Pub Date : 2025-12-01DOI: 10.1016/j.ejwf.2025.07.012
Gabriela Trojahn , Paula Balestrin , Kelly Chiqueto , Eduardo Ferreira , Katherine Jaramillo Cevallos , Sérgio Estelita Barros
Background
Diagnostic methods to determine individual skeletal maturity have been reported to indicate treatment timing in orthodontics.
Objective
To evaluate the changes in cranium/face size ratio (Facial Maturation Index - FMI) between the skeletal maturity stages defined by cervical vertebral maturation (CVM).
Methods
The sample consisted of a set of lateral cephalograms selected from the records of 180 subjects from the Burlington Growth Center and the Forsyth Institute. For each lateral cephalogram, the face area (FA) and neurocranium area (NCA) were delimited and measured. The FMI was calculated by FA/NCA. The FMI was compared and correlated with the CVM stages using ANOVA and Spearman's correlation tests. ROC analysis evaluated the FMI diagnostic performance.
Results
The NCA was similar between all maturation stages. FA and FMI increased significantly with each advance in CVM stages. The female sample tended to have a lower facial growth rate and earlier facial growth acceleration, while males tended to have a longer growth spurt period. There was significant and positive correlation between FMI and CVM stages for female (0.768) and male (0.803) samples. Areas under ROC curves for FMI were 0.851 to female and 0.854 to male sample, showing good diagnostic performance of FMI for discriminating pre-peak maturation stage from peak and post-peak stages.
Conclusion
Changes in cranium-to-face ratio were strongly correlated with CVM maturation stages. The diagnostic performance of FMI shows that it is a clinically useful diagnostic aid for predicting facial growth.
{"title":"8 - A facial maturation index based on cranium-to-face ratio as a predictor of skeletal maturity","authors":"Gabriela Trojahn , Paula Balestrin , Kelly Chiqueto , Eduardo Ferreira , Katherine Jaramillo Cevallos , Sérgio Estelita Barros","doi":"10.1016/j.ejwf.2025.07.012","DOIUrl":"10.1016/j.ejwf.2025.07.012","url":null,"abstract":"<div><h3>Background</h3><div>Diagnostic methods to determine individual skeletal maturity have been reported to indicate treatment timing in orthodontics.</div></div><div><h3>Objective</h3><div>To evaluate the changes in cranium/face size ratio (Facial Maturation Index - FMI) between the skeletal maturity stages defined by cervical vertebral maturation (CVM).</div></div><div><h3>Methods</h3><div>The sample consisted of a set of lateral cephalograms selected from the records of 180 subjects from the Burlington Growth Center and the Forsyth Institute. For each lateral cephalogram, the face area (FA) and neurocranium area (NCA) were delimited and measured. The FMI was calculated by FA/NCA. The FMI was compared and correlated with the CVM stages using ANOVA and Spearman's correlation tests. ROC analysis evaluated the FMI diagnostic performance.</div></div><div><h3>Results</h3><div>The NCA was similar between all maturation stages. FA and FMI increased significantly with each advance in CVM stages. The female sample tended to have a lower facial growth rate and earlier facial growth acceleration, while males tended to have a longer growth spurt period. There was significant and positive correlation between FMI and CVM stages for female (0.768) and male (0.803) samples. Areas under ROC curves for FMI were 0.851 to female and 0.854 to male sample, showing good diagnostic performance of FMI for discriminating pre-peak maturation stage from peak and post-peak stages.</div></div><div><h3>Conclusion</h3><div>Changes in cranium-to-face ratio were strongly correlated with CVM maturation stages. The diagnostic performance of FMI shows that it is a clinically useful diagnostic aid for predicting facial growth.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 399"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705771","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}
Facial soft tissue analysis plays a vital role in orthodontics, orthognathic surgeries, and forensic anthropology. This study aimed to determine a standardized midline to assess the reliability of symmetry analysis in frontal view photographs. Additionally, it evaluated the consistency of soft tissue landmark detection and analysis between different observers and over time.
Methods
A power analysis determined the need for a total of 50 standardized frontal-view photographs. These photographs were obtained from Iranian patients aged 9–40 who were undergoing orthodontic treatment. Thirty-seven standardized landmarks were annotated across the face, facilitating 73 distinct facial analyses. Five midlines were compared to identify the most reliable one for symmetry assessments. A Python-based automated framework was created to calculate the analyses based on landmarks’ x and y coordinates. Inter-observer and intra-observer reliability were assessed using Intraclass Correlation Coefficient (ICC) and Mean Absolute Deviation (MAD) metrics.
