Conversation and Literature about 3D in orthodontics

Many clinicians talk about “impression less” solutions.
Do we need such a solution?

Summary of literature for technology diagnostic models:

Note: “o3dm” is the precursor of the current DPP-Ortho program, which was created based on many years of experience with o3dm.

Comparison of guided and
non – guided implant placement
In vitro study with 3D printing (Part 1)
Dr Łukasz Zadroz˙ ny, Marta Czajkowska & Dr Leopold Wagner, Poland

CAD/CAM 1_2019

The procedure of implantation is becoming an increasingly
popular method for replacing teeth. The critical factor
in the achievement of a therapeutic and aesthetic
long-term effect is the accuracy and precision of implant
placement, being the support for the future prosthetic work.Methodology
Based on the CBCT examination of the patient, who underwent
implantation in the mandible, a 3D model corresponding
to the actual bone and mucosal conditions
before implantation was created in DDS-Pro software
( It was then reprinted 20 times. The
print was produced with selective laser sintering technology
using polyamide powder in the TPM Elite 3600 SLS
System printer (Solveere). It yielded ten identical pairs
of mandibular models.
Użycie modeli wydrukowanych trójwymiarowo pozwala na wykonanie procedur implantologicznych w warunkach
odpowiadających przestrzennie potencjalnej sytuacji klinicznej. Modele wydrukowane w ramach niniejszego badania były
jednak twarde. Skrawany w czasie preparacji łoża materiał osadzał się na wiertle oraz w gwincie implantu, utrudniając jego
wprowadzenie na pełną głębokość wypreparowanego łoża. Wymuszało to użycie znacznie większej, niż stosowana
klinicznie, siły do wprowadzenia implantu.
Przy preparacji łoża w sąsiedztwie zachowanego zęba zwrócono uwagę na konieczność zastosowania przedłużki do wierteł,
aby uniknąć opierania się kątnicy o szablon/ząb. Narzędzia tego brakuje w kasecie do nawigacji Osstem Guide Kit, o czym
należy pamiętać, używając tego zestawu klinicznie i zawsze dodatkowo mieć do dyspozycji standardową kasetę
implantologiczną. Użycie szablonu skraca czas wykonania procedury implantologicznej w porównaniu z procedurą
wykonywaną z wolnej ręki.
Trends in the use of digital study models and other technologies among practicing orthodontists-
Dr.Park, Dr.Laslovich
JCO/July 2016
The authors evaluate the use of digital study models in daily orthodontic practice. They sent 31 questions to a random selection of 2,300 orthodontists, using; about 9% responded…
The rospondents would also be more likely to use intraoral scanners, cone-beam computed tomography (CBCT), and digital study models.
(OrthoCAD, SureSmile, Ortho Insight 3D, DigModel, emodel, O3DM)
Thet said, I found the information to be fascinating. Various methodods used to capture the data needed for digital study models are explored, and the results of the survey are reported in self-explanatory graphs and flow charts. I encourage you to spend some time with this article, looking fopr the underlying trends as much as the raw numbers.W.Ronald Redmonds, DDS, MS
Diagnostic accuracy and measurement sensitivity of digital models for orthodontic purposes: A systematic review
G.Rossini, S.Parrini, T.Castroflorio, A.Deregibus, C.debernardi
AJODO February 2016
Our objectives was to assess the accuracy, validity and reliability of measurements obtained from virtual dental study models compared with those obtained from plaster models. Abstract:

