The effect of root and bone visualization on perceptions of the quality of orthodontic treatment simulations

Objective: To evaluate the effect of root and bone visibility on orthodontists' perceptions of the quality of treatment simulations. Material and Methods: An online survey was used to present orthodontists with setups generated for 10 patients in two different types of view: with and without bone and roots as modeled from a cone-beam computed tomography (CBCT) scan. The orthodontists were asked to rate the quality of the setups from poor to ideal on a 100-point visual analog scale and, if applicable, to identify features of concern that led them to giving a setup a less-than-ideal rating. Results: The quality ratings were significantly lower when roots and bone were visible in the setups (P < .0001). Buccolingual inclination and periodontal concerns were selected significantly more often as reasons for a less-than-ideal rating when roots and bone were shown, whereas occlusal relationship, overjet, occlusal contacts, and arch form were selected significantly more often as reasons for a less-than-ideal rating when roots and bone were not shown. The odds of selecting periodontal concerns as a reason for a less-than-ideal setup rating were 331 times greater when roots and bones were visible than when they were not. Conclusions: Additional diagnostic information derived from CBCT scans affects orthodontists' perceptions of the overall case quality, which may influence their treatment-planning decisions.