Objectives:To assess the effects of lithium on orthodontically induced root resorption (OIRR) and orthodontic tooth movement (OTM) and elucidate the underlying mechanisms in an osteoporotic rat model. Materials and Methods:Thirty 10-week-old female Wistar rats were randomly assigned to ovariectomized (OVX) or sham-operated (Sham) groups. Four weeks post-surgery, each group was further divided to receive either lithium (Li: 0.64 mM/kg) or saline via daily intraperitoneal injection. Orthodontic force was applied for 14 days using a closed-coil spring to move the maxillary first molar mesially. OTM was analyzed using micro-computed tomography on day 14. Histological analysis evaluated OIRR, apoptotic cells, osteoclasts, and odontoclasts. Immunohistochemical staining was used to assess the expression of receptor-activated nuclear factor-kappa B ligand and osteoprotegerin. Results:OIRR was significantly higher in the OVX group than Sham groups. Lithium markedly suppressed OIRR in OVX rats to levels comparable to the Sham + Li group. Lithium significantly reduced the number of apoptotic cells on day 3, decreased the number of odontoclasts, and increased osteoprotegerin expression by day 14. It also prevented excessive tooth tipping without affecting the overall distance of tooth movement, promoting a shift from tipping to bodily movement in the OVX group. Conclusions:In an osteoporotic rat model, lithium effectively suppressed OIRR and promoted bodily tooth movement without reducing OTM distance, suggesting the therapeutic potential of lithium in patients with osteoporosis.
Objectives:To evaluate and compare the effects of leukocyte-platelet-rich fibrin (L-PRF), injectable platelet-rich fibrin (i-PRF; submucosal), and i-PRF (intraligamental) on the rate of maxillary canine retraction. Materials and Methods:A randomized controlled trial was conducted on 33 participants requiring bilateral maxillary first premolar extraction. Participants were divided into three groups: L-PRF in extraction sockets, submucosal i-PRF injections, and intraligamental i-PRF injections. Each group followed a split-mouth design with the contralateral side serving as control. Canine retraction was done using NiTi closed-coil springs delivering 150 g force. Tooth movement was assessed monthly for 5 months using digital model measurements. Results:L-PRF (Group I) achieved significantly greater canine retraction than its control in the first 2 months (4.65 mm vs 3.77 mm). Submucosal i-PRF (Group II) also outperformed its control (4.57 mm vs 3.80 mm) but with declining effect. Intraligamental i-PRF (Group III) failed to show any significant advantage over its control (4.14 mm vs 3.74 mm). Anchorage loss and root resorption were comparable between intervention and control sites in all groups. Conclusions:L-PRF and submucosal i-PRF significantly accelerated canine retraction in the early phase, with greater total movement at 5 months. Intraligamental i-PRF showed no significant effect. All PRF methods were safe, with no increase in anchorage loss or root resorption.
Objectives:To assess the midterm impact of the presurgical nasoalveolar molding (PNAM) technique on nasal symmetry in children with complete unilateral cleft lip and palate (CUCLP), from a submental perspective, following surgical repair. Materials and Methods:Submental-view photographs from 39 children were analyzed: PNAM (n = 13), no PNAM (N-PNAM; n = 13), and age- and sex-matched controls (n = 13). CUCLP participants were 7-9 years old, had ≥ 6-year follow-up after primary repair, and were assessed prior to secondary alveolar bone grafting. Left-to-right ratios for nostril dome height, columella length, columella width, and alar width were compared using one-way analysis of variance with Bonferroni post hoc tests. Results:Columella width was greater in PNAM (1.16 ± 0.24) than N-PNAM (0.93 ± 0.18; P = .02; mean difference 0.23; 95% confidence interval = 0.07, 0.39). No between-groups differences were found for nostril dome height, columella length, or alar width (P > .05). Conclusions:After 6 years of follow-up, PNAM was associated with greater columella-width symmetry in children with CUCLP, while other nasal parameters were comparable among groups.
