Accuracy and reliability of traditional measurement techniques for tooth widths and arch perimeter compared to CAD/CAM.
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Background: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. Aim: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. Method: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). Results: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). Conclusion: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.