  • Digital models are as reliable as plastetr models for orthodontic purposes.
  • Lack of accuracy of measurements on digital models is not clinically significant.
  • Digital models should be considered the new gold standard in orthodontics.
Digital models are as reliable as traditional plaster models, with high accuracy, reliability, and reproducibility. Landmark identification, rather than the measuring device or the software, appears to be the greatest limitation. Furthermore, with their advantages in terms of cost, time, and space required, digital models could be considered the new gold standard in current practice.
„Digital casts in orthodontics: A comparison of 4 software systems”Anna Westerlund, Weronika Tancredi, Maria Ransjo, Andrea Bresin, Spyros Psonis, and Olof Torgersson
Gothenburg Sweden
Am J Orthod Dentofacial Orthop 2015;147:509-16
The introduction of digital cast models is inevitable in the otherwise digitized everyday life of orthodontics. The introduction of this new technology, however, is not straightforward, and selecting an appropriate system can be difficult. The aim of the study was to compare 4 orthodontic digital software systems regarding service, features, and usability. Methods: Information regarding service offered by the companies was obtained from questionnaires and Web sites. The features of each software system were collected by exploring the user manuals and the software programs. Replicas of pretreatment casts were sent to Cadent (OrthoCAD; Cadent, Carlstadt, NJ), OthoLab (O3DM; OrthoLab, Czestochowa, Poland), OrthoProof (DigiModel; OrthoProof, Nieuwegein, The Netherlands), and 3Shape (OrthoAnalyzer; 3Shape, Copenhagen, Denmark). The usability of the programs was assessed by experts in interaction design and usability using the “enhanced cognitive walkthrough” method: 4 tasks were defined and performed by a group of domain experts while they were observed by usability experts. Results: The services provided by the companies were similar. Regarding the features, all 4 systems were able to perform basic measurements; however, not all provided the peer assessment rating index or the American Board of Orthodontics analysis, simulation of the treatment with braces, or digital articulation of the casts. All systems demonstrated weaknesses in usability. However, OrthoCAD and 03DM were considered to be easier to learn for first-time users. Conclusions: In general, the usability of these programs was poor and needs to be further developed. Hands-on training supervised by the program experts is recommended for beginners.
“Comparison of Bolton analysis and tooth size measurements obtained using conventional and three-dimensional orthodontic models.”Nalcaci R1, Topcuoglu T2, OzturkF3
Eur JDent. 2013 Sep;7(Suppl 1):S66-70. doi: 10.4103/1305-7456.119077
The aim of this study was to compare the accuracy, reproducibility, efficacy and effectiveness of measurements obtained using digital models with those obtained using plaster models. Digital models were produced by the Ortho Three-dimensional Models (O3DM) Laboratory and their software (O3DM version 2) was used to obtain measurements. Identical plaster models were used to obtain measurements of teeth with a vernier caliper. All measurements were repeated at least 1 month later by the same operator for both digital and manual methods. The data were analyzed using Cronbach α, Wilcoxon signed rank test and the McNemar test. Use of O3DM software is an acceptable alternative to the traditional vernier caliper method in orthodontic practice.

“Assessment of dental arches in patients with Class II division 1 and division 2 malocclusions using 3D digital models in a Syrian sample.”
Hajeer MY
Eur J Paediatr Dent. 2014 Jun;15(2):151-7

3D digital models (O3DM) with a dedicated programme were used to measure dental arch variables. Significant differences were observed between the two groups in the mesiodistal widths of some teeth but not in the dental arch widths. 3D digital models enabled fast, accurate and reliable measurements of dental arch characteristics in patients with Class II malocclusion. (2) Insignificant differences between Cl II1 and Cl II2 patients were observed regarding Bolton’s ratios and transverse arch measurements.
 „From alginate impressions to digital virtual models: accuracy and reproducibility”
Michel Dalstra, Birte Melsen
School of Dentistry, University of Aarhus, Denmark
Journal of Orthodontics, Vol. 36,2009,36-41
It has been shown that there are no differences in the measurements between plaster models cast immediately after taking impressions in relation to the models cast 3-5 days of collection impression and obtained from them digital models, which ensures the correct measurements even after sending the impression to a professional lab by mail in order to prepare 3D models. Making models (digital models) in one lab provides greater repeatability diagnostic material to carry out further measurements.
“Czy modele cyfrowe mogą zastąpić modele gipsowe?”
Lene Rosbjerg, Emilie Neumann,Michel Dalstra, Birte Melsen.„
Moja Praktyka” the magazine for orthodontists published in Poland 1999 – 2014
Studies have shown that there were no statistically significant differences between measurements taken at the digital models and plaster. The authors also noticed greater security of patient records in digital form (models basically can not be lost or be damaged or been manipulated). It has been proved that the measurements of digital models have better repeatability particularly when they make those with less experience clinical since the possibility of measurement inaccuracies related only to the determination of measurement points and does not occur due to the way of applying the measuring apparatus and the precision of the measurement reading.