Pub Date : 2026-03-01Epub Date: 2025-09-25DOI: 10.1016/j.ortho.2025.101060
Byron Carpio-Salvatierra , Mayra Alejandra Nuñez Aldaz , Deisy Cristina Ferreira Cordeiro , Michael Willian Favoreto , Maria José Burbano-Balseca , Paulo Vitor Farago , Alessandro D. Loguercio
Objectives
To evaluate the influence of different burs for residual resin removal after orthodontic debonding on hydrogen peroxide (H2O2) concentration into the pulp chamber, bleaching efficacy and physical changes on the enamel surface following in-office tooth bleaching.
Material and methods
Sixty premolars subjected to bracket installation and debonding were randomized into five groups (n = 12): no bleaching (control), only bleaching, Carbide bur + bleaching (CB), Diamond FF bur + bleaching (DB) and Zirconia bur + bleaching (ZB). All groups, except the control, received bleaching (H2O2 35%). The H2O2 concentration (μg/mL) in the pulp chamber was measured using a UV-Vis spectrophotometer. Bleaching efficacy was assessed by a digital spectrophotometer (ΔEab, ΔE00, and WID) before and after 7 days of bleaching. Enamel surface alterations were analysed by FE-SEM. All data were submitted to statistical analysis (α = 0.05).
Results
The groups submitted to resin removal with CB and ZB post-orthodontic debonding showed a lower H2O2 concentration when compared to the Only Bleaching group after bleaching procedure (P < 0.02). No significant differences were observed in bleaching efficacy between groups submitted to different burs when compared to the Only bleaching group (P > 0.05) across evaluated parameters.
Conclusions
The use of CB and ZB burs to remove residual resin post-orthodontic debonding results in lower H2O2 concentration. However, bleaching efficacy was unaffected by bur type. Notably, ZB burs provided superior enamel surface preservation.
{"title":"Does resin removal with different burs after orthodontic debonding influence hydrogen peroxide diffusion, bleaching efficacy, and enamel alterations during tooth bleaching? An in-vitro study","authors":"Byron Carpio-Salvatierra , Mayra Alejandra Nuñez Aldaz , Deisy Cristina Ferreira Cordeiro , Michael Willian Favoreto , Maria José Burbano-Balseca , Paulo Vitor Farago , Alessandro D. Loguercio","doi":"10.1016/j.ortho.2025.101060","DOIUrl":"10.1016/j.ortho.2025.101060","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the influence of different burs for residual resin removal after orthodontic debonding on hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) concentration into the pulp chamber, bleaching efficacy and physical changes on the enamel surface following in-office tooth bleaching.</div></div><div><h3>Material and methods</h3><div>Sixty premolars subjected to bracket installation and debonding were randomized into five groups (<em>n</em> <!-->=<!--> <!-->12): no bleaching (control), only bleaching, Carbide bur<!--> <!-->+<!--> <!-->bleaching (CB), Diamond FF bur<!--> <!-->+<!--> <!-->bleaching (DB) and Zirconia bur<!--> <!-->+<!--> <!-->bleaching (ZB). All groups, except the control, received bleaching (H<sub>2</sub>O<sub>2</sub> 35%). The H<sub>2</sub>O<sub>2</sub> concentration (μg/mL) in the pulp chamber was measured using a UV-Vis spectrophotometer. Bleaching efficacy was assessed by a digital spectrophotometer (ΔE<sub>ab</sub>, ΔE<sub>00</sub>, and WI<sub>D</sub>) before and after 7 days of bleaching. Enamel surface alterations were analysed by FE-SEM. All data were submitted to statistical analysis (α<!--> <!-->=<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>The groups submitted to resin removal with CB and ZB post-orthodontic debonding showed a lower H<sub>2</sub>O<sub>2</sub> concentration when compared to the Only Bleaching group after bleaching procedure (<em>P</em> <!--><<!--> <!-->0.02). No significant differences were observed in bleaching efficacy between groups submitted to different burs when compared to the Only bleaching group (<em>P</em> <!-->><!--> <!-->0.05) across evaluated parameters.</div></div><div><h3>Conclusions</h3><div>The use of CB and ZB burs to remove residual resin post-orthodontic debonding results in lower H<sub>2</sub>O<sub>2</sub> concentration. However, bleaching efficacy was unaffected by bur type. Notably, ZB burs provided superior enamel surface preservation.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101060"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-03DOI: 10.1016/j.ortho.2025.101076
Yidan Zhang, Bowen Xu, Chuhan Peng, Linna Bai, Kai Yang
Objective
Orthodontic treatment in periodontitis patients is challenging due to unpredictable bone remodeling and tissue damage. Therefore, this study aimed to investigate the effects of orthodontic force on periodontal ligament cell autophagy, apoptosis, and bone remodeling under various inflammatory states using a rat orthodontic tooth movement (OTM) model.
