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74 - Diagnostic accuracy of ChatGPT-4 in recommending immunohistochemistry panels for salivary gland tumours ChatGPT-4在推荐唾液腺肿瘤免疫组化检查中的诊断准确性
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.078
Valentina Alvarez Silberberg , Maria Carolina Cuevas Nuñez , Rodrigo Diaz Castañeda , Alexandro Gudenschwager , Maria Fernandez-Figueras

Purpose

Salivary gland tumours pose a significant diagnostic challenge due to their histological diversity and overlapping pathological features. Immunohistochemistry (IHC) is a crucial tool in distinguishing these neoplasms, yet selecting the optimal IHC panel remains complex. Artificial intelligence (AI) applications, hold promise in improving diagnostic accuracy by recommending IHC markers. This study evaluates the diagnostic performance of ChatGPT-4 in recommending IHC markers for salivary gland tumours.

Methods

A free version of ChatGPT-4 was used to generate IHC panel recommendations for 21 salivary gland tumour types. A consensus panel of expert pathologists established reference IHC panels, serving as the gold standard for comparison. Chatbot responses were assessed using a structured scoring system measuring accuracy, completeness, and relevance. Cohen’s Kappa analysis quantified agreement between chatbot and pathologist recommendations. Sensitivity, specificity, and F1-scores evaluated diagnostic performance. Consistency across multiple chatbot queries was assessed using repeated measures ANOVA and Bland-Altman analysis. Performance was compared against a rule-based system following strict pathologist guidelines.

Results

The chatbot demonstrated moderate overall agreement (κ=0.53) with pathologists, with higher agreement for benign (κ=0.67) than malignant tumours (κ=0.40). Sensitivity was high (>0.80) for benign tumours but lower for malignant neoplasms. The chatbot frequently recommended unnecessary markers, reducing specificity (<0.50) for several malignancies. Stability analysis revealed variability in chatbot responses, particularly for complex tumour types. ChatGPT underperformed compared to the rule-based system, exhibiting higher rates of incorrect and missed markers.

