Before we start, let us clarify what we are basing our evaluation on. Those familiar with our IOS reviews will understand our comparison process.

Although we could not attend IDS 2021 personally this year, we use these scanners in our practices here in New Zealand. These reviews are based on our own experience and are a summation of thousands of hours of use with these intraoral scanners.

What do all the symbols mean in the review summary tables?

We use checks and crosses to signal yes or no if a scanner has a feature. Then we combine that with a colour of green or red to indicate if it is a good or a bad thing. This is mainly in Software Subscription where having a subscription is not good so it gets a red check mark and if there is no subscription it gets a green cross. So that can lead to some possibly confusing combinations of a green cross or a red checkmark.

Intraoral Scanning Speed

For the longest time, most dentists and a lot of marketing material were focused on scanning speed. So, our first evaluation is based on the speed of the intraoral scanner when taking full arch scans.

Scanning speed has improved significantly over the years and is no longer the be-all and end-all when choosing an IOS.

Unlike two years ago, when there were significant differences between intraoral scan speeds, most reputable scanners these days can achieve full arch scans within 60 seconds.

This is also another reason why our reviews evolve and are refined each year. 60-second full arch scan speeds would be considered excellent two years ago, and now are only above average when looking at the entire market.

Our star-based rating out of 5 is relative, and the evaluation gives an idea of which scanners are the fastest and which are the slowest to capture images.

Intraoral Scanning Flow

We have added this additional criterion to elaborate further on scanning. It is not all about speed. What we mean by scanning flow is how smooth the scanning experience is.

Does the scanner lose its place often? How smart is the artificial intelligence in the scanner? Does the scanner handle the corners or the mouth and the anterior region well without stopping when moving from one quadrant to the other? Is it overall easy to take a full arch scan?

Does the scanner pick up where it left quickly if the scan is interrupted? How well does the scanner stitch up the images, and are there any problems with taking full arch scans? How well does it remove soft tissue artifacts?

These are the questions we are asking ourselves.

Again, a star-based rating is used relative to which scanner felt the best and which felt the most glitchy, laggy, or unresponsive.

Intraoral Scanner Size

This criterion is not just based on the size of the scanner head but the overall size and weight of the scanner.

There is a vast range of different scanner sizes available on the market. Some are the size of a toothbrush, and others weigh more than 500g.

We judge the overall size of the scanner and ergonomics as some are much heavier and more cumbersome than others.

We want to clarify that almost every scanner on the market has an acceptable scanner head size that can be used in even the smallest mouths. Yes, a smaller scanner head can be helpful, but this is not the whole picture as often larger scanner heads have a larger scanning window and thus require less movement to capture the same data.

Therefore, we have focused on the ergonomics, weight and overall how comfortable the scanner felt in the hand and while scanning.

Overall Ease of Use

This is based on the overall user-interface of the scanner software and how seamless the scanning process is. Some software is modern and intuitive, and others look like Windows 95. Some scanners are very polished, while others feel like prototypes.

This criterion takes into account both the hardware and software performance and if there were any problems with scanning, processing, and the overall workflow.

Intraoral Scanner Software

We have added a new criterion in our intraoral scanner reviews. This is in response to the fact that most intraoral scanners are now excelling in speed and operative use. What differentiates scanners now is software and applications.

Some scanners only scan and export files. Others provide a huge range of software such as orthodontic simulation, smile design, model builders for 3D Printing etc. This differentiation between scanners has to be identified, and hence we added this extra comparison criterion this year.

It is incredible to consider how much technology has evolved in just a few years as previously scan speed and being a colour scanner was a significant advantage. Now every latest generation scanner is full colour and has decent scan speeds - the main thing that differentiates scanners now is software and workflows.

Intraoral Scanner Price

This is simple to explain and is still one of the most important aspects for many dentists. We have access to the prices of all intraoral scanners on the market.

Because cost can range significantly based on many factors such as the distributor, geographic location, add-ons, and discounts, we are not giving exact numbers but rather a relative comparison based on the most expensive and the least expensive scanners.

Additional Features

Here are some additional intraoral scanner features we have included in this comparison:

Configurations

Some scanners are USB scanners that can be plugged into any desktop or laptop and used. Others are cart-based with their own specific computer hardware, monitor, and custom-built scanner cart. Some companies provide both options.