Material and methods
Seventy-five male Sprague – Dawley rats were used to establish OTM models for the periodontal health, active periodontitis, and stable periodontitis groups. Orthodontic force was applied at twelve weeks of age, with rats euthanized on days 0, 1, 3, 7, and 14 after force application. Microcomputed tomography quantified the OTM distance, alveolar bone crest resorption, and trabecular bone microarchitecture parameters. Immunohistochemistry and tartrate-resistant acid phosphatase staining evaluated the expression levels of inflammation, autophagy, apoptosis, osteogenesis, and osteoclast numbers in the periodontal ligament.
Results
The active periodontitis group exhibited the greatest OTM distance, alveolar bone resorption, and osteoclast activity, along with consistently high inflammatory factor expression. In this group, autophagy-related proteins increased on the tension side but decreased on the compression side, while apoptotic protein expression significantly rose. Osteokine levels were low, with an earlier peak decline observed in the active periodontitis group. The periodontal health group maintained high osteogenic activity, and the stable periodontitis group fell in between the two.
Conclusions
The inflammatory microenvironment in active periodontitis interacts with orthodontic force to disrupt the protective autophagy-apoptosis balance, coinciding with increased tissue destruction. Healthy, stable periodontium shows adaptive remodeling, emphasizing the importance of controlling inflammation before orthodontic treatment. This animal experimental procedure complies with the ARRIVE guidelines, and this research was approved by the Animal Ethics and Welfare Committee of the School of Stomatology, Capital Medical University (No̊ KQYY-202207-005).
{"title":"Expression of autophagy and apoptosis during orthodontic tooth movement alveolar bone remodeling in rats with varied periodontal conditions","authors":"Yidan Zhang, Bowen Xu, Chuhan Peng, Linna Bai, Kai Yang","doi":"10.1016/j.ortho.2025.101076","DOIUrl":"10.1016/j.ortho.2025.101076","url":null,"abstract":"<div><h3>Objective</h3><div>Orthodontic treatment in periodontitis patients is challenging due to unpredictable bone remodeling and tissue damage. Therefore, this study aimed to investigate the effects of orthodontic force on periodontal ligament cell autophagy, apoptosis, and bone remodeling under various inflammatory states using a rat orthodontic tooth movement (OTM) model.</div></div><div><h3>Material and methods</h3><div>Seventy-five male Sprague – Dawley rats were used to establish OTM models for the periodontal health, active periodontitis, and stable periodontitis groups. Orthodontic force was applied at twelve weeks of age, with rats euthanized on days 0, 1, 3, 7, and 14 after force application. Microcomputed tomography quantified the OTM distance, alveolar bone crest resorption, and trabecular bone microarchitecture parameters. Immunohistochemistry and tartrate-resistant acid phosphatase staining evaluated the expression levels of inflammation, autophagy, apoptosis, osteogenesis, and osteoclast numbers in the periodontal ligament.</div></div><div><h3>Results</h3><div>The active periodontitis group exhibited the greatest OTM distance, alveolar bone resorption, and osteoclast activity, along with consistently high inflammatory factor expression. In this group, autophagy-related proteins increased on the tension side but decreased on the compression side, while apoptotic protein expression significantly rose. Osteokine levels were low, with an earlier peak decline observed in the active periodontitis group. The periodontal health group maintained high osteogenic activity, and the stable periodontitis group fell in between the two.</div></div><div><h3>Conclusions</h3><div>The inflammatory microenvironment in active periodontitis interacts with orthodontic force to disrupt the protective autophagy-apoptosis balance, coinciding with increased tissue destruction. Healthy, stable periodontium shows adaptive remodeling, emphasizing the importance of controlling inflammation before orthodontic treatment. This animal experimental procedure complies with the ARRIVE guidelines, and this research was approved by the Animal Ethics and Welfare Committee of the School of Stomatology, Capital Medical University (N<sup>o</sup>̊ KQYY-202207-005).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101076"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study evaluated the shape memory behaviour of TA-28 compared to PET-G at different thicknesses and temperatures.
Methods
Two materials were tested: thermoformed CA Pro (PET-G) and 3D-printed TA-28 (Graphy, Korea), in 0.5 mm and 0.75 mm thicknesses. A total of 160 aligner strips were fabricated and tested for shape recovery at 30 °C, 37 °C, 40 °C, and 80 °C. Each strip was bent at 100 °C and recovery was measured over 60 minutes using a protractor-based template.