Results
Among the 5 midlines for symmetry analysis, the perpendicular of the interpupillary line passing through the glabella was found to be the most reliable. Overall, the analyses demonstrated relatively good reliability. However, certain landmark points, specifically Gonion (Go), Malar Eminence (ME), Zygion (Zy'), Frontotemporale (Ft'L), and Trichion (Tr'), exhibited lower reliability. Consequently, the reliability of specific analyses, including Bizygomatic width/Facial width, Nasal bridge width/ Endocanthions’ distance, and horizontal symmetry of Go', N', and Zy' was reduced.
Conclusion
This study presents a comprehensive collection of soft tissue landmarks, facial analyses, and their corresponding inter- and intra-observer reliability. Furthermore, the most reliable facial midline for symmetry analysis was determined. This study demonstrated that certain indices defined in three dimensions have lower reliability when drawn in 2-dimensional images, affecting the reliability of derived analyses.
{"title":"Reliability of Comprehensive Facial Soft Tissue Landmark Detection and Analysis Using Frontal View Photographs","authors":"Sahel Hassanzadeh-Samani , Zeynab Pirayesh , Parisa Motie , Mohammad Soroush Ghorbanimehr , Arash Farzan , Hossein Mohammad-Rahimi , Mohammad Behnaz , Saeed Reza Motamedian","doi":"10.1016/j.ejwf.2025.07.732","DOIUrl":"10.1016/j.ejwf.2025.07.732","url":null,"abstract":"<div><h3>Background</h3><div>Facial soft tissue analysis plays a vital role in orthodontics, orthognathic surgeries, and forensic anthropology. This study aimed to determine a standardized midline to assess the reliability of symmetry analysis in frontal view photographs. Additionally, it evaluated the consistency of soft tissue landmark detection and analysis between different observers and over time.</div></div><div><h3>Methods</h3><div>A power analysis determined the need for a total of 50 standardized frontal-view photographs. These photographs were obtained from Iranian patients aged 9–40 who were undergoing orthodontic treatment. Thirty-seven standardized landmarks were annotated across the face, facilitating 73 distinct facial analyses. Five midlines were compared to identify the most reliable one for symmetry assessments. A Python-based automated framework was created to calculate the analyses based on landmarks’ x and y coordinates. Inter-observer and intra-observer reliability were assessed using Intraclass Correlation Coefficient (ICC) and Mean Absolute Deviation (MAD) metrics.</div></div><div><h3>Results</h3><div>Among the 5 midlines for symmetry analysis, the perpendicular of the interpupillary line passing through the glabella was found to be the most reliable. Overall, the analyses demonstrated relatively good reliability. However, certain landmark points, specifically Gonion (Go), Malar Eminence (ME), Zygion (Zy'), Frontotemporale (Ft'L), and Trichion (Tr'), exhibited lower reliability. Consequently, the reliability of specific analyses, including Bizygomatic width/Facial width, Nasal bridge width/ Endocanthions’ distance, and horizontal symmetry of Go', N', and Zy' was reduced.</div></div><div><h3>Conclusion</h3><div>This study presents a comprehensive collection of soft tissue landmarks, facial analyses, and their corresponding inter- and intra-observer reliability. Furthermore, the most reliable facial midline for symmetry analysis was determined. This study demonstrated that certain indices defined in three dimensions have lower reliability when drawn in 2-dimensional images, affecting the reliability of derived analyses.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 334-343"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102788","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}
Aligner treatment has transformed orthodontics by offering a modern, patient-friendly alternative to traditional Fixed Orthodontics. While aligners provide aesthetic and comfortable treatment, they can be costlier and take longer for moderate to severe cases. This in-vitro study compares the treatment-effectiveness-to-time ratio (TTR) of three orthodontic treatment plans simulated using the same software: 1.Aligner therapy 2.Hybrid Aligner 1: Initial fixed orthodontic treatment simulation (upper and lower) from Stage 1, followed by aligner therapy. 3.Hybrid Aligner 2: Aligner therapy for the maxilla and fixed orthodontic simulation for the mandible from start of treatment. The study analyzed 20 STL files with a Peer Assessment Rating (PAR) index of ≥30 and an Index of Orthodontic Treatment Need (IOTN) score of ≥3. Simulations were conducted using Archform software, and their TTR was assessed. Results indicate that Hybrid Aligner 1 achieved the best TTR, demonstrating that combining fixed appliances and aligners provides an efficient, aesthetic, and cost-effective approach, especially for high-PAR cases. These findings highlight the importance of selecting appropriate treatment strategies based on malocclusion severity, patient preferences, and resource availability. Moreover, the study suggests that an algorithm based on TTR could aid in AI-driven treatment planning, reinforcing the orthodontist’s role in managing complex cases with precision using hybrid aligners.
