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Malocclusion is the misalignment of teeth and jaws, affecting oral health and appearance. This study aimed to examine the knowledge, attitude, and practice (KAP) of both adolescents and parents toward malocclusion. This web-based cross-sectional study was conducted at Tianjin between July 2019 and July 2022, enrolled adolescents and their parents. The structural equation model (SEM) was used to analyze the interactions between KAP. A total of 478 adolescents and 380 parents were included. For knowledge, the scores were 6.95 ± 2.69 for adolescents and 7.07 ± 2.90 for parents (possible range, 0-12). For attitude, the scores were 36.96 ± 7.86 for adolescents and 33.26 ± 9.20 for parents (possible range, 13-65). For practice, the scores were 39.88 ± 7.85 for adolescents and 25.75 ± 8.56 for parents (possible range, 11-55). In parents, knowledge, practice, being a service personnel and production personnel, and acquiring knowledge through the Internet were associated with receiving orthodontic treatment. The SEM showed that knowledge directly affected attitudes (β = 0.551, P < 0.001) and practices (β = 1.122, P < 0.001). But attitudes did not affect practices (β=-0.003, P = 0.923). Adolescents and parents demonstrate unsatisfactory levels of knowledge, attitudes, and practices toward malocclusion. Improvements can be made by focusing on enhancing knowledge and encouraging proactive practices., (© 2024. The Author(s).)

The etiology of temporomandibular disorders (TMDs) is remarkably diverse. This case report highlights the use of clear aligners as a probable cofactor of TMD in an adult patient. A 56-year-old woman who presented with a chief concern of crowding was missing teeth in both arches and had generalized tooth wear, an indistinct history of temporomandibular joint musculoskeletal pain, and a self-reported history of clenching. Based on the patient's preferences, clear aligner therapy (CAT) was initiated with a limited treatment goal of providing improved esthetics by reducing the overjet, expanding the arches, and aligning the anterior teeth. A few weeks into CAT, the patient developed acute masticatory facial pain. Therefore, the course of CAT was adjusted in favor of an individualized protocol to alleviate her occlusal symptoms until orthodontic treatment was completed. Dental providers must consider the potential contributory role of CAT in TMDs in patients who adapt poorly to occlusal changes and offer a patient-centered approach to manage the problem., Competing Interests: No conflicts of interest reported.

Introduction: Nonextraction treatment is associated with a greater prevalence of third molar impactions, whereas data on second molars are lacking. This study investigated whether there is a difference in the prevalence of second molar eruption disturbances when crowding is treated with or without extractions., Methods: Patients were grouped by maxillary and mandibular crowding, including mild crowding (<5 mm) without extractions, borderline crowding (5-9 mm) without extractions, and borderline crowding with extractions. The 535 evaluated arches were from 346 patients aged 10-15 years with unerupted second molars at treatment start. The frequency and severity of second molar eruption disturbances were scored in final records using a severity classification based on a modified Archer system, a hybrid Archer Pell-Gregory system, and a partial impaction scale. Pretreatment panoramic radiographs were scored for impaction-risk indicators. Fisher exact test was used., Results: In the maxilla, 20.0% of nonextraction patients with borderline crowding had second molar eruption disturbances compared to 5.2% of extraction patients with borderline crowding (P = 0.010). In the mandible, 27.6% of nonextraction borderline crowding patients had second molar eruption disturbances compared to 7.1% of extraction patients with borderline crowding (P = 0.006). There was no difference in the frequency of eruption disturbances between mild crowding without extractions and borderline crowding without extractions. The prevalence of impactions was higher in the maxilla when molars were apically positioned and in the mandible when molars were mesially angulated or had insufficient space pretreatment., Conclusions: In patients with borderline crowding, extraction treatment reduces the risk of second molar eruption disturbances; however, nonextraction treatment does not increase the risk when compared with patients with mild crowding. When considering extractions for crowding, providers should evaluate second molar impaction-risk indicators on pretreatment radiographs., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: The aim of the study was to determine how the electrical activity of the temporalis, masseter and sternocleidomastoid muscles differs in children with reduced transverse jaw dimension compared to children with normal occlusion., Design: It was a experimental study. Thirty-seven patients were included in the study. 18 in the study group received orthodontic treatment with removable appliances and 19 subjects were classified as normal occlusion subjects in the control group. A panoramic X-ray and digital intraoral scan were taken, followed by an surface electromyography of three muscle pairs (temporalis muscles, masseter muscles, sternocleidomastoid muscles) in resting position, while clenching and clenching on cotton rollers., Results: There was significantly greater activity in the experimental group than in the control group comparing muscles: temporalis muscles and masseter muscles in the resting position. Additionally, significantly greater activity of muscles in the control group was found during clenching. However, the asymmetry index of muscles indicates that there is significantly greater asymmetry of muscles activity in the experimental group. Compared to children with normal occlusion, children with a narrowed transverse dimension of the jaw have statistically significant differences in the bioelectrical activity of the temporalis, masseter and sternocleidomastoid muscles, as well as greater asymmetry in the bioelectrical voltage of the masseter muscles., Conclusions: Patients with reduced transverse dimension of the jaw are characterized by increased resting activity of the masticatory muscles and reduced functional activity of the masticatory muscles. These patients have increased asymmetry in the bioelectrical tension of the masticatory muscles., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: Less than ideal contacts have been reported following aligner therapy, but it is considered a transitory problem, spontaneously resolving with the phenomenon of settling. Methods : Thirty-nine orthodontic patients (14 treated with aligners; 25 with fixed appliances) were evaluated with a digital occlusal analysis system (T-scan™10), assessing Maximum Intercuspation contact simultaneity, symmetry, and relative force distribution at treatment completion and after 3 and 6 months., Results: No significant differences in occlusal contact quality were found between groups at treatment completion or follow-up. The center of force moved posteriorly and remained stable after 3 months but was located more anteriorly in females ( p = 0.01). One-third of patients (both groups combined) had marked contact force asymmetry even after 6 months' retention. Conclusion : Occlusal contacts were comparable at completion of treatment with aligners or brackets and after 3-6 months of retention. Settling did not improve marked asymmetry in all patients.

