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The severe gummy smile and a skeletal class II profile pose challenges in treatment. This case report outlines an effective alternative for addressing these problems in a patient with skeletal class II division 2, class II molar relationship, retroclination of upper incisors, and lip protrusion. Treatment objectives included normalizing the overjet and overbite, improving the gummy smile, and establishing a satisfactory occlusion. A three-dimensional simulation was performed to consult with the patient, assess possible results, and predict treatment biomechanics. The treatment involved the use of two zygomatic and one inter-radicular temporary anchorage devices, along with botulinum toxin. After the 2-year follow-up, a satisfactory dental occlusion, aesthetic improvement, and adequate function were achieved. This approach offers a viable alternative to orthognathic surgery for adults with skeletal class II malocclusion and a severe gummy smile due to hypermobile lip. [ABSTRACT FROM AUTHOR]

Background: The growing integration of digital technologies in orthodontics is shifting the orthodontic diagnosis and recordkeeping paradigm, replacing conventional plaster models with intraoral scanning and 3D photography. This study investigated the impact of orthodontic plaster models on orthodontic diagnosis and treatment planning decisions by orthodontists. Methods: Thirty-three orthodontists assessed six patients' records with different malocclusion cases. Each case was assessed twice by each orthodontist evaluating a case: the first evaluation with digital records without diagnostic casts and the second evaluation with the added diagnostic orthodontic plaster model. Diagnostic and treatment plan decisions for each malocclusion case were compared with and without the aid of the diagnostic orthodontic plaster models to assess the plaster model's impact on the treatment plan's soundness. Results: Statistically insignificant differences were found for the diagnoses and treatment plans with or without the aid of orthodontic plaster models. Intraclass correlation coefficients revealed agreement among orthodontists for both evaluated situations (0.685; p < 0.0001). Plaster models were found to significantly influence orthodontists' decisions about the need for surgical intervention (p = 0.026), but they did not significantly impact the overall malocclusion diagnostic classification nor the decision regarding the extent of treatment, whether comprehensive or limited (p = 0.146) and extraction versus non-extraction approaches (p = 0.266). Conclusions: These findings support the idea that digital record alternatives may be viable for orthodontic recordkeeping purposes. Within the limitations of this study, it can be concluded that the presence or absence of orthodontic plaster models does not significantly impact the orthodontic diagnosis or treatment planning process. [ABSTRACT FROM AUTHOR]

Objective: To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. Methods: A cross‐sectional study was conducted with patients between the ages of 5–15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State‐Trait Anxiety Scale for Children (STAI‐C) was used to evaluate the anxiety. Student t, Mann–Whitney U, chi‐square tests, and logistic regression were used for statistical analysis. Results: One hundred sixty‐two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64–10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02–1.16). Conclusions: Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of malocclusion in Portuguese preschool children, to characterise occlusion in the deciduous dentition, and to study the relationship between malocclusion, sex, and age. Methods: This cross-sectional study included 3–6 years old children, from 25 randomly selected kindergartens from the Lisbon district. Data were collected through an oral examination. Malocclusion was defined as the presence of any type of occlusion anomaly (anterior crossbite, edge-to-edge, increased overjet, open bite, deep overbite, posterior crossbite, scissor bite), spacing anomaly (crowding), or dentition anomaly (supernumerary teeth, agenesis, malformations). Canine class, terminal plane of the deciduous second molars and type of Baume arch were also recorded. Statistical analysis included descriptive and chi-squared test (α = 0.05). Results: The sample included 426 children with a global prevalence of malocclusion of 60.6%. Occlusion anomalies were the most prevalent (59.2%), the most frequent being deep overbite (27%), increased overjet (22.1%) and posterior crossbite (14.1%). Crowding had a prevalence of 1.6% and agenesis of 1.4%. Class I canine (57.3%), straight second molar terminal plane (60.1%) and type I Baume arch (53.3%) were the most common. The mean overjet was 2.6 mm (sd = 2.1) and the mean overbite was 2.2 mm (sd = 2.1). Age was associated with the presence of occlusion anomalies (p = 0.03), and increased overjet prevalence was found to be higher in girls (p = 0.03). Conclusions: The prevalence of malocclusion was high, with occlusion anomalies being the most prevalent. It is important to identify modifiable risk factors associated with malocclusion to prevent this condition in both the deciduous and permanent dentitions. [ABSTRACT FROM AUTHOR]

Objectives: X‐linked hypophosphatemia (XLH) is a rare genetic disease that disturbs bone and teeth mineralization. It also affects craniofacial growth and patients with XLH often require orthodontic treatment. The aim of this study was to describe changes in the dental health of XLH children during orthodontic treatment compared with those in matched controls undergoing similar orthodontic procedures. Materials and Methods: For this retrospective case–control study, we included all individuals less than 16 years old diagnosed with XLH, orthodontically treated in our centre from 2016 to 2022 and pair‐matched them to patients with no chronic or genetic conditions. Clinical and radiological parameters concerning their malocclusion, craniofacial discrepancy and the characteristics and iatrogenic effects of their orthodontic treatment were analysed. Results: Fifteen XLH patients (mean age: 11.3 ± 2.1), pair‐matched to 15 control patients were included. Orthodontic treatment was successfully conducted in XLH patients with slightly shorter duration and similar iatrogenic effects as in the control group, except for the occurrence of dental abscess during and after orthodontic tooth movement. XLH patients did not show more relapse than the controls. Conclusion: Despite the presence of oral manifestations of XLH such as spontaneous abscesses, XLH patients can undergo orthodontic treatment with no obvious additional iatrogenic effects. [ABSTRACT FROM AUTHOR]

The objective of this retrospective study was to compare the dento-alveolar effects of two different expansion protocols, Invisalign First (IF) and Leaf Expander (LE), in patients in mixed dentition with transversal upper maxillary deficiency. Materials and Methods: 30 patients were treated with IF, whereas 38 patients were treated with LE. For each sample 3D digital cast models were analyzed pre and post expansion and transversal diameter of the upper arch, molar rotation and inclination and arch perimeter were measured. Results: LE resulted in a more significant expansion of the molar width and the arch perimeter, with less effect on the expansion of deciduous canines and deciduous molars. IF allowed a more effective molar derotation, but with a greater buccal tipping movement than LE, which determines a more bodily movement of the molars: the expansion determined by IF seems to be more dental than skeletal. Conclusions: IF is a good alternative to LE in case of limited transversal maxillary contraction, particularly when there is a significant mesio-rotation of the first upper molars. [ABSTRACT FROM AUTHOR]

