Superimposition of virtual models using palatal rugae and maximum habitual intercuspation

INTRODUCTION

The superimposition of 3 dimensions (3D) digital models has been increasingly used for evaluating dental changes resulting from orthodontic treatment, and different superimposition techniques have been described. Although the maxilla has areas with greater stability for superimposition, such as the palatal rugae, there is still no reliable method for superimposing models of the lower arch.

OBJECTIVE

Therefore, this article aims to describe a technique for superimposing virtual models.

METHODS

To evaluate pre- and post-orthodontic treatment changes, the Geomagic Qualify 2013 software (3D Systems®, Rock Hill, South Carolina, USA) was used, with reference points in the maxilla, including the rugae and a reference area in the palate and midpalatal raphe. The lower arch was superimposed using the maximum habitual intercuspation (MHI) model as reference.

RESULTS AND CONCLUSION

3D models superimposition using palatal rugae and MHI occlusion seems to offer satisfactory results in the interpretation of clinical changes at different follow-up moments in terms of development and/or orthodontic treatment.

Evaluation of Three-Dimensional Digital Models Formulated From Direct Intra-oral Scanning of Dental Arches in Comparison With Extra-oral Scanning of Poured Dental Models in Terms of Dimensional Accuracy and Reliability

BACKGROUND

The study's objective was to assess the dimensional accuracy and reliability of dental digital models prepared by direct intraoral scanning and indirect scanning of the plaster models compared to the plaster models as the gold standard.

MATERIALS AND METHODS

This study included 20 patients. Nine had a class I malocclusion, seven had a class II malocclusion, and four had a class III malocclusion. Intraoral scanning was done for the upper and lower arches of all the patients enrolled in this study using an intraoral scanner (i700; Medit, Seoul, Korea). The next step was preparing the plaster model for the control group. Addition-silicone impressions were taken for each patient's arches. The impressions were poured according to American Board of Orthodontics (ABO) standards. Finally, the digital models of the indirect scanning group were prepared using a 3D desktop scanner (T710; Medit). In total, 26 measurements were made on the plaster and digital models. Paired t-tests were used to test for significant differences between the studied groups. The reliability of the studied techniques was tested using intraclass correlation coefficients (ICCs). Because of the multiple comparisons, the ɑ level was adjusted and set at 0.002.

RESULTS

No significant differences were found between the intraoral scanning group (20 patients) and the plaster models group (20 patients; P>0.002). The ICCs ranged from 0.814 to 0.993, indicating excellent agreement between the direct digital and traditional plaster models. There were no significant differences between the digital and original plaster models (P>0.002). ICCs ranged from 0.834 to 0.995, indicating excellent agreement between the indirect digital and original plaster models. No significant differences were detected between the direct and indirect digital models (P>0.002). ICCs ranged between 0.813 and 0.999, indicating excellent agreement between direct and indirect digital models.

CONCLUSION

Both direct and indirect scanning techniques are accurate and reliable for digital model preparation and can be considered an alternative to traditional plaster models used in clinical orthodontics diagnostic applications. The intraoral scanning technique can be considered a valid alternative for indirect scanning of the plaster models to prepare digital working models during the digital design and fabrication of orthodontic appliances such as clear aligners.

Comparison of Tooth Size Measurements in Orthodontics Using Conventional and 3D Digital Study Models

(1) Background: The objective of this study was to assess which digitization method produces the biggest deviation in the 3D images of tooth size from plaster models made using alginate impressions, which are considered the gold standard in orthodontics. (2) Methods: The sample used in this study included 30 subjects (10 males and 20 females). Measurements were made on four types of models: (1) digital models obtained through intraoral scanning and digitized models of plaster cast made from (2) alginate impressions, (3) silicone impressions, and (4) conventional plaster models. Mesio-distal (MD) and buccal/labial-lingual/palatal (BL) dimensions were measured on the reference teeth of the right side of the jaw (central incisor, canine, first premolar, and first molar). Comparisons of tooth size between the methods were conducted using a repeated measurement analysis of variance and the Friedman test, while the intraclass correlation coefficient was used to determine agreement between the different methods. (3) Results: The results showed a similar level of agreement between the conventional and digital models in both jaws and the anterior, middle, and posterior segments. Better agreement was found for the MD measurements (r = 0.337-0.798; p ≤ 0.05) compared to the BL measurements (r = 0.016-0.542), with a smaller mean difference for MD (0.001-0.50 mm) compared to BL (0.02-1.48 mm) and a smaller measurement error for MD (0.20-0.39) compared to BL (0.38-0.89). There was more frequently a better level of agreement between 3D images than measurements made using a digital caliper on the plaster models with 3D images. (4) Conclusions: The differences in measurements between the digital models and conventional plaster models were small and clinically acceptable.

