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Digitalization, Technologies, New Approaches, and Telemedicine in Dentistry and Craniofacial/Temporomandibular Disorders

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: closed (30 November 2023) | Viewed by 23693

Special Issue Editors


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Guest Editor
Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
Interests: TMJ; Telemedicine; TMD; DTM; temporomandibular disorders; orofacial pain; temporomandibular joint; bruxism; tooth wear; jaw muscle; electromyographic; masseter muscle activity; invisible orthodontic; temporomandibular joint degenerative disorder
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Biomedicine and Prevention, University of Rome “Tor Vergata,” Rome, Italy
Interests: oral health; TMD; oral surgery; prosthesis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

New technologies, such as digital devices, are available to enhance the effectiveness of the diagnostic process and increase the spectrum of detectable pathologies, dimorphisms, and dysfunctions in the orofacial region, as well as to the new clinical approach to comprehensive Craniofacial and Temporomandibular disorders.

Recently, the extension of methods, such as EMG, CBCT, MRI, to the dental field, is receiving a lot of interest in the medical field. Telemedicine (teledentistry in the field of oral pathology) is a rapidly evolving healthcare delivery mechanism via hardware and/or software through which consultation, medical assistance, and information can be communicated over the computer networks. We are all called upon to keep up with the developments that are occurring simultaneously in dentistry. Digital dentistry provides quantifiable benefits in terms of quality, time savings, and labor cost reductions.

The aim of this Special Issue is to provide the available evidence-based data of innovative advances and knowledge in oral and craniofacial diagnosis, as well as to provide a new approach on management of temporomandibular disorders through upcoming diagnostic and therapeutic technologies.

Dr. Giuseppe Minervini
Dr. Rocco Franco
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral rehabilitation
  • telemedicine
  • technologies
  • Web
  • teledentistry
  • biomaterials
  • bruxism
  • orofacial pain
  • EMG
  • temporomandibular disorders
  • radiology in dentistry
  • dental implants
  • clear aligner
  • esthetics
  • patient perception
  • oral microbioma
  • prosthodontics
  • orthodontics
  • 3D printing
  • anomaly
  • ankylosis
  • computer-based education
  • CAD/CAM
  • oral cancer
  • traumatology
  • deformations
  • diagnosis, therapy orofacial field
  • craniofacial malformations from childhood to adulthood
  • sleep apnea syndrome treatment
  • temporomandibular joint
  • juvenile idiopathic arthritis
  • CBCT
  • MRI
  • digital dentistry
  • computer-aided manufacturing
  • virtual patient
  • facial asymmetry

Published Papers (11 papers)

