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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry and Oral Sciences".

Deadline for manuscript submissions: 20 October 2026 | Viewed by 16996

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Dr. Nunzio Cirulli

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Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Interests: bone and teeth biology; orthodontics; dental movement; dental materials

Special Issue Information

Dear Colleagues,

In recent years, the field of orthodontics has progressed significantly. With rapid advancements in technology, orthodontics is experiencing a transformative shift, offering more efficient, comfortable, and effective treatments. As we look to the future, several emerging technologies and innovations are set to redefine orthodontic care.

Modern orthodontics not only aims to straighten teeth, but it also aims to provide a holistic approach to oral health, jaw alignment, and improvements in the quality of life for patients of all ages.

As we explore these groundbreaking developments, we will also shed light on how these technologies are making orthodontic care more accessible and customized. Therefore, the scope of this Special Issue includes the integration of interdisciplinary approaches, the use of smart technologies, and the promising future of biodegradable materials and personalized medicine in orthodontics.

Furthermore, 3D printing is a particularly exciting advancement in orthodontics. This technology enables the creation of highly customized orthodontic appliances, including aligners, brackets, and retainers.

Artificial Intelligence (AI) is transforming orthodontic diagnostics and treatment planning. Machine learning algorithms can analyze vast amounts of data to predict treatment outcomes with high accuracy. This allows orthodontists to develop more effective and personalized treatment plans based on the predicted movement of teeth.

AI-powered software can monitor a patient’s progress in real time, ensuring that the treatment is on course. This technology can alert orthodontists to any issues that may require adjustments, allowing for timely interventions and reducing the overall treatment duration.

Clear aligners are becoming more integrated with digital platforms, allowing for the enhanced monitoring of treatment progress. Patients can use apps to monitor the usage and progress of their aligners, while orthodontists can access these data to make informed decisions about the treatment plan.

Smart braces equipped with sensors can monitor the forces applied to teeth and relay this information to the orthodontist. These data enable precise adjustments to be made and ensure that the treatment is progressing as planned. Sensors in orthodontic appliances can also track how often patients wear their aligners or follow other treatment protocols.

The importance of technology in orthodontics extends beyond just operational efficiency; it significantly enhances patient outcomes and provides a more streamlined treatment experience.

The main objective of this Special Issue is to collect original articles that present recent experimental research, clinical procedures and innovations that are redefining orthodontic care.

This list does not exclude other areas of research that are related to orthodontic techniques that are enhancing the experience of patients and treatment outcomes.

In this Special Issue, original research articles and reviews are welcome. Research areas may include, but are not limited to, the following:

technology in orthodontics
3D printing in orthodontics
clear aligners
customized orthodontics
Artificial Intelligence in orthodontics

We look forward to receiving your contributions.

Dr. Nunzio Cirulli
Guest Editor

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Keywords

orthodontics
technology in orthodontics
3D printing in orthodontics
clear aligners, customized orthodontics
artificial Intelligence in orthodontics
biomechanics
early treatment
miniscrews

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Published Papers (9 papers)

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Research

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13 pages, 6050 KB

Open AccessArticle

In Vitro and In Vivo Performance of the Leaf Expander^®: Agreement Between Laboratory Testing and Clinical Expansion

by Valentina Lanteri, Andrea Abate, Cinzia Maspero, Talita Deiana, Francesca Silvestrini-Biavati and Alessandro Ugolini

Appl. Sci. 2026, 16(9), 4321; https://doi.org/10.3390/app16094321 - 29 Apr 2026

Viewed by 161

Abstract

(1) Background: Posterior crossbite associated with maxillary transverse deficiency is commonly managed with maxillary expansion, yet the correspondence between laboratory activation behavior and the clinical response of nickel–titanium leaf-spring expanders remains insufficiently defined; therefore, this study aimed to compare in vitro and in vivo performance of the Leaf Expander^® and to assess their agreement. (2) Methods: A retrospective sample of 15 mixed-dentition patients (7–10 years) treated at two university centers with a Leaf Expander^® (6 mm screw; 900 g) was evaluated; interpremolar (E–E), intermolar (6–6), and intercanine (C–C) distances were recorded at baseline (T0, digital models) and at follow-up visits (T1–T5, caliper measurements), while mechanical compression testing (Instron 3365) quantified force release across the activation sequence; normality (Shapiro–Wilk), parametric analyses, and Pearson correlation were used. (3) Results Posterior crossbite correction was achieved in all completed cases, with mean total increases (T0–T5) of 5.4 mm (E–E), 4.4 mm (6–6), and 6.0 mm (C–C); early expansion (T1–T0) averaged 2.5 mm at E–E, and laboratory curves showed an activation peak followed by sustained force release (~6.5–9 N) and a residual-load phase. Agreement between declared activation and clinical response was higher for E–E and 6–6 than for C–C, which showed greater variability. (4) Conclusions: These findings support the Leaf Expander^® as an effective compliance-free slow expansion device and indicate that laboratory force behavior can help interpret the clinical expansion timeline, including delayed expression after activation. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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16 pages, 300 KB

