## 4 Discussion  
In this cross-sectional study, the association between clinical experience and digital knowledge and the capacity of virtual planning in palatal orthodontic miniscrew insertion was evaluated. The test was conducted by three groups of clinicians with different clinical and digital experience (dental students, orthodontics students and orthodontists). The assessment of the individual skills regarding miniscrew virtual positioning according to the level of training seems to have not yet been studied in the literature. Similar studies were performed evaluating differences on digital planning between groups selected by different type of experience on clinical and digital topics [22; 31; 32; 33]. Nevertheless, none of these regarded digitally planned miniscrews insertion. For this study, the use of CBCT was chosen in order to achieve a precise construction of the surgical guide and to evaluate the clinicians' skills, comparing the participants amongst each other. Digital planning is possible with just the radiographical exams and dental scans of the patient. On this topic, there is a debate between authors; some say cone beam computed tomography (CBCT), a volumetric 3D radiographic exam, is mandatory in achieving optimal results. On the contrary, some others say it is, in fact, not [20; 21; 22; 23]. [PERSON] et al. [34] and [PERSON] et al. [21] describe how a dental scan can be simply superimposed on a lateral cephalogram, exploiting only a sagittal plan, because there is no need to verify bone density and thickness of the anterior palatal area. On the other hand, [PERSON] et al. [20] and [PERSON] et al. [35] claim that an accurate analysis of bone quantity and depth cannot be provided by the use of lateral cephalogram alone. The clinician has to first import the DICOM and the STL files, then overlap the two and insert the two implants. The last step is to generate the digital surgical guide, including the implants and teeth for retention [22; 23; 24; 28; 30; 36; 37; 38; 39]. In this study the orthodontists' group demonstrated more clinical experience but this was not statistically significant, thus reflecting the interest of the students for this topic. However, the more extensive clinical experience of the orthodontists can be confirmed by the results obtained in the test, in particular in the sections \"respect of the safe zone\" and \"bicorticalism achievement\". In the post-test survey, the same group mostly reported \"surgical guide realization\" as the answer to the question \"What was the most difficult part?\", highlighting a greater lack of digital knowledge when compared to the other groups. This answer can be considered as the one most related to \"digital knowledge\". On the other hand, the orthodontics students demonstrated a higher digital knowledge, but this was not statistically significant either. Despite the lack of statistical significance, the previously mentioned assumption may be confirmed by the results obtained in \"planning execution time\", in which orthodontics students showed the best result. Instead, for the orthodontics students' group, a greater lack of clinical experience was highlighted by the answer to the post-test survey question \"What was the most difficult part?\" in which the most commonly selected answer was \"miniscrew insertion\". This answer can be considered as the one most related to \"clinical experience\". [PERSON] et al. selected a group of 14 dental technicians and 14 dental students, asking them to virtually design a custom implant abutment three times and evaluating the correlation between computer literacy and planning execution time. This resulted in a shorter time for the clinically experienced group (dental technicians), but the group with the higher reduction time between the tests was the preclinically experienced group (dental students), showing a statistically significant correlation between execution time and computer literacy [32].