European journal of orthodontics最新文献

Background: Outcome studies conducted on patients treated for cleft lip and palate (CLP) typically focus on clinical measures, while significantly fewer investigate patients' subjective perceptions of the long-term outcomes.

Objective: To evaluate oral health related quality of life (OHRQoL) as reported by young adults born with unilateral cleft lip and palate (UCLP).

Material: The study sample consisted of 32 consecutive patients (mean age 19.1 years) born with UCLP that had undergone interdisciplinary treatment. This group was compared with two noncleft control groups: one orthodontically treated group (Ortho) (n = 32, mean age 18.7 years) and one nonorthodontically treated group (Control) (n = 31, mean age 18.6 years).

Method: In this cross-sectional, questionnaire-based study, three instruments, the oral health impact profile-14 (OHIP-14), the jaw functional limitation scale-20 (JFLS-20), and the orofacial esthetic scale (OES) were administered during the final routine follow-up visit at 19 years of age.

Results: No significant differences were found in JFLS-20 and OHIP-14 mean summary scores between the UCLP group and the noncleft groups. For OES, the UCLP group differed significantly from the Ortho group (P = 0.042) but not from the Control group.

Conclusion: Young adults born with UCLP treated in an interdisciplinary team reported overall OHRQoL comparable to peers without a cleft and no history of orthodontic treatment. Their self-perceived orofacial appearance was similar to that of noncleft, nonorthodontically treated peers, but rated less favorable compared to noncleft peers who had received orthodontic treatment.

Background: Recognizing the relationship between body mass index (BMI) and facial morphology is essential for orthodontic treatment planning, as children with higher BMI often display accelerated growth and larger pre-pubertal facial dimensions. This study explores the relationship between BMI and facial soft tissue morphology in a sample of growing non-obese children.

Methods: Facial soft tissues of 113 elementary school students [55 boys; mean age = 11.8 years, standard deviation (SD) = 1.9] were captured using three-dimensional stereophotogrammetry. BMI was calculated from measured height and weight. Geometric morphometric analysis was performed using 14 fixed landmarks and 400 semilandmarks, which were slid to minimize bending energy between individual meshes and the sample average, ensuring homology. Generalized Procrustes analysis and principal component analysis were conducted to evaluate facial size and shape. Multivariate multiple regression models were employed to assess the relationship between BMI, age, and facial characteristics.

Results: The cohort had an average height of 155 cm (SD = 11.8), weight of 46.5 kg (SD = 13.3) and BMI of 18.9 (SD = 3.4). No significant sexual dimorphism in facial dimensions was identified (P = .07). Four principal components (PCs) contributed over 5% of variance: PC1 (27.3%), PC2 (19.9%), PC3 (9.1%), and PC4 (6.1%). Neither BMI nor age showed a significant correlation with centroid size (a proxy for facial size; P = .209). Regression models using PC1-PC4 as outcome variables and BMI and age as predictors demonstrated no significant effect of these variables on facial shape (P > .05 across all models). The study primarily included children prior to their growth spurt.

Conclusions: In non-obese, developing children, BMI, age, and sex were not significantly associated with facial size or shape. It means that BMI alone may not be a sufficient predictor of facial dimensions in children within this age and maturational range.

Objectives: This study aimed at mapping bibliometric networks and analysing citation impact of the most popular orthodontic articles on Twitter/X.

Methods: The top 100 original research articles and systematic reviews/meta-analyses with the most tweets published in the orthodontic journals included in Journal Citation Reports 2023 were retrieved from Altmetric Explorer. Associations were investigated using a random forest algorithm (Boruta) between publication details, Altmetric Attention Score (AAS) and X posts or Web of Science (WoS) citations while co-authorship and keyword networks were visualized using VOSviewer software.

Results: The sample of most-tweeted articles were assigned a median AAS of 7 [interquartile range (IQR); 5, 14], 8 (IQR; 6, 11) X posts and 21 (IQR; 8, 44) WoS citations. Most of the articles referred to human research, originated from European affiliations, authored by more than four scholars, and were published within 10 years prior to search date. AAS and time since publication were confirmed as important article attributes in predicting the number of X posts. Article type, subject, and time since publication were important factors in predicting WoS citation counts received.

Conclusions: Top 100 orthodontic articles on X involved clinical studies and broad author collaborations. Citation count prediction could not be indicated by the popularity of articles on the platform. X engagement and research priorities of scholars need to be re-evaluated to increase the public relevance of orthodontic research.

Objectives: To assess whether timing of orthodontic treatment after periodontal regenerative procedures influences root resorption and orthodontic tooth movement (OTM) in patients with pathologic tooth migration.

