What is Scan Ladder & How Does It Work?

Thinking of Photogrammetry? Here's Why You Don't Need it With Scan Ladder

Here’s what the brochures don’t tell you.

Read on to understand why full-arch accuracy is not an optics problem. It’s a geometry problem. And how SCAN LADDER solves this clinically.

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What Is Photogrammetry in Dentistry?

Photogrammetry is one of the most accurate ways to capture full-arch implant positions, but many clinicians are still unsure what it actually means in everyday dentistry. In this video, we explain the basic concept of photogrammetry, why it is used in full-arch implant dentistry, and how it differs from conventional intraoral scanning workflows. Whether you are new to digital full-arch dentistry or looking to understand where Scan Ladder fits into the accuracy conversation, this is a good place to start.

The real problem in full-arch scanning

Most full-arch inaccuracies are not caused by scanner quality or laboratory skill.

They arise from geometric instability during data capture.

Traditional workflows assume that optical systems alone can resolve implant positions accurately across long spans. In reality, cumulative drift, angular variation and reference instability introduce errors long before the scan reaches the laboratory stage.

Scan Ladder reframes the problem:

full-arch accuracy is a geometric challenge, not an optical one.

The hidden assumptions of photogrammetry

Extraoral photogrammetry systems rely on idealised conditions that rarely exist in real clinical environments.

They assume:

  • perfect camera angles and line-of-sight
  • laboratory-like stability
  • absence of soft-tissue interference
  • zero intraoral movement

While photogrammetry can be highly accurate under controlled conditions, these assumptions limit reliability in everyday clinical practice. Scan Ladder was designed specifically for the realities of intraoral scanning—not theoretical perfection.

What actually happens in the mouth

In real patients, implant scanning faces unavoidable biological and clinical variables:

  • implants may be partially obscured
  • soft tissue moves and deforms
  • intraoral angles vary continuously
  • scan data accumulates drift
  • soft tissue and implant data rarely align perfectly

These factors explain why highly sophisticated optical systems can still produce inconsistent full-arch results.

Scan Ladder introduces a stable geometric reference framework that remains reliable even when biological conditions are imperfect.

Photogrammetry vs Scan Ladder

Photogrammetry is widely regarded as a high-accuracy solution for full-arch implant capture, but it is not the only way to achieve a predictable digital workflow. In this video, we compare photogrammetry with Scan Ladder, looking at the differences in workflow, cost, accessibility, openness, and everyday clinical use. Scan Ladder was designed to offer a practical, open, scanner-friendly alternative for clinicians who want accurate full-arch implant scanning without being locked into a closed system.

Architecture-driven accuracy

Scan Ladder is not just a scan body system—it is a reference architecture.

Its design introduces:

  • centralised geometric anchoring
  • unique per-body landmark geometry
  • controlled rotational indexing
  • a single-cylinder library architecture
  • deterministic spatial identification

By stabilising spatial relationships early in the scanning process, Scan Ladder reduces cumulative error and improves full-arch positional reliability across scanners and software platforms.

This is why Scan Ladder behaves fundamentally differently from conventional scan bodies.

What Is the Scan Ladder?

What exactly is Scan Ladder? In this video, we explain the core concept behind Scan Ladder, how it was designed, and why it helps improve full-arch implant scanning accuracy. Scan Ladder is not just another scan body. It is a complete full-arch implant scanning concept built around centralised scanning, unique landmark geometry, and a simplified digital library workflow.

How Does Scan Ladder Work and Why Is It So Accurate?

Accuracy in full-arch implant scanning is not just about the scanner. It is about the geometry, the workflow, and how the scan data is captured from the very beginning. In this video, we explain how Scan Ladder works and why its design helps reduce scan distortion and improve digital implant position capture. The system is built around unique landmark recognition, central-first scanning, variable scan body lengths, and a single-cylinder library architecture.

Integrating implant and soft tissue data

Accurate implant positioning alone is not sufficient. Soft tissue geometry must also align with implant data for predictable prosthetic outcomes.

TissueSync™ extends the Scan Ladder architecture to soft tissue capture by:

  • linking implant and tissue datasets through shared reference geometry
  • enabling reliable dataset merging
  • reducing mismatch between implant position and soft tissue contours

This creates a unified spatial model rather than disconnected datasets. The result is clinically meaningful accuracy—not just digital precision.

Read the Latest Accuracy Paper

Scan Ladder introduces a new category of reference geometry for full-arch implant workflows.

