Journal of the World Federation of Orthodontists最新文献

Antibiofilm activity of chitosan nanoparticles incorporated into three-dimensional printed clear aligners on Streptococcus mutans after in vivo aging: A randomized clinical trial 在体内老化后，壳聚糖纳米颗粒加入三维打印清晰对准剂对变形链球菌的抗生物膜活性：一项随机临床试验

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.09.003

Malak A. Alhuwaizi , Hayder F. Saloom

Background

To investigate if chitosan nanoparticles (ChNPs), incorporated into three-dimensional-printed clear aligners (CAs), retain their antibiofilm activity against Streptococcus mutans after extended use in the oral environment. Additionally, to measure the impact of the aligners on patient-reported outcomes.

Methods

Participants were randomly assigned to two groups: conventional CA and CA containing 3% ChNPs. They were instructed to wear their aligners for either one week (N = 16) or two weeks (N = 16) before CAs were retrieved. Clinical parameters, including plaque index (PI) and bleeding on probing (BOP), were measured, and the devices were weighed at baseline and at endpoints. A self-reported questionnaire was also completed. Samples from the retrieved devices underwent antibiofilm assays against S. mutans (American Type Culture Collection strain and a clinical isolate).

Results

After two weeks, the experimental group exhibited significantly lower PI and BOP scores compared to the control group (4.61 ± 1.22 vs 16.16 ± 5.26, and 3.83 ± 1.03 vs 5.35 ± 3.03, respectively). The number of colony-forming units was significantly reduced in the ChNPs-containing CAs (effect size > 0.9), with a greater effect against the American Type Culture Collection strain than the clinical isolate at both time points (effect size week 1: 0.953, week 2: 0.621). The ChNPs did not affect the device weight after in vivo aging, and the participants reported higher satisfaction levels.

Conclusions

Three-dimensional-printed CAs with ChNPs retained strong antibiofilm activity against S. mutans after two weeks of in vivo use. This was clinically reflected by lower PI and BOP scores and improved self-reported outcomes.

背景：研究将壳聚糖纳米颗粒（ChNPs）掺入三维打印的透明对准器（CAs）中，在口腔环境中长期使用后，是否能保持其对变形链球菌的抗菌膜活性。此外，测量校准器对患者报告结果的影响。方法：将参与者随机分为常规CA和含有3% ChNPs的CA两组。在取出ca之前，他们被要求佩戴矫正器一周（N = 16）或两周（N = 16）。测量临床参数，包括斑块指数（PI）和探查出血（BOP），并在基线和终点对设备进行称重。还完成了一份自我报告问卷。从回收的设备中提取的样品进行了抗变形链球菌（美国型培养收集菌株和临床分离株）的抗生素膜测定。结果：两周后，实验组PI和BOP评分明显低于对照组（分别为4.61±1.22 vs 16.16±5.26,3.83±1.03 vs 5.35±3.03）。在含有chnps的CAs中，菌落形成单位的数量显著减少（效应量> 0.9），在两个时间点对美国型培养收集菌株的影响都大于临床分离菌株（效应量第1周：0.953，第2周：0.621）。ChNPs在体内老化后不影响设备重量，参与者报告了更高的满意度。结论：含有ChNPs的三维打印CAs在体内使用两周后仍具有较强的抗变形链球菌活性。这在临床上反映为较低的PI和BOP评分以及自我报告结果的改善。

{"title":"Antibiofilm activity of chitosan nanoparticles incorporated into three-dimensional printed clear aligners on Streptococcus mutans after in vivo aging: A randomized clinical trial","authors":"Malak A. Alhuwaizi , Hayder F. Saloom","doi":"10.1016/j.ejwf.2025.09.003","DOIUrl":"10.1016/j.ejwf.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>To investigate if chitosan nanoparticles (ChNPs), incorporated into three-dimensional-printed clear aligners (CAs), retain their antibiofilm activity against <em>Streptococcus mutans</em> after extended use in the oral environment. Additionally, to measure the impact of the aligners on patient-reported outcomes.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to two groups: conventional CA and CA containing 3% ChNPs. They were instructed to wear their aligners for either one week (N = 16) or two weeks (N = 16) before CAs were retrieved. Clinical parameters, including plaque index (PI) and bleeding on probing (BOP), were measured, and the devices were weighed at baseline and at endpoints. A self-reported questionnaire was also completed. Samples from the retrieved devices underwent antibiofilm assays against <em>S. mutans</em> (American Type Culture Collection strain and a clinical isolate).</div></div><div><h3>Results</h3><div>After two weeks, the experimental group exhibited significantly lower PI and BOP scores compared to the control group (4.61 ± 1.22 vs 16.16 ± 5.26, and 3.83 ± 1.03 vs 5.35 ± 3.03, respectively). The number of colony-forming units was significantly reduced in the ChNPs-containing CAs (effect size > 0.9), with a greater effect against the American Type Culture Collection strain than the clinical isolate at both time points (effect size week 1: 0.953, week 2: 0.621). The ChNPs did not affect the device weight after <em>in vivo</em> aging, and the participants reported higher satisfaction levels.</div></div><div><h3>Conclusions</h3><div>Three-dimensional-printed CAs with ChNPs retained strong antibiofilm activity against <em>S. mutans</em> after two weeks of in vivo use. This was clinically reflected by lower PI and BOP scores and improved self-reported outcomes.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 38-45"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

My long and winding road in orthodontics 我漫长而曲折的正畸之路。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.12.003