Trial design: This was a multicenter, randomized, parallel-group clinical trial.

Participants: Patients with stage IV periodontitis presenting with pathologic tooth migration and requiring orthodontic treatment were recruited from four centers in Germany, Italy, and Spain. Inclusion criteria involved completed initial periodontal therapy and presence of intrabony defects requiring regeneration.

Interventions: Forty-seven patients were randomly assigned to early (EOT, 4 weeks post-surgery; n = 24) or late (LOT, 6 months post-surgery; n = 23) orthodontic treatment following regenerative surgery of intrabony defects, treated with one of three biomaterial protocols: deproteinized bovine bone mineral (DBBM), enamel matrix derivative (EMD), or a combination of both.

Outcomes: Primary outcome was external apical root resorption (EARR), assessed using periapical radiographs. Secondary outcomes included the amount of tooth movement (mm) and the duration of orthodontic treatment (months).

Randomization method: Participants were randomized using computer-generated permuted blocks. Allocation was concealed in opaque envelopes.

Blinding: Outcome assessors were blinded to group allocation.

Results: EARR at the end of treatment was comparable between EOT and LOT groups (1.15 ± 1.09 mm vs. 1.25 ± 0.94 mm). No statistically significant differences were observed in the amount of tooth movement between groups, between grafted (test) and non-grafted (control) teeth within the same patient, or in treatment duration. Group allocation, type of grafting biomaterial, orthodontic movement type, and treatment duration had no significant influence on EARR.

Harms: No adverse events were reported.

Conclusions: OTM initiated 4 weeks after regenerative surgery did not increase the risk of EARR compared with late OTM and showed no significant differences in tooth movement or treatment duration, regardless of graft material used. Trial registration number: NCT02761668.

Background: Both fixed and removable functional appliances are commonly used to stimulate mandibular growth and enhance the facial profile of retrognathic patients. This forward posturing of the mandible may affect condylar morphology and position.

Objective: This study systematically evaluated the effects of functional appliance treatment on condylar morphological and positional changes in growing skeletal Class II patients.

Search methods: A comprehensive literature search involved five databases: PubMed, Cochrane Library, ScienceDirect, Web of Science, and Scopus, from 2000 to 2025.

Selection criteria: The study included randomized controlled trials (RCTs) and nonrandomized longitudinal studies which employed cone-beam computed tomography and magnetic resonance imaging. The study selection adhered to the PICO (Population, Intervention, Comparison, and Outcome) criteria, and data extraction was performed using the open-source systematic review software, Rayyan.

Data collection and analysis: The risk of bias was assessed using the Cochrane Risk-of-Bias tool for randomized trials (RoB2) and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool for nonrandomized studies of interventions. To assess the certainty of evidence, the Grading of Recommendations Assessment, Development, and Evaluation tool was employed.

Results: Thirty-four studies were included, comprising 6 RCTs, 23 prospective longitudinal studies, and 5 retrospective longitudinal studies. The overall risk-of-bias assessment indicated that 47.06% of studies were of low risk, and 52.94% of studies had moderate risk of bias. Functional appliances treatment was associated with anterior condylar shifts, altered condylar shape, retracted articular discs, increased joint spaces, and glenoid fossa remodeling. Few studies reported nonsignificant changes in condylar morphology and position following functional appliance treatment. The overall level of scientific evidence was low.

Conclusion: A relatively low level of scientific evidence suggests that treatment with functional appliances may be associated with alterations in condylar position and morphology.

Registration: The protocol for this systematic review was registered in PROSPERO with the ID CRD42024507040.

Objectives: This study aimed to analyze the optimal incisor overtreatment and molar anchorage preparation in premolar-extraction cases with clear aligner therapy (CAT) and generate a formula to provide reference values in the digital setup.

Methods: Eligible patients who underwent upper first premolar extraction with CAT were recruited. Angular changes (buccolingual tipping of central incisors, mesiodistal tipping of upper first molars) and linear movements (incisor retraction, molar protraction) were measured. Target value was defined as the required value for the tooth to revert to its normal angulation. Excessive amount (overtreatment and anchorage preparation) beyond target values were designed in digitized setup. The differences between achieved and target values (DAT) for incisors and molars were analyzed. Associations between DAT and demographic, clinical, cephalometric, and anatomic factors were evaluated.