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Research

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10 pages, 1255 KiB  
Article
Efficacy of Elastodontic Devices in Temporomandibular Disorder Reduction Assessed by Computer Aid Evaluation
by Eleonora Ortu, Sara Di Nicolantonio, Samuele Cova, Davide Pietropaoli, Lucia De Simone and Annalisa Monaco
Appl. Sci. 2024, 14(4), 1651; https://doi.org/10.3390/app14041651 - 18 Feb 2024
Cited by 1 | Viewed by 679
Abstract
Background: The main objective of this study was to compare the clinical efficacy of two different devices, the Eptamed elastodontic device and a common bite sold in pharmacies, by assessing a computer aid evaluation of patients’ surface electromyography (sEMG) and kinesiography activity of [...] Read more.
Background: The main objective of this study was to compare the clinical efficacy of two different devices, the Eptamed elastodontic device and a common bite sold in pharmacies, by assessing a computer aid evaluation of patients’ surface electromyography (sEMG) and kinesiography activity of four pairs of masticatory and postural muscles (anterior temporalis, digastricus, masseters and sternocleidomastoids muscles) before and after 6 months of treatment. Materials and Methods: Twelve adult patients with temporomandibular disorders and in need of orthodontic treatment were enrolled in the study and divided into cases and controls. Cases underwent orthodontic treatment with the Eptamed elastodontic device, while controls were treated with a bite sold in pharmacies. Both groups underwent electromyographic and kinesiographic examinations before and after 6 months from the start of treatment. Results: The Eptamed device was found to guarantee an improvement in the electrical activity of the muscles examined. The subjects in the control group, on the other hand, had a general worsening of electrical activity after wearing a splint purchased in a pharmacy. As for the kinesiographic examination, there was no significant improvement in both groups. Conclusions: the use of the Eptamed device in subjects with TMD ensured a greater relaxation of the chewing muscles than a standard bite, effectively reducing the risk of worsening the symptomatology of temporomandibular disorders. Full article
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11 pages, 773 KiB  
Article
Use of Tens in the Diagnosis of Functional Mandibular Lateral Deviation
by Eleonora Ortu, Sara Di Nicolantonio, Alessandra Mummolo, Ruggero Cattaneo, Davide Pietropaoli and Annalisa Monaco
Appl. Sci. 2023, 13(24), 13258; https://doi.org/10.3390/app132413258 - 14 Dec 2023
Viewed by 868
Abstract
Introduction: The traditional diagnosis of functional lateral deviation is based on a clinical evaluation and dental casts, supported by an instrumental analysis through X-rays; however, these diagnostic techniques do not provide any information about the neuromuscular system. Several years ago, some authors stressed [...] Read more.
Introduction: The traditional diagnosis of functional lateral deviation is based on a clinical evaluation and dental casts, supported by an instrumental analysis through X-rays; however, these diagnostic techniques do not provide any information about the neuromuscular system. Several years ago, some authors stressed the importance of the mandibular rest position and its reproducibility as a diagnostic reference, and this became possible with the development of the Myomonitor, TENS. Aim: The aim of this study was to compare mandible position before and after the use of ultra-low-frequency transcutaneous electric nervous stimulation (ULFTENS) in children with diagnosed functional mandibular lateral deviation. Methods: This study was performed on 60 children, aged between 8 and 13 years, with a mean age of 10.1 years (SD 0.81), and with functional mandibular lateral deviation diagnosed clinically, who were referred to the dental clinic for pediatric dental care. Diagnostic neuromuscular registrations were made for all children, and their casts were mounted on a Galetti articulator at the myocentric position. These casts were then compared to those provided by a wax bite registration in the intercuspidal position. Results: Compared with the existing intercuspidal position, neuromuscular registration showed improvement in 30 (50%) patients, 18 patients (30%) showed no changes, and worsening of the tooth midline discrepancy was assessed in the remaining 12 (20%). The molar relationship did not follow the same trend of the midline because of the three-dimensional changes in the maxillo–mandibular relationship induced by TENS. After TENS, there was a significant correlation between the midline and right side deviation (r > 0.65); there was no correlation between the midline and the left side (r < 0.65). Furthermore, the right molar movement showed no correlation with the contralateral molar (r < 0.65). The posterior areas of the arch moved in a very unpredictable way, resulting in the diagnosis and prognosis of mandibular lateral deviation as absolutely individual and unpredictable. Conclusions: This study suggests that TENS-recorded occlusion is an interesting diagnostic approach in orthodontics since it allows for visualizing the trends of the neuromuscular system. Full article
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11 pages, 271 KiB  
Article
Examining the Influence of Self-Esteem and Digital Literacy on Professional Competence Factors in Dental Education: A Cross-Sectional Study
by Gulsum Ceylan, Melike Ozlem Eken, Selen Yuruk and Faruk Emir
Appl. Sci. 2023, 13(16), 9411; https://doi.org/10.3390/app13169411 - 19 Aug 2023
Viewed by 1186
Abstract
