Maintaining posterior anchorage during orthodontic treatments involving extractions remains a clinically relevant challenge, particularly in cases requiring en-masse retraction of the anterior segment. Anchorage refers to the resistance to unwanted tooth movement, and its loss can significantly compromise treatment outcomes. This systematic review, conducted according to PRISMA guidelines, aimed to compare the effectiveness of the Nance button and the transpalatal arch (TPA) as conventional intraoral anchorage devices to prevent anchorage loss in patients requiring maximum anchorage. A comprehensive literature search was performed using the Web of Science and Ovid platforms, accessing databases including PubMed/MEDLINE, Embase, Scopus, and SciELO. Search terms included “Nance button,” “transpalatal arch,” “anchorage,” “maximum anchorage,” “tooth migration,” and “orthodontic appliance,” with inclusion criteria limited to studies published between 2005 and 2025. From an initial pool of 22 articles, 10 studies were included in the qualitative synthesis. These comprised randomized and non-randomized clinical trials, retrospective studies, and systematic reviews with meta-analyses. Methodological quality and risk of bias were assessed using GRADE, ROBINS-I, RoB 2, and AMSTAR 2 tools. The results confirm that both devices are effective, but not equivalent. For sagittal anchorage purposes, the Nance button has proven to be more effective due to its greater rigidity and ability to limit mesial molar displacement. The TPA is more suitable when transverse and rotational control is required. The device should be selected based on the specific biomechanical requirements of the treatment rather than general criteria. Differentiated use of both appliances should align with the clinical needs of each case, highlighting the importance of individualized orthodontic planning. Further controlled clinical studies are recommended.
在包括拔牙在内的正畸治疗中，维持后牙支抗仍然是一个临床相关的挑战，特别是在需要大规模前段内收的病例中。固支指的是对不需要的牙齿运动的抵抗，它的丢失会严重影响治疗效果。本系统综述根据PRISMA指南进行，目的是比较Nance按钮和经腭弓（TPA）作为传统的口内支抗装置在需要最大支抗的患者中防止支抗丢失的有效性。使用Web of Science和Ovid平台进行全面的文献检索，访问数据库包括PubMed/MEDLINE、Embase、Scopus和SciELO。搜索词包括“Nance按钮”、“经腭弓”、“锚固”、“最大锚固”、“牙齿移动”和“正畸器具”，纳入标准仅限于2005年至2025年间发表的研究。从最初的22篇文章中，有10篇研究被纳入定性综合。这些研究包括随机和非随机临床试验、回顾性研究和带有荟萃分析的系统评价。采用GRADE、ROBINS-I、rob2和AMSTAR 2工具评估方法学质量和偏倚风险。结果证实这两种方法都是有效的，但并不等同。对于矢状支抗的目的，Nance扣已被证明是更有效的，因为它具有更大的刚性和限制近端磨牙位移的能力。当需要横向和旋转控制时，TPA更适合。器械的选择应基于治疗的具体生物力学要求，而不是一般标准。两种矫治器的不同使用应符合每个病例的临床需要，强调个性化正畸计划的重要性。建议进一步的对照临床研究。
{"title":"51 - Comparison between nance button and transpalatal arch for preventing anchorage loss in orthodontics. Systematic review","authors":"Ines Perez , Isadora Valbuena , Fernanda Vargas , Caroline Lynch","doi":"10.1016/j.ejwf.2025.07.055","DOIUrl":"10.1016/j.ejwf.2025.07.055","url":null,"abstract":"<div><div>Maintaining posterior anchorage during orthodontic treatments involving extractions remains a clinically relevant challenge, particularly in cases requiring en-masse retraction of the anterior segment. Anchorage refers to the resistance to unwanted tooth movement, and its loss can significantly compromise treatment outcomes. This systematic review, conducted according to PRISMA guidelines, aimed to compare the effectiveness of the Nance button and the transpalatal arch (TPA) as conventional intraoral anchorage devices to prevent anchorage loss in patients requiring maximum anchorage. A comprehensive literature search was performed using the Web of Science and Ovid platforms, accessing databases including PubMed/MEDLINE, Embase, Scopus, and SciELO. Search terms included “Nance button,” “transpalatal arch,” “anchorage,” “maximum anchorage,” “tooth migration,” and “orthodontic appliance,” with inclusion criteria limited to studies published between 2005 and 2025. From an initial pool of 22 articles, 10 studies were included in the qualitative synthesis. These comprised randomized and non-randomized clinical trials, retrospective studies, and systematic reviews with meta-analyses. Methodological quality and risk of bias were assessed using GRADE, ROBINS-I, RoB 2, and AMSTAR 2 tools. The results confirm that both devices are effective, but not equivalent. For sagittal anchorage purposes, the Nance button has proven to be more effective due to its greater rigidity and ability to limit mesial molar displacement. The TPA is more suitable when transverse and rotational control is required. The device should be selected based on the specific biomechanical requirements of the treatment rather than general criteria. Differentiated use of both appliances should align with the clinical needs of each case, highlighting the importance of individualized orthodontic planning. Further controlled clinical studies are recommended.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 416"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705406","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.2025.07.052
Ahmed Iftikhar Khan , Prof. Dr. Saad Asad , Ayesha Mehboob , Ahmed Iftikhar khan , Uswa Mariam , Muhammad Ali Abbas
Because of their high construct validity, reliability, and feasibility, multiple-choice questions (MCQs) are commonly employed in dentistry, particularly in orthodontics. Nevertheless, it appears that they are unable to critically evaluate many facets of orthodontic management. Adding more assessment methods can help foster critical thinking in orthodontics. The EMQ is a useful assessment tool with a comparatively high degree of feasibility and dependability. Therefore, the purpose of this study is to evaluate orthodontic critical thinking abilities in BDS students by comparing MCQs and EMQs. Using Raosft software, the sample size for this comparative study was determined to be 45. A preset course covering the same theme and subtheme produced a set of 15 EMQs and 15 MCQs, which were validated by three subject matter experts using Cronbach alpha (α=.81). After MEQs and EMQs were validated, ten of each were administered to 45 final-year BDS students on the same day, with a 10-minute interval between each test. The findings indicated that MEQs evaluate orthodontic critical thinking statistically substantially better than MCQs (P-value 0.014). The conclusion is that many aspects of orthodontics can be assessed by incorporating EMQs into the current MCQs evaluation.
