Objectives Miniscrew-assisted rapid palatal expansion (MARPE) has been proposed as an alternative for correcting maxillary transverse deficiency, allowing predominantly skeletal expansion. However, evidence on its clinical and patient-reported outcomes remains heterogeneous and poorly systematized. This scoping review aimed to map and synthesize the available evidence on the clinical and patient-reported outcomes associated with MARPE. Methods This scoping review followed the PRISMA-ScR guidelines, with the protocol registered in the Open Science Framework. Searches were conducted up to October 2025 in Medline (via PubMed), Web of Science, EMBASE, the Cochrane Library, and grey literature. Studies evaluating MARPE for maxillary transverse deficiency and reporting clinical and/or patient-reported outcomes were included. Data were extracted and synthesized descriptively in narrative and tabular formats. Results A total of 149 studies, predominantly observational, were included, with publications increasing from 2015 onwards. The most frequently assessed clinical outcomes were skeletal and dental, particularly midpalatal suture expansion, basal bone width, intermolar distance, and dental tipping. Among patient-reported outcomes, pain and discomfort were most commonly evaluated. Overall, objective clinical outcomes predominated over patient-centred outcomes. Conclusion Clinical outcomes predominated, whereas patient-reported outcomes remained underrepresented. Considerable methodological heterogeneity in outcome definitions, measurements, and reporting limited comparisons across studies and the strength of the available evidence. Greater standardization of outcome reporting and further robust research are needed to support evidence-based clinical recommendations.
Introduction Orthodontic research has grown for more than a century, but its evidence base has not been examined across its full history. We evaluated its evolution in publication growth, citation impact, journal distribution, geographic contribution, and international collaboration. Methods We froze an OpenAlex topic-indexed corpus (“Orthodontics and Dentofacial Orthopedics”) on December 31, 2025, and, after removing pre-1900 metadata artefacts, analysed 46,265 records from 1900 to 2025; in a two-rater manual check of a random sample, 92.4% of records were genuinely orthodontic (precision; recall not assessed). We assessed growth, structural transitions, citation inequality, field-weighted citation impact (FWCI), publishing concentration, country-level output, language, and collaboration. Results Output accelerated after a structural changepoint in 1996: the absolute slope of annual output (records added per year) increased more than 25-fold while the proportional growth rate remained broadly stable; 86.5% of the corpus dates from 1996 onward. Citation impact was skewed (median 2 citations, 35.7% uncited, Gini coefficient 0.794). Annual mean FWCI exceeded 1.0 from 2022 onward, although over short citation windows. Among venue-resolved records, the annual Herfindahl-Hirschman Index fell from 920 in 1990 to 97 in 2024, and 95% of the 2024 output was spread across 460 venues (1455 across all years). Among the 62.5% of records with resolved affiliations, the United States led cumulative output under whole counting (5265 papers), followed by Brazil (3360) and India (2757); India led annual output in 2021–2024. Internationally co-authored papers were associated with higher citation impact than single-country papers in every period (median FWCI 0.90 versus 0.47). Conclusion Orthodontic research is now predominantly post-1990s, globally redistributed, dispersed across a large journal ecosystem, and highly asymmetric in citation impact. These results provide a quantitative baseline; they are consistent with, but do not by themselves establish, implications for literature retrieval, journal selection, and collaborative research strategy.
Introduction Aesthetic outcomes are a primary concern for adult orthodontic patients. Clinicians often rely on soft tissue simulation software, such as Dolphin Imaging (D-Tech) and WebCeph (D-Tech), to manage patient expectations. This study aimed to compare the accuracy of these two tools in predicting soft tissue profile changes in non-growing skeletal Class II patients treated with maxillary first premolar extractions. Methods A retrospective comparative study was conducted on patients treated by the same practitioner with bilateral maxillary first premolar extractions and maximum anchorage. From a private-practice database of 2535 patients treated between January 2015 and January 2025, 34 met the inclusion criteria after eligibility screening. Pre- and post-treatment lateral cephalometric radiographs and profile photographs were used to generate simulations. Predicted cephalometric measurements from D-Tech and W-Tech were compared with each other and with the actual post-treatment results. Statistical analyses included paired t-tests, one-sample t-tests, Bland-Altman plots, and linear regression. Results Thirty-four patients (10 males, 24 females; 35.7±3.5 years) were analysed. Both tools showed a significant discrepancy in the nasolabial angle versus actual results (P<0.001). D-Tech differed significantly in the subnasale to Holdaway-line distance (mean difference 0.81mm [95% CI 0.03 to 1.60]; P=0.042), while W-Tech differed in upper and lower lip position relative to the True Vertical Line (LL–TVL P=0.004; UL–TVL P=0.006). For the remaining parameters, both tools showed good agreement; D-Tech showed a proportional bias for lip–TVL position (greater underestimation at larger values), whereas W-Tech overestimated lower lip thickness. Conclusion Both Dolphin Imaging and WebCeph provide clinically applicable predictions for most soft tissue parameters. Several statistically significant lip-position discrepancies were within the range generally considered clinically imperceptible (=1.5-2.0mm), whereas the nasolabial angle showed a discrepancy that is both statistically and clinically relevant. Predictions should therefore be interpreted with caution, particularly for parameters prone to systematic bias.
