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Accuracy of Automatic Tooth Segmentation via Three Different CAD/CAM Orthodontic Software Packages: A Comparative

M Palone1, I Dilena2, E Morin2

  • 1Private Practice in Ferrara and Artena, Rome, Italy.

Orthodontics & Craniofacial Research
|November 24, 2025
PubMed
Summary

This study found that automatic orthodontic tooth segmentation software has inaccuracies, with a tendency to oversize teeth. While most discrepancies are minor, some may impact interproximal reduction accuracy in clear aligner therapy.

Keywords:
CAD/CAM softwareautomatic tooth segmentationdigital models

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Area of Science:

  • Orthodontics
  • Dental CAD/CAM technology
  • Digital dentistry

Background:

  • Accurate digital models are crucial for modern orthodontic treatments, including clear aligner therapy.
  • Computer-Aided Design (CAD) software automates tooth segmentation, but its accuracy requires validation.

Purpose of the Study:

  • To compare the accuracy of automatic tooth segmentation across three commercial CAD software packages.
  • To evaluate the influence of dental crowding severity on segmentation accuracy.

Main Methods:

  • Three typodonts with varying crowding levels were scanned.
  • 28 individual teeth were scanned for reference (STL files).
  • Segmentation accuracy was assessed using 2D (point discrepancies, width) and 3D (area, volume) measurements, with comparisons to reference files and among software (ArchForm, OrthoSystem, VISION).

Main Results:

  • Most measurements showed inaccuracies, with a general trend of oversized segmented teeth.
  • Crowding severity did not significantly impact segmentation accuracy.
  • Software performance varied, with OrthoSystem and VISION showing higher accuracy than ArchForm, though differences were generally not clinically significant.

Conclusions:

  • Automatic tooth segmentation exhibits inherent inaccuracies, independent of crowding severity.
  • While most single-point discrepancies are clinically negligible, mesial and gingival points, along with mesiodistal width, showed notable overestimation.
  • Overestimation of tooth width may affect interproximal reduction calculations in clear aligner therapy, potentially leading to excessive enamel removal.