Purpose: The aim of this retrospective cohort study was to evaluate the long-term effects of interceptive orthodontic treatment with a removable expansion plate, based on transversal, sagittal, and vertical parameters., Methods: A total of 90 patients needing interceptive treatment due to a crossbite or space deficiency were included. Records consisting of clinical photos, radiographs, and digital dental casts were collected for evaluation at two time points: the start of interceptive treatment (T0) and the start of comprehensive treatment (T1). Molar occlusion, overjet, overbite, presence and type of crossbite, mandibular shift, and transversal measurements were recorded for comparison., Results: After expansion with removable appliances, a significant increase in intermolar width was achieved and could be maintained over the observation period (p < 0.001). However, no significant changes regarding overjet, overbite, or molar sagittal occlusion were observed. Crossbite correction was successful in 86.9% of patients with unilateral crossbite and in 75.0% of patients with bilateral crossbite (p < 0.001)., Conclusion: Early expansion with a removable expansion plate is a successful method to correct crossbites and increase intermolar width in the early mixed dentition phase. Results remain stable until the start of comprehensive treatment in the permanent dentition., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Purpose: To determine the correlation between external apical root resorption and malocclusion-related variables in patients treated with fixed orthodontic appliances., Methods: In all, 103 patients aged 12-15 years and treated with edge-wise appliances either without extractions or with four premolar extractions were included in this retrospective cohort study. External apical root resorption was assessed in the pre- and posttreatment panoramic radiographs of these patients for incisors, canines, premolars, and first molars. A total of 2332 teeth were evaluated in 206 panoramic radiographs obtained from 103 patients. The gender of the patients, duration of orthodontic treatments, presence of premolar extractions, Angle classification, overbite, overjet and amount of crowding were assessed. Wilcoxon signed-rank test, Mann-Whitney U test, and Kruskal-Wallis test were used for statistical analysis of the data., Results: Statistically significant (p < 0.001) root resorption occurred in all examined teeth during orthodontic treatment. The degree of root resorption observed in the premolars was significantly greater in premolar extraction cases than in nonextraction cases. Statistically significant negative correlations were found between the degree of root resorption of the maxillary lateral teeth and between the maxillary first premolar teeth and the amount of maxillary crowding., Conclusions: The orthodontic treatment protocols and the amount of tooth movements achieved were shown to be dependent on the severity of dental malocclusions and they have an influence on the amount of external apical root resorption that occurs during the course of orthodontic treatment., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Aim: The aim of this study was to investigate the psychosocial impact of malocclusion and the motivation for seeking orthodontic treatment among adolescents., Methods: A cross-sectional study included 102 adolescents (ages 11-18) whose malocclusion was rated using 3 occlusal indices: IOTN, DAI, and PAR. The participants answered three structured questionnaires selected to measure Oral Health Related Quality of Life (OHRQoL) through the short form of the Child Oral Health Impact Profile (COHIP), the patient's perceived impact related to orthodontics through the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and self-esteem through the Rosenberg Self-Esteem Scale (RSES). Independent two-tailed t-tests, one-way mixed analysis of variance (ANOVA), and Spearman's correlations were used to test various associations., Results: Patients with higher malocclusion scores displayed increased psychosocial impact with weak to moderate correlations (0.2 < r < 0.3; p < 0.05), but 98% wished their teeth looked better, and 70% were unhappy about their smile esthetics. The IOTN esthetic component AC was better associated with psychosocial implications of malocclusion (p < 0.01). Self-motivated patients (over 80%) had higher impactful psychosocial scores than patients whose parents were motivated for treatment. Sex did not influence the findings. Older adolescents and bullied individuals were more affected by the psychological burden of malocclusion., Conclusion: The results indicate the prevalence of psychosocial and esthetic impacts of malocclusion over oral and functional problems. PIDAQ discriminated better than COHIP between varying degrees of dental aesthetics. The results suggest that the orthodontist should explore patients' expectations of treatment outcomes, not only the chief complaint., (© 2024. The Author(s).)

The objective of this study was to compare the aging changes of the dental arches in patients treated without extractions and untreated normal occlusion subjects after a four-decade follow-up. This retrospective study evaluated two groups: The Treated Group (Group T) comprised 16 patients (6 male; 10 female) presenting with Class I or Class II malocclusions treated orthodontically without extractions. Dental models were evaluated 3 stages: T1 (pretreatment, 13.20 years), T2 (posttreatment, 15.07 years) and T3 (long-term posttreatment, 50.32 years). The Untreated Group (Group UT) consisted of 22 untreated normal occlusion individuals. The dental casts were evaluated at the ages of 13.32 (T1), 17.82 (T2) and 60.95 years (T3). The dental casts were digitized and the irregularity index, intercanine, interpremolar and intermolar widths, overjet and overbite, arch length and perimeter were measured. Intergroup comparisons were performed with independent t tests (P < 0.05). From T1 to T2, the treated group showed maxillary and mandibular crowding and overjet decrease and a maxillary interpremolar and intermolar width increase compared to the untreated group. From T2 to T3, a greater maxillary and mandibular crowding increase and a greater arch length decrease were observed in the treated group compared to the normal occlusion subjects. Overbite increased in the treated group and decreased in the untreated group. The maturational changes of treated patients were different from untreated normal occlusion subjects. Relapse might have contributed for the greater changes observed in incisor crowding and arch length observed in orthodontically treated patients. The aging changes of untreated normal occlusions and nonextraction treated patients, after a four-decade follow-up, proved to be different, indicating that relapse of orthodontic treatment played a role in aging changes of treated patients., (© 2024. The Author(s).)

Purpose: This study aimed to compare the acceptability of removable acrylic appliances (RA) and Invisalign First (IF) clear aligners (Aligntech, USA) among children undergoing orthodontic treatment during the mixed dentition period, considering the severity of malocclusions., Methods: A total of 40 patients, aged 6 to 13 years, were recruited for the study. Malocclusion severity was evaluated using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC). Patients completed the "Acceptance of Orthodontic Appliance Scale (AOAS)" via a face-to-face Google survey. To assess the reliability of the AOAS, the survey was resent to five patients after three months for a second response, and reliability analysis was conducted. Additionally, inter-rater reliability was evaluated by having all patients independently assessed by a second researcher. Data were analyzed using SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05., Results: Although no significant difference was found in IOTN-DHC scores, the IF group demonstrated significantly higher AOAS scores compared to the RA group (p = 0.014). Survey responses revealed noticeable distinctions between groups regarding speaking discomfort, preference for orthodontic appliances, and facial appearance comfort. A negative correlation (r = -0.477, p = 0.034) was observed between malocclusion severity and appliance acceptance., Clinical Significance: This study underscores the significant superiority and advantage of IF over RA among pediatric orthodontic patients during the mixed dentition period., (© 2024. The Author(s).)

Background: Prosthetically guided orthodontics (PGO) can correct the malocclusion for better prosthetic rehabilitation in esthetic rehabilitation. Unlike conventional orthodontic treatment, only minor tooth movement is designed in PGO according to the requirement of subsequent restoration. For better appearance during the treatment, PGO is often performed with clear aligners, which have no metal brackets. It has been proven that the PGO with clear aligners can achieve generally satisfactory outcomes. However, its risk has not been fully known due to the paucity of relevant studies., Case Presentation: Three patients who needed esthetic rehabilitation with mild malocclusion were included in this study. After evaluation, a prosthetic solution alone was considered insufficient to provide optimal outcomes. Thus, they were treated using PGO with clear aligners (Invisalign Go, Align Technology, Santa Clara, California, USA) and accomplished prosthetic rehabilitation subsequently. Dental history and X-ray examination revealed that endodontically treated teeth (ETT) existed in all the cases. Intraoral photographs were collected to compare the pre-treatment and post-treatment dentition. After PGO, posterior ETT did not maintain their position as scheduled and lost occlusal contacts, while all the anterior teeth, including anterior ETT, were moved to the designed position. Corresponding prosthetic rehabilitation was used to solve it after consulting with the patients., Conclusions: Occlusal contact loss of posterior ETT is a potential risk in PGO with clear aligners, affecting the orthodontic result., (© 2024. The Author(s).)