Reliability and time-based efficiency of artificial intelligence-based automatic digital model analysis system

OBJECTIVES

To compare the reliability, reproducibility, and time-based efficiency of automatic digital (AD) and manual digital (MD) model analyses using intraoral scan models.

MATERIAL AND METHODS

Two examiners analysed 26 intraoral scanner records using MD and AD methods for orthodontic modelling. Tooth size reproducibility was confirmed using a Bland-Altman plot. The Wilcoxon signed-rank test was conducted to compare the model analysis parameters (tooth size, sum of 12-teeth, Bolton analysis, arch width, arch perimeter, arch length discrepancy, and overjet/overbite) for each method, including the time taken for model analysis.

RESULTS

The MD group exhibited a relatively larger spread of 95% agreement limits when compared with AD group. The standard deviations of repeated tooth measurements were 0.15 mm (MD group) and 0.08 mm (AD group). The mean difference values of the 12-tooth (1.80-2.38 mm) and arch perimeter (1.42-3.23 mm) for AD group was significantly (P < 0.001) larger than that for the MD group. The arch width, Bolton, and overjet/overbite were clinically insignificant. The overall mean time required for the measurements was 8.62 min and 0.56 min for the MD and AD groups, respectively.

LIMITATIONS

Validation results may vary in different clinical cases because our evaluation was limited to mild-to-moderate crowding in the complete dentition.

CONCLUSIONS

Significant differences were observed between AD and MD groups. The AD method demonstrated reproducible analysis in a considerably reduced timeframe, along with a significant difference in measurements compared to the MD method. Therefore, AD analysis should not be interchanged with MD, and vice versa.

[Degree of reliability of the assessment of the Bolton analysis in three-dimensional virtual models versus plaster models. a review]

Introduction

Bolton analysis is used to determine anomalies with respect to the dental mass, for diagnosis and treatment planning purposes, the possibility of using a digital method was introduced and tested to measure the size of the mesiodistal tooth. In this way, digital dental technology has made digital study models become popular in orthodontics.

Objective

to evaluate the degree of reliability of the evaluation of the Bolton analysis in three-dimensional virtual models versus plaster models through a review of the literature.

Materials and methods

A search was carried out in the primary databases of the international scientific literature on health sciences: Medline, through PubMed, SciELO, Lilacs, and Embase. Review articles published between the year 2000 and October 2021 were included.

Results

The desktop scanner was the best option for digitizing dental models, but this does not detract from CBCT and intraoral laser scanners, which are still an option. Reasonable validity for digitizing 3D models with results within the "clinically acceptable" range was found.

Conclusions

3D digital models generated with intraoral and extraoral scanners are reliable and accurate compared to conventional impressions and save time, in most cases statistically significant differences were found, but of little clinical relevance.

Estimation of Distances within Real and Virtual Dental Models as a Function of Task Complexity

Orthodontists have seen their practices evolve from estimating distances on plaster models to estimating distances on non-immersive virtual models. However, if the estimation of distance using real models can generate errors (compared to the real distance measured using tools), which remains acceptable from a clinical point of view, is this also the case for distance estimation performed on digital models? To answer this question, 50 orthodontists (31 women and 19 men) with an average age of 36 years (σ = 12.84; min = 23; max = 63) participated in an experiment consisting of estimating 3 types of distances (mandibular crowding, inter-canine distance, and inter-molar distance) on 6 dental models, including 3 real and 3 virtual models. Moreover, these models were of three different levels of complexity (easy, medium, and difficult). The results showed that, overall, the distances were overestimated (compared to the distance measured using an instrument) regardless of the situation (estimates on real or virtual models), but this overestimation was greater for the virtual models than for the real models. In addition, the mental load associated with the estimation tasks was considered by practitioners to be greater for the estimation tasks performed virtually compared to the same tasks performed on plaster models. Finally, when the estimation task was more complex, the number of estimation errors decreased in both the real and virtual situations, which could be related to the greater number of therapeutic issues associated with more complex models.

