AIM:The study aimed to compare the fit of thermoformed aligners fabricated on the original dental model over the corresponding dental models created using rapid-prototyping, in horizontal or vertical orientations using scanning electron microscopy (SEM). METHODS:This study involved scanning 10 dental models using a Maestro 3D Desktop Scanner. The 10 processed STL files were then additively manufactured into 20 models using a PolyJet printer, 10 models printed in horizontal or vertical orientations, respectively. Two thermoformed aligners using 0.75 mm Duron blanks were fabricated over each original dental model with a Biostar machine and were adapted over the corresponding additively manufactured models. Models manufactured in two different orientations along with aligners were sectioned on the upper and lower-central incisors, first premolars and first molars and were prepared for SEM evaluation. The difference in data between the two groups was determined using an unpaired t-test. RESULTS:The fit of aligners on additively manufactured dental models in vertical or horizontal orientations was generally comparable. Across all regions evaluated, the mean measured discrepancies ranged below 196.2 ± 44.32 µm, which falls within ranges previously reported in the literature as clinically acceptable for thermoformed aligners (117.76 ± 23.58-196.2 ± 44.32 µm). CONCLUSION:SEM evaluation revealed that thermoformed aligners fabricated on the original dental models demonstrated a comparable fit on rapid-prototyped dental models, with no significant differences observed between models fabricated in horizontal or vertical three-dimensional printing orientations.

Importance: Mini-implants (micro-screws) are widely used as skeletal anchorage devices in orthodontics, most often placed in intra-radicular areas. Objectives: To compare mini-screw success rates and peri-implant biological responses between immediate and delayed loading approaches. Data sources: PubMed, Scopus, EMBASE, Web of Science, CENTRAL, and Ovid (up to March 24, 2026.) Study selection: Randomized controlled trials (RCTs) and prospective controlled clinical trials (CCTs) comparing immediate and delayed loading of mini-implants in orthodontic patients were included. Primary outcome is success rate. Peri-implant biomarkers, stability, and patient-related outcomes were secondary outcomes. Data extraction and synthesis 10 studies (8 RCTs and 2 CCTs) were included in the final review. RoB 2 and ROBINS-I tools were used to assess risk of bias. RevMan 5.4 was used for meta-analysis with a random-effects model. Results: Main outcome(s) and measure(s), Meta-analysis of 4 RCTs showed no significant difference in odds ratio (OR)= 1.07; 95% confidence interval (C.I) = 0.37, 3.08; (P = 0.91) in success rates between immediate (n=90) and delayed loading (n=96). Non-randomized studies also showed no significant difference (OR, 1.67; 95% confidence interval, 0.98–2.84; P = 0.06). Biomarker analysis revealed no meaningful differences in inflammatory response. Although delayed loading showed improved biomechanical parameters, this did not translate into better clinical outcomes. Conclusions: Immediate and delayed loading have similar mini-screw success rates. Although delayed loading yields promising biological and mechanical responses, its clinical advantage remains unclear. Relevance: Both approaches seem safe; however, additional well-designed studies are required to confirm these findings. Registration: PROSPERO (CRD420251017446). Funding: None

Objectives:To assess the acceleratory effect of locally administered injectable platelet-rich fibrin (i-PRF) on overall treatment duration (OTD) and root resorption. Materials and Methods:Patients with anterior crowding requiring extraction of all four first premolars were randomized into i-PRF and control groups, both treated with fixed appliances. The i-PRF group received submucosal injection of i-PRF distal to all canines on the buccal and palatal sides, and canine retraction was performed using sectional mechanics. A second i-PRF injection was administered in the anterior interradicular region, followed by alignment up to 0.018 × 0.025″ stainless steel and space closure with NiTi closed coil springs (150 g). Control patients underwent the same protocol without i-PRF injections. Treatment duration was calculated; root resorption was assessed using cone-beam computed tomography, and volumetric analysis was accomplished using MIMICS software. Results:All 30 enrolled patients (17 females, 13 males; mean age 16.6 ± 2.7 years) completed the study, with 15 patients in each group. The mean OTD was 338.6 ± 37.8 days for the i-PRF group and 374.3 ± 49.3 days for the control group (P = .107). The percentage root volume loss for the central incisor was 3% and 4% in the intervention and control groups (P = .122), respectively, and 5% and 6% for the lateral incisor in the intervention and control groups (P = .767). Both the treatment duration and root volume loss in both groups were statistically and clinically nonsignificant. Conclusions:The use of i-PRF did not significantly reduce OTD or affect root resorption compared with the control group.

