Can 3D imaging and digital software increase the ability to predict dental arch form after orthodontic treatment?

Abstract

This study aimed to evaluate the ability of dental clinicians to predict posttreatment dental arch forms in patients with malocclusion with the aid of 3D imaging and digital software in comparison with a conventional method. Pretreatment and posttreatment dental plaster casts of 100 patients (200 maxillary models and 200 mandibular models) were selected. Three orthodontists selected the best-fitted archwires among 5 commercially available preformed nickel-titanium archwires using 2 methods. In the conventional method, they fit the archwires to pretreatment casts, and in the digital method, they fit the scanned wire to a 3D digital model, using Ortho-Aid, a locally developed 3D software, using clinical bracket points as reference for wire fitness. The predicted posttreatment archwire in each method was compared with the best-fit archwire on the actual posttreatment model of each patient in both methods, and the level of agreement was calculated. The interobserver agreement between the 3 orthodontists in each method was evaluated using intraclass correlation coefficient and the Dahlberg formula. Orthodontists predicted the final treatment outcome in 50% of cases using the conventional method and 58% using the digital method. However, the range of method error was significantly higher in the conventional method (0.425-3.853mm for the conventional vs 0.451-0.584mm for the digital). Although the clinicians' ability to predict the final dental arch form after orthodontic treatment and the agreement between clinicians increased by the use of digital equipment, orthodontists can predict the final arch form in about 60% of patients.