Orthodontic Study Cast Analysis—Reproducibility of Recordings and Agreement Between Conventional and 3D Virtual Measurements

Digital imaging of dental casts has become an alternative to conventional cast analysis in orthodontic treatment planning. The reproducibility of angular measurements made on virtual digital models has not as yet been evaluated. In order to study reproducibility for and agreement between a conventional analysis technique and virtual 3D imaging, 20 dental casts from subjects in the early mixed dentition, were measured twice with each technique by two orthodontists. Variables of interest were incisor rotation, angulation and irregularity, arch width, arch circumference, overjet, and overbite. Standard deviation (Dahlberg 1940) and coefficient of variation were used for evaluation of reproducibility. Mean differences between methods and examiners, correlation between mean differences and mean levels and 95% limits of agreement were used for describing systematic errors. The conventional technique showed less intraexaminer variation for angular variables than the 3D imaging method. Linear variables, with the exception of overbite, showed no clear trend as regards differences in reproducibility between the two methods. In general, examiner 1 showed less intraexaminer variation than examiner 2. The mean differences between the two methods expressed higher values for assessment of rotations with the O3DM method. Both angular and linear variables exhibited poor 95% limits of agreement. The conventional technique showed better overall reproducibility and thus appears to be more suitable for scientific work. However, the reproducibility attained by O3DM is clearly acceptable for clinical use. The two methods should not be used interchangeably.