{"title":"58 - Comparison of treatment effectiveness to time ratio between comprehensive and two different hybrid aligner treatment plan simulations","authors":"Venkata Yudhistar Palla , Sandhya Reddy Rajula , Vdy Attelli , Ojass kumar , Vasavi Lakshmi Prasanna Mukku , Sravani Yerraginnela","doi":"10.1016/j.ejwf.2025.07.062","DOIUrl":"10.1016/j.ejwf.2025.07.062","url":null,"abstract":"<div><div>Aligner treatment has transformed orthodontics by offering a modern, patient-friendly alternative to traditional Fixed Orthodontics. While aligners provide aesthetic and comfortable treatment, they can be costlier and take longer for moderate to severe cases. This in-vitro study compares the treatment-effectiveness-to-time ratio (TTR) of three orthodontic treatment plans simulated using the same software: 1.Aligner therapy 2.Hybrid Aligner 1: Initial fixed orthodontic treatment simulation (upper and lower) from Stage 1, followed by aligner therapy. 3.Hybrid Aligner 2: Aligner therapy for the maxilla and fixed orthodontic simulation for the mandible from start of treatment. The study analyzed 20 STL files with a Peer Assessment Rating (PAR) index of ≥30 and an Index of Orthodontic Treatment Need (IOTN) score of ≥3. Simulations were conducted using Archform software, and their TTR was assessed. Results indicate that Hybrid Aligner 1 achieved the best TTR, demonstrating that combining fixed appliances and aligners provides an efficient, aesthetic, and cost-effective approach, especially for high-PAR cases. These findings highlight the importance of selecting appropriate treatment strategies based on malocclusion severity, patient preferences, and resource availability. Moreover, the study suggests that an algorithm based on TTR could aid in AI-driven treatment planning, reinforcing the orthodontist’s role in managing complex cases with precision using hybrid aligners.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 418"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705379","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}
There is a lack of studies evaluating the potential psychological implications associated with anterior open bite (AOB), such as the impact on self-esteem and social acceptance, particularly across different developmental stages. Understanding the aesthetic and social perception of AOB in childhood can provide valuable insights for early intervention and improve orthodontic care.
Objective
The aim of this cross-sectional study was to evaluate the aesthetic and social impaction of anterior open bite (AOB) among children aged 4 to 12 years.
Materials and Methods
The sample included 272 evaluators (147 girls and 125 boys), divided into three age groups: 4–6, 7–9, and 10–12 years. Images of children's faces from different age groups were created using artificial intelligence, and their smiles were digitally edited using Adobe Photoshop to show AOB and normal overbite. Participants of the study completed a questionnaire to evaluate their aesthetic perception of the images using a Escala numérica numerical rating scale ranging from 0 to 10. Social perception was evaluated with objective questions. The tests t-independent and chi-cuadrado assessed the aesthetic and social impactions, respectively.
Results
The photographs of children with normal overbite showed a statistically significant more positive aesthetic perception, for all evaluated age groups (p<0.001). Regarding social perception, in the 4–6 age group, only the "Beautiful Smile" characteristic showed a statistically significant difference (p=0.002). In the 7–9 and 10–12 age groups, the characteristics "Beautiful Smile" and "Beautiful Teeth" demonstrated statistically significant differences between the images (p<0.001).
Conclusion
Anterior open bite negatively impacts the aesthetic perception of children between 4 and 12 years of age.