Open AccessArticle

Self-Perceived vs. Clinically Assessed Malocclusion in Adolescents: A Cross-Sectional Study

by Lucia Giannini, Federica Macrì, Giovanni Cattaneo, Gianna Dipalma, Francesco Inchingolo and Cinzia Maspero

Appl. Sci. 2026, 16(8), 3822; https://doi.org/10.3390/app16083822 - 14 Apr 2026

Viewed by 305

Abstract

Background: Malocclusion can influence not only oral function, but also adolescents’ perception of dental appearance, psychosocial status, and oral health-related quality of life. The present cross-sectional study aimed to examine the association between the clinical severity of malocclusion and adolescents’ self-perception, as well as to assess the level of agreement between clinician and patient ratings of aesthetic impairment. Methods: The study included 160 consecutive adolescents aged 12 to 17 years who were referred for orthodontic evaluation. Malocclusion severity was determined using the Index of Orthodontic Treatment Need (IOTN), considering both the Dental Health Component (DHC) and the Aesthetic Component (AC). Patients’ perceptions of malocclusion severity, aesthetic concerns, and functional limitations were collected through numeric rating scales, while psychosocial impact was measured using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Correlations were examined with Spearman’s coefficients, agreement between clinician- and self-rated AC scores was evaluated with weighted kappa statistics, and multivariable regression analyses were used to identify independent predictors of patient-reported outcomes. Results: Moderate positive correlations emerged between IOTN-DHC and self-perceived malocclusion severity (rho = 0.42, p < 0.001), and between clinician-rated IOTN-AC and self-perceived severity (rho = 0.47, p < 0.001). Associations were stronger for aesthetic and psychosocial measures than for functional complaints, with the highest correlation observed between clinician-rated IOTN-AC and perceived aesthetic impact (rho = 0.58, p < 0.001). Greater clinical severity was also associated with increased psychosocial burden, as reflected by higher PIDAQ total scores. Agreement between clinician and patient evaluations of aesthetic impairment was fair to moderate (weighted kappa = 0.34) but improved when AC scores were grouped into broader categories (weighted kappa = 0.46). Overall, adolescents tended to perceive their dental aesthetic impairment as more severe than did clinicians. In the multivariable models, clinician-rated IOTN-AC remained an independent predictor of perceived severity, aesthetic impact, and psychosocial burden. Conclusions: Clinical measures of malocclusion severity and adolescents’ self-perception were significantly related, although they reflected partly different aspects of orthodontic treatment need. Combining normative clinical indices with patient-reported outcomes may allow a more complete and patient-centred evaluation of malocclusion. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

10 pages, 819 KB

Open AccessArticle

Comparison of Digital and Traditional Methods for Occlusal Contact Assessment: An Experimental Cross-Sectional Study

by Luca Levrini, Alessandro Deppieri, Andrea Ugas, Piero Antonio Zecca, Salvatore Bocchieri, Stefano Saran, Nicola Giannotta, Alessandro Manelli, Paolo Broido and Andrea Carganico