{"title":"48 - Comparing extended matching questions (EMQs) with multiple-choice questions (MCQs) to evaluate the critical thinking abilities of final-year BDS orthodontic students","authors":"Ahmed Iftikhar Khan , Prof. Dr. Saad Asad , Ayesha Mehboob , Ahmed Iftikhar khan , Uswa Mariam , Muhammad Ali Abbas","doi":"10.1016/j.ejwf.2025.07.052","DOIUrl":"10.1016/j.ejwf.2025.07.052","url":null,"abstract":"<div><div>Because of their high construct validity, reliability, and feasibility, multiple-choice questions (MCQs) are commonly employed in dentistry, particularly in orthodontics. Nevertheless, it appears that they are unable to critically evaluate many facets of orthodontic management. Adding more assessment methods can help foster critical thinking in orthodontics. The EMQ is a useful assessment tool with a comparatively high degree of feasibility and dependability. Therefore, the purpose of this study is to evaluate orthodontic critical thinking abilities in BDS students by comparing MCQs and EMQs. Using Raosft software, the sample size for this comparative study was determined to be 45. A preset course covering the same theme and subtheme produced a set of 15 EMQs and 15 MCQs, which were validated by three subject matter experts using Cronbach alpha (α=.81). After MEQs and EMQs were validated, ten of each were administered to 45 final-year BDS students on the same day, with a 10-minute interval between each test. The findings indicated that MEQs evaluate orthodontic critical thinking statistically substantially better than MCQs (P-value 0.014). The conclusion is that many aspects of orthodontics can be assessed by incorporating EMQs into the current MCQs evaluation.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 415"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705444","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.2025.07.033
Lorena Wilka , Gabriel Bravo Vallejo , Jonas Bianchi , Felicia Miranda , Daniela Garib , Jose Fernando Castanha Henriques
Rapid maxillary expansion (RME) is an effective treatment for maxillary atresia and upper arch crowding, but it might lead to undesirable outcomes like facial asymmetries. Miniscrew-assisted rapid palatal expansion (MARPE) offers a more controlled approach, particularly in adults, using mini-screws to anchor the expander. However, its impact on maxillomandibular asymmetry and nasal cavity width is underexplored. This study aims to evaluate the three-dimensional effects of MARPE in adult patients, analyzing post-treatment maxillomandibular asymmetry and nasal cavity width. It also seeks to explore the role of artificial intelligence (AI)-based software in assessing skeletal asymmetries and optimizing MARPE treatment in clinical settings. This retrospective study involves 12 patients, aged 20-40, with maxillary constriction, treated with MARPE expander anchored by four mini-screws. Cone beam computed tomography (CBCT) scans were taken before expansion (T0) and 6 months after treatment (T1). AI-based 3D evaluation software will analyze changes in skeletal structures, including maxillomandibular alignment and nasal cavity width. Paired t-tests will compare interphase changes (T0-T1) with a significance level of 5%. The study will assess the impact of MARPE on maxillomandibular asymmetry. Additionally, it will examine changes in the nasal cavity width, anticipating potential improvements in airflow due to the expansion. AI-based tools will facilitate precise, reproducible measurements to evaluate treatment outcomes and identify any asymmetries requiring further attention. This study will provide valuable insights into the effects of MARPE on facial symmetry and nasal cavity width, and explore how AI tools can enhance the precision and personalization of orthodontic treatments for adults. The findings could optimize MARPE protocols and improve clinical outcomes in adult patients with maxillary constriction.