{"title":"17 - Aesthetic and social impact of anterior open bite in children and pre-adolescents","authors":"Emilly Faria , Karina Freitas , Paula Cotrin , Fabricio Valarelli , Célia Pinzan","doi":"10.1016/j.ejwf.2025.07.021","DOIUrl":"10.1016/j.ejwf.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of studies evaluating the potential psychological implications associated with anterior open bite (AOB), such as the impact on self-esteem and social acceptance, particularly across different developmental stages. Understanding the aesthetic and social perception of AOB in childhood can provide valuable insights for early intervention and improve orthodontic care.</div></div><div><h3>Objective</h3><div>The aim of this cross-sectional study was to evaluate the aesthetic and social impaction of anterior open bite (AOB) among children aged 4 to 12 years.</div></div><div><h3>Materials and Methods</h3><div>The sample included 272 evaluators (147 girls and 125 boys), divided into three age groups: 4–6, 7–9, and 10–12 years. Images of children's faces from different age groups were created using artificial intelligence, and their smiles were digitally edited using Adobe Photoshop to show AOB and normal overbite. Participants of the study completed a questionnaire to evaluate their aesthetic perception of the images using a Escala numérica numerical rating scale ranging from 0 to 10. Social perception was evaluated with objective questions. The tests t-independent and chi-cuadrado assessed the aesthetic and social impactions, respectively.</div></div><div><h3>Results</h3><div>The photographs of children with normal overbite showed a statistically significant more positive aesthetic perception, for all evaluated age groups (p<0.001). Regarding social perception, in the 4–6 age group, only the \"Beautiful Smile\" characteristic showed a statistically significant difference (p=0.002). In the 7–9 and 10–12 age groups, the characteristics \"Beautiful Smile\" and \"Beautiful Teeth\" demonstrated statistically significant differences between the images (p<0.001).</div></div><div><h3>Conclusion</h3><div>Anterior open bite negatively impacts the aesthetic perception of children between 4 and 12 years of age.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 403"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705404","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.2025.07.050
Wenting Yu , Huifang Yang , Xianju Xie , Ning Zhang , Yuxing Bai
Background
Establishing accurate, reliable, and convenient methods for enamel segmentation and analysis is crucial for effectively planning orthodontic treatments. However, no mature, non-destructive method currently exists in clinical dentistry to quickly and accurately assess the integrity and thickness of enamel chair-side. This study aims to develop a deep learning work, 2.5D Attention U-Net, trained on small sample datasets, for the automatical and accurate segmentation of enamel in clinical settings.
Methods
We propose an automated computer-aided enamel segmentation model based on an instance segmentation network, 2.5D Attention U-Net. The model is trained using manually annotated segmented enamel data, and its performance is evaluated using the Dice metrics. A satisfactory image segmentation model is applied to generate a 3D enamel model for each tooth and to calculate the thickness value of individual enclosed 3D enamel meshes.
Results
The model achieves Dice score on the enamel segmentation task of 96.6%. This study provides an intuitive visualization of irregular enamel morphology and a quantitative analysis of three-dimensional enamel thickness variations. The results indicate that enamel is thickest at the incisal edges of anterior teeth and the cusps of posterior teeth, thinning towards the roots. For posterior teeth, the enamel is thinnest at the central fossae area, with mandibular molars having thicker enamel in the central fossae compared to maxillary molars. The average enamel thickness of maxillary incisors, canines, and premolars is greater than that of mandibular incisors, while the opposite is true for molars. The average enamel thickness gradually increases from the incisors to the molars within the same quadrant.
Conclusions
This study introduces an automatic, efficient, and accurate 2.5D Attention U-Net system to enhance precise and efficient chair-side diagnosis and treatment of enamel-related diseases in clinical settings.
{"title":"46 - Clinically oriented automatic three- dimensional enamel segmentation via deep learning","authors":"Wenting Yu , Huifang Yang , Xianju Xie , Ning Zhang , Yuxing Bai","doi":"10.1016/j.ejwf.2025.07.050","DOIUrl":"10.1016/j.ejwf.2025.07.050","url":null,"abstract":"<div><h3>Background</h3><div>Establishing accurate, reliable, and convenient methods for enamel segmentation and analysis is crucial for effectively planning orthodontic treatments. However, no mature, non-destructive method currently exists in clinical dentistry to quickly and accurately assess the integrity and thickness of enamel chair-side. This study aims to develop a deep learning work, 2.5D Attention U-Net, trained on small sample datasets, for the automatical and accurate segmentation of enamel in clinical settings.</div></div><div><h3>Methods</h3><div>We propose an automated computer-aided enamel segmentation model based on an instance segmentation network, 2.5D Attention U-Net. The model is trained using manually annotated segmented enamel data, and its performance is evaluated using the Dice metrics. A satisfactory image segmentation model is applied to generate a 3D enamel model for each tooth and to calculate the thickness value of individual enclosed 3D enamel meshes.</div></div><div><h3>Results</h3><div>The model achieves Dice score on the enamel segmentation task of 96.6%. This study provides an intuitive visualization of irregular enamel morphology and a quantitative analysis of three-dimensional enamel thickness variations. The results indicate that enamel is thickest at the incisal edges of anterior teeth and the cusps of posterior teeth, thinning towards the roots. For posterior teeth, the enamel is thinnest at the central fossae area, with mandibular molars having thicker enamel in the central fossae compared to maxillary molars. The average enamel thickness of maxillary incisors, canines, and premolars is greater than that of mandibular incisors, while the opposite is true for molars. The average enamel thickness gradually increases from the incisors to the molars within the same quadrant.</div></div><div><h3>Conclusions</h3><div>This study introduces an automatic, efficient, and accurate 2.5D Attention U-Net system to enhance precise and efficient chair-side diagnosis and treatment of enamel-related diseases in clinical settings.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 414"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705446","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}
Precise identification of facial asymmetry is essential in orthodontics and craniofacial diagnostics. This study proposes an automated pipeline leveraging a Siamese Neural Network (SNN) in conjunction with Exploratory Data Analysis (EDA) to detect and quantify facial asymmetry from frontal images. A dataset of 1,200 facial photographs—annotated by expert orthodontists—was used to train and evaluate the system. Facial landmarks were extracted using the MediaPipe model, followed by midline alignment based on ocular centers. EDA methods quantified asymmetry by computing normalized distances from facial key points to the midline in both horizontal and vertical directions. These metrics were further analyzed using statistical techniques such as kernel density estimation and Wasserstein distance. The SNN model, trained on composite mirrored halves of faces, demonstrated strong diagnostic performance, achieving an accuracy of 97% and an AUC of 0.98. Agreement between the model's predictions and expert evaluations was high (Cohen’s Kappa = 0.84). The framework enables objective, non-invasive, and real-time assessment of asymmetry, with potential applications in clinical and research settings.