The primary role of buccal-shelf miniscrew implants (BS-MSI) in orthodontic treatment is to provide extra-alveolar anchorage that alleviates severe crowding and allows for distalization of the entire mandibular arch and may obviate the need for orthognathic surgery, particularly in patients with skeletal malocclusion. The stability of these screws is crucial to their successful function throughout orthodontic treatment. Therefore, this systematic review aimed to assess the success rate and various factors affecting the stability of BS-MSI. The databases were searched electronically using PubMed/MEDLINE, EMBASE, Scopus, and the Cochrane databases on 7th February 2025 and re-searched on 22nd February 2026. The reference list and additional bibliographic databases, including clinical trial registries and Google Scholar, were also searched. This review includes clinical trials published in English, comprising prospective randomised controlled trials (RCTs), non-randomised trials (NRCTs), and retrospective cohort studies (RCs) that described the success rate of BS-MSI for orthodontic anchorage in human subjects. Success rates and associated risk factors for BS-MSI were determined utilising a random-effects model. The determinants influencing stability were categorised into patient, mechanics, and implant-related aspects, and subsequently underwent subgroup analysis and meta-regression. The evaluation of study quality was performed using the Cochrane risk-of-bias tools for randomised trials (RoB 2.0) and non-randomised trials (ROBINS-I). This meta-analysis included nine studies: three RCTs, two NRCTs, and four RCs. A total of 2366 BS-MSI were aggregated in a random-effects model, revealing an overall success rate of 93% (95% CI 0.81-1.00; prediction interval = 0.39-1). In a sensitivity analysis, experiments using more than 100 screws exhibited a 91% success rate, comparable to those with fewer than 100 screws. A meta-regression study indicated an inverse relationship between age and success rate. A considerable heterogeneity was observed across all subgroups. Three assessments indicated a low-, two indicated a moderate-, and four indicated a high-risk of bias. BS-MSI demonstrated a high success rate and therefore can provide a reliable source of orthodontic anchorage. However, given the low certainty and high heterogeneity in the existing evidence, the results should be interpreted with caution. Although numerous factors appear to influence BS-MSI stability, most require further investigation due to inadequate data and data quality. Furthermore, future studies are necessary to corroborate the findings of this meta-analysis and investigate other critical factors, such as location, dental cleanliness, gender, insertion torque, and operator experience, which could not be evaluated due to insufficient data. Trial Registration: PROSPERO registration: CRD420250653597.