{"title":"29 - Artificial intelligence-based three-dimensional evaluation of skeletal asymmetries in adults undergoing rapid palatal expansion","authors":"Lorena Wilka , Gabriel Bravo Vallejo , Jonas Bianchi , Felicia Miranda , Daniela Garib , Jose Fernando Castanha Henriques","doi":"10.1016/j.ejwf.2025.07.033","DOIUrl":"10.1016/j.ejwf.2025.07.033","url":null,"abstract":"<div><div>Rapid maxillary expansion (RME) is an effective treatment for maxillary atresia and upper arch crowding, but it might lead to undesirable outcomes like facial asymmetries. Miniscrew-assisted rapid palatal expansion (MARPE) offers a more controlled approach, particularly in adults, using mini-screws to anchor the expander. However, its impact on maxillomandibular asymmetry and nasal cavity width is underexplored. This study aims to evaluate the three-dimensional effects of MARPE in adult patients, analyzing post-treatment maxillomandibular asymmetry and nasal cavity width. It also seeks to explore the role of artificial intelligence (AI)-based software in assessing skeletal asymmetries and optimizing MARPE treatment in clinical settings. This retrospective study involves 12 patients, aged 20-40, with maxillary constriction, treated with MARPE expander anchored by four mini-screws. Cone beam computed tomography (CBCT) scans were taken before expansion (T0) and 6 months after treatment (T1). AI-based 3D evaluation software will analyze changes in skeletal structures, including maxillomandibular alignment and nasal cavity width. Paired t-tests will compare interphase changes (T0-T1) with a significance level of 5%. The study will assess the impact of MARPE on maxillomandibular asymmetry. Additionally, it will examine changes in the nasal cavity width, anticipating potential improvements in airflow due to the expansion. AI-based tools will facilitate precise, reproducible measurements to evaluate treatment outcomes and identify any asymmetries requiring further attention. This study will provide valuable insights into the effects of MARPE on facial symmetry and nasal cavity width, and explore how AI tools can enhance the precision and personalization of orthodontic treatments for adults. The findings could optimize MARPE protocols and improve clinical outcomes in adult patients with maxillary constriction.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 407"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705578","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.2025.07.029
Gustavo Favarato Ruy , Selly Sayuri Suzuki , Aguinaldo Silva Garcez , Caroline Binda , Pedro Paulo Dalla de Andrade
Transverse maxillary deficiency is a highly prevalent malocclusion, present in all age groups, in individuals who have already passed the bone growth phase, using techniques of maxillary disjunction assisted by mini-implants. The objective was to compare measurements in different regions of the palatine bone and soft tissue of the palate in Cone Beam Computed Tomography (CBCT) in individuals with and without transverse maxillary deficiency, identifying the most favorable sites for insertion of mini implants. The research consisted of a retrospective study with 65 CBCT, 16 tomographies of men and 15 of women, 31 years old on average, with transverse maxillary deficiency. And, 14 tomographies of men and 20 of women, with an average of 33.3 years without transverse maxillary deficiency. The measurements were obtained in 3 positions on the hard palate: distal of the first premolar, distal of the second premolar and distal of the first molar. Statistical analyses were performed using the Shapiro-Wilk test and paired t-test. The results showed that the thickness of the palatine bone was greater in the distal region of the first premolars, decreasing in the distal regions of the second premolars and first molars, with the highest values being at the palatine suture in both groups. Gingival thickness was greater in group A at the distal region of the first premolars. The width of the palatine vault bone ridge was greater in group B at the height of the alveolar bone crest. The width of the gingival ridge was greater at the height of the alveolar bone crest at the distal region of the second premolars in group B, while in group A it was at the distal region of the first molars. The thickness of the gingival mucosa was greater in group A at the median height of the root in the distal region of the first molars. The anatomical structure of the palatine bone differs greatly between individuals, making it important to analyze CBCT for planning the palatine mini-implants.
{"title":"25 - Article analysis of bone and gingival thickness in different palatal regions using cone-beam computed tomography in subjects with and without maxillary transverse deficiency","authors":"Gustavo Favarato Ruy , Selly Sayuri Suzuki , Aguinaldo Silva Garcez , Caroline Binda , Pedro Paulo Dalla de Andrade","doi":"10.1016/j.ejwf.2025.07.029","DOIUrl":"10.1016/j.ejwf.2025.07.029","url":null,"abstract":"<div><div>Transverse maxillary deficiency is a highly prevalent malocclusion, present in all age groups, in individuals who have already passed the bone growth phase, using techniques of maxillary disjunction assisted by mini-implants. The objective was to compare measurements in different regions of the palatine bone and soft tissue of the palate in Cone Beam Computed Tomography (CBCT) in individuals with and without transverse maxillary deficiency, identifying the most favorable sites for insertion of mini implants. The research consisted of a retrospective study with 65 CBCT, 16 tomographies of men and 15 of women, 31 years old on average, with transverse maxillary deficiency. And, 14 tomographies of men and 20 of women, with an average of 33.3 years without transverse maxillary deficiency. The measurements were obtained in 3 positions on the hard palate: distal of the first premolar, distal of the second premolar and