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Trueness in intraoral scanning vs conventional impressions of edentulous arches: are we measuring something that doesn’t actually exist?

April 19, 2026 by
Lucio Lo Russo
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We are measuring thetruenessbetween intraoral scanning (IOS) and conventional impressions of edentulous arches.

The problem is that, in this context (edentulous arches), trueness does not exist.

This is not a provocation: it is a methodological issue.

And from this misunderstanding arises a good part of the confusion — and the questionable conclusions — present in the literature.

The starting point: what is trueness really?

Truenessis defined as:the closeness between a measurement and the “true value”

This implies an essential condition:

👉 there must be a real, stable, and independent reference

In the case of edentulous patients, this assumption is simply not met.

intraoral scan vs conventional impression edentulous arch what should be compared to define trueness

The biological knot: soft tissues do not have a “true” shape

For edentulous arches, both intraoral scanning and conventional impressions replicate deformable soft tissues

  • And these tissues:

  • do not have a unique geometry they depend on the technique used

There is no single biological “ground truth”

  • change their shape under the pressure applied by the

  • What are we really measuring in studies?

  • When a study compares IOS and conventional impressions, what it obtains is:

👉 There is no single biological “ground truth”

What are we really measuring in studies?

When a study compares IOS and conventional footprint, what it gets is:

lack of true reference in edentulous soft tissues comparison possible only as difference between methods

👉 the difference between two representations

Not the trueness. It seems like a semantic nuance. It is not.

The most widespread misunderstanding

That difference is often interpreted as:

👉 “error of intraoral scanning”

Here lies the logical leap:The difference we observe is not an error.

It is the inevitable result of two different ways of interacting with the tissue.

Two approaches, two realities: mucostatic vs mucocompressive

The point is not technological. It is biological.

Intraoral scanning

  • acquisition in the absence of pressure

  • tissues at rest

    👉 mucostatic approach

conventional impression

  • compression of tissues

  • functional modeling

    👉 mucocompressive approach

The consequence we often ignore

Expecting these two techniques to produce the same geometry means assuming that:

👉 soft tissue behaves like a rigid solid

It does not.

It is like comparing two photographs of the same object:

  • one without load

  • one under deformation

E poi chiedersi perché non coincidono.

Clinical implications: we are asking the wrong question

The dominant question in the literature is:

❌ “how much do IOS and conventional impression differ?”

But it is a less useful question.

The correct question is:

✅ “what tissue behavior do I want to record?”

  • mucostatic?

  • mucocompressive?

Because this changes the interpretation of the data

If we change perspective:

  • the difference stops being a problem

  • it becomes aconsistent consequence of the clinical choice

👉 Non è un limite della tecnologia

👉 it is a property of the method

The myth of the unreliability of intraoral scanning

Part of the literature concludes that IOS is:

“less reliable for removable prosthetics”

But often this conclusion arises from:

  • comparison with compressive impressions

  • misuse of the concept of trueness

  • interpretation of the difference as an error

  • transfer of principles from the mucocompressive philosophy to the mucostatic one

👉 It is not the technology that is unreliable.

It is the way we are asking the question.

A necessary paradigm shift

Continuing to numerically compare IOS and conventional impressions leads to:

  • data that are difficult to interpret

  • contradictory conclusions

  • unaware clinical decisions

The key point is another:

👉 stop looking for equality between methods that arise differently

And start consciously choosing:

Conclusion

The literature has tried to apply the concept of trueness to a context in which:

👉 there is no single geometric truth

This has generated:

  • misleading interpretations

  • criticisms that are not always justified

  • clinical confusion

The reality is simpler — and more useful:

👉 we are not comparing accuracy, but two different biological models

And as long as we continue to ask the wrong question,

we will continue to get irrelevant answers.


👉 Do you really want to understand when to choose mucostatic or mucocompressive - and how this affects the prosthetic outcome?

Dive deeper in our video course: Mucostatic vs Mucocompressive...

If you want to go deeper

If you want to see how these concepts translate into clinical practice:

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