ABSTRACT Introduction: The purpose of this study was to comparatively evaluate the accuracy and fit of rapid-prototyped clear retainers printed at two different layer heights (100 µm and 50 µm) using a low-force stereolithography (LFS) 3D printer. Methods: Forty-two retainers were digitally designed using Maestro 3D Dental computer aided designing (CAD) software (AGE Solutions, Pisa, Italy) and rapid prototyped using an LFS printer (Formlabs Inc, Somerville, MA, USA). Half of the retainers (21) were printed at 50 µm layer height and other half at 100 µm. To assess the dimensional accuracy, linear measurements were taken from the 3D printed retainers using digital caliper (accurate to 0.01 mm) and from the digitally designed retainers using Maestro 3D Dental Studio software. The fit of the retainers was further evaluated with a scanning electron microscope. Accuracy was compared across three groups-digitally designed retainers, and those printed at 50 µm and 100 µm layer height using ANOVA/Kruskal‒Wallis tests. The reliability and internal consistency of the linear measurements were evaluated by the intraclass correlation coefficient (ICC with 95% CI) and Cronbach’s alpha, respectively. Paired t-tests were used to compare the fit of rapid prototyped retainers printed at 100 µm and 50 µm layer heights. Additionally, the printing time for each retainer was recorded. Results: There was no statistically significant difference (p value > 0.05) between the accuracy of 3D-printed retainers printed at 100 µm and 50 µm layer heights with a high reliability (ICC>0.9) and high internal consistency (Cronbach’s alpha>0.9). For comparative evaluation of the fit, no statistically significant difference (p>0.05) was observed among the retainers printed at 50 µm and 100 µm layer heights, except at the labio-gingival border and at the middle of the incisal edge of the central incisor. Time required for printing retainers at 50 µm is more than that of 100 µm layer height. Conclusion: Both rapid-prototyped retainers printed at 100 µm and 50 µm layer heights were found to be accurate for clinical use when compared to reference digital retainers with acceptable fit. As the time required for printing retainers at 100 µm is less than that of 50 µm layer height, it is better to use 100 µm layer height for rapid prototyping of the retainers.

Statement of problem The vat polymerization-based 3-dimensional (3D) printing of dental materials necessitates a postpolymerization procedure to complete the fabrication of the printed device. A nitrogen-rich postpolymerization (NRPP) environment has been claimed to prevent the formation of an oxygen-inhibited layer, potentially improving material characteristics. However, a consensus on its impact on properties relevant to dental applications is lacking. Purpose The purpose of this systematic review and meta-analysis was to synthesize evidence comparing the chemical, physical, mechanical, and biological properties of 3D printed dental materials subjected to NRPP against conventional postpolymerization. Material and methods Comprehensive searches were conducted across MEDLINE (via PubMed), Web of Science, Scopus, Open Access Theses and Dissertations, and Google Scholar and using the manual method without language restrictions up to February 2024. Two reviewers screened the literature, assessed the risk of bias (RoB) using the QUality assessment tool for IN vitro studies (QUIN), and independently extracted data from eligible studies. Meta-analysis was undertaken by using a random-effects statistical model with the R-software program, and evidence certainty was rated via the grading of recommendations assessment, development, and evaluation (GRADE) approach. Results Of 275 articles, 14 in vitro studies with a medium RoB were included in the systematic review, with 8 eligible for meta-analysis. These studies involved 3D printed occlusal devices, implant guides, denture bases, interim crowns or fixed partial dentures, and orthodontic aligners. No statistically significant standardized mean difference (SMD) in material properties was found between with and without NRPP for water solubility, dimensional accuracy, water sorption, flexural modulus, flexural strength, hardness, or fracture toughness (P>.05). An exception was the degree of surface polymerization, with an SMD of 1.66% (95% CI, 0.56 to 2.76; I2=65%) favoring NRPP. The overall certainty of evidence was graded as low to very low. Conclusions NRPP does not significantly alter the physical, chemical, or mechanical properties of 3D printed dental materials except for a higher degree of surface polymerization in unpolished occlusal devices. The overall evidence certainty was rated as low to very low.