Rather than relying solely on optics, algorithms or post-processing correction, it stabilises spatial relationships at the point of data acquisition.

This shift—from optical dependency to geometric architecture—explains why Scan Ladder consistently improves accuracy across:

  • intraoral scanners
  • CAD software
  • implant systems
  • clinical skill levels

Scan Ladder is not an alternative to photogrammetry. It is a fundamentally different solution to the same problem.

Scan Ladder x Medit Smart X Accuracy PaperIndependent Testing Proving Scan Ladder
"I believe in delivering not just new technology products, but better experiences for both the clinician and technician. Every detail and every piece of feedback matters to me, enabling me to evolve what is the ultimate universal All On X tool to increase accuracy and better the service to patients in what we do"
Adam Nulty
Creator of Scan Ladder

Our Milestones

Adam Nulty has designed many models that can aid in Digital Dentistry.

From Scan Tools, PPE devices to Training devices and more.

Visit the IDDA at www.idda.org to download more free tools that he has designed.

Read on for the current version of the evolution of the Scan Ladder

  • 2018

    Scan Ladder Version 1

  • 2023

    Scan Ladder Indirect Kit with Random Surface Launched

  • 2024

    Scan Ladder Titanium Direct Kit launched with Rosen Screws direct to MUA

  • 2025

    Version 2 of the Scan Ladder incorporates Common Central Match tech

With Scan Ladder you can do immediate loading SAME DAY, in a full digital protocol.

The Scan Ladder Titanium Direct kit provides the clinician the ability to virtually CAD design with under 20 micron deviation on the same visit.

Each scan body contains the PATENTED random surface.

Each scan body is unique so that the scanner can easily identify position without confusion.

Each scan body contains the PATENTED Central Common Matching hub to work alongside an irregular surface in an All On X scenario so that only ONE library is needed. Simplicity at its best

Proven Accuracy

The Scan Ladder was tested in vivo in a peer reviewed study paper showing accuracy on par with intra oral photogrammetry devices such as the Shining Elite and extra oral photogrammetry.

Read the paper

Arch OR Central Focus

The Scan Ladder Titanium Direct scan bodys allow arch positioning OR central focused scanning meaning the first few frames are close together for increased cross arch accuracy.

With the patented common match cylinder combined with the patented random surface tech, it doesnt matter if only some of the scan bodies are captured.

The common match cylinder also means that the Scan Ladder system is the ONLY All On X system that can be repositioned mid scan without affecting data match or accuracy as the common match cylinder remains exactly the same.

HISTORY OF THE SCAN LADDER

Originally designed by Prof Adam Nulty in 2018, the Scan Ladder(TM) has been through several iterations. The first version was developed in 2018 to improve accuracy in full arch scans in edentulous cases.

Since 2018 the Scan Ladder has evolved through several iterations to increase function and accuracy in application. Namely, through the development of the random scanning surface, similar features/surfaces that can cause error are avoided. There is no tie to specific workflows, manufacturers, labs or scanners.

The newest version designed by Prof Nulty is the ONLY full arch accuracy tool that combines simplicity, openness and a completely random structure. The patented random surface and patented central common match point combined is key to ultimate accuracy.

Direct KitIndirect Kit

Purchase the Scan Ladder Kit Below

  • Scan Ladder Titanium Kit with dental models and case
  • Scan Ladder V2.0 titanium dental scan bodies kit
  • Scan Ladder Titanium Kit for dental implant scanning
  • Scan Ladder Titanium Direct Kit dental implant tool
  • Scan Ladder Titanium Direct Kit for dental implants
  • Scan Ladder Titanium Direct Kit dental implant components
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Scan Ladder

Scan Ladder Titanium Direct Kit

£795.00 GBP
Join the Future of Implant Dentistry and make your All On X - Fast & Accurate! Scan Ladder Titanium Kit Certified Worldwide - CE, UKCA and FDA ALL IN STOCK...
Connection: 1.4mm (Rosen Screw)
Kit Size: 6x Scan Body Titanium Kit
View details
  • Scan Ladder Titanium Kit with dental models and case
  • Scan Ladder V2.0 titanium dental scan bodies kit
  • Scan Ladder Titanium Kit for dental implant scanning
  • Scan Ladder Titanium Direct Kit dental implant tool
  • Scan Ladder Titanium Direct Kit for dental implants
  • Scan Ladder Titanium Direct Kit dental implant components
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