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Predictability of lower incisor tip using clear aligner therapy. Prog Orthod 2022; 23:37. [PMCID: PMC9637687 DOI: 10.1186/s40510-022-00433-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/03/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Uprighting incisors is particularly important with clear aligner therapy as incisor tip determines the mesio-distal space needed in the arch, and consequently the fit of the aligner. The objective of this study was to investigate the accuracy of ClinCheck® software to predict lower incisor tip by comparing digitally prescribed movements with actual clinical outcomes and to determine whether the presence of a vertically orientated rectangular composite attachment influences the efficacy of incisor tip.
Methodology
This retrospective study included 66 lower incisors from 42 non-extraction adult patients treated using the Invisalign® appliance. Twenty-one incisors had vertical attachments, while 45 incisors did not have any attachments. Lower incisor tip was measured at T0 (pre-treatment), T1 (predicted post-treatment) and T2 (achieved post-treatment) on digital models using metrology software. The change in position from T0 to T1 and T0 to T2 was measured from the estimated centre of resistance (CRes) of each tooth. The estimated centre of rotation was plotted relative to the CRes to describe the type of orthodontic tooth movement (OTM) predicted and achieved.
Results
Predicted incisor tip and achieved incisor tip were positively correlated (R2 = 0.55; p < 0.001). For every degree of tip planned 0.4 degrees of tip was achieved. The presence of an attachment resulted in 1.2 degrees greater tip (F = 3.7; p = 0.062) and 0.5 mm greater movement of the predicted apex of the tooth (F = 4.3; p = 0.042) compared with the no attachment group. The type of OTM achieved differed from the type predicted. Sixty-seven percent of incisors investigated were predicted to move by root movement, while 46% achieved this type of movement.
Conclusions
The amount of lower incisor tip achieved was on average substantially less than the ClinCheck® displayed. Vertically orientated rectangular attachments are recommended where large root movement is planned, and their presence slightly improves apex movement.
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Comparing 3D Tooth Movement When Implementing the Same Virtual Setup on Different Software Packages. J Clin Med 2022; 11:jcm11185351. [PMID: 36142998 PMCID: PMC9503059 DOI: 10.3390/jcm11185351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background/objectives: The purpose of this study was to compare the differences in tooth movements when implementing the same virtual setup on the following four different software packages: ClinCheck® Pro, Ortho Analyzer®, SureSmile®, and Ortho Insight 3D®. Materials/Methods: Twenty-five adult patients treated with Invisalign® at the Case School of Dental Medicine (CWRU)’s department of orthodontics were retrospectively collected. Initial stereolithography (STL) files were obtained and imported into three software packages. The teeth were moved in order to replicate the virtual setup from ClinCheck® Pro. The final outcomes were exported from each software package. ClinCheck® Pro STL files were used as the reference while STL files produced by the other software packages were used as the targets. Best fit superimpositions were performed using Geomagic® Control X. Based on the results, tooth position was adjusted in the three software packages until the virtual setups from ClinCheck® Pro were replicated. Once confirmed, the tables containing the tooth movements were compared. The number of aligners and number of attachments automatically generated from each of the software packages were also evaluated. Results: Extrusion/intrusion (p ≤ 0.0001) and translation buccal/lingual (p ≤ 0.0004) were significantly different among the software packages. ClinCheck® Pro and SureSmile® (p ≤ 0.000), SureSmile® and Ortho Insight 3D® (p ≤ 0.014), SureSmile® and Ortho Analyzer® (p ≤ 0.009), and Ortho Insight 3D® and Ortho Analyzer® (p ≤ 0.000) generated a significantly different number of maxillary aligners. The results varied slightly for mandibular aligners, with only ClinCheck® Pro and Ortho Insight 3D® (p ≤ 0.000), SureSmile® and Ortho Insight 3D® (p ≤ 0.000), and Ortho Insight 3D® and Ortho Analyzer® (p ≤ 0.000) exhibiting a significant difference. ClinCheck® Pro and SureSmile® (p ≤ 0.000) differed significantly in the number of attachments produced. Conclusions: There are statistically significant differences in extrusion/intrusion, translation buccal/lingual, the number of aligners, and the number of attachments when implementing the same virtual setup on different software packages. Clinicians may need to consider this when utilizing software programs for digital diagnosis and treatment planning.