Comparison of palatal volume and surface changes between bone-borne and tooth-tissue-borne maxillary expansion on cone beam computed tomography digital cast models

OBJECTIVES

To compare the changes of palatal volume and area in patients treated with tooth-tissue-borne palatal expanders (conventional Haas) and miniscrew-supported palatal expanders (modified Haas).

MATERIALS AND METHODS

The sample included casts of 22 patients treated as part of a clinical study at the Department of Orthodontics, Al-Azhar University, to correct their crossbite malocclusion. Patients were divided equally into two groups upon arrival. The first group, with a mean age of 12 years and 6 months, received the miniscrew-supported palatal expander. The second group, with a mean age of 12 years and 2 months, received the Haas design-palatal expansion appliance. Pre- and post-expansion dental casts were cone beam computed tomography scanned and the slices were constructed into 3D volumes. Fully automated superimposition was done for pre- and post-expansion 3D models. Palatal volume and area were determined, and all measurements were carried out blindly. Paired t-test was used to assess the mean differences within each group and Welch's t-test was applied to assess the mean changes between the two groups. Shapiro-Wilk test was used to test for the normality of the data.

RESULTS

There were no statistical differences in volume changes either within each group or between the groups. Although area changes were statistically significant within each group, the difference between the groups was not significant.

CONCLUSIONS

Changes that result from the use of either method to expand the upper arch occur primarily in the shape of the palate, but not in its size.

A Comparison of Teeth Measurements on Plaster and Digital Models

(1) Background: Modern imaging methods and constantly developing technologies extend the range of diagnostic tools in medicine and in orthodontics. Thanks to them, scientists and doctors can use devices designed to diagnose 3D structures of the human body. The aim of the study was to assess the usefulness of digital orthodontic models as a diagnostic tool in the work of an orthodontist through a comparative analysis of the value of orthodontic measurements made on traditional plaster models and virtual models. (2) Methods: A total of 80 sets of models were made, including 40 sets of plaster models and 40 sets of digital models. A total of 48 diagnostic parameters were developed. They concerned dental parameters. (3) Results: Comparative analysis of crown height values on plaster and digital models showed statistically significant differences (p < 0.05) in 26 out of 48 dental parameters. (4) Conclusions: The differences between the measurements made with the software on the digital models and the measurements made with the traditional method of measurement using the digital caliper on the plaster models were small and clinically acceptable.

Intercenter comparison of slow and rapid maxillary expansion in unilateral complete cleft lip and palate

Objective:

The aim of this study was to compare the occlusal changes of rapid maxillary expansion (RME) and slow maxillary expansion (SME) in patients with unilateral complete cleft lip and palate (UCLP), by means of digital dental models.

Methods:

Group RME was composed by 22 patients (13 males and 9 females), with mean age of 9.9 years, treated with rapid maxillary expansion with Hyrax appliance in Center 1. Group SME was composed by 29 patients (14 females and 15 males), with mean age of 10.7 years, treated with slow maxillary expansion with quad-helix appliance in Center 2. Digital dental models of the maxillary dental arch were obtained immediately pre-expansion (T1) and 6-month post-expansion (T2). Transversal distances, arch perimeter, arch length, palatal depth, palatal volume and posterior tooth inclination were digitally measured. Interphase and intergroup comparisons were performed with paired t-test and independent t-test, respectively.

Results:

Intercanine expansion was 4 to 5mm in both groups, and increase in the intercanine distance was similar for both groups. RME group showed a greater increase in arch distances at the region of permanent premolar and molars, compared to SME group. Arch perimeter increase was greater for RME group, compared to SME. No differences were found for arch length, palatal depth, palatal volume and posterior tooth buccal tipping.

Conclusion:

RME and SME produced similar dentoalveolar outcomes, with greater amount of expansion on RME group.

Agreement of in vitro orthodontic measurements on dental plaster casts and digital models using Maestro 3D ortho studio software

Objective

Diagnostic casts are one of the standard components of orthodontic records. But they have several drawbacks such as the need for physical space for storage and the risk of breaking due to their brittle composition. Today, the digitalization of orthodontic models is a progress in orthodontics. The purpose of this study was to compare and evaluate common orthodontic linear measurements on plaster casts and digital 3D models using Maestro 3D ortho studio® scanner and software (AGE Solutions®, Pontedera, Italy).