Introduction: Social media enhanced access to information, making it easier to share dental treatments., Objective: This study aimed to conduct a descriptive analysis of the clinical cases published on the Align® Global Gallery platform., Material and Methods: A retrospective cross-sectional study of 1,582 cases was conducted, data extracted referred to the following basic information: case number; patient's age; reported gender; Invisalign® package modality; treatment time; aligner exchange protocol; total number of aligners per arch; type of retainers, and inclusion of initial and final panoramic and cephalometric radiographs., Results: The majority were young (mean age 24.6 years, SD = 11.6), female patients (69.1%) with Class I malocclusion (39.4%) and crowding (77.9%). Comprehensive treatment was common (66.5%), with an average treatment time of 18 months (SD = 8.56; 95% CI = 17.6-18.5), with the most frequently reported aligner exchange protocol being 7 days (49.5%), with an average of 50.6 aligners in the upper arch (SD = 26.9; 95% CI = 49.2-51.9), and 48.7 in the lower arch (SD = 26.1; 95% CI = 47.4-50.0). Arch expansion (66.9%) and interproximal reduction (59.7%) were common approaches, while extractions were rare (4.3%). In most cases, initial lateral cephalometric (80.4%) and panoramic (93.3%) radiographs were presented. However, the final radiograph count dropped, with lateral cephalometric at 69.2%, and panoramic at 82.2% of cases., Conclusion: Cases in the Align®Global Gallery mostly feature Class I patients with crowded teeth, treated with expansion and interproximal reduction. The absence of standardized information and post-treatment data restricts the applicability of these findings to broader Invisalign® treatment trends.

Objective: This study assessed patient's satisfaction after orthodontic treatment in the postgraduate orthodontic clinic of the Dental School at the University of Athens (Athens, Greece), and investigated possible correlations between satisfaction after orthodontic treatment and life satisfaction, alongside the influence of age, gender, severity of initial orthodontic malocclusion and duration of retention period., Material and Methods: Patients aged 12 years and above, who had recently completed comprehensive orthodontic treatment, participated completing two questionnaires: a 37-item questionnaire, validated for assessing orthodontic treatment satisfaction; and the 5-item Satisfaction with Life Scale, a valid and reliable measure of life satisfaction. Scores from each questionnaire were summed for each patient. Demographic details, Index of Orthodontic Treatment Need (IOTN) and the duration of the retention period up to questionnaire completion were collected. Multiple regression analysis assessed the relationship between the questionnaires and the evaluated variables., Results: A total of 150 patients answered the questionnaires, being 82 women (55%) and 68 men (45%). The mean age of patients was 18.87 ± 5.97 years (range: 12-47). Most patients expressed satisfaction with treatment outcomes (grades 5 and 6). Satisfaction with orthodontic treatment showed a significant correlation with life satisfaction (p=0.002), but not with gender, age, dental/esthetic components of IOTN, or the duration of the retention period., Conclusion: Satisfaction after orthodontic treatment exhibited a significant correlation with life satisfaction, but it was not affected by gender, age, dental/esthetic components of IOTN, or the duration of the retention period.

Background: This study aims to verify Bolton's values for tooth size ratios and to evaluate possible relationships to different occlusal traits using precise digital measurement methods., Materials and Methods: Including 1000 consecutively selected patients from three study centres a digital, partially automated model analysis was performed utilizing the software OnyxCeph. The measurements comprised tooth width for calculation of anterior (AR) and overall ratio (OR) as a percentage, arch width, length, perimeter, overjet, overbite, space analysis in millimetre and the assessment of the angle classification., Results: AR and OR were significantly increased compared to Bolton's ratios of 77.2% (AR) and 91.3% (OR). In the gender comparison, male patients showed larger tooth size ratios, especially in the OR. Patients with Angle Class II/1 and II/2 had smaller tooth size ratios than patients with Angle Class III and I. Thus, patients with Angle Class II/1 had the largest tooth diameters in all maxillary teeth and with Angle Class II/2 the smallest tooth sizes in the mandible. The largest tooth widths in the lower jaw were observed in the Angle Class III patient group. Furthermore, a negative correlation from AR/OR to overjet, overbite, and available space in lower jaw as well as a positive correlation to available space in upper jaw was detected., Conclusions: There is a clear correlation between the tooth size ratios and the present dysgnathia as well as other orthodontically relevant occlusal traits. This prior knowledge about our patients is extremely important to create an individualized treatment plan and enable sufficient occlusion. To achieve a functionally good occlusion with correct overjet and overbite, it is essential that the maxillary and mandibular teeth are proportional in size. Any deviation from the ideal patient in terms of tooth size, number, shape, or arch must be considered in the pre-therapeutic treatment plan in combination with the existing dysgnathia in order to be able to achieve a stable anterior and posterior occlusion with appropriate adjustments to the therapy post-therapeutically., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Although they have proven effective in the resolution of mild to moderate malocclusions, aligners demonstrate substantial limitations. More complex malocclusions therefore require a combination of auxiliaries, or a hybrid approach involving both aligners and fixed appliances, such as miniscrew-supported appliances or sectionals. This case report presents a 25-year-old female patient with a severe transversal discrepancy associated with an anterior open-bite tendency effectively treated with a tooth bone-borne palatal expander characterized by two expansion screws (tandem expander) and a hybrid treatment with aligners., Methods: After accurate matching between the pretreatment cone-beam computed tomography scan and digital models, four self-drilling miniscrews were inserted palatally using a computer- aided design and computer-aided manufacturing surgical template to guide their correct and safe placement, and a tooth bone-borne appliance was fitted. After this first phase, the hybrid clear aligner approach was used to obtain alignment, leveling, and arch coordination, with the use of a partial lingual fixed appliance., Results: Transverse maxillary deficiency was corrected, crowding has been resolved, Class I molar and canine relationship were obtained, and marginal ridges has been aligned., Conclusions: Double jackscrew of the tandem expander enabled effective expansion of both the posterior segments as required to correct the skeletal discrepancy and the anterior region, thus relieving the dental crowding. Lingual sectional appliances have been shown to increase the effectiveness of clear aligners which, on the other hand, have been shown to be effective in closing the anterior bite by retroclination of the maxillary and mandibular incisors and, only minimally, by extrusion movements., (Copyright © 2024 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: Some orthodontic devices used in children share similar design principles to appliances used to treat obstructive sleep apnoea in adults. As well as treating malocclusion, orthodontic appliances used in children may therefore also have effects on the upper airway., Objective: A review of the literature to assess the effects of orthodontic treatment on the upper airway dimensions in children assessed on CBCT., Materials and Methods: Following registration of the protocol (PROSPERO CRD42023439056), a systematic electronic search of published studies was performed using several databases (PubMed; Scopus, Web of Science and Science Direct) in accordance with the PRISMA guidelines. Inclusion criteria were as follows: age under 18 years, orthodontic treatment with any appliance, a control group who received no treatment or a non-active alternative treatment and airway measurement using CBCT. RoB-2 and ROBINS-I tools were used to assess risk of bias and quality of the evidence., Results: In total, 341 studies were identified following the initial search. Title and abstract screening resulted in 45 studies for further full-text analysis. On completion of the screening process, a total of 23 studies met the inclusion criteria. Study interventions included functional appliances (10 studies), rapid maxillary expansion (RME) (9 studies), reverse-pull headgear (1 study) and 4 premolar dental extractions (3 studies). The included studies had moderate to high risk of bias, and the quality of evidence was low., Conclusion: The scientific evidence shows that functional appliances are associated with significant improvements in both upper airway volume and constriction when used in children however, the effects on the nasal cavity are limited. RME was associated with a significant increase in nasal cavity and nasopharyngeal dimensions, but not the upper pharyngeal airway. Neither reverse-pull headgear nor dental extractions were associated with any change in airway dimensions; however, the evidence is limited. Functional appliances may reduce the severity of obstructive sleep apnoea (OSA) in children., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

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., (© 2024 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

As an international group of orthognathic surgeons, we believe the next big thing in orthognathic surgery will be a clinical and research focus on patient-oriented outcomes and improved quality of life. We expect to see advances in diagnosis and treatment planning, materials development, and patient management., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Treatment of acute cases of amelogenesis imperfecta (AI) is challenging in children due to the absence of a consensus statement on therapeutic recommendations. This article presents the effectiveness of an interdisciplinary approach-including orthodontics, orthognathic surgery, and prosthodontics using digital technology-in a child with AI and skeletal deformities. The early management over a 6-year period had a very positive impact on the quality of life related to oral health. The full-mouth rehabilitation in adulthood with all-ceramic crowns showed a fully satisfactory result after 60 months of follow-up.

