Accuracy of 3-dimensional surgical simulation combined with digital teeth alignment

Abstract

The author initiated the 3D digital teeth alignment and carried out 3D surgical simulation based on this alignment, compared the 3D simulated image with the actual post-treatment 3D image, and evaluated the accuracy of 3D surgical simulation using digital teeth alignment. 3D dental and craniofacial image was established from initial CT and dental cast scan data of 13 adult patients. Surgical simulation was carried out and simulated 3D image was established. Post-treatment 3D image was established from CT data taken after completion of orthodontic treatment, and the Intraclass Correlation Coefficient (ICC) was used for the statistical analysis of the degree of concordance between 19 measurement points of post-treatment 3D image and those of simulated 3D image.In horizontal reference plane, moderate correlation coefficients (p < 0.05) and moderate concordance were showed on maxillary and mandibular canine cusp, mesiobuccal cusp of 1st molar, and anterior teeth, and mental foramen. And low correlation coefficients (p < 0.05) and low concordance were showed on gonion. In sagittal reference plane, low correlation coefficients (p > 0.05) and low concordance were showed on mandibular mesiobuccal cusp of 1st molar and canine cusp. And moderate correlation coefficients (p < 0.05) and moderate concordance were showed on mandibular canine cusp and gonion. High correlation coefficients (p < 0.001) and high concordance were showed on the other measurement points.In coronal reference plane, high correlation coefficients (p < 0.001) and high concordance were showed on all measurement points.In conclusion, accuracy of simulation in the coronal reference plane was high, but accuracy in the sagittal and horizontal reference plane and dental parts was relatively low. These were due to insufficient decompensation in the digital teeth alignment, which was initiated from the initial cast image separated from jaw for pre-surgical orthodontic treatment. Pre-surgical orthodontic teeth alignment should be considered with jaw relations, unlike in ordinary orthodontic teeth alignment. In addition, if more stable method of measuring vertical dimension during surgery will be developed, the accuracy of 3D surgical simulation combined with digital teeth alignment will be improved.