Evaluating the Accuracy of Automated Orthodontic Digital Setup Models

Orthodontic tooth setup provides the orthodontist an insight into the possibilities and limitations of treatment and enables visualization of the final goal of treatment. Lately, artificial intelligence techniques have been applied to the digital setup software to automate the process of tooth segmentation and alignment. The purpose of this study was to evaluate the accuracy and efficiency of automated digital setup software. The diagnostic digital impression data of 30 patients (mean age, 29.8 ± 14.4 y) who underwent non-extraction orthodontic treatment from 2020 to 2022 were collected. Three automated digital setup software programs, Autolign (Diorco, Yongin, Korea), Outcome Simulator Pro (Align Technology, Inc., Arizona, USA), and Ortho Simulation (Medit, Seoul Korea) were tested and compared to the manual setup model using the Maestro 3D Dental Studio software (AGE Solutions S.r.l., Pontedera, Italy). The linear and angular transposition with respect to six dimensions of tooth movements, including occlusal-gingival, facial-lingual, and mesial-distal bodily movement, as well as crown rotation, mesial-distal crown tip, and facial-lingual crown torque, were calculated. The mean error for linear and angular movement ranged 0.39 – 1.40 mm and 3.25 – 7.80 °, respectively. The effectiveness of automated digital setup systems varies among software, tooth type, and the dimension of movement. Although the setup results have shown improvement in the occlusion indices, further manual adjustments may be needed for clinical use, such as indirect bonding and clear aligner therapy.