Mouth breathing is one of the most common oral and maxillofacial abnormalities in children. Children with mouth breathing are often accompanied by obstructive sleep apnea, which not only affects children's dentofacial development, leading to the occurrence of malocclusion, but also may lead to a series of serious systemic complications. The diagnosis and treatment of mouth breathing and its related malocclusions require multidisciplinary collaboration. This paper discusses the etiology and harm of mouth breathing, diagnosis of mouth breathing related problems, correlation between mouth breathing and malocclusion, treatment of mouth breathing related malocclusions.

Early orthodontic treatment is an important means of preventing and treating dentofacial deformities during the period of growth and development. In this stage, children have great potential in growth and development, high adaptability of muscles and temporomandibular joint, and good responsiveness to orthodontic force. Therefore, orthodontic intervention and treatment in this stage can prevent and guide the normal growth and development of dentition, occlusion and maxillofacial complex. This article summarizes the commonly used orthodontic techniques and appliances in the mixed dentition, including interceptive treatment of oral habits, application of functional appliances, fixed appliances, clear aligners, as well as management of severe crowding and space maintenance. This article comprehensively explains the application and indications of different orthodontic techniques in design and appliance selection in the treatment of malocclusions in the mixed dentition.

Background and Objectives: The aim was to compare the activity of the masseter muscles in children with different types of breathing. Materials and Methods: A cross-sectional study was conducted including patients aged 6-12 years with mixed dentition, who came for oral care at the Master's Degree in Pediatric Dentistry program at the Complutense University of Madrid (UCM), according to inclusion and exclusion criteria. The sample was divided into three groups: nasal breathers without dental alterations (control group), oral breathers with dental malocclusion, and oral breathers with previous orthodontic treatment. An electromyography was performed, and statistic methods were conducted with a 95% confidence to contrast hypothesis. Results: A total of 122 children were analyzed and distributed into three groups. The electrical muscle activity of masseters was significantly different between the study groups ( p < 0.001 for all comparisons). Pairwise comparisons revealed a significantly higher electrical muscle activity in the control group (nasal breathers) during chewing compared to both groups of oral breathers ( p < 0.001 for both comparisons). Orthodontic treatment decreased electrical muscle activity during isometric contraction in oral breathers compared to nasal breathers ( p < 0.001), but did not significantly affect electrical muscle activity during chewing. Higher decompensation values were obtained in oral breathers without previous orthodontic treatment compared the other study groups ( p < 0.001 for both comparisons), although electrical muscle activity values were similar in both groups of oral breathers ( p > 0.05 for both comparisons). Conclusions: Differences in electrical muscle activity between nasal and oral breathers can be confirmed. Oral breathers with and without orthodontic treatment showed lower electrical muscle activity of masseters during chewing than nasal breathers, while at isometric contraction, only oral breathers with previous orthodontic treatment showed lower electrical activity. Higher decompensation values were found in oral breathers without previous orthodontic treatment, in comparison to the control group and oral breathers with previous orthodontic treatment.

Objective: To report and rank orthodontic finishing errors recorded in the clinical phase of the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) examination and correlate pretreatment case complexity with orthodontic treatment outcomes., Materials and Methods: This single-center cross-sectional survey collected retrospective data from the clinical phase of BBO examinations between 2016 and 2023. The quality of orthodontic clinical outcomes of each case was assessed by means of the Cast-Radiograph Evaluation (CRE), while case complexity was evaluated using the Discrepancy Index (DI), both tools provided by the American Board of Orthodontics. Survey items were analyzed using descriptive statistics, and a correlation analysis between total CRE and DI scores (p<0.05) was also performed., Results: A total of 447 orthodontic records was included. Orthodontic finishing errors were often observed, and no case was completely perfect. In the total CRE score, an average of 15 points was discounted for each case. Most frequently found issues involved problems with alignment, buccolingual inclination, marginal ridge, and occlusal relationship. The median DI score for initial case complexity was 22.0 (range 10.0 - 67.0). There was no significant correlation between the DI and CRE scores (p=0.106)., Conclusion: Orthodontic finishing errors are inevitable, even in well-finished board-approved cases. Rotation, excessive buccolingual inclination, and discrepancies in marginal ridges are the most frequently observed areas of concern, in that order. Moreover, while case complexity, determined by DI, can impact orthodontic planning and pose challenges for clinicians, the study did not consider it a determining factor in predicting treatment outcomes.

A patient presented desiring to improve her esthetics and reduce masseter muscle pain prior to her upcoming wedding. Although the patient had a full-mouth rehabilitation with porcelain restorations at age 16, she presented with extensive overjet, unbalanced occlusion, and lack of contact from premolar to premolar. The clinician was faced with the challenge of determining the best course of treatment. After completing thorough record-taking and a detailed analysis following a systematic approach, the clinician developed a facially driven treatment plan that was carried out over eight phases. The patient's existing crowns were replaced at a reduced vertical dimension of occlusion, esthetics were enhanced, muscle pain was relieved, and her goals were achieved.

This study evaluated the mandibular development induced by rapid maxillary expansion (RME) therapy in mixed dentition patients with different vertical growth patterns through long-term observation. The research utilized a retrospective design that included two cohorts: a control group consisting of pediatric subjects with individualized malocclusions, and an experimental group received RME therapy. A total of 60 subjects were included; 37 in the RME group (17 males and 20 females) and 23 in the control group (13 males and 10 females). Based on mandibular plane angles, 19 pertinent cephalometric variables were quantified with Dolphin Imaging software, and participants were subclassified into high-angle and normal-angle subgroups. Changes in the groups during the observation period were statistically analyzed with a t -test. Compared to the control group, both sagittal parameters tended to decrease after treatment in the RME group ( p < 0.05), and none of the vertical correlations were statistically different ( p > 0.05). Within the normal-angle experimental subgroup, sagittal parameters markedly decreased when contrasted with their normal-angle control group ( p < 0.05). Notably, a substantive decrease in overjet was solely observable in the sagittal dimension among the high-angle expansion subgroup when compared to the high-angle control subgroup ( p < 0.05). In the vertical dimension, neither the normal-angle nor high-angle subgroups exhibited any statistically significant differences from their respective control cohorts ( p > 0.05). Based on long-term observation, RME therapy promotes mandible sagittal growth of the mandible in subjects with normal-angle vertical growth patterns. A similar tendency was not observed in subjects with high-angle vertical growth patterns. In addition, the mandibular plane angle did not increase after RME in children with high-angles., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

This review aimed to analyze the correlation between atypical swallowing and malocclusions and how this dysfunction can be treated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to conduct this systematic review, and the protocol was registered at International Prospective Register of Systematic Reviews (PROSPERO) with the CRD42024499707. A thorough search was conducted on PubMed, Scopus and Web of Science to find papers that discussed myofunctional and orthodontic treatment for patients with atypical swallowing and malocclusion from 01 January 2003 to 27 November 2023. The search yielded 2554 articles, of which only 12 records were selected for qualitative analysis. The analysis of these articles revealed that orofacial myofunctional therapy, criab appliance, Habit corrector™, and soft tongue restrainers are potential therapies for treating atypical swallowing and malocclusions. The tongue's position affects muscle behavior, leading to malocclusions that can be treated with various therapies, resulting in effective clinical outcomes. However, more research is required to delve deeper into the topic., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

This article addresses the management of dental implants in joint orthodontic-restorative cases, emphasising the role of temporary skeletal anchorage devices and interdisciplinary treatment. Focused on complex malocclusions that require dental implants, the article navigates through critical aspects such as diagnosis, treatment planning, implant positioning challenges and the strategic role of temporary skeletal anchorage devices in cases with compromised anchorage. Effective communication, collaborative efforts and strategic planning are highlighted in determining optimal implant numbers, locations and timing of placement. A collaborative, strategic approach to managing the complexities of joint orthodontic-restorative cases involving dental implants is recommended., (© 2024. The Author(s), under exclusive licence to the British Dental Association.)

