ODI Fellow Report: Digital planning and its implicationsm

To evaluate the three-dimensional clinical predictability of an in-office aligner workflow by comparing digitally planned virtual setups (T1) with post-treatment dental models (T2) using a reproducible open-source protocol. Sixty-eight digital dental models (maxillary and mandibular arches) from adult patients treated with in-office aligners were retrospectively analyzed. T1 and T2 STL models were superimposed using a landmark-based three-dimensional protocol, and linear and angular discrepancies were quantified using freely available Slicer CMF software (version 4.11). Statistical analyses were conducted at a 5% significance level, including intraexaminer reliability assessment after a 15-day interval and Wilcoxon signed-rank test for paired comparisons. Clinically relevant thresholds were defined as linear displacements >0.5 mm and angular deviations >2° RESULTS: Planned and achieved tooth positions showed high three-dimensional agreement. No statistically significant differences were detected for any linear or angular variables (p > 0.05), and all observed deviations remained below predefined clinical relevance thresholds. Incisal edge positions, intercanine widths, and intermolar widths exhibited minimal discrepancies between T1 and T2. Virtual setups for in-office aligner therapy demonstrated high three-dimensional accuracy, with no clinically meaningful differences between planned and achieved tooth positions. These findings support the clinical predictability of digitally planned, in-office aligners. In-office aligner systems provide clinicians with full control over digital planning and fabrication. Their demonstrated predictability supports reliable treatment, reduces the need for refinements, and improves clinical efficiency. Moreover, three-dimensional superimposition may serve as an objective, open-access tool for auditing treatment outcomes and refining digital planning strategies in daily clinical practice.

Digital Planning and Patient-Specific Implants Facilitate Accurate Conventional Sub-Cranial Le Fort III Advancement.

COVID-19 has had a traumatic effect on both the way people live and work in their everyday lives, and the way places function. The rapid transformation of employment practices, including the necessity to stay at home for lockdown periods, has given rise to increased digitisation and technological use to enable people to continue to work and to remain in contact with friends and colleagues. Digital planning, and the enhancement of digital citizen engagement, has been one area that has started to inform local government’s online activity. This is coincidental to the UK government’s interest in transforming planning into a digital and map-based service. This article examines digital planning activity in English local planning authorities since COVID-19 hit the UK, reporting on two interrelated research studies that analysed statements of community involvement and planners’ perceptions of digital planning activity. The article shows that COVID-19 has certainly accelerated the adoption and deployment of digital planning, but it is an activity that has been developing in local planning incrementally for more than two decades. This article was published open access under a CC BY licence: https://creativecommons.org/licences/by/4.0.

Background: Digital workflows have transformed orthognathic surgery by enabling three-dimensional virtual surgical planning (VSP) and, more recently, artificial-intelligence-based predictive modeling. While skeletal accuracy has improved substantially, the clinical value of these tools increasingly depends on their ability to predict soft-tissue outcomes and support complex treatment decisions. Methods: This narrative review synthesizes evidence from 20 peer-reviewed studies, including systematic reviews, clinical cohorts, and machine-learning validations, to evaluate (i) the accuracy of digital patient modeling and VSP transfer, (ii) the performance of predictive models for postoperative outcomes and diagnostic classification, and (iii) associated ethical and governance considerations. Results: Automated craniofacial and dental modeling achieves submillimetric to low-millimetric accuracy, with landmark localization errors typically ≤2 mm and dental landmark errors near 0.4 mm. Clinical cohorts demonstrate that VSP transfers to surgery with mean translational deviations well below 2 mm in all planes. Predictive models estimate soft-tissue and aesthetic outcomes within clinically meaningful error margins and classify the need for orthognathic surgery with AUC values up to ~0.9 in high-risk malocclusion groups. Conclusions: Digital planning in orthognathic surgery has evolved into a precision-oriented, data-driven framework. When combined with predictive modeling and appropriate ethical governance, these technologies can enhance accuracy, personalize treatment strategies, and reduce diagnostic uncertainty, particularly in borderline and asymmetric cases.

