Diagnostic performance of ClinCheck, Dolphin Imaging, and 3D Slicer software for Bolton discrepancy analysis

To evaluate the diagnostic performance of ClinCheck, Dolphin Imaging orthodontic software, and 3D Slicer for the analysis of Bolton discrepancy (BD).

Fifty-five pairs of early-stage digital models of patients treated with Invisalign were printed to measure the BD by manual method with a digital caliper (gold standard). The discrepancy values calculated by ClinCheck were obtained. In addition, the sample STL files were measured using Dolphin Imaging and 3D Slicer software to obtain BD values. To assess reliability, precision, and accuracy of the methods, intraclass correlation coefficients (ICCs), Dahlberg's formula, paired t-tests, and the Bland-Altman method were used, respectively. Repeated-measures analysis of variance with Bonferroni post hoc test was used to assess the difference between groups.

The three methods showed reliable measurements (ICC ≥ 0.7), with the values of anterior Bolton slightly higher than overall Bolton. Measurements for the anterior Bolton showed higher precision (Dahlberg's formula 0.65, 0.70, and 0.55) than those for the overall Bolton. For anterior Bolton, only the measurements obtained by ClinCheck and Dolphin Imaging were accurate (P > .05, no proportion bias), while for overall Bolton, all groups had a significant difference. The Bland-Altman plots demonstrated no consistency for anterior Bolton measurements when 3D Slicer was used and for the overall Bolton.

ClinCheck and Dolphin Imaging showed accuracy to quantify anterior BD. For the overall Bolton measurements, ClinCheck showed a statistical difference from the manual assessment but without relevant clinical significance.