We have made it clear which scanners are which as this may be important for you.

In general cart-based scanners are tidier, and the hardware generally works well with the scanner. USB scanners require more setup as you have to invest in your own computer, cart, and monitor.

Wireless Scanner

Is there a wireless option available for the scanner?

Being wireless is just a quality of life improvement, making the scanner more ergonomic and enjoyable to use. There are some concerns in the market about battery life, which are unfounded in day-to-day use in our testing.

Regardless, batteries do die over time. So you will have to decide if this is an essential feature for you.

Caries Detection

Does the scanner come with caries detection functions such as transillumination or fluorescence?

Software Apps

Another new criterion we added this year. What apps does the scanner software include?

Some scanners have a huge lineup of apps such as ortho simulation, model builder, and smile design, and others are just impression-replacement tools.

CAD/CAM Software

Does the scanner include CAD/CAM software for in-house workflows? Does the scanner software have in-built CAD/CAM design functions? If not, can it be integrated seamlessly with third-party software?

This is a critical distinction for those wanting to carry out single-visit dentistry and milling in-house.

Software Subscription

Some scanners come with yearly subscriptions that are tied with their software. Some don’t.

This can be a key consideration for dentists when purchasing an intraoral scanner.

Be mindful as some companies claim their scanner does not come with a ‘subscription’ and that there are no ongoing costs after purchase, but this is not entirely true.

Many scanners have yearly fees tied with ‘maintenance packages’ covering software updates, maintenance, servicing, and ongoing support.

In contrast, other scanners have subscriptions that, if not paid, results in certain software features being no longer useable. Therefore, we have made it clear if a subscription is mandatory, recommended, or not required at all.

Autoclavable Scanning Tips

Are the scanning tips autoclavable? How many autoclave cycles can be completed before the scanning tip needs to be replaced? If not, are they single-use or rely on cold sterilization?

Open or Closed System?

We no longer include this in our comparisons.

All scanners are now open, allowing the export of at least one of the following files STL, OBJ and/or PLY.

It is great to see this change over the years as due to market pressure, many scanners that were previously closed have now allowed exporting of files (e.g. CEREC).

This is ideal for dental professionals allowing more flexibility and control over the technology and workflows.

Below you will find our comparison of all the major intraoral scanners of 2021. This comparison is based on the combined effort of Dr Hamid Al-Hassiny, Dr Haidar Al-Hassiny, and myself, Dr Ahmad Al-Hassiny.

We are not newcomers to digital dentistry. We have used CAD/CAM daily in our practice and have been doing so for over 15 years. We currently own more than 15 intraoral scanners in our practice. For perspective, we also run 26 dental chairs in New Zealand and a completely digital in-house lab. We are all full-time private dentists, with over 95% of our lab work being carried out in-house, from simple crown and bridge to digital dentures, full arch implant prosthetics, and everything in between.

We have tested all these scanners extensively in a real clinical environment, so we have a real-world insight into what’s important and how it impacts dentists. This comparison is not based on favorites but rather on objective merits.

From our experience, there is no perfect scanner. Instead, each scanner has clear advantages and disadvantages, with some likely being better suited for your needs and budget.

Disclaimer: This is an objective review of all these scanners. The team at iDD remains unwaveringly committed to providing you with impartial and trustworthy information. No company had any part in writing this review or restricting any conclusions iDD makes in our thorough analysis and clinical use of these products. This information is based on our own experience and findings. We want to give you the most transparent and objective overview of these intraoral scanners to help you on your digital dentistry journey.

Enjoy the review.

3Shape - TRIOS 4

3Shape has not released a new scanner since IDS 2019 - when they released the TRIOS 4. Instead, they have focused on software upgrades to improve the current lineup of TRIOS scanners.

The TRIOS 4 is the fourth generation TRIOS scanner and continues to build on the strength of the TRIOS 3, which was already one of the fastest scanners on the market.

The TRIOS 4 is fast, powerful and is easy to use. It comes in multiple configurations, such as a POD (USB) or TRIOS MOVE - arguably the most ergonomic cart on the market.

