The effect of root and bone visualization on perceptions of the quality of orthodontic treatment simulations

Abstract

Introduction: Technological advances in three-dimensional imaging of the dentition have provided orthodontists with more diagnostic information than ever. This study evaluated the effect of root and bone visibility on perceptions of the quality of treatment simulations to assess how the use of advanced imaging such as cone-beam computed tomography (CBCT) may influence treatment planning decisions. Methods: An online survey was used to present 141 orthodontists with setups (digital models of teeth) generated for 10 patients in 2 different types of view: with and without bone and roots as modeled from a cone-beam computed tomography scan. Using a 100-point visual analog scale, the orthodontists were asked to rate the quality of the setups from poor to ideal, and, if applicable, to identify features of concern that led them to giving a setup a less than ideal rating. Results: The quality ratings were significantly lower when roots and bone were visible in the setups (P<0.0001). Buccolingual inclination and periodontal concerns were selected significantly more often as reasons for a less-than-ideal rating when roots and bone were shown, whereas occlusal relationship, overjet, occlusal contacts, and archform were selected significantly more often as reasons for a less-than-ideal rating when roots and bone were not shown. The odds of selecting periodontal concerns as a reason for a less-than-ideal setup rating were 331 times greater when roots and bones were visible than when they were not. Conclusions: Additional diagnostic information derived from CBCT scans affects orthodontists’ perceptions of the overall case quality, which may influence their treatment planning decisions.