Background/rationale Systematic reviews on the effects of pacifiers on occlusion have highlighted the need for quality RCTs. Trial design Single region, three parallel-armed, prospective, randomized controlled trial. Objectives To investigate the correlations between early childhood non-nutritive sucking habits and malocclusion. Specifically to test whether the use of a study pacifier has differing effects compared to other pacifiers and control, and whether the duration of pacifier use or digit sucking influence the occlusion. Participants The subjects were firstborn children, born in 2008 in Vantaa, Finland. Intervention One-third of participants were offered study pacifiers, free of charge, from birth up to 2 years of age. The history of the subjects' sucking habits, including pacifier use was screened in a questionnaire at the age of 2 years, and clinical examinations were performed at the age of 7 years. In addition, the subjects were divided into groups that were equally matched regarding their mother's level of education. Outcomes Posterior crossbite, anterior crossbite, overjet, deep bite, open bite, and crowding. Randomization method Three districts were randomly allocated to three study groups by drawing lots. Blinding It was not possible to blind the clinicians or parents from the intervention. Blinding during data analysis was performed. Results From the original cohort of 2715 children born in the town of Vantaa, 1911 were excluded and 353 were lost to follow-up. The remaining 451 children were divided into three groups according to the use of pacifiers. The prevalence of posterior crossbite at the age of 7 years was higher if a non-study pacifier had been used (P  = .005) even when matched for the mother's level of education (P  = .029). The prevalence of posterior crossbite was higher if the pacifier habit had continued for 12 months or more compared to 11 months or less, 7% and 1%, respectively, (P  = .003). Digit sucking for 12 months or more was associated with crowding (P  = .016). The prevalence of crossbite in the study pacifier group was less than in control pacifiers. Harms No adverse harms were reported other than effects on the dentition. Conclusion The use of pacifiers is associated with the posterior crossbite, especially if their use continues for a year or more. Parents/guardians should be advised to stop the use or reduce the use of pacifiers to a minimum after their child's first birthday. Trial registration ClinicalTrials.gov NCT01854502. [ABSTRACT FROM AUTHOR]

Objectives The aim of this investigation was to evaluate whether Class II malocclusion in adult patients can be successfully corrected using a completely customized lingual appliance (CCLA) in combination with Class II elastics. Methods In order to detect differences in the final treatment outcome, two groups were matched for age and gender. Treatment results of 40 adult orthodontic patients with a Class I malocclusion (Group 1) were compared to 40 adults with a Class II malocclusion (Group 2). All patients had completed treatment with a CCLA (WIN, DW Lingual Systems, Bad Essen, Germany) without known centric occlusion—centric relation discrepancies, issues of compliance, or overcorrection in the individual treatment plan which was defined by a target set-up. In order to compare the treatment results of the two groups, 7 measurements using the American Board of Orthodontics Model Grading System (ABO MGS) and linear measurements for anterior-posterior (AP) and vertical dimensions were assessed at the start of lingual treatment (T1), after debonding (T2B) and compared to the individual target set-up (T2A). Results A statistically significant AP correction was achieved in Group 2 which represented 95% of the planned amount. The planned overbite correction was fully achieved in the Class I and Class II group. In both groups, there was a statistically significant improvement in the ABO scores, with no significant difference between the two groups at T2. 100% of the patients in Group 2 and 92.5% in Group 1 would meet the ABO standards after CCLA treatment. Limitations The main limitation of this study is that only patients who were wearing the elastics as prescribed were retrospectively included. Therefore, the results of this study may have limited generalizability. Conclusions Completely customized lingual appliances in combination with Class II elastics can correct a Class II malocclusion successfully in adult patients. The final treatment outcome can be of a similar high quality in Class I and Class II patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the facial soft tissue characteristics of patients with different types of malocclusion. Methods: The 3dMD scanning data of patients with malocclusion admitted to our hospital from January 2018 to April 2022 were analyzed retrospectively. Forty-seven patients with Class I malocclusion, 43 patients with Class II malocclusion and 44 patients with Class III malocclusion were selected. All patients underwent 3dMD scans prior to orthodontic treatment. Then the differences in the 3D morphological parameters of the facial soft tissues were compared between different sexes and different types of malocclusion. Spearman's correlation was further used to analyze the correlation between each parameter and the classification of malocclusion. Results: In the Class I group and Class II group, there were no significant differences in the 3D morphometric parameters of malocclusion patients of different sexes (P > 0.05). There were significant differences between Al (R)-AL (L), Ac (R)-Ac (L), Prn-Ac (L), n-Prn-Sn, and Al (R)-Al (L)/Ac (L)-Ah (L) values among the three groups of patients. Spearman correlation analysis showed that Ac (R)-Ac (L) and Al (R)-Al (L)/Ac (R)-Ac (L) were correlated with the type of malocclusion. Conclusion: Differences in facial soft tissues exist in patients with Class I, II, and III malocclusion. 3dMD technique may be helpful in developing an effective treatment plan prior to orthodontic treatment. [ABSTRACT FROM AUTHOR]

Class III malocclusion prevalence varies significantly among racial groups, with the highest prevalence observed in southeast Asian populations at 15.80%. These malocclusions often involve maxillary retrognathism, mandibular prognathism, or both, accompanied by maxillary constriction and crossbites. Comprehensive treatment should address anteroposterior, transverse, and vertical imbalances. Microimplant-assisted rapid palatal expansion (MARPE) has shown high success rates for transverse maxillary expansion in late adolescents and adults, presenting a viable alternative to surgically-assisted rapid palatal expansion (SARPE). This case report aims to demonstrate the successful treatment of a young adult female with borderline Class III malocclusion using MARPE and mandibular backward rotation (MBR) techniques. A 21-year-old female presented with a Class III skeletal pattern, anterior/posterior crossbites, and mild dental crowding. Despite her concerns about a concave facial profile, the patient declined orthognathic surgery due to a negative experience reported by a friend. The treatment plan included MARPE to correct maxillary transverse deficiency and MBR to alleviate Class III malocclusion severity. Lower arch distalization was performed using temporary anchorage devices (TADs) on the buccal shelves, and Class II elastics were used to maintain MBR and prevent retroclination of the lower labial segment during anterior retraction. Significant transverse correction was achieved, and the severity of Class III malocclusion was reduced. The lower dentition was effectively retracted, and the application of Class II elastics helped maintain MBR. The patient's final facial profile was harmonious, with well-aligned dentition and a stable occlusal relationship. The treatment results were well-maintained after one year. The MARPE with MBR approach presents a promising alternative for treating borderline Class III cases, particularly for patients reluctant to undergo orthognathic surgery. This case report highlights the effectiveness of combining MARPE and MBR techniques in achieving stable and satisfactory outcomes in the treatment of Class III malocclusion. [ABSTRACT FROM AUTHOR]

Objective: To correlate the sagittal hard tissue movement and soft tissue changes among patients with skeletal class III malocclusion following bimaxillary orthognathic surgery. Material and Methods: Fifty-nine subjects with skeletal class III malocclusion treated consecutively with maxillary advancement and mandibular setback were assessed for skeletal and soft tissue linear changes using presurgical (T1) and post-treatment (T2) lateral cephalograms. Pearson's correlation coefficient test was used to correlate hard and soft tissue parameters. Results: The sagittal hard tissue movement and soft tissue changes for all the parameters assessed in maxilla and mandible showed statistically significant correlations. The ratios of changes for the maxillary protrusion [N-A (HP)] to horizontal subnasale (Sn), superior labial sulcus (Sls), and labrale superioris (Ls) were 0.574:1, 0.703:1, and 0.721:1 respectively. The ratio of horizontal labrale inferioris (Li), mentolabial fold (Mlf), and soft tissue (Pg′) to mandibular protrusion [N-B (HP)] were 0.992:1, 0.970:1, and 0.590:1 respectively and to chin protrusion [N-Pg (HP)] were 1.293:1, 1.252:1, and 1.001:1, respectively. The ratios were different for males and females in maxilla and mandible. Conclusion: Sagittal hard tissue movement and soft tissue changes are significantly correlated. The soft tissue movement in the mandible were more proportionate compared to the maxilla. The sagittal hard tissue to soft tissues movement ratios were greater in maxilla and lesser at pogonion and mentolabial sulcus in females compared to males. The ratios obtained can be used for predicting postsurgical soft tissue changes. [ABSTRACT FROM AUTHOR]

