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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 27 February 2026 | Viewed by 6092

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Special Issue Editors

Prof. Dr. Camelia Szuhanek

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Guest Editor

Department of Orthodontics, Orthodontics Research Center ‘ORTHO CENTER’, “Victor Babeş” University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
Interests: digital and interdisciplinary orthodontics; aligners; orthodontic implants
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Irina Nicoleta Zetu

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Orthodontics Discipline, Surgery I Department, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
Interests: digital and interdisciplinary orthodontics; aligners; orthodontic implants
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to invite you to collaborate on our upcoming Special Issue, “Orthodontics: State of the Art and Perspectives”.

Recent advances in orthodontic diagnostics and treatment planning include digital applications, artificial intelligence, and 3D imaging for reconstruction techniques. These technologies will provide faster and more predictable treatments. We would like to invite orthodontist, dentists, and maxillo-facial surgeons to submit papers on the latest advances in interdisciplinary orthodontic treatment.

Topics include, but are not limited to, the following:

digital orthodontic diagnosis;
intraoral scanners;
facial scanners;
treatment planning and therapy;
aligners;
orthodontic implants;
orthognathic surgery cases;
interdisciplinary orthodontic treatment;
the dental rehabilitation of orthodontic patients.

Prof. Dr. Camelia Szuhanek
Prof. Dr. Irina Nicoleta Zetu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 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

orthodontics
digital orthodontics
intraoral scanners
facial scanners
treatment planning
interdisciplinary treatment
orthodontic implants

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Published Papers (6 papers)

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12 pages, 1809 KB

Open AccessArticle

Integrating 3D Digital Technology Advancements in the Fabrication of Orthodontic Aligner Attachments: An In Vitro Study

by Riham Nagib, Andrei Chircu and Camelia Szuhanek

J. Clin. Med. 2025, 14(14), 5093; https://doi.org/10.3390/jcm14145093 - 17 Jul 2025

Viewed by 457

Abstract

Background/Objectives: The introduction of composite attachments has greatly improved orthodontic aligner therapy, through better force delivery, more predictable movements, and enhanced retention. This in vitro study aims to present and investigate an innovative digital protocol for aligner attachment fabrication incorporating the latest 3D technology used in dentistry. Methods: A virtual attachment measuring 2.5 × 2 × 2 mm was designed using computer-aided design (CAD) software (Meshmixer, Autodesk Inc., San Francisco, CA, USA) and exported as an individual STL file. The attachments were fabricated using a digital light processing (DLP) 3D printer (model: Elegoo 4 DLP, Shenzhen, China) and a dental-grade biocompatible resin. A custom 3D-printed placement guide was used to ensure precise positioning of the attachments on the printed maxillary dental models. A flowable resin was applied to secure the attachments in place. Following attachment placement, the models were scanned using a laboratory desktop scanner (Optical 3D Smart Big, Open Technologies, Milano, Italy) and three intraoral scanners: iTero Element (Align Technology, Tempe, AZ, USA), Aoral 2, and Aoral 3 (Shining 3D, Hangzhou, China). Results: Upon comparison, the scans revealed that the iTero Element exhibited the highest precision, particularly in the attachment, with an RMSE of 0.022 mm and 95.04% of measurements falling within a ±100 µm tolerance. The Aoral 2 scanner showed greater variability, with the highest RMSE (0.041 mm) in the incisor area and wider deviation margins. Despite this, all scanners produced results within clinically acceptable limits. Conclusions: In the future, custom attachments made by 3D printing could be a valid alternative to the traditional composite attachments when it comes to improving aligner attachment production. While these preliminary findings support the potential applicability of such workflows, further in vivo research is necessary to confirm clinical usability. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

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12 pages, 251 KB

Open AccessArticle

Pain Perception and Dietary Impact in Fixed Orthodontic Appliances vs. Clear Aligners: An Observational Study

by Bianca Maria Negruțiu, Cristina Paula Costea, Alexandru Nicolae Pîrvan, Diana-Ioana Gavra, Claudia Judea Pusta, Ligia Luminița Vaida, Abel Emanuel Moca, Raluca Iurcov and Claudia Elena Staniș

