Pub Date : 2025-12-01DOI: 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.
{"title":"75 - Diagnostic algorithm for localization and complexity assessment of impacted maxillary canines","authors":"Gunel Aliyeva , Sura Seyfullayeva , Alima Musayeva","doi":"10.1016/j.ejwf.2025.07.079","DOIUrl":"10.1016/j.ejwf.2025.07.079","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 424"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705227","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}
Pub Date : 2025-12-01DOI: 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.
{"title":"60 - Considerations about Bisphenol-A release from orthodontic clear aligners: a systematic review","authors":"Diego Dos Santos Dias , Karla Dias Castro Dias , Natália dos Santos Dias , Álvaro Teixeira Mattos","doi":"10.1016/j.ejwf.2025.07.064","DOIUrl":"10.1016/j.ejwf.2025.07.064","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 419"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705312","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}
Pub Date : 2025-12-01DOI: 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.
{"title":"31 - Assessing aesthetic outcomes of the surgery-first approach in skeletal class III patients","authors":"Arthur Cunha , Tainá Manso , Jorge Faber , Flavia Artese , José Augusto Mendes Miguel","doi":"10.1016/j.ejwf.2025.07.035","DOIUrl":"10.1016/j.ejwf.2025.07.035","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 408"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705580","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}
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.
{"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 , Khalid Alaman , Fares Alkhudairi , Muhannad Alhaqbani , Mohammed Alshalawi , 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 < 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.</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}
Pub Date : 2025-12-01DOI: 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.
{"title":"16 - Adherence to clinical practice guidelines amongst adolescents with buccal fixed orthodontic appliances in Northeast Netherlands: A cross-sectional study","authors":"Sebastiaan Van Doornik , Anne Marie Kuijpers-Jagtman , Yijin Ren , David Manton , Scott Lietmeijer , Pieter Dijkstra","doi":"10.1016/j.ejwf.2025.07.020","DOIUrl":"10.1016/j.ejwf.2025.07.020","url":null,"abstract":"<div><div><strong>Background:</strong> 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.</div></div><div><h3>Objective</h3><div>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.</div><div><strong>Methods:</strong> 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.</div><div><strong>Results</strong> 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).</div><div><strong>Limitations</strong> The use of self-reported data may have introduced bias, as participants may have provided socially desirable responses.</div><div><strong>Conclusions:</strong> 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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 402-403"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705582","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}
Pub Date : 2025-12-01DOI: 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.
{"title":"21 - Anatomical assessment of intra-alveolar miniscrews for therapeutic use in orthodontics","authors":"Yissel Gatica Villa , Alondra Hormazabal , Camilo Meza , Basthian Parra","doi":"10.1016/j.ejwf.2025.07.025","DOIUrl":"10.1016/j.ejwf.2025.07.025","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 404"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705651","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}
Pub Date : 2025-12-01DOI: 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.
{"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 , Ian Raby , Rocio Aguirre , 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 < 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 > 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).</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}
Pub Date : 2025-12-01DOI: 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.
{"title":"88 - Effects of maxillary expansion and adenotonsillectomy on bruxism in children: A 2-year prospective cohort study","authors":"Carolina Ferrari Piloni De Oliveira , Karine Evangelista , Melissa Ameloti Gomes Avelino , Maria Alves Alves Garcia Silva , José Valladares-Neto","doi":"10.1016/j.ejwf.2025.07.092","DOIUrl":"10.1016/j.ejwf.2025.07.092","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 428-429"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705711","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}
Pub Date : 2025-12-01DOI: 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.
{"title":"11 - A standard automated assessment tool for craniofacial landmarks in CBCT: InVivo7 software","authors":"Luísa Schubach Da Costa Barreto , Heeyeon Suh , Heesoo Oh , Jonas Bianchi , Klaus Barretto dos Santos Lopes Batista , José Augusto Mendes Miguel","doi":"10.1016/j.ejwf.2025.07.015","DOIUrl":"10.1016/j.ejwf.2025.07.015","url":null,"abstract":"<div><h3>Background</h3><div>In craniofacial analysis, artificial intelligence (AI)-driven algorithms facilitate the precise identification of anatomical landmarks on Cone Beam Computed Tomography (CBCT) scans.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 400-401"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705774","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}
The term "artificial intelligence" first introduced in the 1950s, has reached a turning point following recent advances. As chatbot capabilities continue to evolve, it becomes important to ensure that the information they provide remains reliable and accurate.