This document contains abstracts from the 32nd Portuguese Dental Association Annual Meeting. The abstracts cover a range of topics in dentistry, including temporomandibular disorders, oral health in children, radiographic measurements, prescription of anti-inflammatory drugs, irrigation on polishing protocols, and dentin surface treatments. The studies provide valuable insights into various aspects of dental health and contribute to the existing body of knowledge in the field. The document also includes summaries of clinical cases related to external cervical resorption, tooth resorption, dental aesthetic self-perception, and avulsion of a lower canine tooth. These cases highlight the importance of proper assessment, treatment planning, and multidisciplinary approaches in dental care. [Extracted from the article]

Interceptive orthodontics may be indicated in puppies exhibiting dental malocclusion with linguoverted deciduous mandibular canine teeth to alleviate pain and prevent teeth interlock, which may affect growth and development of the mandibles. Historically extraction of deciduous mandibular canine teeth has been recommended as soon as a malocclusion is identified, often as early as 6-8 weeks of age and no later than 12 weeks of age. This early surgical intervention of deciduous teeth extractions risks potential damage to the developing permanent canine teeth resulting in enamel defects often referred to as a Turner's tooth or Turner's hypoplasia. A search of medical records from five veterinary specialty dentistry practices was conducted to identify dogs 8-12 weeks of age who (a) underwent deciduous mandibular canine extractions for management of class 1 or class 2 malocclusion with linguoverted mandibular canine teeth, and (b) were seen for at least one recheck exam to assess for enamel defects on permanent mandibular canine teeth. Furthermore, data was collected to determine the number of dogs that required additional treatment after eruption of the permanent canine teeth due to linguoversion of the permanent canine teeth. All procedures were performed by a board-certified veterinary dentist™ or a supervised veterinary dentistry resident. Seventy-four dogs fit the inclusion criteria and had a total of 143 deciduous mandibular canine teeth extracted, out of which 13 dogs exhibited enamel defects affecting 21 permanent canine teeth. The 13 affected dogs represent a 17.5% cumulative incident rate 13/74 (95%CI 11-28%). Of all extracted teeth, 14.6% (21/143) had enamel defects affecting permanent canine teeth. Twenty-eight dogs required additional treatment to prevent the permanent mandibular canine teeth from causing trauma to the hard palate and gingiva which represented 37.8% (28/74) of all dogs in the study. Age and sex of the dog at the time of extraction were not found to be associated with the likelihood of incidence of enamel defects. This is the first reported rate of enamel defects on permanent mandibular canine teeth following extraction of deciduous mandibular canine teeth and is important to consider when advising or performing extraction of deciduous teeth in dogs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the normal volumetric space and variations in the measurements of different landmarks in adults with different skeletal relations of the maxilla and the mandible based on CBCT data. The study also analyses these landmarks to locate any correlations. Background: Numerous studies in orthodontics have found a relationship between orthodontic treatment and changes in the anatomy and function of the airway. Severe changes in airway morphology can cause breathing difficulties, lower quality of life, and even result in life-threatening conditions such as obstructive sleep apnoea. Consequently, orthodontic diagnosis and treatment planning require a thorough understanding of the airway space and its function. Methods: The present retrospective study was conducted using CBCT records of 120 adult patients, containing 40 samples of each skeletal class (20 males and 20 females). The boundaries were defined for the 3 major regions: the nasopharynx, the oropharynx, and the hypopharynx. Various measurements were recorded across these regions, as well as selective cephalometric landmarks. The obtained data was used to calculate average and standard deviation, while regression analysis was used to evaluate correlations and t-test was used to test statistical significance of gender differences. Results: The results demonstrate that skeletal Class III individuals exhibit a reduced airway volume in the nasopharynx compared to other groups, whereas skeletal Class II individuals displayed a diminished airway volume in the hypopharynx. A strong correlation was observed for Sella turcica parameters. There were no significant differences in skeletal parameters across genders. Nasopharynx cavity volume demonstrated significant differences between skeletal Class I–Class III as well as between skeletal Class II–Class III. Hypopharynx cavity volume also demonstrated significant differences between skeletal Class I–Class II and between skeletal Class II–Class III. Conclusion: The major findings are the presence of a reduced nasopharyngeal volume in skeletal Class III malocclusions while skeletal Class II individuals displayed a diminished hypopharyngeal volume, making these critical areas to consider during the diagnostic and orthodontic treatment planning stages. This study also revealed a consistent correlation between Sella turcica parameters across various facial skeletal profiles, with skeletal Class II patients exhibiting a distinct pattern and skeletal Class I and Class III demonstrating an average relationship. [ABSTRACT FROM AUTHOR]

Background: A correct diagnosis of patients with an Angle Class II malocclusion is needed to guide treatment decisions toward the contributing jaw and to achieve better treatment outcomes. The aim of the study is to evaluate the diagnostic potential of the Fränkel manoeuvre (FM) for detecting the components determining sagittal discrepancy in Angle Class II division 1. Materials and methods: Anonymous questionnaires containing photographs were distributed totwo groups: general practitioner (GP) dentists and orthodontists. The level of the patient's profile aesthetics before (T0) and after (T1) the manoeuvre was determined using a 100 mm visual analog scale, and the 'profile improvement' score was defined as T1 minus T0. The diagnostic ability of the FM was calculated by comparison with lateral cephalometry as a reference standard using receiver operating characteristic (ROC) curve analysis. Results: A total of 102 respondents participated in the survey; 40 were orthodontists, and 62 were GP dentists. According to the post-FM images, the "profile improvement" score (T1-T0) was significantly greater in patients with mandibular retrusion than in those with maxillary protrusion (p < 0.05). The predictive power of FM, coinciding with the area under the ROC curve, was 0.62 for GPs and 0.78 for orthodontists. Conclusions: The FM method is a useful and accurate tool for diagnosing skeletal Angle Class II malocclusion etiology (mandibular retrusion or maxillary protrusion), especially when used by orthodontists. [ABSTRACT FROM AUTHOR]