Objectives:To determine force distribution on the maxillary dentition under a vibrational force (VF) with two frequencies on the left canine (L-CA) using a finite element model (FEM) to quantify effects on targeted and neighboring teeth and to understand effects of different orthodontic appliances on distribution of VF. Materials and Methods:Three-dimensional FEMs of a human maxilla were created. Models included teeth, periodontal ligament, alveolar bone, brackets, archwire, and mouthpiece. Brackets with nine different types of archwires were tested. A VF (0.3 N) with two frequencies was applied to the L-CA. Force distributions on teeth corresponding to the archwires were calculated. FEM was validated experimentally. Results:Peak load (PL) distribution on teeth was bell shaped with maximum force on the L-CA. The L-CA received the most external force (50-82%); the left lateral incisor (L-LI) and first premolar (L-1PM) received between 7% and 18% each, and the left central incisor (L-CI) and second premolar (L-2PM) received only 1-6% each. Increasing wire stiffness caused decrease of force on the L-CA and increase on neighboring teeth. Rectangular wire was stiffer than round wire. The 0.022 × 0.028-in archwire decreased force on the L-CA to 50% and increased force on the L-LI and L-1PM to 15% each. Both magnitudes and distributions of PL corresponding to the two frequencies were similar. Conclusions:External force is primarily withstood by the L-CA and has significantly reduced impact on neighboring teeth. Archwire stiffness reduction increases the proportion of the force on the L-CA, which is desired to ensure the stimulation effect is localized.
Objectives:To evaluate the impact of cone-beam computed tomography (CBCT) integration on clear aligner therapy (CAT) digital treatment planning for maxillary incisors in patients with Class II division 2 malocclusion. Materials and Methods:Digital treatment plans were developed for patients using Spark Approver software (Ormco, Orange, CA, USA), with and without CBCT integration. Planned lingual root torque (LRT) and lingual root movement (LRM) were recorded from the tooth movement table for maxillary incisors that satisfied selection criteria. Predicted lingual dehiscence (PLD) and clinical parameters including number of aligners, prescribed interproximal reduction (IPR), and number of intermediate and challenging tooth movements were recorded. Inferential statistics were used to compare treatment plans developed with and without CBCT. Results:56 maxillary incisors from 18 patients were assessed. With CBCT integration, planned LRT and LRM were significantly reduced by 51.5% and 42.4%, respectively. PLD per tooth significantly decreased from 3.7 mm (SD: 3.5) without CBCT, to 0.8 mm (SD: 1.3) with CBCT. Although no significant differences were observed in the number of aligners, prescribed IPR, or planned intermediate tooth movements, significantly fewer challenging movements were planned when CBCT was utilized. Conclusions:CBCT integration into CAT digital treatment planning significantly alters planned root movements, minimizes PLD, and limits challenging tooth movements. Clinicians must carefully review digital treatment plans to identify and modify planned movements that may exceed anatomical limits to ensure alveolar boundaries are respected.
Objective:To compare changes in oral health-related quality of life (OHRQoL) and subjective food intake ability (key food intake ability [KFIA]) among different Class II camouflage strategies and to assess posterior occlusal contact types in Class II molar finishing. Materials and Methods:Records from 62 patients with Class II malocclusion were categorized into nonextraction, maxillary premolar extraction (ME), and maxillomandibular premolar extraction (MME). The Oral Health Impact Profile-14 (OHIP-14) and KFIA were administered before and after treatment. The American Board of Orthodontics Discrepancy Index and Objective Grading System (OGS) were also evaluated. The primary outcomes were group × time interactions in OHIP-14 and KFIA; the secondary outcome was posterior disclusion in ME cases. Results:Baseline characteristics were similar, except for greater initial overjet and overbite in ME (P < .05). KFIA remained stable after treatment in all groups (P ≥ .05). OHIP-14 improved significantly in total score and psychological discomfort for all patients, with additional improvement in the handicap domain in the MME group; however, no significant group × time interactions were found. Baseline OHIP-14 was the only predictor of posttreatment OHRQoL (P < .001). OGS outcomes were comparable; however, digital analysis showed second-molar posterior disclusion in 10% of ME cases. Conclusions:Class II camouflage treatment improved psychosocial aspects of OHRQoL regardless of extraction pattern; in contrast, subjective masticatory function remained unchanged. Baseline OHRQoL, rather than extraction type or case complexity, predicted final OHRQoL. Posterior occlusal assessment beyond OGS criteria may be useful in ME cases.
