Orthodontic aligner attachments are crucial for enhancing dental movements that aligners alone cannot achieve. With recent advancements in design and materials, treatment precision and efficacy are improving. This study aimed to compare conventional and bulk-fill flowable composites in fabricating orthodontic attachments to determine their loss rate and clinical outcomes. This split-mouth randomized clinical trial enrolled 50 participants (21 men and 29 women; mean age 37.86 ± 6.90 years), who were allocated to two treatment sequences (25 participants per group). In Group 1, the right side received 3 M Filtek Supreme Flowable and the left side received 3 M Filtek Bulk Fill Flowable; in Group 2, the allocation was reversed. This design allowed an intra-individual comparison between materials. After 140 days of follow-up, 150 of 800 attachments had been lost and rebonded, corresponding to an overall failure rate of 18.75

BACKGROUND:This retrospective study aimed to compare the treatment effects of extra-alveolar skeletal anchorage versus intermaxillary elastics in Class III patients. MATERIALS/METHODS:Thirty-eight patients were divided into three groups based on their treatment approach. Group Buccal Shelf (BS) consisted of 10 patients treated with a fixed orthodontic appliance and buccal shelf miniscrews (initial mean age: 21.44 years; mean treatment time: 2.81 years). Group Elastics Torque (ET) comprised 14 patients treated with fixed orthodontic appliance (lower incisors with buccal torque, and upper incisors with torque zero) and intermaxillary elastics (initial mean age: 18.97 years; mean treatment time: 3.12 years). Group Elastics (E): 14 patients treated with a fixed orthodontic appliance (lower incisors torque zero, and upper incisors with buccal torque) and intermaxillary elastics (mean initial age: 19.18 years; mean treatment time: 3.15 years). Cephalograms were taken before and after orthodontic treatment. Dental, skeletal, and soft tissue changes were compared using ANOVA and Tukey tests. RESULTS:Maxillary molars exhibited significantly greater mesial angulation in Group ET compared with Groups BS and E (P = 0.02). Mandibular incisors were significantly more upright (P = 0.03) and retruded (P = 0.00) in Group BS. Group ET showed significantly greater extrusion of the mandibular incisors (P = 0.00). CONCLUSIONS:The use of buccal shelf miniscrews resulted in more upright and retruded mandibular incisors compared with treatment with Class III elastics. Intermaxillary elastics with buccal torque lower incisors and torque zero upper incisors brackets approach showed greater maxillary molar angulation and mandibular incisor extrusion.

This cross-sectional study aimed to assess children's aesthetic and social perceptions of anterior open bite (AOB). The sample comprised 272 evaluators, divided into three age groups: 4-6, 7-9, and 10-12 years old. Artificial intelligence was used to generate the children's facial images, and Adobe Photoshop was used to modify their smiles, obtaining paired images of AOB and normal overbite. Participants completed a questionnaire that included images of children in their age range. An illustrated 5-point Likert scale was used to assess aesthetic rating. Social and aesthetic perceptions were evaluated using objective questions. Independent t-tests and chi-square were applied for data analysis. The aesthetic rating differed significantly, with smiles showing normal overbite judged as statistically significantly more attractive across all age groups. Among the objective responses, only the questions related to aesthetic perception differed between the occlusion statuses depicted. The social judgments were similar between them. An anterior open bite showed a negative impact on the aesthetic perception of children aged 4 to 12 years. The findings suggest that during counseling about the importance of discontinuing deleterious habits, professionals may present smiling photographs of children with and without AOB to reinforce the aesthetic benefits of stopping those habits.

INTRODUÇÃO: A terapia com alinhadores é uma abordagem ortodôntica amplamente utilizada. No entanto, realizar certos movimentos, como rotação e extrusão, continua sendo desafiador. Essa dificuldade é particularmente evidenciada em dentes com formas mais arredondadas, como caninos e pré-molares, e em casos de extrusão de incisivos. Isso muitas vezes resulta em precisão reduzida do tratamento. OBJETIVO: Este estudo teve como objetivo apresentar casos clínicos em que a mecânica auxiliar foi empregada para melhorar os movimentos de rotação e extrusão, abordando cenários de...