Introduction: There are few publications concerning ankyloglossia in mixed-aged groups utilizing myofunctional therapy and frenuloplasty in patients undergoing orthodontic treatment and maxillofacial surgery. While it is well known that ankyloglossia is mainly diagnosed in babies, research on functional and structural disorders in different age groups is less common. Thus, there is a high need for specific information about the influence and effectiveness of frenuloplasty with myofunctional therapy on the stomatognathic function and final treatment outcome for a wider variety of patients, especially those with maxillofacial deformities. Aim: This paper aims to evaluate the impact of lingual frenuloplasty as an adjunct to myofunctional therapy for the treatment of ankyloglossia in children and adults with maxillofacial deformity. Methods: Prospective randomized control trial with 155 subjects. Methods were based on visual observation and examination of the oral cavity. There were two groups: myofunctional therapy vs. myofunctional therapy and lingual frenuloplasty. Patients were randomized based on order of entry into the study. χ2 test, Kruskal–Wallis, ANOVA, Student's t-test and others were used for statistical analyses. Results: The presented protocol with myofunctional therapy and surgical procedures proved to be significantly more effective in improving tongue mobility and stomatognathic functions such as swallowing, breathing, and oral resting postures as compared to the reference group who underwent myofunctional therapy only. Conclusions: Lingual frenuloplasty with myofunctional therapy is highly effective in restoring the equilibrium of the orofacial muscles and the skeleton, which is often disturbed and may lead to unstable functional effects among patients considering orthodontic and orthognathic treatments for maxillofacial deformities. [ABSTRACT FROM AUTHOR]

Evidence that breastfeeding impacts the facial features of children is conflicting. Most studies to date have focused on dental and skeletal malocclusion. It currently remains unclear whether such effects are of sufficient magnitude to be detectable on outward facial appearance. Here, we evaluate the extent to which maternally reported breastfeeding is associated with 3D facial shape in a large adolescent cohort. After extracting 3D facial surfaces from MR scans in 2275 9- and 10-year-old children and aligning the surfaces in dense correspondence, we analyzed the effect of breastfeeding on shape as a dichotomous (no/yes) and semi-quantitative (to assess duration in months) variable using partial least squares regression. Our results showed no effect (p = 0.532) when breastfeeding was dichotomized. However, when treated as a semi-quantitative variable, breastfeeding duration was associated with statistically significant changes in shape (p = 3.61x 10−4). The most prominent facial changes included relative retrusion of the central midface, zygomatic arches, and orbital regions along with relative protrusion of forehead, cheek, and mandible. The net effect was that as breastfeeding duration increased, the facial profile in children became flatter (less convex). The observed effects on the face, however, were subtle and likely not conspicuous enough to be noticed by most observers. This was true even when comparing the faces of children breastfed for 19–24 months to children with no reported breastfeeding. Thus, breastfeeding does appear to have detectable effect on outward facial appearance in adolescent children, but its practical impact appears to be minimal. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of basal bone width is essential for distinguishing individuals with normal occlusion from patients with maxillary transverse deficiency who may require maxillary expansion. Herein, we evaluated the effectiveness of a deep learning (DL) model in measuring landmarks of basal bone width and assessed the consistency of automated measurements compared to manual measurements. Methods: Based on the U-Net algorithm, a coarse-to-fine DL model was developed and trained using 80 cone-beam computed tomography (CBCT) images. The model's prediction capabilities were validated on 10 CBCT scans and tested on an additional 34. To evaluate the performance of the DL model, its measurements were compared with those taken manually by one junior orthodontist using the concordance correlation coefficient (CCC). Results: It took approximately 1.5 s for the DL model to perform the measurement task in only CBCT images. This framework showed a mean radial error of 1.22 ± 1.93 mm and achieved successful detection rates of 71.34%, 81.37%, 86.77%, and 91.18% in the 2.0-, 2.5-, 3.0-, and 4.0-mm ranges, respectively. The CCCs (95% confidence interval) of the maxillary basal bone width and mandibular basal bone width distance between the DL model and manual measurement for the 34 cases were 0.96 (0.94–0.97) and 0.98 (0.97–0.99), respectively. Conclusion: The novel DL framework developed in this study improved the diagnostic accuracy of the individual assessment of maxillary width. These results emphasize the potential applicability of this framework as a computer-aided diagnostic tool in orthodontic practice. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop a deep learning model to predict skeletal malocclusions with an acceptable level of accuracy using airway and cephalometric landmark values obtained from analyzing different CBCT images. Background: In orthodontics, multitudinous studies have reported the correlation between orthodontic treatment and changes in the anatomy as well as the functioning of the airway. Typically, the values obtained from various measurements of cephalometric landmarks are used to determine skeletal class based on the interpretation an orthodontist experiences, which sometimes may not be accurate. Methods: Samples of skeletal anatomical data were retrospectively obtained and recorded in Digital Imaging and Communications in Medicine (DICOM) file format. The DICOM files were used to reconstruct 3D models using 3DSlicer (slicer.org) by thresholding airway regions to build up 3D polygon models of airway regions for each sample. The 3D models were measured for different landmarks that included measurements across the nasopharynx, the oropharynx, and the hypopharynx. Male and female subjects were combined as one data set to develop supervised learning models. These measurements were utilized to build 7 artificial intelligence-based supervised learning models. Results: The supervised learning model with the best accuracy was Random Forest, with a value of 0.74. All the other models were lower in terms of their accuracy. The recall scores for Class I, II, and III malocclusions were 0.71, 0.69, and 0.77, respectively, which represented the total number of actual positive cases predicted correctly, making the sensitivity of the model high. Conclusion: In this study, it is observed that the Random Forest model was the most accurate model for predicting the skeletal malocclusion based on various airway and cephalometric landmarks. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to analyze changes in mandibular width and frontal view ramus inclination using cone beam CT in patients with skeletal class III malocclusion who underwent BSSRO, with the removal of bone interference between segments. Methods: For all 20 subjects, cone-beam CT imaging was performed prior to surgery (T1), immediately post-surgery (T2), and 6 months after surgery (T3). Reorientation was performed using R2GATE software (MegaGen, Seoul, Korea). The gonion and antegonial notch were used as reference points in the sagittal view, and the most lateral point of the condyle head was used as the reference point in the frontal view. All measurements were recorded in the frontal view. Results: Inter-gonial width decreased by 2.64 mm at T3-T2 (P <.001) and by 2.58 mm at T3-T1 (P <.05). Inter-antegonial width decreased by 1.75 mm at T3-T2 (P <.05) and by 3.5 mm at T3-T1 (P <.001). In the frontal view, the right ramus inclination based on the gonion increased by 2.07° at T3-T1 (P <.05). The left ramus inclination based on gonion increased by 2.45° at T2-T1 (P <.05) and by 3.94° at T3-T1 (P <.001). The right ramus inclination based on antegonial notch increased by 2.35° at T2-T1 (P <.05) and by 3.04° at T3-T1 (P <.01). The left ramus inclination based on antegonial notch increased by 2.73° at T2-T1 (P <.001) and by 3.18° at T3-T1 (P <.001). Conclusions: During bilateral sagittal split osteotomy, removing bone interference between the proximal and distal segments results in a reduction of postoperative mandibular width and an increase in frontal view ramus inclination. [ABSTRACT FROM AUTHOR]