This study aims to investigate the effects of digital literacy and self-esteem on dental students’ perceptions of professional competence and to provide recommendations for improving educational programs in dental schools. A mixed-methods, descriptive, and relational scanning design was employed, using a questionnaire comprising [...] Read more.
This study aims to investigate the effects of digital literacy and self-esteem on dental students’ perceptions of professional competence and to provide recommendations for improving educational programs in dental schools. A mixed-methods, descriptive, and relational scanning design was employed, using a questionnaire comprising demographic information, the Rosenberg Self-Esteem Scale (RSES), the Digital Literacy Scale (DLS), and the Professional Competence Scale (PCS). The sample included 427 dental students in Istanbul, Turkey. Statistical analyses included Cronbach Alpha, Confirmatory Factor Analysis, Mann–Whitney U, Kruskal–Wallis, Spearman’s rho correlation, and the Generalized Linear Model (Logit Model). The majority of participants were female (65.6%), aged 21 or older (85.2%), and in their 4th grade of study (35.2%). There were no significant differences in PCS scores concerning gender, age, grade, type of residence, and residence location (p > 0.05). However, PCS scores were significantly higher among those who listed dentistry among their top five preferences, expressed high satisfaction with education, and demonstrated high professional interest (p < 0.05). A significant, positive correlation was observed between PCS and RSES (r = 0.398; p < 0.01), DLS (r = 0.404; p < 0.01), preference (r = 0.120; p < 0.05), education satisfaction (r = 0.298; p < 0.01), and occupational interest (r = 0.502; p < 0.05). Furthermore, the Logit Model analysis revealed that RSES (B = 0.290; p < 0.01), DLS (B = 0.258; p < 0.01), education satisfaction (B = 0.806; p < 0.05), and occupational interest (B = 3.825; p < 0.01) significantly influenced PCS. The findings underscore self-esteem and digital literacy’s integral role in shaping dental students’ perceptions of their professional abilities. Digital literacy is a substantial pillar supporting students’ professional competency. Coupled with a genuine interest in the field and bolstered self-confidence, digital literacy proves instrumental in enhancing students’ academic success in dentistry. By emphasizing and expanding upon digital literacy content within the curriculum, universities can further propel advancements in the dental domain. As such, it is pivotal for dental institutions to weave strategies into their educational fabric to elevate students’ self-esteem and digital proficiency. Full article
12 pages, 4419 KiB  
Article
Quantitative Evaluation of the Infrazygomatic Crest Thickness in Polish Subjects: A Cone-Beam Computed Tomography Study
by Marta Gibas-Stanek, Julia Ślusarska, Michał Urzędowski, Szczepan Żabicki and Małgorzata Pihut
Appl. Sci. 2023, 13(15), 8744; https://doi.org/10.3390/app13158744 - 28 Jul 2023
Cited by 1 | Viewed by 1064
Abstract
Infrazygomatic crest (IZC) mini-implants are frequently used as an absolute anchorage when intrusive or distally directed forces are required during orthodontic treatment. The aim of the present study was to evaluate the thickness of the IZC area in Polish patients as well as [...] Read more.
Infrazygomatic crest (IZC) mini-implants are frequently used as an absolute anchorage when intrusive or distally directed forces are required during orthodontic treatment. The aim of the present study was to evaluate the thickness of the IZC area in Polish patients as well as to assess dependency between bone availability, sex, and age. The study material was 100 cone beam computed tomography scans (CBCT) of the maxilla of patients of the University Dental Clinic in Krakow (50 men and women each). IZC bone thickness was measured at nine different points. The biggest bone thickness was recorded in the interdental space between the first and second molar at the height of 12 mm (6.03 ± 2.64 mm). The thinnest bone depth was localized at the level of the mesial root of the first molar, 16 mm above the occlusal plane (2.42 ± 2.16). There was a significant and negative correlation between bone thickness and age in the case of measurements taken buccally to the first molar. Only two out of nine measurements showed a sex dependency (points I2 and I3). Considering vertical and sagittal dimensions, the most favorable conditions for IZC mini-implant placement were found interdentally, between the first and second molar, 12 mm above the occlusal plane. Full article
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14 pages, 1900 KiB  
Article
A Digital 3D Retrospective Study Evaluating the Efficacy of Root Control during Orthodontic Treatment with Clear Aligners
by Monica Macrì, Silvia Medori, Giuseppe Varvara and Felice Festa
Appl. Sci. 2023, 13(3), 1540; https://doi.org/10.3390/app13031540 - 25 Jan 2023
Cited by 5 | Viewed by 2248
Abstract
This study aimed to investigate the efficacy of torque movement and the incidence of root resorption in the maxillary and mandibular teeth with clear aligner therapy using cone-beam computed tomography. The sagittal root positions, the faciolingual inclinations, and the root lengths of 672 [...] Read more.