This case report outlines the effective treatment of a multifaceted orthodontic case involving multiple impacted and supernumerary teeth and complete transposition in a 10-year-old girl. She presented with missing anterior teeth, an Angle’s class I molar relation on the left, Angle’s class II molar relation on the right, and various dental anomalies. On cone-beam computed tomography (CBCT) evaluation, the patient had vertically impacted four teeth (central incisors, right lateral incisors, and canine) and four supernumerary teeth. The treatment plan included surgical extraction of impacted teeth, orthodontically guided eruption, extraction of supernumerary teeth, and atypical extraction of #12, #24, #34, and #44 due to arch length tooth material discrepancy. #12 was extracted as there was palatal fenestration and had an open root apex. The spatial position and orientation of the impacted teeth were assessed using CBCT. The orthodontic treatment employed a rigid metal framework with NiTi coil springs for guided eruption. Interdisciplinary collaboration among orthodontists, dental surgeons, and other specialists, along with meticulous planning and controlled force application, was crucial. Satisfactory aesthetics, functional occlusion, and stability were obtained at the end of the treatment, demonstrating the effectiveness of orthodontic intervention in complex cases.

IntroductionThis review synthesizes the available evidence pertinent to the effect of platelet-rich fibrin on the rate of orthodontic tooth movement during comprehensive orthodontic treatment.MethodThis review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Nine electronic databases were searched until January 2024 without restrictions, followed by a hand search of the reference lists. Controlled randomized split-mouth human studies assessing the effect of platelet-rich fibrin on the rate of orthodontic tooth movement were included. All relevant data from the included studies were extracted and pooled for qualitative and quantitative analysis. Risk-of-Bias was assessed using the Cochrane Risk of Bias tool. The certainty of the evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation tool.ResultsFrom 515 studies, eleven randomized clinical trials were included for qualitative analysis and nine for quantitative analysis. The certainty of the evidence for these studies was low to moderate. The overall risk of bias for most studies was of some concern. The pooled estimate of the data from ten studies has a mean revealed difference of 1.31 (0.13–2.48) at a 95 % confidence interval with significant heterogeneity.ConclusionsThis systematic review suggest that platelet-rich fibrin enhances the orthodontic tooth movement rate, but the evidence quality was moderate. Further, based on the currently available evidence, the effectiveness of platelet-rich fibrin on the acceleration of orthodontic tooth movement could not be fully established.Trial registrationPROSPERO: (CRD42021261836).

The aim of this systematic review was to compare the treatment outcomes of digital nasoalveolar moulding (dNAM) technique with conventional nasoalveolar moulding (cNAM) or non-presurgical intervention protocol in infants with unilateral (UCLP) or bilateral (BCLP) cleft lip and palate. A bibliometric search by MEDLINE (via Ovid), Embase, Cochrane Library, grey literature and manual method was conducted without language restriction until November 2023. Literature screening and data extraction were undertaken in Covidence. The risk of bias was evaluated using the Newcastle-Ottawa Scale and RoB-2. Pooled effect sizes were determined through random-effects statistical model using R-Software, and the certainty of evidence was assessed using the GRADE approach. Among 775 retrieved articles, nine studies were included for qualitative synthesis (6-UCLP, 3-BCLP), with only three eligible UCLP studies for meta-analysis. In the UCLP group, very low certainty of evidence indicated no difference in alveolar cleft width (SMD, 0.13 mm; 95% CI, -0.31 to 0.57; I2, 0%), soft tissue (lip) cleft gap, nasal width, nasal height, and columellar deviation angle changes between dNAM and cNAM. In the BCLP group, qualitative synthesis suggested similar changes in alveolar, lip, and nasal dimensions with dNAM and cNAM. In both cleft groups (UCLP, BCLP), reduced alveolar cleft width was observed in the dNAM group compared to the non-presurgical intervention protocol, along with fewer clinical visits and reduced chairside time for dNAM compared to cNAM. It can be concluded that the treatment outcomes with dNAM were comparable to cNAM in reducing malformation severity and were advantageous in terms of chairside time and clinical visit frequency. However, the overall quality of evidence is very low and standardization is needed for the virtual workflow regarding the alveolar movements and growth factor algorithms. Registration: PROSPERO-database (CRD42020186452).