Objectives: Temporomandibular disorders (TMDs) have a relatively high prevalence among university students. This study aimed to identify independent risk factors for TMD in university students and develop an effective risk prediction model. Methods: This study included 1,122 university students from four universities in Changchun City, Jilin Province, as subjects. Predictive factors were screened by using the least absolute shrinkage and selection operator (LASSO) regression and the machine learning Boruta algorithm in the training cohort. A multifactorial logistic regression analysis was used to construct a TMD risk prediction model. Internal validation of the model was conducted via bootstrap resampling, and an external validation cohort comprised 205 university students undergoing oral examinations at the Stomatological Hospital of Jilin University. Results: The prevalence of TMD among university students was 44.30%. Ten predictive factors were included in the model, comprising gender, facial cold stimulation, unilateral chewing, biting hard or resilient foods, clenching teeth, grinding teeth, excessive mouth opening, malocclusion, stress, and anxiety. The model demonstrated good predictive ability with area under the receiver operating characteristic curve (AUC) values of 0.853, 0.838, and 0.821 in the training cohort, internal validation cohort, and external validation cohort, respectively. The calibration curves demonstrated that the predicted results were consistent with the actual results, and the decision curve analysis (DCA) indicated the model's high clinical utility. Conclusions: An online nomogram of TMD in university students with good predictive performance was constructed, which can effectively predict the risk of TMD in university students. The model provides a useful tool for the early identification and treatment of TMDs in university students, helping clinicians to predict the probability of TMDs in each patient, thus providing more personalized and accurate treatment decisions for patients. [ABSTRACT FROM AUTHOR]

Objective •To observe the therapeutic effects of bracketless and invisible orthodontic treatment on periodontitis, as well as on gingival crevicular fluid and serum interleukin-6 (IL-6), matrix metalloproteinase-8 (MMP-8) and tumors. The impact of necrosis factor-alpha (TNF-α) levels fills the current knowledge gap regarding the impact of different orthodontic treatment modalities on biomarker levels in periodontitis patients. Methods • 100 patients with malocclusion secondary to periodontitis were selected as subjects. They were divided into a control group (n=50) and a study group (n=50) according to the random number method. The control group was treated with a straight wire appliances, and the study group was given bracketless and invisible orthodontic treatment. Clinical effects, Periodontal indicators [plaque index (PLI), gingival crevicular bleeding index (SBI), gingival index (GI), periodontal pocket probe depth (PD), clinical attachment loss (CAL)], gingival crevicular fluid and serum IL-6, MMP-8 and TNF-α levels and the incidence of adverse reactions were compared between the two groups. The uniqueness of this method is that it compares the impact of traditional straight-wire orthodontic treatment and invisible orthodontic treatment without brackets on biomarker levels and clinical effects in patients with periodontitis. In order to understand the role of orthodontic treatment methods in Provides useful information for use in periodontitis treatment. Results • The main findings of this study highlight the significant impact of bracketless clear braces in improving periodontal indicators and cytokine levels. Patients treated with bracketless clear braces demonstrate better clinical outcomes in periodontitis treatment compared with traditional straight-wire orthodontic treatment. The response rate of the study group was higher than that of the control group (94.00% vs. 72.00%) (P < .05). After 2 years of treatment, PLT, SBI, GI, PD and CAL were decreased in both groups and the observation group was significantly lower than the control group (P < .05). After 6 months of treatment, the levels of IL-6, MMP-8 and TNF-α in gingival crevicular fluid and serum were decreased in both groups, and the observation group was significantly lower than the control group (P < .05). There was no significant difference in the incidence of adverse reactions between the two groups (P > .05). Conclusion • The treatment of periodontitis without brackets has a significant effect, which can improve the periodontal condition and reduce the levels of IL-6, MMP-8 and TNF-α in gingival crevicular fluid and serum. Bracketless invisible braces have shown potential clinical significance in improving periodontal indicators and cytokine levels in patients with periodontitis, providing support for providing more comfortable and effective orthodontic treatment options, which may help promote patients’ Oral health. These findings suggest the positive role of bracketless invisible braces in comprehensive periodontal treatment, which is expected to influence the practice of orthodontics and periodontal treatment and improve patient treatment experience and effects. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate through analysis using CBCT the transverse and axial diameters of the mandibular condyles in subjects affected by juvenile idiopathic arthritis (JIA) and compare them with those of healthy subjects. Methods: The study was conducted on CBCT scans from the digital archive of the Department of Biomedical Surgical and Dental Sciences, University of Milan, including patients with JIA and using healthy subjects as controls. Inclusion criteria: aged between 7 and 25 years old at the time of the CBCT examination; Caucasian ethnicity; diagnosis of JIA according to the International League of Associations for Rheumatology (ILAR) criteria documented in patients' records; TMJ involvement; good quality CBCTs covering our region of interest (ROI), from the glabella to the mandibular inferior border; no previous orthodontic/orthopedic treatment; no history of craniofacial trauma or congenital birth defects involving the craniofacial area. Each CBCT scan underwent examination using 3Diagnosys® software. Since data were normally distributed, parametric tests were used for analysis. The sample was divided into three groups: (1) bilateral JIA subjects, (2) unilateral JIA subjects, and (3) healthy controls. Results: We found a statistically significant reduction (p < 0.0001) in the transverse diameter (TR-Diam) of the affected condyles by an average of 1.7 mm, while the axial diameter (AX-Diam) again showed a slight reduction, on average by 0.1 mm, with a non-statistically significant value. Another comparison was made between the unaffected condyles of patients with unilateral JIA and the healthy condyles of the control group. The unilateral unaffected condyles were found to be slightly smaller than those of healthy patients, but without statistically significant differences. We found that in both JIA males and females, the condylar growth tends to stop earlier than the healthy ones. Conclusions: The transverse diameter was found to be more affected than the axial one, causing typical bone resorption and condylar shape. Moreover, we showed that the pathology, in the case of unilateral JIA, does not compromise only the affected condyles; the corresponding condyle that seems to be healthy is actually partially compromised. In addition, we observed that the growth of affected condyles of JIA subjects tends to stop earlier than the condyles of the healthy controls. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization considers malocclusion one of the most essential oral health problems. This disease influences various aspects of patients’ health and well-being. Therefore, making it easier and more accurate to understand and diagnose patients with skeletal malocclusions is necessary. Objectives: The main aim of this research was the establishment of machine learning models to correctly classify individual Arab patients, being citizens of Israel, as skeletal class II or III. Secondary outcomes of the study included comparing cephalometric parameters between patients with skeletal class II and III and between age and gender-specific subgroups, an analysis of the correlation of various cephalometric variables, and principal component analysis in skeletal class diagnosis. Methods: This quantitative, observational study is based on data from the Orthodontic Center, Jatt, Israel. The experimental data consisted of the coded records of 502 Arab patients diagnosed as Class II or III according to the Calculated_ANB. This parameter was defined as the difference between the measured ANB angle and the individualized ANB of Panagiotidis and Witt. In this observational study, we focused on the primary aim, i.e., the establishment of machine learning models for the correct classification of skeletal class II and III in a group of Arab orthodontic patients. For this purpose, various ML models and input data was tested after identifying the most relevant parameters by conducting a principal component analysis. As secondary outcomes this study compared the cephalometric parameters and analyzed their correlations between skeletal class II and III as well as between gender and age specific subgroups. Results: Comparison of the two groups demonstrated significant differences between skeletal class II and class III patients. This was shown for the parameters NL-NSL angle, PFH/AFH ratio, SNA angle, SNB angle, SN-Ba angle. SN-Pg angle, and ML-NSL angle in skeletal class III patients, and for S-N (mm) in skeletal class II patients. In skeletal class II and skeletal class III patients, the results showed that the Calculated_ANB correlated well with many other cephalometric parameters. With the help of the Principal Component Analysis (PCA), it was possible to explain about 71% of the variation between the first two PCs. Finally, applying the stepwise forward Machine Learning models, it could be demonstrated that the model works only with the parameters Wits appraisal and SNB angle was able to predict the allocation of patients to either skeletal class II or III with an accuracy of 0.95, compared to a value of 0.99 when all parameters were used (“general model”). Conclusion: There is a significant relationship between many cephalometric parameters within the different groups of gender and age. This study highlights the high accuracy and power of Wits appraisal and the SNB angle in evaluating the classification of orthodontic malocclusion. [ABSTRACT FROM AUTHOR]