Materials and Methods

Study casts of 30 orthodontic patients were selected. Tooth width, space analysis, Bolton analysis, overjet, overbite, and linear measurements of dental arch dimensions were performed by two examiners on plaster casts and digital models.

Statistical Analysis

Intra‐ and interexaminer agreements were evaluated in both manual and digital methods and paired t test was used for evaluating the agreement between the manual and digital measurement. The significance level was set at 0.05.

Results

The intraexaminer agreement was excellent (ICC > 0.75) for most variables in both manual and digital methods. The correlation between the two examiners was significant (p < .05) for most manual and digital measurements. The differences between the manual and digital measurements, although maybe statistically significant, were not clinically significant for most variables.

Conclusion

The use of “Maestro 3D” (AGE Solutions, Pontedera, Italy) scanner and software was acceptable for orthodontic diagnostic measurements instead of study casts.

Reliability of Tooth Width Measurements Delivered by the Clin-Check Pro 6.0 Software on Digital Casts: A Cross-Sectional Study

The purpose of this study was to assess the accuracy and reliability of tooth width measurements and Bolton Indices delivered by the Clin-Check Pro 6.0 software (Align Technology, San José, CA, USA). Fifty-four plaster casts were selected and measured with a manual calliper by a trained and calibrated observer. The data gathered were compared with those delivered by the software on the corresponding fifty-four virtual casts. The method reliability of the software was assessed by comparing the measurements performed by the software on 201 pairs of clin-checks corresponding to two consecutive treatment phases. Accuracy and reliability were statistically assessed using a mixed model. The software tends to provide larger widths compared with the manual method. Statistically significant differences were found in 23 teeth. At a global level, the mean difference between the methods was −0.19 mm, with a Dahlberg error of 0.24 mm and an intraclass correlation coefficient of 0.98. The Bolton Indices delivered by the two methods had a moderate correlation (ICC = 0.59; 0.69). The within method reliability of the software was extremely high. Tooth width measurements delivered by the software, despite the positive bias, can be considered accurate and clinically acceptable for all teeth except molars. The Bolton Indices made available by the software are not accurate and clinically acceptable, especially in the case of mandibular excess.

Evaluation of accuracy of 3-dimensional printed dental models in reproducing intermaxillary relational measurements: Based on inter-operator differences

Objective

Although, digital models have recently been used in orthodontic clinics, physical models are still needed for a multitude of reasons. The purpose of this study was to assess whether the printed models can replace the plaster models by evaluating their accuracy in reproducing intermaxillary relationships and by appraising the clinicians’ ability to measure the printed models.

Methods

Twenty sets of patients’ plaster models with well-established occlusal relationships were selected. Models were scanned using an intraoral scanner (Trios 3, 3Shape Dental System) by a single operator. Printed models were made with ZMD-1000B light-curing resin using the stereolithography method 3-dimensional printer. Validity, reliability, and reproducibility were evaluated using measurements obtained by three operators.

Results

In evaluation of validity, all items showed no significant differences between measurements taken from plaster and printed models. In evaluation for reliability, significant differences were found in the distance between the gingival zeniths of #23–#33 (DZL_3) for the plaster models and at #17–#43 (DZCM_1) for the printed models. In evaluation for reproducibility, the plaster models showed significant differences between operators at midline, and printed models showed significant differences at 7 measurements including #17–#47 (DZR_7).

Conclusions

The validity and reliability of intermaxillary relationships as determined by the printed model were clinically acceptable, but the evaluation of reproducibility revealed significant inter-operator differences. To use printed models as substitutes for plaster models, additional studies on their accuracies in measuring intermaxillary relationship are required.

Assessment of the accuracy of laser-scanned models and 3-dimensional rendered cone-beam computed tomographic images compared to digital caliper measurements on plaster casts

Purpose

This study investigated the accuracy of laser-scanned models and 3-dimensional (3D) rendered cone-beam computed tomography (CBCT) compared to the gold standard (plaster casts) for linear measurements on dental arches.