Appl. Sci. 2026, 16(1), 132; https://doi.org/10.3390/app16010132 - 22 Dec 2025

Viewed by 1353

Abstract

This cross-sectional experimental study compared a digital intraoral-scanner-based method with a traditional wax-registration method for the quantitative assessment of static occlusal contacts. Twenty adults with natural dentition were evaluated using an intraoral scan analyzed through a Java-based software (PixCount.java, version 1.0, version 1.0, University of Insubria, Varese, Italy) and wax registration analyzed with Z_TMJ software (Z_TMJ, version 1.0, University of Insubria, Varese, Italy). The primary outcome was the percentage distribution of static occlusal contacts between hemi-arches. A paired t-test and the intraclass correlation coefficient (ICC) were used to evaluate differences and agreement. Mean contact distribution was 49.75 ± 3.44% for the digital method and 48.02 ± 5.31% for the wax method. No statistically significant difference was observed (p > 0.05), and agreement analysis showed moderate concordance (ICC ≈ 0.43). Digital analysis provided superior visualization and workflow efficiency, whereas wax registration remained a practical, low-cost option. These findings indicate that both methods provide clinically meaningful information, with the digital approach offering additional practical advantages. The observed consistency between the two techniques supports the expanding role of digital tools in routine occlusal assessment. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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12 pages, 1455 KB

Open AccessArticle

Effects on Condylar Position of Head Flexion Typically Induced by the Use of Portable Electronic Devices: An Observational Study

by Marian Turbatu, Laura Pittari, Francesco Ferrini, Teresa Laborante, Alessandro Nota and Simona Tecco

Appl. Sci. 2025, 15(24), 13245; https://doi.org/10.3390/app152413245 - 17 Dec 2025

Viewed by 836

Abstract

The widespread use of portable electronic devices has increasingly promoted the prolonged maintenance of non-physiological postures, particularly anterior and downward head flexion. Therefore, this study aimed to analyze the condylar and incisor relationship displacement induced by this improper posture. A total of 20 adult subjects (9 F, 11 M; mean age 27 ± 5) were recruited at the Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy. Mandibular kinematics was recorded using JMA-Optic AG (Zebris Medical GmbH, Isny, Germany). The protocol adopted consisted of three phases: (1) Habitual occlusion with light clenching, (2) Neuromuscular rest position (RP) verified by surface electromyography (sEMG), (3) Anterior head flexion (40–60°) (HF), simulating the posture typically observed during portable digital device use. Millimetric measurements of condylar displacement from RP to HF and incisal plane changes were collected. Data were analyzed descriptively with Microsoft Excel, and inferentially with StatPlus Pro (AnalystSoft, StatPlus: mac Pro, version 8). The right condyle exhibited a mean displacement of 1.9 mm in the downward direction (p < 0.001), while the left condyle showed a downward displacement of 1.5 mm (p < 0.001). No significant difference was observed between the two sides. At the dental level, the lower incisor revealed a mean shift of 1.0 mm superiorly (p < 0.001) and 0.7 mm anteriorly (p < 0.001). The HF determines a significant condylar and incisal plane displacement, and may predispose individuals to TMJ disorders, supporting the hypothesis of an emerging cranio-cervico-mandibular condition linked to prolonged use of high-tech display terminals, here proposed as ED-TMD (Electronic Device-Induced Temporomandibular Disorder). Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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12 pages, 938 KB

Open AccessArticle

Comparison of the Predictability of Dentoalveolar Expansion with Different Aligner Systems in Orthodontics: A Longitudinal Clinical Study in Adult Patients

by Oscar Suarez, Alfonso Alvarado-Lorenzo, Elena Calzadilla-Suárez, Giuseppe Scuzzo, Jhonny León-Valencia, Carlos Colino-Paniagua, Jose Manuel Granero-Marín and Pedro Colino-Gallardo

Appl. Sci. 2025, 15(16), 9074; https://doi.org/10.3390/app15169074 - 18 Aug 2025

Cited by 2 | Viewed by 9074

Abstract

Aligners represent a therapeutic option in orthodontics, offering advantages such as aesthetics, comfort, and individualized prescriptions for each patient. However, the predictability of maxillary expansion is subject to variability. The objective of this article is to evaluate the efficacy and predictability of aligners in maxillary expansion. One hundred adult patients were included in this study, divided into four groups, each assigned to a different brand of clear aligners: Angel Aligners, Invisalign, Spark, or HeySmile. Digital models were obtained at three stages: initial STL (T1), prediction (T2), and final (T3) (before the first refinement). The models were measured to obtain linear distances between canines, first bicuspids, second bicuspids, and first molars. Statistical analysis was performed using SPSS 28.0. The best predictability was obtained in the lower arch (68.900%) for second bicuspids, while the worst accuracy was for canines (39.290% in the upper arch using Invisalign). Angel aligner showed the highest percentage of predictability (60.002%) among the evaluated brands, followed by HeySmile (59.895%), Spark (59.275%), and Invisalign (57.153%). The results show that clear aligners are an effective treatment for transverse movements in both arches. However, further research is needed to improve predictability. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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16 pages, 3450 KB

