Search Results (44)

Background and Objectives: Halitosis can impair psychosocial well-being, and orthodontic appliances may modify plaque retention and oral ecology. We compared patient-perceived halitosis burden, clinician-rated malodor, and oral health-related quality of life (OHRQoL) among clear aligner users, fixed-brace patients, and untreated controls, and explored oral and salivary correlates of worse malodor severity. Methods: This cross-sectional study (March 2024–November 2025) enrolled 184 participants aged 15–35 years (aligners n = 62; fixed braces n = 64; controls n = 58). Outcomes were HALT (0–100), organoleptic score (0–5), and OHIP-14 (0–56). Plaque index, gingival inflammation, tongue coating, and unstimulated salivary flow were recorded; low flow was defined as <0.25 mL/min. Organoleptic score ≥ 2 was used descriptively for clinically relevant malodor prevalence, whereas organoleptic score ≥3 defined a moderate-to-severe malodor phenotype for secondary exploratory internal modeling. Multivariable robust linear models (HALT) and proportional-odds ordinal logistic regression (organoleptic severity) were used. Results: Fixed braces showed higher HALT (53.7 ± 6.2) than controls (46.3 ± 6.4) and aligners (41.7 ± 7.4) (p < 0.001), higher organoleptic scores (2.9 ± 0.4 vs. 2.4 ± 0.6 vs. 2.2 ± 0.6; p < 0.001), and worse OHIP-14 (18.6 ± 4.7 vs. 15.9 ± 4.3 vs. 13.8 ± 4.8; p < 0.001). Clinically relevant malodor prevalence (organoleptic ≥ 2) was 96.9% in fixed braces, 79.3% in controls, and 66.1% in aligners (p < 0.001); because ≥2 was used as a broad descriptive threshold, these values should be interpreted as descriptive rather than diagnostic prevalence estimates. In adjusted models, greater tongue coating, higher plaque, and low salivary flow were associated with worse organoleptic severity, whereas appliance category did not remain independently associated with HALT once concurrent clinical correlates were included. Conclusions: Fixed braces showed higher unadjusted malodor burden and worse OHRQoL than aligners and untreated controls, but appliance category should be interpreted as a contextual exposure linked to plaque-retentive conditions rather than as a standalone causal determinant. Plaque accumulation, tongue coating, and lower salivary flow showed the strongest associations with worse malodor severity. These findings should be interpreted in light of the cross-sectional design, possible observer and selection bias, and residual confounding. Full article

Introduction: This study aimed to evaluate the educational value of YouTube videos presenting information on pediatric orthodontic treatments, specifically clear aligners, fixed braces, and lingual braces. Methods: A cross-sectional analysis was conducted on 150 of the most-viewed English-language YouTube videos (50 per treatment type). Videos were assessed for accuracy, depth of explanation, source type (expert, commercial, or general user), and viewer engagement metrics. Statistical comparisons were made using the Kruskal–Wallis test and Dunn’s post hoc tests with Bonferroni correction. Results: Fixed brace videos demonstrated more accuracy (average score 4.2/5), than both clear aligners (p = 0.03) and lingual braces (p < 0.001), with 60% originating from expert sources. Clear aligner and lingual brace videos had lower accuracy scores (3.8 and 3.5, respectively), reflecting higher proportions of commercial influence (50% and 55%). The findings highlighted the predominance of promotional content in clear aligner and lingual brace videos, raising concerns about potential misinformation. Conclusions: YouTube provides accessible but variable-quality information on pediatric orthodontics. Fixed brace videos offer more reliable educational content, while clear aligner and lingual brace videos are more susceptible to commercial bias. Efforts to promote expert-driven content and implement content verification systems are needed to improve the quality of online orthodontic information for parents and caregivers. Full article