Eustaquio A. Araujo

This manuscript presents the transcript of the World Federation of Orthodontists Honorary Lecture delivered at the opening ceremony of the 10th International Orthodontic Congress in Rio de Janeiro, titled “My Long and Winding Road in Orthodontics.” The lecture reflects on the author’s professional journey in orthodontics and the evolution of the speciality over several decades, illustrated through representative clinical cases. The narrative traces major paradigm shifts in orthodontic practice, including the transition from banding to bonding, advances in anchorage control, the introduction of skeletal anchorage systems, the emergence of aligner-based therapies, and the integration of digital technologies into diagnosis and treatment planning. Clinical cases are presented to demonstrate how these developments have influenced treatment strategies for complex malocclusions, including vertical discrepancies, anterior open bite, severe skeletal deformities, and interdisciplinary orthodontic–surgical cases. Long-term follow-up records are included when available, emphasizing treatment stability and the enduring importance of accurate diagnosis and patient cooperation. Beyond technical advances, the lecture underscores the broader role of orthodontics in improving function, esthetics, and quality of life, while highlighting the values of mentorship, collaboration, and lifelong learning. This Honorary Lecture transcript is intended to offer inspiration and clinical insight to orthodontic students, residents, and practitioners by sharing lessons learned from a lifetime dedicated to the speciality.

本手稿是在巴西里约热内卢举行的第10届国际正畸大会开幕式上，世界正畸医师联合会名誉演讲的文稿，题为“我在正畸学上漫长而曲折的道路”。讲座通过具有代表性的临床案例，反映了作者在正畸学方面的职业历程和几十年来该专业的演变。叙述了正畸实践中的主要范式转变，包括从绑扎到粘接的转变，锚固控制的进展，骨骼锚固系统的引入，基于对准器的疗法的出现，以及将数字技术整合到诊断和治疗计划中。临床案例展示了这些发展如何影响复杂错咬合的治疗策略，包括垂直差异、前开咬、严重骨骼畸形和跨学科正畸手术病例。长期随访记录包括在可能的情况下，强调治疗的稳定性和持久的重要性，准确的诊断和病人的合作。除了技术进步，讲座还强调了正畸在改善功能、美学和生活质量方面的更广泛作用，同时强调了指导、合作和终身学习的价值。本荣誉讲座讲稿旨在通过分享终身致力于正畸专业的经验教训，为正畸学生、住院医师和从业者提供灵感和临床见解。

{"title":"My long and winding road in orthodontics","authors":"Eustaquio A. Araujo","doi":"10.1016/j.ejwf.2025.12.003","DOIUrl":"10.1016/j.ejwf.2025.12.003","url":null,"abstract":"<div><div>This manuscript presents the transcript of the World Federation of Orthodontists Honorary Lecture delivered at the opening ceremony of the 10th International Orthodontic Congress in Rio de Janeiro, titled <em>“My Long and Winding Road in Orthodontics.”</em> The lecture reflects on the author’s professional journey in orthodontics and the evolution of the speciality over several decades, illustrated through representative clinical cases. The narrative traces major paradigm shifts in orthodontic practice, including the transition from banding to bonding, advances in anchorage control, the introduction of skeletal anchorage systems, the emergence of aligner-based therapies, and the integration of digital technologies into diagnosis and treatment planning. Clinical cases are presented to demonstrate how these developments have influenced treatment strategies for complex malocclusions, including vertical discrepancies, anterior open bite, severe skeletal deformities, and interdisciplinary orthodontic–surgical cases. Long-term follow-up records are included when available, emphasizing treatment stability and the enduring importance of accurate diagnosis and patient cooperation. Beyond technical advances, the lecture underscores the broader role of orthodontics in improving function, esthetics, and quality of life, while highlighting the values of mentorship, collaboration, and lifelong learning. This Honorary Lecture transcript is intended to offer inspiration and clinical insight to orthodontic students, residents, and practitioners by sharing lessons learned from a lifetime dedicated to the speciality.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 3-19"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tech -Neck: Orthodontic implications of screentime overload 技术颈：屏幕时间过多对正畸的影响

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2026.01.001

Vinod Krishnan (Editor-in-Chief)

引用次数: 0

Orthodontic management of severe open bite in a growing patient using miniscrew-supported appliances: A case report 使用微型支架支持的矫治器治疗日益严重的开放咬伤：一例报告。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.08.003

Niki Arveda , Francesca Cremonini , Martina Rumpianesi , Federico Oliani , Emanuele Paoletto , Luca Lombardo

Background

Anterior open bite can negatively impact facial aesthetics, as well as cause functional impairment and social challenges. We present the case of an adolescent patient with a severe anterior open bite.

Methods

After an initial phase of expansion using an expander on palatal mini-screw implants, the patient was treated with a fixed buccal appliance and intermaxillary elastics. Skeletal anchorage was used to achieve effective posterior control. Finally, minor finishing was performed with aligners, and the case was completed with multiple restorations of the teeth.

Results

The combination of a fixed appliance and intermaxillary elastics resulted in the extrusion and retroclination of the maxillary incisors, leading to bite closure. Successful results were achieved, with good occlusion, improved facial aesthetics, and stability maintained over the 2-year retention period.

Conclusions

Temporary anchorage devices offer reliable anchorage for posterior vertical control. With appropriate treatment planning -taking into account incisor display, growth potential and biomechanics- this approach can serve as a non-surgical alternative for managing severe open bite cases.

