Search Results (84)

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

Background: Distalization is a fundamental orthodontic strategy for correcting Class II and Class III malocclusions, particularly in cases where specific dental or skeletal conditions favor its application. Recent technological advances have enabled complex dental movements to be performed using clear aligners, aided by digital planning platforms such as ClinCheck^®. Methods: This retrospective study aimed to evaluate the accuracy of ClinCheck^® in predicting molar and canine distalization outcomes with the Invisalign^® system and to identify clinical factors influencing treatment predictability. Thirty patients with complete permanent dentition and at least 2 mm of programmed distalization were selected. Planned movements were extracted from the Invisalign^® Doctor Site and compared to achieved outcomes using Geomagic^® Control X™ software. Occlusal improvements were assessed using the Peer Assessment Rating (PAR) index. Results: The results revealed significant discrepancies between the programmed and achieved distalization, with mean deviations greater than 1 mm in both arches. Skeletal anchorage with mini-screws significantly improved distalization outcomes in the maxillary arch; however, no significant effect was observed in the mandibular arch. Additionally, no significant associations were found between distalization outcomes and skeletal pattern (ANB angle) or facial biotype. Conclusions: Clear aligners are effective in achieving substantial occlusal improvements, particularly when combined with personalized digital planning and supplementary strategies such as skeletal anchorage. Mandibular cases demonstrated greater reductions in PAR scores, emphasizing the potential of aligners in complex distalization treatments. Full article

Obstructive sleep apnea syndrome (OSAS) in children and adolescents is a prevalent and multifactorial disorder associated with significant short- and long-term health consequences. While adenotonsillectomy (AT) remains the first-line treatment, a substantial proportion of patients—especially those with obesity, craniofacial anomalies, or comorbid conditions—exhibit persistent or recurrent symptoms, underscoring the need for individualized and multimodal approaches. This review provides an updated and comprehensive overview of current and emerging treatments for pediatric OSAS, with a focus on both surgical and non-surgical options, including pharmacological, orthodontic, and myofunctional therapies. A narrative synthesis of recent literature was conducted, including systematic reviews, randomized controlled trials, and large cohort studies published in the last 10 years. The review emphasizes evidence-based indications, mechanisms of action, efficacy outcomes, safety profiles, and limitations of each therapeutic modality. Adjunctive and alternative treatments such as rapid maxillary expansion, mandibular advancement devices, myofunctional therapy, intranasal corticosteroids, leukotriene receptor antagonists, and hypoglossal nerve stimulation show promising results in selected patient populations. Personalized treatment plans based on anatomical, functional, and developmental characteristics are essential to optimize outcomes. Combination therapies appear particularly effective in children with residual disease after AT or with specific phenotypes such as Down syndrome or maxillary constriction. Pediatric OSAS requires a tailored, multidisciplinary approach that evolves with the child’s growth and clinical profile. Understanding the full spectrum of available therapies allows clinicians to move beyond a one-size-fits-all model, offering more precise and durable treatment pathways. Emerging strategies may further redefine the therapeutic landscape in the coming years. Full article

Background and Objectives: To systematically map and evaluate the current literature on the application of artificial intelligence (AI) in teleorthodontics, focusing on clinical use, technological approaches, outcomes, and limitations. Materials and Methods: A scoping review was conducted following a formal and recognized methodological framework. Three databases (PubMed, Scopus, Web of Science) were searched until 30 April 2025. Studies were included if they reported original data on AI applications in orthodontic remote monitoring or virtual care. Data extraction focused on study design, type of AI, clinical setting, reported outcomes, and main findings. Results: Nine studies met the inclusion criteria. Most research focused on the use of the Dental Monitoring™ (DM) system, which employs deep learning algorithms to analyze intraoral scans captured via smartphones. Reported benefits included reduced in-office visits (up to 33%), accurate 3D tracking of tooth movement, improved hygiene compliance, and high patient engagement. However, significant variability was observed in the repeatability and precision of AI decisions, especially in GO/NO-GO aligner progression instructions. One study explored an alternative system, StrojCHECK™, based on a decision tree algorithm, showing improved compliance with personalized feedback. Conclusions: AI-powered teleorthodontic systems show potential to enhance treatment efficiency and patient engagement, particularly in aligner therapy. However, their current clinical application remains narrowly focused on commercial monitoring platforms, with limited validation and transparency. This review highlights the early stage of real-world AI integration in orthodontics, underlining the need for independent validation, broader applications beyond monitoring, and robust ethical frameworks. In this context, AI should be used as a complementary tool, never a substitute, for clinical judgment. Full article

