Abstract Background Virtual simulation has advanced in dental healthcare, but the impact of different tomographic techniques on virtual pati
Abstract Background Virtual simulation has advanced in dental healthcare, but the impact of different tomographic techniques on virtual patient (VP) creation remains unclear. This study primarily aimed to automatically create VP from facial scans (FS), intraoral scans (IOS), multislice (MSCT), and cone beam computed tomography (CBCT); Secondarily, to quantitatively compare artificial intelligence (AI)-driven, AI-refined and semi automatically registered (SAR) VP creation from MSCT and CBCT and to compare the effect of soft tissue on the registration with MSCT and CBCT. Methods A dataset of 20 FS, IOS, and (MS/CB)CT scans was imported into the Virtual Patient Creator platform to generate automated VPs. The accuracy (percentage of corrections required), consistency, and time efficiency of the AI-driven VP registration were then compared to those of the AI-refined and SAR (clinical reference) using Mimics software. The surface distance between the registered FS and the (MS/CB)CT surface rendering using SAR and AI-driven methods was measured to assess the effect of soft tissue on registration. Results All three registration methods achieved 100% accuracy for VP creation with both MSCT and CBCT (p > 0.999), with no significant differences between tomographic techniques either (p > 0.999). Perfect consistency (1.00) was obtained with AI-driven and AI-refined methods, and slightly lower for SAR (0.977 for MSCT and 0.895 for CBCT). Average registration times were 24.9 and 28.5 s for AI-driven and AI-refined, and 242.3 and 275.7 s for SAR with MSCT and CBCT respectively. The total time was significantly shorter for MSCT (313.7 s) compared to CBCT (850.3 s) (p 0.05), AI-driven resulted in a smaller surface distance than SAR (p