Materials and Methods

CBCT scans and plaster models from 30 patients were retrieved. Plaster models were scanned by an Emerald laser scanner (Planmeca, Helsinki, Finland). Sixteen different measurements, encompassing the mesiodistal width of teeth and both arches' length and width, were calculated using various landmarks. Linear measurements were made on laser-scanned models using Autodesk Meshmixer software v. 3.0 (Autodesk, Mill Valley, CA, USA), on 3D-rendered CBCT models using OnDemand 3D v. 1.0 (Cybermed, Seoul, Korea) and on plaster casts by a digital caliper. Descriptive statistics, the paired t-test, and intra- and inter-class correlation coefficients were used to analyze the data.

Results

There were statistically significant differences between some measurements on plaster casts and laser-scanned or 3D-rendered CBCT models (P<0.05). Molar mesiodistal width and mandibular anterior arch width deviated significantly different from the gold standard in both methods. The largest mean differences of laser-scanned and 3D-rendered CBCT models compared to the gold standard were 0.12±0.23 mm and 0.42±0.53 mm, respectively. Most of the mean differences were not clinically significant. The intra- and inter-class correlation results were acceptable for all measurements (>0.830) and between observers (>0.801).

Conclusion

The 3D-rendered CBCT images and laser-scanned models were useful and accurate alternatives to conventional plaster models. They could be used for clinical purposes in orthodontics and prostheses.

Assessing the validity and reliability of tooth widths and bolton ratios obtained from digital models and plaster models

Aim:

The aim of the study is to compare and evaluate the validity and reliability of tooth widths and Bolton ratios measured from digital models obtained from intraoral scanners and plaster models derived from alginate and polyvinyl siloxane impression materials.

Materials and Methods:

Alginate and polyvinylsiloxane impression was taken for 40 subjects, orthokal stone was poured and grouped as Group I and Group II, respectively. Intraoral scanning was done using Trios Pod 3shape for the same patients, digital models were obtained and grouped as Group III. OrthoAnalyzer software was used for obtaining measurements in digital models and Aerospace Vernier calipers in plaster models. The validity and reliability of the three groups were quantified and compared.

Results:

Validity measurements showed significant differences between tooth widths and Bolton ratios obtained from digital models and plaster models indicating higher accuracy for plaster models whereas reliability coefficients were excellent for digital models indicating better reproducibility of values.

Conclusion:

The study shows significant differences in accuracy on measuring with vernier calipers and Orthoanalyzer software showing plaster models are still better than digital models for measuring tooth widths and bolton ratios.

Association between incisor positions and amount of interdental stripping in patients undergoing orthodontic treatment

INTRODUCTION

The study aimed to investigate the effect of a nonextraction treatment approach with interdental stripping (IDS) on the dentofacial structures in patients with dental and skeletal Class I, II, and III malocclusions.

METHODS

A total of 60 patients with mild-to-moderate crowding of the teeth and nonsevere skeletal malocclusion were included and divided into 3 groups: Class I, Class II, and Class III groups (n = 20 per group). In all patients, nonextraction orthodontic treatment was administered, and those who underwent IDS at the jaw quadrants as needed were evaluated. For pretreatment and posttreatment evaluation, lateral cephalometric radiography and 3-dimensional dental model scans were acquired for each patient. For statistical analysis, paired-samples t test and 1-way analysis of variance with Tukey post-hoc test were used for parametric variables, whereas the Wilcoxon paired signed rank test and Kruskal-Wallis test with Dunn post-hoc test were used for nonparametric variables.

RESULTS

An increase in the maxillary incisor angle was observed in patients with Class I and Class III malocclusions, whereas a decrease was observed in patients with a Class II malocclusion (P < 0.05). Mandibular incisor angles were significantly increased in the Class II malocclusion group (P < 0.05) but unchanged in the other groups. IDS was more frequently applied to the posterior aspect of the maxilla and mandible in patients with a Class II malocclusion than in patients with other malocclusion types, and the amount of IDS at the anterior aspect of the mandible was significantly higher in the Class III group.

CONCLUSIONS

Combined nonextraction orthodontic treatment and IDS yielded successful treatment outcomes. IDS application was localized to different jaw regions according to the different malocclusion types.

