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Objectives: To prospectively follow up a previously reported sample, analyzing (1) changes in third molar (M3) position after completion of 2 different types of orthodontic treatment: (2) non-extraction treatment with (HG) vs without cervical headgear (non-HG) and (3) first or second premolar extractions (PM1-2) compared to a non-extraction group (NE). Methods: A total of 474 patients were prospectively followed up. Panoramic radiographs were taken pre- (T1), post-treatment (T2) and at follow-up (T3). T3 records (a mean of three years after treatment) were available for 135 (HG vs non-HG) and 134 patients (PM1-2 vs NE), respectively. Angulation, vertical position, relation with the mandibular canal and mineralization status of M3 at T2 and T3 were statistically compared. Results: The HG group presented more M3 with ideal vertical orientation at T3. In NE-cases, further improvement in angulation and orientation can be expected after debonding, as well as a deterioration in the relationship with the mandibular canal. Extractions accelerated upper M3 vertical eruption and PM2 extractions led to long-term larger lower retromolar spaces. Conclusions: The use of cervical headgear increased upper M3 uprighting three years after debonding, while little changes in M3 position were found after orthodontic treatment with extractions. However, PM2 extractions led to larger retromolar spaces and better M3 angulation in the long term.

Objectives: To compare the performance of the Malmgren index on 2D and 3D radiographs. Methods: Patients with a panoramic radiograph and a cone beam computed tomography (CBCT) taken at an interval of

Age-related skeletal and soft-tissue changes are important in orthodontics, especially due to the increase of adult patients seeking treatment. The aim of this study is to assess the available evidence regarding age-related skeletal and soft-tissue changes in untreated Angle Class I. Articles studying skeletal and soft-tissue changes in orthodontically untreated subjects with Angle Class I and comparing them between age groups were included. Studies focusing on a single age group or in languages other than English were excluded. Risk of bias was assessed with both the MINORS and ROBINS-I tools. 50 studies were included, showing high methodological heterogeneity and a lack of information in subjects over 60 years old. In subjects with Angle Class I, the mandibular plane inclination was reported to reduce from 7 and 20 years old, while the anterior and posterior facial height continue to increase in late adult life. The anterior cranial base length increases until 20 years old, afterwards decreasing slowly until late adulthood. Nasal width increases and the nasolabial angle decreases during adolescence. Upper lip length and lower lip length increase from 6 to 18 years along with retrusion of the lips in late adulthood. Age-related skeletal and soft-tissue changes are documented in the literature from childhood until the fifth decade of life, but studies mostly focus on subjects until 20 years old. Changes after the second decade of life are studied only for the vertical and sagittal dimensions. No changes are reported in the transversal dimension beyond 15 years for neither skeletal nor soft tissues. Well-designed, long-term prospective cohort studies considering all three dimensions of skeletal and soft tissues are needed for confirmation of these findings (PROSPERO: CRD42020203206). ispartof: ODONTOLOGY vol:111 issue:2 pages:263-309 ispartof: location:Japan status: published

Summary Objective To investigate the use of blended learning (BL) in Postgraduate Education in Orthodontics. Methods A self-developed online questionnaire was sent to 244 teaching staff members of the European Orthodontic Departments. They were asked to answer it and share it with their postgraduate students. 18 questions for teaching staff and 27 for postgraduate students evaluated the use, perceptions, feedback options, learning outcomes, and teacher’s role in BL. The answers of teaching staff and students were statistically compared by Fisher’s Exact Test, Chi-Square Test, Unpaired t-test, and Mann–Whitney Test. Results 124 completed questionnaires were received, 44 from teaching staff and 80 from postgraduate students. Teaching staff is more acquainted with BL than students (P = 0.001). Both groups found BL courses a good alternative to traditional courses (P = 0.654). The use of interactive multimedia was more appreciated by students (P = 0.015). Both groups found students’ results not to change with BL, but teaching staff had a more negative perception (P = 0.012). In general, teaching staff perceived feedback and interaction as less essential than postgraduates in BL. Teaching staff felt more like coaches when using BL, while postgraduates did not perceive any changes in teachers’ roles (P = 0.006). Limitations: Due to the General Data Protection Regulation it was not possible to directly contact the postgraduate students in Postgraduate Orthodontic Programs throughout Europe. Therefore, this study completely relied on the goodwill of the teaching staff being contacted. Conclusion The main differences in perception between teaching staff and postgraduate students were student results, teachers’ role, use, and importance of feedback and interactive multimedia. Although both groups found BL courses to stimulate students’ learning and to be a relevant cost-effective addition to traditional courses, they were hesitant to fully replace them with BL.

The aim of the present study was to evaluate if, after treatment with aligners (ALIGN) and fixed orthodontic appliance (FOA), alterations of the neuromuscular activity may occur and if differences in these changes can be detected between the two treatments. Sixteen healthy patients (7 FOA, 9 ALIGN) with class I or class II molar relation were recruited. Standardized surface electromyography (ssEMG) was used to evaluate the activity of the masticatory muscles (masseters-MM and temporalis-TM) before the beginning of the orthodontic treatment (T1), at the end (T2), and 3 months (T3) after the end of the treatment. Intragroup (within timepoints) and intergroup differences were statistically analyzed. At T1, the mean values of each ssEMG index were within the normal range in both groups. At T2, the FOA group showed larger differential recruitment of the MM than TA muscles with a value slightly over the normal range. All the indexes were normalized at T3, and no differences emerged between groups. In the FOA group, the index of MM symmetrical contraction increased significantly at T3 compared to T1 and T2. In the ALIGN group, no significant changes were observed between each timepoint. In FOA subjects, a slight alteration of the muscular activity appeared immediately after bracket removal and this alteration normalized after 3 months of rescue. In subjects treated with aligners, no significant alteration of the muscular activity was assessed.

