Accuracy and reliability of the expected root position setup methodology to evaluate root position during orthodontic treatment

Current methods to evaluate root position either are inaccurate (panoramic radiograph) or expose patients to relatively large amounts of radiation (cone-beam computed tomography [CBCT]). A method to evaluate root position by generating an expected root position (ERP) setup was recently reported but has not been validated. The purpose of this study was to quantitatively assess the accuracy and reliability of the ERP setup with adequate statistical power. This retrospective study included 15 subjects who had completed phase 2 orthodontic treatment. An ERP setup was generated for all patients after treatment. The ERP setup was compared with the posttreatment CBCT scan, which served as the control. The mesiodistal angulation and buccolingual inclination of all teeth in both the ERP setup and the posttreatment CBCT scan were measured and compared. Bland-Altman analysis was used to assess interoperator reliability, intraoperator reliability, and agreement between the ERP setup and the posttreatment CBCT scan. Bland-Altman plots showed high interoperator and intraoperator reliabilities. These plots also showed strong agreement between the ERP setup and the posttreatment CBCT scan; 11.8% of teeth measured for mesiodistal angulation and 9.6% of teeth measured for buccolingual inclination were outside the ±2.5° range of clinical acceptability. We validated that the method to generate an ERP setup to evaluate root position for posttreatment orthodontic assessment is accurate and reliable. •A method to evaluate root position with minimal radiology was assessed.•The expected root position setup was compared with the posttreatment CBCT scan.•The generated expected root position setup accurately depicted root position.•No radiation in addition to the pretreatment CBCT scan was required for this approach.