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Orthodontics: State of the Art and Prospects
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Orthodontics: State of the Art and Prospects

A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (5 June 2026) | Viewed by 4783

Editors

Prof. Dr. Beatriz Tarazona-Álvarez

E-Mail Website
Guest Editor
Department of Orthodontics, Faculty of Medicine and Dentistry, Universidad de Valencia, Valencia, Spain
Interests: 3D facial analyis; 3D cephalometry; accelerated orthodontics; mini screws; digital planning
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Natalia Zamora-Martínez

E-Mail Website
Guest Editor
Department of Orthodontics, Faculty of Medicine and Dentistry, Universidad de Valencia, Valencia, Spain
Interests: 3D facial analyis; 3D cephalometry; accelerated orthodontics; mini screws; digital planning
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, orthodontics has made remarkable advances thanks to digital technology and new materials. Today, clear aligners, lingual orthodontics and self-ligating brackets have improved the aesthetics and efficiency of treatment. Tools such as artificial intelligence, intraoral scanners, 3D cameras, CBCT or 3D printing allow for more accurate diagnoses and personalised treatment plans. In addition, accelerated orthodontics and bioengineering aim to reduce treatment times and improve the patient experience.

As the future of orthodontics points toward less invasive approaches, nanotechnology, and treatments based on big data, it is imperative that we continue to research and disseminate knowledge in this field. Therefore, in this Special Issue, we invite you to share your research in our journal and contribute to the growth of the scientific community and the development of new solutions for dental health. Your participation is key to continued innovation.

Prof. Dr. Beatriz Tarazona-Álvarez
Prof. Dr. Natalia Zamora-Martínez
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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

  • digital orthodontics
  • clear aligners
  • 3D printing
  • accelerated orthodontics
  • digital treatment plan
  • nanotechnology

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Published Papers (4 papers)