Background: The present study aimed to identify the differences between experiences, in terms of oral health-related quality of life, pain, side effects and/or other complications, of adults undergoing orthodontic treatment using removable aligners and fixed labial or lingual appliances. Methods: The review was registered with PROSPERO, and a comprehensive electronic search was undertaken without language or date restrictions. Randomised and non-randomised trials and prospective cohort and cross-sectional studies along with case series were included. The Cochrane Collaboration’s Risk of Bias 2 Tool, Newcastle–Ottawa Scale and The Risk Of Bias In Non-Randomized Studies—of Interventions tools were used to assess quality. Data were grouped in terms of oral health-related quality of life, pain side effects and/or other complications. Results: Data from 35 studies were included; 9 were eligible for meta-analysis. Thus 2611 participants were included related to removable aligners (n = 513), fixed labial (n = 1816) and lingual (n = 218) appliances or a combination (n = 64) of appliances. The standardised mean differences in visual analogue scale pain reports between 24 h and 7 days were −10.02 (95% CI: −11.13, −8.91) for aligners and −6.40 (95%CI: −10.42, −2.38) for labial appliances (p = 0.09). There was a significant improvement in dental self-confidence following fixed labial appliance treatment (p = 0.001). Conclusions: No difference was detected in short-term pain with aligners and labial appliances. Aligners may have less impact on oral health-related quality of life measures compared to labial appliances. Lingual appliances have a persistent impact on speech, despite some adaptability. Any deterioration in oral health-related quality of life measures during treatment appears temporary. Further randomised trials using validated assessment tools and comparing aligners and labial and lingual appliances are required. Full article

Background: The development of the curve of Spee (CoS) is influenced by skeletal morphology, orofacial growth, tooth eruption timing, mandibular relationships, overbite, and neuromuscular development. This systematic review aims to determine the most effective orthodontic methods in correcting the curve of Spee. Methods: The systematic review protocol was registered on the PROSPERO platform and conducted according to the Cochrane and PRISMA guidelines. For its development, a standardized search was performed across different databases (MEDLINE, Cochrane Library, Embase and Web of Science) and grey literature. The risk of bias was assessed using Faggion, Jr.’s guidelines for in vitro and in silico studies of dental materials, and the Rob-2 and ROBINS-1 tools for clinical studies. Results: The initial search found 748 studies, with 44 selected after full-text review. Of these, 22 were included in the quantitative analysis, assessing the effectiveness of braces (with or without extractions) and invisible aligners. Key methods for correcting the curve of Spee include various orthodontic archwires (nickel–titanium (NiTi), stainless steel, beta-titanium), continuous and segmented techniques, reverse curve archwires, aligners, and treatment modalities including extraction protocols. Most in vitro studies and randomized studies had a high risk of bias, and non-randomized studies showed moderate to high bias risk. Conclusions: The results suggest that conventional techniques, particularly non-extraction approaches, may be more effective than aligners in correcting the curve of Spee, although the available evidence remains limited. Full article

(1) Background: The present study aimed to evaluate the effects of fixed orthodontic treatment using the Damon self-ligating system on incisor inclination and soft tissue facial profile. Additionally, the study compared the outcomes of premolar extraction versus non-extraction approaches on these parameters. (2) Methods: This retrospective study included 72 patients who were treated with the Damon self-ligating bracket system (Damon, Ormco, Orange, CA, USA). Thirty-five patients (mean age 12.5 years; 20 girls and 15 boys) underwent premolar extraction (Group Ex), while 37 patients (mean age 12.8 years; 16 girls and 21 boys) were treated without extractions (Group NonEx). Lateral cephalometric radiographs were taken pre- and posttherapeutically, and measurements were conducted using OnyxCeph3™ (Image Instruments, Chemnitz, Germany). (3) Results: Following orthodontic treatment, the upper incisors in group Ex were significantly more retruded (p < 0.01), while the mandibular incisors in group NonEx were significantly more proinclined (p < 0.01). Both lips in group Ex, and the upper lip in the group NonEx, exhibited a greater distance from the esthetic line post-therapy (p < 0.01). The position of the lips relative to the SR line did not significantly change in group Ex, whereas group NonEx showed a significantly increased lip protrusion (p < 0.01). A weak negative correlation (−0.37) was observed between the increased retroclination of the upper incisors and the retrusion of the upper lip relative to the SR line. (4) Conclusions: Premolar extraction, as part of a treatment strategy for cases with severe crowding, combined with Damon™ self-ligating braces, does not adversely affect the soft tissue profile. Full article