{"title":"36 - Automated analysis of facial symmetry using artificial intelligence","authors":"Mohammad Behnaz , Shahab Kavousinejad , Kazem Dalaei , Mohammadreza Safavi , Hoori Mirmohammadsadeghi , Asghar Ebadifar","doi":"10.1016/j.ejwf.2025.07.040","DOIUrl":"10.1016/j.ejwf.2025.07.040","url":null,"abstract":"<div><div>Precise identification of facial asymmetry is essential in orthodontics and craniofacial diagnostics. This study proposes an automated pipeline leveraging a Siamese Neural Network (SNN) in conjunction with Exploratory Data Analysis (EDA) to detect and quantify facial asymmetry from frontal images. A dataset of 1,200 facial photographs—annotated by expert orthodontists—was used to train and evaluate the system. Facial landmarks were extracted using the MediaPipe model, followed by midline alignment based on ocular centers. EDA methods quantified asymmetry by computing normalized distances from facial key points to the midline in both horizontal and vertical directions. These metrics were further analyzed using statistical techniques such as kernel density estimation and Wasserstein distance. The SNN model, trained on composite mirrored halves of faces, demonstrated strong diagnostic performance, achieving an accuracy of 97% and an AUC of 0.98. Agreement between the model's predictions and expert evaluations was high (Cohen’s Kappa = 0.84). The framework enables objective, non-invasive, and real-time assessment of asymmetry, with potential applications in clinical and research settings.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 410"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705590","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.2025.07.043
Romney Guimaraes , Agnaldo Silva Garcez Segundo , Kee-Joon Lee , Selly Sayuri Suzuki
Mini-implant-assisted rapid palatal expansion (MARPE) is an age-dependent technique, primarily due to the increased interdigitation of the midpalatal suture with aging, which leads to greater resistance to expansion. This study aimed to assess the biological response of the corticopuncture method, a technique designed to weaken the midpalatal suture, during maxillary expansion in mature adult rats. A total of 42 rats were included in the study and divided into three groups: a control group (CN) - no expansion or corticopuncture (n = 6), a rapid maxillary expansion group (ERM), and a rapid maxillary expansion + corticopuncture group (ERM+CP). The animals were euthanized at baseline (day 0 for the CN group) and at 3, 7, and 14 days post-expansion (ERM and ERM+CP groups). Microtomographic, histological, and immunohistochemical analyses were conducted to assess the biological responses. Both ERM and ERM+CP groups exhibited significant differences compared to the CN group across all measurements analyzed. Notably, ERM+CP group demonstrated greater trabecular separation than ERM group at days 7 and 14 (p<0.05). In linear measurements, ERM+CP group showed significantly greater expansion compared to the ERM group (p<0.05). On the contrary, bone volume relative to total volume and bone density were lower in the ERM+CP group than in the ERM group (p<0.05). Histological and immunohistochemical analyses revealed increased osteoclastic activity in the ERM+CP group, particularly on day 3. These findings suggest that maxillary expansion assisted by corticopuncture enhances suture separation compared to expansion alone, likely due to the biological response induced by the procedure
{"title":"39 - Biological responses to corticopuncture-assisted palatal expansion in mature adult rats","authors":"Romney Guimaraes , Agnaldo Silva Garcez Segundo , Kee-Joon Lee , Selly Sayuri Suzuki","doi":"10.1016/j.ejwf.2025.07.043","DOIUrl":"10.1016/j.ejwf.2025.07.043","url":null,"abstract":"<div><div>Mini-implant-assisted rapid palatal expansion (MARPE) is an age-dependent technique, primarily due to the increased interdigitation of the midpalatal suture with aging, which leads to greater resistance to expansion. This study aimed to assess the biological response of the corticopuncture method, a technique designed to weaken the midpalatal suture, during maxillary expansion in mature adult rats. A total of 42 rats were included in the study and divided into three groups: a control group (CN) - no expansion or corticopuncture (n = 6), a rapid maxillary expansion group (ERM), and a rapid maxillary