Virtual model analysis as an alternative approach to plaster model analysis: reliability and validity

The objective of this study was to assess the feasibility of virtual models as an alternative to orthodontic plaster models. Virtual dental models (obtained from OrthoCAD (R)) and corresponding plaster models of 80 patients in the permanent dentition were randomly selected from patients seeking orthodontic care. Inter-examiner error was assessed by measuring tooth width, overjet, overbite, intermolar width, intercanine width, and midline discrepancy. Criterion validity of virtual model analysis was determined by the agreement between the measurements from virtual and plaster models. Test-retest reliability was determined by remeasuring 10 virtual models 1 week later. Comparison analysis was assessed by calculating the mean directional differences and standardized directional differences. Correlation analysis was determined by calculating the intraclass correlation coefficients (ICCs). Both intra-and inter-examiner reliability and test-retest reliability of virtual model analysis were acceptable in measuring intercanine, intermolar, overjet, overbite, midline discrepancy, space analysis, and tooth width (ICC > 0.7). Good criterion validity was indicated by agreement between the results from the plaster and virtual models (ICC > 0.8). There were substantial agreements for canine and molar relationship classifications (k > 0.70). The results suggest that analysis performed on virtual models is as valid as traditional plaster models for intra-and inter-arch relationship.