Background: Contemporary fixed orthodontic appliances are shifting from non‐customized pre‐adjusted appliances to custom‐designed and printed appliances with novel digital setup systems. We are one step closer to precision dentistry and orthodontics using personalized mechanics and custom appliances. However, despite the evidential enhancement and other improvements to fixed appliances, tooth movement is still limited to five degrees of freedom. Opening or closing spaces still requires manually placing elastomeric chains or coil springs. Aim: In this article, we aimed to demonstrate how advancements in CAD/CAM technology, reverse engineering, and digital customization are helping orthodontics constantly evolve, enabling treatment with enhanced esthetics and minimal compliance. The clinical system (InBrace®, Irvine, CA) described in this article uses a patient‐specific, digitally designed multiloop NITI wire that delivers friction‐free, light, and continuous forces and activates automatically whenever the malocclusion deviates from the digital setup. Conclusion: Through digital customization, InBrace allows for automated tooth movement in all six degrees of freedom, including space opening or closure, via programmed non‐sliding mechanics. Clinical Significance: Precision orthodontics and personalized treatment have been significant developments in orthodontics recently. This article focuses on how a technologically advanced lingual appliance system could achieve targeted cosmetic results methodically via automation and personalization. [ABSTRACT FROM AUTHOR]

Background: Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over‐extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. Objective: The present study compares the post‐operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Methods: Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre‐operative and 6‐week post‐operative cone‐beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three‐dimensionally. Post‐operative variables were compared with their pre‐operative counterparts using either repeat‐measure 2‐way analysis of variance or Wilcoxon matched‐pairs signed rank test. Results: Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter‐group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p <.0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p =.0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. Conclusion: Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients. [ABSTRACT FROM AUTHOR]

Background: Mandibular malpositioning may result in an abnormal concentration of stresses within the temporomandibular joint (TMJ) in adult rats, which may further lead to a series of pathological changes, such as articular cartilage wear, subchondral bone sclerosis and osteophyte formation. However, the pathological and adaptive changes in condylar cartilage caused by different stress distributions are still controversial. Objective: The aim of this study was to observe the effect of sagittal changes in mandibular position on condylar cartilage by changing the occlusal vertical dimension (OVD) in adult rats. Methods: Fifteen‐week‐old female rats were divided into three groups: control (CON), increased OVD (iOVD) and loss of occlusion (LO) groups. An occlusal plate and tooth extraction were used to establish the animal model. TMJ samples of the experimental and CON groups were observed and investigated by bone morphological, histomorphological and immunohistochemical staining analyses at 3 days, 1 week, 2 weeks, 4 weeks and 8 weeks. Weight curves were plotted. Results: Micro‐computed tomography showed that, compared with the CON group, cartilage destruction followed by repair occurred in both experimental groups, which was similar to the trend observed in haematoxylin‐eosin staining. All experimental results for the iOVD group showed an approximately similar time trend. Compared with the iOVD group, the toluidine blue and immunohistochemical staining results in the LO group showed no obvious change trend over time. Conclusion: Compared with occlusal loss, an increase in OVD caused faster and more severe damage to condylar cartilage, and subchondral bone repair occurred later. [ABSTRACT FROM AUTHOR]

Background: Class II subdivision is a malocclusion characterized by dental and functional asymmetry that is difficult to manage. Impaired muscle function can result in asymmetrical growth, leading to occlusal instability. Objective(s): The study aimed to assess occlusal force in patients with Class II subdivision malocclusion using Innobyte. Additionally, the discrepancies of force generated at the position of maximum intercuspidation between the left and right sides of the arches were evaluated. Methods: The occlusal force of 66 patients with Class II subdivision malocclusion (group S) was measured and compared with that of 66 patients with Class I (group I) and 66 patients with Class II malocclusion (group II). The S group patients had a Class I molar on the right side and a Class II molar on the left side. ANOVA test, followed by the Games‐Howell post hoc test, was performed to compare the mean of the total force among the groups. To assess the difference in force between the right and left arches, one‐way ANOVA test followed by Tukey's post hoc comparison was performed. Finally, a boxplot was created to show the trend of occlusal force recorded in the three groups of patients. Results: The occlusal force differed significantly among the groups (p <.001). Post hoc Games‐Howell analysis showed significant differences as follows: the total force in group S was 165.24 N greater than in group II and in group I was 218.06 N greater than in group II. The difference (right–left) in total force between the groups was statistically significant (p <.001). Tukey's post hoc test showed following significant correlation: in group S was 53.51 N greater than in group II and 63.12 N greater than in group I. Conclusions: Among the analysed groups, patients with Class II malocclusion exhibited the lowest value of occlusal force. In patients with Class II subdivision malocclusion, force asymmetry, characterised by a higher value on the Class I side and a lower value on the Class II side was observed. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the prevalence of, and relationship between, bullying and malocclusion in schoolchildren aged 10–14 years in the South East of the UK. Design: Cross-sectional cohort study. Setting: Sixteen primary and secondary schools in South East of the UK. Participants: Schoolchildren aged 10–14 years who were consented to participate. Methods: The prevalence and nature of bullying were measured using a questionnaire. Traits of malocclusion and the need for orthodontic treatment were assessed by clinical examination and determined by the Index of Orthodontic Treatment Need (IOTN) Dental Health (DHC) and Aesthetic components (AC). Results: Complete data were collected for 698 participants. The number defined as being bullied was 68 (9.7%). There was no difference in the prevalence of bullying between gender, ethnicity or age. Higher rates of bullying were reported in mixed sex schools (P = 0.03). Participants with an increased overjet (P = 0.02) and/or a greater need for treatment, as measured by IOTN DHC (P = 0.01) and AC (P = 0.01), reported higher rates of bullying. While there was no difference in the overall prevalence of bullying between genders, boys were more likely than girls to experience physical bullying (P <0.001) and being called names (P = 0.03) Conclusion: A significant relationship was evident between being bullied and certain traits of malocclusion. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. Design: A cross-sectional study. Participants: A total of 82 participants aged 18–45 years recruited at a screening clinic. Methods: A questionnaire was completed in person using a tablet with digital forms. Results: Almost half of the participants (49%) knew about aligners; 40% were aged 18–24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort. Conclusion: Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the need for orthodontic treatment and socioeconomic status. Design: A cross-sectional study. Setting: Low, middle and high socioeconomic group schools in the same educational district in Cairo, Egypt. Participants: A total of 324 Egyptian schoolchildren aged 11–14 years. Methods: Validated questionnaires were used to assess self-reported bullying frequency and intensity, self-esteem and OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to assess the orthodontic treatment need and the participants' occlusion was classified according to the British Standard Incisors (BSI) classification. Results: Bullying was found to be prevalent in 61.7% of the sample. Regression analysis revealed that participants with a Class II division 1 incisor relationship had the highest odds ratio (OR) for predicting bullying (OR = 1.86, 95% confidence interval [CI] = 1.38–2.15). Being bullied was significantly associated with lower self-esteem (OR = 0.47, 95% CI = 0.13–0.78), worse OHRQoL (OR = 2.73, 95% CI = 1.95–3.15) and a high need for orthodontic treatment, as determined by the IOTN Dental Health Component score (OR = 1.33, 95% CI = 1.05–1.95) and IOTN Aesthetic Component score (OR = 1.52, 95% CI = 1.12–1.88). Moreover, participants in high and middle socioeconomic groups had a lower OR for predicting bullying than those in the low socioeconomic group (OR = 0.27, 95% CI = 0.13–0.54). Conclusion: The bullying prevalence among Egyptian schoolchildren aged 11–14 years was very high. The prevalence of bullying was higher in schoolchildren with higher orthodontic treatment need and Class II division 1 incisor relationship. Bullying was correlated to poor self-esteem as well as poor OHRQoL. In addition, low socioeconomic status was found to be a potential predictor for bullying. [ABSTRACT FROM AUTHOR]