distal of the first molar. Statistical analyses were performed using the Shapiro-Wilk test and paired t-test. The results showed that the thickness of the palatine bone was greater in the distal region of the first premolars, decreasing in the distal regions of the second premolars and first molars, with the highest values being at the palatine suture in both groups. Gingival thickness was greater in group A at the distal region of the first premolars. The width of the palatine vault bone ridge was greater in group B at the height of the alveolar bone crest. The width of the gingival ridge was greater at the height of the alveolar bone crest at the distal region of the second premolars in group B, while in group A it was at the distal region of the first molars. The thickness of the gingival mucosa was greater in group A at the median height of the root in the distal region of the first molars. The anatomical structure of the palatine bone differs greatly between individuals, making it important to analyze CBCT for planning the palatine mini-implants.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 406"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705656","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.2025.07.032
Joberth Rainner Baliza De Paula , Liris Cristina Nepomuceno Pinto , Luana Karine Amaro Silva , Arthur Cunha , Henrique Martins Da Silveira , José Augusto Mendes Miguel
Advances in artificial intelligence (AI) in dentistry have been driven by improvements in data processing, algorithmic programming, and computational software. In recent decades, the rapid development of AI has enhanced safety in orthodontics, improving diagnostic predictability and treatment planning efficiency. This pilot study aimed to evaluate the use of AI in assessing upper airway dimensions in Class III patients undergoing bimaxillary orthognathic surgery. The software 3D Slicer (Version 5.9.0, Revision 33451) was used and compared with Dolphin ImagingⓇ (Chatsworth, Califórnia,. EUA). Six patients (mean age: 18.7 ± 2.42 years; mean BMI: 26.5 ± 7.2 kg/m²) underwent upper airway measurements before surgery (T0) and six months postoperatively (T1). The mean airway area (AA) and airway volume (AV) using 3D Slicer were 1,403 ± 416 mm² at T0 and 1,405 ± 143 mm² at T1, and 35,687 ± 12,924 mm³ at T0 and 35,026 ± 4,307 mm³ at T1. The mean airway area and airway volume using Dolphin ImagingⓇ were 1,526 ± 375 mm² at T0 and 1,528 ± 182 mm² at T1, and 36,921 ± 11,672 mm³ at T0 and 36,260 ± 3,980 mm³ at T1. A correlation matrix using Pearson's coefficients was employed for analysis. Overall, correlations were moderate (0.5 < |r| < 0.7) but not statistically significant (p > 0.05). Strong correlations (|r| > 0.7) were observed, such as T0 AA Dolphin and T0 3D Slicer (r = 1.000, p < 0.001). Bland-Altman analyses were also performed, estimating bias, lower and upper agreement limits, and 95% confidence intervals. The results demonstrated a small mean bias (-2.50) but wide agreement limits. The AI-based 3D Slicer software demonstrated comparable performance to Dolphin ImagingⓇ in measuring upper airway dimensions in Class III patients undergoing orthognathic surgery. The correlation analysis indicated a strong agreement between the two methods, though not all correlations were statistically significant. Bland-Altman analysis showed minimal bias but large agreement ranges, suggesting some variability between the two software programs. Further studies with larger sample sizes are recommended to validate these findings and refine AI applications in airway assessment.
{"title":"28 - Artificial intelligence in upper airway assessment: A pilot study in Class III patients undergoing orthognathic surgery","authors":"Joberth Rainner Baliza De Paula , Liris Cristina Nepomuceno Pinto , Luana Karine Amaro Silva , Arthur Cunha , Henrique Martins Da Silveira , José Augusto Mendes Miguel","doi":"10.1016/j.ejwf.2025.07.032","DOIUrl":"10.1016/j.ejwf.2025.07.032","url":null,"abstract":"<div><div>Advances in artificial intelligence (AI) in dentistry have been driven by improvements in data processing, algorithmic programming, and computational software. In recent decades, the rapid development of AI has enhanced safety in orthodontics, improving diagnostic predictability and treatment planning efficiency. This pilot study aimed to evaluate the use of AI in assessing upper airway dimensions in Class III patients undergoing bimaxillary orthognathic surgery. The software 3D Slicer (Version 5.9.0, Revision 33451) was used and compared with Dolphin Imaging<sup>Ⓡ</sup> (Chatsworth, Califórnia,. EUA). Six patients (mean age: 18.7 ± 2.42 years; mean BMI: 26.5 ± 7.2 kg/m²) underwent upper airway measurements before surgery (T0) and six months postoperatively (T1). The mean airway area (AA) and airway volume (AV) using 3D Slicer were 1,403 ± 416 mm² at T0 and 1,405 ± 143 mm² at T1, and 35,687 ± 12,924 mm³ at T0 and 35,026 ± 4,307 mm³ at T1. The mean airway area and airway volume using Dolphin Imaging<sup>Ⓡ</sup> were 1,526 ± 375 mm² at T0 and 1,528 ± 182 mm² at T1, and 36,921 ± 11,672 mm³ at T0 and 36,260 ± 3,980 mm³ at T1. A correlation matrix using Pearson's coefficients was employed for analysis. Overall, correlations were moderate (0.5 < |r| < 0.7) but not statistically significant (p > 0.05). Strong correlations (|r| > 0.7) were observed, such as T0 AA Dolphin and T0 3D Slicer (r = 1.000, p < 0.001). Bland-Altman analyses were also performed, estimating bias, lower and upper agreement limits, and 95% confidence intervals. The results demonstrated a small mean bias (-2.50) but wide agreement limits. The AI-based 3D Slicer software demonstrated comparable performance to Dolphin Imaging<sup>Ⓡ</sup> in measuring upper airway dimensions in Class III patients undergoing orthognathic surgery. The correlation analysis indicated a strong agreement between the two methods, though not all correlations were statistically significant. Bland-Altman analysis showed minimal bias but large agreement ranges, suggesting some variability between the two software programs. Further studies with larger sample sizes are recommended to validate these findings and refine AI applications in airway assessment.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 407"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705660","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.2025.07.084