Objectives
To assess the reliability, accuracy, and readability of the responses provided by 3 chatbots (ChatGPT 4.0, Google Gemini 1.5, and Claude 3.5 Sonnet) to inquiries about ortho-perio treatment procedures.
Methods
16 questions regarding treatments related to orthodontics and periodontics were presented to 3 different chatbots, and their responses were collected. 2 orthodontists and 1 periodontist assessed the answers using multiple tests. For reliability (Modified DISCERN tool), for accuracy (Likert scale and the Accuracy of Information Index (AOI)), and for readability (the Flesch-Kincaid Reading Ease Score (FRES) and Grade Level (FKGL)) were used.
Results
Regarding Likert scale, the highest average scores were given to ChatGPT at 4.9, followed by Claude at 4.8 and Gemini at 4.5. A statistically significant difference was observed between the scores of both chatbots and Gemini, with p-values of 0.003 and 0.015, respectively. Looking at the Accuracy of Information Index (AOI) scores, ChatGPT had the highest average score of 8.8, followed by Claude with 8.8, and Gemini with 8.1. The scores of ChatGPT and Claude were found to be statistically significantly higher compared to Gemini, with p-values of 0.003 and 0.005, respectively. Regarding DISCERN test, the highest average score was observed for Gemini with 34.8. Claude and ChatGPT both showed statistically significant differences with Gemini, with p-value of 0.001. About FRES and FKGL, all chatbots produced college-level texts that were challenging to read.
Conclusions
Regarding questions about ortho-perio treatment procedures, Gemini demonstrated good reliability. In terms of accuracy, ChatGPT and Claude received higher scores than Gemini.
{"title":"12 - A study to evaluate the quality of information provided by various chatbots on ortho-perio treatment procedures","authors":"Elif Gokce Erkan , Başak Arslan Avan , Neslihan Yılmaz","doi":"10.1016/j.ejwf.2025.07.016","DOIUrl":"10.1016/j.ejwf.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>The term \"artificial intelligence\" first introduced in the 1950s, has reached a turning point following recent advances. As chatbot capabilities continue to evolve, it becomes important to ensure that the information they provide remains reliable and accurate.</div></div><div><h3>Objectives</h3><div>To assess the reliability, accuracy, and readability of the responses provided by 3 chatbots (ChatGPT 4.0, Google Gemini 1.5, and Claude 3.5 Sonnet) to inquiries about ortho-perio treatment procedures.</div></div><div><h3>Methods</h3><div>16 questions regarding treatments related to orthodontics and periodontics were presented to 3 different chatbots, and their responses were collected. 2 orthodontists and 1 periodontist assessed the answers using multiple tests. For reliability (Modified DISCERN tool), for accuracy (Likert scale and the Accuracy of Information Index (AOI)), and for readability (the Flesch-Kincaid Reading Ease Score (FRES) and Grade Level (FKGL)) were used.</div></div><div><h3>Results</h3><div>Regarding Likert scale, the highest average scores were given to ChatGPT at 4.9, followed by Claude at 4.8 and Gemini at 4.5. A statistically significant difference was observed between the scores of both chatbots and Gemini, with p-values of 0.003 and 0.015, respectively. Looking at the Accuracy of Information Index (AOI) scores, ChatGPT had the highest average score of 8.8, followed by Claude with 8.8, and Gemini with 8.1. The scores of ChatGPT and Claude were found to be statistically significantly higher compared to Gemini, with p-values of 0.003 and 0.005, respectively. Regarding DISCERN test, the highest average score was observed for Gemini with 34.8. Claude and ChatGPT both showed statistically significant differences with Gemini, with p-value of 0.001. About FRES and FKGL, all chatbots produced college-level texts that were challenging to read.</div></div><div><h3>Conclusions</h3><div>Regarding questions about ortho-perio treatment procedures, Gemini demonstrated good reliability. In terms of accuracy, ChatGPT and Claude received higher scores than Gemini.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 401"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705775","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}