Conclusion

AI-powered chatbots show potential in aiding IHC marker selection but currently lack the precision required for clinical implementation.
目的唾液腺肿瘤由于其组织多样性和重叠的病理特征,对诊断提出了重大挑战。免疫组化(IHC)是鉴别这些肿瘤的重要工具,但选择最佳的免疫组化组仍然很复杂。人工智能(AI)应用有望通过推荐免疫组化标记物来提高诊断准确性。本研究评估ChatGPT-4在推荐唾液腺肿瘤IHC标记物方面的诊断性能。方法使用ChatGPT-4免费版本生成21种唾液腺肿瘤类型的免疫组化推荐。由病理学专家组成的共识小组建立了参考免疫组化小组,作为比较的金标准。聊天机器人的回答使用一个结构化的评分系统来评估准确性、完整性和相关性。科恩的Kappa分析量化了聊天机器人和病理学家建议之间的一致性。敏感性、特异性和f1评分评估诊断性能。使用重复测量ANOVA和Bland-Altman分析评估多个聊天机器人查询的一致性。在严格的病理学指导下,将表现与基于规则的系统进行比较。结果聊天机器人与病理学家表现出中等程度的总体一致性(κ=0.53),对良性肿瘤(κ=0.67)的一致性高于恶性肿瘤(κ=0.40)。良性肿瘤的敏感性较高(>0.80),而恶性肿瘤的敏感性较低。聊天机器人经常推荐不必要的标记物,降低了几种恶性肿瘤的特异性(<0.50)。稳定性分析揭示了聊天机器人反应的可变性,特别是对于复杂的肿瘤类型。与基于规则的系统相比,ChatGPT表现不佳,显示出更高的不正确和遗漏标记率。结论人工智能聊天机器人在帮助免疫组化标志物选择方面具有潜力,但目前缺乏临床实施所需的精度。
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引用次数: 0
75 - Diagnostic algorithm for localization and complexity assessment of impacted maxillary canines 上颌埋伏牙定位与复杂性评估的诊断算法
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.079
Gunel Aliyeva , Sura Seyfullayeva , Alima Musayeva
Accurate diagnosis and evaluation of treatment complexity in maxillary canine impaction are essential for effective orthodontic planning. This study aimed to determine the prevalence and causes of canine impaction and to develop a diagnostic scoring system to assess treatment difficulty based on clinical and radiological criteria. A retrospective analysis of 11,704 patient records from the “Ortho-1” clinic over 35 years identified 255 cases of impaction of tooth 13 (2.17%) and 290 cases of tooth 23 (2.47%). Bilateral impaction was found in 94 cases (0.8%). Statistical analysis was performed in 44 patients who completed orthodontic treatment for bilateral impaction. A diagnostic index was developed based on: 1.⁠ ⁠Angulation to the midline (1–3 points), 2.⁠ ⁠Vertical depth relative to three occlusal reference lines (1–3 points), 3.⁠ ⁠Mesiodistal displacement (0–2 points), 4.⁠ ⁠Presence of complicating factors such as supernumerary teeth, odontomas, cysts, or rotations (0–1 point). The total score defines treatment difficulty: • 2–3 points: mild, • 4–5: moderate, • 6–9: severe. A statistically significant correlation was found between the total score and treatment duration. Higher scores were associated with increased treatment time and risk of complications. The proposed algorithm allows for more precise localization of impacted canines, individualized prognosis, and optimized treatment planning.
准确的诊断和评估上颌牙嵌塞的治疗复杂性对于制定有效的正畸计划至关重要。本研究旨在确定犬嵌塞的患病率和原因,并根据临床和放射学标准制定诊断评分系统来评估治疗难度。回顾性分析“ortho1”门诊35年来11704例患者的记录,发现13号牙嵌塞255例(2.17%),23号牙290例(2.47%)。双侧嵌塞94例(0.8%)。对44例完成双侧嵌塞正畸治疗的患者进行统计分析。建立了一种诊断指标:1。2.与中线成角(1-3点)相对于三条咬合参考线(1-3点)的垂直深度,4.中远端位移(0-2个点);存在复杂因素,如多牙、牙瘤、囊肿或旋转(0-1分)。总分定义治疗难度:•2-3分为轻度,•4-5分为中度,•6-9分为重度。总评分与治疗时间有显著的统计学相关性。得分越高,治疗时间越长,并发症风险越高。所提出的算法允许更精确地定位影响犬,个性化预后和优化治疗计划。
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引用次数: 0
60 - Considerations about Bisphenol-A release from orthodontic clear aligners: a systematic review 正畸透明矫正器释放双酚a的考虑:一项系统综述
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.064
Diego Dos Santos Dias , Karla Dias Castro Dias , Natália dos Santos Dias , Álvaro Teixeira Mattos
The widespread adoption of clear orthodontic aligners has raised concerns regarding potential Bisphenol-A (BPA) release, a compound linked to endocrine disruption and adverse health outcomes. Despite preliminary in vitro studies suggesting trace BPA leaching from aligner materials, there remains a lack of comprehensive synthesis assessing the magnitude, clinical significance, and methodological consistency of these findings. This study aims to systematically evaluate and synthesize evidence on BPA release from clear orthodontic aligners. A systematic review was conducted in accordance with the PRISMA statement. Eligibility criteria included studies reporting BPA release from clear aligners only published within the last five years. Electronic databases including PubMed/MEDLINE and Cochrane Library were used with MeSH terms “Bisphenol A”, “Orthodontics” and “Orthodontic Appliances, Removable”. Study selection involved independent screening by two reviewers, with discrepancies resolved by consensus. Risk of bias was assessed using adapted quality appraisal tool for study selection, and data extraction captured study design, BPA quantification methods, exposure duration, and outcomes. The search results found five studies that met inclusion criteria, comprising four in vitro investigations and one ex vivo study. The studies consistently reported detectable BPA concentrations released over immersion periods of 24 hours to 10 days. Discussion emphasizes the need for standardized testing protocols to improve comparability. The evidence indicates that clear aligners can release trace amounts of BPA under laboratory and clinical conditions. However, due to limited clinical data, definitive conclusions regarding patient safety cannot be drawn. Further rigorous in vivo studies and harmonized laboratory protocols are warranted to assess exposure risk and long-term health implications.
