Introduction and aims The efficacy of acrylic splint expander (Splint) and Invisalign First aligners (First) in increasing transverse width in mixed dentition have been well documented, but little is known about their sagittal and vertical effects. Since sagittal and vertical changes are particularly critical in growing patients, the objective of this study was to assess and compare the sagittal and vertical treatment effects of First and Splint in mixed dentition with transverse maxillary deficiency. Methods Sixty subjects were included after propensity score matching (PSM) from initial 163 cohort: the Splint group (n = 20), the First group (n = 20), and the Natural Growth (Natural) group (n = 20). Lateral cephalograms were acquired before the initiation of treatment (T0) and at a minimum of one year after treatment (T1). Sixteen cephalometric variables were assessed to detect differences within and between groups from T0 to T1. Intra-group analyses were conducted using paired t-tests, while inter-group comparisons were performed using analysis of variance (ANOVA). Statistical significance was set at P < .05. Results In all groups, a significant increase (P < .05) were observed in ANS-Me, N-Me, and S-Go during the T1-T0 period. In the Splint group, ANB and NA-PogA significantly decreased (P < .05), whereas SNB significantly increased (P < .05). In the First group, both overjet and overbite significantly decreased (P < .05), with a greater reduction observed compared to the other two groups (P < .05). No significant differences were found in the remaining variables, either within or between the groups. Conclusions Splint therapy improved skeletal relationships, resulting in reduced facial convexity. First therapy produced a pronounced reduction in overjet and overbite primarily through dentoalveolar effects.

Miniscrew-assisted rapid palatal expansion has gained increasing use in skeletally mature patients with maxillary transverse deficiency. This study aimed to evaluate three-dimensional skeletal changes after miniscrew-assisted rapid palatal expansion in adults with maxillary transverse deficiency and mandibular deviation, with particular emphasis on bilateral maxillary changes, mandibular adaptation, and the associated changes in mandibular deviation. Twenty-one adults (mean age, 21.7 years; 7 males, 14 females) with maxillary transverse deficiency and mandibular deviation who underwent miniscrew-assisted rapid palatal expansion were retrospectively included. Cone-beam computed tomography images obtained before and after expansion were retrospectively collected for analysis. Three-dimensional measurements were performed using Mimics 21.0 software, bilateral maxillary transverse, vertical, and sagittal variables, mandibular linear measurements, and mandibular rotational variables were analyzed. Paired comparisons were performed between sides and time points. Correlation analyses were used to explore associations between skeletal changes and improvement in mandibular deviation. Before treatment, the upper dental width was greater on the deviated side than on the non-deviated side (P < 0.05, q < 0.05). The deviated side also showed smaller vertical distances at the alveolar bone, first molar cusp, and coronoid (P < 0.05, q < 0.05). The mandible was rotated toward the deviated side in both roll and yaw. After treatment, both basal bone width and upper dental width increased on both sides (P < 0.05, q < 0.05). Selected vertical maxillary variables increased, particularly on the deviated side, whereas mandibular roll and yaw were significantly reduced (P < 0.05, q < 0.05). Mandibular deviation decreased by 1.59 ± 0.84 mm (P < 0.05, q < 0.05). Correlation analysis showed that the reduction in mandibular deviation was associated with changes in mandibular roll and yaw (P < 0.05). In adults with maxillary transverse deficiency and mandibular deviation, miniscrew-assisted rapid palatal expansion resulted in transverse maxillary expansion, showed trends toward reduced interside vertical discrepancies in selected variables, and decreased mandibular deviation. Improvement in mandibular deviation was associated with adaptive mandibular rotational changes.

