Search Results (264)

The use of orthodontic microimplants in daily practice is now an indispensable part of orthodontic treatment. Unfortunately, the use of skeletal anchorage is associated with a relatively high risk of loss of microimplant stability because of inflammation developing in the surrounding soft tissues. The aim of this systematic review is to identify possible methods of orthodontic microimplant surface modifications providing antibacterial properties. The PubMed, Web of Science, Embase, and Cochrane Reviews databases were searched, and a literature review was conducted. The search was performed between 1 December 2024 and 31 December 2024. The authors used the PICO format to facilitate the search of abstracts and ensure that the relevant components of the question are well defined. The systematic review was written based on the principles detailed in PRISMA. The quality of the papers was assessed based on a tool developed by the authors. Three papers were rated Low Risk of Bias (RoB), four were rated Moderate RoB, and three were rated High RoB. All of the studies presented a method to increase the antibacterial properties of microimplants. More research with a unified methodology is necessary to confirm the effectiveness of the analyzed methods. ZnO, antibiotics, chlorhexidine, silver compounds, selenium, HA, and PEG polymerization plasma represent an interesting perspective for improving the antibacterial properties of orthodontic microimplants. Full article

Osteoclastogenesis—the activation and differentiation of osteoclasts—is one of the pivotal processes of bone remodeling and is regulated by RANKL/RANK signaling, the decoy function of osteoprotegerin (OPG), and a cascade of pro- and anti-inflammatory cytokines. The disruption of this balance leads to pathological bone loss in diseases such as osteoporosis and rheumatoid arthritis. FFAR4 (Free Fatty Acid Receptor 4), a G protein-coupled receptor for long-chain omega-3 fatty acids, has been confirmed as a key mediator of metabolic and anti-inflammatory effects. This review focuses on how FFAR4 acts as the selective receptor for the omega-3 fatty acid docosahexaenoic acid (DHA). It activates two divergent signaling pathways. The Gαq-dependent cascade facilitates intracellular calcium mobilization and ERK1/2 activation. Meanwhile, β-arrestin-2 recruitment inhibits NF-κB. These collective actions reshape the cytokine environment. In macrophages, DHA–FFAR4 signaling lowers the levels of TNF-α, interleukin-6 (IL-6), and IL-1β while increasing IL-10 secretion. Consequently, the activation of NFATc1 and NF-κB p65 is profoundly suppressed under TNF-α or RANKL stimulation. Additionally, DHA modulates the RANKL/OPG axis in osteoblastic cells by suppressing RANKL expression, thereby reducing osteoclast differentiation in an inflammatory mouse model. Full article

Background: Inadequate presurgical planning is a key contributor to suboptimal outcomes in orthognathic surgery. This study aims to assess the accuracy of a digital surgical planning workflow conducted prior to any orthodontic intervention. Methods: Digital planning was performed for 26 patients before orthodontic treatment (T0) and compared to the actual preoperative planning (T1). Digitized plaster casts were merged with CBCT data and converted to orthodontic setups to create a 3D virtual head model. After voxel-based registration of T0 and T1, dental arches were virtually osteotomized and repositioned according to planned outcomes. These T0 segments were then aligned with T1 planning using bony landmarks of the maxilla. Anatomical landmarks were used to construct virtual triangles on maxillary and mandibular segments, enabling assessment of positional and orientational differences. Transformations between T0 and T1 were translated into clinically meaningful metrics. Results: Significant differences were found between T0 and T1 at the dental level. T1 exhibited a greater clockwise rotation of the dental maxilla (mean: 2.85°) and a leftward translation of the mandibular dental arch (mean: 1.19 mm). In SARME cases, the bony mandible showed larger anti-clockwise roll differences. Pitch variations were also more pronounced in maxillary extraction cases, with both the dental maxilla and bony mandible demonstrating increased clockwise rotations. Conclusions: The proposed orthognathic surgical planning workflow shows potential for simulating mandibular outcomes but lacks dental-level accuracy, especially in maxillary anterior torque. While mandibular bony outcome predictions align reasonably with pretreatment planning, notable discrepancies exceed clinically acceptable thresholds. Current accuracy limits routine use; further refinement and validation in larger, homogeneous patient groups are needed to enhance clinical reliability and applicability. Full article

