Digital treatment objectives: procedure and clinical application

the introduction of digital study models in the orthodontic practice changed the traditional stone gipsotec to a virtual gipsotec and the orthodontist has the possibility to see, immediately on the computer, this basic analysis with a great reduction of space and time. The aim of this study is to extend the use of digital models to the occlusal virtual set-up in 3D and have the orthodontist simulate and visualize the resulting occlusion from a suggested treatment plan for the malocclusion.

a case is presented where the treatment plan involvers extractions. The malocclusion is a Class II division 1 in the permanent dentition where an extraction treatment of 1.4, 2.4, 3.5 et 4.5 is planned: the final result shows the new occlusal relationship with proper anchorage management of the extraction spaces. From the primary silicon impression, a digital model is obtained followed by the virtual set up according the prescription of the treatment plan. More digital treatment objectives can be performed for the same malocclusion from the primary digital models, according to different treatment plans and the resulting occlusion visualized.

the basic principle for the virtual occlusal set-up is the straight-wire system with the final position of the teeth resulting both from the bracket prescription and the final rectangular wire in a full slot engagement.

the resulting dental arches show a correct arch form, arch coordination and a proper dental intercuspation. The results coming from different virtual simulations are analyzed; all these simulations need only one pair of impressions. Limits of this virtual method are that it can be used only in full permanent dentition and for cases of dento-alveolar or dento-dental discrepancy.