Letícia Vieira Koch , Jurandir Barbosa , Roberta Basting , Victor Angelo Martins Montalli
The digital tools currently available provide numerous new possibilities for planning and diagnosis in orthodontics. Among the technological innovations, the digital execution of orthodontic setups stands out, replacing the previously used plaster models. This technology is widely employed in the fabrication and planning of clear aligners, both in-office and by specialized companies. Data interpretation and the study of this new planning approach present challenges for orthodontists in the context of advancing digital orthodontics. This study aimed to develop educational material in the form of an e-book with video lessons, offering a practical approach and serving as a source of consultation and support in the study, interpretation, and management of virtual planning by orthodontists, with the goal of democratizing and facilitating access to this recent tool in digital orthodontics. The educational material was structured into the following topics: history, introduction to virtual planning, analysis of movement complexity, use of auxiliary devices, interproximal reductions, interproximal collisions, staging of movements, and application of attachments. The material was made available for free download through Instagram and a website, with promotional strategies carried out in collaboration with the educational institution and the authors involved. The relevance of the developed material was assessed using the Net Promoter Score (NPS) tool, applied at the end of the reading for users who downloaded the material. The scores obtained indicated excellent acceptance and utilization of the material, highlighting its importance as an educational resource for digital orthodontics.
{"title":"80 - Digital orthodontic planning: A practical guide for orthodontists clincheck for invisible aligners","authors":"Letícia Vieira Koch , Jurandir Barbosa , Roberta Basting , Victor Angelo Martins Montalli","doi":"10.1016/j.ejwf.2025.07.084","DOIUrl":"10.1016/j.ejwf.2025.07.084","url":null,"abstract":"<div><div>The digital tools currently available provide numerous new possibilities for planning and diagnosis in orthodontics. Among the technological innovations, the digital execution of orthodontic setups stands out, replacing the previously used plaster models. This technology is widely employed in the fabrication and planning of clear aligners, both in-office and by specialized companies. Data interpretation and the study of this new planning approach present challenges for orthodontists in the context of advancing digital orthodontics. This study aimed to develop educational material in the form of an e-book with video lessons, offering a practical approach and serving as a source of consultation and support in the study, interpretation, and management of virtual planning by orthodontists, with the goal of democratizing and facilitating access to this recent tool in digital orthodontics. The educational material was structured into the following topics: history, introduction to virtual planning, analysis of movement complexity, use of auxiliary devices, interproximal reductions, interproximal collisions, staging of movements, and application of attachments. The material was made available for free download through Instagram and a website, with promotional strategies carried out in collaboration with the educational institution and the authors involved. The relevance of the developed material was assessed using the Net Promoter Score (NPS) tool, applied at the end of the reading for users who downloaded the material. The scores obtained indicated excellent acceptance and utilization of the material, highlighting its importance as an educational resource for digital orthodontics.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 426"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705782","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}
Background: Direct 3D printing of aligners using Tera Harz TC-85 material (GraphyⓇ, Seoul, Republic of Korea) eliminates the need for printed dental models, offering a potentially more precise, efficient, and cost-effective alternative. Current guidelines recommend wearing aligners for 22 hours daily and replacing them every 15 days.
Objectives: This in vitro study evaluates the mechanical properties of Tera Harz TC-85 aligners at different time intervals (D0, D7, D14) in artificial saliva to assess force delivery and deformation over time.
Methods: Eighteen identical Class I aligners (GRAPHYⓇ, Forestadent Bernhard Foerster GmbHⓇ, Pforzheim, Germany) were divided into three groups (D0, D7, D14) and subjected to continuous aging in Fusayama-Mayer artificial saliva (Serlabo Technologies, Vedene, France) at 37°C. Following aging, aligners underwent traction testing using a Universal Testing Machine (LRX Plus Dynamometer Lloyd Instruments) to measure maximum tensile and yield strength.
Results: The average rupture force was 169.98 N (SD 32.32, CV 19.02%) at the molars and 222.67 N (SD 35.56, CV 15.97%) at the incisors. Deformation at D0 was significantly different from D7 and D14 in both incisors and molars (p < 0.001).
Conclusions: The mechanical stability of Tera Harz TC-85 suggests that aligners should be replaced weekly rather than every 15 days. Direct 3D printing does not reduce the total number of aligners needed, as shape memory becomes unstable over time.