Over the last decades the percentage of adult orthodontic patients has substantially increased. Undeniably, an important motif for seeking orthodontic care at an older age is smile improvement, but this is not all. Frequently, impaired dentofacial aesthetics are combined with several other issues: severe dentoskeletal malocclusions; multiple tooth loss due to caries or endodontic failure; dental agenesis or trauma; periodontal breakdown; or functional problems, such as temporomandibular disorders or obstructive sleep apnoea. Therefore, comprehensive adult treatment mostly requires close collaboration of a team of equally well-trained dental specialists to select and execute the most suitable treatment option for the individual patient from day one. With joint planning, intensive communication with the patient and the involved specialists, and continuous monitoring of the treatment process, true patient-centred care can be delivered. In order to serve the individual patient best, the treating orthodontist does not only need thorough speciality training and continuing education, but furthermore, should be well-equipped with sufficient knowledge of the other dental fields of expertise. In combination with digital technology as an important tool for enhancing communication and efficient exchange of information between all involved team members, excellent joint clinical skills will take comprehensive interdisciplinary treatment to the next level., (© 2024. The Author(s).)

Pathological tooth wear is a dental problem that affects all age groups and appears to be increasing in prevalence. A subset of these patients may benefit from a combination of orthodontic and restorative care which will be discussed in this article. Orthodontics can help to create the necessary vertical, anterior-posterior and mesio-distal space for restorative work, reducing the need for tooth reduction and lessening the biological costs of restorative care, helping to reposition the gingival margins where this impacts upon aesthetics, as well as correcting co-existing malocclusion., (© 2024. The Author(s), under exclusive licence to the British Dental Association.)

Objectives: To assess skeletal and dental effects and evaluate possible side effects of maxillary expansion with two different appliances, directly after expansion and 1 year postexpansion., Materials and Methods: Forty-two patients with unilateral posterior crossbite (mean 9.5 ± 0.9 years) were randomized to either rapid maxillary expansion (RME) banded on the deciduous second molars and bonded to the primary canines or slow expansion with quad helix (QH) on the permanent first molars. Cone-beam computed tomography records were taken at baseline, directly after correction of the posterior crossbite and at follow-up 1 year after expansion., Results: All patients were analyzed. RME opened the midpalatal suture more anteriorly and inferiorly (mean 4.1 mm) and less posteriorly and superiorly (mean 1.0 mm). No effect on midpalatal suture could be shown in the QH group after expansion, P < .001. Buccal bone width had significantly decreased (P < .001) in the QH group compared with the RME group. Buccal fenestrations and root resorption on the left first molar had a higher prevalence directly after expansion finished in the QH group (P = .0086, P = .013) but were not significant at 1-year follow-up (P = .11, P = .22)., Conclusions: Opening of the suture with RME was more anterior and inferior, and the QH did not open the midpalatal suture at all. More buccal bone loss and fenestrations were seen on the permanent first molar in patients treated with conventional QH than RME anchored to deciduous teeth., (© 2024 by The EH Angle Education and Research Foundation, Inc.)