Background/Objectives: Orthodontic camouflage is a treatment strategy designed to address mild to moderate skeletal discrepancies through dental compensation when growth modification or orthognathic surgery (OGS) is unsuitable or declined by the patient. This report highlights the treatment of a child with a skeletal Class II pattern, Class II division 1 malocclusion, a 10.8 mm overjet, traumatic overbite, and unilateral temporomandibular joint (TMJ) ankylosis on the left side. Methods: The treatment plan focused on correcting the proclination of the maxillary incisors and improving the facial profile. A non-extraction camouflage approach using pre-adjusted edgewise appliances was implemented following a gap arthroplasty procedure on the left TMJ. Results: The patient achieved a satisfactory treatment outcome, with an ideal static and functional occlusion and significant improvement in facial esthetics. The approach effectively managed the severe mandibular retrognathia and TMJ ankylosis without OGS, thereby minimizing the risk of progressive condylar resorption. Conclusions: This case underscores the importance of personalized treatment plans tailored to each patient’s dental, skeletal, and individual needs. It demonstrates that non-surgical camouflage treatments can be a viable alternative for addressing severe mandibular retrognathia with TMJ ankylosis, achieving favorable esthetic and functional outcomes. Full article

The advancement of digital technologies has revolutionized the medical field, offering new opportunities for the biomechanical analysis and simulation of anatomical structures. This study explored the modeling of mandibular and dental components using advanced methods such as finite element analysis (FEA) and three-dimensional modeling. Special attention was given to the distribution of masticatory forces and their impact on premolars, highlighting the biomechanical differences between restorative materials such as amalgam and composites. The results indicate that each material presents specific advantages depending on the loading conditions, emphasizing the need for personalized dental treatments. This study confirms the effectiveness of numerical methods in optimizing the design of dental structures and supports the applicability of these techniques in orthodontics, maxillofacial surgery, and dental prosthetics. Full article

Objective: Intraoral scanners (IOS) provide high-precision 3D data of teeth and gingiva, critical for personalized orthodontic diagnosis and treatment planning. However, traditional segmentation methods exhibit reduced performance with complex dental structures, such as crowded, missing, or irregular teeth, constraining their clinical applicability. This study aims to develop an advanced 3D point cloud segmentation model to enhance the automated processing of IOS data in intricate orthodontic scenarios. Methods: A 3D point cloud segmentation model was developed, incorporating relative coordinate encoding, Transformer-based self-attention, and attention pooling mechanisms. This design optimizes the extraction of local geometric features and long-range dependencies while maintaining a balance between segmentation accuracy and computational efficiency. Training and evaluation were conducted using internal and external orthodontic datasets. Results: The model achieved a mean Intersection over Union (IoU) of 92.14% on the internal dataset and 91.73% on the external dataset, with Dice coefficients consistently surpassing those of established models, including PointNet++, TSGCN, and PointTransformer, demonstrating superior segmentation accuracy and robust generalization. Conclusions: The model significantly enhances tooth segmentation accuracy in complex orthodontic scenarios, such as crowded or irregular dentitions, enabling orthodontists to formulate treatment plans and simulate outcomes with greater precision—for example, optimizing clear aligner design or improving tooth arrangement efficiency. Its computational efficiency supports clinical applicability without excessive resource consumption. However, due to the limited sample size and potential influences from advancements in IOS technology, the model’s generalizability requires further clinical testing and optimization in real-world orthodontic settings. Full article

