Pub Date : 2026-04-01Epub Date: 2025-06-12DOI: 10.1053/j.sodo.2025.06.002
Nikolaos Pandis , Tomasz Burzykowski
Research on digital treatment planning has grown exponentially over the last decade. A question of interest is how closely do the prescribed and achieved tooth movement outcomes agree? Common approaches applied in attempt to answer this question include the use of the correlation coefficient, various accuracy formulas that calculate the percentage of the achieved treatment outcome compared to the prescribed one, or the classical paired t-test comparing the prescribed and achieved outcomes and claiming agreement in case of statistical non-significance. In this article, we explain why such approaches are problematic and should not be used. We describe alternative, more suitable methods based on the concept of clinical equivalence. Clinical equivalence means that differences between prescribed and achieved outcomes that fall in a small, pre-defined range are considered as clinically irrelevant. Appropriate methods include the use of the confidence interval for the mean difference, the two one-sided tests approach (TOST), and statistical modelling. The advantages and disadvantages of the methods are discussed, and applicability and recommendations are provided. Finally, sample size calculation for studies aimed at evaluation of the agreement between the prescribed and achieved tooth movement outcomes is discussed. Regardless of the chosen analytical approach, the selection of the equivalence threshold is paramount to the correct and clinically relevant interpretation of the study results.
{"title":"Comparing prescribed and achieved treatment outcomes in digitally planned orthodontic treatment: statistical approaches","authors":"Nikolaos Pandis , Tomasz Burzykowski","doi":"10.1053/j.sodo.2025.06.002","DOIUrl":"10.1053/j.sodo.2025.06.002","url":null,"abstract":"<div><div><span>Research on digital treatment planning has grown exponentially over the last decade. A question of interest is how closely do the prescribed and achieved tooth movement<span> outcomes agree? Common approaches applied in attempt to answer this question include the use of the correlation coefficient, various accuracy formulas that calculate the percentage of the achieved treatment outcome compared to the prescribed one, or the classical paired t-test comparing the prescribed and achieved outcomes and claiming agreement in case of statistical non-significance. In this article, we explain why such approaches are problematic and should not be used. We describe alternative, more suitable methods based on the concept of clinical equivalence. Clinical equivalence means that differences between prescribed and achieved outcomes that fall in a small, pre-defined range are considered as clinically irrelevant. Appropriate methods include the use of the confidence interval for the mean difference, the two one-sided tests approach (TOST), and </span></span>statistical modelling<span><span>. The advantages and disadvantages of the methods are discussed, and applicability and recommendations are provided. Finally, sample size calculation for studies aimed at evaluation of the agreement between the prescribed and achieved </span>tooth movement outcomes is discussed. Regardless of the chosen analytical approach, the selection of the equivalence threshold is paramount to the correct and clinically relevant interpretation of the study results.</span></div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 308-317"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-10-03DOI: 10.1053/j.sodo.2025.09.021
Mohammed Alsammarraie , Edwin Yen , Dan Romanyk , Paul Major , Abdularaheem Alwafi , Bingshuang Zou
Clear aligner therapy (CAT) has become increasingly popular in orthodontics; however, concerns persist about its predictability and effectiveness. The finite element method (FEM) has become an important tool for studying aligner biomechanics and force delivery, offering insights that are often hard to obtain clinically. This scoping review aimed to map FEM applications in CAT research and critically assess their methodological approaches, highlighting strengths, limitations, and areas for improvement. Six electronic databases were searched up to June 2, 2025. A total of 448 records were screened, resulting in 149 full-text articles, of which 50 met the inclusion criteria. Studies were examined concerning model development, representation of the periodontal ligament (PDL) and bone, material property assignment, meshing strategies, boundary conditions, contact interactions, and post-processing analyses. Significant methodological variation was observed. About half of the studies modeled bone as a single structure, whereas others distinguished cortical from cancellous bone. Most assumed a linear, isotropic PDL, although some employed bilinear or nonlinear viscoelastic models. Boundary conditions usually fixed the maxilla and mandible, while contact constraints connected biologically linked tissues. Meshing strategies differed between native and external software, with tetrahedral elements being most common. Displacement was assessed using either global or local coordinate systems, influencing clinical interpretation. Stress analysis was primarily limited to von Mises stress, although a few reports also included principal stresses. Validation was infrequent, with only isolated attempts using radiological or in vitro data. FEM offers useful insights into CAT biomechanics, but its conclusions are constrained by methodological differences and a lack of validation. Developing standardized protocols is crucial for enhancing reproducibility and clinical applicability.