Class III skeletal malocclusion can be managed with surgical or nonsurgical orthodontic therapy. In selected cases, camouflage treatment may be planned after an accurate evaluation, also including Wits appraisal and Holdaway angle. Several studies have already analyzed the achieved outcomes between orthodontic camouflage and surgical therapy using multibracket appliances. However, recent advances in three-dimensional (3D) digital planning with clear aligners (CA) have opened new opportunities for managing Class III discrepancies. This research aims to evaluate, retrospectively, the dentoskeletal and aesthetic outcomes obtained using three-dimensional (3D) digital planning with clear aligners with 2 different protocols (surgical approach versus camouflage). Lateral x-rays of 23 Class III patients treated successfully (8 patients with a camouflage protocol and 15 with bimaxillary surgery) were collected and analyzed using Dolphin (Dolphin Imaging & Management Solutions, Chatsworth, CA) before (T0) and after (T1) treatment. Statistical comparisons between the 2 groups were performed using the t test and ANCOVA test ( P < 0.05). Independent t tests revealed statistically significant improvements in the surgical group for SNB (-2.7 degrees), Wits (+6.8mm), Overjet (+5.7mm), and IMPA (+3.3 degrees). However, ANCOVA revealed significant group effects only for SNB and ANB, favoring the surgical approach, and for upper-incisor inclination, favoring the camouflage approach, indicating that baseline severity accounted for most of the differences observed in unadjusted analyses. Both camouflage and surgical protocols with clear aligners achieved clinically meaningful outcomes; however, statistically significant dentoskeletal improvements were observed only in the surgical group, while the camouflage approach showed satisfactory root torque control.

Ameloblastoma is a locally aggressive tumor that most commonly arises in the mandible. It has a high rate of recurrence if inadequately excised. We report a case of a patient who developed recurrence of his ameloblastoma in his fibula flap mandibular reconstruction despite clear resection margins 23 years after resection. This is the first reported case of recurrent ameloblastoma in a neo-mandible reconstruction in the setting of negative margins. We discuss its surgical management using digital planning and reconstruction using a contralateral free fibula flap. Ameloblastoma is a locally aggressive entity that requires complete excision. Recurrence can even occur in the reconstruction, which can present a challenge to manage. Consideration should be given to repeat excision and second osseous flap reconstruction.

ObjectiveThe use of virtual surgical planning (VSP) in orthognathic surgery is increasing. The aim of this study was to investigate which type of dentofacial deformity makes the surgeon choose VSP and if VSP influences the choice of surgical techniques. Furthermore, we sought to evaluate if use of VSP affects surgical time and blood loss during surgery.Material and methodsPatients having undergone orthognathic surgery and registered in the Swedish quality registry for orthognathic surgery (NROK) between 2018 and 2019 were eligible for inclusion in this study. An evaluation of the usage of VSP was performed together with an analysis of operation time and bleeding during surgery. A total of 862 patients were evaluated.ResultsOut of the 862 patients who had orthognathic surgery, 224 were VSP cases. Patients diagnosed with maxillary retrusion (p = 0.0024), maxillary vertical hyperplasia (p < 0.001), mandibular protrusion (p = 0.0031), laterogenia (p < 0.001) or craniofacial deformity (p = 0.0033) were more often digitally planned. Patients who underwent VSP and bimaxillary surgery showed a tendency of reduced operating time andless bleeding during surgery; however, the results were inconclusive.ConclusionThe present study shows that VSP was used more frequently in patients with maxillary retrusion, maxillary vertical hyperplasia, mandibular protrusion, laterogenia, and craniofacial deformity in comparison with other diagnoses. Alongside the findings that VSP cases had more diagnoses per patient and that a larger number of surgical procedures were performed in this group, this indicates a preference for using digital planning in more complex orthognathic cases.

BackgroundZygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP.The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards.ResultsFourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05).ConclusionsZygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.

The method of digital planning of the sinus-lifting operation using data from computed tomography, laser surface scanning of the dentition, as well as a number of computer programs, the use of which in the treatment of tooth loss allows you to accurately position the window for lateral access to the maxillary sinus. This technique is based on digital planning for open sinus-lift surgery.