Comparison of Mandibular Arch Expansion by the Schwartz Appliance Using Two Activation Protocols: A Preliminary Retrospective Clinical Study

BACKGROUND AND OBJECTIVES

Dental crowding is more pronounced in the mandible than in the maxilla. When exceeding a significant amount, the creation of new space is required. The mandibular expansion devices prove to be useful even if the increase in the lower arch perimeter seems to be just ascribed to the vestibular inclination of teeth. The aim of the study was to compare two activation protocols of the Schwartz appliance in terms of effectiveness, particularly with regard to how quickly crowding is solved and how smaller is the increasing of vestibular inclination of the mandibular molars.

MATERIALS AND METHODS

We compared two groups of patients treated with different activation's protocols of the lower Schwartz appliance (Group 1 protocol consisted in turning the expansion screw half a turn twice every two weeks and replacing the device every four months; Group 2 was treated by using the classic activation protocol-1/4 turn every week, never replacing the device). The measurements of parameters such as intercanine distance (IC), interpremolar distance (IPM), intermolar distance (IM), arch perimeter(AP), curve of Wilson (COW), and crowding (CR) were made on dental casts at the beginning and at the end of the treatment.

RESULTS

A significant difference between protocol groups was observed in the variation of COWL between time 0 and time 1 with protocol 1 with protocol 1 subjects showing a smaller increase in the parameter than protocol 2 subjects. The same trend was observed also for COWR, but the difference between protocol groups was slightly smaller and the interaction protocol-by-time did not reach the statistical significance. Finally, treatment duration in protocol 1 was significantly lower than in protocol 2.

CONCLUSION

The results of our study suggest that the new activation protocol would seem more effective as it allows to achieve the objective of the therapy more quickly, and likely leading to greater bodily expansion.

The Heritability of Palatal Rugae Morphology Among Siblings*, †

Although there is clinical applicability of the palatal rugae as an identification tool in forensic odontology, controversy exists whether the palatal rugae patterns are stable or variable. The greater the genetic component, the higher the probability that palatal rugae patterns are stable. The aim of this study was to compare the palatal rugae morphology between full siblings and the proportion of variability due to genetic component. This cross-sectional study was conducted on digital models of 162 siblings aged 15-30 years old. The palatal rugae patterns were assessed with Thomas and Kotze (1983) classification using Geomagic Studio software (3D Systems, Rock Hill, SC). The palatal rugae morphology between siblings showed significantly similar characteristics for total number of left rugae (p = 0.001), left primary rugae (p = 0.017), secondary rugae for right (p = 0.024) and left sides (p = 0.001), right straight rugae (p = 0.010), and right convergent rugae (p = 0.005) accounting for at least 6.25%-12.8% of the variability due to heredity. Despite the similarities found, the palatal rugae patterns showed significant differences between siblings of at least 46.9% (p = 0.001). Zero heritability was found in 9 of the 14 rugae patterns. Meanwhile, total number of rugae, primary, backward, and convergent rugae showed moderate heritability (h²  > 0.3) and total number of secondary rugae showed high heritability (h²  > 0.6). In conclusion, despite the individuality characteristics, an appreciable hereditary component is observed with significant similarities found between sibling pairs and the palatal rugae patterns were both environmentally and genetically influenced.

Three-dimensional comparison of 2 digital models obtained from cone-beam computed tomographic scans of polyvinyl siloxane impressions and plaster models

Purpose

This study was performed to evaluate the dimensional accuracy of digital dental models constructed from cone-beam computed tomographic (CBCT) scans of polyvinyl siloxane (PVS) impressions and cast scan models.

Materials and Methods

A pair of PVS impressions was obtained from 20 subjects and scanned using CBCT (resolution, 0.1 mm). A cast scan model was constructed by scanning the gypsum model using a model scanner. After reconstruction of the digital models, the mesio-distal width of each tooth, inter-canine width, and inter-molar width were measured, and the Bolton ratios were calculated and compared. The 2 models were superimposed and the difference between the models was measured using 3-dimensional analysis.

Results

The range of mean error between the cast scan model and the CBCT scan model was −0.15 mm to 0.13 mm in the mesio-distal width of the teeth and 0.03 mm to 0.42 mm in the width analysis. The differences in the Bolton ratios between the cast scan models and CBCT scan models were 0.87 (anterior ratio) and 0.72 (overall ratio), with no significant difference (P>0.05). The mean maxillary and mandibular difference when the cast scan model and the CBCT scan model were superimposed was 53 µm.