{"title":"Current practice and application of finite element analysis in clear aligners: A scoping review","authors":"Mohammed Alsammarraie , Edwin Yen , Dan Romanyk , Paul Major , Abdularaheem Alwafi , Bingshuang Zou","doi":"10.1053/j.sodo.2025.09.021","DOIUrl":"10.1053/j.sodo.2025.09.021","url":null,"abstract":"<div><div>Clear aligner therapy (CAT) has become increasingly popular in orthodontics; however, concerns persist about its predictability and effectiveness. The finite element method (FEM) has become an important tool for studying aligner biomechanics and force delivery, offering insights that are often hard to obtain clinically. This scoping review aimed to map FEM applications in CAT research and critically assess their methodological approaches, highlighting strengths, limitations, and areas for improvement. Six electronic databases were searched up to June 2, 2025. A total of 448 records were screened, resulting in 149 full-text articles, of which 50 met the inclusion criteria. Studies were examined concerning model development, representation of the periodontal ligament (PDL) and bone, material property assignment, meshing strategies, boundary conditions, contact interactions, and post-processing analyses. Significant methodological variation was observed. About half of the studies modeled bone as a single structure, whereas others distinguished cortical from cancellous bone. Most assumed a linear, isotropic PDL, although some employed bilinear or nonlinear viscoelastic models. Boundary conditions usually fixed the maxilla and mandible, while contact constraints connected biologically linked tissues. Meshing strategies differed between native and external software, with tetrahedral elements being most common. Displacement was assessed using either global or local coordinate systems, influencing clinical interpretation. Stress analysis was primarily limited to von Mises stress, although a few reports also included principal stresses. Validation was infrequent, with only isolated attempts using radiological or in vitro data. FEM offers useful insights into CAT biomechanics, but its conclusions are constrained by methodological differences and a lack of validation. Developing standardized protocols is crucial for enhancing reproducibility and clinical applicability.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 318-330"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This scoping review aimed to evaluate the accuracy of fully automatic AI-based cephalometric linear and angular measurements - defined as the degree of agreement between AI-generated and manual tracings, expressed as mean differences or mean absolute errors - by synthesizing evidence from comparative studies.
Materials and methods
A systematic search was conducted in PubMed, Web of Science, and Scopus on March 22, 2025, following PRISMA-ScR guidelines. Eligible studies were retrospective validation or comparative studies involving human lateral cephalograms, fully automatic AI analysis tools, and manual cephalometric measurements as the reference. Studies focusing only on landmark detection without measurement comparison were excluded. Data extracted included sample size, AI software used, types of cephalometric parameters analyzed, and accuracy outcomes.
Results
Out of 629 records screened, 10 studies met the inclusion criteria. The included software systems varied (e.g., WebCeph, OrthoDx, CephX, Cephio), and all used manual tracings by orthodontists as the reference. Compared to manual tracing, AI usually showed a good agreement in dental measurements (e.g., U1-NA, L1-NB, IMPA). Conversely, a lower agreement was observed for specific skeletal (e.g., SNA, SNB, GoGn-SN) and soft tissue measurements (e.g., nasolabial angle), with deviations often exceeding 2 mm or 2° compared to the reference. Measurement reproducibility was often high, but did not always equate to accuracy, since many studies reported intraclass correlation coefficient values, which assess reliability and internal consistency rather than capturing the actual magnitude of error when AI measurements are compared with manual tracings.