Objectives:To characterize the sagittal translation-tipping balance associated with reported maxillary molar distalization outcomes during clear aligner therapy (CAT) using a prespecified model-based descriptor. Materials and Methods:A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420261306794). PubMed, Scopus, and WOS were searched from inception to February 2026. Studies reporting maxillary molar distalization by CAT and providing crown displacement (Dcrown) and angulation change (θ) were included. A prespecified sagittal rigid-body approximation was applied. Tipping-related displacement was estimated as Dtip = Leff·tan(|θ|), where Leff was set as crown-to-center of resistance lever arm. Bodily displacement was defined as Dbod = Dcrown-Dtip. The primary outcome was the BF (Dbod/Dcrown). Descriptive analyses were performed separately for maxillary first (U6) and second (U7) molars. Results:Twelve studies were included. Median Dcrown was 1.78 mm for U6 and 1.72 mm for U7. Median BF was 0.70 for U6 and 0.78 for U7. Using prespecified BF thresholds, translation-dominant movement was observed in 56.3% of U6 arms and 60.0% of U7 arms. Mixed behavior was observed in 37.5% of U6 arms and 26.7% of U7 arms, whereas tipping-dominant behavior occurred in 6.3% of U6 arms and 13.3% of U7 arms. Internal validation against root displacement showed that 66.7% of predictions were within 0.50 mm and 88.9% within 0.75 mm of observed apical movement. Conclusions:Maxillary molar distalization by CAT is more often translation-dominant than tipping-dominant; however, mixed movement patterns are common and tipping-dominant behavior can occur, particularly in U7.
Objectives:To reevaluate transpalatal arch (TPA) biomechanics for molar rotation by transitioning from the traditional linear beam model to a statically indeterminate elastic portal frame analysis. Materials and Methods:A mathematical model based on Castigliano's second theorem simulated the TPA as a curved portal frame. Different modes of rotational activation were applied to standard and omega-loop designs across variable palatal heights (10 mm to 18 mm) using stainless steel and beta-titanium, incorporating a 2° mechanical clearance to simulate clinical insertion conditions. Results:Palatal height was the primary determinant of TPA stiffness, acting as a lever arm that converts sagittal forces into torsion. In unilateral activation, average to high palatal vaults (palatal height ≥ 14 mm) generated spontaneous neutrality through the interaction between structural compliance and mechanical clearance, where the moment on the nonactivated side dissipates entirely. Regarding stiffness, contrary to clinical assumptions, the omega loop provided modest additional flexibility (less than 5% for unilateral activation, up to 15% for symmetric activation). Conclusions:The TPA functions as a flexible elastic frame, not a rigid linear beam. Vertical legs significantly dampen the force system, rendering the omega loop mechanically redundant. Notably, compensatory bends, generally used for unilateral rotation activation, are often biomechanically unnecessary in high-vaulted patients, as the system naturally reduces the contralateral moment to zero within the mechanical tolerance of the attachment.
Objectives:To assess whether craniofacial morphology and vertical growth patterns are associated with a preference for hard or soft alimentary boluses in a sample of orthodontic patients. Materials and Methods:This cross-sectional study included 121 orthodontic patients (69 females, 52 males; mean age = 12.3 ± 3.3 years). Before-treatment, lateral skull x-rays were collected and lateral cephalometric analysis performed, considering variables SpP^GoGn, SN^GoGn, SpP^CoOr, and AN^B. Before undergoing chewing pattern analysis, each patient was asked to chew a standardized soft bolus (chewing gum) and subsequently a standardized hard bolus (wine gum) in a flavor of their choice. Subsequently, each patient was asked to express a preference for one of the two boluses, and the answer was recorded. To assess the association between bolus hardness preference and cephalometric variables, multiple linear regression analyses were performed, controlling for sex and age. Results:Soft bolus was preferred by 64% of subjects (n = 77) and hard bolus by 36% (n = 44). Increased SpP^GoGn angle was significantly associated with soft-bolus preference (P <.05) as well as being female but was independent of age. SN^GoGn increased with age (P <.05) but did not correlate with bolus preference or sex. No significant associations were observed for SpP^CoOr and AN^B. Conclusions:Soft bolus preference was significantly associated with increased intermaxillary divergence but not with cranial divergence, mandibular rotation, or sagittal skeletal relationship. These findings suggest that patients with intermaxillary hyperdivergent patterns may self-select softer boluses, due to a compensatory functional-structural feedback loop.