清洁正畸矫正器的广泛使用引起了人们对潜在的双酚a (BPA)释放的担忧,BPA是一种与内分泌干扰和不良健康结果有关的化合物。尽管初步的体外研究表明从对准器材料中痕量的BPA浸出,但仍然缺乏对这些发现的规模、临床意义和方法学一致性的综合评估。本研究旨在系统评价和综合正畸矫正器中BPA释放的证据。根据PRISMA声明进行了系统审查。资格标准包括仅在最近五年内发表的关于透明矫正器释放BPA的研究。电子数据库包括PubMed/MEDLINE和Cochrane Library, MeSH检索词为“双酚A”、“Orthodontics”和“Orthodontic appliance, Removable”。研究选择由两位评论者进行独立筛选,差异通过共识解决。使用适用于研究选择的质量评价工具评估偏倚风险,数据提取捕获了研究设计、双酚a量化方法、暴露时间和结果。检索结果发现5项研究符合纳入标准,包括4项体外研究和1项离体研究。这些研究一致报告了浸泡24小时到10天后释放的可检测到的BPA浓度。讨论强调需要标准化的测试方案以提高可比性。有证据表明,在实验室和临床条件下,透明对准器可以释放微量的双酚a。然而,由于临床数据有限,无法得出关于患者安全的明确结论。有必要进一步进行严格的体内研究和统一的实验室规程,以评估接触风险和长期健康影响。
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引用次数: 0
31 - Assessing aesthetic outcomes of the surgery-first approach in skeletal class III patients 评估III类骨骼患者手术优先入路的美学效果
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.035
Arthur Cunha , Tainá Manso , Jorge Faber , Flavia Artese , José Augusto Mendes Miguel
Despite the growing interest in the Surgery-First Approach (SFA), there is insufficient scientific evidence to compare the facial aesthetic outcomes of SFA with the Conventional Surgery Approach (CSA), and no consensus on whether one technique delivers better results after treatment. Consequently, this retrospective study aimed to evaluate aesthetic perception in patients treated with CSA and SFA. 34 patients were allocated into two groups of surgery protocol (CSA=16; SFA=18) and each group were matched according to skeletal discrepancy. The evaluators were divided into three categories (n=23 each): (1) oral and maxillofacial surgeons, (2) orthodontists and (3) laypeople. Profile images before surgery (T1) and after orthodontic-surgical treatment (T2) were analyzed using a 5-point Likert scale. Then, participants answered the following question: “Which surgical technique was used? SFA or CSA? Spearman's correlation coefficient, Friedman, and Kappa tests were applied to examine correlations between variables (p<0.05). One-way ANOVA and independent t-tests compared aesthetic perception scores between evaluators. A strong positive correlation was observed between surgeons and orthodontists (r=0.86; p<0.001), while the correlation between laypeople and specialists was weaker (r=0.48; p=0.03; r=0.55; p=0.01). There was no statistically significant difference between the scores regarding patients' aesthetic perception given by each groups of evaluators (>0.05) and separately (>0.05). When Kappa test was used regarding the type of surgical protocol performed the results reveals an extremely low agreement between the evaluators as indicated by a low Kappa value (κ=0.007). This study demonstrated that there were no noticeable differences in the aesthetics of the facial profile of Class III patients between the SFA and CSA. Regardless of the level of training of the evaluators, it was not possible to differentiate the surgical technique used.
尽管人们对手术优先入路(SFA)越来越感兴趣,但没有足够的科学证据来比较SFA和传统手术入路(CSA)的面部美学结果,并且对于哪种技术在治疗后的效果更好也没有共识。因此,本回顾性研究旨在评估CSA和SFA治疗患者的美感。将34例患者分为两组手术方案(CSA=16, SFA=18),根据骨骼差异进行匹配。评估者分为三类(各23人):(1)口腔颌面外科医生;(2)正畸医生;(3)非专业人员。采用5点Likert量表分析手术前(T1)和正畸手术治疗后(T2)的侧像。然后,参与者回答以下问题:“使用了哪种手术技术?”SFA还是CSA?采用Spearman相关系数、Friedman和Kappa检验检验变量之间的相关性(p<0.05)。单因素方差分析和独立t检验比较了评价者之间的审美知觉得分。外科医师与正畸医师之间存在较强的正相关(r=0.86; p<0.001),外行人与专科医师之间存在较弱的相关性(r=0.48; p=0.03; r=0.55; p=0.01)。各组评价者对患者的美感评分(>0.05)与单独评分(>0.05)比较,差异无统计学意义。当Kappa试验用于评估所执行的手术方案类型时,结果显示评估者之间的一致性极低,Kappa值很低(κ=0.007)。本研究表明,在SFA和CSA之间,III类患者的面部轮廓美学没有明显差异。无论评估人员的培训水平如何,都不可能区分所使用的手术技术。
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引用次数: 0
32 - Assessment of change in enamel color and surface hardness following the use of ICON resin infiltration and remineralizing agent: An in vitro study 使用ICON树脂浸润和再矿化剂后牙釉质颜色和表面硬度变化的评估:一项体外研究
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.036
Naif Almosa , Khalid Alaman , Fares Alkhudairi , Muhannad Alhaqbani , Mohammed Alshalawi , Rahaf Zawawi
Dental enamel is a highly mineralized tissue with a well-packed crystalline structure. Orthodontic appliances act as stagnation areas that can become households where dental plaque accumulates, disrupting the typical mineral exchange between the dental enamel and oral fluids, potentially leading to the demineralization of enamel and the development of subsurface porous areas referred to as white spot lesions. This study aimed to evaluate the change in enamel color and surface micro-hardness fol- lowing the use of resin-infiltration concept material (ICON) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) remineralizing agent. Fifty-four extracted human third molars were collected and randomly divided into three groups: group A: control with no surface treatment; group B: treated using ICON; and group C: treated using CPP-ACFP. The change in color and micro-hardness of the enamel surface were measured using spectrophotometer and Vickers hardness number, respectively. The measurements were taken at three timelines; baseline (BL), after demineralization (DM), and after surface treatment (TX). The three groups showed no significant differences in enamel color change after demineralization (p < 0.05). However, after surface treatment in relation to the baseline, groups B and C had a significant increase in color change