Background and Objectives: Orthodontic treatment aims to enhance dental aesthetics and function, yet many patients report dissatisfaction. This study was designed with the following objectives: To assess overall patient satisfaction during active orthodontic treatment; to identify key psychosocial and clinical predictors of satisfaction, including self-confidence, social experiences, and cost perception; to evaluate the impact of orthodontist–patient communication on satisfaction and perceived treatment outcomes; to explore the relationship between aesthetic improvement and willingness to undergo treatment again. Materials and Methods: A cross-sectional survey was conducted using structured questionnaires to assess satisfaction, pain perception, treatment expectations, and communication quality. Statistical analyses, including correlations and regression models, were used to identify predictors of satisfaction. The study included 450 orthodontic patients from the north-eastern region of Romania, undergoing active treatment at the time of data collection. Results: The strongest predictor of satisfaction was improved self-confidence and smile aesthetics (r = 0.62). Effective communication with orthodontists significantly increased satisfaction (r = 0.58, p = 0.002), while perceived high costs had a negative impact (r = −0.41). Pain and discomfort were common, with 90% of patients experiencing treatment-related pain, leading to reduced compliance. Social embarrassment due to braces also contributed to dissatisfaction (r = −0.47). Conclusions: Patient satisfaction with orthodontic treatment is primarily influenced by aesthetic improvements and effective communication. While enhanced smile perception boosts confidence, financial concerns and social discomfort may negatively affect the overall experience. Improving accessibility to treatment and providing comprehensive patient support are essential for optimizing patient satisfaction. Full article

According to the World Health Organization, malocclusion type III is third, most important oral health problem. It may be the least prevalent malocclusion, but it is the most noticeable and challenging for orthodontic therapy. With this narrative review, we wanted to give a summation of the most current knowledge about diagnostics, different therapy options, limitations, and additional factors that can influence the therapy of class III malocclusion to help clinicians and researchers focus on the specific approaches. Therapy options were divided into the following groups: orthopedic, orthodontic, and surgical. The SNA, SNB, and ANB angles (cephalometric values) are the best ones to examine improvements in different skeletal improvements, while dentoalveolar improvements were also described, emphasizing the limitation of orthopedic therapy to change the skeletal discrepancy. Eruption-guided appliances and chin cups are more effective in early childhood, mixed dentition, during permanent teeth eruption, with no significant skeletal discrepancy. If a discrepancy exists, a face mask is the first therapy choice. The therapy of an underdeveloped maxilla can be solved with different palate expanders. Bulkiness, lack of long-term results, and duration of therapy make fixed orthodontic appliances with braces and elastic traction favorable nowadays. If the skeletal discrepancy is major, a surgical approach should be considered. One of the main limitations in articles is the combination of different therapy approaches, ages, and dentition preferred for device application, duration of therapy, and lack of information about long-term outcomes. On the other hand, the lack of original articles is noticeable, so further research should be done. Full article

Artificial Intelligence (AI) is rapidly transforming orthodontic care by providing personalized treatment plans that enhance precision and efficiency. This narrative review explores the current applications of AI in orthodontics, particularly its role in predicting tooth movement, fabricating custom aligners, optimizing treatment times, and offering real-time patient monitoring. AI’s ability to analyze large datasets of dental records, X-rays, and 3D scans allows for highly individualized treatment plans, improving both clinical outcomes and patient satisfaction. AI-driven aligners and braces are designed to apply optimal forces to teeth, reducing treatment time and discomfort. Additionally, AI-powered remote monitoring tools enable patients to check their progress from home, decreasing the need for in-person visits and making orthodontic care more accessible. The review also highlights future prospects, such as the integration of AI with robotics for performing orthodontic procedures, predictive orthodontics for early intervention, and the use of 3D printing technologies to fabricate orthodontic devices in real-time. While AI offers tremendous potential, challenges remain in areas such as data privacy, algorithmic bias, and the cost of adopting AI technologies. However, as AI continues to evolve, its capacity to revolutionize orthodontic care will likely lead to more streamlined, patient-centered, and effective treatments. This review underscores the transformative role of AI in modern orthodontics and its promising future in advancing dental care. Full article