This study aimed to investigate the efficacy of torque movement and the incidence of root resorption in the maxillary and mandibular teeth with clear aligner therapy using cone-beam computed tomography. The sagittal root positions, the faciolingual inclinations, and the root lengths of 672 teeth, from central incisors to first molars for each arch, were measured and compared on virtual cross sections from pre-treatment and post-treatment cone-beam computed tomography of 28 patients who received comprehensive orthodontic treatment with clear aligners. An improvement of root position was found in incisors, canines, and premolars of the upper and lower arches: over 78% of their root was centered in the alveolus at the end of orthodontic treatment. There was a statistically significant torque increase for incisors, canines, and first premolars at the end of therapy. The most considerable torque changes were achieved in incisors and canines, while the lowest was in posterior teeth. The maxillary and mandibular central incisors achieved 3.26 ± 1.95° and 2.97 ± 2.53° of mean torque increase, respectively. The root length loss was greater in the upper and lower central incisors. All teeth showed mild resorption (<10%) except for two upper lateral incisors, which showed moderate resorption (10.79% and 10.23%). Comprehensive treatment with clear aligners improved sagittal root position and increased torque, especially in the anterior teeth. Most teeth showed mild resorption after clear aligner therapy, and only two showed moderate resorption. Full article
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10 pages, 1810 KiB  
Article
Virtual Surgical Reduction in Atrophic Edentulous Mandible Fractures: A Novel Approach Based on “in House” Digital Work-Flow
by Vincenzo Abbate, Umberto Committeri, Stefania Troise, Paola Bonavolontà, Luigi Angelo Vaira, Guido Gabriele, Federico Biglioli, Filippo Tarabbia, Luigi Califano and Giovanni Dell’Aversana Orabona
Appl. Sci. 2023, 13(3), 1474; https://doi.org/10.3390/app13031474 - 22 Jan 2023
Cited by 2 | Viewed by 1775
Abstract
Atrophic edentulous mandible fractures are a challenge for maxillo-facial surgeons because of low vascularization, low bone regeneration, and lack of occlusion. Whereas occlusion is the main guide in the reduction of mandibular fractures, the aim of our study is to show the advantages [...] Read more.
Atrophic edentulous mandible fractures are a challenge for maxillo-facial surgeons because of low vascularization, low bone regeneration, and lack of occlusion. Whereas occlusion is the main guide in the reduction of mandibular fractures, the aim of our study is to show the advantages of using virtual surgical planning (VSP) in surgery when the occlusal guide is absent. This work is a prospective study that shows the in-house digital workflow for the management of these fractures in the Maxillo-Facial Surgery Unit of Federico II University Hospital of Naples. Four patients who satisfied the criteria were included in the study. For each patient, the same defined CAD/CAM-based was applied. The workflow followed four steps: (1) bone segmentation and virtual reduction of fracture fragments; (2) three-dimensional printing of virtually reduced mandible and modelling of 2.4 reconstruction plate on printed resin model; (3) surgery aided by the pre-formed plate; (4) digital and clinical outcomes analysis. In the last step, a distance colour map was conducted to compare the virtual planning and postoperative CT outcome. In all cases, the discrepancies values between the two images were lower than 1.5 mm, and good clinical outcomes in terms of facial symmetry, absence of sensory disturbance, and possibility of prosthetic rehabilitation were obtained. In conclusion, the VSP, with our in-house workflow brings benefits in the management of atrophic edentulous mandible fractures in terms of the high accuracy of bone repositioning. Full article
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10 pages, 1517 KiB  
Article
Effectiveness of Machine Learning in Assessing the Diagnostic Quality of Bitewing Radiographs
by Mohammed A. Barayan, Arwa A. Qawas, Asma S. Alghamdi, Turki S. Alkhallagi, Raghad A. Al-Dabbagh, Ghadah A. Aldabbagh and Amal I. Linjawi
Appl. Sci. 2022, 12(19), 9588; https://doi.org/10.3390/app12199588 - 24 Sep 2022
Cited by 2 | Viewed by 1679
Abstract
Background: Identifying the diagnostic value of bitewing radiographs (BW) is highly dependent on the operator’s knowledge and experience. The aim of this study is to assess the effectiveness of machine learning (ML) to classify the BW according to their diagnostic quality. Methods: 864 [...] Read more.
Background: Identifying the diagnostic value of bitewing radiographs (BW) is highly dependent on the operator’s knowledge and experience. The aim of this study is to assess the effectiveness of machine learning (ML) to classify the BW according to their diagnostic quality. Methods: 864 BW radiographs from records of 100 patients presented at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia were assessed. The radiographic errors in representing proximal contact areas (n = 1951) were categorized into diagnostic and non-diagnostic. Labeling and training of the BW were done using Roboflow. Data were divided into validation, training, and testing sets to train the pre-trained model Efficientdet-d0 using TensorFlow. The model’s performance was assessed by calculating recall, precision, F1 score, and log loss value. Results: The model excelled at detecting “overlap within enamel” and “overlap within restoration (clear margins) with F1 score of 0.89 and 0.76, respectively. The overall system errors made by the built model showed a log loss value of 0.15 indicating high accuracy of the model. Conclusions: The model is a “proof of concept” for the effectiveness of ML in diagnosing the quality of the BW radiographs based on the contact areas. More dataset specification and optimization are needed to overcome the class imbalance. Full article
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Review