Introduction: This study had 2 objectives: (1) to evaluate the clinical efficacy of the Mesial-Distalslider (MD) appliance when used for simultaneous maxillary molar mesialization and distalization in patients with a maxillary asymmetrical relationship and (2) to compare the outcomes with those achieved using the unilateral Mesialslider (UM) appliance., Methods: The sample included 40 subjects (25 females and 15 males) with a mean age of 22 years (range, 8-55 years). The patients were divided into 2 groups: 20 patients treated with an MD appliance (group 1) and a group of 20 patients treated with a UM appliance (group 2). Superimposition of digital dental models using regions of interest on the palate was performed to evaluate the 3-dimensional molar movements, the proclination or retroclination of the maxillary incisors, and the displacement of the maxillary midline., Results: At the end of the treatment, the MD group's total movements were 4.5 ± 2.2 mm (sagittal), -0.4 ± 2.4 mm (transverse), and 0.3 ± 0.9 mm (vertical) along the mesialization side and -2.4 ± 1.7 mm (sagittal), -0.5 ± 1.5 mm (transverse), and 0.2 ± 1.4 (vertical) along the distalization side. UM group total movements were 5.5 ± 3.6 mm (sagittal), -0.4 ± 2.7 mm (transverse), and 0.1 ± 2.0 mm (vertical). Incisor displacements were minimal. No statistically significant differences were found between the MD and UM groups for all the parameters., Conclusions: The use of the MD enables controlled movements in the sagittal direction with negligible dental side effects in the other planes (transverse and vertical). Furthermore, it facilitates asymmetrical movements simultaneously in the desired direction without the patient's compliance and provides good anchorage control., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to evaluate the efficacy of Invisalign First Phase I treatment compared with tooth-borne rapid maxillary expansion (RME) in mixed dentition patients by examining changes in palatal volume, palatal surface area, and maxillary interdental transverse measurements., Methods: In this open-label, 2-arm, parallel, randomized controlled trial, patients with a posterior transverse discrepancy ≤6 mm were allocated into the clear aligner therapy (CAT) group (Invisalign First Phase I treatment) and RME group (tooth-borne RME) according to a computer-generated randomization list immediately before the start of treatment. Digital models were obtained before the beginning of the treatment (T0) and at the end of the retention period/treatment (T1) using an intraoral scanner. Palatal volume was measured as the primary outcome, and palatal surface area and intermolar and intercanine transverse widths at the cusps and gingival level were measured as secondary outcomes. Patients and interventionists were not blinded because of the nature of the intervention., Results: Out of 50 patients, 41 (19 males and 22 females; mean age, 8.12 ± 1.53 years) were enrolled and divided into 2 groups: 20 in the CAT group and 21 in the RME group. Two participants did not receive the allocated intervention for different reasons (1 patient discontinued the intervention in the CAT group, and another patient was lost to follow-up in the RME group). Thus, 19 patients (5 males and 14 females; mean age, 8.48 ± 1.42 years) were analyzed from the CAT group, and 20 patients (12 males and 8 females; mean age, 7.83 ± 1.19 years) from the RME group. Regarding intragroup comparisons, all outcome measures significantly increased from T0 to T1 in both groups. In terms of intergroup comparisons, there were no significant differences in the variation (Δ) of outcome measures between the 2 groups from T0 to T1, except for the intermolar width at the gingival level (P <0.005). The change in palatal volume was 532.01 ±540.52 mm³ for the RME group and 243.95 ± 473.24 mm³ for the CAT group (P = 0.084), with a moderate effect size (d = 0.57)., Conclusions: RME showed trends favoring better outcomes compared with Invisalign First Phase I treatment across all assessed measures. The only parameter that showed statistically significant differences between the 2 groups was variation in intermolar width at the gingival level, suggesting the occurrence of buccal tipping in patients undergoing Invisalign First Phase I treatment., Trial Registration: The trial was registered at ClinicalTrial.gov (no. NCT04760535)., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To compare the dentofacial characteristics of children with and without adenoid and/or tonsillar hypertrophy., Methods: A consecutive sample of orthodontic patients aged 6-12 that took pre-treatment lateral cephalograms were included in this study. Those with history of previous orthodontic treatment, adenoidectomy or tonsillectomy, or craniofacial anomalies were excluded. The diagnosis of adenoid and tonsillar hypertrophy was based on Fujioka's and Baroni's methods, according to which the subjects were divided into four groups: the adenoid hypertrophy only (AHO) group; tonsillar hypertrophy only (THO) group; combined adenoid and tonsillar hypertrophy (AH+TH) group; and no adenoid or tonsillar hypertrophy (NH) group. Cephalograms were used for skeletal and dental measurement. Data were analyzed using one-way ANOVA, LSD post-hoc tests and Chi-square test., Results: A total of 598 patients were included. Compared with the NH group, the THO group had significantly larger SNB angle (P < 0.001), as well as significantly smaller ANB angle (P<0.001) and Wits value (P = 0.001). The U1-L1 angle of AHO group was significantly smaller than that in the NH group (P = 0.035). The proportion of adenoid hypertrophy in Class II patients was significantly higher than that in Class III patients (P = 0.001). The proportion of tonsillar hypertrophy in Class III patients was significantly higher than that in Class I patients (P < 0.001) and Class II patients (P < 0.001)., Conclusion: Over 80 % of children seeking orthodontic treatment had either adenoid or tonsillar hypertrophy. Children with adenoid hypertrophy tend to have skeletal Class II malocclusion, while those with tonsillar hypertrophy tend to have skeletal Class III malocclusion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Purpose: The aim of this retrospective study was to determine orthognathic surgery indicators for Japanese patients with jaw deformities using both Index of Orthognathic Functional Treatment Needs (IOFTN) and maxillofacial morphometric analysis., Subjects and Methods: The subjects were 89 patients treated with orthognathic surgery and 92 patients treated with orthodontic treatment alone, and were classified as class I, II, or III according to the ANB angle. Based on the results for IOFTN and the results of cephalometric analysis, the indication criteria for orthognathic surgery were examined., Results: In IOFTN analysis, none of patients in the orthognathic surgery group were classified as category 1 or 2, while 48% of the patients in the orthodontic treatment group were classified as category 4 or 5. The results of the cephalometric analysis of patients in classified categories 4 and 5 showed that the orthognathic surgery group had significantly greater lateral mandibular deviation in Class I cases, significantly more severe degree of mandibular retrusion in Class II cases, and significantly more severe degree of mandibular prognathism in Class III cases. The results of the logistic regression analysis showed that IOFTN was a common variable as an indication criterion for orthognathic surgery, and several different variables were also selected from the cephalometric measurements in each group., Conclusion: IOFTN is a highly sensitive and useful indicator as a criterion for orthognathic surgery. However, in the choice of treatment strategy, maxillofacial morphometric analyses and the patient's desired goal are important., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: The aim of the present study was to compare the changes in overjet and overbite measurements achieved in adolescent patients following an initial series of Invisalign® aligners (Align Technology, San Jose, California) with those planned by orthodontists via its ClinCheck® digital treatment planning facility., Methods: Data provided by Align regarding patients who had completed an initial series of Invisalign® aligner treatment and were less than 18-years old were assessed in relation to pre-treatment, planned and achieved overjet and overbite measurements. Descriptive statistics, Wilcoxon rank-sum, Mann Whitney calculations were computed., Results: A total of 290 patients satisfied inclusion criteria. The median (interquartile range (IQR)) age was 14.17 (13,15.42) years. The median achieved overjet and overbite changes were less than those planned (p<0.01) with 53.33% of the planned median overjet increase achieved and 52.94% of planned median overjet reduction achieved. Additionally, 58.33% of the planned median overbite increase was achieved and 55.55% of the planned median overbite reduction was achieved. A total of 21.52% patients recorded no change or an increase from pre-treatment to the achieved overjet where reduction was planned, whereas 41.67% recorded no change or a reduction in overjet where increase was planned. A total of 18.72% recorded no change or an increase in overbite where reduction was planned, whereas 20.75% recorded no change or a reduction in overbite where increase was planned., Conclusions: Less than 60% of the planned overjet and overbite changes per patient were achieved. Between 18.72 and 41.67% of patients experienced no change or changes in overjet and overbite in the opposite direction to that planned. This is likely to be clinically significant., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Data Sources: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID and ProQuest searched up to June 2023. Any clinical study with parallel arms and matched malocclusion severity should include permanent dentition participants with mild to mild-to-moderate anterior crowding. Participants should have undergone orthodontic treatment with either orthodontic labial fixed appliances or removable clear aligners. Total treatment time (primary outcome), chair time, number of appointments, and emergency visits (secondary outcomes) should also be reported., Study Selection: Two reviewers selected the studies to be considered in two stages. If needed, a third reviewer was included to solve discrepancies. Endnote and Rayyan software supported the process., Data Extraction and Synthesis: The same two reviewers independently extracted the required data from the included studies. If needed, a third reviewer was included to solve discrepancies. Endnote and Rayyan software supported the process., Results: Ten studies were finally included (six RCTs and four non-RCTs). Only one included samples in which teeth were extracted due to crowding. The total included sample was 718 participants (aged 20-29 years). Only one study did not report crowding equivalency between groups., Conclusions: Based on low to very low certainty levels, treatment duration is likely similar, chair time and emergency visits are less frequent, and the number of appointments is increased with clear aligners., (© 2024. The Author(s), under exclusive licence to British Dental Association.)

Introduction: In the treatment of malocclusion, continuous monitoring of the three-dimensional relationship between dental roots and the surrounding alveolar bone is essential for preventing complications from orthodontic procedures. Cone-beam computed tomography (CBCT) provides detailed root and bone data, but its high radiation dose limits its frequent use, consequently necessitating an alternative for ongoing monitoring., Objectives: We aimed to develop a deep learning-based cross-temporal multimodal image fusion system for acquiring root and jawbone information without additional radiation, enhancing the ability of orthodontists to monitor risk., Methods: Utilizing CBCT and intraoral scans (IOSs) as cross-temporal modalities, we integrated deep learning with multimodal fusion technologies to develop a system that includes a CBCT segmentation model for teeth and jawbones. This model incorporates a dynamic kernel prior model, resolution restoration, and an IOS segmentation network optimized for dense point clouds. Additionally, a coarse-to-fine registration module was developed. This system facilitates the integration of IOS and CBCT images across varying spatial and temporal dimensions, enabling the comprehensive reconstruction of root and jawbone information throughout the orthodontic treatment process., Results: The experimental results demonstrate that our system not only maintains the original high resolution but also delivers outstanding segmentation performance on external testing datasets for CBCT and IOSs. CBCT achieved Dice coefficients of 94.1 % and 94.4 % for teeth and jawbones, respectively, and it achieved a Dice coefficient of 91.7 % for the IOSs. Additionally, in the context of real-world registration processes, the system achieved an average distance error (ADE) of 0.43 mm for teeth and 0.52 mm for jawbones, significantly reducing the processing time., Conclusion: We developed the first deep learning-based cross-temporal multimodal fusion system, addressing the critical challenge of continuous risk monitoring in orthodontic treatments without additional radiation exposure. We hope that this study will catalyze transformative advancements in risk management strategies and treatment modalities, fundamentally reshaping the landscape of future orthodontic practice., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The secondary alveolar bone grafting procedure is typically recommended during the late mixed dentition phase, prior to the eruption of the permanent canine, in patients with cleft lip and palate. The anatomical and functional adaptations observed in the grafted area allow spontaneous migration and eruption of the adjacent maxillary canine. An alveolar bone graft can be performed using autogenous bone or recombinant human bone morphogenetic protein-2 (rhBMP-2). Employing rhBMP-2 in a collagen membrane eliminates the need for a donor site, thus reducing surgical morbidity. This paper aims to present a case involving complete orthodontic rehabilitation with a three-year follow-up of a male patient with a unilateral complete cleft lip and palate, posterior and anterior crossbite, where grafting was performed with rhBMP-2 at a single centre. Orthodontic intervention began at 8 years of age with rapid maxillary expansion, followed by facemask therapy. The alveolar bone grafting procedure was performed using rhBMP-2 in a collagen membrane, according to the surgical protocol developed by the Oslo team. Comprehensive orthodontic treatment started 15 months post bone grafting, during which the maxillary permanent lateral incisor distal to the alveolar cleft was successfully moved mesially into the grafted region. This intervention resulted in adequate occlusal and periodontal outcomes. The alveolar graft with rhBMP-2 produced adequate and stable alveolar bone formation, facilitating tooth eruption, orthodontic movement, and stability at the cleft site., (Copyright © 2024 CEO. All rights reserved.)

