a single scan — the other delivers unmatched precision in two steps.

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What is an IO Scan Body (intraoral scanning) technique?

IO scan bodies, such as the Elos Accurate® Scan Body, are used with intraoral scanners to capture digital implant impressions. A scan body (also called an intraoral scan body) is a small, precisely manufactured component that attaches to a dental implant. It serves as a reference object for the scanner because the scan body has a specific shape with known dimensions and features; the scanning software can recognize it and pinpoint the implant’s location and orientation in the digital model. They are screwed or snapped into the implant in place of a healing abutment or temporary crown during the scan.

Elos Scan Body - Courtesy of https://elosmedtech.com/dental-professionals/scanbody/

For single implants, your intraoral scanner already has you covered.

Benefits of IO Scan Body technique

The following are the benefits of the IO scan body technique:

Convenience & accessibility – Works with intraoral scanners already in use in many dental offices, making adoption easy and cost-effective.
One-step digital workflow – Captures implant positions and soft-tissue details in a single scan, eliminating the need for merging multiple datasets.
Improved patient comfort – No need for traditional impression trays; the scanning process is minimally invasive and well-tolerated by patients.
Faster turnaround time – Digital impressions can be instantly sent to dental labs, reducing delays in case completion.
Ideal for single and short-span implant cases – Highly effective for single implant crowns and small bridges, where accuracy is maintained.
Reduced material costs – Eliminates the need for physical impression materials and model pouring, lowering long-term costs.
Integration with digital workflows – Compatible with CAD/CAM systems, enabling streamlined lab fabrication of custom abutments and restorations.
No special equipment beyond a scanner is needed – Unlike photogrammetry, which requires a dedicated system, the IO scan body technique leverages existing scanner technology.

The best full-arch solution isn’t always the most fixed one—it’s the most appropriate one.

What is the IO Scan Body workflow?

IO Scan Body – The Scan body is properly seated and secured in each implant.
Intraoral Scan – An intraoral scanner (IOS) is passed over the region, capturing not only the scan bodies but also the surrounding teeth, gingiva, and any other relevant anatomy.
Record Data – The scanner creates a point cloud or mesh of the surface, which the software converts into a 3D digital model (.STL or color models such as .PLY or .OBJ).
Reconciliation of Data – Using the scan body’s unique features, the dental lab software aligns a virtual implant analog in place of the scan body by referencing the manufacturer’s library for that scan body. This allows the software to correctly position a digital implant replica in the 3D model.
Fabrication – Now a custom abutment and crown/bridge can be designed.

However, capturing implant positions with an intraoral scanner does have challenges, especially as the number of implants increases or the span extends to a full arch. In a fully edentulous case (no teeth for reference and multiple implants), intraoral scanners may struggle to capture the image. The scanner must stitch together images of each scan body across the arch; as it moves from one implant to the next, small errors can accumulate.

Photogrammetry vs. IO Scan Body: Key Differences

Both photogrammetry and IO scan body techniques enable digital implant impressions, but they differ significantly in methodology and ideal use cases. Below is a comparison of key aspects:

Description	Photogrammetry	IO Scan Body Technique
Capture Method	Photogrammetry: Technique extraoral photographic capture of multi-unit abutment markers using a specialized camera.	IO Scan Body: Technique Intraoral optical scanning of the mouth.
Accuracy Single Unit	Photogrammetry: Generally on par with other methods (photogrammetry’s benefits are less pronounced for single implants, and it’s rarely used just for one implant given the setup).	IO Scan Body: Excellent for single units. Intraoral scanners are very accurate for single implant crowns or 2–3 unit cases, with results comparable to conventional impressions.
Accuracy Full Arch	Photogrammetry: Proven to be the most accurate method for full-arch multi-unit abutment position capture.	IO Scan Body: Accuracy diminishes over long spans due to accumulated stitching errors
Equipment Needed	Photogrammetry: Photogrammetry unit (camera system) and compatible photogrammetry scan bodies. Software to process images and export MUA coordinate data. Also requires an IOS or traditional impression materials for the second step (to get soft tissue detail).	IO Scan Body: Intraoral Scanner (IOS) and corresponding implant scan bodies. No extra camera; uses the same IOS device used for other digital impressions. Software with libraries for the scan bodies is needed.
Speed & Chair Time	Photogrammetry: Fast capture. Multiple multi-unit abutments captured in one go.	IO Scan Body: Scanning time increases along with the number of implants.
Ease of Use	Photogrammetry: There is a learning curve to master the photogrammetry system and workflow. Once learned the process is straight forward.	IO Scan Body: Familiar workflow for those used to IOS. Scanning implants is similar to scanning teeth though extra care is needed.
Soft Tissue Capture	Photogrammetry: Does not capture soft tissue or occlusion. Requires a supplemental intraoral scan or physical impression.	IO Scan Body: Captures soft tissues, adjacent teeth and occlusion in the same scan. For ideal restorative designs, a separate scan of the tissue should be done to get best emergence profiles coming out of the implant site.
Patient Comfort	Photogrammetry: High patient comfort. No bulky impression trays. The camera capture is quick and done outside the mouth.	IO Scan Body: Generally comfortable especially when compared to traditional impressions. However it is done inside the mouth and the patient must hold their mouth open for the duration of the scan
Best indications for Use	Photogrammetry: Optimized for complex cases: Full-arch multi-unit abutments, All On X immediate load, cases where maximum accuracy is essential.	IO Scan Body: Everyday implant dentistry: Single implant crowns; implant bridges in partially edentulous patients. Can be extended to full-arch cases but careful technique is required.
Cost & Accessibility	Photogrammetry: Dedicated photogrammetry systems are a significant investment and not yet commonplace in all dental offices. Typically justified for high multi-unit abutment volume or complex case focus. Some dentist collaborate with labs such as Burbank Dental Lab that have photogrammetry capabilities	IO Scan Body: Intraoral scanners in dental offices are common place. Using it for implants requires minimal investment (just the scan bodies and training). Thus digital implant scanning with IOS is highly accessible.

Photogrammetry is typically reserved for specialized scenarios where its unparalleled accuracy is needed, whereas IO scan body techniques cover the broad range of everyday implant procedures. A cutting-edge dental practice might employ both: using intraoral scanning for routine cases and bringing out photogrammetry for the big cases (much like a specialist tool).

On the other hand, a practice without photogrammetry can still successfully treat complex cases, but they must be vigilant about technique or possibly use conventional impressions as a backup for full-arch situations.

The good news is that both methods are far superior to the old ways in terms of patient experience – no one enjoys cumbersome impression trays, and both digital methods significantly improve comfort and accuracy.

Digital impressions aren’t the future of implant dentistry — they’re the present.

3 STEPS TO PHOTOGRAMMETRY SCANS

WE HELP YOU GET IT RIGHT EVERY TIME

STEP 1

Burbank Dental Lab implant scan specialist provides the special scan bodies for insertion in the patient’s newly placed implant sites.

STEP 2

Scan Bodies are removed and special healing abutments are placed on the implant sites. Soft tissue can now be scanned with an intra-oral scanner.

STEP 3

The data from both scans are then sent to the dental laboratory. The ICam4d data and soft tissue scans are aligned to become a high-precision dental model.

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