Open AccessArticle

Comparative In Vitro Analysis of Composite Resins Used in Clear Aligner Attachments

by Francesca Gazzani, Denise Bellisario, Chiara Pavoni, Loredana Santo, Paola Cozza and Roberta Lione

Appl. Sci. 2025, 15(15), 8698; https://doi.org/10.3390/app15158698 - 6 Aug 2025

Cited by 1 | Viewed by 1441

Abstract

Background: Attachments are essential components in clear aligner therapy, enhancing retention and improving the predictability of tooth movements. Mechanical and wear properties of the composite resins used for attachment reproduction are critical to maintaining their integrity and shape over time. This study aimed to evaluate and compare the mechanical properties, thermal behavior, and wear performance of the hybrid composite Aligner Connect (AC) and the flowable resin (Connect Flow, CF). Methods: Twenty samples (ten AC and ten CF) were reproduced. All specimens underwent differential scanning calorimetry (DSC), combustion analysis, flat instrumented indentation, compression stress relaxation tests, and tribological analysis. A 3D wear profile reconstruction was performed to assess wear surfaces. Results: DSC and combustion analyses revealed distinct thermal transitions, with CF showing significantly lower Tg values (103.8 °C/81.4 °C) than AC (110.8 °C/89.6 °C) and lower residual mass after combustion (23% vs. 61%), reflecting reduced filler content and greater polymer mobility. AC exhibited superior mechanical properties, with higher maximum load (585.9 ± 22.36 N) and elastic modulus (231.5 ± 9.1 MPa) than CF (290.2 ± 5.52 N; 156 ± 10.5 MPa). Stress relaxation decrease was less pronounced in AC (18 ± 4%) than in CF (20 ± 4%). AC also showed a significantly higher friction coefficient (0.62 ± 0.060) than CF (0.55 ± 0.095), along with greater wear volume (0.012 ± 0.0055 mm³ vs. 0.0070 ± 0.0083 mm³) and maximum depth (36.88 ± 3.642 µm vs. 17.91 ± 3.387 µm). Surface roughness before wear was higher for AC (Ra, 0.577 ± 0.035 µm; Rt, 4.369 ± 0.521 µm) than for CF (Ra, 0.337 ± 0.070 µm; Rt, 2.862 ± 0.549 µm). After wear tests, roughness values converged (Ra, 0.247 ± 0.036 µm for AC; Ra, 0.236 ± 0.019 µm for CF) indicating smoothened and similar surfaces for both composites. Conclusions: The hybrid nanocomposite demonstrated greater properties in terms of stiffness, load-bearing capacity, and structural integrity when compared with flowable resin. Its use may ensure more durable attachment integrity and improved aligner–tooth interface performance over time. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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Review

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15 pages, 1131 KB

Open AccessReview

Current Evidence of Artificial Intelligence Tools Applied in Pediatric Dentistry: A Narrative Review

by Antonino Lo Giudice

Appl. Sci. 2026, 16(9), 4492; https://doi.org/10.3390/app16094492 - 2 May 2026

Abstract

Background. Artificial intelligence (AI) is increasingly recognized as a transformative technology in healthcare, with growing interest in its applications within pediatric dentistry. Given the unique clinical, developmental, and behavioral characteristics of pediatric patients, AI-based systems may offer valuable support in improving diagnosis, prevention, and treatment planning. Methods. A narrative review was conducted to synthesize current evidence on AI applications in pediatric dentistry. A comprehensive search strategy, including predefined keywords and free terms, was applied across multiple databases (Embase, Scopus, PubMed, and Web of Science) up to 1 January 2026. Reviews addressing AI-based technologies in pediatric dental care were selected and analyzed. Results. The available literature indicates that AI is being progressively applied across multiple domains of pediatric dentistry, although with varying levels of evidence. More extensively investigated areas include diagnostic imaging, caries detection, orthodontic assessment, and growth evaluation, where AI systems—particularly those based on machine learning and deep learning—have demonstrated high accuracy and reproducibility. Other emerging fields, such as remote monitoring, behavioral management, preventive strategies, and patient education, show promising potential but remain less explored. Overall, AI-based tools appear to enhance diagnostic support, enable early detection of oral conditions, and contribute to more personalized and efficient clinical workflows. Conclusions. AI represents a rapidly evolving adjunct in pediatric dentistry with the potential to improve clinical decision-making, preventive care, and patient management. Despite encouraging results, further validation in real-world settings, along with careful consideration of ethical, legal, and data-related challenges, is required to support its responsible integration into routine clinical practice. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