Although clear aligner can be efficient and predictable in some tooth movements, mandibular molar protraction is the least predictable owing to biological and biomechanical limitations. This case report presents a 20-year-old female with poor prognosed left mandibular first molar (#36), deviated dental midline and mild crowding. After extraction of #36, clear aligners and an Albert cantilever were used for treatment. Through carefully designed dual mechanical system, we achieved uprighting and protraction of #37 within 27 months, with crown and root movements of 9.9mm and 12.1mm, respectively. The predictability of the crown and root movement was 107.6% and 84.6%. Coincident dental and facial midline, class I molar and canine relationship and good root parallelism were also achieved. Large-distance mandibular molar protraction can be achieved effectively with a combination of Albert cantilever arm and clear aligner., (Copyright © 2024 CEO. Published by Elsevier Masson SAS. All rights reserved.)

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., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The clinical protocol and effectiveness of dental expansion with Clear Aligner Therapy (CAT), especially among adults is still unclear. There is a need to map and explore knowledge gaps of dental expansion with CAT among children and adults., Objective: This scoping review explores the extent and depth of the available literature regarding the effectiveness and predictability of CAT in performing orthodontic expansion in both children and adults., Methods: The following databases were consulted as sources of information: PubMed, MEDLINE, Embase, Web of Science, Scopus, LILACS, COCHRANE Library, and ProQuest Dissertations & Thesis, in which the search was limited to studies on children or adults requiring transverse arch expansion and using clear orthodontic aligners. Two independent reviewers assessed the citations and extracted data, which was then synthesized in a narrative format., Results: Over all, 698 citations were retrieved, and 33 were included. Among these, 3 were systematic reviews, 4 were cohort studies, 2 were case-control studies, and 24 were case series. Eighty-five percent of the included studies were published in the last 5 years. Despite different protocols and measurement methods, aligners were effective for arch expansion in adults and children, and the expansion predictability was greater for the lower arch than for the upper arch. The evidence suggests that arch width increment is more predictable in the premolar region and less predictable in the canine and second molar areas, with high variability across studies., Conclusions: Orthodontic aligners have demonstrated effectiveness in expanding arches in both adults and children. However, the literature suggests a decrease in arch width toward the posterior region, and there is no evidence of skeletal gains. To provide more conclusive evidence, randomized controlled clinical studies are warranted., Registration: This review was registered in the Open Science Framework database (DOI: https://doi.org/10.17605/OSF.IO/6EG8F)., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: To study and compare the effects of clear aligners without brackets and traditional fixed aligners in orthodontic treatment., Methods: The samples were collected from January 2022 to April 2023. The control group (n = 26) received orthodontic treatment using traditional fixed appliances. The research group (n = 20) received orthodontic treatment using the clear aligners without brackets. Compare the therapeutic effects and related evaluation indicators between two groups., Results: The total effective ratio was compared between the 2 groups, and the study group was greater(P < 0.05). After treatment, the detected values of the periodontal condition indicators (plaque index, debris index, and gingival bleeding index), serum inflammatory factors (CRP, IL-6 and TNF-α) of the two groups, were less than before, also were all less than the control group. (P < 0.05). After therapy, in comparison of the control group, the value of mastication efficiency, comfort and psychological evaluation, sleep indicators and the points of the four dimensions of life quality in the study group was greater, and the detection results were obviously greater than before(P < 0.05)., Conclusion: In the orthodontic therapy of sufferers with malocclusion, compared with the traditional fixed appliance, the clear aligners without brackets can enhance the treatment effects, improve the periodontal condition and masticatory function, and reduce the inflammatory responses, so that patients can feel more comfortable, thereby improving their psychology, sleep and quality of life. In the future, with the continual advancement of technology and people's pursuit of beauty, the application of clear aligners without brackets in orthodontic treatment will become more and more extensive. The continuous introduction of new materials and new technologies will further improve the effects and comfort of the clear aligners without brackets, reduce treatment time and discomfort, and also reduce patients' resistance to aligners, bringing patients a better treatment experience., (© 2024. The Author(s).)

Introduction: The arrival date young patient's first orthodontic consultation is unrestricted but may influence the choice of treatment plan as well as its modalities. The objective of this study was to determine the factors that influence the date of the first consultation at the orthodontic office: advice from a third party or a health professional, the patient's gender, the socioeconomic level, the actual need for orthodontic treatment, and the vertical and anteroposterior skeletal dysmorphia., Materials and Methods: Young patient's file younger than 16 years were systematically included. A Wilcoxon and Kruskal-Wallis test was performed in univariate and multivariate analysis. The threshold was 5%., Results: 456 young patients were included. Anteroposterior skeletal discrepancy, referral by an acquaintance, and socioeconomic level appeared to be factors influencing patient arrival date. Gender, actual need for orthodontic treatment, referral from a health professional, and vertical skeletal discrepancy did not influence the arrival date at the office., Discussion: The date of consultation is not related to the actual orthodontic treatment need. Word-of-mouth seems to play an important role. Patients seem to relate an anteroposterior discrepancy to the need to consult an orthodontist, but do not relate it to vertical discrepancy, although ventilation may be related to severe dysmorphia., Conclusion: This study encourages more communication about orthodontic treatment indications with patients and caregivers.