Conclusion

There was no statistically significant difference in most of the measurements. The maximum tooth size difference was 0.15 mm, and the average difference in model overlap was 53 µm. Digital models produced by scanning impressions at a high resolution using CBCT can be used in clinical practice.

Efficiency and Accuracy of Three-Dimensional Models Versus Dental Casts: A Clinical Study

Objective

The aim of this study was to compare the accuracy of digital and plaster model methods and the time required for analysis.

Methods

A total of 30 subjects (20 females, 10 males; mean age, 14.36±6.30 years), who required plaster models for the construction of either a fixed or a removable orthodontic appliance, were randomly selected. As part of the diagnostic records, digital impressions with a three-dimensional (3D) intra-oral scanner (TriosColor-P13 Shape) were taken from all subjects. Conventional impressions for the orthodontic appliances were taken with alginate (Orthoprint, Zhermack, Italy), and the plaster models were obtained (Scheu-Dental, GmbH.D-58642, Iserlohn, Germany). Two groups were formed. In the conventional measurement group, manual measurements were taken on the plaster models, while in the digital measurement group, the 3Shape OrthoAnalyzer 2013 software was used to make the measurements on the 3D models. In both groups, the total time required to perform the Bolton analysis and space analysis was recorded, and the results were compared.

Results

There was no statistically significant difference found between the two groups in terms of the measurement values. The total time to perform all the analyses was determined to be shorter with digital models compared to conventional plaster models (p<0.001).

Conclusion

The Bolton analysis and space analysis measurements carried out on 3D models did not show any statistically significant difference compared to plaster models. The time taken to perform the analyses was shorter using digital models than for conventional plaster models.

A novel method for superimposition and measurements on maxillary digital 3D models-studies on validity and reliability

Background

Serial 3D models can be used to analyze changes, but correct superimposition is crucial before measurements can be assessed. Earlier studies show that every palatal structure changes due to growth or treatment. Here, we describe a new method that uses an algorithm-based analysis to perform superimpositions and measurements in maxillary 3D models. This method can be used to identify deformations. In a second step, only unchanged areas are used for superimposition.

Objectives

This study investigates the validity and reliability of this novel method.

Methods

Digital 3D models from 16 cases were modified by an independent 3D engineer to simulate space closure and growth. True values for tooth movements were available as reference. Measurements and repeated measurements were performed by four observers.

Results

The total tooth movement had an absolute mean error of 0.0225 mm (SD 0.03). The intraclass correlation coefficient (ICC) was 0.9996. Rotational measurements had an absolute mean error of 0.0291 degrees (SD 0.04 degrees) and an ICC of 0.9999.

Limitations

Serial models need to be taken with a moderate interval (1 to 2 years). Obvious changed areas in the palate need to be cropped before processing the models.

Conclusion

The tested method is valid and reliable with excellent accuracy and precision even when changes through growth or orthodontic treatment occur.

Three-dimensional evaluation of mandibular anterior dental crowding in digital dental casts

Introduction:

Digital dental models provide a more accurate and comprehensive assessment of orthodontic cases. Although this technique is quite promising, there are few three-dimensional measurements methods described in the literature.

Objective:

The aim of this study was to propose a method for assessing the degree of mandibular anterior dental crowding in the three planes of space, using digital dental models.

Methods:

Thirty dental casts were selected and scanned by Maestro 3D Dental Scanner and imported by Geomagic Qualify 2013 software. The degree of crowding was calculated by two examiners, based on the Little's Irregularity Index, by means of the definition of axial, coronal and sagittal planes for each model. Intraexaminer analysis was performed with Dahlberg's Formula (DF) and Intraclass Correlation Coefficients (ICC), and interexaminer analysis was performed with ICC and paired t-test.

Results:

The ICC showed an excellent agreement (p < 0.05) for all measurements, except for the intraexaminer and interexaminer in the Z-axis, in which it was found a moderate agreement. The DF showed a satisfactory accuracy with all measurements showing less than 1 mm difference. The paired t-test showed statistical difference between the examiners in two measurements, although it was clinical irrelevant.