compared to the control group (p < 0.05), and group B showed a statistically significant increase in enamel color changes compared to group C. Additionally, all groups exhibited a significant reduction in enamel micro-hardness after demineralization in comparison to their baseline (p < 0.05). Group C showed a significant increase in micro-hardness after surface treatment compared to groups A and B (p < 0.05), while group B showed a significant decrease in enamel micro-hardness compared to groups A and C (p < 0.05). These findings suggest that teeth treated with CPP-amorphous calcium fluoride phos- phate (CPP-ACFP) show a significant improvement in enamel surface color after demineralization compared to the teeth treated with resin infiltration (ICON) and the non-treated teeth. Additionally, enamel surfaces treated with CPP-ACFP show significant enamel hardness regaining, while resin infiltration (ICON) compromises enamel surface hardness.
牙釉质是一种高度矿化的组织,具有良好的晶体结构。正畸矫形器作为一个停滞区域,可以成为牙菌斑积聚的家庭,破坏牙釉质和口腔液体之间典型的矿物质交换,潜在地导致牙釉质脱矿和表面下多孔区域的发展,即白斑病变。本研究旨在评价树脂渗透概念材料(ICON)和酪蛋白磷酸肽-无定形氟化钙磷酸盐(CPP-ACFP)再矿剂对牙釉质颜色和表面显微硬度的影响。收集拔除的人第三磨牙54颗,随机分为3组:A组:对照组,不作表面处理;B组:ICON治疗;C组:用CPP-ACFP治疗。分别用分光光度计和维氏硬度值测定牙釉质表面的颜色变化和显微硬度。测量是在三个时间轴上进行的;基线(BL)、脱矿后(DM)和表面处理后(TX)。三组脱矿后牙釉质颜色变化差异无统计学意义(p < 0.05)。但表面处理后,B组和C组牙釉质颜色变化较对照组显著增加(p < 0.05), B组牙釉质颜色变化较C组显著增加(p < 0.05)。各组牙釉质脱矿后显微硬度较基线均显著降低(p < 0.05)。表面处理后,C组牙釉质显微硬度较a、B组显著升高(p < 0.05), B组牙釉质显微硬度较a、C组显著降低(p < 0.05)。结果表明,cpp -非晶态氟化磷酸钙(CPP-ACFP)处理后的牙釉质脱矿后表面颜色明显改善,优于树脂渗透处理(ICON)和未处理的牙釉质表面颜色。此外,CPP-ACFP处理的牙釉质表面显示出明显的牙釉质硬度恢复,而树脂渗透(ICON)会损害牙釉质表面硬度。
{"title":"32 - Assessment of change in enamel color and surface hardness following the use of ICON resin infiltration and remineralizing agent: An in vitro study","authors":"Naif Almosa ,&nbsp;Khalid Alaman ,&nbsp;Fares Alkhudairi ,&nbsp;Muhannad Alhaqbani ,&nbsp;Mohammed Alshalawi ,&nbsp;Rahaf Zawawi","doi":"10.1016/j.ejwf.2025.07.036","DOIUrl":"10.1016/j.ejwf.2025.07.036","url":null,"abstract":"<div><div>Dental enamel is a highly mineralized tissue with a well-packed crystalline structure. Orthodontic appliances act as stagnation areas that can become households where dental plaque accumulates, disrupting the typical mineral exchange between the dental enamel and oral fluids, potentially leading to the demineralization of enamel and the development of subsurface porous areas referred to as white spot lesions. This study aimed to evaluate the change in enamel color and surface micro-hardness fol- lowing the use of resin-infiltration concept material (ICON) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) remineralizing agent. Fifty-four extracted human third molars were collected and randomly divided into three groups: group A: control with no surface treatment; group B: treated using ICON; and group C: treated using CPP-ACFP. The change in color and micro-hardness of the enamel surface were measured using spectrophotometer and Vickers hardness number, respectively. The measurements were taken at three timelines; baseline (BL), after demineralization (DM), and after surface treatment (TX). The three groups showed no significant differences in enamel color change after demineralization (p &lt; 0.05). However, after surface treatment in relation to the baseline, groups B and C had a significant increase in color change compared to the control group (p &lt; 0.05), and group B showed a statistically significant increase in enamel color changes compared to group C. Additionally, all groups exhibited a significant reduction in enamel micro-hardness after demineralization in comparison to their baseline (p &lt; 0.05). Group C showed a significant increase in micro-hardness after surface treatment compared to groups A and B (p &lt; 0.05), while group B showed a significant decrease in enamel micro-hardness compared to groups A and C (p &lt; 0.05). These findings suggest that teeth treated with CPP-amorphous calcium fluoride phos- phate (CPP-ACFP) show a significant improvement in enamel surface color after demineralization compared to the teeth treated with resin infiltration (ICON) and the non-treated teeth. Additionally, enamel surfaces treated with CPP-ACFP show significant enamel hardness regaining, while resin infiltration (ICON) compromises enamel surface hardness.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 409"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705581","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
16 - Adherence to clinical practice guidelines amongst adolescents with buccal fixed orthodontic appliances in Northeast Netherlands: A cross-sectional study 16 -荷兰东北部青少年口腔固定矫治器临床实践指南的依从性:一项横断面研究
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.020
Sebastiaan Van Doornik , Anne Marie Kuijpers-Jagtman , Yijin Ren , David Manton , Scott Lietmeijer , Pieter Dijkstra
Background: Adolescents undergoing treatment with fixed orthodontic appliances are at greater risk for dental caries and white spot lesions (WSLs), primarily due to difficulties in maintaining proper oral hygiene. Preventive strategies, aligned with clinical practice guidelines, are essential to mitigate these risks.