We have used TRIOS scanners for over five years in our practice, and we own both TRIOS 3 and 4. We can routinely achieve full-arch scans using these scanners within 45 seconds. The quickest we have on record is 17 seconds.

The TRIOS4 also comes with surface caries detection via the built-in fluorescence technology. This no longer requires a second scan, like in 2019. The other benefit of the TRIOS scanners is the range of "Patient Engagement" Apps included with them, such as patient monitoring, smile design, and orthodontic simulation.

TRIOS 4 is one of the only wireless scanners on the market. Although we have heard many times from other reps that this can cause connectivity issues and problems with scanning, this was never our experience. The wireless scanner works without any issue, and it is a great quality-of-life option to have. The battery life should be improved, however.

Since 2019 the most significant improvements have been 3Shape announcing that they are offering a no yearly fees option for TRIOS scanners. This was a major shift in their business model as previously if you didn't pay the yearly fee, you could not use the scanner at all.

The second big announcement was 3Shape Unite - a new app-based platform.

3Shape TRIOS 4 Configuration Options

TRIOS 4 POD (laptop scanner)

TRIOS 4 MOVE or MOVE + (touchscreen cart)

Dentsply Sirona - CEREC Primescan

Dentsply Sirona is another major IOS company that has not released a new scanner since IDS in 2019. The Primescan was one of the most anticipated releases of 2019 and remains the flagship of the Dentsply Sirona scanners.

The Primescan is another incredibly fast and high-tech scanner. It is one of the fastest, if not the, fastest scanner on the market. It has an exceptional AI, which makes scanning very efficient. It provides one of the most fluid scanning experiences.

The scanner size is much larger than the previous generation Omnicam, but for the most part, this does not cause major issues when scanning. Yes, it is much heavier and larger, but it also boasts one of the largest fields of view of any scanner and therefore captures a lot of data when held in one spot compared to others. This counteracts the large size.

Back in 2019, the Primescan had a rocky start with many software issues. These issues (for the most part) have been resolved, and the company has been working on optimizations over the past two years.

The Primescan only comes in a cart configuration. Although it is mobile between surgeries, it is not portable. This means that transporting the Primescan between practices or outside the clinic is not convenient.

The Primescan comes in two options - either with the CEREC Software included for CAD design (CEREC Primescan AC with CEREC Software) or just the scanner only for scan and send to lab workflows (Primescan AC with Connect Software).

Offering a scanner-only option to penetrate the market of dentists that do not want to carry out CAD/CAM chairside workflows for single-visit dentistry, has met with arguably limited success, especially in light of the cheaper intraoral scanner alternatives.

The company's focus is same-day dentistry and CAD/CAM. When combined with a CEREC Primemill, milling machine and CEREC SpeedFire furnace, it provides hands-down the best same-day workflow compared to any other system or combination available.

Over the years, most advancements have been to the CAD software, with the scanner only having limited software applications such as a smile design application. For example, other apps found in the competitors, such as caries detection, orthodontic simulation, model builder, etc., are not found in the CEREC Software.

The CEREC chairside system also has some limitations like not being able to export models to print and not being able to import scans from other IOS devices into the chairside unit.

Dentsply Sirona - Primescan Configuration Options

Primescan is Cart only (touchscreen cart), it comes in two options:
CEREC Primescan AC with CEREC Software for CAD/CAM and chairside workflows.
Primescan AC with Connect Software as a scanner only

Planmeca - Emerald S

Planmeca is the third major dental company that has not yet released a new scanner since 2019 but instead focused on software improvements to its existing line-up.

The Planmeca Emerald S is another fast scanner - do you see the pattern? Many companies have focused on scanning speed in the past ten years, and now there are multiple different 'fast' options. The differentiating factor between scanners is now software.

Since 2019, Planmeca has released Romexis 6.0 - the desperately needed overhaul to the software and UI. This new software works a lot better than before.

One stand-out feature of the Emerald S is that it is very lightweight. At 235 grams, this is lighter than the TRIOS and CEREC scanners. It is also the only other company, apart from Dentsply Sirona, that offers the entire chairside CAD/CAM workflow - meaning they make a scanner, CAD software, and milling machine.