Results: Undesired lingual tipping (-5.5 ± 7.1º) of central incisors and mesial tipping (0.2 ± 2.5º) of first molars were observed. DAT of incisor proclination was significantly associated with incisor overtreatment, U1-SN, incisor retraction, incisor and canine attachment. DAT of molar inclination was significantly correlated with molar anchorage preparation, overbite, molar mesial displacement, incisor overtreatment, crowding, U1-SN, and cortical anchorage of canines.

Limitations: Residual confounding may persist due to limitations inherent to observational studies.

Conclusions: Optimal incisor overtreatment is influenced by incisor retraction, U1-SN, incisor and canine attachment. Molar anchorage preparation is influenced by molar mesial displacement, U1-SN, overbite, incisor overtreatment, crowding, and cortical anchorage of canines.

Background: Bullying, including cyberbullying, is a global concern. Few studies have looked at the impact of dentofacial features on bullying and their relationship with psychosocial factors. This study aimed to assess the prevalence of bullying, cyberbullying, low self-esteem, high psychological distress, and investigate the relation with Oral Health-Related Quality of Life (OHRQoL) in adolescents.

Methods: This cross-sectional survey used a self-administered questionnaire distributed among middle school students (ages 10-15). The questionnaire assessed bullying/victimization (Florence Bullying and Cyberbullying Scales), self-esteem (Rosenberg scale), psychological distress (Strengths and Difficulties Questionnaire), and OHRQoL (CPQ11-14 ISF:16). Two-level (school and student) logistic regressions with random intercept analyzed relationships between OHRQoL and other variables.

Results: Among 437 participants, 18% reported bullying victimization, 14% admitted bullying perpetration, 6% experienced cybervictimization, and 4% perpetrated cyberbullying. Low self-esteem was found in 22%, and 26% reported high psychological distress. CPQ11-14 ISF:16 was associated with victimization (OR = 1.08; 95%CI from 1.05 to 1.10; P < 0.001), bullying perpetration (OR = 1.07; 95%CI from 1.04; 1.11; P < 0.001), cybervictimization (OR = 1.07; 95%CI from 1.03 to 1.10; P < 0.0001), cyberbullying perpetration (OR = 1.09; 95%CI from 1.04; 1.13; P < 0.001), low self-esteem (OR = 1.07; 95%CI from 1.04 to 1.10; P < 0.001), and high psychological distress (OR = 1.10; 95%CI from 1.07 to 1.13; P < 0.001). The four most implicated reasons for teasing related to mouth/teeth/chin were tooth color or shape, orthodontic appliance wear, protruding maxillary incisors, and spacings or missing teeth.

Conclusions: The present study found a relationship between perceived oral health and bullying/cyberbullying, low self-esteem, and psychological distress. Furthermore, it highlighted that adolescents can be teased as a result of their dentofacial characteristics.

Background: Accelerated tooth movement after orthognathic surgery has been observed in clinical settings and referenced in the literature.

Objective: To map the existing literature on whether orthodontic tooth movement is accelerated by reactive bone remodeling after orthognathic surgery.

Search methods: A scoping literature review of human and animal studies was conducted. Unrestricted searches in six electronic databases and gray literature sources were performed and updated in January 2025. A manual search of the reference list was also undertaken.

Selection criteria: We searched for primary studies assessing the rate of tooth movement (primary outcome) or change in bone remodeling or bone density (secondary outcomes) in patients who underwent orthognathic surgery or in animals subjected to major jaw osteotomy.

Data collection and analysis: Two independent reviewers selected studies and extracted data, with a third reviewer consulted if needed.

Results: Out of 8296 identified records, eight studies published between 2008 and 2021 were included. In the animal model (n = 4), significant individual variation was noted in the rate of tooth movement following osteotomies. In humans (n = 4), metabolic changes in bone markers and a decreased alveolar bone density were recognized.

Limitations: The results of the present scoping review are based mainly on human secondary outcomes.

Conclusions and implications: Increased cellular and molecular activity following orthognathic surgery or major jaw osteotomy has been demonstrated in human and animal models. This biological response is associated with the systemic acceleratory phenomenon and regional acceleratory phenomenon triggered by the extent of surgical trauma. At the local level, these changes involve enhanced bone remodeling activity accompanied by a transient reduction in bone mineral density. Most available evidence in humans suggests that these effects are temporary, typically peaking within the first month post-surgery and diminishing within three months. However, definitive evidence supporting a clinically significant acceleration of orthodontic tooth movement in humans remains limited, with current understanding primarily based on robust animal studies. While the primary outcome could not be demonstrated in humans and warrants further investigation, the potential for optimizing the efficiency of post-surgical orthodontic treatment should not be overlooked.

Registration: Open Science Framework (10.17605/OSF.IO/CWGA3).