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Research

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12 pages, 934 KB  
Article
Agreement Between Manual and Digital Mesiodistal Tooth Measurements on Digitized Plaster Models: A Tooth-Level Analysis
by Helena Brawańska, Wiktoria Kukla, Viktoryia Serha, Marcin Gruca, Agata Gawrychowska-Janicka and Agnieszka Machorowska-Pieniążek
J. Clin. Med. 2026, 15(15), 5911; https://doi.org/10.3390/jcm15155911 - 29 Jul 2026
Viewed by 301
Abstract
Background: Reliable mesiodistal tooth-width measurements are essential for orthodontic diagnosis and treatment planning. Digital models obtained by scanning plaster casts may facilitate orthodontic workflows; however, the extent of agreement between manual caliper measurements and digital measurements on digitized plaster models remains clinically relevant, [...] Read more.
Background: Reliable mesiodistal tooth-width measurements are essential for orthodontic diagnosis and treatment planning. Digital models obtained by scanning plaster casts may facilitate orthodontic workflows; however, the extent of agreement between manual caliper measurements and digital measurements on digitized plaster models remains clinically relevant, particularly at the individual-tooth level. Objective: To evaluate the agreement, repeatability, and inter-method differences between manual and digital mesiodistal tooth-width measurements from the canine to the first molar on digitized plaster models. Methods: Plaster models from 30 orthodontic patients were analyzed. The models were digitized using a 3Shape TRIOS 4 intraoral scanner. Mesiodistal widths of teeth 13–16, 23–26, 33–36, and 43–46 were measured using digital calipers on plaster models and using 3Shape Unite platform version 1.7.33.2 (3Shape A/S, Copenhagen, Denmark) on the corresponding digital models. Manual and digital measurements were each performed twice at 24 h intervals. For both methods, the mean of the two repeated measurements was used for inter-method comparison. Manual and digital intra-observer repeatability was assessed using the intraclass correlation coefficient (ICC). Inter-method differences (ΔMD = mean manual − digital) were analyzed using Bland–Altman analysis. Differences exceeding 0.3 mm were considered to exceed the predefined threshold of potential clinical relevance. Results: A total of 480 teeth were analyzed. Manual and digital intra-observer repeatability were excellent (ICC = 0.985 and ICC = 0.976, respectively). Manual measurements were on average 0.150 mm higher than digital measurements (SD = 0.407 mm; median = 0.145 mm; IQR = 0.29 mm), with 95% limits of agreement ranging from −0.647 mm to 0.947 mm. At the single-tooth level, 212 out of 480 measurements (44.2%) exceeded the predefined 0.3 mm threshold. First molars and selected premolars showed the highest discrepancy rates, whereas canines generally showed lower discrepancy rates. Conclusions: Manual and digital mesiodistal tooth-width measurements performed on digitized plaster models showed good agreement under the tested conditions. However, individual tooth-level differences exceeding the predefined 0.3 mm threshold were frequent, particularly for posterior teeth. Therefore, digital measurements obtained from digitized plaster models should be interpreted with caution in clinical situations requiring high precision at the level of individual tooth dimensions. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Prospects)
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15 pages, 4764 KB  
Article
Clinical Feasibility and Skeletal Effects of Digitally Guided Supragingival Miniplates for Herbst Therapy in Late Adolescents: A Pilot Study
by Ignasi Arcos, Andre Walter, Théophile Marc, Luis Carlos Ojeda and Andreu Puigdollers
J. Clin. Med. 2026, 15(8), 3059; https://doi.org/10.3390/jcm15083059 - 16 Apr 2026
Viewed by 684
Abstract
Background: Conventional Herbst appliances are effective for the correction of skeletal Class II malocclusion, but they are frequently associated with dentoalveolar side effects, particularly lower incisor proclination. Skeletal anchorage systems may improve orthopedic outcomes; however, submucosal miniplates require invasive surgical procedures that [...] Read more.
Background: Conventional Herbst appliances are effective for the correction of skeletal Class II malocclusion, but they are frequently associated with dentoalveolar side effects, particularly lower incisor proclination. Skeletal anchorage systems may improve orthopedic outcomes; however, submucosal miniplates require invasive surgical procedures that may reduce patient acceptance. This pilot clinical study evaluated the feasibility, safety, and skeletal effects of a minimally invasive digitally guided protocol using supragingival miniplates for bone-supported Herbst therapy in late adolescents. Methods: Eleven late-adolescent patients (14–17 years; cervical vertebral maturation stages CS4–CS5) with skeletal Class II malocclusion due to mandibular retrusion were prospectively treated using a bone-supported Herbst appliance anchored to digitally planned supragingival stainless-steel miniplates fixed with bicortical miniscrews. Miniscrew placement was planned by merging CBCT and intraoral scan data and performed using 3D-printed surgical guides. Cephalometric variables, including SNA, SNB, Wits appraisal, mandibular plane angle, and incisor inclinations, were assessed before treatment and after a 10-month Herbst phase. Mandibular advancement was additionally explored using a complementary linear measurement (SeMndb-line). Results: All patients completed treatment without anchorage loss, appliance failure, or surgical complications. Significant skeletal improvements were observed, including an increase in SNB (+3.36°, p < 0.001) and a reduction in Wits appraisal (−2.65 mm, p < 0.001). The SeMndb-line increased by +3.49 mm (p < 0.001), supporting effective mandibular advancement. Lower incisor inclination remained stable (Δ = −0.18°, p = 0.909), indicating effective dentoalveolar control. No clinically relevant changes in vertical skeletal pattern were observed. Conclusions: Digitally guided supragingival miniplates for bone-supported Herbst therapy appear to be a feasible and minimally invasive approach for the treatment of skeletal Class II malocclusion in late adolescents. This protocol achieved clinically meaningful mandibular advancement while minimizing dentoalveolar side effects. Given the pilot design, small sample size, and lack of a control group, further controlled studies with larger samples and long-term follow-up are required. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Prospects)