Conclusions
AI-driven cephalometric measurement tools demonstrate higher accuracy for dental measurements but remain inconsistent for skeletal and soft tissue measurements. Differences in software algorithms and anatomical complexity contribute to variability. Human validation remains essential to ensure clinically reliable measurements.
目的：本综述旨在通过综合来自比较研究的证据，评估全自动基于人工智能的头颅测量线性和角度测量的准确性——定义为人工智能生成的和人工跟踪之间的一致程度，以平均差异或平均绝对误差表示。材料和方法按照PRISMA-ScR指南，于2025年3月22日在PubMed、Web of Science和Scopus中进行了系统检索。符合条件的研究是回顾性验证或比较研究，涉及人类侧位脑电图、全自动人工智能分析工具和手动测量作为参考。排除了仅关注地标检测而不进行测量比较的研究。提取的数据包括样本量、使用的人工智能软件、分析的头颅测量参数类型和准确性结果。结果在筛选的629份文献中，有10项研究符合纳入标准。所包含的软件系统各不相同（例如，WebCeph, OrthoDx, CephX, Cephio），并且都使用正畸医生的手动跟踪作为参考。与人工追踪相比，人工智能通常在牙齿测量（例如，U1-NA, L1-NB， IMPA）中显示出良好的一致性。相反，对特定骨骼（如SNA、SNB、GoGn-SN）和软组织测量（如鼻唇角）的一致性较低，与参考值相比偏差通常超过2mm或2°。测量的再现性通常很高，但并不总是等同于准确性，因为许多研究报告了类内相关系数值，这些值评估的是可靠性和内部一致性，而不是捕捉人工智能测量与人工跟踪比较时的实际误差程度。结论ai驱动的头颅测量工具对牙齿测量具有较高的准确性，但对骨骼和软组织测量仍不一致。软件算法和解剖复杂性的差异导致了变异。人体验证仍然是确保临床可靠测量的必要条件。
{"title":"Accuracy of artificial intelligence fully-automatic cephalometric analysis in linear and angular measurement: a critical scoping review","authors":"Alessandro Polizzi , Ludovica Nucci , Sara Serra , Gaetano Isola , Rosalia Leonardi","doi":"10.1053/j.sodo.2025.08.008","DOIUrl":"10.1053/j.sodo.2025.08.008","url":null,"abstract":"<div><h3>Aim</h3><div>This scoping review aimed to evaluate the accuracy of fully automatic AI-based cephalometric linear and angular measurements - defined as the degree of agreement between AI-generated and manual tracings, expressed as mean differences or mean absolute errors - by synthesizing evidence from comparative studies.</div></div><div><h3>Materials and methods</h3><div>A systematic search was conducted in PubMed, Web of Science, and Scopus on March 22, 2025, following PRISMA-ScR guidelines. Eligible studies were retrospective validation or comparative studies involving human lateral cephalograms, fully automatic AI analysis tools, and manual cephalometric measurements as the reference. Studies focusing only on landmark detection without measurement comparison were excluded. Data extracted included sample size, AI software used, types of cephalometric parameters analyzed, and accuracy outcomes.</div></div><div><h3>Results</h3><div>Out of 629 records screened, 10 studies met the inclusion criteria. The included software systems varied (e.g., WebCeph, OrthoDx, CephX, Cephio), and all used manual tracings by orthodontists as the reference. Compared to manual tracing, AI usually showed a good agreement in dental measurements (e.g., U1-NA, L1-NB, IMPA). Conversely, a lower agreement was observed for specific skeletal (e.g., SNA, SNB, GoGn-SN) and soft tissue measurements (e.g., nasolabial angle), with deviations often exceeding 2 mm or 2° compared to the reference. Measurement reproducibility was often high, but did not always equate to accuracy, since many studies reported intraclass correlation coefficient values, which assess reliability and internal consistency rather than capturing the actual magnitude of error when AI measurements are compared with manual tracings.</div></div><div><h3>Conclusions</h3><div>AI-driven cephalometric measurement tools demonstrate higher accuracy for dental measurements but remain inconsistent for skeletal and soft tissue measurements. Differences in software algorithms and anatomical complexity contribute to variability. Human validation remains essential to ensure clinically reliable measurements.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 397-403"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-07-17DOI: 10.1053/j.sodo.2025.07.006
Sanghee Lee , Greg J. Huang , Hayley Cowan , Yushan Huang