The aim of the present study was to evaluate if, after treatment with aligners (ALIGN) and fixed orthodontic appliance (FOA), alterations of the neuromuscular activity may occur and if differences in these changes can be detected between the two treatments. Sixteen healthy patients (7 FOA, 9 ALIGN) with class I or class II molar relation were recruited. Standardized surface electromyography (ssEMG) was used to evaluate the activity of the masticatory muscles (masseters-MM and temporalis-TM) before the beginning of the orthodontic treatment (T1), at the end (T2), and 3 months (T3) after the end of the treatment. Intragroup (within timepoints) and intergroup differences were statistically analyzed. At T1, the mean values of each ssEMG index were within the normal range in both groups. At T2, the FOA group showed larger differential recruitment of the MM than TA muscles with a value slightly over the normal range. All the indexes were normalized at T3, and no differences emerged between groups. In the FOA group, the index of MM symmetrical contraction increased significantly at T3 compared to T1 and T2. In the ALIGN group, no significant changes were observed between each timepoint. In FOA subjects, a slight alteration of the muscular activity appeared immediately after bracket removal and this alteration normalized after 3 months of rescue. In subjects treated with aligners, no significant alteration of the muscular activity was assessed.

Methodological bias can directly affect the interpretation of research data. Studies reporting on excavated skeletons represent a valuable source of information in medicine, dentistry, archaeology and anthropology, and forensic sciences. However, these studies represent a specific setting with their own methodology, for which no quality assessment tool is available. The aim was to develop a critical appraisal tool to assess the methodological quality of studies reporting on archaeologically excavated human skeletons. An international Delphi study was therefore conducted to support item generation and ensure content validity for a new tool. Experts from the following domains were consulted: dentistry, forensic sciences, archaeology and anthropology, general medicine, epidemiology, and statistics. Participants judged the relevance and comprehensiveness of items retrieved from the literature. Consensus was predefined as 75% agreement between experts, and achieved within two Delphi rounds. As a result, 44 and 32 participants completed the first and second Delphi rounds, respectively, achieving consensus on 17 items. This research provides the first evidence-based tool for the methodological assessment of studies reporting on archaeologically excavated skeletons. Clinicians and researchers can use this tool for critical appraisal of studies or when performing systematic reviews. Future research will focus on psychometric testing of the newly developed tool. ispartof: Archaeometry vol:64 issue:6 pages:1499-1513 status: Published online

OBJECTIVES: To compare changes in root length of maxillary incisors with and without dental trauma throughout orthodontic treatment. MATERIALS AND METHOD: Patients younger than 18 years, with trauma on at least one maxillary incisor, undergoing orthodontic treatment between 2017 and 2021 were included, using the contralateral side as control without trauma when available. Periapical radiographs were taken pre-treatment and at 6 months intervals, and root/crown ratio was calculated. Linear mixed models were used to describe the evolution of root length at the different time points and to compare trauma and control values. Differences between central and lateral incisors and between treatment modalities were additionally explored. RESULTS: A total of 1768 measurements were performed on 499 teeth (201 with trauma) in 135 patients. Incisor root length significantly decreased during orthodontic treatment in teeth with and without trauma. Lateral incisors with trauma were more susceptible to root resorption than those without trauma and central incisors. No significant decrease in root length was observed with removable appliances, which never exceeded 15 months of treatment. Treatment with fixed appliances led to gradually increasing, significant root length shortening in teeth with and without trauma. CONCLUSION: Treatment duration directly correlated with root length shortening both in teeth with and without trauma history. Teeth with trauma showed significantly more root resorption after treatment with fixed appliances while removable appliances had no significant influence on root length. CLINICAL RELEVANCE: Previous history of dental trauma is no absolute contra-indication to start orthodontic treatment, as long as treatment duration is kept as short as possible. ispartof: Clinical Oral Investigations vol:26 issue:12 pages:7179-7190 ispartof: location:Germany status: accepted

UNLABELLED: BACKGROUND AND OBJECTIVE(S): (1) To derive descriptive statistics of three-dimensional (3D) facial shape, lip and cheek muscle pressure in subjects of European descent with normal dental occlusion. (2) To analyse the effect of age and sex on 3D-facial soft tissue morphology and muscle pressure in the same sample. (3) To assess the independent effect of muscle pressure on face shape. METHOD: 129 subjects with normal occlusion were cross-sectionally recruited and divided into: children (mixed dentition), adolescents and adults (permanent dentition, < and ≥18 years respectively). Muscle pressure was recorded using the Iowa Oral Performance Instrument. MeshLab, MeVisLab and Meshmonk tool box were used to clean, annotate landmarks and generate the 3D images. Two-way analysis of variance and post-hoc tests were used to analyse age and sex differences in face shape and muscle pressure. The effect of muscle pressure on face shape was analysed by Pearson correlation and Partial Least Square regression. RESULTS: Significant facial differences were observed between adults and adolescents and adults and children in both sexes, showing flattening of cheeks and lips and protrusion of nose and chin. Significant cheek protrusion and retrusion of the vertical midface were found in adult women compared to men. Lip and cheek pressure increased with age, but their effect on face shape was not significant. CONCLUSIONS: This study provides 3D age- and sex-specific facial models and muscle pressure of subjects without malocclusion. These can be used as a reference for clinicians focused on facial assessment in treatment planning and follow-up. ispartof: Computers In Biology And Medicine vol:151 part A issue:Pt A ispartof: location:United States status: Published online