A Comparative Evaluation of Digital and Conventional Approaches in Orthodontic Space and Tooth Size Analysis: A Retrospective Comparative Study
DOI:
https://doi.org/10.15517/qjxe1f39Keywords:
Models, dental; Orthodontics; Imaging, three-dimensional; Dental impression technique; Reproducibility of results; Observer variation.Abstract
Aim of the study was to comparatively assess the sensitivity of digital measurements for space discrepancies and tooth size analysis in comparison to conventional plaster models, digital models, and rescanned plaster models. Orthodontic pre-treatment records were obtained from 40 randomly selected patients undergoing orthodontic treatment in the permanent dentition (mean age: 20.83; 14 males, 26 females). Intraoral 3D records and conventional plaster models were collected. Digital measurements were performed using an intraoral scanner (iTero Element, Align Technologies, San Jose, Calif), while conventional measurements were derived from alginate impressions used to create plaster models. These plaster models were subsequently digitized using the same intraoral 3D scanner. All measurements from the digitized models were analyzed using the OrthoCAD software (Cadent, Carlstadt, NJ, USA). No significant differences were observed among the groups for measurements of Hayes-Nance Maxilla Actual, Hayes-Nance Maxilla Required, Hayes-Nance Maxilla Discrepancy, Bolton Overall Maxilla, Bolton Overall Mandible, Bolton Overall Discrepancy, Bolton Overall Ratio (%), Overbite, and Overjet (p>0.05). Throughout the study, no variations were observed in Hayes-Nance, Bolton analyses, or overjet-overbite measurements across digital models, plaster models, and digitized plaster models. The mean differences between methods were generally within 1 mm, suggesting clinical comparability for most analyses. However, moderate intra-examiner reliability was observed for Bolton Anterior Ratio and Overbite, indicating that these variables should be interpreted with caution. Within the limitations of this study, scanning plaster models with an intraoral scanner appears to be a feasible and clinically acceptable alternative to direct digital scanning.
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Proffit W.R., Fields H.W., Larson B., Sarver D.M. Contemporary Orthodontics - E-Book. Elsevier Health Sciences; 2018: 746.
Selvaraj M., Sennimalai K. Orthodontic model analysis in permanent dentition: A review of past, and current methods. IP Indian J Orthod Dentofacial Res. 2022; 8 (4): 220-226. DOI: https://doi.org/10.18231/j.ijodr.2022.038
Goracci C., Franchi L., Vichi A., Ferrari M. Accuracy, reliability, and efficiency of intraoral scanners for full-arch impressions: A systematic review of the clinical evidence. Eur J Orthod. 2016; 38 (4): 422-8. DOI: https://doi.org/10.1093/ejo/cjv077
Saleh W.K., Ariffin E., Sherriff M., Bister D. Accuracy and reproducibility of linear measurements of resin, plaster, digital, and printed study models. J Orthod. 2015; 42 (4): 301-6. DOI: https://doi.org/10.1179/1465313315Y.0000000016
Akyalcin S., Dyer D.J., English J.D., Sar C. Comparison of 3-dimensional dental models from different sources: Diagnostic accuracy and surface registration analysis. Am J Orthod Dentofac Orthop. 2013; 144: 831-7. DOI: https://doi.org/10.1016/j.ajodo.2013.08.014
Akyalcin S. Are digital models replacing plaster casts? Dentistry. 2011; 1: e102. DOI: https://doi.org/10.4172/2161-1122.1000e102
Suryajaya W., Purbiati M., Ismah N. Accuracy of digital dental models and three-dimensional printed dental models in linear measurements and Bolton analysis. J Orthod. 2020; 47 (2): 113-118.
Krishnan V., Davidovitch Z. Conventional or digital – Orthodontic study models are here to stay! J World Fed Orthod.2021; 10 (2): 47-53. DOI: https://doi.org/10.1016/j.ejwf.2021.05.002
Quimby M.L., Katherine W.L., Rashid R.G., Firestone A.R. The accuracy and reliability of measurements made on computer-based digital models. Angle Orthod. 2004; 74: 298-303.