Objective Maxillary transverse deficiency is a common orthodontic challenge, often addressed with expansion techniquesThis study compared the buccal bone thickness, tooth inclinations and transverse dimensions of the maxillary arch after treatment with Damon self-ligating appliances and TMA auxiliary expansion arch (AEA). Methods The sample consisted of 30 patients with mild maxillary atresia, divided into two groups: Group 1 (Self-ligating) consisted of 15 patients with mean age of 19.55 years (SD= 1.31) assessed initially and at the end of alignment and leveling with self-ligating appliances. Group 2 (AEA) comprised 15 individuals with mean age of 29.23 years (SD= 9.13) treated with a TMA auxiliary expansion arch. Buccal bone thickness, tooth inclinations and transverse distances of the maxillary arch before and after treatment for each patient were assessed and compared between the groups using cone beam computed tomography. Intergroup comparisons were performed with independent t tests. Results The self-ligating group showed a significantly greater increase in the distance between the maxillary first premolars compared to the AEA group during treatment. Conclusion The self-ligating appliance showed greater expansion in the premolar region compared to the TMA auxiliary expansion arch.

INTRODUCTION:This research aimed to evaluate changes in dental arch shape during orthodontic treatment and long-term follow-up (T3) in patients treated with 4 premolar extractions because of mild to severe initial dental crowding using the geometric morphometric analysis. METHODS:The sample consisted of 32 patients treated with 4 premolar extractions divided into 2 groups according to the Little's irregularity index (LII) at pretreatment (T1; mild or severe crowding). Group mild crowding: 15 subjects with an initial LII of ≤6 mm, and mean T1, posttreatment (T2), and T3 ages of 13.52, 16.05, and 55.15 years, respectively. The mean treatment and T3 times were 2.53 and 39.09 years, respectively. Group severe crowding: 17 subjects with an initial LII of >6 mm with mean T1, T2, and T3 ages of 13.43, 15.48, and 54.41 years, respectively. The mean treatment and T3 times were 2.05 and 38.92 years, respectively. The images from the digital dental models at T1, T2, and T3 were analyzed with principal components analysis and canonical variates analysis on shape variables after a generalized procrustes analysis, to examine intragroup and intergroup arch shape changes at T1, T2, and T3. RESULTS:The principal components analysis revealed that the arch shape variations at T1 were related to the displacement of incisors and canines. At T2, the variations were due to the 4-premolar extractions and anterior retraction. The variation after nearly 40 years was related to both the relapse of anteroinferior teeth and the aging of the occlusion. The arch shape changed with treatment and remained acceptable at T3. The canonical variates analysis illustrated that the maxillary and mandibular shape of dental arches were similar for both groups. CONCLUSIONS:Dental arch shape was modified during orthodontic treatment and remained relatively stable at T3 in both groups, despite some degree of relapse and maturational changes in the occlusion.

Upper fixed retainers show great variation in the materials used and the teeth involved. Among the most commonly used are smooth stainless steel wires and multistranded wires. The proper choice of wire for fixed retention should allow for the tooth's physiological movement while exerting minimal force on the teeth. Objective To compare the stability of alignment and periodontal health of the maxillary anterior teeth 3 and 6 months posttreatment between patients using multistranded and straight stainless steel fixed retainers. Material and Methods The sample consisted of 24 patients after orthodontic treatment and was divided into 2 groups: Group 1 used a 2 × 2 multistranded retainer. Group 2: Using a 2 × 2 straight stainless steel fixed retainer. Little's initial, final, 3- and 6-month posttreatment irregularity indexes and periodontal health indices in the 3 phases were evaluated. Intergroup comparison of sex and bleeding on probing was performed using the chi-square test. The intragroup comparison of Little's index was calculated with repeated measures ANOVA and Tukey's test. The intergroup comparison of Little's index and probing depth was performed using the independent t-test. Intergroup comparison of the Gingival and Plaque Index was calculated using the Mann-Whitney U test. Results There was no statistically significant difference between the Little irregularity index in the 2 groups at the end of treatment and the posttreatment follow-up stage. The straight stainless steel retainer group showed greater bleeding on probing on the palatal surface 3 and 6 months after treatment than the multistranded group. Conclusion The 2 × 2 multifilament and straight stainless steel retainers showed a similar amount of relapse and the same periodontal conditions 3 and 6 months posttreatment. The straight stainless steel group showed greater bleeding on probing on the palatal face than the multistranded group 3 and 6 months posttreatment.