Results
TA-28 exhibited significantly higher shape recovery than PET-G at all temperatures (P ≤ 0.001). Recovery increased with temperature and was greatest for the 0.5 mm TA-28 samples. At 37 °C, TA-28 reached up to 60.7% recovery within 60 minutes, while PET-G showed negligible change. Three-way ANOVA revealed significant interactions among material, thickness, and temperature (P = 0.005).
Conclusion
TA-28 aligners demonstrate superior shape memory properties compared to PET-G, particularly at body temperature. TA-28 samples with 0.5 mm thickness recovered faster and to a greater extent, offering more consistent force delivery.
Clinical significance
Directly 3D-printed TA-28 aligners may enhance treatment predictability, reduce patient discomfort, and provide sustained orthodontic force due to their temperature-responsive shape recovery. These findings support the use of smart materials in future orthodontic aligner design.
本研究评估了TA-28与PET-G在不同厚度和温度下的形状记忆行为。方法测试两种材料：热成型CA Pro （PET-G）和3d打印TA-28（韩国，Graphy），厚度分别为0.5 mm和0.75 mm。共制作了160个对准器条带，并在30°C， 37°C， 40°C和80°C下测试了形状恢复。每个条带在100°C下弯曲，使用量角器为基础的模板在60分钟内测量恢复。结果在不同温度下，sta -28的形状恢复明显高于PET-G （P≤0.001）。回收率随温度升高而增加，其中0.5 mm TA-28样品的回收率最高。37℃时，TA-28在60分钟内的回收率高达60.7%，而PET-G的变化可以忽略不计。三因素方差分析显示，材料、厚度和温度之间存在显著的相互作用（P = 0.005）。结论与PET-G相比，ta -28矫正剂具有更好的形状记忆性能，特别是在体温下。0.5 mm厚度的TA-28样品恢复得更快，在更大程度上，提供更一致的力传递。直接3d打印TA-28矫正器可以提高治疗的可预测性，减少患者的不适，并且由于其温度响应形状恢复而提供持续的正畸力。这些发现支持了智能材料在未来正畸矫正器设计中的应用。
{"title":"Effect of varying thicknesses and temperature changes on shape memory behaviour in 3D DPA versus thermoformed clear aligner materials: An in vitro study","authors":"Venkata Durga Mahendra Tivanani, Swetha Reddy Dalli, Praveen Kumar Varma Datla, Anoosha Manda, Sai Keerthi Velagala, Padma Priya Cv","doi":"10.1016/j.ortho.2025.101073","DOIUrl":"10.1016/j.ortho.2025.101073","url":null,"abstract":"<div><h3>Background</h3><div>The present study evaluated the shape memory behaviour of TA-28 compared to PET-G at different thicknesses and temperatures.</div></div><div><h3>Methods</h3><div>Two materials were tested: thermoformed CA Pro (PET-G) and 3D-printed TA-28 (Graphy, Korea), in 0.5<!--> <!-->mm and 0.75<!--> <!-->mm thicknesses. A total of 160 aligner strips were fabricated and tested for shape recovery at 30<!--> <!-->°C, 37<!--> <!-->°C, 40<!--> <!-->°C, and 80<!--> <!-->°C. Each strip was bent at 100<!--> <!-->°C and recovery was measured over 60<!--> <!-->minutes using a protractor-based template.</div></div><div><h3>Results</h3><div>TA-28 exhibited significantly higher shape recovery than PET-G at all temperatures (<em>P</em> <!-->≤<!--> <!-->0.001). Recovery increased with temperature and was greatest for the 0.5<!--> <!-->mm TA-28 samples. At 37<!--> <!-->°C, TA-28 reached up to 60.7% recovery within 60<!--> <!-->minutes, while PET-G showed negligible change. Three-way ANOVA revealed significant interactions among material, thickness, and temperature (<em>P</em> <!-->=<!--> <!-->0.005).</div></div><div><h3>Conclusion</h3><div>TA-28 aligners demonstrate superior shape memory properties compared to PET-G, particularly at body temperature. TA-28 samples with 0.5<!--> <!-->mm thickness recovered faster and to a greater extent, offering more consistent force delivery.</div></div><div><h3>Clinical significance</h3><div>Directly 3D-printed TA-28 aligners may enhance treatment predictability, reduce patient discomfort, and provide sustained orthodontic force due to their temperature-responsive shape recovery. These findings support the use of smart materials in future orthodontic aligner design.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101073"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-03DOI: 10.1016/j.ortho.2025.101064
Shankargouda Patil , Alia Choudhary , Harriet Young , Quinton Ashton , Aasha Patel , Reji Mathew , Frank W. Licari , Tarek El-Bialy
Purpose
This systematic review aimed to assess the accuracy of digital cephalometric tracing with manual hand tracing.
