Accuracy of digital jaw relation determination in different occlusal conditions — an in vitro study

In orthodontics, accurate registration of jaw relationships is essential for correct diagnosis and treatment planning. Therefore, accuracy of the digital spatial registration of maxillary and mandibular models and – for the first time—the influence of dentition stage and malocclusion type on this procedure were investigated under controlled conditions.

Eight pairs of jaw models, representing different occlusal and developmental statuses (m1–m8), were scanned using two IOS types (PS: Primescan; TR: Trios4). Buccal scans for registering maxillary and mandibular models were repeated (n = 3). Reference scans were obtained using a desktop scanner (RDS; Ceramill Map 600). Arch-specific 3D coordinate systems were used to calculate the linear and angular deviations among different registrations. Trueness of registration by PS and TR was calculated using a statistical mixed-effect model (random-effect: model-type). Precision values of IOS registrations across m1–m8 were characterized as standard deviations (SDs).

As maximum deviations compared to RDS, PS showed caudal translation (0.11 ± 0.02 mm), while TR showed ventral translation (0.08 ± 0.06 mm), of the maxillary relative to the mandibular model. Maximum rotational values were calculated for tilting around the transverse axis (PS: anteinclination (0.25 ± 0.16°), TR: retroinclination (0.27 ± 0.16°)). These deviations varied with the malocclusion type. The lowest IOS precision was recorded for sagittal translation (PS: 0.013 ± 0.005 mm, TR: 0.021 ± 0.010 mm) and rotation around the transverse axis (PS: 0.051 ± 0.013°, TR: 0.076 ± 0.031°).

Registrations using buccal IOS scans showed quantifiable but clinically negligible 3D deviations from reference scan registrations, whereby the type of tooth and jaw misalignment did not appear to have a clinically relevant influence. Therefore, the examined IOSs appear to be suitable for digital jaw relation determination in everyday clinical orthodontic practice.