Orthodontic treatment demand has surged due to heightened aesthetic concerns and the increased recognition of oral health’s role in overall well-being. This systematic review was conducted by searching across multiple databases (PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar) for observational studies published between January 2000 and April 2024 that assessed personality traits using validated instruments, with inclusion criteria focused on outcomes such as pain perception, treatment attitude, compliance, satisfaction, and quality of life. The results consistently indicate that negative personality traits, particularly high neuroticism, are associated with increased pain perception, lower satisfaction, and reduced compliance. In contrast, positive traits, including extraversion, agreeableness, and conscientiousness, were correlated with improved orthodontic outcomes and more favorable treatment attitudes. Additionally, extraversion and openness were observed to moderate the negative impact of malocclusion severity on oral health-related quality of life. When examining gender, overall differences were minimal; however, some studies indicated that females reported slightly higher pain scores. These findings underscore the multifaceted role of personality by suggesting that psychological profiling should be incorporated into clinical practice. By recognizing individual personality profiles, clinicians can tailor treatment approaches to foster patient-centered care, optimizing orthodontic outcomes and enhancing overall patient satisfaction. 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: Managing unilateral maxillary lateral incisor agenesis (UMLIA) with an associated microdontic or peg-shaped contralateral incisor (Mi or Peg MLI) presents clinical and esthetic challenges. Deciding between orthodontic space opening (OSO) or closure (OSC) and whether to restore or extract the Mi or Peg MLI are critical factors for achieving optimal treatment outcomes. Methods: A systematic review was conducted using a dual strategy across Scopus, Web of Science, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases. The Cochrane RoB2 tool was used for randomized controlled trials (RCTs), the ACROBAT-NRSI tool for non-randomized studies, and the JBI Manual for case reports. High-quality case reports were included when the literature was limited. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) tool evaluated the certainty of evidence, considering bias, inconsistency, indirectness, imprecision and other considerations. Results: Thirty-five studies met the inclusion criteria, assessing treatment modalities, esthetic outcomes, periodontal health, and occlusal and temporomandibular joint (TMJ) function. Both OSO and OSC demonstrated similar occlusal and TMJ outcomes, while slight differences in esthetic and periodontal results were noted between the two approaches. Direct composite and indirect ceramic restorations showed comparable effectiveness for reshaping the Mi or Peg MLI. Extraction combined with OSC contributed to improved smile symmetry. Conclusions: A personalized, multidisciplinary approach is essential for treating UMLIA with an Mi or Peg MLI. Both OSO and OSC are viable options, and the choice should be tailored to the patient’s specific clinical scenario, with attention to achieving the best esthetic and periodontal outcomes. Further research is needed to refine treatment protocols and support clinical decision-making. Full article

Background: Obstructive sleep apnea (OSA) is characterized by repetitive complete or partial closure of the upper airway during sleep, which is a potentially life-threatening disorder. A cephalogram is a simple and effective examination to predict the risk of OSA in orthodontic clinical practice. This study aims to analyze the relationship between craniofacial characteristics and the severity of OSA using polysomnography and cephalogram data. Gender differences in these parameters are also investigated. Methods: This study included 112 patients who underwent a complete clinical examination, standard polysomnography study, and cephalometric analysis to diagnose obstructive sleep apnea. This study divided the participants into male and female groups to study the correlation between cephalometric parameters and the severity of OSA. The analysis involved 39 cephalometric parameters. The severity of obstructive sleep apnea was evaluated by the apnea–hypopnea index (AHI) and the lowest nocturnal oxygen saturation (LSaO₂). Results: The final assessment included 112 adult participants (male/female = 67:45, mean age: 28.4 ± 7.29 years, mean male age: 28.8 ± 7.62 years, mean female age: 27.8 ± 6.79 years). Multivariate analysis revealed that the mandibular position, incisor inclination, facial height, and maxillary first molar position were strongly associated with OSA severity. Gender-specific differences in cephalometric predictors were identified, with distinct parameters correlating with the AHI and LSaO₂ in males and females. Notably, the LSaO₂ demonstrated stronger associations with craniofacial morphology in females than males. Conclusions: Cephalometric analysis can be effective in assessing the risk and severity of OSA based on the correlation between cephalometric parameters and the AHI/LSaO₂. There is a clear difference between the cephalometric parameters associated with OSA severity in male and female individuals. This gender-dependent pattern may assist the personalized diagnosis and management of OSA in clinical practice. 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