Methods
PubMed, SCOPUS and Web of Science databases were searched for relevant articles. After an initial search, which revealed 279 potentially relevant articles, their titles and abstracts were screened. After screening, 23 full-text articles were assessed in depth. Fifteen publications were removed from the analysis considering the predetermined inclusion criteria. The quality of the methodology of the selected 9 studies was analyzed using 12-point criteria, which included study design, measurement, and statistical analysis.
Results
The data thus collected was analyzed for reliable and reproducible variables. All studies were carried out on the digital format of lateral cephalograms. The analysis included both angular and linear measurements. The results brought about statistically significant differences in certain methods and were clinically acceptable even though they were minimal. A few measured variables were the cephalogram quality, lip posture, positioning, and difficulty in locating landmarks.
Conclusions
This review concluded that digital cephalometric tracing was equally reliable as tracing manually, with a moderate quality of evidence. This study also suggested that the literature presented here was accurate enough for clinical application. Thus, digital cephalometric analyses can potentially improve the workflow in clinical and research settings saving time and effort.
PROSPERO – registration number (CRD42024537255).
目的：本系统综述旨在评估数字头视追踪与手视追踪的准确性。方法在spubmed、SCOPUS和Web of Science数据库中检索相关文章。在初步搜索后，发现了279篇可能相关的文章，然后筛选了它们的标题和摘要。筛选后，对23篇全文文章进行深度评估。考虑到预定的纳入标准，从分析中删除了15份出版物。采用12点标准对所选9项研究的方法学质量进行分析，包括研究设计、测量和统计分析。结果所收集的数据具有可靠和可重复性。所有的研究都是在侧位脑电图的数字格式上进行的。分析包括角度和线性测量。结果在某些方法上带来了统计学上的显著差异，即使差异很小，临床也可以接受。测量的几个变量是脑电图质量、唇姿、定位和定位标志的难度。结论：本综述得出的结论是，数字头位追踪与人工追踪同样可靠，证据质量中等。本研究还表明，本文所提供的文献是足够准确的，可用于临床应用。因此，数字头颅测量分析可以潜在地改善临床和研究设置的工作流程，节省时间和精力。普洛斯彼罗-注册号（CRD42024537255）。
{"title":"Accuracy of digital vs. manual cephalometric tracing: A systematic review","authors":"Shankargouda Patil , Alia Choudhary , Harriet Young , Quinton Ashton , Aasha Patel , Reji Mathew , Frank W. Licari , Tarek El-Bialy","doi":"10.1016/j.ortho.2025.101064","DOIUrl":"10.1016/j.ortho.2025.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review aimed to assess the accuracy of digital cephalometric tracing with manual hand tracing.</div></div><div><h3>Methods</h3><div>PubMed, SCOPUS and Web of Science databases were searched for relevant articles. After an initial search, which revealed 279 potentially relevant articles, their titles and abstracts were screened. After screening, 23 full-text articles were assessed in depth. Fifteen publications were removed from the analysis considering the predetermined inclusion criteria. The quality of the methodology of the selected 9 studies was analyzed using 12-point criteria, which included study design, measurement, and statistical analysis.</div></div><div><h3>Results</h3><div>The data thus collected was analyzed for reliable and reproducible variables. All studies were carried out on the digital format of lateral cephalograms. The analysis included both angular and linear measurements. The results brought about statistically significant differences in certain methods and were clinically acceptable even though they were minimal. A few measured variables were the cephalogram quality, lip posture, positioning, and difficulty in locating landmarks.</div></div><div><h3>Conclusions</h3><div>This review concluded that digital cephalometric tracing was equally reliable as tracing manually, with a moderate quality of evidence. This study also suggested that the literature presented here was accurate enough for clinical application. Thus, digital cephalometric analyses can potentially improve the workflow in clinical and research settings saving time and effort.</div><div>PROSPERO – registration number (CRD42024537255).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101064"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This retrospective expert consensus study (PKUSSIRB No.202058145) aimed to establish expert consensus-derived evaluation criteria for orthodontic treatment outcomes using the Merge Ranking Method on post-treatment dental casts.
Material and methods
From patients treated at the Department of Orthodontics from January 2018 to December 2022, 216 cases were randomly selected for evaluation by 65 orthodontic experts using the Merge Ranking Method. Concurrently, nine objective indicators of the 216 post-treatment dental casts were measured by three researchers. The consistency analysis of experts’ subjective evaluation and researchers’ objective measurement was conducted, respectively. Through subjective-to-objective correlation analysis and regression analysis, the objective indicators significantly correlated with experts’ subjective evaluations were selected, their weights were determined, and the threshold values of grading evaluation were screened.