To evaluate patients' adaptability to attachments and their quality of life during the use of Invisalign®. 25 patients (mean age: 32.3 years) beginning treatment with Invisalign using attachments were evaluated. A questionnaire containing questions regarding comfort, esthetic, and Ohip-14 was applied in 4 stages: the same-day attachments were installed 15, 45, and 90 days after installation. Intragroup comparison between the evaluated stages was performed using repeated measures ANOVA. The correlation between the number of attachments and discomfort was assessed using Pearson's correlation test. The day the attachments were bonded was considered the most uncomfortable for patients to cheek adaptation (7.52 ± 2.87). There were no differences in aesthetic appearance and quality of life concerning the patient's perception of the attachments during the first 3 months of treatment. On the installation day, the maxillary attachments were more uncomfortable for the lips, cheeks, and tongue (p = 0.043; 0.013 and 0.004, respectively), while the mandibular attachments were for the lips and tongue (p = 0.004 and 0.029, respectively). There was a positive correlation between anterior attachments and the tongue on the first day (p = 0.010). For posterior attachments, this correlation occurred with the lips, cheeks, and tongue on the installation day (p = 0.002; 0.039 and 0.031, respectively), remaining significant at all stages only regarding lips (T1: p = 0.022; T2: p = 0.032 and T3: p = 0.017). There was some discomfort in the cheeks when the attachments were bonded. However, after 15 days, there was an improvement in adaptability and quality of life. The number of anterior and posterior attachments was correlated with the lips, cheeks, and tongue discomfort at installation, and the number of posterior attachments, with lips discomfort during all stages evaluated. Orthodontists may guide their patients regarding adaptation to the attachments. Additionally, the orthodontist may base their treatment plans on using the fewest attachments possible.

Introduction Despite extensive research on orthodontic aligners, there is limited evidence evaluating the standard 22-hour daily wear protocol that is globally recommended. While numerous factors influence patient compliance, the effectiveness of reducing wear time has yet to be thoroughly studied. This trial investigates whether a 12-hour daily wear protocol can provide similar treatment outcomes to the traditional 22-hour protocol in patients undergoing treatment with Invisalign aligners, specifically in those with mild malocclusions. Methods Fifty participants (21 men, 29 women) underwent orthodontic treatment with Invisalign aligners and were randomly allocated to one of the groups: Group 1 comprised 25 patients (9 men, 16 women) with a mean age of 38.56 years (± 7.57) and consisted of participants who used Invisalign aligners in a 22-hour daily protocol while Group 2 comprised 25 patients (12 men, 13 women) with a mean age of 37.15 years (± 6.23) and consisted of participants who used Invisalign aligners in a 12-hour daily protocol. Blinding of the clinician and participants was impossible but was performed at the time of measurements. All participants received the allocated intervention. Results The maxillary and mandibular Little irregularity index were significantly corrected with treatment at T2 in both groups. The mandibular Little irregularity index showed a statistically greater correction in the 22-hour group. There was no statistically significant difference between the groups considering maxillary and mandibular intercanine, interpremolar, intermolar widths, overjet, and overbite at T2. Conclusion The suggested 12-hour daily protocol for orthodontic aligners usage is able to promote an adequate improvement in patient’s treatment, except for the correction of the mandibular irregularity that is more efficient in 22-hour daily protocol.