Background: Orthodontic treatment with fixed appliances often induces pain. Despite existing research on pain management, the dynamic nature of orthodontic pain and its relationship with tooth movement remain underexplored. This study surveys adults under fixed appliance therapy to investigate pain dynamics, modifying factors, and perceived tooth movement, aiming to provide insights for improved patient care and treatment outcomes. Methods: This study focused on healthy individuals aged 18 to 50 undergoing fixed appliance treatment for up to six months after having braces bonded. A 24-question survey was administered over a one-month period. The survey explored pain intensity, pain dynamics, modifying factors, and perceived tooth movement. Results: Pain typically began within the first few hours after bonding and peaked the following day for most respondents. The upper incisors and molars were the most frequently reported areas of pain, corresponding to the teeth perceived as moving earliest. Chewing was identified as the primary external pain trigger. Gender significantly influenced pain perception, with women reporting higher pain levels and greater use of medication. The majority of participants managed without medication. Conclusions: Pain during the early phase of fixed appliance therapy follows a predictable pattern, with peak intensity occurring on the day after bonding. Pain perception strongly correlates with early tooth movement, particularly in the upper incisors. Gender differences were evident, but other demographic factors had minimal influence. Chewing was the primary pain aggravator, emphasizing the need for dietary modifications. Understanding these findings can help orthodontists develop personalized pain management strategies. Full article

Background/objective: In orthodontic therapy, the periodontal ligament plays a critical role in the bone remodeling process by stimulating osteoblasts in tension zones and promoting bone resorption through osteoclasts in compression zones in response to mechanical stress. These processes are regulated by key cytokines, such as RANKL and IL-1, which are influenced by factors such as patient age and force application. This work evaluates the effectiveness of clear aligners versus traditional braces on periodontal health in patients with periodontitis, following PRISMA guidelines and utilizing specific inclusion and exclusion criteria. Methods: A systematic review of 1664 records was conducted, leading to the inclusion of eight studies that focus on the impact of orthodontic treatments on periodontal health. The review identifies various biases present in the literature. Results: The findings reveal that clear aligners, in contrast to fixed appliances, improve oral hygiene and reduce inflammation, leading to better periodontal outcomes. Fixed appliances, on the other hand, may exacerbate plaque accumulation and inflammation, which can worsen periodontal health. Conclusions: Clear aligners offer advantages over fixed appliances in terms of enhancing periodontal health, improving patient compliance, and providing long-term benefits, particularly in patients with severe periodontitis. The effectiveness of clear aligners is linked to better management of periodontal complications and overall oral hygiene. Treatment decisions should be based on patient-specific criteria to optimize outcomes. Full article

The integration of 3D printing has transformed orthodontics, allowing for the creation of highly customized intraoral devices that support traditional orthodontic treatments. This review examines the innovations and applications of 3D-printed accessories in orthodontics, focusing on customization, precision, and workflow improvements. In-office 3D printing enables reduced dependence on external labs, enhancing efficiency and potentially lowering costs. Key topics include material properties, biocompatibility, and clinical applications, alongside an evaluation of both successes and limitations highlighted in recent studies. Unlike prior research focused on aligners and braces, this review centers on auxiliary devices, demonstrating how 3D printing can revolutionize these less-studied accessories in orthodontics. The rise of 4D memory shape materials signals a potential breakthrough in “smart orthodontics”, where directly printed devices can adapt over time. This innovation could lead to a new era of personalized dynamic orthodontic solutions with 3D-printed auxiliaries, providing unprecedented customization and expanding the scope of orthodontic care. Further research is essential to address challenges related to durability, biocompatibility, and long-term clinical performance to optimize 3D printing’s role in orthodontic treatments. Full article

Clear aligners have transformed orthodontic care by providing an aesthetic, removable alternative to traditional braces. However, their significant environmental footprint, contributing to approximately 15,000 tons of plastic waste annually, poses a critical challenge. To address this issue, advancements in 4D printing have introduced “smart” aligners with shape memory properties, enabling reshaping and reducing the number of aligners required per treatment. This study focuses on ClearX aligners, an innovative 4D-printed solution aimed at extending usage duration and minimizing environmental impact. Using a comprehensive suite of tests, including morphological, optical, and mechanical evaluations conducted via scanning electron microscopy, UV-Vis spectroscopy, infrared spectroscopy, and bending and strain assessments, we evaluated the optical and mechanical stability of the ClearX material before and after thermal activation. Our results demonstrate that ClearX aligners retain their structural and functional properties after reshaping. Temporary changes in transparency, observed only under prolonged treatment durations exceeding manufacturer recommendations, are fully reversible within 12 h and do not compromise the aligner’s usability. These findings support the potential of ClearX aligners to effectively combine patient-centered, high-quality orthodontic care with sustainable practices. Full article

