Although Invisalign is generally able to achieve predicted tooth positions with high accuracy in nonextraction cases, some of the actual outcomes may differ from the predicted outcomes. Knowledge of dimensions in which the final tooth position is less consistent with the predicted position enables clinicians to build necessary compensations into the virtual treatment plan.
Objective: To elicit the magnitude, directional bias, and frequency of bracket positioning errors caused by the transfer of brackets from a dental cast to the patient's dentition in a clinical setting. Materials and Methods: A total of 136 brackets were evaluated. The brackets were placed on dental casts and scanned using cone beam computed tomography (CBCT) to capture 3-D positioning data. The brackets were then transferred to the patient's dentition with an indirect bonding method using vinyl polysiloxane (VPS) trays and later scanned using CBCT to capture the final bracket positioning on the teeth. Virtual models were constructed from the two sets of scan data and digitally superimposed utilizing best-fit, surface-based registration. Individual bracket positioning differences were quantified using customized software. One-tailed t tests were used to determine whether bracket positioning was within limits of 0.5 mm in the mesiodistal, buccolingual, and vertical dimensions, and 2u for torque, tip, and rotation. Results: Individual bracket positioning differences were not statistically significant, indicating, in general, final bracket positions within the selected limits. Transfer accuracy was lowest for torque (80.15%) and highest for mesiodistal and buccolingual bracket placement (both 98.53%). There was a modest directional bias toward the buccal and gingival. Conclusion: Indirect bonding using VPS trays transfers the planned bracket position from the dental cast to the patient's dentition with generally high positional accuracy. (Angle Orthod. 2016;86:468-474.)
Objective: To determine the influence of landmark labeling on the accuracy and precision of an indirect facial anthropometric technique. Materials and Methods: Eighteen standard linear craniofacial measurements were obtained from 10 adults using the 3dMDface system, with landmarks labeled (Labeled_3D) and without landmarks labeled (Unlabeled_3D) before image acquisition, and these were compared with direct anthropometry (Caliper). Images were acquired twice in two different sessions 1 week apart (T1 and T2). Accuracy and precision were determined by comparing mean measurement values and absolute differences between the three methods. Results: Mean measurements derived from three-dimensional (3D) images and direct anthropologic measurements were mostly similar. However, statistically significant differences (P , .01) were noted for seven measurements in Labeled_3D and six measurements in Unlabeled_3D. The magnitudes of these differences were clinically insignificant (,2 mm). In terms of precision, results demonstrated good reproducibility for both methods, with a tendency toward more precise values in Labeled_3D, when compared with the other two techniques (P , .05). We found that Labeled_3D provided the most precise values, Unlabeled_3D produced less precise measurements, and Caliper was the least capable of generating precise values. Conclusions: Overall, soft tissue facial measurement with the 3dMDface system demonstrated similar accuracy and precision with traditional anthropometry, regardless of landmarking before image acquisition. Larger disagreements were found regarding measurements involving ears and soft tissue landmarks without distinct edges. The 3dMDface system demonstrated a high level of precision, especially when facial landmarks were labeled. (Angle Orthod. 2011;81:245-252.)
Introduction
The aims of this study were to analyze 3-dimensional skeletal changes in subjects with Class II malocclusion treated with the Herbst appliance and to compare these changes with treated Class II controls using 3-dimensional superimposition techniques.
Methods
Seven consecutive Herbst patients and 7 Class II controls treated with Class II elastics who met the inclusion criteria had cone-beam computed tomographs taken before treatment, and either after Herbst removal or at posttreatment for the control subjects. Three-dimensional models were generated from the cone-beam computed tomography images, registered on the anterior cranial bases, and analyzed using color maps and point-to-point measurements.
Results
The Herbst patients demonstrated anterior translation of the glenoid fossae and condyles (right anterior fossa, 1.69 ± 0.62 mm; left anterior fossa, 1.43 ± 0.71 mm; right anterior condyle, 1.20 ± 0.41 mm; left anterior condyle, 1.29 ± 0.57 mm), whereas posterior displacement predominated in the controls (right anterior fossa, −1.51 ± 0.68 mm; left anterior fossa, −1.31 ± 0.61 mm; right anterior condyle, −1.20 ± 0.41 mm; left anterior condyle, −1.29 ± 0.57 mm; P <0.001). There was more anterior projection of B-point in the Herbst patients (2.62 ± 1.08 mm vs 1.49 ± 0.79 mm; P <0.05). Anterior displacement of A-point was more predominant in the controls when compared with the Herbst patients (1.20 ± 0.53 mm vs −1.22 ± 0.43 mm; P <0.001).
Conclusions
Class II patients treated with the Herbst appliance demonstrated anterior displacement of the condyles and glenoid fossae along with maxillary restraint when compared with the treated Class II controls; this might result in more anterior mandibular projection.
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