expansion + corticopuncture group (ERM+CP). The animals were euthanized at baseline (day 0 for the CN group) and at 3, 7, and 14 days post-expansion (ERM and ERM+CP groups). Microtomographic, histological, and immunohistochemical analyses were conducted to assess the biological responses. Both ERM and ERM+CP groups exhibited significant differences compared to the CN group across all measurements analyzed. Notably, ERM+CP group demonstrated greater trabecular separation than ERM group at days 7 and 14 (p<0.05). In linear measurements, ERM+CP group showed significantly greater expansion compared to the ERM group (p<0.05). On the contrary, bone volume relative to total volume and bone density were lower in the ERM+CP group than in the ERM group (p<0.05). Histological and immunohistochemical analyses revealed increased osteoclastic activity in the ERM+CP group, particularly on day 3. These findings suggest that maxillary expansion assisted by corticopuncture enhances suture separation compared to expansion alone, likely due to the biological response induced by the procedure</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 411"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705593","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.2025.07.030
Babak Sayahpour , Ani Nebiaj , Bernd Freisleben , Markus Muehling
Background: Accurate identification of dental malocclusions is essential for orthodontic care yet remains labour-intensive and examiner-dependent.
Objective: To develop and validate a deep-learning model for automated detection of malocclusions on routine clinical photographs.
Materials and Methods: A dataset of 2,077 anonymised, high-resolution intra-oral images (frontal occlusion, right/left buccal, maxillary, mandibular) was extracted from the OnyxCephⓇ database of Goethe University Frankfurt. Images were labelled for malocclusion traits according to Index of Orthodontic Treatment Need criteria and augmented by rotation, reflection, scaling, brightness variation and noise. An advanced YOLOv11 object-detection network was trained with an 80/10/10 split and evaluated by mean average precision at 0.5 intersection-over-union (mAP-50).
Results: The model achieved an mAP-50 = 0.854, corresponding to 85 % agreement with specialist diagnoses. Average inference time was 0.05 s on a consumer-grade GPU, enabling real-time chairside use.
Conclusions: This pilot study shows that deep-learning object detection can reliably identify common malocclusions from photographic records and could streamline orthodontic diagnostics. Future work should assess clinical impact using larger multicentre datasets and iterative network optimisation.
背景：准确识别牙齿错颌是必不可少的正畸护理，但仍然是劳动密集型和检查员依赖。目的：建立并验证一种用于临床常规照片错颌自动检测的深度学习模型。材料和方法：从法兰克福歌德大学的OnyxCephⓇ数据库中提取2,077张匿名的高分辨率口腔内图像（额颌、右/左颊、上颌、下颌）。根据正畸治疗需求指数（Index of Orthodontic Treatment Need）标准标记图像的错颌特征，并通过旋转、反射、缩放、亮度变化和噪声进行增强。采用80/10/10分割训练先进的YOLOv11目标检测网络，并以0.5相交-超并（mAP-50）的平均精度进行评估。结果：模型达到了mAP-50 = 0.854，与专家诊断的符合率达到85%。在消费级GPU上，平均推理时间为0.05秒，支持实时椅边使用。结论：本初步研究表明，深度学习对象检测可以可靠地从照片记录中识别常见的咬合错误，并可以简化正畸诊断。未来的工作应该使用更大的多中心数据集和迭代网络优化来评估临床影响。
{"title":"26 - Artificial intelligence for the automated detection of dental malocclusions from clinical images","authors":"Babak Sayahpour , Ani Nebiaj , Bernd Freisleben , Markus Muehling","doi":"10.1016/j.ejwf.2025.07.030","DOIUrl":"10.1016/j.ejwf.2025.07.030","url":null,"abstract":"<div><div><strong>Background:</strong> Accurate identification of dental malocclusions is essential for orthodontic care yet remains labour-intensive and examiner-dependent.</div><div><strong>Objective:</strong> To develop and validate a deep-learning model for automated detection of malocclusions on routine clinical photographs.</div><div><strong>Materials and Methods:</strong> A dataset of 2,077 anonymised, high-resolution intra-oral images (frontal occlusion, right/left buccal, maxillary, mandibular) was extracted from the OnyxCeph<sup>Ⓡ</sup> database of Goethe University Frankfurt. Images were labelled for malocclusion traits according to Index of Orthodontic Treatment Need criteria and augmented by rotation, reflection, scaling, brightness variation and noise. An advanced YOLOv11 object-detection network was trained with an 80/10/10 split and evaluated by mean average precision at 0.5 intersection-over-union (mAP-50).</div><div><strong>Results:</strong> The model achieved an mAP-50 = 0.854, corresponding to 85 % agreement with specialist diagnoses. Average inference time was 0.05 s on a consumer-grade GPU, enabling real-time chairside use.</div><div><strong>Conclusions:</strong> This pilot study shows that deep-learning object detection can reliably identify common malocclusions from photographic records and could streamline orthodontic diagnostics. Future work should assess clinical impact using larger multicentre datasets and iterative network optimisation.</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":"145705657","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.2025.07.022
