The advancement of digital technologies in dentistry has ushered in new methodologies for diagnosing and treating malocclusions, moving away from traditional methods toward more efficient and precise digital setups. The digital dental setup represents a significant evolution from the traditional setup introduced by Harold Kesling, which involved manually adjusting plaster crowns on a wax base. This older method, while effective, was time-consuming, required significant expertise, and incurred higher costs due to the intensive labor and materials involved.
In contrast, digital setups are performed using software applications that manipulate 3D digital models of patients' teeth. These models provide accurate 3D representations of intraoral surfaces, making them highly reliable, researchers noted in Progress in Orthodontics. The software enables quick adjustments, offers high precision without physical material loss, and allows unlimited modifications to achieve the desired tooth alignment. Furthermore, the software can access a variety of dental arch forms either from an online library or custom-made, enhancing the customization of treatment plans. Digital setups also facilitate the superimposition of before and after models, providing a clear visual comparison to aid in the evaluation of treatment effectiveness and planning.
The practical applications of digital setups are broad and include sharing proposed orthodontic treatment plans with health care providers for collaborative decision-making. Additionally, they can be used in consultations with patients, helping them understand the treatment options and expected outcomes, thus playing a crucial role in informed consent processes, noted the researchers. This not only enhances patient engagement but also improves communication between patients and health care providers, fostering a collaborative treatment environment, they wrote.
Despite these advantages, the primary focus of existing research on digital setup accuracy has been centered around its use in planning and predicting the outcomes of aligner treatments. There remains a relative paucity of data concerning its effectiveness in predicting outcomes for fixed orthodontic treatments, particularly in more complex cases such as those involving multidisciplinary restorative strategies or orthognathic surgery.
To address this gap, the study of 25 adult patients aimed to evaluate the predictive accuracy of digital setup in managing cases of class I malocclusion with moderate crowding. By superimposing the digital models predicted by digital setup onto the actual treatment outcomes, the study assessed how well the digital setup could forecast the results of treatments using fixed appliances.
The study unveiled that, while the average deviations between predicted and actual outcomes were relatively minimal, at less than 1 mm, individual cases showed significant variations, with some discrepancies reaching 2-3 mm. Notably, these deviations were more pronounced in the posterior regions of the dental arches and in the positioning of anterior teeth, highlighting the challenges of accurately simulating real-life orthodontic dynamics through digital models.
The results indicated that while digital setup is highly effective, there are still challenges with predicting certain treatment outcomes, particularly in the spatial positioning of teeth when using fixed orthodontic appliances. The study highlighted that digital setup, although a powerful diagnostic and planning tool, must be used judiciously, especially in complex cases where the precise prediction of tooth movement is critical.
The authors disclosed having no relevant conflicts of interest.