Objectives: Facial soft tissue imaging is crucial in orthodontic treatment planning, and the structured light scanning technology found in the latest iPhone models constitutes a promising method. Currently, studies which evaluate the accuracy of smartphone-based three-dimensional (3D) facial scanners are scarce. This study compares smartphone scans with cone-beam computed tomography (CBCT) images. Materials and Methods: Three-dimensional images of 23 screened patients were captured with the camera of an iPhone 13 Pro Max and processed with the Scandy Pro application; CBCT scans were also taken as a standard of care. After establishing unique image pairs of the same patient, linear and angular measurements were compared between the images to assess the scanner’s two-dimensional trueness. Following the co-registration of the virtual models, a heat map was generated, and root mean square (RMS) deviations were calculated for quantitative assessment of 3D trueness. Precision was determined by comparing consecutive 3D facial scans of five participants, while intraobserver reliability was assessed by repeating measurements on five subjects after a two-week interval. Results: This study found no significant difference in soft tissue measurements between smartphone and CBCT images (p > 0.05). The mean absolute difference was 1.43 mm for the linear and 3.16° for the angular measurements. The mean RMS value was 1.47 mm. Intraobserver reliability and scanner precision were assessed, and the Intraclass Correlation Coefficients were found to be excellent. Conclusions: Smartphone facial scanners offer an accurate and reliable alternative to stereophotogrammetry systems, though clinicians should exercise caution when examining the lateral sections of those images due to inherent inaccuracies. Full article

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, and expert opinions were excluded. Indexed databases (MEDLINE/PubMed, Embase, Scopus, and Web of Science) were searched up to the end point of May 2025, without time and language barriers. The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias (RoB) and quality of evidence were assessed. Results: Three randomized clinical trials (RCTs) and seven non-RCTs were included. In all RCTs and five non-RCTs, OMP was assessed using subgingival plaque samples. Periodontopathogenic bacteria and Gram-negative anaerobic microbes were more often identified in patients undergoing fixed OT than CAT. The biofilm mass was higher in patients undergoing fixed OT than CAT. In two RCTs, periodontopathogenic bacteria were dominant among patients undergoing fixed OT than CAT. All RCTs and two non-RCTs had a high RoB. The certainty of evidence was “moderate” in 70% of the studies. Conclusions: Due to a high RoB, variability in study designs, and lack of power analysis, direct comparisons remain limited. Full article

A challenge in orthodontic treatment is the long time taken to move teeth, which extends the long treatment period. Accordingly, various treatment protocols and orthodontic materials have been developed to shorten the orthodontic treatment period. However, controlling biological reactions is considered necessary to further shorten this treatment period. Orthodontic force results in compression of the periodontal ligament in the direction of tooth movement, resulting in various reactions in the periodontal ligament that induce osteoclast development, alveolar bone absorption, and teeth movement. The aforementioned reactions include immune reactions. Cytokines are substances responsible for intercellular communication and are involved in various physiological actions, including immune and inflammatory reactions. They cause various cellular responses, including cell proliferation, differentiation, cell death, and functional expression. Various cytokines are involved in biological reactions during orthodontic tooth movement (OTM). It is important to understand the role of cytokines during OTM in order to elucidate their biological response. This review discusses the role of cytokines during OTM. Full article

Background: Treacher Collins Syndrome (TCS) is a rare, congenital craniofacial syndrome. Its most characteristic feature is mandibular and midface hypoplasia. Due to malformations of the facial skeleton, airway abnormalities can also be observed, predisposing individuals to obstructive sleep apnoea (OSA). OSA in TCS may contribute to significant morbidity, including developmental delays, cardiovascular disorders and reduced quality of life. Objectives: This narrative review aims to present the true prevalence of OSA and the treatment options for TCS patients. Additionally, the pathophysiology and diagnostic tools for this condition were briefly outlined. Methods: The literature search included publications from PubMed, Scopus, Web of Science and Cochrane Library. The chosen period of time for these publications was 2000–2024. Results: The results showed that OSA is a serious problem among TCS patients. Although there is no standardised treatment protocol, the primary methods often include mandibular distraction osteogenesis (MDO) and continuous positive airway pressure (CPAP). Approaches such as hypoglossal nerve stimulation (HNS) need further investigation, especially with longitudinal observations. Conclusions: The development of treatment options seems to be promising, suggesting a favourable outlook for standardising the treatment protocols. Full article

Fluoride gels are widely used in dental prophylaxis due to their proven ability to prevent demineralization and promote remineralization of hard dental tissues. However, the effectiveness of fluoride release from such gels may be significantly influenced by environmental factors such as pH and the presence of calcium ions. This in vitro study aimed to evaluate how these variables affect fluoride ion release from three commercially available fluoride gels—Clarben, Flairesse, and Lunos. The gels were incubated in artificial saliva of varying pH levels (4.5, 6.0, 7.0, and 7.5) with and without the addition of calcium, as well as in other water-based media—tap water, deionized water, and 0.9% NaCl solution. Fluoride release and changes in pH were measured and statistically analyzed using a multifactorial ANOVA. The results revealed that fluoride release was highest in calcium-free environments and at neutral to slightly alkaline pH, while the presence of calcium significantly reduced fluoride availability. Among the tested products, Flairesse and Lunos exhibited sensitivity to calcium’s presence, unlike Clarben. Fluoride release was generally higher in water than in artificial saliva. Additionally, all gels induced a decrease in pH, which varied depending on the initial pH and calcium content. These findings underline the importance of environmental conditions in optimizing the clinical efficacy of fluoride gel applications. Full article