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15 pages, 609 KiB  
Review
Correlation between Temporomandibular Disorders and Tinnitus and Possible Treatment Strategies: Comprehensive Review
by Angelo Michele Inchingolo, Alessio Danilo Inchingolo, Vito Settanni, Nicole De Leonardis, Merigrazia Campanelli, Grazia Garofoli, Stefania Benagiano, Giuseppina Malcangi, Elio Minetti, Andrea Palermo, Francesco Inchingolo, Gianna Dipalma and Assunta Patano
Appl. Sci. 2023, 13(15), 8997; https://doi.org/10.3390/app13158997 - 5 Aug 2023
Cited by 1 | Viewed by 1670
Abstract
This study intends to investigate the relationship between otologic symptoms, in particular, tinnitus, and temporomandibular disorders (TMD). The literature studies during the previous 20 years had focused on the treatment and alleviation of the otologic symptoms and were limited to randomized clinical trials, [...] Read more.
This study intends to investigate the relationship between otologic symptoms, in particular, tinnitus, and temporomandibular disorders (TMD). The literature studies during the previous 20 years had focused on the treatment and alleviation of the otologic symptoms and were limited to randomized clinical trials, case reports, and prospective studies. The following Boolean keywords, (tinnitus) AND (temporomandibular disorders OR temporomandibular therapy), were used in the databases of PubMed, Scopus, and Web of Science between 2003 and 9 May 2023 with an English language restriction. Results: The computerized search turned up 693 articles in total, and after eliminating duplicates, reviewing them, and determining their eligibility, 20 papers were included. Conclusion: The connections between temporomandibular TMD and tinnitus are numerous and intricate. It is unclear whether TMD could be the source of tinnitus or only its symptoms. Tinnitus may not always occur in persons with TMD, indicating that additional causes may potentially be involved in its occurrence. The precise mechanisms behind the link between TMD and tinnitus need to be clarified by additional study. Full article
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17 pages, 986 KiB  
Review
Investigation on the Application of Artificial Intelligence in Prosthodontics
by Abdulkhaliq Ali F. Alshadidi, Ahid Amer Alshahrani, Lujain Ibrahim N. Aldosari, Saurabh Chaturvedi, Ravinder S. Saini, Saeed Awod Bin Hassan, Marco Cicciù and Giuseppe Minervini
Appl. Sci. 2023, 13(8), 5004; https://doi.org/10.3390/app13085004 - 16 Apr 2023
Cited by 12 | Viewed by 6806
Abstract
Artificial intelligence (AI) is a contemporary, information-driven innovative technology. Prosthetic dentistry, also known as prosthodontics, is the restoration and reconstruction of missing teeth utilizing implants for permanent and removable prostheses. It enhances healthy soft and hard tissues, promoting oral health. This study examined [...] Read more.
Artificial intelligence (AI) is a contemporary, information-driven innovative technology. Prosthetic dentistry, also known as prosthodontics, is the restoration and reconstruction of missing teeth utilizing implants for permanent and removable prostheses. It enhances healthy soft and hard tissues, promoting oral health. This study examined the use of artificial intelligence in prosthodontics to diagnose abnormalities and create patient-specific prostheses. Two researchers searched Google Scholar, Scopus, PubMed/MEDLINE, EBSCO host, Science Direct, and Web of Science (MEDLINE, WOS, and KJD). Articles on AI in English were reviewed. We also collected the following broad article aspects: research and control groups, assessment methodology, outcomes, and quality rankings. This methodological study examined AI use in prosthodontics using the latest scientific findings. The findings were statistically evaluated using ANOVA. Titles and abstracts revealed 172 AI-related dentistry studies, which were analyzed in this research. Thirty-eight papers were eliminated. According to the evaluation, AI was found to have significantly increased in prosthodontics. Despite the vast number of studies documenting AI applications, the description of the data illustrated the latest breakthroughs in AI in prosthodontics, highlighting its use in automatically produced diagnostics, predicting analytics, and classification or verification tools. Full article
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Other