背景：前牙开咬不仅会对面部美观产生负面影响，还会导致功能障碍和社会挑战。我们提出的情况下，青少年患者与严重的前开咬。方法：患者在使用扩展器对腭微型螺钉种植体进行初始阶段的扩展后，使用固定颊矫治器和上颌间弹性矫治器进行治疗。采用骨锚定实现有效的后路控制。最后，用牙齿矫正器进行小修整，病例完成了多次牙齿修复。结果：固定矫治器配合上颌间弹性矫治器，使上颌门牙挤压后倾，导致牙合闭合。结果取得了良好的咬合效果，改善了面部美观，并在2年的保留期内保持了稳定性。结论：临时支抗装置为后路垂直控制提供了可靠的支抗。通过适当的治疗计划-考虑到门牙的显示，生长潜力和生物力学-这种方法可以作为非手术治疗严重开咬病例的替代方法。

{"title":"Orthodontic management of severe open bite in a growing patient using miniscrew-supported appliances: A case report","authors":"Niki Arveda , Francesca Cremonini , Martina Rumpianesi , Federico Oliani , Emanuele Paoletto , Luca Lombardo","doi":"10.1016/j.ejwf.2025.08.003","DOIUrl":"10.1016/j.ejwf.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Anterior open bite can negatively impact facial aesthetics, as well as cause functional impairment and social challenges. We present the case of an adolescent patient with a severe anterior open bite.</div></div><div><h3>Methods</h3><div>After an initial phase of expansion using an expander on palatal mini-screw implants, the patient was treated with a fixed buccal appliance and intermaxillary elastics. Skeletal anchorage was used to achieve effective posterior control. Finally, minor finishing was performed with aligners, and the case was completed with multiple restorations of the teeth.</div></div><div><h3>Results</h3><div>The combination of a fixed appliance and intermaxillary elastics resulted in the extrusion and retroclination of the maxillary incisors, leading to bite closure. Successful results were achieved, with good occlusion, improved facial aesthetics, and stability maintained over the 2-year retention period.</div></div><div><h3>Conclusions</h3><div>Temporary anchorage devices offer reliable anchorage for posterior vertical control. With appropriate treatment planning -taking into account incisor display, growth potential and biomechanics- this approach can serve as a non-surgical alternative for managing severe open bite cases.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 54-61"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A diagnostic and treatment planning checklist for vertical problems in orthodontic patients 正畸患者垂直问题的诊断和治疗计划检查表。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.09.002

Flavia Artese , Carlo Bosoni

Vertical discrepancies in orthodontics represent a complex and multifactorial diagnostic challenge. Traditional approaches often lack a consistent correlation between facial patterns, overbite, and occlusal vertical dimension, limiting a comprehensive treatment planning. This article proposes a diagnostic checklist structured around five key factors—lower anterior facial height, incisor display at rest, posterior dental height, overbite, and occlusal wear—to assess vertical problems across macro-, mini-, and microesthetic levels. The amount of incisor display at rest serves as the guiding parameter for planning vertical tooth movements and determining jaw positioning. Each diagnostic factor contributes uniquely to evaluating vertical proportions, esthetic balance, and functional occlusion. The checklist offers clinicians a hierarchical tool to decode clinical and cephalometric findings and translate them into individualized treatment strategies. Possible therapeutic options include anterior or posterior tooth intrusion or extrusion, restoration of worn teeth, and orthodontic or orthognathic repositioning of dental or skeletal structures. Three clinical cases—addressing deep bite, open bite, and occlusal wear—illustrate the application of the checklist. These examples underscore the critical role of incisor display in planning and executing movements that harmonize the face, smile, and occlusion.

正畸的垂直差异是一个复杂和多因素的诊断挑战。传统的方法通常缺乏面部模式、覆咬和咬合垂直尺寸之间的一致相关性，限制了全面的治疗计划。本文提出了一份诊断清单，该清单围绕五个关键因素进行构建，即前面部低高度、静息时门牙显示、后牙高度、覆咬和咬合磨损，以评估宏观、微观和微观审美水平上的垂直问题。静息时门牙显示量是规划牙齿垂直运动和确定下颌定位的指导参数。每个诊断因素都有助于评估垂直比例、审美平衡和功能性闭塞。该检查表为临床医生提供了一种分层工具来解码临床和颅测量结果，并将其转化为个性化的治疗策略。可能的治疗选择包括前牙或后牙侵入或挤压，磨损牙齿的修复，牙齿或骨骼结构的正畸或正颌重新定位。三个临床病例-解决深咬，开咬和咬合磨损-说明了清单的应用。这些例子强调了门牙显示在计划和执行协调面部、微笑和咬合的动作中的关键作用。