Funding: The present study has not received any contributions from private or public funding agencies. The National Council for Scientific and Technological Development (CNPq) supports Professor Graziela De Luca Canto.

Background: The congenital absence of mandibular second premolars is a common anomaly requiring careful treatment planning. Conventional extraction of the primary molar often causes spontaneous space closure but may lead to mesial tipping of adjacent teeth. Hemisection offers an alternative to control tooth movement and reduce tipping. However, evidence comparing hemisection and conventional extraction, particularly on space closure and tooth angulation, is limited.

Objectives: To compare conventional extraction with hemisection of the mandibular primary second molars in terms of space closure, tooth angulation, complications and associated economic implications in patients with congenital absence of mandibular second premolars.

Trial design: prospective, randomised longitudinal split-mouth.

Materials and methods: Patients with bilateral agenesis of the second mandibular molars and unerupted second molars were included and randomly allocated to either extraction or hemisection on the left or right side of the mandible. Clinical and radiographic examinations were conducted at baseline (T1) and after a mean follow-up period of 4.2 years (T2). Measurements of the residual spaces and tooth angulation of the mandibular first molar and premolar following extraction were blinded assessed on panoramic radiographs and cast models. The number of visits, chair time, social costs, and direct and indirect costs were calculated using cost minimisation analysis.

Results: A total of 40 patients (25 boys and 15 girls) with a mean age of 10.03 ± 1.07 years at T1 participated. No patient was lost to follow-up. The residual space between the first permanent molar and the first permanent premolar was 2.04 ± 1.67 mm for hemisection and 2.39 ± 1.86 mm for extraction (p = 0.053). A larger residual space was observed between the first permanent premolar and the canine on the hemisection side (1.80 ± 1.01 mm) than on the extraction side (1.55 ± 0.92 mm), (p = 0.045). No difference was found between the interventions regarding the angulation of the first permanent molar (p = 0.0914) or the angulation of the first permanent premolar (p = 0.7812). Hemisection resulted in significantly more complications (p = 0.0176) and was associated with substantially higher material costs, more chair time and higher indirect costs than conventional extraction (p < 0.0001).

Conclusion: Hemisection is not recommended as an interceptive extraction option for patients with congenitally missing mandibular second premolars, as only minimal, clinically irrelevant differences were observed compared with conventional extraction. Moreover, hemisection is associated with increased costs and a higher risk of complications.

Trial registration: The trial was registered with https://www.researchweb.org/is/sverige, registration number: 967125.

Background: White spot lesions (WSLs) are frequently encountered after orthodontic treatment. Natural remineralization is often limited, necessitating supplementary treatments.

Objectives: This study evaluated the remineralizing effects of 10% xylitol varnish, 5% fluoride varnish, and placebo on WSLs after orthodontic treatment.

Materials and methods: This single-center, randomized, placebo-controlled, triple-blind clinical trial enrolled 84 patients (n = 28/group) aged 14‒25 years, who had developed WSLs after completing orthodontic treatment. The participants were randomly assigned to 5% fluoride varnish, 10% xylitol varnish, or placebo varnish groups. Randomization was performed using computer-generated block randomization. Participants, the clinician applying the varnishes and outcome assessors were all blinded to group allocation. Varnishes were applied every three months after debonding, and enamel mineralization was assessed using DIAGNOdent and visual scoring at baseline (T0), 6 months (T1), and 12 months (T2). Statistical analysis included the Kruskal-Wallis test, GEE modeling, and chi-squared test for WSL frequency (p < 0.05).

Results: Eighty-one participants were included in the intention-to-treat (ITT) and 76 in the per-protocol analyses. Significant improvements in mineral content were observed in all the groups after six (p = 0.007) and 12 months (p < 0.001). At T2, the fluoride group demonstrated a greater increase in enamel mineralization compared to the xylitol group (p= 0.045 in ITT, p = 0.063 in per-protocol). Visual assessment revealed significantly fewer WSLs in the fluoride group (12.1%) compared to the placebo group (25.1%) at T2 (OR = 0.41, 95% CI: 0.24-0.69, p = 0.001). No significant difference in WSL reduction was noted between the xylitol and placebo groups.

Conclusions: Both fluoride and xylitol varnishes improved enamel mineralization, with fluoride showing superior long-term efficacy in reducing WSLs. These findings support using fluoride varnish after orthodontic treatment to prevent and manage WSLs.

Harms: No harm was observed during this study.

Trial registration: This trial was registered and approved by the Iranian Registry of Clinical Trials under the registration code IRCT20180913041032N2.

Funding: This study was funded by Shiraz University of Medical Sciences.