Ibrahim Alshahrani , Ali Alhaizaey
As a sub-specialty of dentistry, orthodontics continuously searches for novel tools and techniques to improve outcomes for patients and treatment accuracy. The development of tools that improve the precision of orthodontic interventions while also streamlining processes has become more of a focus in recent years such as orthodontic plier with protractor. orthodontists can now manipulate wire at precise angles due to its integrated protractor. This development offers a simplified approach to orthodontic treatment while addressing the drawbacks of conventional techniques. By providing real-time angle measurement, the integrated protractor promotes uniformity in wire adjustments and improves treatment results. The plier’s ergonomic comfort is prioritized in its design, making it simple for orthodontic practitioners to use. The Orthodontic Plier with Protractor is a useful addition to orthodontic instruments that advances accuracy and efficiency in orthodontic wire bending procedures by fusing functionality with user-friendly characteristics. By using this cutting-edge tool, practitioners support the ideas of technology integration and evidence-based practice while also furthering the continual evolution of orthodontics.
{"title":"18 - An orthodontic plier with protractor for orthodontic wire bending","authors":"Ibrahim Alshahrani , Ali Alhaizaey","doi":"10.1016/j.ejwf.2025.07.022","DOIUrl":"10.1016/j.ejwf.2025.07.022","url":null,"abstract":"<div><div>As a sub-specialty of dentistry, orthodontics continuously searches for novel tools and techniques to improve outcomes for patients and treatment accuracy. The development of tools that improve the precision of orthodontic interventions while also streamlining processes has become more of a focus in recent years such as orthodontic plier with protractor. orthodontists can now manipulate wire at precise angles due to its integrated protractor. This development offers a simplified approach to orthodontic treatment while addressing the drawbacks of conventional techniques. By providing real-time angle measurement, the integrated protractor promotes uniformity in wire adjustments and improves treatment results. The plier’s ergonomic comfort is prioritized in its design, making it simple for orthodontic practitioners to use. The Orthodontic Plier with Protractor is a useful addition to orthodontic instruments that advances accuracy and efficiency in orthodontic wire bending procedures by fusing functionality with user-friendly characteristics. By using this cutting-edge tool, practitioners support the ideas of technology integration and evidence-based practice while also furthering the continual evolution of orthodontics.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 403"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705707","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}
Molar distalization has generated additional attention with the advent of skeletal anchorage devices. However, relapse after distalization is one of the challenges and the quantum of relapse following distalization, especially over the long-term remains controversial. This systematic review and meta-analysis aim to evaluate the long-term vertical and sagittal stability of molars postdistalization.
Methods
A systematic search was conducted in electronic databases (PubMed, Scopus, Ovid, Embase, Cochrane and LILACS) up to April 11, 2025. Studies assessing molar position changes after active distalization and during follow-up periods were included. Data extraction and risk of bias assessments were performed using the ROBINS-I tool for non-randomized studies. A meta-analysis was conducted to quantify relapse in vertical and sagittal dimensions.