This article describes a novel maxillary regional superimposition method using pre- and post-treatment Cone-Beam Computed Tomography (CBCT) images and intraoral scans (IOS). 10 pre- and post-treatment CBCT and IOS were utilized to create virtual 3D models. These models were generated by merging CBCT and IOS data within image processing software. The fused models were then exported in STL format for superimposition. Initial rough alignment of pre- and post-treatment models was performed automatically using the Iterative closest point (ICP) algorithm, followed by manual refinement. To ensure accuracy and reliability, a root mean square (RMS) error and intra- and inter-rater reliability test were conducted, respectively. Color-coded distance maps allow visualization of tooth positional changes. By employing this maxillary regional superimposition technique fusing CBCT and IOS scans, a more robust, precise and comprehensive assessment of skeletal and dental changes during treatment is possible.
{"title":"A novel technique for maxillary regional superimposition using merged CBCTs and intra-oral scans","authors":"Sanghee Lee , Greg J. Huang , Hayley Cowan , Yushan Huang","doi":"10.1053/j.sodo.2025.07.006","DOIUrl":"10.1053/j.sodo.2025.07.006","url":null,"abstract":"<div><div>This article describes a novel maxillary regional superimposition method using pre- and post-treatment Cone-Beam Computed Tomography (CBCT) images and intraoral scans (IOS). 10 pre- and post-treatment CBCT and IOS were utilized to create virtual 3D models. These models were generated by merging CBCT and IOS data within image processing software. The fused models were then exported in STL format for superimposition. Initial rough alignment of pre- and post-treatment models was performed automatically using the Iterative closest point (ICP) algorithm, followed by manual refinement. To ensure accuracy and reliability, a root mean square (RMS) error and intra- and inter-rater reliability test were conducted, respectively. Color-coded distance maps allow visualization of tooth positional changes. By employing this maxillary regional superimposition technique fusing CBCT and IOS scans, a more robust, precise and comprehensive assessment of skeletal and dental changes during treatment is possible.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 381-386"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
External apical root resorption (EARR) is a significant complication of orthodontic treatment, characterized by varying degrees of root loss due to patient and treatment related factors. In this study, we investigated genes previously implicated in post-orthodontic EARR.
Methods
Using the gnomAD database, we evaluated these genes for intolerance to genetic variation and assessed the ethnic distribution of loss-of-function (LoF) variants. The DOMINO algorithm was employed to predict inheritance patterns, while the STRING database was used to investigate protein-protein interactions and enriched biological processes.
Results
The constraint metrics for LRP1 and LRP6 suggested strong intolerance to LoF variants, whereas TNFRSF11B, TNFSF11, and IL-1B suggested moderate intolerance. Inheritance pattern analysis indicated that TNFRSF11B, IL-1B, TNFSF11, SFRP2, VDR, WNT3A, LRP6, and LRP1 are 'very likely dominant'; CASP1, IL-6, and TNFRSF11A are 'likely dominant'; and the remaining genes are 'likely or very likely recessive' except for SPP1, which may be 'either dominant or recessive'. Pathogenic or likely pathogenic variants in LRP1, LRP6, VDR, TNFRSF11A, TNFRSF11B, IL-1RN, and TNFSF11 were identified in five or more ethnic groups, suggesting that the genetic risk for EARR is broadly distributed. LRP1 and IL-1RN variants were most frequent in European (Finnish) and East Asian populations, respectively. Key biological pathways identified included the positive regulation of prostaglandin secretion and bone resorption.