OBJECTIVE:Rotational movements, particularly in premolars, remain among the most challenging tooth movements to achieve with clear aligners. This study aims to evaluate the clinical effectiveness of single versus double attachments in the correction of premolar rotation using clear aligner therapy. METHODS:A total of 100 patients with premolar rotation who underwent clear aligner therapy between 2022 and 2025 were screened. Only those who met the predefined inclusion and exclusion criteria were included in the final analysis. Digital impressions at baseline (T0) and completion of the rotational movement (T1) were analyzed using 3D software to evaluate premolar rotational movement. Intergroup comparisons were performed using the Mann-Whitney U test, while intragroup comparisons between expected and achieved outcomes used the Wilcoxon signed-rank test. RESULTS:Of the 29 eligible patients, 47 rotated premolars were analyzed. Significant differences between predicted and achieved premolar rotation were observed in both groups (P<0.001). The single-attachment group showed a predicted 14.31°±5.81° versus an achieved 5.41°±4.88°, while the double-attachment group had predicted 18.02°±7.41° versus an achieved 11.00°±6.88°. Notably, the double attachment group achieved greater rotational correction, P<0.01, and higher treatment efficiency, median 60.61%, P<0.01. CONCLUSIONS:Clear aligners demonstrate limited predictability for correcting premolar rotation. Double attachments significantly improve rotational outcomes and treatment efficiency compared with single attachments. These findings support the clinical use of double attachments for challenging premolar rotations. ETHICAL APPROVAL:This study was approved by the Ethics Committee of Xiangya Stomatological Hospital, Central South University (Approval No. LYEC2025-K0027).

OBJECTIVE:This study evaluated the skeletal impact of miniscrew-assisted rapid palatal expansion (MARPE) in sagittal and vertical planes. We aimed to clarify how this treatment affects the jaw structure of late adolescent and adult patients. METHODS:We searched electronic databases for relevant literature. Study selection, quality appraisal, and data retrieval were completed by two authors independently. Quantitative data synthesis and heterogeneity assessments were executed using a random-effects model within the Review Manager 5.4 software environment. RESULTS:Eleven studies were included, seven of which provided data for the meta-analysis. Regarding sagittal outcomes, MARPE led to significant increments in SNA (mean: 0.79°; 95% CI: 0.08-1.5; P = .03) and ANB (mean: 1.18°; 95% CI: 0.49-1.87; P = .0008). In contrast, the vertical dimensions remained relatively stable, with SN-MP (1.28°; P = .10) and MP-FH (1.09°; P = .44) failing to reach statistical significance. No substantial deviations were identified across any other parameters evaluated in this study. CONCLUSIONS:The meta-analysis demonstrated that while MARPE treatment produces statistically significant sagittal skeletal changes, the magnitude of these changes is relatively small, suggesting a clinically modest impact on maxillary retrusion and mandibular protrusion. However, the limited availability of data hinders a conclusive determination of its impact on vertical dimensions. Resolving this issue requires high-quality prospective longitudinal trials with larger cohorts.

Modern industrialization and urbanization have led to environmental challenges, including noise pollution and water contamination, which threaten ecosystems and human health. Current materials designed to address these issues are limited in performance and functionality. In this study, vessel-like channeled cellulose aerogels (VCAs) with hierarchical and anisotropic pore structures were proposed. These aerogels exhibited an ultralow density of 1.5 mg cm-3 (VCAs-0.1) with negative Poisson's ratio behavior and superelasticity at liquid nitrogen temperature. Additionally, VCAs-0.4 demonstrated efficient sound-absorbing performance with a noise reduction coefficient of 0.47 under low areal density (11.17 mg cm-2). VCAs-0.2 exhibited a chloroform absorption capacity of 384 g g-1 and a thermal conductivity of 24.3 mW m-1 K-1. The aerogels further exhibited preliminary in vitro cytocompatibility and degradation under the tested soil burial conditions. These results demonstrate the potential of VCAs as multifunctional porous materials for acoustic control and environmental remediation.

Oral diseases, encompassing conditions such as periodontitis, head and neck squamous cell carcinoma, pulpitis, and mucosal infections, remain a major global health burden due to their high prevalence and complex, multifactorial pathophysiology. The unique anatomical structure of the oral cavity, together with persistent microbial challenges and dynamic immune responses, imposes substantial limitations on conventional drug delivery strategies. Biomimetic cell membrane-based materials have recently emerged as a promising class of delivery platforms, leveraging natural biological interfaces to confer inherent biocompatibility, immune evasion, prolonged circulation, specific targeting, and biofilm-interactive capabilities. These features position them as a transformative approach for improving therapeutic precision and efficacy in oral disease management. In this review, we provide a systematic and materials-oriented overview of biomimetic cell membrane-based drug delivery systems. Specifically, we discuss: (1) the biological sources, classification, and physicochemical properties of membrane-coated systems, along with their fabrication and engineering strategies; (2) the mechanistic basis of targeting, immune modulation, and nanobiointerface interactions, and their applications across representative oral diseases; and (3) current challenges, including scalable manufacturing, functional controllability, biosafety, and clinical translation. Furthermore, we highlight emerging directions such as stimuli-responsive membrane systems and multifunctional integrated platforms, aiming to provide a conceptual framework for the rational design and clinical advancement of biomimetic drug delivery systems in complex disease settings.