{"title":"A diagnostic and treatment planning checklist for vertical problems in orthodontic patients","authors":"Flavia Artese , Carlo Bosoni","doi":"10.1016/j.ejwf.2025.09.002","DOIUrl":"10.1016/j.ejwf.2025.09.002","url":null,"abstract":"<div><div>Vertical discrepancies in orthodontics represent a complex and multifactorial diagnostic challenge. Traditional approaches often lack a consistent correlation between facial patterns, overbite, and occlusal vertical dimension, limiting a comprehensive treatment planning. This article proposes a diagnostic checklist structured around five key factors—lower anterior facial height, incisor display at rest, posterior dental height, overbite, and occlusal wear—to assess vertical problems across macro-, mini-, and microesthetic levels. The amount of incisor display at rest serves as the guiding parameter for planning vertical tooth movements and determining jaw positioning. Each diagnostic factor contributes uniquely to evaluating vertical proportions, esthetic balance, and functional occlusion. The checklist offers clinicians a hierarchical tool to decode clinical and cephalometric findings and translate them into individualized treatment strategies. Possible therapeutic options include anterior or posterior tooth intrusion or extrusion, restoration of worn teeth, and orthodontic or orthognathic repositioning of dental or skeletal structures. Three clinical cases—addressing deep bite, open bite, and occlusal wear—illustrate the application of the checklist. These examples underscore the critical role of incisor display in planning and executing movements that harmonize the face, smile, and occlusion.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 76-91"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep learning-based system for automated staging of lower molar maturation 基于深度学习的下磨牙成熟自动分期系统。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.08.004

Fernando Biskupovic , Flavia Rosenberg , Luz María Searle , Pamela Ramírez , María Jesús Larrañaga , Sebastián Maldonado , Carla Vairetti , Rodrigo Oyonarte

Background

Assessing a patient’s maturation status is essential for treatment planning in dentofacial orthopedics. Dental development, as classified by Demirjian’s method into eight stages, is a reliable indicator of skeletal maturity relative to the pubertal growth spurt. Automating this assessment may improve efficiency by reducing subjectivity and supporting timely orthodontic interventions.

Methods

A cross-sectional study was conducted using segmented panoramic radiographs to classify the maturation stages of lower second and third molars. These classifications served as training data for machine learning models using four convolutional neural network (CNN) architectures: Xception, ResNet, MobileNet, and Inception. Model performance was evaluated on three datasets: second and third molars combined (ST), second molars only (S), and third molars only (T). Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to visualize model attention.

Results

A total of 1805 images were analyzed. Inception achieved the best performance in both the ST dataset (accuracy 0.96, precision 0.86, recall 0.85, and F1 score 0.85) and the S dataset (accuracy 0.98, precision 0.92, recall 0.91, and F1 score 0.89). For the T dataset, ResNet performed the best (accuracy 0.96, precision 0.94, recall 0.95, and F1 score 0.81). Inter-examiner agreement was high, with a mean kappa coefficient of 0.94. Grad-CAM heat maps confirmed that the model focused on relevant dental structures.

Conclusions

The proposed deep learning system, especially the Inception model, demonstrated high accuracy and strong agreement with experts when classifying dental maturation stages. These findings support its use as a complementary diagnostic tool to aid clinical decision-making in growth assessment.

背景：评估患者的成熟状态对牙面骨科的治疗计划至关重要。根据Demirjian的方法，牙齿发育分为八个阶段，是相对于青春期生长的骨骼成熟的可靠指标。自动化评估可以通过减少主观性和支持及时的正畸干预来提高效率。方法：采用分段全景x线片进行横断面研究，对下第二、第三磨牙的成熟阶段进行分类。这些分类作为机器学习模型的训练数据，使用四种卷积神经网络（CNN）架构：Xception、ResNet、MobileNet和Inception。在三个数据集上评估模型的性能：第二和第三磨牙合并（ST），第二磨牙(S)和第三磨牙(T)。采用梯度加权类激活映射（Gradient-weighted Class Activation Mapping, Grad-CAM）可视化模型注意力。结果：共分析图像1805张。Inception在ST数据集（准确率0.96，精度0.86，召回率0.85，F1得分0.85）和S数据集（准确率0.98，精度0.92，召回率0.91，F1得分0.89）中都取得了最好的性能。对于T数据集，ResNet表现最好（准确率0.96，精密度0.94，召回率0.95，F1得分0.81）。审查员之间的一致性很高，平均kappa系数为0.94。Grad-CAM热图证实该模型聚焦于相关的牙齿结构。结论：所提出的深度学习系统，特别是盗梦空间模型，在对牙齿成熟阶段进行分类时显示出较高的准确性和与专家的强烈一致性。这些发现支持其作为辅助诊断工具，以帮助临床决策生长评估。

{"title":"Deep learning-based system for automated staging of lower molar maturation","authors":"Fernando Biskupovic , Flavia Rosenberg , Luz María Searle , Pamela Ramírez , María Jesús Larrañaga , Sebastián Maldonado , Carla Vairetti , Rodrigo Oyonarte","doi":"10.1016/j.ejwf.2025.08.004","DOIUrl":"10.1016/j.ejwf.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Assessing a patient’s maturation status is essential for treatment planning in dentofacial orthopedics. Dental development, as classified by Demirjian’s method into eight stages, is a reliable indicator of skeletal maturity relative to the pubertal growth spurt. Automating this assessment may improve efficiency by reducing subjectivity and supporting timely orthodontic interventions.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using segmented panoramic radiographs to classify the maturation stages of lower second and third molars. These classifications served as training data for machine learning models using four convolutional neural network (CNN) architectures: Xception, ResNet, MobileNet, and Inception. Model performance was evaluated on three datasets: second and third molars combined (ST), second molars only (S), and third molars only (T). Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to visualize model attention.</div></div><div><h3>Results</h3><div>A total of 1805 images were analyzed. Inception achieved the best performance in both the ST dataset (accuracy 0.96, precision 0.86, recall 0.85, and F1 score 0.85) and the S dataset (accuracy 0.98, precision 0.92, recall 0.91, and F1 score 0.89). For the T dataset, ResNet performed the best (accuracy 0.96, precision 0.94, recall 0.95, and F1 score 0.81). Inter-examiner agreement was high, with a mean kappa coefficient of 0.94. Grad-CAM heat maps confirmed that the model focused on relevant dental structures.</div></div><div><h3>Conclusions</h3><div>The proposed deep learning system, especially the Inception model, demonstrated high accuracy and strong agreement with experts when classifying dental maturation stages. These findings support its use as a complementary diagnostic tool to aid clinical decision-making in growth assessment.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 31-37"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A split-mouth randomized controlled trial on leukocyte- and platelet-rich fibrin’s role in bone density, trabecular complexity, and canine retraction 一项关于富含白细胞和血小板的纤维蛋白在骨密度、小梁复杂性和犬后收中的作用的裂口随机对照试验。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.07.733