Background: The aim of this study was to compare oral health-related quality of life (OHRQoL) among adolescents granted (G) versus not granted (NG) publicly funded orthodontic treatment., Materials and Methods: Adolescents aged 15-20 years who were granted versus not granted publicly funded orthodontic treatment responded to a web-based survey, assessing OHRQoL in relation to functional impact, psychological impact, and motivators for orthodontic treatment. Before the survey, pretesting of the questionnaire was conducted to ensure its reliability. Differences between the groups were tested using the chi-squared and Mann-Whitney U-tests. Reliability was assessed using Cohen's κ and Pearson's correlation coefficient during the pretest phase., Results: One hundred and forty patients, equally distributed between a G and an NG group, responded to the survey. Gender, age, and demographic distribution were comparable in both groups. All respondents expressed a high subjective treatment need and similar answers regarding functional aspects. Orthodontic treatment motivators (G: 86.2% and NG: 94.7%, p = 0.443) were primarily related to improved self-esteem, overall well-being, facial appearance, and being able to laugh without embarrassment. The NG group expressed a more negative OHRQoL impact due to the appearance of their teeth compared with the G group (p < 0.001) and a negative impact caused by the position of their teeth (p < 0.001)., Conclusions: Orthodontic treatment need indices should aim to reinforce subjective measures as adolescents express similar motivators for orthodontic treatment, regardless of the clinician's objectively based decision about treatment need., (© 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: While retention appliances are widely used in orthodontics, there is still no evidence-based consensus regarding the optimal type of appliance or time of retention., Objectives: To compare chairside rectangular chain retainers, which can be placed in one sitting, with conventional multi-stranded bonded retainers regarding their levels of stability, biological side effects, complications, and patient experiences., Trial Design: A single-centre, two-arm, parallel-group randomized controlled trial., Methods: In total, 48 patients were included in this single-centre, randomized controlled trial conducted in Varberg, Region Halland, Sweden. The patients were randomized to two groups: the chairside rectangular chain retainer group, using the Ortho FlexTech retainer (OFT); and the conventional retainer group, using the 0.0195 Penta One multi-stranded spiral wire (PeO). The primary outcome was Little´s irregularity index (LII) evaluated at debond (T0) and at 3 months (T3) and 12 months (T12). The secondary outcomes were inter-canine distance (ICD), plaque index (PI), calculus index (CI), bleeding on probing (BoP), and caries, evaluated at T0, T3, and T12, as well as patients' perceptions, evaluated at T3 and T12, and technical complications that were registered throughout the study period. The Mann-Whitney U-test was used for continuous variables for inter-group comparisons, and the Wilcoxon Signed Rank test was used for intra-group comparisons., Results: There were no statistically significant differences between the groups regarding LII, biological side effects, technical complications, or patients' experiences. However, there was a small but statistically significant difference between the groups regarding the maintenance of the ICD. Within the OFT group, there was a significant increase in CI, and within the PeO group, there was a significant increase in BoP., Conclusions: In terms of clinical relevance, the chairside rectangular chain retainer and the conventional multi-stranded spiral wire provide similar outcomes with respect to the stability of alignment, biological side-effects, technical complications, and patients' experiences short-term., Trial Registration: VGFOUreg-929962. Keywords: Orthodontic retainers; fixed retainers; retention; stability., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objective: Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement., Methods: This randomized, parallel-group, single-blind clinical trial included 60 female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group 1 took ibuprofen (400 mg), whereas those in group 2 received LLLT (808 nm, 200 mW, 2 J/cm 2 ) on both buccal and lingual sides of the teeth. In group 3 (LAT), the laser (808 nm, 200 mW, 24 J/cm 2 ) was applied bilaterally to acupuncture points (SI 18, ST 6, LI 4, SJ 2, and SJ 5). Subjects in group 4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using a visual analogue scale (VAS)., Results: The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to a negligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05)., Conclusions: With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients., Trial Registration: IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objectives: Evaluate long-term spontaneous occlusal changes following L7 extraction in adolescent patients., Materials and Methods: Study models of 144 participants (63 males, 81 females) retrospectively assessed prior to L7 extraction (9-16 years old; T1) and following L8 eruption (14-25 years old; T2). All received upper fixed appliances. A sub-group (n = 86) received no lower fixed appliances and acted as controls. Occlusal changes were compared between treatment (lower fixed appliance) and control (no lower fixed appliance) groups using PAR index. At T2, L8 occlusal outcome was assessed using ABO grading system., Results: Mean follow-up period 6 (SD 2) years. At T1, lower scores observed in control group for Lower Anterior (P < .001), Midline (P = .033) and Lateral Segments (P = .040) components. At T2, lower scores continued being observed in control group for Midline (P < .001) and Lateral segment (P = .019) components. Higher decrease in Lower Anterior PAR scores observed in treatment group (<.001) with comparable scores between groups at T2 (P = .057). Similar PAR score changes between groups for Lateral Segments, Overjet and Overbite components. At T2, no significant difference observed in Total PAR score reduction between control (83%) and treatment (82%) groups. Good-to-acceptable occlusal outcome of the L8 observed in 81.55% of cases at T2 with no difference between groups., Conclusion: In growing patients with mild mandibular crowding, extraction of L7 followed by upper fixed appliance therapy, leads to favourable occlusal changes over a 6-year follow-up period, with or without lower fixed appliance therapy, being an alternative extraction protocol where lower fixed appliance therapy is not recommended., (© 2024 The Authors. Orthodontics & Craniofacial Research published by John Wiley & Sons Ltd.)

Introduction: This 3-arm parallel, double-blind study aimed to evaluate the alignment efficiency of 3 different diameters of superelastic nickel-titanium (NiTi) archwires during the initial phase of orthodontic treatment., Methods: Ninety-three patients with nonextraction treatment in the mandibular arch (using 0.022-in Roth prescription brackets) were randomly allocated into 3 groups: 0.012-in NiTi (group 1), 0.014-in NiTi (group 2), and 0.016-in NiTi (group 3). The alignment change was measured using the modified Little's irregularity index before archwire placement and every 4 weeks. The alignment efficiency of the 3 groups was analyzed., Results: Ninety patients were analyzed (group 1: n = 29, group 2: n = 31, and group 3: n = 30; overall mean age, 16.6 years). The overall Wald test analysis revealed that wire type was not statistically significant (P = 0.91), whereas time exhibited significance as expected (P <0.001). Furthermore, the interaction between wire type and time was not significant (P = 0.93). The time-adjusted estimated difference between 0.014-in and 0.012-in was -0.49 (95% confidence interval, -2.83 to 1.85; P = 0.68). The time-adjusted estimated difference between 0.016-in and 0.012-in was -0.45 (95% confidence interval, -2.95 to 2.05; P = 0.72). No harm was observed., Conclusions: The clinical performance of 3 different sizes of NiTi archwires was similar. In addition, 0.014-in and 0.016-in NiTi archwires demonstrated better performances in aligning any irregularities because of a greater number of wire deformations in the 0.012-in group., Registration: IR.TBZMED.REC.1395.1039., Protocol: The protocol was not published before trial commencement., Funding: None., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: To compare the anterior crowding correction after sequential use of the first 5 aligners between two aligner exchange protocols (7 and 14 days) in mature adult patients., Materials and Methods: Thirty-six patients over 35 years who received orthodontic treatment with Invisalign® were randomly allocated to two different aligner replacement sequence protocols: Group 1: exchange every 7 days (n = 18); and Group 2: exchange every 14 days (n = 18). All patients were scanned with iTero Element 5D® (Align Technology) in two treatment times: at pre-treatment (T1) and after using the first five aligners (T2). Little's Irregularity Index (LII) and arch widths were evaluated with OrthoCAD software. Intra and intergroup comparisons were performed with the dependent and independent t-tests. The results were considered significant for P < .05., Results: Thirty-five patients completed the study. Both groups' maxillary and mandibular Irregularity Indexesi were significantly lower at T2. There was no significant difference in inter-canine, inter-premolar, and intermolar distances. G2 (14 days) presented a greater decrease in mandibular irregularity than G1 (7 days)., Conclusion: Both exchange protocols (7 and 14 days) effectively correct anterior crowding in the initial phase of orthodontic treatment with aligners in mature adult patients. However, the 14-day exchange protocol provided a greater correction in mandibular anterior crowding in the evaluated period than the 7-day exchange protocol., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)