Results
The 65 orthodontic experts demonstrated: (1) moderate pairwise consistency (mean Spearman's ρ = 0.560, 95% bootstrap CI: 0.556-0.564), (2) significant group-level concordance across two independent panels (Kendall's W = 0.544–0.606, all P < 0.001), and (3) near-perfect cross-panel reliability for 24 overlapping cases (Kendall's τ-b = 0.833–0.880, P < 0.001), confirming panel homogeneity for subsequent analyses. Inter-rater reliability among the three researchers showed excellent consistency (mean ICC = 0.835, 95% CI: 0.788–0.882, range: 0.736–0.920), paralleled by high intra-rater reliability (mean ICC = 0.832, 95% CI: 0.806–0.858, range: 0.715–0.948) across all 216 cases. Six objective indicators (occlusal relationship, overbite, alignment, overjet, occlusal contact, and buccal-lingual inclination) significantly predicted expert evaluations in a regression model (cumulative R2 = 0.598, P < 0.001). The threshold values for grading orthodontic treatment outcomes as Excellent, Good, Fair, Poor, and Worst were screened to be 1.846, 2.454, 3.492, and 4.312, respectively.
Conclusions
This expert consensus study demonstrated moderate consistency in subjective orthodontic outcome evaluation, with the occlusal relationship emerging as the primary quality determinant. The developed Merge Ranking Method addressed conventional ranking limitations through its innovative two-stage approach: initial segmented evaluation reduced expert fatigue, while subsequent dynamic adjustments improved borderline case classification.
{"title":"Expert consensus-derived evaluation criteria for orthodontic treatment outcomes using a novel ranking method: A retrospective dental cast analysis study","authors":"Huanhuan Chen, Hanwei Zheng, Yue Lai, Wei Li, Chenda Meng, Tianyi Wang, Guangying Song, Bing Han, Tianmin Xu","doi":"10.1016/j.ortho.2025.101057","DOIUrl":"10.1016/j.ortho.2025.101057","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective expert consensus study (PKUSSIRB No.202058145) aimed to establish expert consensus-derived evaluation criteria for orthodontic treatment outcomes using the Merge Ranking Method on post-treatment dental casts.</div></div><div><h3>Material and methods</h3><div>From patients treated at the Department of Orthodontics from January 2018 to December 2022, 216 cases were randomly selected for evaluation by 65 orthodontic experts using the Merge Ranking Method. Concurrently, nine objective indicators of the 216 post-treatment dental casts were measured by three researchers. The consistency analysis of experts’ subjective evaluation and researchers’ objective measurement was conducted, respectively. Through subjective-to-objective correlation analysis and regression analysis, the objective indicators significantly correlated with experts’ subjective evaluations were selected, their weights were determined, and the threshold values of grading evaluation were screened.</div></div><div><h3>Results</h3><div>The 65 orthodontic experts demonstrated: (1) moderate pairwise consistency (mean Spearman's ρ<!--> <!-->=<!--> <!-->0.560, 95% bootstrap CI: 0.556-0.564), (2) significant group-level concordance across two independent panels (Kendall's W<!--> <!-->=<!--> <!-->0.544–0.606, all <em>P</em> <!--><<!--> <!-->0.001), and (3) near-perfect cross-panel reliability for 24 overlapping cases (Kendall's τ-b<!--> <!-->=<!--> <!-->0.833–0.880, <em>P</em> <!--><<!--> <!-->0.001), confirming panel homogeneity for subsequent analyses. Inter-rater reliability among the three researchers showed excellent consistency (mean ICC<!--> <!-->=<!--> <!-->0.835, 95% CI: 0.788–0.882, range: 0.736–0.920), paralleled by high intra-rater reliability (mean ICC<!--> <!-->=<!--> <!-->0.832, 95% CI: 0.806–0.858, range: 0.715–0.948) across all 216 cases. Six objective indicators (occlusal relationship, overbite, alignment, overjet, occlusal contact, and buccal-lingual inclination) significantly predicted expert evaluations in a regression model (cumulative R<sup>2</sup> <!-->=<!--> <!-->0.598, <em>P</em> <!--><<!--> <!-->0.001). The threshold values for grading orthodontic treatment outcomes as Excellent, Good, Fair, Poor, and Worst were screened to be 1.846, 2.454, 3.492, and 4.312, respectively.</div></div><div><h3>Conclusions</h3><div>This expert consensus study demonstrated moderate consistency in subjective orthodontic outcome evaluation, with the occlusal relationship emerging as the primary quality determinant. The developed Merge Ranking Method addressed conventional ranking limitations through its innovative two-stage approach: initial segmented evaluation reduced expert fatigue, while subsequent dynamic adjustments improved borderline case classification.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101057"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-29DOI: 10.1016/j.ortho.2025.101062
Tianyi Xie, Boxi Yan
Long-term absence of posterior teeth often leads to significant overeruption of the antagonists, posing a substantial challenge for restorative treatment planning. This case report presents an interdisciplinary approach for a skeletal class II, hyperdivergent patient accompanied by missing maxillary second premolars (15,25), left maxillary second molar (27), mandibular first and second molars (36,37,46,47) and severe overeruption of maxillary first molars (16,17). The maxillary first molars were intruded using both buccal and palatal miniscrews while the existing maxillary spaces were closed. In the mandible, the existing spaces were strategically redistributed through the substitution of third molars for missing second molars, complemented by implant-supported restoration of the first molars. After 35 months of active treatment, well-aligned dentition, ideal intercuspation, and a notably improved facial profile were achieved, which remained stable during the 17 months follow-up. Overeruption resulting from long-standing absence of opposing teeth can be effectively managed through orthodontic intrusion with temporary anchorage devices. The strategic use of existing third molars for space redistribution offers a cost-effective, biologically conservative solution that preserves natural dentition.