Objectives:To evaluate effectiveness of different debonding methods for aligner attachments regarding pain level, attachment removal time, and remnant adhesive amount. Material and Methods:Thirty-two patients (13 female and 19 male; mean age: 26.0 ± 7.9 years) who underwent aligner attachment debonding were included. Attachments were debonded using two different techniques with a split-mouth design. For each patient, two diagonal quadrants were debonded with an adhesive removal plier (Plier group, n = 296), and contralateral quadrants with a 24-blade carbide bur (Bur group, n = 294). In the Plier group, a carbide bur was also used to remove remaining adhesive after debonding with pliers. Pain levels were recorded using a numeric rating scale (NRS) for anterior and posterior segments. In the Plier group, adhesive remnants were scored using adhesive remnant index. Average removal time per attachment was measured. Data were analyzed with Wilcoxon signed-rank, Mann-Whitney U, and Pearson's χ2 tests (P < .05). Results:Removal time per attachment was slightly longer with the Bur group; however, this difference was not statistically significant. In lower posterior segments, NRS scores were significantly higher with the Bur technique (median 2.0) compared to the Plier technique (median 1.0, P = .028). After plier debonding, ARI (adhesive remnant index) score "1" was more frequent in optimized (60.8%) than conventional (43.5%) attachments (P = .004). Conclusions:Both debonding techniques yielded clinically similar results. The Bur technique resulted in significantly higher pain only in lower posterior segments. Adhesive removal pliers were effective for optimized and conventional attachments, usually leaving less than half of the adhesive.
Objectives:To assess the effect of autologous platelet lysate (APL) on rate of orthodontic canine retraction and to measure levels of soluble receptor activator of nuclear factor κ-B ligand (sRANKL) and osteoprotegerin (OPG) in the gingival crevicular fluid (GCF) over a period of 2 months. Materials and Methods:This split-mouth trial included 13 patients, with 28 sites randomly allocated to either the experimental or control side. After leveling and aligning, 0.6 mL of APL was injected buccally, distally, and palatally on the experimental side at T0 (baseline, day 1) and T31 (day 31). Canine retraction was performed using NiTi closed-coil springs (150 g). Digital models at T0 (baseline day 1), T30 (day 30), and T60 (day 60) were used to measure canine retraction rate. OPG and sRANKL levels from GCF samples were measured at days 0, 1, 7, 21, 30, 31, 37, 51, and 60 via enzyme-linked immunosorbent assay. Results:No statistically significant difference was found in the rate of canine retraction at any time interval. OPG levels showed a statistically significant difference at T0 and T21; however, no significant differences were observed across any other time intervals. sRANKL remained stable throughout all intervals, except for a small late decrease at T60 on the control side. Conclusions:APL did not significantly enhance the rate of canine retraction, and OPG and sRANKL levels showed no consistent changes.
