Digital model superimpositions: are different software algorithms equally accurate in quantifying linear tooth movements?

Samar M Adel, Nikhilesh R Vaid, Nadia El-Harouni, Hassan Kassem, Abbas R Zaher, Samar M Adel, Nikhilesh R Vaid, Nadia El-Harouni, Hassan Kassem, Abbas R Zaher

Abstract

Background: To evaluate the accuracy of three different 3D digital model registration software packages for linear tooth movement measurements, with reference to a 3D digital virtual setup (DS).

Methods: Twenty maxillary and mandibular pre-treatment scans of patients undergoing clear aligner therapy were used. Digital Setups were generated from pre-treatment scans using OrthoAnalyzer software. Both the pretreatment digital scans (T1) and Digital Setups (T2) were converted to STL files to be imported to the three studied software packages: Geomagic, OrthoAnalyzer and Compare. Linear changes in tooth positions were calculated for all the registered pairs.

Results: The change in tooth position was compared between the calculated tooth movement using each of the registration software packages versus the actual generated tooth movement from the Digital Setups. Continuous data was expressed as mean and standard deviation. Intraclass Correlation Coefficients for agreements between Digital Simulation and each software was used. Intra and Inter-examiner reliabilities were also assessed using Intraclass Correlation Coefficients. Significance of the obtained results was expressed at p ≤ 0.01. Geomagic software showed agreements > 0.90 for maxillary linear tooth movements and between 0.75 and 0.90 for mandibular measurements. OrthoAnalyzer software showed agreements between 0.50 and < 0.75 for maxillary and mandibular measurements. Compare software showed agreements > 0.90 for maxillary and mandibular linear tooth movements, indicating the best consistency.

Conclusions: Compare and Geomagic software packages consistently showed maximum accuracy in measuring the amount of tooth movement in the maxillary arch compared to the reference standard. Compare software showed the highest agreements in the mandibular arch. None of the three studied software packages showed poor agreement with the Digital Setup across all tooth movement measurements. Buccolingual tooth movements showed the highest agreements amongst linear measurements.

Keywords: 3D digital models; 3D tooth movement; Aligner therapy; Digital Setup; Digital orthodontics; Registration; Scanning.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Research flowchart
Fig. 2
Fig. 2
Segmentation of teeth and virtual tooth movements during Digital Setup generation
Fig. 3
Fig. 3
Registration of a maxillary models, b mandibular models, c corresponding heat maps by Geomagic software. Three points on the medial ends of third and second rugae areas in the maxillary arch and three points on the mucogingival junction (MGJ) between first premolar and second premolar, second premolar and first molar, first molar and second molar were selected as reference landmarks, followed by a global and fine regional surface registration
Fig. 4
Fig. 4
Registration of a maxillary models, b mandibular models with corresponding heat maps by OrthoAnalyzer software. In the maxillary arch, three points on the medial ends of third and second rugae areas, plus an area of the palate limited anteriorly by the medial 2/3 of the third rugae and laterally by two lines parallel to the mid-palatal suture were used as the landmark. In the mandibular arch, three points on the MGJ between first premolar and second premolar, second premolar and first molar, first molar and second molar, plus an area 1 mm above and below the selected points on the MGJ
Fig. 5
Fig. 5
Registration of maxillary models and mandibular models by Compare software. a Global alignment of maxillary and mandibular T2 (orange) over T1 model (white). b Superimposition of individual segmented teeth from T2 (green) over the unsegmented T1 model (white). c Placement of coordinates at the center of resistance of each tooth

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