Three-dimensional (3D) printing is transforming dentistry by enabling precise and personalized treatments in prosthodontics, orthodontics, and endodontics. However, challenges such as high costs, material limitations, and post-processing requirements hinder its broader adoption. This scoping review aims to explore and map the breadth of evidence regarding the clinical applications, benefits, and limitations of 3D printing in these disciplines, while identifying research gaps and future opportunities. A scoping review was conducted following the PRISMA for scoping reviews framework. Research from PubMed, Google Scholar, and Scopus was systematically searched, covering studies from January 2006 to November 2024. Key topics included applications, material properties, and technological challenges in prosthodontics, orthodontics, and endodontics. Results: In prosthodontics, 3D printing facilitates the fabrication of crowns, bridges, and dentures with high accuracy, though material strength and stability remain challenges. Orthodontics benefits from 3D-printed aligners and diagnostic models, improving patient comfort and treatment precision, but issues with material durability persist. In endodontics, 3D-printed surgical guides and training models enhance procedural accuracy and educational outcomes. Across disciplines, 3D printing reduces production time and enhances customization but incurs high costs and requires significant post-processing. This scoping review highlights the transformative potential of 3D printing in dentistry, providing an overview of current and future advancements and limitations. While 3D printing has improved precision, efficiency, and patient satisfaction, material and cost-related barriers remain. Future research should address these challenges to expand its clinical applicability and enhance personalized dental care. Full article

Background/Objectives: Direct-to-Consumer Orthodontics (DTCO) has gained popularity through social media, offering clear aligner treatments without in-person supervision. However, there is limited research on the related user experiences, satisfaction, and complications, particularly in Spain. This study aimed to evaluate user experiences, satisfaction levels, and complications associated with DTCO in a sample of Spanish consumers. Additionally, differences among major DTCO providers were analyzed. Methods: A cross-sectional online survey was conducted over one year. This questionnaire, adapted from previous studies and reviewed by certified orthodontists, assessed user awareness, reasons for treatment selection, communication with providers, discomfort, complications, and satisfaction. A total of 101 valid responses were analyzed using statistical means. Results: The majority of respondents reported that their expectations were not met, and they would not recommend DTCO. Cost was the primary motivation for treatment selection, followed by convenience. Many users experienced complications, leading to dental consultations. While overall satisfaction levels did not significantly differ among providers, variations were observed in discomfort levels, in-person care availability, and the need for additional consultations. Conclusions: DTCO offers affordability and convenience but raises concerns regarding treatment quality and supervision. In most cases, users’ expectations were not met, highlighting the need for greater patient education and regulatory oversight. Full article

Background/Objectives: Orthodontic treatment offers significant functional and aesthetic benefits, but it often causes discomfort, impacting patients’ daily activities, including diet and medication use. The primary aim of this observational study was to assess the influence of orthodontic patients’ age, gender, and living environment on pain duration, diet impairment, and analgesic use one week after their first adjustment visit to the orthodontist. Methods: This observational study included a sample of 194 orthodontic patients who completed a questionnaire consisting of six single-choice questions. The questions addressed the following variables: age, gender, living environment, pain duration, diet impairment, and analgesic use. The main inclusion criteria encompassed undergoing fixed orthodontic treatment on the upper arch for one week using a 0.0016-inch superelastic NiTi archwire (American Orthodontics, Sheboygan, WI, USA) and presenting moderate to severe crowding of the upper and lower anterior teeth. Results: Female patients were significantly more likely to experience diet impairment than males (51.9% vs. 33.3%, p = 0.013). Among female patients reporting pain lasting approximately one week, a higher proportion resided in rural areas (25% vs. 6.8%, p = 0.045), whereas male patients reporting the same pain duration predominantly lived in urban areas (12.5% vs. 0%, p = 0.028). Overall, 55.7% of participants used analgesics, with females in rural areas being the most frequent users. Additionally, patients who used analgesics were significantly more likely to experience diet impairment than those who did not (64.3% vs. 49.1%, p = 0.041). Conclusions: Female patients residing in rural areas reported a longer duration of pain, which led to a greater likelihood of experiencing diet impairment and increased consumption of analgesics compared to their counterparts. These findings highlight the need for personalized pain management strategies in orthodontic treatment, especially for patients with increased vulnerability to discomfort. Full article