Objectives:To evaluate the effect of plaque-disclosing tablet (PDT) instructions on periodontal parameters in patients with bonded lingual retainers (LR). Materials and Methods:Forty-two patients with bonded mandibular lingual retainers were randomly allocated to two groups. The traditional oral hygiene instruction (TOHI) group (n = 21; 17 females, four males) received conventional verbal and visual oral hygiene education. The plaque-disclosing tablet instruction (PDTI) group (n = 21; 18 females, three males) received the same instructions as the TOHI group plus specific education on the use of PDT. An additional control group without lingual retainers (n = 21; 14 females, seven males) received identical instructions as the TOHI group. Plaque index (PI), gingival index (GI), calculus index (CI), and bleeding on probing (BOP) were recorded on the mandibular anterior teeth immediately after retainer placement (T0), at 3 months (T1), and at 6 months (T2). Statistical analyses were performed using the Shapiro-Wilk test, one-way analysis of variance (ANOVA), least significant difference test, Tamhane T2 test, chi-square test, and repeated-measures ANOVA. Results:At T1, TOHI and PDTI groups exhibited significantly higher periodontal scores compared with the control group (eg, PI: TOHI 0.86 ± 0.65, PDTI 0.62 ± 0.65, control 0.27 ± 0.17; P < .05). At T2, periodontal parameters in the PDTI group were significantly lower than in the TOHI group whereas no significant differences were found between the PDTI and control groups (P > .05). Conclusions:The use of plaque-disclosing tablets in patients with bonded lingual retainers may improve periodontal health.
Objectives:To evaluate and compare the efficiency of Hanks Herbst (HH) and twin block (TB) functional appliances in the treatment of adolescents with Class II malocclusion. Methods:A two-arm parallel randomized controlled trial, stratified by sex, was conducted in a single United Kingdom hospital. Eighty adolescents (10-14 years) with overjet ≥ 7 mm were randomized 1:1 to HH or TB. Participants received either a fixed HH or removable TB appliance, followed by comprehensive fixed appliance therapy. Skeletal and dental outcomes were assessed as well as patient-reported outcomes. The primary outcome was time to reduce overjet to < 4 mm; secondary outcomes included skeletal or dental changes, peer assessment rating scores, treatment duration and failure, and oral health-related quality of life. Results:At the completion of the functional phase (T1), HH demonstrated significantly greater overjet reduction (1.3 mm; P < .001), improved molar relationships, and increased mandibular length (2 mm; P = .03). By the completion of full treatment (T2), most skeletal and dental differences were no longer significant, except for a small residual overjet favoring TB (0.6 mm). Peer assessment rating scores improved substantially in both groups, with no significant differences at T2 (HH = 4.6 ± 4.2; TB = 4.1 ± 3.4; P = .60). Patient-reported outcomes at T2 were largely similar, although TB participants reported higher embarrassment at T1 (46% vs 18%). Treatment failures were higher in the TB group (37.5% vs 17.5%). Conclusions:The HH appliance provides efficient short-term overjet correction. However, following comprehensive fixed appliance therapy, skeletal, occlusal, and patient-reported outcomes are comparable between HH and TB. Both clinical effectiveness and patient experience should guide functional appliance selection.
Objectives:To evaluate the biomechanical effects of counterclockwise overcorrection design on extraction space closure with clear aligners (CAs) using finite element analysis (FEA). Materials and Methods:A maxillary first premolar extraction model with attachments and CAs was constructed from cone beam computed tomography and intraoral scan data. Counterclockwise anterior overcorrection was simulated as a two-factor design: (1) overcorrection, ranging from 0° to 5°, applied at a fixed position, and (2) overcorrection applied at five different positions with a constant magnitude of 3°. Tooth displacements were analyzed to assess sagittal, vertical, and transverse biomechanical responses. Results:Without overcorrection, space closure exhibited characteristic excessive tipping toward the extraction site, including anterior torque loss, posterior mesial tipping, and unfavorable vertical displacements. Overcorrection of 1°-4° substantially mitigated these effects, improving torque control and vertical stability, whereas ≥ 5° compromised space closure efficiency. The position of the overcorrection axis significantly influenced the movement patterns of canines and second premolars. With 3° of overcorrection positioned anteriorly, canines exhibited extrusive movement whereas second premolars showed intrusive movement. Conversely, when overcorrection was positioned posteriorly, canines underwent intrusive movement and second premolars exhibited extrusive movement, with further reduced sagittal tipping angles. Conclusions:Overcorrection in clear aligner therapy functions biomechanically like V-bends in conventional archwires, counteracting excessive tipping toward the extraction site during extraction space closure. The biomechanical outcome is sensitive to the degree and position of overcorrection, highlighting the need for individualized overcorrection strategies.