{"title":"Interdisciplinary management of a skeletal class II, hyperdivergent patient accompanied by multiple missing teeth and severe overeruption with orthodontic assisted space redistribution and implant restoration","authors":"Tianyi Xie, Boxi Yan","doi":"10.1016/j.ortho.2025.101062","DOIUrl":"10.1016/j.ortho.2025.101062","url":null,"abstract":"<div><div>Long-term absence of posterior teeth often leads to significant overeruption of the antagonists, posing a substantial challenge for restorative treatment planning. This case report presents an interdisciplinary approach for a skeletal class II, hyperdivergent patient accompanied by missing maxillary second premolars (15,25), left maxillary second molar (27), mandibular first and second molars (36,37,46,47) and severe overeruption of maxillary first molars (16,17). The maxillary first molars were intruded using both buccal and palatal miniscrews while the existing maxillary spaces were closed. In the mandible, the existing spaces were strategically redistributed through the substitution of third molars for missing second molars, complemented by implant-supported restoration of the first molars. After 35 months of active treatment, well-aligned dentition, ideal intercuspation, and a notably improved facial profile were achieved, which remained stable during the 17 months follow-up. Overeruption resulting from long-standing absence of opposing teeth can be effectively managed through orthodontic intrusion with temporary anchorage devices. The strategic use of existing third molars for space redistribution offers a cost-effective, biologically conservative solution that preserves natural dentition.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101062"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-08DOI: 10.1016/j.ortho.2025.101078
Yunlin Guan , Wei Liu , Ting Sang , Jun Wu , Shiyun Peng
In this case report, we described the successful treatment of a 17-year-old male with Class II Division 2 and a Brodie occlusion, with bilateral scissor bite, maxillomandibular transverse discrepancy, deep overbite and Class II molar relationship, using a fixed Herbst appliance. The treatment was carried out in two phases. In the first phase, the Herbst appliance was used to advance the mandible, correcting the sagittal relationship while simultaneously improving transverse and vertical discrepancies, with minimal reliance on patient compliance. In the second phase, fixed appliances combined with temporary anchorage devices (TADs) were employed to refine tooth alignment, coordinate the arches, and achieve a stable occlusion. Following treatment, all objectives were achieved, including complete correction of the bilateral scissors-bite, normalization of overjet and overbite, coordinated arch forms, and bilateral Class I molar relationships. The patient's facial profile and smile aesthetics were notably improved. Stability was confirmed after a 3-year retention period. This case highlights the effectiveness of Herbst therapy followed by TAD-assisted orthodontics in achieving functional correction, aesthetic enhancement, and long-term stability in patients with Brodie bite and complex three-dimensional discrepancies.
{"title":"Fixed orthodontics in a Class II Division 2 young adult with Brodie's occlusion and three-dimensional anomalies using a Herbst appliance and miniscrew: A case report","authors":"Yunlin Guan , Wei Liu , Ting Sang , Jun Wu , Shiyun Peng","doi":"10.1016/j.ortho.2025.101078","DOIUrl":"10.1016/j.ortho.2025.101078","url":null,"abstract":"<div><div>In this case report, we described the successful treatment of a 17-year-old male with Class II Division 2 and a Brodie occlusion, with bilateral scissor bite, maxillomandibular transverse discrepancy, deep overbite and Class II molar relationship, using a fixed Herbst appliance. The treatment was carried out in two phases. In the first phase, the Herbst appliance was used to advance the mandible, correcting the sagittal relationship while simultaneously improving transverse and vertical discrepancies, with minimal reliance on patient compliance. In the second phase, fixed appliances combined with temporary anchorage devices (TADs) were employed to refine tooth alignment, coordinate the arches, and achieve a stable occlusion. Following treatment, all objectives were achieved, including complete correction of the bilateral scissors-bite, normalization of overjet and overbite, coordinated arch forms, and bilateral Class I molar relationships. The patient's facial profile and smile aesthetics were notably improved. Stability was confirmed after a 3-year retention period. This case highlights the effectiveness of Herbst therapy followed by TAD-assisted orthodontics in achieving functional correction, aesthetic enhancement, and long-term stability in patients with Brodie bite and complex three-dimensional discrepancies.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101078"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-08DOI: 10.1016/j.ortho.2025.101063
Denise Caffer , Daniela Garib , Carolina Faber , Alexandre Meireles Borba , Luiz Volpato , Rita de Cássia Moura Carvalho Lauris , Araci Malagodi de Almeida , Rafael Guerra Lund
Aim
This study aimed to compare the changes in upper airway dimensions produced by conventional expanders (CE) and differential expanders (DE, which display two parallel jackscrews) in children with bilateral cleft lip and palate (BCLP).