Objective

This study aimed to evaluate how well adolescents receiving buccal fixed appliance treatment in the northeast of the Netherlands followed national clinical practice guidelines (CPGs) for oral hygiene measures.
Methods: A questionnaire was administered to 539 adolescents aged 12–17 years who were receiving treatment with buccal fixed appliances, recruited from ten private orthodontic clinics. The survey measured compliance with six key recommendations from the Dutch CPGs, generating an adherence score ranging from 0 to 6. Descriptive statistics and linear regression with 1000 bootstrap samples were used to explore the association between participant characteristics and adherence levels.
Results Out of 539 adolescents, 485 initiated the questionnaire and 393 (72.9%) provided data suitable for analysis (57% female; nearly half aged 13 or 14). The median adherence score was 5 (IQR 4–5), with 22.6% (n = 89) achieving full adherence (score of 6). Male participants had significantly lower adherence scores than females (−0.442, 95% CI: −0.979 to −0.234). Older adolescents showed a trend toward lower adherence (−0.066 per year, 95% CI: −0.136 to 0.002). Participants with higher educational backgrounds also exhibited slightly reduced adherence (−0.534, 95% CI: −0.953 to −0.096).
Limitations The use of self-reported data may have introduced bias, as participants may have provided socially desirable responses.
Conclusions: Overall, guideline adherence amongst adolescents with buccal fixed appliances appears limited, particularly amongst males and older teens. Customised educational strategies may help improve compliance in these groups.
背景:青少年在接受固定正畸矫治器治疗时,患龋齿和白斑病变(WSLs)的风险更高,主要是由于难以保持适当的口腔卫生。与临床实践指南相一致的预防战略对于减轻这些风险至关重要。目的本研究旨在评估荷兰东北部接受口腔固定矫治器治疗的青少年遵循国家临床实践指南(CPGs)口腔卫生措施的情况。方法:对来自10家私立正畸诊所的539名12-17岁接受口腔固定矫治器治疗的青少年进行问卷调查。该调查衡量了荷兰CPGs提出的六项关键建议的依从性,得出了从0到6的依从性评分。采用描述性统计和线性回归方法对1000个bootstrap样本进行分析,探讨参与者特征与依从性水平之间的关系。结果在539名青少年中,485人发起问卷调查,393人(72.9%)提供了适合分析的数据,其中57%为女性,近一半为13岁或14岁。依从性评分中位数为5 (IQR 4-5), 22.6% (n = 89)达到完全依从性(得分6)。男性受试者的依从性评分明显低于女性(- 0.442,95% CI: - 0.979至- 0.234)。年龄较大的青少年表现出较低依从性的趋势(每年- 0.066,95% CI: - 0.136至0.002)。具有较高教育背景的参与者也表现出轻微的依从性降低(- 0.534,95% CI: - 0.953至- 0.096)。自我报告数据的使用可能会引入偏见,因为参与者可能已经提供了社会期望的反应。结论:总体而言,使用口腔固定矫治器的青少年遵循指南的情况有限,尤其是男性和年龄较大的青少年。定制的教育策略可能有助于提高这些群体的依从性。
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引用次数: 0
21 - Anatomical assessment of intra-alveolar miniscrews for therapeutic use in orthodontics 牙槽内微型支架在正畸治疗中的解剖学评价
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.025
Yissel Gatica Villa , Alondra Hormazabal , Camilo Meza , Basthian Parra

Background

Absolute anchorage in orthodontics has significantly advanced with the use of intra-alveolar miniscrews (MTIs), offering predictable control of tooth movement with reduced dependence on patient cooperation.

Objectives

To analyze the anatomical, physical, and clinical considerations that influence the safe and effective use of MTIs in the maxilla and mandible, aiming to guide clinical decision-making and minimize complications.

Methods

A literature review was conducted, integrating recent scientific articles and anatomical sources to evaluate insertion zones, angulation, miniscrew dimensions, materials, and clinical indications or contraindications for MTIs.