4D printing is an innovative digital manufacturing technology that originated by adding a fourth dimension, i.e., time, to pre-existing 3D technology or additive manufacturing (AM). AM is a fast-growing technology used in many fields, which develops accurate 3D objects based on models designed by computers. Dentistry is one such field in which 3D technology is used for manufacturing objects in periodontics (scaffolds, local drug-delivering agents, augmentation of ridges), implants, prosthodontics (partial and complete dentures, obturators), oral surgery for reconstructing jaw, and orthodontics. Dynamism is a vital property needed for the survival of materials used in the oral cavity since the oral cavity is constantly subjected to various insults. 4D printing technology has overcome the disadvantages of 3D printing technology, i.e., it cannot create dynamic objects. Therefore, constant knowledge of 4D technology is required. 3D printing technology has shortcomings, which are discussed in this review. This review summaries various printing technologies, materials used, stimuli, and potential applications of 4D technology in dentistry.

BackgroundFluoridated mouth rinses improve anti-cariogenic environment but decrease oral pH below critical value, affecting orthodontic bracket surface topography and causing corrosive changes over prolonged use. This invitro study aimed to quantitatively and qualitatively assess the surface topography and metallic ion release of the stainless steel (SS) brackets at varying acidic and alkaline pH.Materials and methodsForty unused SS brackets were divided into four groups (Group A, B, C, D) and immersed for 48- hours in solutions of artificial saliva and sodium fluoride (0.2 %) mouth rinse at varying pH of 5.5,6.7,7 and 8. The surface morphologic changes were analyzed under scanning electron microscope (SEM) at 50×, 150×, and 500× magnification. The changes in slot area were scored using the customized scale. The Energy Dispersive Xray Spectroscopy Analysis (EDAX) was used to estimate the probed elements' atomic and weight percentage.ResultsThe mean score of the scale was 3.4 for the brackets immersed in the acidic solution which was statistically significant (p = 0.00)and for alkaline and neutral solutions (p = 0.00). Chromium was found to be significantly higher in the alkaline solution (p = 0.016) followed by the neutral solution. Carbon was found excess in acidic solution than the neutral and alkaline solution.ConclusionQuantitative and qualitative analysis of the ion release in stainless steel brackets using SEM and EDAX revealed the corrosive effect of fluoride ion causing maximum surface changes in acidic medium and chromium release in alkaline pH.

Objectives The purpose of this study was to evaluate the accuracy and cost-effectiveness of the dental models 3D printed in vertical and horizontal orientation as compared to the conventional plaster and digital models. Methods This study involved scanning 50 plaster models using Maestro 3D Desktop Scanner (AGE Solutions, Pisa, Italy). The STL file obtained from the scanner was processed and three-dimensionally (3D) printed in the horizontal and vertical orientation using a PolyJet 3D printer (Objet 30 prime, Stratasys Ltd., Eden Prairie, Minnesota, United States). The accuracy of the rapid-prototyped (3D printed) models was measured from the pre-determined landmarks and was compared among the groups. In addition, determining the cost-effectiveness of the 3D printed models in different orientations was based on the amount of material (resin) utilized during the 3D printing process. ANOVA was used to determine the accuracy of the models. Results There were statistically insignificant differences (P>0.05) among rapid-prototyped models (≤0.06mm) compared to plaster models and digital models for the linear measurements made in all three planes of space. The dental models printed in the horizontal orientation were found to be more cost-effective than those printed in a vertical orientation in terms of the amount of material (resin) utilized and printing time during the 3D printing process. Conclusions The accuracy of rapid-prototyped models 3D printed in the horizontal and vertical orientations was comparable to the plaster models and digital models for clinical applications. Horizontally printed models were more cost-effective than vertically printed models.