Materials and methods
The initial clinical trial sample included 50 patients with complete BCLP who were treated with RME before the secondary bone graft procedure at a single centre—Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP). The patients were divided into two groups. Group DE were treated with differential expanders, while Group CE received Hyrax expansion during pre-bone graft orthodontics. Pre-expansion (T1) and six months post-expansion (T2) cone-beam computed tomography (CBCT) images were analysed to assess upper airway dimensions, including the nasal cavity, nasopharynx, oropharynx, and total pharyngeal space. Intergroup comparisons were performed using independent T-tests (α = 0.004).
Results
Of the initial 50 patients, the final Group DE consisted of 20 patients with a mean age of 9.07 years while the CE group included 19 patients (13 males and 6 females), with a mean initial age of 9.19 years. No statistically significant differences were observed between the changes of the two groups in the analysed variables, indicating that both expanders had similar effects on increasing upper airway dimensions.
Conclusion
Both CE and DE effectively increase upper airway dimensions in BCLP patients. These findings support that the choice of expander should be guided by the dental upper arch shape and the clinician's preferences.
{"title":"Comparison of differential and conventional rapid maxillary expansion on upper airway dimensions in children with bilateral complete cleft lip and palate: A CBCT-based secondary analysis of a clinical trial","authors":"Denise Caffer , Daniela Garib , Carolina Faber , Alexandre Meireles Borba , Luiz Volpato , Rita de Cássia Moura Carvalho Lauris , Araci Malagodi de Almeida , Rafael Guerra Lund","doi":"10.1016/j.ortho.2025.101063","DOIUrl":"10.1016/j.ortho.2025.101063","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to compare the changes in upper airway dimensions produced by conventional expanders (CE) and differential expanders (DE, which display two parallel jackscrews) in children with bilateral cleft lip and palate (BCLP).</div></div><div><h3>Materials and methods</h3><div>The initial clinical trial sample included 50 patients with complete BCLP who were treated with RME before the secondary bone graft procedure at a single centre—Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP). The patients were divided into two groups. Group DE were treated with differential expanders, while Group CE received Hyrax expansion during pre-bone graft orthodontics. Pre-expansion (T1) and six months post-expansion (T2) cone-beam computed tomography (CBCT) images were analysed to assess upper airway dimensions, including the nasal cavity, nasopharynx, oropharynx, and total pharyngeal space. Intergroup comparisons were performed using independent T-tests (α<!--> <!-->=<!--> <!-->0.004).</div></div><div><h3>Results</h3><div>Of the initial 50 patients, the final Group DE consisted of 20 patients with a mean age of 9.07<!--> <!-->years while the CE group included 19 patients (13 males and 6 females), with a mean initial age of 9.19<!--> <!-->years. No statistically significant differences were observed between the changes of the two groups in the analysed variables, indicating that both expanders had similar effects on increasing upper airway dimensions.</div></div><div><h3>Conclusion</h3><div>Both CE and DE effectively increase upper airway dimensions in BCLP patients. These findings support that the choice of expander should be guided by the dental upper arch shape and the clinician's preferences.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101063"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-10-09DOI: 10.1016/j.ortho.2025.101079
Mohammad Moslem Imani , Arya Imani , Sattar Akbari , Masoud Sadeghi , Annette B. Brühl , Serge Brand
Background and objectives
Obstructive sleep apnea (OSA), marked by recurrent upper airway obstruction during sleep, poses significant risks due to its association with cardiovascular diseases. This study systematically analyzed the link between circulating vascular cell adhesion molecule-1 (VCAM-1) levels and OSA, highlighting its role as a biomarker of endothelial dysfunction and its potential connection to cardiovascular disease.