Intermaxillary elastics are one of the most widely used methods for Class III compensatory treatment. However, their application often leads to undesirable side effects, potentially compromising smile aesthetics. More recently, skeletal anchorage has gained popularity as an alternative approach, particularly for mandibular molar distalization in Class III correction. Objective To compare cephalometric data of patients with Class III malocclusion using intermaxillary elastics or skeletal anchorage. Materials and Methods The sample included 38 patients with Class III malocclusion. Group 1: 10 patients treated with fixed appliances (Roth prescription) and skeletal anchorage with extra-alveolar miniscrews in the buccal shelf. Group 2: 14 patients treated with fixed appliances (Class III Biofunctional prescription) and intermaxillary elastics. Group 3: 14 patients treated with fixed appliances (Roth prescription) and intermaxillary elastics. Initial and final lateral cephalograms were traced and compared using ANOVA and Tukey tests. Results At treatment end, upper molars were more mesially angulated in the Biofunctional group than in the Buccal Shelf and Roth groups. Lower incisors were more upright and retruded in the Buccal Shelf group than in the other groups. Greater extrusion of lower incisors was seen in the Biofunctional group than in the Buccal Shelf group. Conclusion Class III elastic treatments with the Biofunctional prescription resulted in greater counterclockwise occlusal plane rotation than skeletal anchorage. Skeletal anchorage in the buccal shelf led to more upright and retruded lower incisors compared to elastics.

Facial aesthetics, especially the smile, greatly influence attractiveness and social interactions, being a factor increasingly valued in contemporary society. Objective This study aimed to compare the attractiveness of the smile in Class II patients treated with a Twin Force Bite Corrector appliance or surgically. Material and Methods The sample consisted of smile photographs of 30 patients before and after treatment. All had Class II malocclusion, treated without extraction, divided into two groups based on the treatment. Group 1 (TFBC) had 15 patients (10 men, 5 women, mean starting age 19.55 years), with a treatment time of 2.58 years. Group 2 (Surgical) had 15 patients (6 men, 9 women, mean starting age 20.14 years), with a treatment time of 2.36 years. Photos were standardized, placed on a black-and-white scale, and evaluated via Google Forms by laypeople, dentists, and orthodontists, rating smile attractiveness from 0 to 10. Inter-group comparisons used the independent t-test. Results Both groups showed significant improvements in smile attractiveness, but the surgical group had greater final scores. Orthodontists gave higher ratings than laypeople and dentists. Conclusion The improvement in smile attractiveness was similar in both groups, but patients treated surgically had greater smile attractiveness at the end of treatment.

Background There is a lack of studies evaluating the potential psychological implications associated with anterior open bite (AOB), such as the impact on self-esteem and social acceptance, particularly across different developmental stages. Understanding the aesthetic and social perception of AOB in childhood can provide valuable insights for early intervention and improve orthodontic care. Objective The aim of this cross-sectional study was to evaluate the aesthetic and social impaction of anterior open bite (AOB) among children aged 4 to 12 years. Materials and Methods The sample included 272 evaluators (147 girls and 125 boys), divided into three age groups: 4–6, 7–9, and 10–12 years. Images of children's faces from different age groups were created using artificial intelligence, and their smiles were digitally edited using Adobe Photoshop to show AOB and normal overbite. Participants of the study completed a questionnaire to evaluate their aesthetic perception of the images using a Escala numérica numerical rating scale ranging from 0 to 10. Social perception was evaluated with objective questions. The tests t-independent and chi-cuadrado assessed the aesthetic and social impactions, respectively. Results The photographs of children with normal overbite showed a statistically significant more positive aesthetic perception, for all evaluated age groups (p<0.001). Regarding social perception, in the 4–6 age group, only the "Beautiful Smile" characteristic showed a statistically significant difference (p=0.002). In the 7–9 and 10–12 age groups, the characteristics "Beautiful Smile" and "Beautiful Teeth" demonstrated statistically significant differences between the images (p<0.001). Conclusion Anterior open bite negatively impacts the aesthetic perception of children between 4 and 12 years of age.