Seema Gupta, Meghna M. Kothiwal, Adeel A. Bajjad, Chirag Sahgal, Anil Sharma, Kajol Kumari, Prarthana Bharadwaj

Background

Orthodontic treatment often leads to alveolar bone loss, necessitating interventions to optimize bone preservation during canine retraction. This study evaluated the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in enhancing bone density (BD), trabecular architecture, and canine movement following first premolar extraction.

Methods

A single-center, split-mouth RCT (ClinicalTrials.gov: CTRI/2024/01/061503) enrolled 35 patients (20 males, 15 females; mean age: 18.8 ± 2.04 years males, 19.13 ± 1.96 years females) with Class I bimaxillary protrusion or Class II Division 1 malocclusion, requiring bilateral first premolar extractions (70 sites). Contralateral sockets were randomized (computer-generated sequence, 1:1 ratio) to L-PRF or natural healing (control) to reduce inter-patient variability. Bone density, trabecular patterns, and fractal dimension were evaluated via cone-beam computed tomography scans (ImageJ analysis), and canine movement measured monthly over 4 months using study models. Blinded evaluators analyzed outcomes using t-tests, mixed-model analysis, and Pearson correlations (P < 0.05). Recruitment occurred January 2024–January 2025.

Results

All 70 sites were analyzed (no loss to follow-up). L-PRF significantly increased bone density (562.28 ± 13.63 HU vs. 533.00 ± 5.84 HU, P = 0.001, Cohen’s d = 2.79), fractal dimension (1.8 ± 0.12 vs. 1.52 ± 0.15, P = 0.001, Cohen’s d = 2.01), and canine movement (3.53 ± 0.23 mm vs. 2.71 ± 0.22 mm, P = 0.001, Cohen’s d = 3.48), but with greater tipping. Trabecular complexity improved significantly (P < 0.05). No adverse events occurred.

Conclusion

L-PRF significantly enhanced bone density, trabecular architecture, and canine retraction over a follow-up period of four months, offering a promising adjunct to orthodontic treatment.

背景：正畸治疗经常导致牙槽骨丢失，需要采取干预措施来优化牙槽骨保存。本研究评估了富含白细胞和血小板的纤维蛋白（L-PRF）在第一前磨牙拔牙后增强骨密度（BD）、小梁结构和犬运动的功效。方法：采用单中心裂口随机对照试验（ClinicalTrials.gov: CTRI/ 20124/01/061503），纳入35例（男性20例，女性15例；平均年龄：男性18.8±2.04岁，女性19.13±1.96岁），均为I类双颌前突或II类1类错颌，需要双侧第一前磨牙（70个部位）拔除。对侧窝随机（计算机生成的顺序，1:1比例）至L-PRF或自然愈合（对照组），以减少患者间的差异。通过锥形束计算机断层扫描（ImageJ分析）评估骨密度，小梁模式和分形维数，并使用研究模型在4个月内每月测量犬的运动。盲法评估者使用t检验、混合模型分析和Pearson相关性分析结果（P < 0.05）。招聘发生在2024年1月至2025年1月。结果：70个部位均被分析，随访无损失。L-PRF显著增加了骨密度（562.28±13.63 HU vs. 533.00±5.84 HU, P = 0.001, Cohen’s d = 2.79）、分形维数（1.8±0.12 vs. 1.52±0.15,P = 0.001, Cohen’s d = 2.01）和犬类运动（3.53±0.23 mm vs. 2.71±0.22 mm, P = 0.001, Cohen’s d = 3.48），但显著增加了倾翻。小梁复杂性显著改善（P < 0.05）。无不良事件发生。结论：L-PRF在4个月的随访中显著提高了骨密度、小梁结构和犬科内收，为正畸治疗提供了一种有希望的辅助治疗方法。