背景：使用Tera Harz TC-85材料直接3D打印牙齿矫正器（GraphyⓇ，Seoul, Republic of Korea）消除了对打印牙齿模型的需求，提供了一种潜在的更精确、更高效、更经济的替代方案。目前的指南建议每天佩戴牙齿矫正器22小时，每15天更换一次。目的：本体外研究评估Tera Harz TC-85对准器在人工唾液中不同时间间隔（D0, D7, D14）的力学性能，以评估力传递和变形随时间的变化。方法：18个相同的I类对准器（GRAPHYⓇ，Forestadent Bernhard Foerster GmbHⓇ，Pforzheim, Germany）分为3组（D0, D7, D14），在37°C的Fusayama-Mayer人工唾液（Serlabo Technologies, Vedene, France）中持续老化。老化后，矫直器使用通用试验机（LRX Plus Dynamometer Lloyd Instruments）进行牵引测试，以测量最大拉伸强度和屈服强度。结果：磨牙的平均破裂力为169.98 N (SD 32.32, CV 19.02%)，门牙的平均破裂力为222.67 N （SD 35.56, CV 15.97%）。门牙和磨牙在D0的变形与D7和D14有显著差异（p < 0.001）。结论：Tera Harz TC-85的机械稳定性建议每周更换矫正器，而不是每15天更换一次。直接3D打印不会减少所需对准器的总数，因为形状记忆会随着时间的推移而变得不稳定。
{"title":"87 - Effects of aging on the mechanical properties of GraphyⓇ orthodontic aligners: An in vitro study","authors":"Vande Vannet Bart , Ursat Pauline , Ursat Eric , Hocquel Thibaut , Canceill Thibault","doi":"10.1016/j.ejwf.2025.07.091","DOIUrl":"10.1016/j.ejwf.2025.07.091","url":null,"abstract":"<div><div><strong>Background:</strong> Direct 3D printing of aligners using Tera Harz TC-85 material (Graphy<sup>Ⓡ</sup>, Seoul, Republic of Korea) eliminates the need for printed dental models, offering a potentially more precise, efficient, and cost-effective alternative. Current guidelines recommend wearing aligners for 22 hours daily and replacing them every 15 days.</div><div><strong>Objectives:</strong> This in vitro study evaluates the mechanical properties of Tera Harz TC-85 aligners at different time intervals (D0, D7, D14) in artificial saliva to assess force delivery and deformation over time.</div><div><strong>Methods:</strong> Eighteen identical Class I aligners (GRAPHY<sup>Ⓡ</sup>, Forestadent Bernhard Foerster GmbH<sup>Ⓡ</sup>, Pforzheim, Germany) were divided into three groups (D0, D7, D14) and subjected to continuous aging in Fusayama-Mayer artificial saliva (Serlabo Technologies, Vedene, France) at 37°C. Following aging, aligners underwent traction testing using a Universal Testing Machine (LRX Plus Dynamometer Lloyd Instruments) to measure maximum tensile and yield strength.</div><div><strong>Results:</strong> The average rupture force was 169.98 N (SD 32.32, CV 19.02%) at the molars and 222.67 N (SD 35.56, CV 15.97%) at the incisors. Deformation at D0 was significantly different from D7 and D14 in both incisors and molars (p < 0.001).</div><div><strong>Conclusions:</strong> The mechanical stability of Tera Harz TC-85 suggests that aligners should be replaced weekly rather than every 15 days. Direct 3D printing does not reduce the total number of aligners needed, as shape memory becomes unstable over time.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 428"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705787","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.2025.07.008
Ariana Azevedo , Joana Silva , Eugénio Martins , Alberto Canabez , Domingo Martin , Conchita Martin
Background
Mandibular kinematics is essential for assessing orofacial functions and understanding dysfunctions related to different types of malocclusion. Recording real-time mandibular dynamics aids in understanding kinematics, essential for treatment planning and outcomes.
Objective
To analyze mandibular kinematics within an orthodontic population employing the Modjaw optical tracking system.
Methods
A total of one hundred fifty-four patients participated in this observational study. Initial orthodontic records were analyzed. Mandibular kinematics was recorded using ModjawⓇ. Skeletal and dental parameters were determined by cephalometric analysis (ANB angle for skeletal classification).
Results
Significant variations in mandibular kinematics were detected across skeletal classes. The findings indicate that maxillomandibular relationships have a direct influence on mandibular movement and orthodontic treatment planning.
Conclusion
Individuals classified as Class III demonstrated significantly lower values in multiple key parameters, indicating that skeletal classification is crucial in influencing mandibular kinematic characteristics.