Background: Orthodontic treatments have evolved significantly, with clear aligners becoming increasingly popular due to their aesthetic appeal and ease of use. This study systematically reviewed the impact of clear aligners in the changes in the oral microbiota compared to traditional fixed appliances. Methods: Following PRISMA guidelines, a systematic review was conducted using two databases such as Scopus, Web of Science, and the PubMed search engine. The studies included were those published between 2010 and 2023, involving adults over 18 years using clear aligners and fixed appliances. The data on oral microbiota changes were extracted and analyzed. Results: The review included eight studies, highlighting the differences in microbial changes associated with clear aligners versus fixed appliances. Clear aligners were associated with fewer detrimental changes in the oral microbiota, potentially due to their removable nature allowing for better hygiene. Fixed appliances showed a tendency to harbor more pathogenic bacteria, which is likely due to their difficulty to clean. Conclusions: Clear aligners may offer a better alternative to fixed appliances in terms of maintaining a healthier oral microbiota. Their design and ease of hygiene contribute to less accumulation of pathogenic bacteria, showing a more positive impact on maintaining a balanced oral microbiota when compared to fixed appliances. Full article

Despite the rise in popularity of ceramic braces for adults, the risk of enamel microcracks (EMCs) upon removal remains a significant drawback for both dental professionals and patients. Our study aimed to assess the effects of thermocycling, pre-curing, and co-curing techniques with different bonding agents on the enamel surface of teeth after the removal of ceramic brackets. We also examined the incidence, quantity, length, and direction of EMCs on tooth surfaces. Additionally, the adhesive remnant index (ARI) scores and orthodontic bracket bond failure modes were evaluated and compared. The study divided 40 extracted upper canine teeth into ten groups for further analysis. Two groups had intact enamel as the negative control, while the remaining groups had orthodontic ceramic brackets bonded using different bonding agents and curing techniques. Thermocycling was performed in five groups, and ARI was assessed after debonding. The study findings were statistically significant (p < 0.05) in demonstrating the impact of curing techniques on EMCs and debonding outcomes. Seventh-generation bonding agents resulted in complete adhesive removal (ARI = 0). The microcracks’ incidence, number, and length showed insignificant results. Differences in ARI between thermocycler and non-thermocycler samples were insignificant. Both co-curing and pre-curing techniques yielded comparable ARI results. This study highlights the importance of using advanced bonding agents to minimize enamel damage during ceramic bracket debonding. Full article

(•) Orthognathic surgery is a necessary procedure for the correction of severe skeletal discrepancies, among which are skeletal Class III malocclusions. Currently, both conventional fixed braces and clear aligners can be used in orthognathic surgery. However, the use of clear aligners remains a little-chosen option. The present study aimed to evaluate the skeletal and aesthetic improvements in adults with Class III malocclusion after surgical treatment and compare the results achieved by fixed appliances versus clear aligners. The study sample included four patients (three males and one female, aged 18 to 34 years) with skeletal Class III malocclusion, three of whom underwent a bimaxillary surgery and one of whom underwent only a bilateral sagittal split osteotomy. Two patients were treated with fixed appliances and two with clear aligners. The pre- and post-surgical hard and soft tissue cephalometric measurements were performed and compared for each patient and between fixed appliances and clear aligners. One year after surgery, all patients showed an essential modification of the face’s middle and lower third with an increase in the convexity of the profile and the Wits index and a reduction in the FH^NB angle. No differences were noted between fixed appliances and aligners. Therefore, thanks to the 3D-assisted surgery associated with orthodontics, every participant achieved proper occlusal function and an improved facial aesthetics. In addition, the clear aligners can be considered a valid alternative for pre- and post-surgical orthodontic treatment. Full article