20 pages, 1308 KB

Open AccessReview

Presurgical Orthopedic Interventions in Cleft Lip and Palate: A Scoping Review of Current Approaches and Evidence Distribution

by Ana Catarina Machado, Inês Francisco, Carlos Miguel Marto, Raquel Travassos, Catarina Nunes, Catarina Oliveira, Anabela Baptista Paula and Francisco Vale

Appl. Sci. 2026, 16(7), 3542; https://doi.org/10.3390/app16073542 - 4 Apr 2026

Viewed by 541

Abstract

Background: Cleft lip and/or palate (CLP) is a common craniofacial malformation with aesthetic, functional, and psychosocial impacts. Although surgical repair is performed early in life, scar tissue formation may intensify maxillary deformities. Presurgical orthopedic interventions have therefore been introduced to optimize anatomical conditions prior to surgery. This scoping review aimed to systematically map presurgical orthopedic approaches described in the literature for patients with CLP. Methods: A Scoping Review was conducted in accordance with PRISMA-ScR guidelines. The protocol was registered in the Open Science Framework. Searches were performed in PubMed, Embase, Web of Science, and Cochrane databases without language or date restrictions. Two independent reviewers assessed the articles and extracted data. Results: A total of 207 studies were included, with a predominance of case series, case reports, and cohort studies, reflecting a generally low level of evidence. Nasoalveolar molding (NAM) was the most frequently reported intervention, while other appliances such as the Hotz plate and Latham device were considerably less represented. Across studies, reported outcomes included reduction of the alveolar cleft, improved nasal symmetry, and facilitation of feeding; however, variability in protocols and outcome measures limited comparability. Conclusions: The available evidence is heterogeneous and largely based on observational designs, which restricts definitive conclusions regarding the comparative effectiveness of presurgical orthopedic approaches. The predominance of NAM in the literature may reflect clinical preference rather than superior evidence, highlighting the need for standardized protocols and higher-quality studies. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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Other

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28 pages, 2129 KB

Open AccessSystematic Review

Cephalometric Assessment and Long-Term Stability of Anterior Open-Bite Correction with Skeletal Anchorage: A Systematic Review and Meta-Analysis

by Alessandro Ugolini, Margherita Donelli, Alessandro Bruni, Nunzio Cirulli, Massimo Berlen, Andrea Abate and Valentina Lanteri

Appl. Sci. 2025, 15(21), 11415; https://doi.org/10.3390/app152111415 - 24 Oct 2025

Viewed by 2426

Abstract

This systematic review evaluated the dento-skeletal effects and long-term stability of anterior open-bite (AOB) correction with temporary anchorage devices (TADs). A comprehensive search up to May 2025 was conducted in PubMed, Scopus, Web of Science, Embase, Cochrane Library, LILACS, Scielo, Epistemonikos, Google Scholar, and ScienceDirect. Eligible studies included randomized and non-randomized trials and case series with cephalometric outcomes. Risk of bias was assessed with the MINORS tool. A qualitative synthesis was performed, and studies meeting criteria were included in the meta-analysis. Ot of 1885 records, 22 studies were included qualitatively; 5 entered meta-analysis. Treatment yielded a mean overbite increase of 5.6 mm and reduction in N-Me of 2.8 mm. FMA and SN-GoMe decreased by about 2° and 1.6°, ANB by 1.7°, while SN-Pog increased by 1.4°. Most studies reported stability up to 3 years. Despite heterogeneity and predominance of non-randomized studies, evidence suggests TADs effectively correct AOB through overbite improvement and mandibular counterclockwise rotation. Reported effects appear stable, supporting skeletal anchorage as a reliable, less invasive alternative to surgery in selected patients. Full article

(This article belongs to the Special Issue Innovative Materials and Technologies in Orthodontics)

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