Leifert M.F., Leifert M.M., Efstratiadis S.S., Cangialosi T.J. Comparison of space analysis evaluations with digital models and plaster dental casts. Am J Orthod Dentofac Orthop. 2009; 136: 16.e1-e4. DOI: https://doi.org/10.1016/j.ajodo.2008.11.019
Yılmaz H., Özlü F.Ç., Karadeniz C. Efficiency and accuracy of three-dimensional models versus dental casts: A clinical study. Turkish J Orthod. 2019; 32 (4): 214-8. DOI: https://doi.org/10.5152/TurkJOrthod.2019.19034
Flügge T.V., Schlager S., Nelson K., Nahles S., Metzger M.C. Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner. Am J Orthod Dentofac Orthop. 2013; 144 (3): 471-8. DOI: https://doi.org/10.1016/j.ajodo.2013.04.017
Watanabe-Kanno G.A., Abrão J., Junior H.M., Sánchez-Ayala A., Lagravère M.O. Determination of tooth-size discrepancy and Bolton ratios using Bibliocast Cécile3 digital models. Int Orthod. 2010; 8 (3): 215-26. DOI: https://doi.org/10.1016/j.ortho.2010.07.014
Schepke U., Meijer H.J., Kerdijk W., Cune M.S. Digital versus analog complete-arch impressions for single-unit premolar implant crowns: Operating time and patient preference. J Prosthet Dent. 2015; 114: 403-6.e1. DOI: https://doi.org/10.1016/j.prosdent.2015.04.003
Gjelvold B., Chrcanovic B.R., Korduner E.K., Collin-Bagewitz I., Kisch J. Intraoral digital impression technique compared to conventional impression technique: A randomized clinical trial. J Prosthodont. 2016; 25: 282-7. DOI: https://doi.org/10.1111/jopr.12410
Siqueira R., Galli M., Chen Z., Mendonça G., Meirelles L., Wang H.L., Chan H.L. Intraoral scanning reduces procedure time and improves patient comfort in fixed prosthodontics and implant dentistry: A systematic review. Clin Oral Investig. 2021; 25: 6517-31. DOI: https://doi.org/10.1007/s00784-021-04157-3
Keating A.P., Knox J., Bibb R., Zhurov A.I. A comparison of plaster, digital, and reconstructed study model accuracy. J Orthod. 2008; 35: 191-201. DOI: https://doi.org/10.1179/146531207225022626
Amuk N.G., Karsli E., Kurt G. Comparison of dental measurements between conventional plaster models, digital models obtained by impression scanning, and plaster model scanning. Int Orthod. 2019; 17: 151-8. DOI: https://doi.org/10.1016/j.ortho.2019.01.014
Rossini G., Parrini S., Castroflorio T., Deregibus A., Debernardi C.L. Diagnostic accuracy and measurement sensitivity of digital models for orthodontic purposes: A systematic review. Am J Orthod Dentofacial Orthop. 2016; 149: 161-70. DOI: https://doi.org/10.1016/j.ajodo.2015.06.029
Nelwan S.C., Karuniadewi A.A., Nowwarote N., Dewi A.M., Prayogo R.D. Accuracy of Digital Intraoral Scans Three-dimensional Surface Analysis Compared with Plaster Models Dental Measurement in Mixed Dentition. Int J Clin Pediatr Dent. 2024; 17 (12): 1363-1369. DOI: https://doi.org/10.5005/jp-journals-10005-3013
Warnecki M., Nahajowski M., Papadopoulos M.A., Kawala B., Lis J., Sarul M. Assessment of the reliability of measurements taken on digital orthodontic models obtained from scans of plaster models in laboratory scanners. A systematic review and meta-analysis. Eur J Orthod. 2022; 44 (5): 522-529. DOI: https://doi.org/10.1093/ejo/cjac005
Alassiry A.M. Clinical aspects of digital three-dimensional intraoral scanning in orthodontics-A systematic review. Saudi Dent J. 2023; 35 (5): 437-442. DOI: https://doi.org/10.1016/j.sdentj.2023.04.004
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