Conclusion:

When comparing the three planes of space, the Z-axis showed the greatest variation in landmarks placement; however, overall, the present method seems precise and reproducible.

Model Analysis of Digital Models in Moderate to Severe Crowding: In Vivo Validation and Clinical Application

Objective

We investigated the suitability of intraoral-scan models for measuring tooth dimensions and the amount of crowding in patients with severe tooth crowding.

Materials and Methods

Fifty-eight patients who had undergone intraoral scans for diagnosis were included. Cast models were divided into two groups depending on the amount of crowding, as determined by initial caliper-based measurements (mild crowding [MC] group: <3.0 mm; severe crowding [SC] group: >4.5 mm). Twenty maxillary models and 20 mandibular models were used in this study. For the three types of models (i.e., IS digital model, C cast model, and CS digital model), the reproducibility and the precision of linear measurements were evaluated.

Results

We found that linear measurements made using digital calipers on a plaster model and on the relevant software were reproducible. There was no significant difference in most linear measurements between digital models and the C model. There were differences in the amount of crowding (p < .05), although these were not clinically significant. There was no relationship between the precision of crowding in the three types of models and the severity of crowding.

Conclusions

Digital models can be used for measuring crowding in both mild and severe crowding cases. However, crowding measured by digital models tends to be lesser than that measured by cast models, and this should be considered during clinical application.

Accuracy and eligibility of CBCT to digitize dental plaster casts

OBJECTIVES

Software-based dental planning requires digital casts and oftentimes cone-beam computed tomography (CBCT) radiography. However, buying a dedicated model digitizing device can be expensive and might not be required. The present study aimed to assess whether digital models derived from CBCT and models digitized using a dedicated optical device are of comparable accuracy.

MATERIAL AND METHODS

A total of 20 plaster casts were digitized with eight CBCT and five optical model digitizers. Corresponding models were superimposed using six control points and subsequent iterative closest point matching. Median distances were calculated among all registered models. Data were pooled per scanner and model. Boxplots were generated, and the paired t test, a Friedman test, and a post-hoc Nemenyi test were employed for statistical comparison. Results were found significant at p < 0.05.

RESULTS

All CBCT devices allowed the digitization of plaster casts, but failed to reach the accuracy of the dedicated model digitizers (p < 0.001). Median distances between CBCT and optically digitized casts were 0.064 + - 0.005 mm. Qualitative differences among the CBCT systems were detected (χ ² = 78.07, p < 0.001), and one CBCT providing a special plaster cast digitization mode was found superior to the competitors (p < 0.05).

CONCLUSION

CBCT systems failed to reach the accuracy from optical digitizers, but within the limits of the study, accuracy appeared to be sufficient for digital planning and forensic purposes.

CLINICAL RELEVANCE

Most CBCT systems enabled digitization of plaster casts, and accuracy was found sufficient for digital planning and storage purposes.

Comparison of 2 root surface area measurement methods: 3-dimensional laser scanning and cone-beam computed tomography

Purpose

The aim of this study was to compare the use of 3-dimensional (3D) laser scanning and cone-beam computed tomography (CBCT) as methods of root surface measurement.

Materials and Methods

Thirty teeth (15 maxillary first premolars and 15 mandibular first premolars) from 8 patients who required extractions for orthodontic treatment were selected. Before extraction, pre-treatment CBCT images of all the patients were recorded. First, a CBCT image was imported into simulation software (Mimics version 15.01; Materialise, Leuven, Belgium) and the root surface area of each tooth was calculated using 3-Matic (version 7.01, Materialise, Leuven, Belgium). After extraction, all the teeth were scanned and the root surface area of each extracted tooth was calculated. The root surface areas calculated using these 2 measurement methods were analyzed using the paired t-test (P<.05). Correlations between the 2 methods were determined by calculating the Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to assess intraobserver reliability.

Results

The root surface area measurements (230.11±41.97 mm²) obtained using CBCT were slightly greater than those (229.31±42.46 mm²) obtained using 3D laser scanning, but not significantly (P=.425). A high Pearson correlation coefficient was found between the CBCT and the 3D laser scanner measurements. The intraobserver ICC was 1.000 for 3D laser scanning and 0.990 for CBCT.

Conclusion

This study presents a novel CBCT approach for measuring the root surface area; this technique can be used for estimating the root surface area of non-extracted teeth.