BackgroundAlveolar bone dehiscence/fenestration is common during orthodontic excessive tooth movement, especially in patients with thin gingiva and alveolar bone, compromising treatment outcomes. Free gingival grafting (FGG) shows preventive potential, but its mechanism remains unclear due to limited animal models.MethodsForty 6-week-old male Sprague-Dawley (SD) rats were randomized into 3 groups: FGG + force (FGG + orthodontic force), Sham + force (incision/suture without graft + force) and Blank (no surgical procedure + no force). Right incisors served as internal controls. Orthodontic force (80 ± 1 g) was applied 1 week post-FGG. Rats were euthanized at 4, 8, and 12 weeks post-force application. Micro-CT quantified alveolar bone parameters; histological staining (H&E) and immunohistochemistry (OPN, RUNX2) evaluated bone remodeling.ResultsMicro-CT analysis of the overall data (all time points combined) revealed that in the FGG + force group, the left experimental side had significantly greater alveolar bone height, thickness, bone volume, and bone mineral density compared with the contralateral control side (p < 0.05). No significant left-right differences were observed in the Sham + force or Blank groups. Histologically, newly formed epithelial pegs confirmed successful graft integration. Immunohistochemistry showed upregulation of osteogenesis-related proteins RUNX2 and OPN in the FGG + force group, consistent with improved bone morphological parameters.ConclusionIn this study, we established an excessive orthodontic tooth movement model of maxillary anterior teeth in Sprague-Dawley rats to simulate the changes of alveolar bone resorption and bone defects that frequently occur during orthodontic treatment in patients with thin gingiva and thin alveolar bone. Using micro-CT and histopathological examination, we found that performing FGG prior to orthodontic intervention alleviated orthodontic force-induced alveolar bone resorption during excessive tooth movement. This study provides a referable rat model for exploring the regulatory effect of keratinized gingival grafting on alveolar bone remodeling, and lays a preliminary experimental foundation for the prophylactic application of FGG in orthodontic patients with a thin gingiva-thin bone phenotype.

The development of personalized, semipermeable, and biodegradable polymer/metal composite membranes for guided bone regeneration surgery presents a promising solution to address large and complex alveolar bone defects without the need for a secondary surgical removal. However, fabricating such membranes with a customized curved surface shape and semipermeablity remains challenging. In this study, we propose a novel methodology that integrates electrophoretic assembly (electrophoretic deposition) and laser powder bed fusion additive manufacturing processes to create personalized, semipermeable, and biodegradable polymer/metal composite membranes suitable for guided bone regeneration applications. Specifically, we first designed a personalized porous Zn substrate using an adaptively unit-cell arrayed filling method, which achieved a complex and manufacturable curved surface shape while ensuring integrity of unit cells and uniform stress distribution. Subsequently, the Zn substrate was fabricated by laser powder bed fusion, and was utilized as both the bracing structure and the template for conformal electro-growth of chitosan/gelatin cryogel to obtain the desired polymer/metal composite membrane. This composite membrane allowed efficient nutrient transfer while inhibiting 100 % fibroblasts infiltration. As compared to Zn substate, coverage of conformal chitosan/gelatin cryogel enhanced mechanical properties and reduced the biodegradation rate of the membrane. Furthermore, the composite membrane exhibited remarkable osteogenesis and anti- infection capacity in vitro. These findings highlight the promising potential of our integrated additive manufacturing approach in fabricating personalized polymer/metal composite materials for biomedical applications.

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.

