# Diagnostic Accuracy and Agreement Between AI and Clinicians in Orthodontic 3D Model Analysis
## 2 Materials and Method
### Statistical Analysis  
All statistical analyses were performed using R version 4.2.2 (integrated in BioRender) and RStudio (v2025.05.0 + 496). Descriptive visualizations, including box plots, bar graphs with standard deviation (SD), and dot plots, were generated using BioRender. The normality of data distributions was assessed using the Shapiro-Wilk test. For paired comparisons of continuous variables, the paired t-test was used for normally distributed  
\begin{table}
\begin{tabular}{c c c} \hline \hline
**Term** & **Description** & **Objective** & **Groups** \\ \hline \multirow{8}{*}{Bolton Analysis} & Compares the mesiodistal widths of & \multirow{2}{*}{Helps identify size imbalances} & \multirow{2}{*}{Orthodontist, Titan} \\  & maximillary and mandibular teeth to & & \\  & determine the tooth size discrepancy & & \\  & between arches. It consists of two key & & \\  & components: Overall Bolton Ratio and & & \\  & Anterior Bolton Ratio. & & \\ \hline \multirow{8}{*}{Olevation Analysis} & Overall Bolton Analysis & \multirow{2}{*}{Ensures overall compatibility of } & \multirow{2}{*}{Orthodontist, Titan} \\  & compares the total mesiodistal width of & & \\  & first molar) to that of the corresponding & & \\  & 12 maxillary teeth. If the actual & & \\  & mandibular width exceeds the ideal & & \\  & value based on the maxillary width, a & & \\  & mandibular excess is present; conversely, & & \\  & if the mandibular width is less, a & & \\  & maxillary excess is indicated. & & \\ \hline \multicolumn{3}{c}{Anterior Bolton Analysis} & \multirow{2}{*}{Orthodontist, Titan} \\  & Compares the mesiodistal widths of the & \multirow{2}{*}{Dental Design,} \\  & six anterior mandibular teeth (canine to & & \\  & canine) to the six anterior maxillary teeth. & & \\  & As with the overall ratio, discrepancies & & \\  & can be expressed in millimeters as either & & \\  & mandibular or maxillary excess, & & \\  & depending on which arch has the surplus & & \\  & tooth material. & & \\ \hline \multirow{3}{*}{Space Analysis} & Measures the amount of space available & \multirow{3}{*}{Assists in determining if there is } & \multirow{3}{*}{Orthodontist, Titan} \\  & in the dental arch and compares it to the & & \\  & space required for proper alignment. & & dental arch. \\ \hline \multirow{3}{*}{Overbite} & Refers to the vertical overlap of the upper & \multirow{3}{*}{Used to assess the degree of } \\  & front teeth over the lower front teeth. & & \\  & & & \\  & & & \\  & & & \\ \hline \multirow{3}{*}{Overjet} & Refers to the horizontal distance between & \multirow{3}{*}{Helps in assessing the forward } & \multirow{3}{*}{Orthodontist, Titan} \\  & the upper and lower front teeth. & & \\  & & & \\  & & front teeth. & \\ \hline \multirow{3}{*}{Angle Classification (Molar Relationship)} & Angle Classification (Molar Relationship) & \multirow{3}{*}{Used for diagnosing the type of } \\  & is a system used to classify malocclusion & & \\  & based on the relationship between the & & \\  & upper and lower first molars. The upper & & \\  & first molar’s position is fixed, and & & \\  & classification is based on its relation to & & \\  & the lower molars. & & \\ \hline \hline \end{tabular}
\end{table}
Table 1: Tooth size, space, and model analysis parameters.  
data, and the Wilcoxon signed-rank test was applied for non-normally distributed data. For comparisons among three related groups, repeated measures ANOVA was conducted for normally distributed variables, and the Friedman test was used for non-normal distributions. For categorical variables, including categorical comparisons between platforms and inter-rater agreement assessments, [PERSON]'s kappa statistic was used to evaluate the level of agreement [34]. A \(p\)-value of less than 0.05 was considered statistically significant.