Introduction: The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly. Patient concerns: A 10-year-old boy presented with no complaints for a routine orthodontic evaluation during the mixed dentition. Primary diagnoses: The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine. Interventions: Phase 1 started with rapid maxillary expansion to correct the maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months. Results: An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up. Conclusion: In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition. [ABSTRACT FROM AUTHOR]

Tooth transposition is the positional interchange of two adjacent teeth, which may be incomplete or complete. The root apex may remain in a normal position despite a severely displaced crown. The aim of this paper is to provide a literature review on the incidence, aetiology and treatment options for pseudo-transposed mandibular incisors. A case series is also presented highlighting the various management techniques that have been utilised in treating five cases of pseudo-transposed mandibular lateral incisors. [ABSTRACT FROM AUTHOR]

Background: Identification of tooth ankylosis before comprehensive orthodontic treatment can be challenging. This case series illustrates different presentations of tooth ankylosis, the importance of early diagnosis, the use of surgical luxation to aid orthodontic alignment of ankylosed teeth and its sequelae. Case presentation: All three cases were adolescents: a 14-year-old girl with a highly placed upper left lateral incisor and history of general anaesthesia; a 14-year-old boy with an impacted upper right first premolar and history of dental trauma; and a 13-year-old girl with an infraoccluded upper left central incisor with history of replantation due to avulsion. Iatrogenic malocclusion developed from attempts to align these ankylosed teeth. Subsequently, surgical luxation was performed, and the ankylosed teeth were successfully aligned. However, it was associated with pulp calcification, root resorption and recurrence of ankylosis. Conclusion: Surgical luxation and orthodontic alignment of ankylosed teeth can be considered a useful short-term solution to delay the need of surgical removal and teeth replacement. [ABSTRACT FROM AUTHOR]

Distalization of mandibular molars comes with significant challenges, especially in adult and young adult patients. In selected cases, third molar extraction procedures offer the opportunity to place miniplates for anchorage to distalize mandibular molars, providing additional solutions to the traditional extraction of premolars or a single incisor. This approach can be of special interest to adult patients, who may have life commitments and time restraints that limit traditional orthodontic and surgical treatment options, and it can improve the efficiency of dental care. This case series describes 3 clinical scenarios in which miniplates were placed with minimal invasiveness during the removal of impacted third molars, offering the patients nontraditional orthodontic treatment options. Awareness of these options is essential for general dentists so that they can explain all treatment possibilities and provide appropriate referrals to patients with impacted third molars. [ABSTRACT FROM AUTHOR]

The objective of this article is to report the clinical case and 4-year follow-up of a 5-year-old child with multiple dental anomalies, emphasizing the importance of early diagnosis and use of combined pediatric surgery and orthodontic approaches. A 5-year-old boy, accompanied by his mother, sought dental care for dental caries and tooth pain. Clinical and radiographic examinations revealed active caries, a supernumerary primary tooth in the region of the mandibular right second premolar, and severe ankylosis of the primary mandibular right second molar. The treatment plan involved extraction of the supernumerary tooth as well as sectioning and extraction of the ankylosed molar. When the patient was 6 years old, the permanent mandibular right first molar showed signs of an altered eruptive process, and orthodontic treatment was initiated. A unilateral band-and-loop space maintainer with coil springs designed to move the permanent first molar was placed on the primary first molar. A new panoramic radiograph, obtained when the patient was aged 7 years, suggested the presence of an odontoma in the apical region of the primary maxillary right canine. Surgical removal and histopathologic examination of the lesion confirmed that it was a developing odontoma. After surgery, due to occlusal anomalies that included transverse maxillary deficiency, deep overbite, and midline deviation, the patient underwent rapid maxillary expansion therapy with a Haas-type appliance. When the patient was 8 years old, orthodontic treatment continued with a removable palatal Hawley expander and a fixed mandibular lingual arch. Currently, at the age of 9 years, the child is still undergoing fixed orthodontic treatment after surgical exposure of the impacted permanent maxillary right canine and bonding of an orthodontic attachment to enable traction. A multidisciplinary approach to the management of dental anomalies promotes a favorable prognosis and ensures comprehensive treatment of young patients. [ABSTRACT FROM AUTHOR]

Objective: To three-dimensionally evaluate the position and morphology of the TMJ in skeletal Class I with variable degrees of overbite and overjet in comparison with normal peers. Methods: Pretreatment CBCT scans of 126 adults were retrieved. Based on the severity of overjet and overbite, the sample was divided into three main groups and six subgroups (18 patients each): the first group with a normal overbite and variable overjet degree and the second group with normal overjet and variable overbite degree. These six subgroups were compared with a third control group of normal overjet and overbite. Results: There were significant differences in vertical condylar position, vertical and anteroposterior condylar inclinations, condylar height, and significant posterior condylar positioning in severe deep overbite, compared with the control group. Conclusion: There were significant changes in the TMJ components in severe deep overbite cases. Therefore, sever deep overbite could be considered a predisposing factor for temporomandibular disorders. [ABSTRACT FROM AUTHOR]