{"title":"4 - A comparative study of mandibular kinematics in an orthodontic population using optical jaw tracking technology","authors":"Ariana Azevedo , Joana Silva , Eugénio Martins , Alberto Canabez , Domingo Martin , Conchita Martin","doi":"10.1016/j.ejwf.2025.07.008","DOIUrl":"10.1016/j.ejwf.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Mandibular kinematics is essential for assessing orofacial functions and understanding dysfunctions related to different types of malocclusion. Recording real-time mandibular dynamics aids in understanding kinematics, essential for treatment planning and outcomes.</div></div><div><h3>Objective</h3><div>To analyze mandibular kinematics within an orthodontic population employing the Modjaw optical tracking system.</div></div><div><h3>Methods</h3><div>A total of one hundred fifty-four patients participated in this observational study. Initial orthodontic records were analyzed. Mandibular kinematics was recorded using Modjaw<sup>Ⓡ</sup>. Skeletal and dental parameters were determined by cephalometric analysis (ANB angle for skeletal classification).</div></div><div><h3>Results</h3><div>Significant variations in mandibular kinematics were detected across skeletal classes. The findings indicate that maxillomandibular relationships have a direct influence on mandibular movement and orthodontic treatment planning.</div></div><div><h3>Conclusion</h3><div>Individuals classified as Class III demonstrated significantly lower values in multiple key parameters, indicating that skeletal classification is crucial in influencing mandibular kinematic characteristics.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 398"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705197","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.2025.07.075
Nermin Taghiyeva , F. Deniz Uzuner
Herbst appliance is a fixed functional appliance used in the treatment of skeletal Class II anomaly. This case report presents the skeletal and dental changes achieved using a digital cast Herbst appliance combined with hyrax screw in the treatment of a 15-year-old male patient with skeletal Class II anomaly. The growing male patient (mp3u) has skeletal Class II anomaly with maxillary prognathism (SNA:86°, SNB:80°), low angle pattern (SNGoGn:25°), Class II Division 1 malocclusion, 8mm overjet and 2.5 mm maxillary crowding. The digital oral scanning was done by iTeroⓇ and on 3D models, digital cast of the combined Hyrax+Herbst appliance was designed. The digital cast Herbst appliance was used with a total duration of 7 months. The hyrax screw was activated 2 months; twice (0.25 mm per turn) weekly in the first, once weekly in the second month, for a total of 12 turns. During the treatment the appliance was well tolerated. After treatment, significant improvement was observed in convex facial profile, SNA angle decreased to 82°, SNB angle to 78°, mild posterior rotation occurred (SNGoGn:28°) and the molar relationship was corrected to bilateral Class I. Maxillary incisors demonstrated notable retrusion and 1-NB increased from 4 mm to 6 mm, reflecting minor proclination. The 3 mm activation of the expansion screw translated into an approximate 2 mm increase in transverse arch width. This reduced maxillary crowding from 2.5 mm to 0.5 mm. The retrusion of maxillary incisors and maxilla was favorable for this patient that may contributed to the combined application of the Hyrax and the Herbst. Whereas no mandibular advancement had occurred which may attribute to the mandibular posterior rotation. As a conclusion, expansion combined with Herbst treatment is suitable for the patients with skeletal Class II anomaly due to maxillary protrusion with low angle tendency and maxillary incisor protrusion.
赫布斯特矫治器是一种用于治疗骨骼II类畸形的固定功能矫治器。本病例报告介绍了使用数字铸造Herbst矫治器结合hyrax螺钉治疗一名15岁男性II类骨骼畸形患者的骨骼和牙齿改变。生长中的男性患者（mp3u）骨骼II类异常，上颌前突（SNA:86°，SNB:80°），低角度模式（SNGoGn:25°），II类1类错颌，8mm溢出和2.5 mm上颌拥挤。通过iTeroⓇ进行数字口腔扫描，在三维模型上设计Hyrax+Herbst组合矫治器的数字铸型。使用数字铸造赫布斯特矫治器，总持续时间为7个月。hyrax螺钉激活2个月；第一个月每周2次（0.25 mm /匝），第二个月每周1次，共12匝。治疗期间，矫治器耐受性良好。治疗后，面部轮廓凸出明显改善，SNA角降至82°，SNB角降至78°，轻微后旋（SNGoGn:28°），磨牙关系矫正为双侧i类。上颌切牙明显后缩，1-NB从4 mm增加到6 mm，轻微前倾。3毫米的膨胀螺钉激活转化为大约2毫米的横向拱宽增加。这减少了上颌拥挤从2.5毫米到0.5毫米。上颌门牙和上颌骨的后缩对该患者有利，这可能是Hyrax和Herbst联合应用的原因。而下颌未发生前进，这可能归因于下颌后旋。综上所述，扩张联合Herbst治疗适用于上颌前突低角度倾向及上颌切牙前突所致骨骼II类异常患者。
{"title":"71 - Dentoskeletal effects of digital cast herbst+hyrax appliance in the treatment of a Class II/1 malocclusion: A case report","authors":"Nermin Taghiyeva , F. Deniz Uzuner","doi":"10.1016/j.ejwf.2025.07.075","DOIUrl":"10.1016/j.ejwf.2025.07.075","url":null,"abstract":"<div><div>Herbst appliance is a fixed functional appliance used in the treatment of skeletal Class II anomaly. This case report presents the skeletal and dental changes achieved using a digital cast Herbst appliance combined with hyrax screw in the treatment of a 15-year-old male patient with skeletal Class II anomaly. The growing male patient (mp3u) has skeletal Class II anomaly with maxillary prognathism (SNA:86°, SNB:80°), low angle pattern (SNGoGn:25°), Class II Division 1 malocclusion, 8mm overjet and 2.5 mm maxillary crowding. The digital oral scanning was done by iTero<sup>Ⓡ</sup> and on 3D models, digital