Conclusions
These results are derived from computational analyses, and the gnomAD database does not include EARR-specific phenotypic data. Nonetheless, understanding the genetic architecture of EARR is important for improving risk stratification, diagnosis, and individualized treatment planning. Prospective studies involving patients with EARR are needed to validate these findings and determine their clinical relevance.
{"title":"Computational characterization of variants observed in gnomAD database and functional enrichment of genes implicated in external apical root resorption","authors":"Luke Hovey , Helda Said , Aline Petrin , Lina Moreno–Uribe , Negin Katebi , Veerasathpurush Allareddy , Shankar Rengasamy Venugopalan","doi":"10.1053/j.sodo.2025.12.003","DOIUrl":"10.1053/j.sodo.2025.12.003","url":null,"abstract":"<div><h3>Objective</h3><div>External apical root resorption (EARR) is a significant complication of orthodontic treatment, characterized by varying degrees of root loss due to patient and treatment related factors. In this study, we investigated genes previously implicated in post-orthodontic EARR.</div></div><div><h3>Methods</h3><div>Using the gnomAD database, we evaluated these genes for intolerance to genetic variation and assessed the ethnic distribution of loss-of-function (LoF) variants. The DOMINO algorithm was employed to predict inheritance patterns, while the STRING database was used to investigate protein-protein interactions and enriched biological processes.</div></div><div><h3>Results</h3><div>The constraint metrics for <em>LRP1</em> and <em>LRP6</em> suggested strong intolerance to LoF variants, whereas <em>TNFRSF11B, TNFSF11,</em> and <em>IL-1B</em> suggested moderate intolerance. Inheritance pattern analysis indicated that <em>TNFRSF11B, IL-1B, TNFSF11, SFRP2, VDR, WNT3A, LRP6,</em> and <em>LRP1</em> are 'very likely dominant'; <em>CASP1, IL-6</em>, and <em>TNFRSF11A</em> are 'likely dominant'; and the remaining genes are 'likely or very likely recessive' except for <em>SPP1,</em> which may be 'either dominant or recessive'. Pathogenic or likely pathogenic variants in <em>LRP1, LRP6, VDR, TNFRSF11A, TNFRSF11B, IL-1RN</em>, and <em>TNFSF11</em> were identified in five or more ethnic groups, suggesting that the genetic risk for EARR is broadly distributed. <em>LRP1</em> and <em>IL-1RN</em> variants were most frequent in European (Finnish) and East Asian populations, respectively. Key biological pathways identified included the positive regulation of prostaglandin secretion and bone resorption.</div></div><div><h3>Conclusions</h3><div>These results are derived from computational analyses, and the gnomAD database does not include EARR-specific phenotypic data. Nonetheless, understanding the genetic architecture of EARR is important for improving risk stratification, diagnosis, and individualized treatment planning. Prospective studies involving patients with EARR are needed to validate these findings and determine their clinical relevance.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 410-417"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-13DOI: 10.1053/S1073-8746(26)00010-1
{"title":"FMii --- Table of Contents","authors":"","doi":"10.1053/S1073-8746(26)00010-1","DOIUrl":"10.1053/S1073-8746(26)00010-1","url":null,"abstract":"","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages v-vi"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-12-02DOI: 10.1053/j.sodo.2025.11.011
Nikhillesh Vaiid , Reem A. Alansari
As Seminars in Orthodontics commemorates three decades, this editorial reflects on the journal's role in bridging empirical evidence and practical orthodontic insights. The rise of IMRAD-structured reporting has enhanced transparency, yet narrative reviews remain crucial for contextualizing heterogeneous data, unpacking conceptual tensions, and guiding clinical judgment. This issue celebrates structured science alongside historical context, rationale, and technique, areas where IMRAD alone falls short. We advocate for methodological rigor and transparency in narrative reviews, integrating structured approaches without compromising interpretive depth. Preserving this scholarship requires cultural and procedural shifts, valuing careful synthesis alongside novelty. Future directions include standardized reporting, impact assessment, enhanced training, and innovative editorial processes, ensuring continued intellectual significance.
