ROBOTICS IN ORTHODONTICS: EFFICACY OF CAD/CAM-MANUFACTURED ARCHWIRES IN PREDICTING AND IMPLEMENTING CLINICAL OUTCOMES

Abstract

Introduction: The advent of intraoral scanning, computer-aided design and manufacturing, and three-dimensional radiographic imaging has made orthodontic diagnosis and treatment planning more comprehensive and multi-dimensional. With the aid of such advances, the SureSmile® technology eliminates manual wire bending performed by the orthodontist through robotically fabricated wires. These wires incorporate all the requisite bends to achieve the tooth movements desired by the clinician. The purpose of this retrospective study was to evaluate the accuracy of the tip and torque virtual predictions that are expressed by the robotically manufactured wires of SureSmile®. Materials and Methods: CBCTs taken after treatment using the SureSmile® technology were procured from a private practice. These CBCT images were superimposed with the predicted tooth positions using stable skeletal structures in the Dolphin Imaging Software. The tooth apex and crown were digitized and used to calculate tip and torque values for each tooth type. A paired samples t-test was performed to assess if differences in tip and torque values are present between the predicted and actual final outcomes. Results: 16 patients were utilized in this study, which encompassed evaluation of 339 teeth. Paired samples t-test show that: 1) SureSmile® predictions of most teeth were statistically similar to the actual clinical outcomes (p≥0.05); however, 2) torque expression on upper canines (p=0.003) and lower lateral incisors (p=0.007) were not accurately predicted. Conclusions: SureSmile® archwires can reliably predict tooth tip and torque positions and translate them to clinical movements for most of the types of teeth studied. It is recommended that overcorrections for upper canine torques and lower lateral incisors are incorporated into the planned movements if the clinician deems it clinically necessary.