Material and methods
The databases searched for the meta-analysis included PubMed/Medline, Scopus, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI), up to March 22, 2025. Effect sizes were calculated using the standard mean difference (SMD) with 95% confidence intervals (CIs), and advanced statistical techniques such as subgroup, meta-regression, and sensitivity analyses were employed to ensure the robustness of findings. Additional assessments included publication bias tests and trial sequential analysis to confirm adequate sample size and reliability.
Results
Of 406 identified records, 19 articles (28 studies) met inclusion criteria, revealing significantly higher VCAM-1 levels in OSA patients (SMD = 1.90, 95% CI: 1.45–2.35; P < 0.00001). Subgroup analyses consistently showed elevated VCAM-1 level, with variations across ethnicity and OSA severity, while sensitivity analysis confirmed robustness despite high heterogeneity (I2 = 94%). Publication bias and trial sequential analysis highlighted reliability but emphasized cautious interpretation of results.
Conclusions
VCAM-1 shows potential as a biomarker for OSA, indicating systemic inflammation and endothelial dysfunction linked to cardiovascular risks. Its utility in early detection and treatment development is promising, but further research is needed to validate findings across populations and explore its connection to OSA-related comorbidities for innovative therapies.
背景和目的：阻塞性睡眠呼吸暂停（OSA），以睡眠期间反复出现的上气道阻塞为特征，因其与心血管疾病相关而具有重大风险。本研究系统分析了循环血管细胞粘附分子-1 （VCAM-1）水平与OSA之间的联系，强调了其作为内皮功能障碍的生物标志物的作用及其与心血管疾病的潜在联系。材料与方法：meta分析检索的数据库包括PubMed/Medline、Scopus、Cochrane Library、Web of Science、CNKI，检索截止日期为2025年3月22日。使用95%置信区间（ci）的标准平均差（SMD）计算效应量，并采用亚组、元回归和敏感性分析等先进统计技术来确保结果的稳健性。其他评估包括发表偏倚检验和试验顺序分析，以确认足够的样本量和可靠性。结果：在406篇文献中，有19篇（28项研究）符合纳入标准，显示OSA患者的VCAM-1水平显著升高（SMD=1.90, 95% CI: 1.45-2.35; P2=94%）。发表偏倚和试验序列分析强调可靠性，但强调对结果的谨慎解释。结论：VCAM-1有可能作为OSA的生物标志物，表明全身性炎症和内皮功能障碍与心血管风险相关。它在早期检测和治疗开发中的应用是有希望的，但需要进一步的研究来验证人群的发现，并探索其与osa相关合并症的联系，以进行创新治疗。
{"title":"A systematic review, meta-analysis, and trial sequential analysis on association of circulating vascular cell adhesion molecule-1 (VCAM-1) levels in obstructive sleep apnea adults: A possible link between cardiovascular disease and obstructive sleep apnea","authors":"Mohammad Moslem Imani , Arya Imani , Sattar Akbari , Masoud Sadeghi , Annette B. Brühl , Serge Brand","doi":"10.1016/j.ortho.2025.101079","DOIUrl":"10.1016/j.ortho.2025.101079","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Obstructive sleep apnea (OSA), marked by recurrent upper airway obstruction during sleep, poses significant risks due to its association with cardiovascular diseases. This study systematically analyzed the link between circulating vascular cell adhesion molecule-1 (VCAM-1) levels and OSA, highlighting its role as a biomarker of endothelial dysfunction and its potential connection to cardiovascular disease.</div></div><div><h3>Material and methods</h3><div>The databases searched for the meta-analysis included PubMed/Medline, Scopus, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI), up to March 22, 2025. Effect sizes were calculated using the standard mean difference (SMD) with 95% confidence intervals (CIs), and advanced statistical techniques such as subgroup, meta-regression, and sensitivity analyses were employed to ensure the robustness of findings. Additional assessments included publication bias tests and trial sequential analysis to confirm adequate sample size and reliability.</div></div><div><h3>Results</h3><div>Of 406 identified records, 19 articles (28 studies) met inclusion criteria, revealing significantly higher VCAM-1 levels in OSA patients (SMD<!--> <!-->=<!--> <!-->1.90, 95% CI: 1.45–2.35; <em>P</em> <!--><<!--> <!-->0.00001). Subgroup analyses consistently showed elevated VCAM-1 level, with variations across ethnicity and OSA severity, while sensitivity analysis confirmed robustness despite high heterogeneity (I<sup>2</sup> <!-->=<!--> <!-->94%). Publication bias and trial sequential analysis highlighted reliability but emphasized cautious interpretation of results.</div></div><div><h3>Conclusions</h3><div>VCAM-1 shows potential as a biomarker for OSA, indicating systemic inflammation and endothelial dysfunction linked to cardiovascular risks. Its utility in early detection and treatment development is promising, but further research is needed to validate findings across populations and explore its connection to OSA-related comorbidities for innovative therapies.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101079"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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