Comparison of dental movements in digital setups created by orthodontists and "3shape design service®" engineers: A cross-sectional study.

ABSTRACT

INTRODUCTION: The demand for faster and invisible orthodontic treatments has led to the increased use of clear aligners, facilitated by advancements in digital treatment planning. This study aims to evaluate the reliability of digital orthodontic setups performed by orthodontists compared to those by 3Shape Design Service®engineers. MATERIAL AND METHODS: A monocentric, cross-sectional observational study was conducted at Bretonneau Hospital from October 2022 to May 2023. All patients meeting the inclusion criteria and willing to participate were included in the study. Intraoral scans were used to create treatment setups using the Ortho System® software, performed by both orthodontists and 3Shape® engineers. The primary objective was to compare the dental movements (rotation, intrusion, extrusion, buccolingual inclination, tipping, mesiodistal translation and buccolingual translation) between the two groups. Secondary objectives included the number of teeth displaced, aligners needed, interproximal enamel reduction and number of attachments placed. RESULTS: Nineteen patients with mild to moderate malocclusion were included. Statistically significant differences were found in tooth displacements between the two groups with engineers executing greater dental movements for derotation (4.9±2.6 vs. 3.7±2.3), tipping (0.79±0.69 vs. 0.26±0.44), bucco-lingual (0.40±0.26 vs. 0.08±0.11) and mesio-distal translations (0.31±0.20 vs. 0.20±0.17). Secondary measures showed no significant differences except for the number of teeth displaced (15.32±5.21 vs. 9.68±4.82), which was higher in the 3Shape group. DISCUSSION: While digital setups by engineers showed more significant tooth movements, the practical impact on mild malocclusion treatment was minimal. This study highlights the need for precise treatment objectives and consideration of overcorrection practices. CONCLUSION: For mild malocclusions, outsourcing setups to 3Shape engineers can be an alternative to in-office setups by orthodontists. However, further studies are needed to evaluate setup reliability for more complex malocclusions.