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

Objective: To evaluate the cytotoxicity and endocrine-disrupting potential of materials used in removable orthodontic retainers. Methods: A literature search (2015–2025) covered in vitro cytotoxicity, estrogenicity, in vivo tissue responses, and clinical biomarkers in PMMA plates, thermoplastic foils, 3D-printed resins, PEEK, and fiber-reinforced composites. Results: Thirty-eight in vitro and ten clinical studies met inclusion criteria, identified via a structured literature search of electronic databases (2015–2025). Photopolymer resins demonstrated the highest cytotoxicity, whereas thermoplastics and PMMA exhibited predominantly mild effects, which diminished further following 24 h water storage. Bisphenol-type compound release was reported, but systemic exposure remained below regulatory limits. No statistically significant mucosal alterations or endocrine-related effects were reported in clinical studies. Conclusions: Retainer materials are generally biocompatible, though data on long-term endocrine effects are limited. Standardized biocompatibility assessment protocols are necessary to enable comparative evaluation across diverse orthodontic materials. Single-use thermoplastics contribute to microplastic release and pose end-of-life management challenges, raising concerns regarding environmental sustainability. Full article

Background/Objectives: A previous study evaluating convex facial profiles at rest demonstrated that combined orthodontic and orthognathic surgical treatment is more effective in enhancing facial aesthetics compared to orthodontic camouflage alone. The present follow-up study aimed to reassess these findings by incorporating both profile and frontal facial views in the aesthetic evaluation. Methods: This retrospective cohort study sample included 36 consecutively selected patients with convex facial profiles and Class II Division 1 malocclusion. Two groups of 18 non-growing patients with similar characteristics were compared. Group A was treated with orthodontics and orthognathic surgery, whereas Group B was treated with orthodontics exclusively. Pre- and post-treatment profile and frontal facial photographs were simultaneously presented to orthodontists, oral and maxillofacial surgeons, convex profile patients, and laypeople, asking them to assess changes in facial appearance. Results: Significant positive changes in facial appearance were perceived for Group A, in contrast to no changes for Group B, with a difference of 17/100 visual analogue scale (VAS) units. The rater groups demonstrated a high degree of consistency (ICC > 0.88). Multivariate analysis revealed significant differences in perceived changes between the two treatment groups (F = 14.63, p < 0.001, Pillai’s Trace = 0.36, and partial η² = 0.36), with no significant effects from the rater group (p > 0.05). Similar results are evident when only profile photos were rated (p > 0.05). Conclusions: The combined orthodontic and orthognathic surgery approach effectively enhances facial appearance in convex profile cases, whereas orthodontic treatment alone does not result in significant changes. These findings should be clearly communicated during patient consultations and considered in treatment planning. Full article

The aim of this study was to evaluate the influence of filler type, filler content, and filler silanization on the flexural strength (FX), elastic modulus (E_m), shore D hardness (SDH), and two-body wear (2BW) of polyaryletherketone (PAEK) compounds. Specimens (40 wt% PEEK, 40 wt% PEK) with different filler types: 20 wt%: fumed silica (FS), calcium silicate (CS), feldspar (FP), magnesium silicate hydrate (MSH), no filler (NF); different filler content: 20, 25 or 30 wt% CS; different filler silanization: 20 wt% CS silanized with alkylsilane/aminosilane, FP silanized with methylsilane/ vinylsilane, no silanization; and PEEK₂₀ (BioHPP) or PEEK₂₅ (BioHPP plus) controls were fabricated and tested for FX, E_m, and SDH. Two-body wear (4 × 100,000 cycles, 50 N, 2.5 Hz) with composite resin antagonists was measured with PAEK_i (35 wt% PEEK, 35 wt% PEK, 30 wt% CS), PAEK_ii (70 wt% PEEK, 30 wt% CS), PAEK_iii (70 wt% PEEK, 25 wt% CS, 5 wt% FP), and PEEK₂₀ controls. Data were analyzed with Kolmogorov–Smirnov-, Kruskal–Wallis-H-, post hoc Scheffé test, pairwise comparisons, Bonferroni correction, one-way ANOVA, and Spearman rho (α = 0.05). An abrasion area analysis was performed. Adding filler increased FX, E_m, and SDH, with CS and MSH showing the highest values for FX and E_m. Adding 30 wt% CS increased FX, E_m, and SDH compared with 20 wt%. Silanization with methylsilane increased FX, E_m, and SDH. Silanization with aminosilane increased FX and SDH. PEEK₂₀ showed the lowest 2BW compared with all EPCs. No material losses were detected on the antagonists. PAEK compounds with 25 to 30 wt% CS increased FX and E_m compared to lower contents, no filler, or PEEK₂₀. Higher values of FX and E_m did not lead to lower 2BW. Full article