Moebius syndrome (MS) is a rare congenital neuromuscular disorder characterized by weakness or paralysis (palsy) of abducens and facial nerves, or other cranial nerves which may be affected. Diagnosis, treatment, and dental management of MS patients are focused on treating manifestations like malocclusion, while catering to associated extraoral (neurologic, dermatologic, ocular) complications, aiming to improve their quality of life. Here, we report the case of a 9-year-old female patient with MS who underwent orthodontic camouflage using combined orthopedic-orthodontic therapy using a high-pull chin cup and fixed orthodontic appliance to improve skeletal mal-relation and facial appearance. The outcome displayed great improvement in function and better esthetics, improving not only the patient's but also the family's quality of life. A year's follow-up showed successful maintenance of the achieved results. A multidisciplinary approach in MS not only helps in overcoming the treatment challenges but also provides great psychosocial benefits to these patients.

We congratulate the team of Shirey et al for their recently published article (Shirey N, Mendonca G, Groth C, Kim-Berman H. Comparison of mechanical properties of 3-dimensional printed and thermoformed orthodontic aligners. Am J Orthod Dentofacial Orthop 2023;163:720-8). The article gains the attention of the fraternity by presenting evidence-based information on 2 yet-to-be commercially available resins that could extend more choices to 3-dimensionally printed aligners directly. However, on constructive deliberation, we wish to detail a few observations of the present reporting. Comparison of mechanical properties of 3-dimensional printed and thermoformed orthodontic alignersAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 163Issue 5PreviewOrthodontic treatment using clear aligners has experienced exponential growth since its introduction in the late 1990s. Three-dimensional (3D) printing has also grown in popularity among orthodontists, and companies have begun to produce resins to directly print clear aligners. This study aimed to examine the mechanical properties of commercially available thermoformed aligners and direct 3D-printed aligners under laboratory conditions and a simulated oral environment. Full-Text PDF Authors’ responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 165Issue 1PreviewThank you for your letter. We would like to address your comments: Full-Text PDF

Background: The study was to compare the ultrasonographic (USG) and cone-beam computed tomographic (CBCT) measurements of the width of anterior midpalatal suture (MPS) opening following rapid palatal expansion (RPE). Methods: The study included 13 patients (boys: 6; girls: 7) with a mean age of 11.85 ± 1.82 years who underwent RPE therapy for maxillary transverse deficiency. The width of the anterior MPS opening was measured in real-time USG, postscan USG image, and CBCT that were obtained immediately after maxillary expansion. The postscan USG and CBCT measurements were performed twice by two examiners at different times. The intraclass correlation coefficient (ICC), Bland–Altman plot, and paired t -test were performed to evaluate intra- and inter-examiner reliability, level of agreement, and systematic error between different measurements. Results: On serial USG evaluation, the MPS opening was seen as the discontinuity in the margins of the maxillary cortical bone, which was not evident before expansion or after the retention period. The intra- and inter-examiner reliability was high (ICC >0.9) for all the measurements. The Bland–Altman plot showed considerable agreement between the different methods, with maximum observations having a mean difference which was within the 95% limits of agreement (real-time vs. postscan USG: ±0.75 mm; CBCT vs. real-time USG: ±0.93 mm; and CBCT vs. postscan USG image: ±1.09 mm). The systematic differences were not statistically significant ( P < 0.05) for all the computed measurements. Conclusion: USG can be used as a reliable nonionizing imaging modality to assess the anterior MPS opening following RPE.

The inception of the laboratory work for a removable tooth moving appliance construction by sectioning the teeth from the malocclusion model to align them with wax and achieve minor dental correction has evolved into a state of digital planning and appliance manufacturing for a wide spectrum of malocclusion. The disruptive technology of directly printing clear aligners has drawn the clinician and researcher's interest in the orthodontic fraternity contemporarily. This workflow enables to the development of an in-house aligner system with complete control over desired aligner thickness, extent, and attachments; also technically resource-efficient with greater accuracy by excluding all the intermediate steps involved in the thermoforming method of manufacturing. This promising exploratory subject demands to be well-received with further research-based improvements. This article intends to summarize the digital orthodontic workflow and the literature evidence.