The Dutch spatial planning legal act of 2008 was aimed at improving efficiency and effectiveness in the development, evaluation and monitoring of spatial planning policy (Ministry of VROM, 2006a). One of the main effects of this legal act was the widespread availability and use of digital spatial plans (Ministry of VROM 2006a, b). This reform led to the expectation that all digital spatial plans would be exchangeable and comparable. In practice, this exchange and comparison required carrying out complex procedures due to uncertainty caused by differences in the scope of spatial plans as well as their intended use. Furthermore the uncertainty resulted in a lack of confidence in spatial plans by policymakers and supporting GIS staff. Our overarching research question was: how can uncertainty caused by incomplete geo-information sources be dealt with? We proposed two techniques—fuzzy logic and visualisation—for policy makers to deal with uncertainty resulting from incomplete geo-information sources in spatial planning at the regional and national planning levels. We used two case studies in the Netherlands to illustrate the results of applying these techniques. The fuzzy set theory provides extra information by converting the discrete borders of continuous objects into fuzzy borders that improve the resemblance to the real object and thus make it more realistic. As shown in the second case study, visualisation also improves the degree of realism and thus provides additional information. Both case studies showed that providing additional information reduces the uncertainty felt by policymakers.

Pre-operative planning is very important in the process of a Total Hip Replacement (THR) because it is a method for determining the size and optimal implant position. Currently, a manual implant size identification technique of trial and error is used to determine the appropriate implant size for patients. This step was used repeatedly until the appropriate implant of the patient encountered and the survey found that this procedure requires a long time, and is said to be less efficient. Therefore, a digital method should be developed so that the implant size identification process can be effectively implemented. This paper will show a conceptual framework developed for THR digital pre-operative planning. This framework can be used as a guide to researchers who interested in the development of THR digital templating software.

It is very hard to acquire the information what you really want with the accumulation of large amount of data. Data mining technology has been achieved a great progress with the rapid development of computer science, artificial intelligence, and warehouse. City planning is a job with strong subjective which promotes the development of digital city planning. This makes an increasing demand of data mining technology in areas of digital city planning. This paper described the history and theory development of data mining technologies, especially, rough set whose chief advantage is that it does not need any preliminary or additional information about data. Then some successful applications of rough set were introduced. Furthermore, merits and shortages of some data mining techniques such as rough sets, fuzzy sets, and neural networks were discussed. Finally, the problems faced by city designers were addressed and the possible resolution was also presented.

Digital factory is a new technology to construct a virtual plant environment to implement integration between process planning and manufacturing execution. In the analysis of the application of various software for digital factory technology in digital factory layout planning. It puts forward that Microstation platform as a digital factory planning which planners and designers use to facilitate plant and Microstation as a planning platform in practical applications.

Using a single bone-borne maxillary appliance with twofold mechanics, that is, rapid palatal expander and nonfrictional distalizing appliance (Pendulum) is a valuable option to treat young-adult patients with poor compliance. In this particular case, the same appliance was used to disinclude 2.3, eliminating reaction forces on the arch. Therefore, the first expansive phase was followed by the distalizing phase. After enough space was obtained for the recovery of tooth 2.3, a triple-looped titanium-molybdenum alloy (TMA) spring was used to perform canine orthodontic traction. The core concept is that digital planning and optimal positioning of two palatal mini-screws can ensure a bicortical anchorage which, in turn, enabled to tolerate the different orthodontic phases. As a matter of fact, a tooth-bone-borne anchorage was followed by a pure bone-borne anchorage with no lost of stability.

A new method for positioning mini-implants in orthodontic patients with tooth position anomalies (ICD-10 K07.3) using a navigation surgical template is proposed. The template is used to position a mini-implant precisely based on the visualization results of cone beam computed tomography (CBCT), which facilitates safe and dynamic orthodontic tooth movements. CBCT visualization during the initial placement of mini-implants in the most stable position has significantly reduced the risks of premature loss of stability. Proper placement, in turn, leads to the successful completion of treatment using cortical bone support. Keywords: Mini-implants, digital planning, orthodontics, navigational surgical template, interdisciplinary interaction, dental surgery, case presentation