Results
From the 2594 studies initially identified, six studies (all nonrandomized control trials) were included for the systematic review and five studies were included for the meta-analysis. All studies showed moderate risk of bias. The mean relapse in the sagittal plane was 1.58 ± 0.84 mm (35%) linearly and 2.98 ± 2.07° (53%) angularly. In the vertical plane, it relapsed by 1.44 ± 1.26 mm. Meta-analysis showed a net distalization in the molar position in long-term sagittal plane by 2.77 mm (95% CI 2.33–3.20) and 1° distally (95% CI −2.37° to 4.38°), and in the vertical plane by −0.65 mm (95% CI −2.27 to 0.96). The I2 ranged from 60% to 98% indicating high heterogeneity. The relapse was minimal for the incisal, skeletal, and soft tissues parameters.
Conclusions
Long-term assessment following molar distalization demonstrated conclusive evidence of relapse in the sagittal and vertical direction. There was greater relapse in the vertical than in the sagittal direction. There was minimal literature assessing the relapse in the transverse direction. Hence, this systematic review advocates the need for long-term retention postdistalization.
背景：随着骨骼锚定装置的出现，磨牙远端引起了更多的关注。然而，远端术后复发是一个挑战，远端术后复发的数量，特别是长期的复发仍然存在争议。本系统综述和荟萃分析旨在评估磨牙远端后的长期垂直和矢状稳定性。方法：系统检索截至2025年4月11日的PubMed、Scopus、Ovid、Embase、Cochrane、LILACS等电子数据库。评估主动远端后和随访期间磨牙位置变化的研究包括在内。使用ROBINS-I工具对非随机研究进行数据提取和偏倚风险评估。进行了一项荟萃分析，以量化垂直和矢状维度的复发。结果：从最初确定的2594项研究中，6项研究（均为非随机对照试验）被纳入系统评价，5项研究被纳入meta分析。所有研究均显示中等偏倚风险。矢状面平均线性复发1.58±0.84 mm(35%)，角复发2.98±2.07°（53%）。垂直方向复发1.44±1.26 mm。荟萃分析显示，长期矢状面磨牙位置净远端为2.77 mm (95% CI 2.33-3.20)，远端为1°（95% CI -2.37°至4.38°），垂直平面为-0.65 mm （95% CI -2.27至0.96）。I2在60% ~ 98%之间，异质性较高。复发是最小的切，骨骼和软组织参数。结论：拔除磨牙后的长期评估证实了矢状面和垂直方向复发的确凿证据。垂直方向复发率高于矢状方向。在横向上评估复发的文献很少。因此，本系统综述提倡术后长期保留的必要性。
{"title":"Long term stability of molar position postdistalization: A systematic review and meta-analysis","authors":"Kutraaleeshwaran Velmurugan, Venkateswaran Ananthanarayanan, Sridevi Padmanabhan, Vignesh Kailasam","doi":"10.1016/j.ejwf.2025.07.734","DOIUrl":"10.1016/j.ejwf.2025.07.734","url":null,"abstract":"<div><h3>Background</h3><div>Molar distalization has generated additional attention with the advent of skeletal anchorage devices. However, relapse after distalization is one of the challenges and the quantum of relapse following distalization, especially over the long-term remains controversial. This systematic review and meta-analysis aim to evaluate the long-term vertical and sagittal stability of molars postdistalization.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in electronic databases (PubMed, Scopus, Ovid, Embase, Cochrane and LILACS) up to April 11, 2025. Studies assessing molar position changes after active distalization and during follow-up periods were included. Data extraction and risk of bias assessments were performed using the ROBINS-I tool for non-randomized studies. A meta-analysis was conducted to quantify relapse in vertical and sagittal dimensions.</div></div><div><h3>Results</h3><div>From the 2594 studies initially identified, six studies (all nonrandomized control trials) were included for the systematic review and five studies were included for the meta-analysis. All studies showed moderate risk of bias. The mean relapse in the sagittal plane was 1.58 ± 0.84 mm (35%) linearly and 2.98 ± 2.07° (53%) angularly. In the vertical plane, it relapsed by 1.44 ± 1.26 mm. Meta-analysis showed a net distalization in the molar position in long-term sagittal plane by 2.77 mm (95% CI 2.33–3.20) and 1° distally (95% CI −2.37° to 4.38°), and in the vertical plane by −0.65 mm (95% CI −2.27 to 0.96). The I<sup>2</sup> ranged from 60% to 98% indicating high heterogeneity. The relapse was minimal for the incisal, skeletal, and soft tissues parameters.</div></div><div><h3>Conclusions</h3><div>Long-term assessment following molar distalization demonstrated conclusive evidence of relapse in the sagittal and vertical direction. There was greater relapse in the vertical than in the sagittal direction. There was minimal literature assessing the relapse in the transverse direction. Hence, this systematic review advocates the need for long-term retention postdistalization.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 355-366"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138789","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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