Results

The interradicular region between the second premolar and first molar is the safest for MTI insertion. Ideal angulation ranges from 30°–45° buccally and 0°–20° palatally in the maxilla, and 20°–40° in the posterior mandible. Preferred MTIs measure 1.5–2.0 mm in diameter and 6–9 mm in length. Titanium is recommended for thin bone; stainless steel for dense bone. Self-drilling or self-tapping systems should be selected based on cortical thickness. Indications include intrusion, distalization, retraction, and verticalization. Contraindications include active periodontal disease, anatomical restrictions, and systemic conditions like uncontrolled diabetes or bisphosphonate use.

Conclusions

The success of MTIs relies on detailed anatomical planning via 3D imaging, proper screw selection, and thorough evaluation of patient-specific factors. A comprehensive understanding of these variables enhances primary stability, reduces risks, and supports predictable orthodontic outcomes.
随着牙槽内微型支架(MTIs)的使用,绝对固支在正畸学中有了显著的进步,它提供了可预测的牙齿运动控制,减少了对患者合作的依赖。目的分析影响上下颌骨mti安全有效使用的解剖学、物理和临床因素,指导临床决策,减少并发症。方法通过文献回顾,综合近期科学文献和解剖学资料,对mti的植入区域、角度、微孔尺寸、材料、临床适应症或禁忌症进行评价。结果第二前磨牙与第一磨牙根间区是MTI最安全的植入位置。理想角度为上颌骨颊部30°-45°,腭部0°-20°,下颌骨后部20°-40°。首选的mti直径为1.5-2.0毫米,长度为6-9毫米。薄骨推荐使用钛;不锈钢用于致密骨。应根据皮质厚度选择自钻或自攻系统。适应症包括侵入、远端、后收和垂直。禁忌症包括活动性牙周病、解剖学限制和全身疾病,如未控制的糖尿病或使用双膦酸盐。结论mti的成功依赖于通过3D成像进行详细的解剖规划、正确的螺钉选择和对患者特异性因素的全面评估。全面了解这些变量可以提高初级稳定性,降低风险,并支持可预测的正畸结果。
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引用次数: 0
15 - Acute changes in swallowing and electromyographic activity of the masticatory muscles while changing the occlusal vertical dimension with bite stops 吞咽和咀嚼肌电图活动的急性变化,同时改变咬合垂直尺寸
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.019
Victor Rojas , Ian Raby , Rocio Aguirre , Andres Celis

Introduction

Temporary bite-raising or bite-opening is often required in patients undergoing orthodontic treatment but the implications of increasing OVD remain a controversial issue based on existing evidence, although it is considered meaningful in rehabilitative procedures.

Objective

Determine the acute changes in tongue pressure and electromyographic (EMG) activity of the masseter and temporalis muscles during swallowing while increasing the occlusal vertical dimension (OVD).

Materials and Methods

Twenty-two participants were enrolled. Swallowing was measured at the basal OVD in two conditions: saliva swallowing (SS) and swallowing a semi-solid consistency element (yogurt swallowing, YS), regarding changes in tongue pressure and the EMG activity of the temporalis and masseter muscles. The same measurements were performed while increasing the OVD by 2, 4, and 6 mm. A tongue pressure sensor, Flexiforce A-201 model (Tekscan), was used to analyze the contact pressure of the tongue on the hard palate. Electromyography was recorded using EMG Works acquisition software. Comparisons between conditions were performed using ordinary least squares linear regression models. A significance level of P < 0.05 was applied, and 95% confidence intervals were calculated for all outcomes.

Results

The masseter and temporalis muscles showed no differences in EMG activity in SS condition with OVDs of 2, 4, and 6 mm (P > 0.05). In the YS condition, the masseter showed significant differences between basal OVD in the SS condition and all OVDs in the YS condition (P < 0.05), whereas the temporalis showed no differences. Tongue pressure showed differences in SS condition between OVDs at 0, 4, and 6 mm (P < 0.05). Significant results were observed between the SS and YS conditions at the same OVDs (P < 0.05).