Objectives:To assess the reliability of the diagnostic method using Diagnocat artificial intelligence (AI)-generated standard tessellation language (STL) files and Geomagic Wrap software and to evaluate whether cone-beam computed tomography (CBCT) quality influences the consistency of AI-based segmentation and related measurements. Materials and Methods:Forty orthodontic patients (20 from Spain and 20 from Sweden) were analyzed at two treatment time points (T0: beginning; T1: before using stainless-steel wires). STL files for each upper incisor were analyzed in Geomagic Wrap considering volume loss and tooth length. Reproducibility was assessed through repeated tooth reconstruction in an AI model, and the impact of the mesh correction tool and CBCT type was evaluated. Results:Intraobserver and interobserver reliability was high (intraclass correlation coefficient = 0.93). AI reconstructions were highly consistent. No significant differences were found between STL generations, except in one case. Mesh correction significantly affected volume measurements in the teeth from higher-dose CBCT scans. No significant differences were found between CBCT types in either root volume (P = .861) or length loss (P = .082). Analysis of variance showed no significant differences between CBCT types. Conclusions:The method is reproducible and reliable for linear and volumetric external apical root resorption (EARR) measurements using AI-generated STL models. CBCT image quality does not appear to influence volume measurements. Mild EARR was observed between T0 and T1, with no significant differences.
Objectives:To compare the incidence of bond failures and white spot lesions (WSLs) between brackets bonded with either light-cured resin-modified glass ionomer cement (GC Fuji Ortho LC) or light-cured composite resin (3M Transbond Plus Color Change Adhesive) after 18 months of treatment. Materials and Methods:90 patients were allocated to the trial, and 84, with a mean age of 16.7 ± 2.6 years, were analyzed. The cross-mouth method was employed in each patient, in which two diagonal quadrants (e.g., upper right and lower left, or vice versa) were randomly assigned to the FujiOrtho group, and the opposite diagonal quadrants to the Transbond group. All patients were monitored for an average of 18 months for bond failure and WSL incidence. Multilevel mixed Poisson regression with robust standard errors was used to compare the groups. Results:Overall, failure rates were 12.9% in the FujiOrtho group and 2.1% in the Transbond group, with an adjusted relative risk (aRR) of 6.21 (95% CI: 3.89-9.94), adjusted for age, sex, maxilla/mandible, tooth position, and treating orthodontist. Overall, WSL incidence was 8.3% in the FujiOrtho group and 8.8% in the Transbond group, with an aRR of 0.95 (95% CI: 0.80-1.13). Conclusions:Transbond Plus demonstrated a significantly lower bond failure rate compared to GC FujiOrtho LC, with a 3.6 times reduced risk of bracket failure. There were neither statistically nor clinically significant differences in the incidence of WSLs between the two groups.
Objectives:To evaluate the effect of different antimicrobial solutions on the mechanical properties of aligners (Invisalign, Align Technology Inc., San Jose, CA, USA). Material and Methods:Invisalign aligners were used, originating from an orthodontic treatment sequence to correct malocclusion in the upper arch. Specimens were obtained from the buccal surfaces extending from the upper right canine to the second molar and used for mechanical testing (n = 60). The test specimens were divided into seven groups: 0.5% sodium hypochlorite (HYP); sodium bicarbonate (BIC); neutral detergent (DET); 0.12% chlorhexidine digluconate (CX); white vinegar (VIN); Corega tabs (COR) and distilled water (DW) (control). Results:After 7 days, significant intergroup differences in Young's modulus were observed, with HYP differing from DW and DET (P < .05). After 14 days, a significant difference was observed between CX and COR (P < .05). Significant changes related to immersion time were detected for DET, CX, and COR between 7 and 14 days (P < .05). No statistically significant differences were found in the maximum deformation values for any solution (P > .05). Conclusions:Stiffness of the materials was influenced by immersion in different solutions, with specific intergroup differences observed after 7 and 14 days. Significant changes over time were detected for DET, CX, and COR. However, immersion in the evaluated solutions did not significantly affect maximum deformation of the material.
