A Comparative Study of Two Digital Model Analysis Based on Bolton Ratio

Objective: The goal is to assess the intra – and inter – examiner reliability of Bolton analysis using two commonly used software packages, OrthoCad and NemoCast, based on digital model measurements. Method: Fifty patients’ pretreatment models of different malocclusions were selected and 3 – dimensional virtual orthodontic models created using iTero element 2 scanners. Three examiners measured tooth widths at their greatest mesio – distal dimension, determining anterior and total Bolton discrepancies utilizing the respective software. Statistical analyses were performed using SPSS IBM24.0, Intraclass Correlation Coefficient (ICC) and Concordance Correlation Coefficient (CCC) package programs to investigate accuracy, repeatability and reliability of OrthoCAD software compared to Nemocast software for conducting Bolton analysis. Results: For both software the Inter – examiner and intra – examiner total as well as anterior Bolton ratios’ correlation coefficient values were high and reproducible and no statistically significant differences were detected, which meant that the reproducibility/reliability was almost perfect. However, Nemocast and OrthoCad created total and/or anterior ratios were found to be statistically different. Conclusion: Orthocad and Nemocast are well established software and both can generate reproducible results which can be used easily by trained clinicians. Further upgrading of these computerized software is needed to overcome problems encountered in identifying landmarks. Further improvement of these and other similar software is likely to make them more user friendly.