To study the predictability of a digital Keslings setup: A Pilot study

Abstract

Background: The diagnostic setup proposed by H.D. Kingsley serves as a practical aid in treatment planning and diagnosis. Virtual setups, also known as the virtual Keslings setup, are a new development in dentistry and orthodontics. As there is very limited literature available on this topic, the purpose of this pilot study was to calculate the accuracy of the predicted treatment outcome achieved by using the Digital Keslings setup when compared to the final treatment outcome achieved clinically.

Materials and Methods: 25 Subjects with bimaxillary proclination, who were to be treated with all 4 first premolar extraction, were selected for the study. The pre-treatment intraoral scans of all 25 patients were taken using the 3Shape - Trios 3 intraoral scanner. A digital keslings setup was performed using these digital models, on the 3Shape Orthoanalyser to predict the final treatment outcome. Measurements were made on this final predicted model. Following this, the treatment was started by the Orthodontists. The treatment plan employed in Kesling's prediction was used to treat the patients in the study After the treatment was completed, an intraoral scan kept all the previous parameters constant. These post-treatment scans were again uploaded on the 3 Shape Orthoanalyser software. These scans were superimposed on the models on which the Keslings setup was performed and the amount of discrepancy was noted between what was predicted and what was finally achieved post-treatment to see the accuracy of the Keslings setup.

Results: A statistically significant difference was noted between what was predicted using the digital Keslings setup and what was achieved clinically in relation to The intermolar distance, intercanine distance, and angle of the long axis of 11 that were predicted virtually were more than what we achieved clinically and the A-P distance planned virtually was more than what was achieved Clinically – suggesting a greater amount of retraction being achieved clinically than virtually.

Conclusion: The digital Kesling setup is a boon in dentistry. It helps us to plan treatment and visualize the outcome however the results that we obtain using Kesling’s setup were statistically different from that of values obtained clinically. Thus, we can conclude that a keslings setup cannot accurately predict the treatment outcome.