A pilot study of root position in orthodontic diagnosis model set-up

Abstract

To investigate the importance of root information in diagnosis set-up by constructing three-dimensional (3D) digital models with individual anatomic roots. Pretreatment cone-beam CT (CBCT) and laser scanning data were collected from two patients (extraction and non-extraction each) with skeletal Class I malocclusion. Threshold segmentation of the CBCT was performed to generate a 3D digital model which has individually isolated tooth. This model and the scan model were superimposed to generate an integrated model (Mo) composed of high-resolution surface scan crowns sutured to the CBCT roots. Pretreatment dentition plaster model were made into set-up model. The diagnosis model set-up was performed successively by three orthodontists and one senior orthodontic technician. Set-up model scan of each patient after tooth alignment was obtained. The isolated composite teeth were individually superimposed onto the set-up model surface scan to creat set-up model (Ma, Mb, Mc, Md) containing root position. These isolated composite teeth were also superimposed onto the posttreatment surface scan depicting the posttreatment model (M). In order to observe whether diagnosis model set-up would cause exposure of the root, Ma-Md were compared with Mo, which showed the true positions of alveolus. In order to validate the accuracy of the expected root position setup, Ma-Md were compared with the true root position represented by M. Color displacement maps generated to measure the discrepancies of root positions. Nonparallel and exposure of the root was found in all setup models. Color displacement maps through molar superimpositions showed maximum differences of 8.79 mm for the maxillary teeth and 9.96 mm for the mandibular teeth. Diagnosis model set-up based only on crown can not absolutely ensure the good alignment of roots without root exposure. It is necessary to construct the integrated model including root for diagnosis during tooth arrangement process.