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24 pages, 1762 KB  
Systematic Review
Assessment of the Effectiveness and Predictability of Maxillary Molar Distalization with Clear Aligner Systems: A Systematic Review of the Literature
by Pau Badía i Martí, Carlos Bellot-Arcís, Beatriz Tarazona-Álvarez, Vanessa Paredes-Gallardo and Natalia Zamora-Martínez
J. Clin. Med. 2026, 15(14), 5568; https://doi.org/10.3390/jcm15145568 - 15 Jul 2026
Viewed by 541
Abstract
Background/Objectives: Maxillary molar distalization is a commonly used orthodontic approach for correcting dentoalveolar Class II malocclusions. However, the predictability of such movements when performed with clear aligners remains uncertain. This systematic review aimed to identify the effectiveness and most predictable protocol for [...] Read more.
Background/Objectives: Maxillary molar distalization is a commonly used orthodontic approach for correcting dentoalveolar Class II malocclusions. However, the predictability of such movements when performed with clear aligners remains uncertain. This systematic review aimed to identify the effectiveness and most predictable protocol for achieving maxillary molar distalization using clear aligner systems. In this review, effectiveness was defined as the amount of distal movement achieved (mm), while predictability was defined as the ratio between achieved and planned movement (%). Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement across PubMed-Medline, Scopus, Embase, Web of Science, and Cochrane Handbook databases, with no restrictions on language or publication date. The search was performed up to April 2026. Studies evaluating maxillary molar distalization with clear aligners were screened based on predefined eligibility criteria. Results: Of the 1388 articles initially identified, 16 met the inclusion criteria (11 retrospective cohort studies and 5 prospective experimental studies), comprising a total of 461 patients. Reported distalization effectiveness varied widely, ranging from 31.1% to 88.4%. A meta-analysis could not be performed owing to substantial clinical and methodological heterogeneity. Conclusions: Clear aligners can achieve maxillary molar distalization; however, the effectiveness decreases as greater distal movement is prescribed, making it unlikely that the clinician’s ideal plan will be fully realized. The use of auxiliary elements, such as Class II elastics, attachments, or skeletal anchorage devices, may reduce anterior proclination and enhance posterior anchorage. Longer aligner-wear intervals (e.g., 14 days) were associated with higher predictability in several of the included studies, although the current evidence is insufficient to establish this interval as definitively superior. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Prospects)
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16 pages, 1128 KB  
Systematic Review
The Influence of Diabetes on Orthodontic Treatment: A Systematic Review of the Clinical Considerations and Challenges in Response
by Paula García-Rios, Francisco Javier Rodríguez-Lozano, Julia Guerrero-Gironés, Miguel R. Pecci-Lloret, Ricardo E. Oñate-Sánchez and Nuria Pérez-Guzmán
J. Clin. Med. 2025, 14(14), 4879; https://doi.org/10.3390/jcm14144879 - 9 Jul 2025
Cited by 4 | Viewed by 2609
Abstract
Background/Objectives: Diabetes mellitus is defined as a group of metabolic diseases characterized by chronically elevated blood glucose levels. This condition influences the course of orthodontic treatment, as it affects various clinical aspects of the patient that must be taken into consideration prior to [...] Read more.
Background/Objectives: Diabetes mellitus is defined as a group of metabolic diseases characterized by chronically elevated blood glucose levels. This condition influences the course of orthodontic treatment, as it affects various clinical aspects of the patient that must be taken into consideration prior to initiation. Therefore, achieving adequate control and management of diabetic patients undergoing orthodontic therapy is essential. This article presents a qualitative synthesis of studies addressing how diabetes affects orthodontic treatments, emphasizing the importance of understanding the necessary considerations prior to initiating treatment and how to manage potential complications. Methods: This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A database search was performed on 5 May 2025, in PubMed, Scopus, Scielo, and The Cochrane Library, using terms related to “diabetes mellitus” and “orthodontic treatments”. Studies meeting the search criteria were included, particularly those that were published in the past ten years and reported on the influence of diabetes on orthodontic treatment. The quality of the case–control studies was assessed using the Newcastle–Ottawa Scale (NOS); for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used; and for experimental studies, the SYRCLE’s Risk of Bias Tool was applied. Results: Fourteen studies ultimately met the inclusion criteria. The evidence showed that diabetes increases gingival bleeding due to elevated levels of advanced glycation end-products (AGEs) and pro-inflammatory cytokines; reduces the efficiency of tooth movement; increases root resorption and affects bone remodeling; and compromises both periodontal and pulpal responses, thereby hindering tissue regeneration. It was also observed that the use of insulin or antidiabetic agents such as metformin may partially mitigate these adverse effects. Conclusions: This systematic review reveals a clear relationship between diabetes and various clinical aspects that influence the progression of orthodontic treatments. Nonetheless, further studies are needed to better understand the impact of this systemic condition on dental treatment outcomes. Full article
(This article belongs to the Special Issue Orthodontics: State of the Art and Prospects)
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