{"title":"Enduring value of narrative reviews in orthodontics: Integrating story and structure beyond IMRAD in contemporary scholarly discourse","authors":"Nikhillesh Vaiid , Reem A. Alansari","doi":"10.1053/j.sodo.2025.11.011","DOIUrl":"10.1053/j.sodo.2025.11.011","url":null,"abstract":"<div><div>As <em>Seminars in Orthodontics</em> commemorates three decades, this editorial reflects on the journal's role in bridging empirical evidence and practical orthodontic insights. The rise of IMRAD-structured reporting has enhanced transparency, yet narrative reviews remain crucial for contextualizing heterogeneous data, unpacking conceptual tensions, and guiding clinical judgment. This issue celebrates structured science alongside historical context, rationale, and technique, areas where IMRAD alone falls short. We advocate for methodological rigor and transparency in narrative reviews, integrating structured approaches without compromising interpretive depth. Preserving this scholarship requires cultural and procedural shifts, valuing careful synthesis alongside novelty. Future directions include standardized reporting, impact assessment, enhanced training, and innovative editorial processes, ensuring continued intellectual significance.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 269-274"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-08-05DOI: 10.1053/j.sodo.2025.07.014
Akriti Tiwari , Arnaldo Perez-Garcia , Carlos Flores-Mir
Malocclusion, a misalignment of teeth, affects over 50% of adolescents globally. It significantly impedes functional well-being and contributes to psychological distress. While removable orthodontic appliances (ROAs) are clinically effective in addressing malocclusion, adherence to recommended treatment regimens remains challenging, with poor adherence rates ranging from 43% to 50% among adolescents. Theoretically-informed interventions have proven effective in addressing adherence to treatment recommendations. This paper discusses the Theoretical Domains Framework (TDF) and the Integrative Model of Behavioral Prediction (IMBP) as conceptual frameworks that can guide efforts to bridge the gap between research findings on treatment adherence and their implementation. Traditional knowledge translation (KT) approaches need to be complemented by behavioral change approaches to address the poor adherence to wearing ROAs. The paper recommends theory-informed, evidence-based behavioral interventions, such as motivational interviewing, peer support programs, and audit and feedback. These interventions are specifically designed to address proximal determinants of behaviors, including motivation, social norms, affective responses, and perceived behavioral control, which can lead to better orthodontic outcomes, shorter treatment times, and more efficient healthcare. This perspective paper aims to guide future initiatives focused on developing and evaluating strategies to improve adolescents' adherence to removable orthodontic appliances.