Conclusion

The stomatognathic system rapidly adapts to acute changes in OVD.
在接受正畸治疗的患者中,通常需要暂时提高咬位或打开咬位,但根据现有证据,增加OVD的含义仍然是一个有争议的问题,尽管它被认为在康复过程中有意义。目的观察吞咽过程中咬肌和颞肌在增大咬合垂直维数(OVD)时舌压及肌电活动的急性变化。材料与方法共纳入22例受试者。吞咽在两种情况下进行基础OVD测量:唾液吞咽(SS)和半固体稠度吞咽(酸奶吞咽,YS),关于舌压的变化和颞肌和咬肌的肌电图活动。在将OVD分别增加2、4和6 mm的情况下,进行了相同的测量。舌压力传感器flexforce A-201 (Tekscan)用于分析舌在硬腭上的接触压力。使用EMG Works采集软件记录肌电图。使用普通最小二乘线性回归模型进行条件之间的比较。采用P <; 0.05的显著性水平,所有结果均计算95%置信区间。结果在ovd为2、4、6 mm时,咬肌和颞肌肌电活动无显著性差异(P > 0.05)。在YS条件下,咬肌在SS条件下的基底OVD与YS条件下的所有OVD之间存在显著差异(P < 0.05),而颞肌没有差异。舌压在0、4和6 mm处显示出ovd间SS状态的差异(P < 0.05)。在相同的ovd条件下,SS和YS条件的差异有统计学意义(P < 0.05)。结论口颌系统能快速适应OVD的急性变化。
{"title":"15 - Acute changes in swallowing and electromyographic activity of the masticatory muscles while changing the occlusal vertical dimension with bite stops","authors":"Victor Rojas ,&nbsp;Ian Raby ,&nbsp;Rocio Aguirre ,&nbsp;Andres Celis","doi":"10.1016/j.ejwf.2025.07.019","DOIUrl":"10.1016/j.ejwf.2025.07.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporary bite-raising or bite-opening is often required in patients undergoing orthodontic treatment but the implications of increasing OVD remain a controversial issue based on existing evidence, although it is considered meaningful in rehabilitative procedures.</div></div><div><h3>Objective</h3><div>Determine the acute changes in tongue pressure and electromyographic (EMG) activity of the masseter and temporalis muscles during swallowing while increasing the occlusal vertical dimension (OVD).</div></div><div><h3>Materials and Methods</h3><div>Twenty-two participants were enrolled. Swallowing was measured at the basal OVD in two conditions: saliva swallowing (SS) and swallowing a semi-solid consistency element (yogurt swallowing, YS), regarding changes in tongue pressure and the EMG activity of the temporalis and masseter muscles. The same measurements were performed while increasing the OVD by 2, 4, and 6 mm. A tongue pressure sensor, Flexiforce A-201 model (Tekscan), was used to analyze the contact pressure of the tongue on the hard palate. Electromyography was recorded using EMG Works acquisition software. Comparisons between conditions were performed using ordinary least squares linear regression models. A significance level of P &lt; 0.05 was applied, and 95% confidence intervals were calculated for all outcomes.</div></div><div><h3>Results</h3><div>The masseter and temporalis muscles showed no differences in EMG activity in SS condition with OVDs of 2, 4, and 6 mm (P &gt; 0.05). In the YS condition, the masseter showed significant differences between basal OVD in the SS condition and all OVDs in the YS condition (P &lt; 0.05), whereas the temporalis showed no differences. Tongue pressure showed differences in SS condition between OVDs at 0, 4, and 6 mm (P &lt; 0.05). Significant results were observed between the SS and YS conditions at the same OVDs (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The stomatognathic system rapidly adapts to acute changes in OVD.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 402"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705698","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
88 - Effects of maxillary expansion and adenotonsillectomy on bruxism in children: A 2-year prospective cohort study 上颌扩张和腺扁桃体切除术对儿童磨牙的影响:一项为期2年的前瞻性队列研究
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.092
Carolina Ferrari Piloni De Oliveira , Karine Evangelista , Melissa Ameloti Gomes Avelino , Maria Alves Alves Garcia Silva , José Valladares-Neto

Background

Bruxism, a behavior mediated by the central nervous system and modulated by the biopsychosocial model, may manifest as involuntary, repetitive, and nonnutritive masticatory muscle activity during sleep and awake. The treatment involves a multidisciplinary team. On a positive perspective, approaches focusing on the enlargement of airway patency have shown positive results.

Objectives

To assess the impact of rapid maxillary expansion (RME) and adenotonsillectomy (AT) in children with bruxism, determining the optimal alternating sequence for these interventions. Additionally, to identify factors associated with influencing the outcomes.

Methods

Children aged 4 to 9 years were allocated into three groups: G1 (AT-first followed by ERM); G2 (RME-first followed by AT); and G3 (RME without an AT indication). The diagnosis of probable bruxism, including sleep (SB) or awake (AB), was established through a comprehensive assessment five different time points (T0 to T4). Data analysis employed bivariate analysis and the “generalized estimating equation models”, with Bonferroni's adjustment for multiple comparisons (p < 0.05).

Results

Fifty-four children participated (mean age 6.67 years, SD = 1.25), which 34 having an indication for AT (G1, n = 17; G2, n = 17), and 20 had non-AT indication (G3). Significant reductions were observed in SB from T0 to T2 in G1 (p = 0.009) and in AB from T0 to T3 in G2 (p = 0.010). Bruxism was associated with sleep and behavior factors, respiratory conditions, and clinical signs (p < 0.05).

