Utilizing three-dimensional data in orthodontic practice and research.

The recent prevalence of three dimensional (3D) images of soft and hard tissues provides a wealth of new data from which the clinician can evaluate these changes. However, evaluating this new data presents new and significant challenges. Current approaches utilizing multi-dimensional data for the precise evaluation of changes related to treatment and growth sets are reviewed. The results of current validation studies exploring approaches to these problems are reviewed, including the registration of longitudinal data using maxillary and mandibular regions of reference. Challenges related to the consistent selection of points on complex three-dimensional structures are circumvented using an automated, shape analysis based approach. Imaging using these new modalities yields a tremendous amount of data. Analysis of large data sets from cross-sectional studies with multiple variables are simplified using a principle components analysis, from which a reduced set of variables is constructed. Examples of this approach are presented. The use of advanced methods to process and interpret data from 3D imaging modalities highlights critical aspects of craniofacial growth and form.

Moving towards precision orthodontics: An evolving paradigm shift in the planning and delivery of customized orthodontic therapy.

Advances in precision medicine portend similar progress in orthodontics and will be increasingly harnessed to achieve customized treatment approaches and enhance treatment efficiencies. Our goal is to provide a background on emerging advances in computer technologies and biomedicine and highlight their current and likely future applications to precision orthodontics. A review of orthodontically relevant technologies and advances in pertinent biological research was undertaken. Innovations in computer hardware and software, and 3D imaging technologies offer the ability for customized treatment and biomechanical planning that will be more fully realized within the next few decades. These technologies combined with 3D printing are already being applied to customized appliance fabrication such as aligners and retainers. The future prospects for custom fabrication of orthodontic brackets of appropriate material properties and smart devices are highly desirable and compelling goals. Within biomedicine, the fundamental understanding of cartilage growth and bone biology is currently being tested in animal models to modify mandibular growth and modulate tooth movement, respectively. Some of these discoveries will ultimately have clinical applications in orthodontics including for growth modification, accelerating orthodontic tooth movement, and enhancing anchorage or retention of teeth. Additional genomic and proteomic information will add to further customization of orthodontic diagnosis and treatments. Over the coming decades, precision orthodontics will continue to benefit from advances in many fields and will require the integration of advances in technology, and biomedical and clinical research to deliver optimal, efficient, safe, and reproducible personalized orthodontic treatment.