Orthodontic finishing errors detected in board-approved cases: common types and prediction

Area of Science:

• Orthodontics
• Dental Public Health
• Clinical Quality Assessment

Background:

• Orthodontic finishing quality is crucial for long-term treatment success and patient satisfaction.
• Assessing common finishing errors provides insights into areas needing improvement in orthodontic education and practice.
• The Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) examination offers a unique dataset for evaluating clinical outcomes.

Purpose of the Study:

• To identify and rank orthodontic finishing errors from BBO clinical examinations.
• To correlate pretreatment case complexity with the quality of orthodontic treatment outcomes.
• To provide data for enhancing orthodontic finishing standards.

Main Methods:

• A retrospective cross-sectional survey of 447 orthodontic records from BBO examinations (2016-2023).
• Orthodontic outcome quality assessed using the Cast-Radiograph Evaluation (CRE).
• Pretreatment case complexity evaluated using the Discrepancy Index (DI).

Main Results:

• Orthodontic finishing errors were prevalent in all cases, with an average of 15 points deducted from CRE scores.
• Most frequent errors included alignment, buccolingual inclination, marginal ridge, and occlusal relationship issues.
• No significant correlation was found between initial case complexity (DI) and treatment outcome quality (CRE) (p=0.106).

Conclusions:

• Orthodontic finishing errors, particularly in rotation, inclination, and marginal ridges, are common even in board-certified cases.
• While case complexity presents challenges, it was not a determining factor for treatment outcomes in this cohort.
• Continuous evaluation and feedback are essential for improving orthodontic finishing standards.