INTRODUÇÃO: O Invisalign Palatal Expander (IPE) é uma inovação recente desenvolvida pela Align Technology, lançado no Brasil em 2025, com o objetivo de promover a expansão rápida da maxila em pacientes em crescimento. OBJETIVO: Este artigo apresenta um caso clínico de um paciente com 7 anos de idade, mordida cruzada posterior unilateral, tratado com o uso do IPE, destacando a evolução clínica e os resultados obtidos. RELATO DO CASO: Foram utilizados 40 expansores, totalizando 10 mm de expansão em 30 dias de uso — inicialmente com trocas duas vezes ao dia por 10 dias,...

BACKGROUND:Women remain underrepresented in the academic world. This study aimed to compare the numbers of female and male authors in high-impact orthodontic journals during the pre- and post-COVID-19 pandemic periods. MATERIAL AND METHODS:A total of 7902 papers published in eight orthodontic journals (American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, European Journal of Orthodontics, Journal of Orofacial Orthopedics, Journal of the World Federation of Orthodontists, Korean Journal of Orthodontics, Orthodontics & Craniofacial Research, and Progress in Orthodontics) were screened. They were divided into two groups: Group 1 (G1): Pre-pandemic (2015-2019) and Group 2 (G2): Post-pandemic (2020-2024). The data were collected manually, including the journal, type of study, gender, and authorship position. Descriptive statistical analyses were used. The sex of the authors before and after the pandemic was compared using the chi-square test. The Mann-Whitney U test was used to compare the total number of authors and the total number of male and female authors. RESULTS:5494 papers were evaluated and included in the study. There was no significant difference in gender distribution in single-authored papers. After the pandemic, there was a significant increase in women in first and last author positions. The total number of authors and proportion of female authorship in intermediate positions increased significantly post-pandemic. The European Journal of Orthodontics was the only journal that had more female first authors than males in the post-pandemic period. CONCLUSION:The pandemic has not negatively affected female participation in orthodontic publications. There was a significant increase in female authorship after 2020, indicating a gradual reduction in gender disparities in this field.

Women have achieved significant social and civil gains since the 20th century, such as the increase in female students in fields previously dominated by men, like medicine and dentistry. According to Ioannidou et al., women now represent the majority of PhD students (52.4%) compared to male students. However, they remain underrepresented in the academic world as professors and as conference speakers. With women being the majority in university classrooms, it is common to assume that the number of female and male authors in academic papers is balanced. However, gender inequality in educational and research environments remains persistent. Despite some progress observed over the past ten years, a previous study showed that women hold less space in authorship positions overall and are less likely than men to be first or last authors. From mid-March 2020 to the beginning of 2023, the COVID-19 pandemic affected the entire world. As a result, schools and universities had to halt in-person activities, directly impacting the number of publications. In addition to many research projects being interrupted, the academic landscape shifted its focus to studies related to the newly discovered, highly contagious virus. The COVID-19 pandemic affected researchers unevenly, potentially creating cumulative advantages for men.Objective: This study aimed to compare the number of female and male authors in Qualis A orthodontic journals in pre- and post-COVID-19 pandemic periods.Material and Methods: A total of 6,952 papers published in seven orthodontic journals (AJODO, DPJO, EJO, JOOF, KJO, OCR, and PIOR) between 2015-2024 were evaluated. After screening, they were divided into two groups: Group 1 (G1): Pre-pandemic (2015-2019) and Group 2 (G2): Post-pandemic (2020-2024). The data was collected manually, identifying the journal, type of study, gender, and authorship position. Descriptive statistical analyses were used. The sex of the authors before and after the pandemic was compared using the chi-square test. The Mann-Whitney U test was used to compare the total number of authors and the total number of male and female authors.Results: The evaluation included 4689 papers. There was no significant difference in gender distribution in single-authored papers. After the pandemic, there was a significant increase in women in first and last author positions. The total number of authors, including female and male authors in intermediate positions, also increased significantly post-pandemic.Conclusion: The pandemic has not negatively affected female participation in orthodontic publications. On the contrary, there was a significant increase in female authorship after 2020, indicating a gradual reduction in gender disparities in this field.