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24 pages, 1604 KiB  
Systematic Review
Acceleration Techniques for Teeth Movements in Extractive Orthodontic Therapy
by Gianna Dipalma, Assunta Patano, Irene Ferrara, Fabio Viapiano, Anna Netti, Sabino Ceci, Daniela Azzollini, Anna Maria Ciocia, Giuseppina Malcangi, Alessio Danilo Inchingolo, Francesco Inchingolo, Andrea Palermo and Angelo Michele Inchingolo
Appl. Sci. 2023, 13(17), 9759; https://doi.org/10.3390/app13179759 - 29 Aug 2023
Cited by 1 | Viewed by 1304
Abstract
For a world that is constantly trying to speed up every procedure while obtaining the maximum result, traditional orthodontics have the biological limitation of using light and constant forces that allow tooth movement in a time frame that is only sometimes short. The [...] Read more.
For a world that is constantly trying to speed up every procedure while obtaining the maximum result, traditional orthodontics have the biological limitation of using light and constant forces that allow tooth movement in a time frame that is only sometimes short. The treatment time could be lengthened if surgical procedures are programmed in the plan. Methods to accelerate tooth movement and reduce the duration of treatment while minimising complications are investigated and reported in the dental literature (e.g., low-level laser therapy, corticotomy, and micro-osteoperforations). This systematic review aims to analyse and summarise the strategies for quickening orthodontic movement during extraction orthodontic treatment, including any potential drawbacks or adverse consequences. The review will evaluate each approach’s effectiveness, safety, and evidence quality, compare their benefits and disadvantages, and analyse the implications for clinical practice and future research. Pubmed, Science Direct, Scopus, and Web of Science were searched using the keywords “acceleration” AND “dental movement” AND “orthodontic” between 1 April 2003 and 1 April 2023. After carefully scanning the study findings, forty-four publications were chosen for the systematic review. Most therapies discussed and provided in the literature seem promising and successful in enhancing orthodontic treatments. The success of operations like corticotomies, piezo-incisions, micro-osteoperforations, osteogenic distraction, low-level laser therapy, the administration of pharmacological treatments, and infiltrations with PRF and PRP were statistically significant and appear to be promising and effective in optimising orthodontic treatments. These strategies expedite treatment and enhance the patient experience, potentially broadening orthodontic appeal and minimising issues like cavities and enamel demineralisation. Further studies, with larger samples and standardised treatment protocols, are needed to investigate the efficacy of these tooth movement acceleration modalities. Full article
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14 pages, 2911 KiB  
Systematic Review
Mandibular Molar Distalization in Class III Malocclusion: A Systematic Review
by Angelo Michele Inchingolo, Assunta Patano, Giuseppina Malcangi, Daniela Azzollini, Claudia Laudadio, Anna Maria Ciocia, Roberta Sardano, Laura Ferrante, Merigrazia Campanelli, Gianna Dipalma, Daniela Di Venere, Alessio Danilo Inchingolo and Francesco Inchingolo
Appl. Sci. 2023, 13(16), 9337; https://doi.org/10.3390/app13169337 - 17 Aug 2023
Cited by 3 | Viewed by 3135
Abstract
Class III Malocclusion presents a complex orthodontic challenge with various treatment options, including orthodontic camouflage and orthognathic surgery. Among these, mandibular molar distalization stands as an orthodontic approach for treating Class III Malocclusion in adults. This systematic review aims to evaluate the current [...] Read more.
Class III Malocclusion presents a complex orthodontic challenge with various treatment options, including orthodontic camouflage and orthognathic surgery. Among these, mandibular molar distalization stands as an orthodontic approach for treating Class III Malocclusion in adults. This systematic review aims to evaluate the current evidence regarding mandibular molar distalization techniques in the treatment of Class III. The search across PubMed, Scopus, Cochrane, and Web of Science databases yielded 582 articles, from which eight met the inclusion criteria. These inclusion criteria were as follows: English language, full text, studies randomized clinical trials, and retrospective studies that evaluated various methods of mandibular distalization for Class III Malocclusion in adult patients, from 2013 to May 2023. Lower molar distalization has gained attention as a non-surgical alternative with effective and efficient outcomes. However, various treatment modalities have limitations, including reliance upon malocclusion severity, diagnosis, patient cooperation, and operator experience. From the studies analyzed, it was found that techniques using skeletal anchorage with TADs, mini-plates, or ramal plates, offer stable anchorage and controlled tooth movement, they allow unilateral action in cases of asymmetry, and they are the most effective methods for achieving distal body displacement of the tooth. Despite the promising results, the relatively small number of studies calls for more high-quality research to explore the efficacy and outcomes of different mandibular molar distalization approaches. The lack of standardized protocols and guidelines for mandibular molar distalization in Class III Malocclusion is also attributed to the limited available literature. Full article
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