{"title":"A knowledge translation perspective on improving adherence to removable appliances in adolescents","authors":"Akriti Tiwari , Arnaldo Perez-Garcia , Carlos Flores-Mir","doi":"10.1053/j.sodo.2025.07.014","DOIUrl":"10.1053/j.sodo.2025.07.014","url":null,"abstract":"<div><div>Malocclusion, a misalignment of teeth, affects over 50% of adolescents globally. It significantly impedes functional well-being and contributes to psychological distress. While removable orthodontic appliances (ROAs) are clinically effective in addressing malocclusion, adherence to recommended treatment regimens remains challenging, with poor adherence rates ranging from 43% to 50% among adolescents. Theoretically-informed interventions have proven effective in addressing adherence to treatment recommendations. This paper discusses the Theoretical Domains Framework (TDF) and the Integrative Model of Behavioral Prediction (IMBP) as conceptual frameworks that can guide efforts to bridge the gap between research findings on treatment adherence and their implementation. Traditional knowledge translation (KT) approaches need to be complemented by behavioral change approaches to address the poor adherence to wearing ROAs. The paper recommends theory-informed, evidence-based behavioral interventions, such as motivational interviewing, peer support programs, and audit and feedback. These interventions are specifically designed to address proximal determinants of behaviors, including motivation, social norms, affective responses, and perceived behavioral control, which can lead to better orthodontic outcomes, shorter treatment times, and more efficient healthcare. This perspective paper aims to guide future initiatives focused on developing and evaluating strategies to improve adolescents' adherence to removable orthodontic appliances.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 289-294"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-06-30DOI: 10.1053/j.sodo.2025.06.009
Veerasathpurush Allareddy , Rahma Mungia , Min Kyeong Lee , Maysaa Oubaidin , Gregg H. Gilbert , National Dental Practice-Based Research Network Collaborative Group
Practice-Based Research Networks (PBRN) are optimal settings for research to be conducted in the real world of clinical practice where the majority of care is provided. In this narrative review, we provide an overview of the National Dental Practice-Based Research Network (Network), which is one of the largest and most successful Dental PBRNs, and its impact on orthodontics. The Network is currently in its third seven-year round of funding and has conducted 58 studies to date. There are over 8,000 members enrolled in the Network. The largest prospective cohort study on anterior open bites was conducted through the Network. The Network provides resources and opportunities to engage clinicians in practice-based participatory research where clinical studies with direct impact on clinical outcomes are conducted.
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Pub Date : 2026-04-01Epub Date: 2025-07-29DOI: 10.1053/j.sodo.2025.07.007
Tony Weir, Maurice J Meade
Recent years have seen an increase in aligner use by orthodontists and an increase in corresponding research. Potential deficiencies in aligner and auxiliary material properties and design, and wear protocols have been suggested as contributory factors in sub-optimal clear aligner therapy (CAT) outcomes. The aim of the present narrative review was to summarise the evidence regarding five specific factors to be considered in the choice of a clear aligner system. The findings indicated that the use of aligners with variable moduli of elasticity may offer the potential for improved treatment outcomes, with simple alignment using softer materials and more complex movements with higher modulus materials. CAT using straight extended trimlines provide better, larger areas of contact with tooth surfaces. This potentially improves force delivery to achieve more ideal tooth movement. The findings of the present review indicated that optimised attachments do not confer significant clinical advantages over conventional attachments. Aligner wear protocols should be determined by the case-specific features of biology and the type of tooth movement to be performed. Bite ramps and torque ridges are not efficacious in managing deep overbite and lingual root torque.
{"title":"Optimising clear aligner therapy: What current evidence says about materials, attachments, and protocols","authors":"Tony Weir, Maurice J Meade","doi":"10.1053/j.sodo.2025.07.007","DOIUrl":"10.1053/j.sodo.2025.07.007","url":null,"abstract":"<div><div>Recent years have seen an increase in aligner use by orthodontists and an increase in corresponding research. Potential deficiencies in aligner and auxiliary material properties and design, and wear protocols have been suggested as contributory factors in sub-optimal clear aligner therapy (CAT) outcomes. The aim of the present narrative review was to summarise the evidence regarding five specific factors to be considered in the choice of a clear aligner system. The findings indicated that the use of aligners with variable moduli of elasticity may offer the potential for improved treatment outcomes, with simple alignment using softer materials and more complex movements with higher modulus materials. CAT using straight extended trimlines provide better, larger areas of contact with tooth surfaces. This potentially improves force delivery to achieve more ideal tooth movement. The findings of the present review indicated that optimised attachments do not confer significant clinical advantages over conventional attachments. Aligner wear protocols should be determined by the case-specific features of biology and the type of tooth movement to be performed. Bite ramps and torque ridges are not efficacious in managing deep overbite and lingual root torque.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 2","pages":"Pages 376-380"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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