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In order to facilitate the planning process and provide additional information, this study examines a statistical shape model (SSM) to compute the course of dental roots based on a surface scan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Plaster models of orthognathic patients were scanned and superimposed with three-dimensional data of a cone-beam computer tomography (CBCT). Based on the open-source software \u201cR\u201d, including the packages Morpho, mesheR, Rvcg and RvtkStatismo, an SSM was generated to estimate the tooth axes. The accuracy of the calculated tooth axes was determined using a leave-one-out cross-validation. The deviation of tooth axis prediction in terms of angle or horizontal shift is described with mean and standard deviation. The planning dataset of an implant surgery patient was additionally analyzed using the SSM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>71 datasets were included in this study. The mean angle between the estimated tooth-axis and the actual tooth-axis was 7.5\u2009\u00b1\u20094.3\u00b0 in the upper jaw and 6.7\u2009\u00b1\u20093.8\u00b0 in the lower jaw. The horizontal deviation between the tooth axis and estimated axis was 1.3\u2009\u00b1\u20090.8\u00a0mm close to the cementoenamel junction, and 0.7\u2009\u00b1\u20090.5\u00a0mm in the apical third of the root. Results for models with one missing tooth did not differ significantly. In the clinical dataset, the SSM could give a reasonable aid for implant positioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With the presented SSM, the approximate course of dental roots can be predicted based on a surface scan. There was no difference in predicting the tooth axis of existent or missing teeth. In clinical context, the estimation of tooth axes of missing teeth could serve as a reference for implant positioning. 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Ethical approval was waived (No. 20\u20131342) by the local Ethics Committee of the Albert-Ludwigs-University Freiburg, Germany, in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study. The authors affirm that human research participants provided informed consent for publication of the images in figure(s).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}