ArticleJournal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]2026
Influence of Superimposition Strategies and Landmark Distribution on the Full-Arch Trueness of Orthodontic Digital Models.
Article in Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the influence of superimposition protocols and landmark distribution on deviation outcomes in orthodontic full-arch models. MATERIALS AND
methodsTwenty plaster models were scanned using an intraoral and desktop scanner. Ten models were evaluated for landmark suitability and inter-scanner coordinate agreement. All models were superimposed using automatic global best-fit (AGB), three-point landmark (3PL) alignment with two different triads, and area-specific alignment (ASA). Deviation metrics were root mean square (RMS), absolute average (Abs. Avg.), and (90-10)/2. Mixed-effects models were utilized for analysis.
resultsThe alignment protocol significantly affected all metrics (p < 0.001). The protocol × arch interaction was significant for RMS (p < 0.001) and (90-10)/2 (p = 0.046), but not Abs. Avg. (p = 0.484). AGB and both 3PL triads produced comparable outcomes (p > 0.05), whereas ASA yielded higher deviations (p < 0.01), particularly in the mandible (RMS increased by approximately 27 μm relative to AGB).
conclusionsAGB and 3PL protocols yield comparable reference-based trueness, whereas ASA produced higher deviations. This effect is strongly arch-dependent, suggesting the unreliability of restricted-region registration in mandibular datasets. CLINICAL SIGNIFICANCE: Digital superimposition trueness depends heavily on the alignment protocol. Standardizing registration is essential, as minor positional differences impact symmetry and finishing decisions.
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