Background: The objective of this investigation was to assess the oral health (OH) of Bosnia and Herzegovinian adolescents in relation to differences and socioeconomic status (SES). Methods: This cross-sectional study included 306 school children from high schools located in the Tuzla Canton (Bosnia and Herzegovina). The sample consisted of 183 females and 123 males between 15 and 18 years old (mean of 16.82 years old). The study was conducted between December 2019 and March 2020, via an Annex 8 questionnaire from the World Health Organization (WHO), which collected information on OH behaviours, self-perceptions of oral health and dietary factors responsible for the OH of each subject. SES was categorized using five variables (occupation, education, income, place of residence and number of family members). Cross-tabulations were evaluated according to sex and socioeconomic status (SES) via the chi-square test. Results: Over 40% of the participants consumed sweets, cakes and biscuits on daily basis, whereas 41.5% of the participants visited a dentist only in the case of pain. The consumption of sweets (p = 0.024) and cakes and biscuits (p = 0.011) on a daily basis was significantly greater in female adolescents than in male adolescents. Compared with male adolescents, female adolescents reported occasional toothaches more frequently (p = 0.001) and were more dissatisfied with their dental appearance (p = 0.008) but presented a greater frequency of flossing (p = 0.001) and toothbrushing (3–5 times a day) (p = 0.0001). There was no association between the different levels (below average, average, above average) of SES and factors affecting OH status of adolescents. Conclusions: The study revealed significant sex differences in several factors affecting OH status and revealed no relationship between SES and OH behaviours or between perceptions and risk factors affecting OH in 15–18-year-old adolescents. Data obtained from this study might help in the creation of new OH prevention programs aimed at improving the OH status of adolescents in Bosnia and Herzegovina. Full article

(1) The aim was to evaluate the predictability of treatment outcomes using clear aligner therapy (CAT) and ClinCheck Web 1.4 (Align Technology, Inc., San Jose, CA, USA) software in mandibular incisor intrusion in both children and adults with deep bite malocclusion. (2) This study included healthy children and adults with skeletal Class I or mild to moderate Class II/III malocclusions, mild to moderate dental crowding (<5 mm), and deep overbite (OB) who underwent CAT. Pre-treatment (T1) and post-treatment (T2) orthodontic treatment records were assessed and compared to initial planned ClinCheck movements. The cephalometric parameters evaluated included bodily intrusion (Centroid-C point), IMPA, L1-NB, and L1-A-Po. Clinical expression of CAT was compared to ClinCheck predictions using paired sample t-tests, and differences between growing and non-growing groups were assessed using a repeated measures ANOVA with Tukey post hoc analysis. (3) The sample included 48 patients (mean age 19.79 ± 11.78 years), including 18 adults (mean age 30.28 ± 13.79 years) and 30 children (mean age 13.5 ± 2.05 years). The predicted vertical mandibular incisor movement (intrusion) was significantly higher using ClinCheck (2.32 mm) compared to clinical treatment (0.22 mm). The angular movements of IMPA, L1-NB, and L1-APo were all significantly higher using ClinCheck (4.6°) compared to clinical expression of 0.79°, 0.55°, and 1.21°, respectively. There were no significant differences between children and adults with respect to vertical or angular tooth movements. (4) CAT and ClinCheck software significantly overpredicts orthodontic tooth movements related to mandibular incisor intrusion in both adults and children with no statistical difference between the groups. Full article

Objectives: This narrative review aims to redefine Open Mouth Posture Syndrome (OMPS) as a multifactorial condition with overlapping symptoms and a cyclical pathophysiology. A novel classification system for OMPS subtypes is proposed to standardize research approaches and enhance clinical understanding. Methods: An interdisciplinary literature review was conducted, focusing on structural, functional, and adaptive mechanisms underlying OMPS. Subtype definitions were refined based on recent findings. Results: OMPS is categorized into five subtypes: Obstructive, Habitual, Anatomical, Sleep-Disordered Breathing, and Tongue-Related Pathologies. These subtypes share interconnected etiologies and manifestations, contributing to a feedback loop that complicates diagnosis and management. Conclusions: This classification system lays the foundation for future research and clinical protocols, emphasizing the need for a systematic approach to understanding OMPS. Full article