Research Article|Articles in Press

Comparing virtual setup software programs for clear aligner treatment

Published:March 14, 2023DOI:


      • Different software programs use different algorithms.
      • Different algorithms provide different outcomes.
      • Different software programs for virtual setup do not provide the same outcomes using the same numbers for tooth movement.



      The aim of this study was to compare the outcomes of the same amount of tooth movement among four different virtual setup software programs.


      This retrospective study included 32 patients who underwent Invisalign treatment. Patients’ initial stereolithography (STL) files were imported to three different software programs (SureSmile Aligner [Dentsply Sirona, Charlotte, NC], Ortho Insight 3D [Motion View software, Chattanooga, TN], and Ortho Analyzer [3Shape, Copenhagen, Denmark]). After virtually moving teeth based on the numbers from ClinCheck Pro (Align Technology, Inc., Santa Clara, CA) tooth movement tables, final STL files were exported from all four software programs. ClinCheck Pro final STL files were used as references, while final STL files from the other software programs were used as targets. Superimpositions were performed between references and target STL files using Geomagic Control X software (3D Systems, Rock Hill, SC), and color-coded maps were obtained to illustrate potential differences.


      Intraclass correlation coefficient showed a high degree of reliability for repeated methodology (0.995–0.997). The differences among absolute averages (Abs Avg.), averages of positive values (+Avg.), and negative values (−Avg.) for both upper and lower models were significant among all software programs (ClinCheck Pro, SureSmile Aligner, Ortho Insight 3D, and Ortho Analyzer), for both upper and lower STL files, the smallest difference was found between ClinCheck Pro and SureSmile Aligner with a median of (0.03, 0.31, −0.19) mm for upper and (0.02, 0.29, −0.17) mm for lower STL files (Abs Avg., +Avg. and −Avg.), respectively. The biggest difference was found to be between ClinCheck Pro and Ortho Analyzer with a median of (0.05, 0.46, −0.45) mm for upper and (0.06, 0.48, −0.40) mm for lower STL files. There were no significant differences in the number of aligners per patient.


      Final outcomes of the same amount of tooth movement in four different software programs differed significantly. The number of aligners per patient remained unchanged.


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