{"title":"A split-mouth randomized controlled trial on leukocyte- and platelet-rich fibrin’s role in bone density, trabecular complexity, and canine retraction","authors":"Seema Gupta, Meghna M. Kothiwal, Adeel A. Bajjad, Chirag Sahgal, Anil Sharma, Kajol Kumari, Prarthana Bharadwaj","doi":"10.1016/j.ejwf.2025.07.733","DOIUrl":"10.1016/j.ejwf.2025.07.733","url":null,"abstract":"<div><h3>Background</h3><div>Orthodontic treatment often leads to alveolar bone loss, necessitating interventions to optimize bone preservation during canine retraction. This study evaluated the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in enhancing bone density (BD), trabecular architecture, and canine movement following first premolar extraction.</div></div><div><h3>Methods</h3><div>A single-center, split-mouth RCT (ClinicalTrials.gov: CTRI/2024/01/061503) enrolled 35 patients (20 males, 15 females; mean age: 18.8 ± 2.04 years males, 19.13 ± 1.96 years females) with Class I bimaxillary protrusion or Class II Division 1 malocclusion, requiring bilateral first premolar extractions (70 sites). Contralateral sockets were randomized (computer-generated sequence, 1:1 ratio) to L-PRF or natural healing (control) to reduce inter-patient variability. Bone density, trabecular patterns, and fractal dimension were evaluated via cone-beam computed tomography scans (ImageJ analysis), and canine movement measured monthly over 4 months using study models. Blinded evaluators analyzed outcomes using t-tests, mixed-model analysis, and Pearson correlations (<em>P</em> < 0.05). Recruitment occurred January 2024–January 2025.</div></div><div><h3>Results</h3><div>All 70 sites were analyzed (no loss to follow-up). L-PRF significantly increased bone density (562.28 ± 13.63 HU vs. 533.00 ± 5.84 HU, <em>P</em> = 0.001, Cohen’s d = 2.79), fractal dimension (1.8 ± 0.12 vs. 1.52 ± 0.15, <em>P</em> = 0.001, Cohen’s d = 2.01), and canine movement (3.53 ± 0.23 mm vs. 2.71 ± 0.22 mm, <em>P</em> = 0.001, Cohen’s d = 3.48), but with greater tipping. Trabecular complexity improved significantly (<em>P</em> < 0.05). No adverse events occurred.</div></div><div><h3>Conclusion</h3><div>L-PRF significantly enhanced bone density, trabecular architecture, and canine retraction over a follow-up period of four months, offering a promising adjunct to orthodontic treatment.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 20-30"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of maxillary expansion on hearing outcomes in patients with cleft lip and palate: A systematic review 上颌扩张对唇腭裂患者听力预后的影响：一项系统综述。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.09.004

Hamza Parvez Siddiqui , Karthik Sennimalai , Madhanraj Selvaraj , Abhijeet Jaiswal

Background

Otological management in patients with cleft lip and/or palate has focused on early interventions such as ventilation tube placement. Improving palatal width and nasal airflow by maxillary expansion may enhance Eustachian tube function. Thus, we aimed to determine whether maxillary expansion therapy had any effect on hearing outcomes in cleft palate patients.

Material and Method

Electronic searches employing defined keywords relevant to hearing impairment and maxillary expansion with no restriction on publication year or status, in adolescent nonsyndromic cleft patients were undertaken in PubMed, Scopus, Web of Science, Ovid MEDLINE, EBSCOhost, The Cochrane Library, LILACS, OpenGrey, and Google Scholar until January 15, 2025. Two authors on the Covidence software performed data extraction. The Methodological Index for Nonrandomized Studies and the Cochrane Risk of Bias tool were utilized to assess the risk of bias of the included studies.

Results

The search retrieved 68 studies, of which four studies finally met the inclusion criteria that included 158 patients with cleft and 26 non-cleft participants. The improvement in hearing threshold varied from 3 to 21 decibels (dB) in the included final studies. Pure tone audiograms and tympanometry were largely used by studies with variations across the types of expanders employed for maxillary expansion. The risk of bias varied from moderate to high risk.

Conclusion

A preliminary analysis suggests that maxillary expansion may help improve hearing outcomes for patients with cleft palate, although the certainty of evidence by GRADE assessment was low to very low. More high-quality studies with randomized designs and extended follow-up are required to validate these conclusions and elucidate their clinical implications.

背景：唇裂和/或腭裂患者的耳科治疗一直侧重于早期干预，如放置通气管。通过上颌扩张改善腭宽和鼻腔气流，可增强咽鼓管功能。因此，我们的目的是确定上颌扩张治疗是否对腭裂患者的听力结果有任何影响。材料和方法：在PubMed、Scopus、Web of Science、Ovid MEDLINE、EBSCOhost、The Cochrane Library、LILACS、OpenGrey和谷歌Scholar等网站对青春期非综合征性唇腭裂患者进行电子检索，使用与听力障碍和上颌扩张相关的定义关键词，不限制发表年份或状态，直到2025年1月15日。covid软件的两位作者进行了数据提取。采用非随机研究方法学指数和Cochrane偏倚风险工具评估纳入研究的偏倚风险。结果：检索到68项研究，其中4项研究最终符合纳入标准，包括158例唇裂患者和26例非唇裂参与者。在纳入的最终研究中，听力阈值的改善从3到21分贝（dB）不等。纯音听力图和鼓室测量在研究中被广泛应用于上颌扩张器类型的变化。偏倚风险从中度到高风险不等。结论：初步分析表明上颌扩张可能有助于改善腭裂患者的听力结果，尽管通过GRADE评估证据的确定性很低到很低。需要更多随机设计的高质量研究和长期随访来验证这些结论并阐明其临床意义。