J. Clin. Med. 2025, 14(14), 5060; https://doi.org/10.3390/jcm14145060 - 17 Jul 2025

Viewed by 440

Abstract

Background and Objectives: Orthodontic treatment, whether fixed or removable, offers several benefits, including improved aesthetics, enhanced oral function, and increased self-confidence. However, it may also cause discomfort and pain, particularly following adjustment visits. This study aimed to assess pain characteristics (latency and continuity), food impairment, weight loss, and analgesic use in relation to treatment duration and appliance type. Methods: This observational study included 160 orthodontic patients who completed a structured questionnaire comprising 13 single-choice items. The questionnaire assessed age, gender, residential environment, educational status, type and duration of orthodontic treatment, pain characteristics (duration, latency, continuity), food impairment, and analgesic use. Inclusion criteria specified patients with moderate anterior crowding undergoing fixed orthodontic treatment or treatment with clear aligners on both arches, for at least one month. All fixed appliance cases involved 0.022-inch-slot Roth prescription brackets. Results: Patients undergoing fixed orthodontic treatment reported a higher frequency of pain (91.4%), greater need for analgesics (95.2%), and more food impairment compared to those with clear aligners. Patients treated for less than 6 months more frequently reported pain lasting 1 week (57.1%), while those treated for 1–2 years more commonly reported pain lasting several days (43.8%). Conclusions: Fixed orthodontic appliances are associated with greater discomfort, longer pain latency, more frequent analgesic use, and higher dietary impact compared to clear aligners. These findings emphasize the importance of personalized patient counseling and proactive pain management to improve compliance, enhance quality of life, and support informed decision-making in orthodontic care. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

10 pages, 1253 KB

Open AccessArticle

Evaluation of Anteroposterior Inclinations of Maxillary Lateral Teeth and Canines Measured on Cephalometric Radiographs in Patients with Skeletal Class I and Class II—A Pilot Study

by Maciej Warnecki, Marek Nahajowski, Beata Kawala, Joanna Lis and Michał Sarul

J. Clin. Med. 2025, 14(12), 4323; https://doi.org/10.3390/jcm14124323 - 17 Jun 2025

Viewed by 325

Abstract

Background/Objectives: Routinely, clinicians planning the mechanics of orthodontic treatment for their patients do not take into account the inclinations of canine and lateral teeth. This is due to a lack of solid evidence in the area. Additionally, sound data is lacking on differences between tooth inclinations in patients presenting class II, subdivision 1 and class II, subdivision 2 relationships. This study is meant to investigate this matter. Methods: To conduct this study, cephalograms of 83 patients scheduled for orthodontic treatment were retrospectively selected from the records of the Department of Orthodontics at Wroclaw Medical University and analyzed. Patients were divided into three groups (class I, class II subdivision 1, class II subdivision 2). Inclinations of the long axes of canine and lateral teeth were measured in relation to the palatal plane. Results: We established that there exist statistically significant differences in inclination for some of the teeth assessed. Conclusions: Multiple correlations were found between tooth inclination and some cephalometric measurements, particularly the SNB angle. The canines and upper premolars undergo a natural distal tilt to compensate for the mandible’s retruded position. Clinicians planning treatment for skeletal class II patients should formulate treatment plans involving the distal tipping of lateral teeth with great care, as such patients may already exhibit distal inclinations of the lateral teeth. Patients with skeletal class II, division 2 may present greater demands in terms of proper orthodontic treatment mechanics compared to class II, division 1 patients. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

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20 pages, 7671 KB

Open AccessArticle

Associations of Digital Measurements: Analysis of Orthopantomography Versus Lateral Cephalograms for Evaluation of Facial Asymmetry

by Andra-Alexandra Stăncioiu, Alexandru Cătălin Motofelea, Anca Adriana Hușanu, Lorena Vasica, Riham Nagib, Adelina Popa and Camelia Szuhanek

J. Clin. Med. 2025, 14(4), 1296; https://doi.org/10.3390/jcm14041296 - 15 Feb 2025

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Abstract

Background/Objectives: This study aimed to compare the associations of digital measurements obtained from orthopantomographies (OPGs) or panoramic radiographs and lateral cephalograms in evaluating facial asymmetry in patients with different skeletal classes. The sample consisted of 128 Romanian patients (67 females, 61 males) who sought orthodontic treatment. These measurements are an essential diagnostic tool for evaluating facial asymmetry in order to treat them. Methods: Lateral cephalograms and OPGs were obtained for each patient, and digital tracing was performed using the WebCeph program. Angular measurements (ANB, FMA, gonial angles) and linear measurements (ramus height, mandibular body length) were assessed on both imaging modalities. Results: Strong positive correlations were found between the gonial angle and ramus height measurements obtained from lateral cephalograms and OPGs (rs range: 0.800–0.946; p < 0.001). However, the mandibular body length showed weaker correlations between the two methods. Significant sex differences were observed, with males exhibiting larger craniofacial measurements compared to females (p < 0.05). The study population was quite young, as seen by the cohort’s median age of 21 years and interquartile range (IQR) of 16 to 29 years. Lateral Ceph: the FMA angle median value of 22° (IQR: 17–25), gonial angle median of 121° (IQR: 116–127), mandibular ramus height median value of 44 mm (IQR: 41–48 mm), and mandibular body length median value of 70 mm (IQR of 65 to 76 mm). OPG: gonial angles on the right and left sides yield medians of 121° (IQR: 116–127) and 122° (IQR: 117–127); the mandibular ramus height on the right and left sides shows medians of 44.0 mm (IQR: 40.0–47.0 mm) and 43 mm (IQR: 40–48 mm); and the mandibular body on the right side presents a median of 71 mm (IQR: 67–76 mm) and the left side has a median of 71 mm (IQR: 67–75 mm). Conclusions: The findings suggest that OPGs can be reliably used to measure the gonial angle and ramus height, providing results comparable to lateral cephalograms. However, caution should be exercised when predicting horizontal measurements from OPGs. The standardization of the OPG recording process and further research with larger sample sizes are required to establish standard panoramic norms for OPG parameters in the assessment of facial asymmetry. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