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Brandenburg LS, Berger L, Schwarz SJ, Meine H, Weingart JV, Steybe D, Spies BC, Burkhardt F, Schlager S, Metzger MC. Reconstruction of dental roots for implant planning purposes: a feasibility study. Int J Comput Assist Radiol Surg 2022; 17:1957-1968. [PMID: 35902422 PMCID: PMC9468133 DOI: 10.1007/s11548-022-02716-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/04/2022] [Indexed: 11/27/2022]
Abstract
Purpose Modern virtual implant planning is a time-consuming procedure, requiring a careful assessment of prosthetic and anatomical factors within a three-dimensional dataset. In order to facilitate the planning process and provide additional information, this study examines a statistical shape model (SSM) to compute the course of dental roots based on a surface scan. Material and methods Plaster models of orthognathic patients were scanned and superimposed with three-dimensional data of a cone-beam computer tomography (CBCT). Based on the open-source software “R”, including the packages Morpho, mesheR, Rvcg and RvtkStatismo, an SSM was generated to estimate the tooth axes. The accuracy of the calculated tooth axes was determined using a leave-one-out cross-validation. The deviation of tooth axis prediction in terms of angle or horizontal shift is described with mean and standard deviation. The planning dataset of an implant surgery patient was additionally analyzed using the SSM. Results 71 datasets were included in this study. The mean angle between the estimated tooth-axis and the actual tooth-axis was 7.5 ± 4.3° in the upper jaw and 6.7 ± 3.8° in the lower jaw. The horizontal deviation between the tooth axis and estimated axis was 1.3 ± 0.8 mm close to the cementoenamel junction, and 0.7 ± 0.5 mm in the apical third of the root. Results for models with one missing tooth did not differ significantly. In the clinical dataset, the SSM could give a reasonable aid for implant positioning. Conclusions With the presented SSM, the approximate course of dental roots can be predicted based on a surface scan. There was no difference in predicting the tooth axis of existent or missing teeth. In clinical context, the estimation of tooth axes of missing teeth could serve as a reference for implant positioning. However, a higher number of training data must be achieved to obtain increasing accuracy. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-022-02716-x.
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Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. .,Department of Oral and Maxillofacial Surgery, Albert-Ludwigs University Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Lukas Berger
- Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Steffen Jochen Schwarz
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Hans Meine
- Fraunhofer Institute for Digital Medicine MEVIS, Am Fallturm 1, 28359, Bremen, Germany
| | - Julia Vera Weingart
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - David Steybe
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Felix Burkhardt
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Stefan Schlager
- Department of Prosthodontics, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Clinic, Medical Center -University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
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Al-Shafi S, Pandis N, Darendeliler MA, Papadopoulou AK. Authors’ response. Am J Orthod Dentofacial Orthop 2022; 161:e94-e95. [DOI: 10.1016/j.ajodo.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/01/2022]
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Abstract
Among the innovations that have changed modern orthodontics, the introduction of new digital technologies in daily clinical practice has had a major impact, in particular the use of 3D models of dental arches. The possibility for direct 3D capture of arches using intraoral scanners has brought many clinicians closer to the digital world. The digital revolution of orthodontic practice requires both hardware components and dedicated software for the analysis of STL models and all other files generated by the digital workflow. However, there are some negative aspects, including the need for the clinician and technicians to learn how to use new software. In this context, we can distinguish two main software types: dedicated software (i.e., developed by orthodontic companies) and open-source software. Dedicated software tend to have a much more user-friendly interface, and be easier to use and more intuitive, due to being designed and developed for a non-expert user, but very high rental or purchase costs are an issue. Therefore, younger clinicians with more extensive digital skills have begun to look with increasing interest at open-source software. The aim of the present study was to present and discuss some of the best-known open-source software for analysis of 3D models and the creation of orthodontic devices: Blue Sky Plan, MeshMixer, ViewBox, and Blender.
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