Therefore, Planmeca offers an alternative to the CEREC workflow for those looking for a cheaper option. The software is acceptable but has some limitations, for example, not designing opposing restorations simultaneously. For the most part, it is a decent alternative to CEREC for same-day dentistry, but arguably, it is not better.

The benefit of Planmeca is that it is cheaper than CEREC, with the added advantage that there are absolutely no subscription fees. All software is included with no memberships or clubs.

The other advantage of the Planmeca Emerald S is that it has caries detection abilities via the "Cariosity Tip" which uses transillumination technology. This can be utilized as an additional inter-proximal screening tool.

Planmeca - Emerald S Configuration Options

Planmeca Emerald S USB scanner that can be used with touch screen displays.

Medit - i700

Medit disrupted the entire industry back in 2018 with the release of the Medit i500, and since then, they have been doubling down. The company released a new scanner before IDS in April 2021, called the Medit i700.

Improving many aspects of the previous generation Medit i500, the i700 scanner is impressively fast and smooth. It provides a scan experience that rivals some of the top scanners on the market and is only a fraction of the price.

Add to that no subscription fees except for a cloud storage above a free one GB limit. The cost for this cloud storage is almost comedically priced at $1 per month for 10 TB of cloud storage. Will we see an increase in this price in the future?

Medit i700 is a USB scanner and can be used with any appropriate computer. It is one of the lightest scanners on the market at 245 grams and is one of the only USB scanners that can be used with USB C alone with no power cord to the scanner itself - a large quality of life benefit for minimizing cables and clutter.

The Medit i700 is a scanner-only device. Unlike the previously mentioned scanners, which all have CAD software, this scanner doesn't. However, it does have some of the best software apps found in any scanner in the entire market.
Medit Smile Design, Compare, CrownFit Checker, Orthodontic Simulator, Model Builder, and recently Medit Temporaries are all apps found in the software for free, and they all work very well.

Since 2019, the software has evolved at a rapid rate. The team behind Medit is constantly adding new features. Every month something is added, and optimizations are occurring all the time.

The scanner requires an online connection to work. Although it has an offline mode, the scanner can only be used for 44 days offline before forcing an internet connection. This is a key aspect to realize for those who may not have access to stable internet connections.

Medit - i700 Configuration Options

Medit i700 USB scanner that can be used with touch screen displays.

Align - iTero Element 5D Plus

The iTero Element 5D Plus series was released in February 2021 as the latest generation intraoral scanner by Align Technology, the parent company of the iTero intraoral scanners. This new scanner was a surprising release as iTero had just launched the Element 5D in IDS 2019.

We reviewed the iTero Element 5D and found that although it was built with some fantastic technology, the computer hardware let it down significantly, resulting in a laggy user experience. The new iTero Element 5D Plus resolves many of these issues.

The Element 5D Plus is not exactly a completely new scanner as it is the same as the previous generation Element 5D. Instead, the changes are entirely hardware-related. Significant improvements to the computer components have resulted in a vastly better user experience. The Element 5D Plus is much faster than any other iTero scanner available.
Scanner size and ergonomics are still significant drawbacks of the scanner.

The iTero Element 5D Plus has not changed compared to the previous generation, Element 5D, and is large, heavy, and quite bulky to use. This scanner weighs close to 500 grams, making it one of the heaviest intraoral scanners on the market, double the weight of some other scanners.

The Element 5D Plus is the best scanner for Invisalign-focused clinics. This is because Invisalign has locked out all other latest-generation scanners on this list. Additionally, the Element 5D Plus has arguably the best ortho simulation tool found in any scanner - the Invisalign Outcome Simulator.

Align recently released a new auto-upload function for the Element 5D/5D Plus. This new auto-upload feature will streamline Invisalign case submissions by enabling intraoral scan images to be used instead of traditional intraoral photos.

The Element 5D Plus has caries detection functions using Near-Infrared Imaging (NIRI). The imaging system is impressive as it simultaneously records 3D, Intraoral Colour, and Near-Infrared Images (NIRI) in one scan. The only scanner to capture all this information in one scan.

iTero scanners can also be integrated with exocad for CAD/CAM interested practices.