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16 pages, 1993 KB

Open AccessSystematic Review

Impact of Molar Teeth Distalization by Clear Aligners on the Temporomandibular Joint: Systematic Review and Meta-Analysis

by Kacper Galant, Sylwia Dąbrowska, Natalia Turosz and Konrad Małkiewicz

J. Clin. Med. 2025, 14(16), 5836; https://doi.org/10.3390/jcm14165836 - 18 Aug 2025

Viewed by 350

Abstract

Background: This review aimed to assess the association between upper molar distalization using clear aligners (CAs) and structural changes in the temporomandibular joint (TMJ). Methods: On February 20, 2025, the following databases were searched: PubMed, Embase, BASE, Web of Science, and Scopus. Studies were included if they reported on orthodontic treatment with CAs involving upper molar distalization and presented TMJ parameter measurements before and after treatment. The JBI Critical Appraisal Checklist for Quasi-Experimental Studies was used to assess the risk of bias. The collected data were analyzed using the paired t-test, mean difference assessment, and Spearman correlation matrix. Results: A total of 4 articles out of 238 records retrieved were included in the review. The mean age of patients was 23.18–29.80 years, and the treatment duration was 1.90–2.21 years. The most important changes were in the posterior and superior joint spaces (PJS and SJS) (p < 0.05), with SJS increasing in two studies (0.56 and 0.7 mm) and PJS increasing in one and decreasing in another (−0.94 and 0.36 mm). Conclusions: Limited evidence suggests that molar distalization with CAs may influence TMJ dimensions to a small extent. However, the results are inconsistent and require further validation with high-quality studies to draw firm conclusions. Registration: The review was pre-registered using the OpenScience Framework (OSF) on 17 April 2025—osf.io/9xyr8. No funding or conflicts of interest were reported. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

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17 pages, 1256 KB

Open AccessSystematic Review

Integrating Artificial Intelligence into Orthodontic Education: A Systematic Review and Meta-Analysis of Clinical Teaching Application

by Carlos M. Ardila, Eliana Pineda-Vélez and Anny Marcela Vivares Builes

J. Clin. Med. 2025, 14(15), 5487; https://doi.org/10.3390/jcm14155487 - 4 Aug 2025

Viewed by 558

Abstract

Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, and the perceived quality of AI-generated educational content. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase through May 2025. Eligible studies involved AI-assisted educational interventions in orthodontics. A mixed-methods approach was applied, combining meta-analysis and narrative synthesis based on data availability and consistency. Results: Seven studies involving 1101 participants—including orthodontic students, clinicians, faculty, and program directors—were included. AI tools ranged from cephalometric landmarking platforms to ChatGPT-based learning modules. A fixed-effects meta-analysis using two studies yielded a pooled Global Quality Scale (GQS) score of 3.69 (95% CI: 3.58–3.80), indicating moderate perceived quality of AI-generated content (I² = 64.5%). Due to methodological heterogeneity and limited statistical reporting in most studies, a narrative synthesis was used to summarize additional outcomes. AI tools enhanced diagnostic skills, learner autonomy, and perceived satisfaction, particularly among students and junior faculty. However, barriers such as limited curricular integration, lack of training, and faculty skepticism were recurrent. Conclusions: AI technologies, especially ChatGPT and digital cephalometry tools, show promise in orthodontic education. While learners demonstrate high acceptance, full integration is hindered by institutional and perceptual challenges. Strategic curricular reforms and targeted faculty development are needed to optimize AI adoption in clinical training. Full article

(This article belongs to the Special Issue Orthodontics: State of the Art and Perspectives)

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