Aim or purpose: To evaluate the effects of miniscrew-assisted rapid palatal expansion (MARPE) on facial symmetry changes in adults with maxillary transverse deficiency (MTD) and mandibular deviation (MD). Materials and methods: This retrospective study approved by the Institutional Review Board (IRB-2023-045), analyzed 21 adults (9 males and 12 females, aging from 18-37 years old) with MTD and MD (Me to midsagittal plane(MSP) distance >4 mm) treated with MARPE. Patients’ Pre- and post-MARPE CBCT scans (T0/T1) were compared. Eighteen linear and angular parameters were analyzed and evaluated using paired t-tests (measurements between two sides of MSP; measurements of the same side between T0 and T1). Pearson’s correlation, multiple linear regression and path analysis assessed variable relationships. Results: Pre-MARPE, maxillary transverse and vertical asymmetry coexisted with significant mandibular roll and yaw rotations toward the deviated side (p<0.05). Post-MARPE, vertical distance changes were more pronounced on the deviated side (p<0.05), while mandibular roll and yaw rotated toward the non-deviated side with reduced angles (p<0.05), accompanied by a 1.59±0.84 mm decrease in the Me-to-MSP distance (p<0.001). Path analysis revealed that asymmetric vertical maxillary changes indirectly correlated with mandibular deviation (MD) improvement (p<0.05). Conclusions: MARPE might improve facial symmetry in patients with MTD and MD by asymmetrical expansion effect and inducing compensatory mandibular rotation toward the non-deviated side. MARPE may offer the potential to improve facial asymmetry.

Objectives Maxillary transverse deficiency(MTD) is one of the etiological factors of mandibular deviation(MD). Early correction of maxillary transverse deficiency can improve mandibular deviation to a certain extent. Circummaxillary sutures are closely related to maxillary development; however, there is no research on the relationship between the circummaxillary sutures and mandibular deviation in adults. This study aimed to investigate the changes of circummaxillary sutures in patients with MD and MTD after micro-implant assisted rapid palatal expansion (MARPE) and to analyze their correlation with mandibular deviation. Method Fifty-six cone-beam computed tomography scans for 28 patients (mean age 17.92 ± 3.86 years) were evaluated before (T0) and after (T1) MARPE. All patients were diagnosed with mandibular deviation and maxillary transverse deficiency prior to receiving MARPE therapy. The mandibular deviation was diagnosed by the distance between the menton point and the median sagittal plane was greater than 2 mm, then measured the distance at T0 and T1. The width changes of eight circummaxillary sutures (frontonasal, frontomaxillary, frontozygomatic, nasomaxillary, zygomaticomaxillary, zygomaticotemporal, pterygomaxillary, and midpalata sutures) were measured on slices which can ensure the maximum bone sutures width of T0 in each patient. Then track the same level at T1 images measure the width of the sutures and compare it with T0. Comparison of data is based on (1) deviated side: side of the chin. (2) non-deviated side: opposite side of the chin bias. In addition, the correlation coefficient between the changes of menton point to the median sagittal plane and the variation in the circummaxillary sutures was calculated. Results 1. The distance from the menton point to the median sagittal plane decreased in all cases (ΔT1-T0 = -1.40 ± 0.62), and the difference was statistically significant ( P < 0.05).

Statement of problem Soft tissue integration helps prevent the bacterial invasion of dental implants, but bibliometric studies on the top 50 most cited articles in the field of soft tissue integration are lacking. Purpose The purpose of this bibliometric study was to analyze the 50 most cited articles since 1999 to explore global trends and research hotspots. Material and methods A specific search strategy of the Science Citation Index Expanded (Web of Science) was devised, and relevant article-based, journal-based, and author-based parameters were analyzed. Correlation analysis was performed (α=.05). Results The number of citations ranged from 71 to 586. Clinical Oral Implants Research was the most cited journal (1722 citations). Berglundh, Tord was the author with the most publications (6 publications) and citations (957 citations). Dental implants and titanium were the keywords with the highest frequency. Switzerland was the country with the highest number of publications (12 publications). Correlation was found between the publication year and average annual citations (P<.001). Conclusions This study determined the scientific progress in soft tissue integration. The surface design of dental implant materials is essential for the soft tissue integration of dental implants. Soft tissue integration has been a focus of interest in the past few years, but many experiments still need to be done to improve soft tissue compatibility with innovative materials.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.

Introduction and aims Finite element analysis (FEA) is an incrementally practical and precise tool for the prediction of stress effects on different tissue structures and has therefore interested dental researchers for decades. This bibliometric and visualized study was aimed to assess the research progress related to FEA in the dental sciences in terms of research trends and frontiers. Methods The articles about FEA studies in this field during 1999 to 2024 were obtained from Web of Science Core Collection. Then, these results were analysed and plotted using Microsoft Excel, VOSviewer, and CiteSpace in order to find out the historical evolution, current hotspots, and future directions. Results Total 2838 literature records related to the topic were retrieved from Web of Science Core Collection. The most active country and institution were USA (538 documents) and Universidade Estadual Paulista (140 documents), respectively. Baggi et al from University of Naples Federico II was the author with the most highly cited article (352 citations), which was published on the Journal of Prosthetic Dentistry in 2008. Dental Materials ranked first (231 documents) among the 10 journals with the greatest numbers of relevant publications. The top three trending keywords were ‘dental implant’, ‘stress distribution’, and ‘fracture’. The endocrown, clear aligner, and posterior edentulism were scientific frontiers in this field. Conclusion The present study provides a comprehensive bibliometric analysis of research in the dental science by FEA approaches, which will identify active hotspots of scientific interest to guide further research endeavours.

