Accuracy of Dolphin visual treatment objective (VTO) prediction software on class III patients treated with maxillary advancement and mandibular setback.

Robert J Peterman,Rene Johe,Padma M Mukherjee,Shuying Jiang

doi:10.1186/s40510-016-0132-2

Robert J Peterman, Rene Johe + Show 2 more

Open Access

https://doi.org/10.1186/s40510-016-0132-2

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Abstract

BackgroundDolphin® visual treatment objective (VTO) prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes. Although surgical soft tissue prediction is considered to be a vital tool, its accuracy is not well understood in tow-jaw surgical procedures. The objective of this study was to quantify the accuracy of Dolphin Imaging’s VTO soft tissue prediction software on class III patients treated with maxillary advancement and mandibular setback and to validate the efficacy of the software in such complex cases.MethodsThis retrospective study analyzed the records of 14 patients treated with comprehensive orthodontics in conjunction with two-jaw orthognathic surgery. Pre- and post-treatment radiographs were traced and superimposed to determine the actual skeletal movements achieved in surgery. This information was then used to simulate surgery in the software and generate a final soft tissue patient profile prediction. Prediction images were then compared to the actual post-treatment profile photos to determine differences.ResultsDolphin Imaging’s software was determined to be accurate within an error range of +/− 2 mm in the X-axis at most landmarks. The lower lip predictions were most inaccurate.ConclusionsClinically, the observed error suggests that the VTO may be used for demonstration and communication with a patient or consulting practitioner. However, Dolphin should not be useful for precise treatment planning of surgical movements. This program should be used with caution to prevent unrealistic patient expectations and dissatisfaction.

Highlights

Dolphin® visual treatment objective (VTO) prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes
Intra-examiner results showed that Intra-class correlation coefficient (ICC) are 0.729 and 0.834 in the X-axis and 0.694 and 0.533 in the Y-axis for the investigator RP and investigator RL, respectively, which indicated that a good reliability in the X-axis and moderate reliability in the Y-axis existed between repeated measurements of each investigator
It is important to consider that the VTO predictions utilized in this study assume that pre-surgical orthodontic tooth movements and surgical jaw and tooth movements would be perfectly executed as treatment planned

Summary

Introduction

Dolphin® visual treatment objective (VTO) prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes. The objective of this study was to quantify the accuracy of Dolphin Imaging’s VTO soft tissue prediction software on class III patients treated with maxillary advancement and mandibular setback and to validate the efficacy of the software in such complex cases. One of the great challenges in orthodontics is the treatment planning and management of orthognathic surgical cases. Visual treatment objective (VTO) images help the orthodontist to predict hard and soft tissue changes that may occur as a result of surgery and can be utilized to treatment plan orthognathic cases and to communicate with patients and surgeons. Seventy percent of prospective orthognathic surgery patients mention esthetics as their principle motivation, further highlighting the importance of soft tissue treatment planning [6]

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