Accuracy of Dolphin visual treatment objective (VTO) prediction software on class III patients treated with maxillary advancement and mandibular setback.
BACKGROUND
Dolphin® visual treatment objective (VTO) prediction software is routinely utilized by orthodontists during the treatment planning of orthognathic cases to help predict post-surgical soft tissue changes. Although surgical soft tissue prediction is considered to be a vital tool, its accuracy is not well understood in tow-jaw surgical procedures. The objective of this study was to quantify the accuracy of Dolphin Imaging's VTO soft tissue prediction software on class III patients treated with maxillary advancement and mandibular setback and to validate the efficacy of the software in such complex cases.


METHODS
This retrospective study analyzed the records of 14 patients treated with comprehensive orthodontics in conjunction with two-jaw orthognathic surgery. Pre- and post-treatment radiographs were traced and superimposed to determine the actual skeletal movements achieved in surgery. This information was then used to simulate surgery in the software and generate a final soft tissue patient profile prediction. Prediction images were then compared to the actual post-treatment profile photos to determine differences.


RESULTS
Dolphin Imaging's software was determined to be accurate within an error range of +/- 2 mm in the X-axis at most landmarks. The lower lip predictions were most inaccurate.


CONCLUSIONS
Clinically, the observed error suggests that the VTO may be used for demonstration and communication with a patient or consulting practitioner. However, Dolphin should not be useful for precise treatment planning of surgical movements. This program should be used with caution to prevent unrealistic patient expectations and dissatisfaction.
Department of Orthodontics, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, 07103, USA.
Robert J
RJ
Peterman
Department of Institutional Assessment and Quality Improvement, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, 07103, USA.
Shuying
S
Jiang
Department of Orthodontics, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, 07103, USA.
Rene
R
Johe
Department of Orthodontics, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, 07103, USA. Padma.mukherjee@rutgers.edu.
Padma M
PM
Mukherjee
D000328:Adult; D002508:Cephalometry / Q000379:methods*; D002680:Chin / Q000033:anatomy & histology; D003198:Computer Simulation; D005145:Face / Q000033:anatomy & histology; D005260:Female; D005544:Forecasting; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008046:Lip / Q000033:anatomy & histology; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery* / Q000628:therapy*; D008334:Mandible / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D008437:Maxilla / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D009666:Nose / Q000033:anatomy & histology; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010347:Patient Care Planning; D023861:Photography, Dental; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D016896:Treatment Outcome; D014716:Vertical Dimension; D055815:Young Adult