Consideration of root position in virtual tooth setup for extraction treatment: A comparative study of simulated and actual treatment results

OBJECTIVE: The purpose of the present study was to compare the root positions in virtual tooth setups using only crowns in a simulated treatment with those achieved in the actual treatment. METHODS: Pre- and post-treatment intraoral and corresponding cone beam computed tomography (CBCT) scans were obtained from 15 patients who underwent orthodontic treatment with premolar extraction. A conventional virtual tooth setup was used for the treatment simulation. Pre- and post-treatment three-dimensional digital tooth models were fabricated by integrating the patients’ intraoral and CBCT scans. The simulated root positions in the virtual setup were obtained by merging the crown in the virtual setup and root in the pre-treatment tooth model. The root positions of the simulated and actual post-treatment tooth models were compared. RESULTS: Differences in root positions between the simulated and actual models were > 1 mm in all teeth, and statistically significant differences were observed (p < 0.05), except for the maxillary lateral incisors. The differences in the inter-root angulation were > 1° in all teeth, and statistically significant differences were observed in the maxillary and mandibular canines. CONCLUSIONS: The virtual tooth setup using only crown data showed errors over the clinical limits. The clinical application of a virtual setup using crowns and roots is necessary for accurate and precise treatment simulation, particularly in extraction treatment.