Background: The opinion on whether a patient with an anterior open bite should be treated surgically or not is controversial. These patients generally suffer from associated discomfort due to their occlusal instability and musculoskeletal pain. Clinical Presentation: A 60-year-old woman visited the clinic with dental mobility of her upper central incisors as her chief complaint. She had a severe anterior open bite, with a history of continuous grinding and multiple dental restorations in poor condition. Additionally, she suffered neck pain with movement restrictions. Conclusion: Dentists can evaluate and treat patients with an anterior open bite using this integrative model (physical therapy/dentistry) as a possible alternative as part of the treatment for anterior open bite patients. [ABSTRACT FROM AUTHOR]

This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects. Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled. Clinical treatment was classified into 3 phases. In phase I, techniques such as orthognathic surgery, microsurgery, and distraction osteogenesis were employed to reconstruct the correct 3-dimensional (3D) jaw position relationship. In phase II, bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions. In phase III, implant-supported overdentures or fixed dentures were used for occlusal reconstruction. A summary of treatment methods, clinical efficacy evaluation, comparative analysis of imageological examinations, and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects. All data are summarized using the arithmetic mean ± standard deviation and compared using independent sample t -tests. In 15 patients with old jaw fractures and dentition defects (an average age of 32 years, ranging from 18 to 53 years), there were 7 cases of malocclusion of single maxillary fracture, 6 of malocclusion of single mandible fracture, and 2 of malocclusion of both maxillary and mandible fractures. There were 5 patients with single maxillary dentition defects, 2 with single mandibular dentition defects, and 8 with both maxillary and mandibular dentition defects. To reconstruct the correct 3D jaw positional relationship, 5 patients underwent Le Fort I osteotomy of the maxilla, 3 underwent bilateral sagittal split ramus osteotomy of the mandible, 4 underwent open reduction and internal fixation for old jaw fractures, 3 underwent temporomandibular joint surgery, and 4 underwent distraction osteogenesis. All patients underwent jawbone augmentation, of whom 4 patients underwent a free composite vascularized bone flap (26.66%) and the remaining patients underwent local alveolar bone augmentation. Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation (73.33%). The 15 patients received 81 implants, of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures. The survival rate of all implants was 93.82%. The final imageological examination of 15 patients confirmed that the malocclusion was corrected, and the clinical treatment ultimately achieved occlusal function reconstruction. The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy, phonetics, aesthetics, and comfort after treatment. Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment, consisting of 3D spatial jaw correction, alveolar bone augmentation and soft tissue augmentation, and implant-supported occlusal reconstruction, achieving satisfactory clinical therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the impact of soft tissue structure on the psychosocial effects of malocclusions in women and men. Material and Methods: The severity of malocclusion was determined in 84 individuals with a Class I skeletal pattern. The Psychosocial Impact of Dental Aesthetics Questionnaire was administered to determine the malocclusion perceptions of the patients. Arnett's soft tissue analysis was performed to determine the soft tissue structure. The difference between the sociodemographic factors and severity of malocclusion averages of men and women was statistically examined. Subsequently, the impact of Arnett's soft tissue analysis parameters on the Psychosocial Impact of Dental Aesthetics Questionnaire scores of each gender was evaluated. Results: No statistically significant association was observed between women and men related to the sociodemographic factors and the severity of malocclusions. The number of Arnett's soft tissue analysis parameters affecting the Psychosocial Impact of Dental Aesthetics Questionnaire scores was higher in men than women. Women were more psychologically affected by malocclusions, while men were affected by soft tissue structure changes, and women were affected by dental factors. Conclusion: Although the soft tissue structure did not affect the perception of malocclusions in women, women experienced a more severe psychological effect of malocclusion. [ABSTRACT FROM AUTHOR]

(1) Objectives: The purpose of this review was to compare the effects of combining skeletal anchorage and Class II devices, both from an overall perspective and individually for each type of appliance, considering as main outcomes the vertical dimensions and the inclination of the mandibular and maxillary incisors. (2) Materials and Methods: A search without time restrictions was performed up to February 2024 in PubMed, PubMed Central, Scopus, and Medline for randomized controlled trials, as well as prospective and retrospective cohort studies, considering Class II patients treated with and without skeletal anchorage. The effect measure used for the meta-analytic evaluation was the standardized mean difference (SMD). The SMD calculation was obtained by subtracting the mean values of T1–T0 for each individual treatment and then calculating the SMD between the treatments involved. The meta-analysis was performed using the standardized mean difference of the mean difference of the T1–T0 change in the outcome between the different treatments evaluated as the effect size. (3) Results: A total of 1217 documents were initially retrieved. According to the PRISMA protocol, 18 studies comparing different skeletal anchorage protocols (upper/lower miniscrews and miniplates), combined with four appliances (Herbst, Forsus, Carriere Motion, and elastics), were included in the analysis. No significant difference in skeletal divergence was found between groups from an overall point of view (SMD: 0.19 (−0.48 to 0.83) according to the random-effects model). A statistically significant reduction in IMPA° was found in patients treated with temporary anchorage devices (TADs) (SMD of 5.58 (3.40 to 7.75)), except for the elastics group (SMD: 3.76 (−0.91 to 8.43)). The effect on the upper incisors' inclination appeared to be strictly dependent on the type of anchorage (TADs in one or both of the arches). Some limitations must be considered when interpreting the results: the small number of studies included and the heterogeneity among them are among the limitations, and the temporal disparity among some studies; the ages of the patients were not always comparable; and, finally, the clinical relevance of the effects of TADs is sometimes questionable. (4) Conclusions: The vertical dimension seems not to be significantly affected by skeletal anchorage; instead, the proclination of mandibular incisors is generally reduced when TADs are used. Skeletal anchorage might be useful if lingual tipping of the upper incisors is required; however, it is influenced by the anchorage protocol. [ABSTRACT FROM AUTHOR]

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Copyright of Acta Odontologica Turcica is the property of Acta Odontologica Turcica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To retrospectively evaluate the effects of single mandibular advancement (MA) and two-jaw surgery (2J-S) on the pharyngeal airway space (PAS) and hyoid position for the correction of skeletal Class II malocclusion. Methods: Eleven adult patients who underwent only MA surgery and twelve adult patients who underwent Le Fort I maxillary impaction-MA surgery (2-JS) were included in the retrospective study. A total of 46 cephalometric recordings obtained before (T1) and after treatment (T2) were examined. Craniofacial changes, area, and linear measurements of the pharyngeal airway and hyoid bone position were obtained in both groups. The Wilcoxon signed-rank test was used to evaluate time-dependent changes within groups. The Mann-Whitney U test was used to compare differences between groups. Results: Hyoid-Vert values increased significantly in both groups (MA, p<0.01; 2J-S, p<0.05); however, Hyoid-Hor values decreased significantly only in the 2J-S group (p<0.01). The anteroposterior dimensions of the airway increased in both groups, except for the PNS-P and PPS groups (p<0.01). Although a significant increase was observed in the nasopharyngeal area (A1) in the MA group (p<0.05), the decrease was found to be statistically significant in 2JG (p<0.01). Significant increases were found in the oropharyngeal (A2) and hypopharyngeal areas (A3) in both groups (p<0.01, p<0.05). Conclusion: Both surgical procedures for the correction of Class II malocclusion resulted in increased hypopharyngeal, oropharyngeal, and total airway measurements. [ABSTRACT FROM AUTHOR]