The purpose of this study was to explore the effect of viewing digital setups on orthodontic treatment planning. Six cases were identified from the UW Graduate Clinic to represent different case types that could benefit from a diagnostic setup. The cases included adolescent and adult patients with a variety of conditions, such as missing teeth, dental crowding, or subdivisions. Twenty-two orthodontists and seven orthodontic residents treatment planned each case, indicating their most recommended plan and up to two alternative plans. After treatment planning each case, digital setups of each treatment plan indicated by the practitioner were viewed. After viewing the setup(s) for each case, practitioners were asked if they still recommended the same plan as they had originally, or if they would now choose a different plan. Their confidence levels in the success of their plans were recorded before and after viewing the setups. After viewing the digital setups, 23.6% of treatment plans changed, with changes that included adding or removing IPR, change in extraction pattern, or change in the management of missing teeth. In addition, practitioner confidence level increased after viewing the setups. While initial confidence levels were lower for a) complex cases, b) cases where the treatment plan changed, and c) orthodontic residents, the final confidence levels were uniformly high among all practitioners. The most helpful features of digital setups were the abilities to: superimpose the setup with the original model, determine the amount of tooth movement needed, check the final incisal relationship (overjet and overbite), and establish the IPR amount required. Digital setups can influence treatment plans and the level of confidence the practitioner has in the plan. Setups can be helpful when deciding on the most recommended treatment plan prior to starting treatment.

BackgroundClear aligner therapy has evolved considerably since its introduction 20 years ago. Clinicians have become more experienced with aligner therapy, but little is known about the types of malocclusions that clinicians currently treat with aligners. Similarly, it is not known if viewing digital vs plaster models has any impact on the treatment planning process for aligners. The aim of this study was to assess which types of malocclusions are recommended for treatment with clear aligners, and also to determine if recommendations for aligner treatment differed when using digital versus plaster models.MethodsSixteen orthodontists treatment planned 20 cases at two time points with either the same or different model formats (digital versus plaster). As part of the treatment planning process, they were asked whether each patient was a good candidate for Invisalign® treatment, and if not, why. Generalized estimating equations regression (GEE), the permutation test, and a logistic regression model with GEE were used to analyze the data.ResultsNo significant difference was found between the Invisalign® choices in the digital model group and those in the plaster model group at T1 (p = 0.59). There was no significant difference between the agreement rate of the different formats group and that of the same format group (p = 0.97). Cases with extractions had less Invisalign® recommendations (15%) compared to cases with no extractions (55%) (p = 0.0015). Cases with surgery had less Invisalign® recommendations (29%) compared to cases with no surgery (57%) (p = 0.035).ConclusionsIn this study, viewing orthodontic records with digital versus plaster models did not influence decisions about Invisalign® recommendations. Additionally, the orthodontists in this study tended to not recommend Invisalign® for extraction cases, surgical cases, or difficult cases.

The purpose of this study was to investigate differences in orthodontists' treatment plans based on digital models compared with plaster models. Additionally, we assessed whether digital or plaster models influence the reliability of orthodontists' treatment plans, as well as the amount of time required to arrive at the plan. Methods: Sixteen orthodontists planned treatment for 20 patients at 2 time points using either the same or different model formats (digital or plaster). The treatment plan decisions and time spent making the plans were recorded. The permutation test and a random effects model were used to analyze the data. Results: The treatment plans arrived at with digital and plaster models were similar. With respect to extractions, the mean difference between digital and plaster formats was 11.9% (95% CI, 7.5%-16.3%). For surgery, the mean difference was 9.4% (95% CI, 5.0%-13.8%). There was no significant difference in the agreement rate between those who viewed models in different formats compared with those who viewed models twice in the same format (P .0.05). The time spent to plan treatment with plaster models was not significantly different from the time spent with digital models (P 5 0.87). Conclusions: Based on this study, digital models can be substituted for plaster models with no significant differences in the final plans, the reliability of the plans, and the time required to create the plan.

Columbia University College of Dental Medicine, in partnership with the Harlem United Community AIDS Center, has developed a service-learning (SL) program for use in the training of Advanced Education in General Dentistry (AEGD) residents. This article presents basic tenets of SL, their applicability for dentistry, and our experience implementing SL in care of people living with HIV/AIDS. It proposes that social-behavioral theory, when incorporated into the basic components of SL, can play a useful role in resolving a number of challenges inherent in competency-based training programs. Although the article provides examples of how a particular theory, the Theory of Planned Behavior, might be applied in the SL context, opportunities for the application of other social-behavioral theories potentially exist. Dr. Kunzel is Associate Professor of Clinical