Conclusions

The combined effect of AT and ERM tended to enhance the reduction of both SB and AB, despite a non-significant resurgence in the follow-up period. Notably, starting with AT was more effective for SB, while commencing with RME was more significant for AB. The distribution of different associated factors over the 2-year follow-up emphasized the dynamic nature of bruxism, influenced by a multifactorial etiology and lifestyle factors.
磨牙症是一种由中枢神经系统介导并受生物心理社会模式调节的行为,可表现为睡眠和清醒时咀嚼肌的不自主、重复和非营养性活动。治疗涉及多学科团队。从积极的角度来看,专注于扩大气道通畅的方法已经显示出积极的结果。目的评估快速上颌扩张术(RME)和腺扁桃体切除术(AT)对磨牙儿童的影响,确定这些干预措施的最佳交替顺序。此外,确定影响结果的相关因素。方法将4 ~ 9岁儿童分为3组:G1组(AT-first后ERM);G2 (rme先后AT);G3(无AT指征的RME)。通过对5个不同时间点(T0 ~ T4)的综合评估,确定有无磨牙的诊断,包括睡眠(SB)或清醒(AB)。数据分析采用双变量分析和“广义估计方程模型”,多重比较采用Bonferroni调整(p < 0.05)。结果54例患儿(平均年龄6.67岁,SD = 1.25),其中有AT指征34例(G1, n = 17;G2, n = 17),无AT指征20例(G3)。G1从T0到T2的SB显著降低(p = 0.009),G2从T0到T3的AB显著降低(p = 0.010)。磨牙症与睡眠和行为因素、呼吸状况和临床症状相关(p < 0.05)。结论AT和ERM的联合作用倾向于增强SB和AB的降低,尽管在随访期间无明显回升。值得注意的是,从AT开始治疗SB更有效,而从RME开始治疗AB更显著。在2年的随访中,不同相关因素的分布强调了磨牙症的动态性质,受多因素病因和生活方式因素的影响。
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引用次数: 0
11 - A standard automated assessment tool for craniofacial landmarks in CBCT: InVivo7 software 11 - CBCT颅面标志的标准自动评估工具:InVivo7软件
IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.015
Luísa Schubach Da Costa Barreto , Heeyeon Suh , Heesoo Oh , Jonas Bianchi , Klaus Barretto dos Santos Lopes Batista , José Augusto Mendes Miguel

Background

In craniofacial analysis, artificial intelligence (AI)-driven algorithms facilitate the precise identification of anatomical landmarks on Cone Beam Computed Tomography (CBCT) scans.

Objectives

This study investigates the functionality of the three-dimensional imaging software InVivo7, assessing its potential as an automated tool for craniofacial landmark identification in CBCT scans.

Methods

AI-assisted automatic landmark tracing in InVivo7 was employed to identify anatomical landmarks in CBCT images. Each landmark was manually verified by a skilled evaluator to ensure accuracy, particularly for soft tissue markers and dental measurements, which often presented challenges for AI detection. The study utilized a standardized cephalometric analysis to compare the software’s performance. The evaluation included assessing the software's ability to recognize skeletal, dental, and soft tissue structures accurately.

Results

The AI-enhanced software demonstrated high precision in identifying craniofacial landmarks, with manual verification confirming its reliability, leading to the subsequent creation of a customized automated configuration for orthodontic diagnosis and treatment outcome evaluation. Specific clinical measures, such as the facial plane angle and molar relationships, were calculated using established formulas, allowing the software to categorize molar relationship classes (Angle Class I, II, III).

Conclusions

InVivo7 presents a reliable and efficient tool for craniofacial landmark analysis, enhancing diagnostic accuracy while reducing manual labor. Ongoing validation and software updates are essential to fully optimize its clinical applicability and ensure consistent performance across diverse patient populations.
在颅面分析中,人工智能(AI)驱动的算法有助于在锥形束计算机断层扫描(CBCT)扫描中精确识别解剖地标。目的研究三维成像软件InVivo7的功能,评估其作为CBCT扫描颅面地标识别自动化工具的潜力。方法采用InVivo7软件中ai辅助的自动地标追踪识别CBCT图像中的解剖地标。每个标记都由熟练的评估人员手动验证,以确保准确性,特别是软组织标记和牙齿测量,这通常给人工智能检测带来挑战。该研究利用标准化的头测分析来比较软件的性能。评估包括评估软件准确识别骨骼、牙齿和软组织结构的能力。结果人工智能增强软件在识别颅面标志方面表现出很高的精度,人工验证证实了其可靠性,从而导致随后创建用于正畸诊断和治疗结果评估的定制自动化配置。具体的临床测量,如面部平面角度和磨牙关系,使用已建立的公式计算,允许软件分类磨牙关系类别(角类I, II, III)。结论sinvivo7是一种可靠、高效的颅面标志分析工具,可在减少人工劳动的同时提高诊断准确性。持续的验证和软件更新对于充分优化其临床适用性和确保在不同患者群体中的一致表现至关重要。
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引用次数: 0
期刊
Journal of the World Federation of Orthodontists
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