Aim or purpose: To assess and compare the sagittal and vertical treatment effects of Invisalign First and acrylic splint expanders in mixed dentition patients with transverse maxillary deficiency. Materials and methods: Sixty subjects were included after propensity score matching (PSM), and were equally divided into three groups: the acrylic splint expander (Splint) group (n=20), the Invisalign First (First) group (n=20), and the Natural Growth (Natural) group (n=20). Lateral cephalograms were acquired before the initiation of treatment (T0) and at a minimum of one year after treatment (T1). Sixteen cephalometric variables were assessed to detect differences within and between groups from T0 to T1. Intra-group analyses were conducted using paired t-tests, while inter-group comparisons were performed using analysis of variance (ANOVA). Statistical significance was set at p < 0.05. Results: In all groups, a significant increase (p < 0.05) were observed in ANS-Me, N-Me, and S-Go during the T1-T0 period. In the Splint group, ANB and NA-PogA significantly decreased (p < 0.05), whereas SNB significantly increased (p < 0.05). In the First group, both overjet and overbite significantly decreased (p < 0.05), with a greater reduction observed compared to the other two groups (p < 0.05). Conclusions: 1. Both First and Splint therapy were effective in controlling clockwise rotation of mandible to some extent compared to the Natural group. 2. First therapy resulted in a greater reduction of overjet and overbite. 3. Splint therapy led to a reduction in profile convexity.

OBJECTIVES:Maxillary transverse deficiency is a common malocclusion frequently observed in orthodontic clinics. Miniscrew-assisted rapid palatal expansion (MARPE) not only produces greater skeletal expansion but also offers advantages such as simple miniscrew implantation without flap elevation, enhanced patient comfort, and an expanded age range and indications for palatal expansion. However, the fixed connection between the expander and the miniscrews makes the expander difficult to remove, significantly hindering its clinical application. This study aims to employ a non-common path of insertion connection device-comprising 3D-printed miniscrew caps and silk fibroin (SF) electrospun membranes-to optimize the clinical operation of non-co-located MARPE in orthodontic expansion. METHODS:The removable connection device for non-common path of insertion MARPE consists of 3D-printed miniscrew caps and SF electrospun membranes. First, the miniscrew cap was measured using reverse engineering software (Geomagic Wrap) to generate optimal fit data, and designed with the 3D creation program Cinema4D to form an internal cylinder and an external protective ring, with the design saved as a STL file. The data were then imported into Voxelddance Tango software to design a virtual base scaffold, and the cap was fabricated using a 3D printer. Subsequently, SF and polyethylene oxide (PEO) were electrospun at various mass ratios to form SF electrospun membranes. The morphology was observed using scanning electron microscope (SEM), and Fourier-transform infrared (FTIR) spectroscopy was used to analyze the secondary structural conformation of both the miniscrew cap and the SF electrospun membranes. Tensile and compression tests were conducted to evaluate their mechanical properties, and the sealing performance of the removable connection device (with and without the SF electrospun membrane) was compared. In addition, cell compatibility was assessed by co-culturing the miniscrew caps and SF electrospun membranes with mouse embryonic fibroblasts (NIH 3T3), using a live/dead cell staining kit and the cell counting kit-8 (CCK-8). Finally, a 13-year-old male patient at palatal suture stage D was selected. Pre-implantation cone beam computed tomography (CBCT) measured the palatal soft and hard tissue thickness at the planned insertion site, and 2 miniscrews were implanted at the optimal bone density site between the second premolar and the first molar. An intraoral scan model was used to integrate teeth 13 and 23 into a tooth-bone hybrid-supported expander, which was customized. The miniscrew caps were trial-fitted, and the expander was adjusted until it fitted perfectly without interference. The expander was then bonded, with the SF electrospun membrane wrapped around and covering the miniscrews, and the miniscrew cap applied. Light-cured resin was used to connect the expander and the miniscrew caps. The patient was instructed to perform expansion once daily for a total of 28 sessions, with close monitoring of the expansion process to obtain pre- and post-expansion data and assess expansion efficacy. RESULTS:The friction force and load pressure of the miniscrew caps were (54.7±9.57) N and (148.61±15.29) N, respectively. Among SF electrospun membranes prepared with 10%, 20%, and 30% PEO, the 20% PEO membrane exhibited the most uniform fiber diameter and the most continuous, stable electrospinning process. Degradation experiments revealed no significant weight changes for all SF electrospun membranes at days 1, 3, and 7. FTIR analysis showed that all membranes exhibited similar characteristic bands; thus, the 20% PEO SF electrospun membrane was selected for further study. Under wet conditions, the maximum tensile stress of the 20% PEO membrane was (2.46±0.26) N. In in vitro simulations, both macroscopic observations and SEM showed excellent sealing between the miniscrew caps and the electrospun membranes. NIH 3T3 cells co-cultured with the SF membrane and miniscrew caps, when stained with a live/dead assay, exhibited typical fibroblast morphology and high viability. CCK-8 results showed that by day 3, cell viability in the SF membrane group reached 111.46%, suggesting an increasing trend in cell activity. Finally, in a 13-year-old male patient at palatal suture stage D, after non-common path of insertion MARPE with the removable connection device, a 2.5 mm gap was observed between teeth 11 and 21. Six months later, CBCT re-examination showed significant widening of the palatal suture, confirming successful expansion. CONCLUSIONS:The removable connection device for non-common path of insertion MARPE demonstrates excellent mechanical properties and biocompatibility, effectively opening the palatal suture at stage D. With its simple operation and promising clinical application prospects, this device offers an optimized approach for orthodontic palatal expansion.