Given the increase in life expectancy and the growing focus on healthy aging, it is essential to conduct studies that demonstrate the long-term effects of orthodontic treatment. The objective of this study was to compare soft tissue profile changes after 37 years of follow-up in orthodontically treated patients with and without the extraction of four premolars. The sample of 40 cephalometric radiographs of orthodontically treated individuals was evaluated at pre-treatment (T1), post-treatment (T2), and long-term follow-up (T3). The individuals were divided into two groups according to the treatment protocol. The Extraction Group consisted of 24 individuals (16 females and 8 males), with an average long-term follow-up of 36.99 years. The Non-Extraction Group consisted of 16 individuals (10 females and 6 males), with an average long-term follow-up of 36.58 years. Soft tissue cephalometric analyses were performed using Dolphin Imaging software. Intergroup comparisons were made using the independent t-test. The results showed that both groups exhibited similar soft tissue profile changes after orthodontic treatment and long-term follow-up. In conclusion, orthodontic treatments with and without extractions resulted in similar soft tissue profile changes at the end of treatment and after 37 years of follow-up.

Objective: Public health in Brazil has witnessed substantial transformations over the past four years due to the impact of the COVID-19 pandemic. This study aimed to quantify and compare the dental preventive procedures performed within the Brazilian Public Health System (SUS) during the initial two years of the COVID-19 pandemic (2020-2021) against the preceding two-year period (2018-2019), assessing the pandemic's impact on public dental health services Methods: Data were retrospectively obtained from the Outpatient Information System (SIA/SUS) and the Brazilian Institute of Geography and Statistics (IBGE). Annual and total procedure numbers for 3 variables were established in each region. The indicators were: Educational activity/guidelines for groups in primary care, collective action of fluoride mouthwash and collective action of supervised toothbrushing. Descriptive analysis with annual percentage change (APC) was used. Results: The preventive procedures decreased from 2018 to 2021, drastically dropping from 2020 to 2021. There was a 54% reduction in educational activity/guidelines for groups in primary care. There was a drastic reduction in the collective actions of fluoride mouthwash and supervised toothbrushing. Conclusion: Dental preventive procedures in the SUS decreased from 2018 to 2021, but a greater decrease was observed in the first two years of the pandemic.

OBJECTIVE:to investigate whether a 12-h daily wear protocol can provide similar treatment outcomes to the traditional 22-h protocol in patients undergoing treatment with Invisalign aligners, specifically in those with mild malocclusions. NULL HYPOTHESIS:There is no significant difference between the 22-h and the 12-h protocol. TRIAL DESIGN:Single-centre randomized clinical trial with two parallel arms and a 1:1 allocation ratio. PARTICIPANTS:50 adult patients with Class I malocclusion and a maximum Little Irregularity Index (LII) of 2 mm. INTERVENTIONS:Group 1 (9 men, 16 women; 38.56 ± 7.57 y) was treated with the 22-h protocol. Group 2 (12 men, 13 women; 37.15 ± 6.23 y) was treated with the 12-h protocol. PRIMARY OBJECTIVE:to compare the outcomes of 22-h versus 12-h daily wear in Class I patients with mild crowding. SECONDARY OBJECTIVE:to compare the intercanine, inter-premolars, intermolar distances, overjet and overbite in T1 and T2 on both groups. RANDOMIZATION:randomization sequence was generated with a 1:1 allocation ratio. BLINDING:the measurements in the T1 and T2 scannings were made by a blinded operator. RESULTS:The maxillary and mandibular Little irregularity index (LII) were significantly corrected with treatment at T2 in both groups. The mandibular LII showed a statistically greater correction in the 22-h group. There was no statistically significant difference between the groups considering maxillary and mandibular intercanine, interpremolar, intermolar widths, overjet, and overbite at T2. CONCLUSION:The recommended 12-h daily protocol for orthodontic aligner use can achieve adequate alignment in the maxilla in cases of very mild crowding. However, correction of mandibular irregularity is significantly less efficient with this protocol compared with the 22-h regimen. REGISTRATION:This clinical trial was registered under UTN U1111-1303-5576 at the Brazilian Registry of Clinical Trials (ReBEC).