Radeke Johanna, von der Wense Cynthia, Lapatki Bernd G
Department of Orthodontics, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany,
J Orofac Orthop. 2014 Jul;75(4):264-74. doi: 10.1007/s00056-014-0217-9. Epub 2014 Jul 6.
Over recent years, we have witnessed a growing trend in orthodontics toward the use of three-dimensional (3D) techniques for diagnostic purposes, treatment planning, and fabricating appliances. This study was undertaken to compare the traditional manual technique of using vernier calipers to take orthodontic measurements on plaster dental casts versus an all-digital measuring technique based on virtual 3D scans of casts. In this study, we focused on the quantitative agreement between and time requirements of both methods.
Plaster casts obtained from the jaws of 55 fully dentate patients who had not previously undergone orthodontic treatment underwent 3D scanning using a white-light scanner (d-Station (3D); Breuckmann, Meersburg, Germany). Once the casts had been blinded by an independent individual, three examiners with different degrees of expertise in dentistry and orthodontics measured the mesiodistal widths of teeth 6-6 in each jaw. A randomized sequence was used when taking the measurements three times using OnyxCeph(3TM) analysis software (Image Instruments, Chemnitz, Germany) and a dental vernier caliper. Bland-Altman plots were used to illustrate the level of agreement between the two methods, standard deviations of repeated measurements were calculated to assess their reproducibility, and the Wilcoxon's signed-rank test was employed to compare their time requirements.
The Bland-Altman analysis of all single values revealed no statistically significant difference between the software-based and caliper-based measurements of mesiodistal tooth width. Assuming the presence of normal distribution, the limits of agreement disclosed a 95% probability for the software values to range between +0.499 and -0.545 mm of the same value measured with the caliper. The standard deviations of repeated measurements were 0.33 mm with the software and 0.21 mm with the caliper. The digital method required significantly less time (p<0.01); however, differences were observed to be associated with operator experience.
Inexperienced examiners, in particular, take measurements of mesiodistal tooth dimensions faster using a software-based method than when using a dental vernier caliper. Similar values were obtained with both methods.
近年来,我们目睹了正畸领域在诊断、治疗计划制定及矫治器制作方面使用三维(3D)技术的趋势日益增长。本研究旨在比较使用游标卡尺在石膏牙模上进行正畸测量的传统手工技术与基于牙模虚拟3D扫描的全数字测量技术。在本研究中,我们关注两种方法之间的定量一致性和时间要求。
从55名未曾接受过正畸治疗的全口牙患者的颌骨获取石膏模型,使用白光扫描仪(d-Station (3D);德国梅尔斯堡的Breuckmann公司)进行3D扫描。在由独立人员对模型进行盲法处理后,三名在牙科和正畸方面具有不同专业水平的检查者测量了每侧颌骨中6 - 6牙齿的近远中宽度。使用OnyxCeph(3TM)分析软件(德国开姆尼茨的Image Instruments公司)和牙科游标卡尺进行三次测量时采用随机顺序。使用Bland-Altman图来说明两种方法之间的一致性水平,计算重复测量的标准差以评估其可重复性,并采用Wilcoxon符号秩检验比较它们的时间要求。
对所有单个值的Bland-Altman分析显示,基于软件和基于卡尺的近远中牙宽度测量之间无统计学显著差异。假设呈正态分布,一致性界限表明软件值在与卡尺测量的相同值的 +0.499至 -0.545毫米范围内的概率为95%。软件重复测量的标准差为0.33毫米,卡尺为0.21毫米。数字方法所需时间显著更少(p<0.01);然而,观察到差异与操作者经验有关。
特别是对于经验不足的检查者,使用基于软件的方法比使用牙科游标卡尺更快地测量近远中牙尺寸。两种方法获得的值相似。