{"title":"Effects of maxillary expansion on hearing outcomes in patients with cleft lip and palate: A systematic review","authors":"Hamza Parvez Siddiqui , Karthik Sennimalai , Madhanraj Selvaraj , Abhijeet Jaiswal","doi":"10.1016/j.ejwf.2025.09.004","DOIUrl":"10.1016/j.ejwf.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Otological management in patients with cleft lip and/or palate has focused on early interventions such as ventilation tube placement. Improving palatal width and nasal airflow by maxillary expansion may enhance Eustachian tube function. Thus, we aimed to determine whether maxillary expansion therapy had any effect on hearing outcomes in cleft palate patients.</div></div><div><h3>Material and Method</h3><div>Electronic searches employing defined keywords relevant to hearing impairment and maxillary expansion with no restriction on publication year or status, in adolescent nonsyndromic cleft patients were undertaken in PubMed, Scopus, Web of Science, Ovid MEDLINE, EBSCOhost<strong>,</strong> The Cochrane Library, LILACS, OpenGrey, and Google Scholar until January 15, 2025. Two authors on the Covidence software performed data extraction. The Methodological Index for Nonrandomized Studies and the Cochrane Risk of Bias tool were utilized to assess the risk of bias of the included studies.</div></div><div><h3>Results</h3><div>The search retrieved 68 studies, of which four studies finally met the inclusion criteria that included 158 patients with cleft and 26 non-cleft participants. The improvement in hearing threshold varied from 3 to 21 decibels (dB) in the included final studies. Pure tone audiograms and tympanometry were largely used by studies with variations across the types of expanders employed for maxillary expansion. The risk of bias varied from moderate to high risk.</div></div><div><h3>Conclusion</h3><div>A preliminary analysis suggests that maxillary expansion may help improve hearing outcomes for patients with cleft palate, although the certainty of evidence by GRADE assessment was low to very low. More high-quality studies with randomized designs and extended follow-up are required to validate these conclusions and elucidate their clinical implications.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 46-53"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orthodontic treatment with clear aligners in an adult obstructive sleep apnea patient with skeletal class II malocclusion, scissors bite, and a constricted mandibular arch: A case report 正畸治疗成人阻塞性睡眠呼吸暂停患者骨骼II类错颌，剪刀咬合，下颌弓收缩：1例报告。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-02-01 DOI: 10.1016/j.ejwf.2025.09.005

Wenfeng Li , Ruoyu Li , Yang Cao, Chen Zhou, Weicai Wang

Orthodontic management of a 22-year-old male patient is detailed, featuring a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, significant mandibular arch constriction, and mild obstructive sleep apnea (OSA) is reported. Clear aligners were used to correct the scissors bite and effectively intrude the posterior teeth. The treatment objectives were successfully achieved, including the intrusion of right posterior teeth, uprighting of the severely tilted mandibular posterior teeth, correction of the deep bite, expansion of the dental arches, and enhancement of the oral cavity and upper airway volume, ultimately leading to the resolution of OSA in the adult patient, all without notable adverse effects. The therapeutic efficacy remained well sustained at the 24-month follow-up. This case report highlights the efficacy of clear aligners in treating patients with a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, severe arch constriction, and mild OSA.

本文报告1例22岁男性患者的正畸治疗，主要表现为骨骼II类颌间关系，单侧剪刀咬合，深咬合，下颌弓明显收缩，轻度阻塞性睡眠呼吸暂停（OSA）。使用矫正器矫正剪型咬合，有效侵入后牙。成功达到治疗目标，右后牙侵入，下颌严重倾斜后牙扶正，深咬合矫正，牙弓扩张，口腔及上气道容积增大，最终使成年患者OSA得到缓解，均无明显不良反应。在24个月的随访中，治疗效果保持良好。本病例报告强调了透明矫正器在治疗II类颌骨间关系、单侧剪咬、深咬、严重弓缩和轻度OSA患者中的疗效。

{"title":"Orthodontic treatment with clear aligners in an adult obstructive sleep apnea patient with skeletal class II malocclusion, scissors bite, and a constricted mandibular arch: A case report","authors":"Wenfeng Li , Ruoyu Li , Yang Cao, Chen Zhou, Weicai Wang","doi":"10.1016/j.ejwf.2025.09.005","DOIUrl":"10.1016/j.ejwf.2025.09.005","url":null,"abstract":"<div><div>Orthodontic management of a 22-year-old male patient is detailed, featuring a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, significant mandibular arch constriction, and mild obstructive sleep apnea (OSA) is reported. Clear aligners were used to correct the scissors bite and effectively intrude the posterior teeth. The treatment objectives were successfully achieved, including the intrusion of right posterior teeth, uprighting of the severely tilted mandibular posterior teeth, correction of the deep bite, expansion of the dental arches, and enhancement of the oral cavity and upper airway volume, ultimately leading to the resolution of OSA in the adult patient, all without notable adverse effects. The therapeutic efficacy remained well sustained at the 24-month follow-up. This case report highlights the efficacy of clear aligners in treating patients with a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, severe arch constriction, and mild OSA.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 62-75"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Canine distal movement impact on teeth and aligner deformation in clear aligner treatment: A 3D finite element study. 在牙齿矫正器治疗中，犬远端运动对牙齿和矫正器变形的影响：一项三维有限元研究。

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2026-01-28 DOI: 10.1016/j.ejwf.2025.12.004

Shuo Wang, Xiuqian Peng, Zhen Tian, Yiran Wang, Yanheng Zhou

Background: Although the use of clear aligners (CAs) has gained popularity in orthodontics, it faces challenges in extraction cases, particularly the "roller coaster effect" (mesial molar movement, distal canine tipping, and lingual incisor tipping/extrusion). Previous finite element studies focused on CAs as force-applying agents, neglecting counterforces from teeth to CAs. This study aimed to analyze how canine distal movement patterns affect incisors via tooth-aligner force interactions.

