Dr. Dov Almog and colleagues have provided an interesting pilot study of patients’ responses to varied presentations of a treatment plan ("The Effect of Esthetic Consultation Methods on Acceptance of Diastema-Closure Treatment Plan: A Pilot Study," July JADA).
It should come as no surprise that the "winner" was the computer-imaging simulation. In a society as immersed as ours in the technology of movies, television and video games, a computerized morphing from space to no space between the central incisors should be expected to most effectively catch the attention and imagination of the average patient.
Two points regarding the article should be mentioned. The first is the ever-present danger of the implied warranty in projections of treatment. This is especially true with the computer-generated imaging techniques for esthetic procedures. If the patient agrees to proceed with treatment, and the result appears to differ from the computer prediction, the patient may feel that he or she has a valid complaint. Admittedly, the likelihood of this problem is minor in the present case, but the caution has been raised in the more complex prediction of treatment results in orthognathic surgery.1
The second point is a suggestion for the further studies encouraged by the authors. In Dr. Almog’s study, the only treatment option presented was that of increasing the widths of the central incisors with restorative material. An astute patient might find the projected appearance of the treated teeth unacceptable when compared with the adjacent ones. Future investigations should include for patient consideration the additional presentation via imaging and diagnostic setup of the orthodontic option.
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