cast of the combined Hyrax+Herbst appliance was designed. The digital cast Herbst appliance was used with a total duration of 7 months. The hyrax screw was activated 2 months; twice (0.25 mm per turn) weekly in the first, once weekly in the second month, for a total of 12 turns. During the treatment the appliance was well tolerated. After treatment, significant improvement was observed in convex facial profile, SNA angle decreased to 82°, SNB angle to 78°, mild posterior rotation occurred (SNGoGn:28°) and the molar relationship was corrected to bilateral Class I. Maxillary incisors demonstrated notable retrusion and 1-NB increased from 4 mm to 6 mm, reflecting minor proclination. The 3 mm activation of the expansion screw translated into an approximate 2 mm increase in transverse arch width. This reduced maxillary crowding from 2.5 mm to 0.5 mm. The retrusion of maxillary incisors and maxilla was favorable for this patient that may contributed to the combined application of the Hyrax and the Herbst. Whereas no mandibular advancement had occurred which may attribute to the mandibular posterior rotation. As a conclusion, expansion combined with Herbst treatment is suitable for the patients with skeletal Class II anomaly due to maxillary protrusion with low angle tendency and maxillary incisor protrusion.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 423"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705203","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.2025.07.086
Juliana Do Espirito Santo Russo , Rafael Bittencourt , Sergio Mota-Júnior , Diego Lorenzoni , Claudia Mattos
Background
The exposure of maxillary incisors (MxI) and mandibular incisors (MdI) can influence smile perception, yet its impact on attractiveness needs further investigation.
Objectives
To evaluate how MxI and MdI exposure affects smile attractiveness perception by laypeople.
Methods
The study, approved by the Ethics Research Committee, used photographs of two young female volunteers (extraoral and intraoral) with slightly open mouths. Images were altered in an image manipulation program to remove distracting factors and create 5 variations of incisors exposure: 100% MxI exposure (100MxI), 80% MxI - 20% MdI exposure (80MxI-20MdI), 60% MxI - 40% MdI exposure (60MxI-40MdI), 40% MxI - 60% MdI exposure (40MxI-60MdI), and 20% MxI-80% MdI exposure (20MxI-80MdI). Participants evaluated image attractiveness using a 0-10 visual analog scale through the Qualtrics XM online platform. Statistical analysis employed repeated measures ANOVA.
Results
Among 50 evaluators (33 women, 17 men, mean age 36 years), images showing 100MxI (mean 7.48) and 80MxI-20MdI (mean 7.73) received significantly higher attractiveness scores than the remaining images. Attractiveness scores decreased progressively with increased MdI exposure, with 40MxI-60MdI and 20MxI-80MdI rated least attractive (mean 3.55 and 2.37, respectively).
Conclusions
The MxI-MdI exposure proportion significantly influenced smile aesthetic perception, with greater MxI exposure considered more attractive.
{"title":"82 - Does the proportion of maxillary and mandibular incisor influence smile aesthetics?","authors":"Juliana Do Espirito Santo Russo , Rafael Bittencourt , Sergio Mota-Júnior , Diego Lorenzoni , Claudia Mattos","doi":"10.1016/j.ejwf.2025.07.086","DOIUrl":"10.1016/j.ejwf.2025.07.086","url":null,"abstract":"<div><h3>Background</h3><div>The exposure of maxillary incisors (MxI) and mandibular incisors (MdI) can influence smile perception, yet its impact on attractiveness needs further investigation.</div></div><div><h3>Objectives</h3><div>To evaluate how MxI and MdI exposure affects smile attractiveness perception by laypeople.</div></div><div><h3>Methods</h3><div>The study, approved by the Ethics Research Committee, used photographs of two young female volunteers (extraoral and intraoral) with slightly open mouths. Images were altered in an image manipulation program to remove distracting factors and create 5 variations of incisors exposure: 100% MxI exposure (100MxI), 80% MxI - 20% MdI exposure (80MxI-20MdI), 60% MxI - 40% MdI exposure (60MxI-40MdI), 40% MxI - 60% MdI exposure (40MxI-60MdI), and 20% MxI-80% MdI exposure (20MxI-80MdI). Participants evaluated image attractiveness using a 0-10 visual analog scale through the Qualtrics XM online platform. Statistical analysis employed repeated measures ANOVA.</div></div><div><h3>Results</h3><div>Among 50 evaluators (33 women, 17 men, mean age 36 years), images showing 100MxI (mean 7.48) and 80MxI-20MdI (mean 7.73) received significantly higher attractiveness scores than the remaining images. Attractiveness scores decreased progressively with increased MdI exposure, with 40MxI-60MdI and 20MxI-80MdI rated least attractive (mean 3.55 and 2.37, respectively).</div></div><div><h3>Conclusions</h3><div>The MxI-MdI exposure proportion significantly influenced smile aesthetic perception, with greater MxI exposure considered more attractive.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 426"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705251","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}
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