Objectives:To evaluate the accuracy of an artificial intelligence (AI) model developed by DentalMonitoring for assessing occlusal parameters from patient-acquired intraoral images, using intraoral scanner (IOS)-derived three-dimensional (3D)measurements as the reference standard. Materials and Methods:This multicenter prospective study included 430 orthodontic patients from three clinics in the United States. Each participant completed a DentalMonitoring scan using the DM ScanBox and a clinician-acquired IOS scan. Midline deviation, overbite, overjet, and canine class were measured on IOS-generated 3D models using metrology-grade software (ZEISS Inspect). Three independent, blinded technicians performed measurements, with the median value used as the reference. Agreement between AI-generated and reference measurements was assessed using Passing-Bablok regression and relative bias analyses at predefined clinical thresholds. Results:All occlusal parameters demonstrated agreement within clinically acceptable limits. Midline deviation and overbite showed the highest concordance, with intercepts near 0.00 mm, relative biases below 3%, and mean biases of -0.01 ± 0.26 mm and -0.04 ± 0.39 mm, respectively. Overjet was modestly overestimated (mean bias = +0.29 ± 0.52 mm), while canine class showed increasing underestimation at higher values (mean bias = -0.31 ± 0.91 mm). Conclusions:The evaluated AI model demonstrated high agreement with IOS-based 3D measurements for midline deviation and overbite, with greater variability for overjet and canine classification. These results support the use of AI-assisted monitoring for screening and follow-up, while highlighting the need for further validation prior to routine clinical implementation.
Objectives:To evaluate the relationship between skeletal classification and the anterior and posterior components of cranial base flexure and glenoid fossa position. Materials and Methods:Pretreatment cone-beam computed tomography records of 420 patients were stratified by sex, age, and skeletal classification based on standards for maxillomandibular differential for age-specific patients. Cephalometric measurements (Basion, Nasion, superior aspect of glenoid fossa) were recorded, and their angular deviation, horizontal, and vertical distance from Sella were measured using a 7° constructed plane (H-P) from S-N as a reference. Results were analyzed using regression analysis and analysis of variance, along with intraclass correlation coefficient for reliability. Results:Cranial base flexure was found to be significantly smaller in Class III individuals than Class I or II, due to a larger deflection in posterior cranial base angle from the horizontal plane. The position of Basion relative to Sella was also noted to have a significantly shorter horizontal and significantly longer vertical length in these same individuals. The position of the glenoid fossa showed that Class II patients tended to have a more posterior horizontal displacement from Sella when than those in Class I or III. All measurements, except for cranial base flexure, were significantly larger in males than females. Statistical significance was measured at P < .05. Conclusions:Cranial base angle is significantly smaller in Class III individuals, due to an anteriorly positioned posterior cranial base. The posterior position of the glenoid fossa appears to contribute to the anteroposterior position of the condyle in Class II patients.
Objectives:To evaluate the biological response of mandibular central incisors to anterior bite turbos (ABTs) during fixed orthodontic treatment, focusing on pulpal blood flow (PBF), tooth mobility, and pain perception. Materials and Methods:Fifty-five patients undergoing fixed appliance therapy were assigned to two groups: an experimental group (n = 29) and a control group (n = 26). All received 0.014-inch nickel-titanium arch wires. ABTs were bonded to the palatal surfaces of the maxillary central incisors in the experimental group. Lower incisor PBF was measured using laser Doppler flowmetry at baseline, 20 minutes, 1 week, and 1 month after bonding. Tooth mobility was recorded after 1 month using the Miller Index. Pain was assessed using a 10-cm Visual Analogue Scale over 7 days. Results:PBF declined after 1 week in both groups and recovered after 1 month, with no significant differences between groups (P > .05). Tooth mobility was significantly greater in the bite turbo group (P < .001), with 74.1% of patients showing Grade 2 mobility compared with 25% in the control group. Pain peaked within 24 hours and declined significantly by day 7 (P < .001) in both groups, with no significant between-groups differences. Conclusions:ABTs do not adversely affect pulpal circulation or pain perception. The increase in tooth mobility in the bite turbo group is a normal adaptive response and remains within safe clinical limits. Using ABTs to correct deep overbite is biologically safe.