Background Autogenous soft tissue grafting is indicated in thin gingival biotypes before orthodontic proclination or labial movements to increase the keratinized gingiva and prevent gingival recession. However, its effect on local alveolar bone remodeling is unclear. The aim of this study was to investigate the effects of autogenous soft tissue grafting on local alveolar bone after orthodontic proclination or labial movements. Methods Sixteen patients with a thin scalloped gingival biotype, narrow keratinized gingiva, or thin cortical bone requiring orthodontic proclination or labial movement of teeth were included. Cone-beam computed tomography (CBCT) images were obtained before grafting and at least 6 months after surgery. Sixty mandibular teeth were included, and the vertical bone level and horizontal labial bone thickness were measured. The results were compared using paired t-tests or Wilcoxon signed-rank test. Results The horizontal labial bone thickness increased, especially at 6 mm below the cementoenamel junction (CEJ) in the mandibular central and lateral incisors ( P < 0.05). The total alveolar bone area of the canines, first premolars, and second premolars increased at 3, 6, and 9 mm below the CEJ, respectively, and the differences were statistically significant ( P < 0.05). Additionally, vertical bone height increased minimally on the labial side, but the differences were not statistically significant ( P > 0.05). Conclusions New bone regeneration was observed on the labial (pressure) side after autogenous soft tissue grafting, which may represent a mechanism to effectively prevent gingival recession and maintain periodontal health. IRB approval All the experimental procedures involving humans in this study were approved by the Medical Ethics Committee of Xiangya Stomatological Hospital, Central South University ( No. 20190048).

To evaluate the correlation between obstructive sleep apnea (OSA) and temporomandibular joint (TMJ) morphology, tooth wear condition, orofacial pain through a follow-up program. Seventy one OSA patients were divided into three groups according to their (apnea hypopnea index) AHI: mild group (n = 23), moderate group (n = 24), and severe group (n = 24). All patients had OSA therapies around six months after confirm the diagnosis of OSA. The tooth wear score and orofacial pain condition of all patients were recorded via clinical examination. Cone beam computed tomography (CBCT) images were also taken when confirm the diagnosis of OSA (T0), 6 months after the diagnosis (T1), and 6 months after the OSA treatment (T2). Parameters indicating the condylar morphology and joint space were evaluated. The differences of clinical symptoms and TMJ conditions among T0, T1 and T2 time point were detected in the three groups respectively. The changes in T1-T0 and T2-T1 of all descriptions among three groups were also compared. The correlations between AHI and clinical symptoms were detected with Spearman correlation analysis. In mild group, there was no difference in all clinical symptoms and TMJ morphology among the three time points. Both in moderate and severe group, the condylar volume, superficial area, wear score, visual analogue scales (VAS), and R value (indicating condyle position) displayed significant differences among the three time points (P < 0.05). From T0 to T1, mild group displayed fewer decreases in the condylar volume and superficial area and fewer increases in wear score than that in moderate and severe group (P < 0.05). From T1 to T2, there was a greatest reduction in severe group for R value, and significant difference in the description of VAS and R value were found among the three groups. AHI was negatively correlated condylar volume and condylar superficial area, and was positively correlated with tooth wear score and VAS (P < 0.05). Moderate to severe OSA will aggravate orofacial pain and tooth wear, affect TMJ volume and superficial area, even change the location of condyles. Appropriate OSA therapies may be effective ways to alleviate these adverse effects in long-term.

