The use of in-house clear aligner production has been adopted in some orthodontic practices as a means of improving efficiency, adaptability, and clinical oversight. Manufacturing appliances within the practice enables modifications to be made more readily in response to treatment progress, and reduces reliance on external providers. When combined with remote patient monitoring (RPM), aligners may be manufactured in batches at defined treatment checkpoints rather than as a complete sequence in advance. This approach facilitates closer matching between appliance design and patient progress, may reduce the number of refinements required, and can help to limit unnecessary use of materials. CPD/Clinical Relevance : The integration of remote patient monitoring with in-house batch manufacturing optimizes clear aligner therapy and creates an adaptive workflow.
This case report details the orthodontic and orthognathic management of a 15-year-old female patient presenting with Class II division 1 malocclusion, mandibular retrognathia, congenital absence of the lower right second premolar (LR5), and impacted third lower molars. Treatment involved upper and lower fixed appliances, space redistribution, and molar uprighting to facilitate the eruption of impacted lower third molars. Following pre-surgical orthodontics, a bilateral sagittal split osteotomy was performed to advance the mandible and achieve skeletal and occlusal correction. The multidisciplinary approach successfully corrected the skeletal discrepancy, improved facial harmony and established a functional occlusion, highlighting the value of closely integrated orthodontic-surgical treatment in managing complex malocclusions. CPD/Clinical Relevance: A multidisciplinary approach is crucial for the effective management of Class II division 1 malocclusion with mandibular retrognathia, hypodontia, and impacted lower third molars, ensuring optimal skeletal correction, occlusal function, and aesthetic balance.
This is the first of two articles exploring the rich history of maxillary expansion to the modern developments of slow maxillary expansion used today in orthodontics. This article provides important references and highlights what limited evidence there is when comparing expansion techniques. CPD/Clinical Relevance: It is important for clinicians to appreciate different expansion methods and appliances, as well as the history behind them.
Substance use among adolescents is an increasing public health concern with clear implications for orthodontic treatment and oral health. Consequences may include poor oral hygiene, reduced compliance, and compromised treatment outcomes. As clinicians who routinely treat adolescents, orthodontists are ideally positioned to recognize early risk behaviours. This article explores the impact of substance use on orthodontic care, reviews available screening tools, and discusses their practical implementation and current challenges. Incorporating validated screening into orthodontic assessments can strengthen safeguarding, facilitate timely intervention, and support comprehensive, patient-centred care. CPD/Clinical Relevance: Integrating substance use screening tools into orthodontic practice enables clinicians to identify and respond to risk behaviours in adolescents, reinforcing safeguarding duties, contributing to fairer outcomes and enhanced overall wellbeing.