Methods: A three-dimensional finite element model was developed, including teeth, periodontal ligament, attachments, and CAs, based on cone-beam computed tomography and intraoral scanning data. Three groups simulated different canine distal movement modes: Group 1 (bodily movement with vertical rectangular attachments), Group 2 (bodily movement with paired optimized attachments), and Group 3 (distal tipping with vertical rectangular attachments). Multi-step iterative modeling methods were used to simulate long-term treatment, analyzing tooth displacements, contact stresses, and CA deformations.

Results: All groups demonstrated distal tipping of canines with the rotation center at the apical third, despite bodily movements in Groups 1 and 2. Group 2 exhibited significant canine rotation (3.36°). Incisors revealed unintended displacements: Groups 1 and 2 demonstrated higher lingual cervical pressure from CAs, causing greater buccal displacement (0.30-0.39 mm) and rotation (1.30-1.74°) compared to Group 3 (0.14-0.23 mm, 0.59-1.01°). Group 3 revealed better CA adaptation and reduced incisor movement due to minimized counterforces from actively tipped canines.

Conclusions: As current attachments cannot achieve bodily canine distalization, tipping is inevitable. Designed bodily movements induce CA deformation and incisor lingual tipping/extrusion, while active distal tipping reduces adverse effects. Orthodontists should avoid programming unattainable bodily canine movements in premolar extraction cases and prioritize tipping-based strategies with subsequent root control.

背景：尽管在正畸学中使用透明矫正器（CAs）已经越来越普遍，但在拔牙时仍面临挑战，特别是“过山车效应”（近中磨牙移动、远端犬齿倾斜和舌切牙倾斜/挤压）。以前的有限元研究主要集中在ca作为施力剂，而忽略了牙齿对ca的反作用力。本研究旨在分析犬科动物远端运动模式如何通过牙齿矫正器力相互作用影响门牙。方法：基于锥形束计算机断层扫描和口腔内扫描数据，建立包括牙齿、牙周韧带、附着体和ca的三维有限元模型。三组模拟犬的不同远端运动模式：组1（带垂直矩形附件的身体运动），组2（带配对优化附件的身体运动）和组3（带垂直矩形附件的远端倾翻）。采用多步迭代建模方法模拟长期治疗，分析牙齿位移、接触应力和CA变形。结果：尽管第1组和第2组有身体运动，但所有组均表现出犬的远端倾斜，旋转中心位于根尖第三。组2犬齿旋转明显（3.36°）。与组3 （0.14-0.23 mm, 0.59-1.01°）相比，组1和组2表现出来自ca的较高舌颈压力，导致更大的颊位移（0.30-0.39 mm）和旋转（1.30-1.74°）。第3组表现出更好的CA适应和减少门牙运动，因为主动尖牙的反作用力最小。结论：由于目前的附着物无法实现犬体远端，因此倾翻是不可避免的。设计的身体运动诱导CA变形和切牙舌倾斜/挤压，而主动远端倾斜减少不利影响。在前磨牙拔牙的情况下，正畸医生应该避免规划无法实现的犬类身体运动，并优先考虑基于倾斜的策略和随后的牙根控制。

{"title":"Canine distal movement impact on teeth and aligner deformation in clear aligner treatment: A 3D finite element study.","authors":"Shuo Wang, Xiuqian Peng, Zhen Tian, Yiran Wang, Yanheng Zhou","doi":"10.1016/j.ejwf.2025.12.004","DOIUrl":"https://doi.org/10.1016/j.ejwf.2025.12.004","url":null,"abstract":"<p><strong>Background: </strong>Although the use of clear aligners (CAs) has gained popularity in orthodontics, it faces challenges in extraction cases, particularly the \"roller coaster effect\" (mesial molar movement, distal canine tipping, and lingual incisor tipping/extrusion). Previous finite element studies focused on CAs as force-applying agents, neglecting counterforces from teeth to CAs. This study aimed to analyze how canine distal movement patterns affect incisors via tooth-aligner force interactions.</p><p><strong>Methods: </strong>A three-dimensional finite element model was developed, including teeth, periodontal ligament, attachments, and CAs, based on cone-beam computed tomography and intraoral scanning data. Three groups simulated different canine distal movement modes: Group 1 (bodily movement with vertical rectangular attachments), Group 2 (bodily movement with paired optimized attachments), and Group 3 (distal tipping with vertical rectangular attachments). Multi-step iterative modeling methods were used to simulate long-term treatment, analyzing tooth displacements, contact stresses, and CA deformations.</p><p><strong>Results: </strong>All groups demonstrated distal tipping of canines with the rotation center at the apical third, despite bodily movements in Groups 1 and 2. Group 2 exhibited significant canine rotation (3.36°). Incisors revealed unintended displacements: Groups 1 and 2 demonstrated higher lingual cervical pressure from CAs, causing greater buccal displacement (0.30-0.39 mm) and rotation (1.30-1.74°) compared to Group 3 (0.14-0.23 mm, 0.59-1.01°). Group 3 revealed better CA adaptation and reduced incisor movement due to minimized counterforces from actively tipped canines.</p><p><strong>Conclusions: </strong>As current attachments cannot achieve bodily canine distalization, tipping is inevitable. Designed bodily movements induce CA deformation and incisor lingual tipping/extrusion, while active distal tipping reduces adverse effects. Orthodontists should avoid programming unattainable bodily canine movements in premolar extraction cases and prioritize tipping-based strategies with subsequent root control.</p>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0