We read this article published in April 2023 by Yi et al (Yi F, Liu OS, Lei L, Liu SL, Wang Y, Chu YH, et al. Factors related to microimplant-assisted rapid palatal expansion in teenagers and young adults: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2023;163:475-82) with great interest. 1 Tonello D.L. Ladewig V.M. Guedes F.P. Ferreira Conti A.C.C. Almeida-Pedrin R.R. Capelozza-Filho L. Midpalatal suture maturation in 11-to 15-year-olds: a cone-beam computed tomographic study. Am J Orthod Dentofacial Orthop. 2017; 152: 42-48 Abstract Full Text Full Text PDF PubMed Google Scholar , 2 Grünheid T. Larson C.E. Larson B.E. Midpalatal suture density ratio: a novel predictor of skeletal response to rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2017; 151: 267-276 Abstract Full Text Full Text PDF PubMed Google Scholar We appreciate and congratulate the authors for discussing the interesting aspects of microimplant-assisted rapid palatal expansion (MARPE) in this article. However, we seek help to clear some of our doubts regarding a few points. 1.What criteria and/or protocols were used to include subjects in MARPE treatment? 2.Given that pretreatment cone-beam computed tomography is available, is it advisable and/or necessary to go for MARPE in midpalatal suture maturation stage B? 3.Table III mentions the midpalatal suture density (MPSD) ratio as MPSD ratios 2, 3, and 4. However, it is mentioned as the MPSD ratio usually lies between 0 and 1 in the same article. Please clarify. Furthermore, how was it calculated and determined to be MPSD ratios 2, 3, and 4? Queries regarding the effects of a flash-free system on dental plaque accumulation and the bonding-debonding processAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 163Issue 4PreviewWe read the article by Yıldırım et al (Yıldırım ZB, Ramoğlu Sİ. Effects of a flash-free system on dental plaque accumulation and bonding-debonding process: a clinical study. Am J Orthod Dentofacial Orthop 2023;163:54-9). We congratulate the authors for publishing this interesting trial and would like to draw their attention to the following points. Full-Text PDF Authors’ responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 164Issue 4PreviewWe appreciate your accurate summary of this article. These comments are all valuable and helpful for revising and improving our paper and the important guiding significance of our research. Full-Text PDF

The present study aimed to evaluate the wear behavior of BaTiO3 (BT) modified 3Y-TZP ceramic composites compared to commercially available 3Y-TZP products and provided evidence relevant to its clinical use. A set of BT-modified 3Y-TZP (BT/3Y-TZP) ceramic composites was prepared. The mechanical properties and wear behavior of BT/3Y-TZP ceramic composites were investigated. The 3D digital microscopy, scanning electron microscopy (SEM), and scanning transmission electron microscopy (STEM) analyses of the worn surface helped to reveal the underlining mechanisms. In comparison with commercially available 3Y-TZP ceramics, the mechanical properties of the BT/3Y-TZP composite ceramics could meet the clinical requirements. More importantly, the 5 mol% BT/3Y-TZP showed the best wear properties against natural tooth enamel for the dry and saliva lubrication tests. The SEM and STEM analyses confirmed a stable transfer enamel layer formed on the surface of 5 mol% BT/3Y-TZP ceramic composite under dry as well as saliva environments. The in site formed tribofilm with self-lubricating function contributed to the reduced wear of the antagonist teeth. Therefore, the enamel-friendly 5 mol% BT/3Y-TZP may be a new material option for restorative dentistry. Moreover, the interface transfer theory could provide a new way of thinking to find more enamel-friendly dental restorative materials in the future.