Department of Orthodontics, School of Dentistry, Bushehr University of Medical Sciences, Bushehr, Iran.
Department of Orthodontics, School of Dentistry, Tehran Shahed University of Medical Sciences, Tehran, Iran.
Am J Orthod Dentofacial Orthop. 2019 Dec;156(6):870-877. doi: 10.1016/j.ajodo.2019.07.009.
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 (0.425-3.853 mm for the conventional vs 0.451-0.584 mm 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.
本研究旨在评估牙科临床医生在 3D 成像和数字软件的辅助下,与传统方法相比,预测错颌患者治疗后牙弓形态的能力。
选择 100 名患者(200 个上颌模型和 200 个下颌模型)的治疗前和治疗后牙石膏模型。三位正畸医生使用两种方法,从 5 种市售预成型镍钛弓丝中选择最合适的弓丝。在传统方法中,他们将弓丝适配到治疗前的模型上,而在数字方法中,他们使用本地开发的 3D 软件 Ortho-Aid 将扫描的弓丝适配到 3D 数字模型上,使用临床托槽点作为弓丝适配的参考。在每种方法中,预测的治疗后弓丝与每位患者的实际治疗后模型上的最佳适配弓丝进行比较,并计算一致性水平。在每种方法中,使用组内相关系数和 Dahlberg 公式评估三位正畸医生之间的观察者间一致性。
正畸医生使用传统方法预测最终治疗结果的准确率为 50%,使用数字方法的准确率为 58%。然而,传统方法的方法误差范围明显更高(传统方法为 0.425-3.853 毫米,数字方法为 0.451-0.584 毫米)。
尽管使用数字设备增加了临床医生预测正畸治疗后最终牙弓形态的能力和临床医生之间的一致性,但正畸医生只能预测约 60%的患者的最终牙弓形态。