Journal of the World Federation of Orthodontists最新文献_第8页

76 - Diagnostic concordance among cephalometric parameters of skeletal class or facial pattern 骨骼类型或面部类型的头侧测量参数的诊断一致性

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.080

Alejandro Diaz Muñoz , Juan Diego Idrovo , Valentina Zaffiri , Germán Manríquez

Although a wide variety of cephalometric parameters have been proposed for classifying skeletal class or facial pattern, no universally accepted parameters exist. This may lead to challenges in clinical interpretation and introduce bias in orthodontic research. This study aimed to determine the diagnostic concordance among five skeletal class and four facial pattern cephalometric parameters. A total of 439 lateral cephalometric radiographs from an anonymized database at the Faculty of Dentistry, University of Chile, were analyzed, and five skeletal class and four facial pattern parameters were determined for each individual. Diagnostic concordance among these parameters was assessed using the weighted Cohen's kappa and weighted Cohen's chi-square tests. Statistically significant differences in diagnosis were observed depending on the cephalometric parameter used to determine skeletal class or facial pattern. The weighted Cohen’s kappa test classified most concordances among skeletal class or facial pattern parameters as “Fair” or “Moderate,” whereas the weighted Cohen’s chi-squared test revealed significant discordance in most comparisons. We conclude that commonly used cephalometric parameters for classifying skeletal class or facial pattern demonstrate significant discrepancies, which may lead to inconsistencies in clinical practice. These findings highlight the need for more reliable and standardized diagnostic alternatives in orthodontics.

虽然已经提出了各种各样的头颅测量参数来分类骨骼类型或面部模式，但没有普遍接受的参数存在。这可能会导致临床解释的挑战，并在正畸研究中引入偏见。本研究的目的是确定5个骨骼类别和4个面部模式的颅面测量参数的诊断一致性。对来自智利大学牙科学院匿名数据库的439张侧位头颅x线片进行了分析，并确定了每个个体的5个骨骼类别和4个面部模式参数。使用加权Cohen’s kappa检验和加权Cohen’s卡方检验评估这些参数的诊断一致性。根据用于确定骨骼类型或面部类型的头侧测量参数，观察到诊断的统计学显著差异。加权科恩卡帕检验将骨骼类别或面部模式参数之间的大多数一致性分类为“公平”或“中等”，而加权科恩卡方检验显示大多数比较中存在显着的不一致性。我们的结论是，常用的头颅测量参数用于分类骨骼类型或面部模式显示显着差异，这可能导致临床实践中的不一致。这些发现强调了在正畸学中需要更可靠和标准化的诊断替代方案。

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引用次数: 0

45 - Changes in the median palatal suture and pterygopalatine suture following HYRAX and MARPE appliances 使用HYRAX和MARPE矫形器后中腭缝合和翼腭缝合的变化

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.049

Anderson Carlos De Oliveira , Maria Antônia Netto Barbosa , Luciana Quintanilha Pires Fernandes , Natália Julie de Sousa Melcop , Flavia Raposo Gebara Artese , Jonas Capelli Junior

Rapid maxillary expansion (RME) is an effective approach for treating transverse maxillary deficiencies. It can be performed conventionally using the Hybrid Rigid Expansion (HYRAX) appliance or with bone anchorage in the MARPE technique. There is evidence that failure to open the pterygopalatine suture (PPS) may be a limiting factor. The present study aimed to evaluate the effect of RME on the PPS using MARPE and HYRAX appliances, and to assess the pattern of the midpalatal suture (MPS) opening. Thirty-one patients were selected (HYRAX group: n = 17, mean age 14.7 ± 0.8 years; MARPE group: n = 14, mean age 16.2 ± 2 years). Cone-beam computed tomography was performed at two time points: before RME (T1) and after RME (T2). Dolphin Imaging software was used for orientation and measurements. To assess method error, this process was repeated in six patients after a 15-day interval. All measurements were performed by the same examiner, who was randomly assigned. The Intraclass Correlation Coefficient indicated excellent reproducibility of the method. In the HYRAX group, posterior nasal spine (PNS) opening was 75% of the opening of the anterior nasal spine (ANS), while in the MARPE group, PNS opening was 87% of the ANS opening. PPS disarticulation occurred in 35% of HYRAX patients, whereas in the MARPE group, PPS was disrupted in 58% of patients. Despite the higher incidence of PPS opening in the MARPE group compared to the HYRAX group, there was no statistically significant difference between the groups (p = 0.224). Although the MARPE group showed a tendency toward a more parallel opening of the MPS compared to the HYRAX group, there was no difference in the prevalence of PPS disarticulation after RME in both groups. It is suggested that PPS may be a limiting factor for MPS opening, as in patients in whom it was disrupted, the of MPS opening pattern was nearly perfectly parallel.

上颌快速扩张术是治疗上颌横向缺损的有效方法。它可以传统地使用混合刚性膨胀（HYRAX）矫治器或在MARPE技术中使用骨锚定。有证据表明，打开翼腭缝合线（PPS）失败可能是一个限制因素。本研究采用MARPE和HYRAX矫形器评估RME对PPS的影响，并评估中腭缝合（MPS）的开放模式。选取31例患者（HYRAX组：n = 17例，平均年龄14.7±0.8岁；MARPE组：n = 14例，平均年龄16.2±2岁）。锥形束计算机断层扫描在RME前（T1）和RME后（T2）两个时间点进行。Dolphin Imaging软件用于定位和测量。为了评估方法误差，在间隔15天后，对6例患者重复该过程。所有测量均由同一名随机分配的审查员进行。类内相关系数表明该方法重复性好。HYRAX组鼻后棘（PNS）开口为鼻前棘（ANS）开口的75%，MARPE组鼻后棘（PNS）开口为鼻前棘（ANS）开口的87%。35%的HYRAX患者发生PPS脱臼，而在MARPE组中，58%的患者发生PPS脱臼。尽管MARPE组PPS打开发生率高于HYRAX组，但两组间差异无统计学意义（p = 0.224）。尽管与HYRAX组相比，MARPE组表现出MPS更平行开放的趋势，但两组在RME后PPS脱臼的发生率没有差异。提示PPS可能是MPS开放的限制因素，因为在它被破坏的患者中，MPS开放模式几乎完全平行。

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引用次数: 0

22 - Antibiofilm activity of an orthodontic adhesive loaded with copper nanoparticles: In vitro study 负载铜纳米颗粒的正畸胶粘剂的抗生物膜活性：体外研究

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.026

Melissa Solar , Romina Valdenegro , Miguel Neira , Valentina Vega , Juan Guillermo Valenzuela , Cristian Covarrubias

The formation of bacterial biofilm around brackets is a leading cause of caries during orthodontic treatment. Poor patient adherence to oral hygiene protocols necessitates preventive solutions independent of patient cooperation. Copper, known for its antimicrobial and "antifouling" properties, prevents biofilm formation or aids in microorganism removal. Advances in nanotechnology have enhanced copper's efficacy by enabling its production as nanoparticles (nCu), offering superior properties compared to its macro- or micro-scale forms. Nanoparticles also provide controlled release and sustained effects, making them ideal for developing bioactive dental materials. This study incorporated nCu into an orthodontic adhesive and evaluated its antibiofilm activity in vitro. Discs (8 mm diameter, 1 mm height) were fabricated with the adhesive, both with and without two nCu concentrations. Nanoparticle incorporation was confirmed via SEM-EDX. Discs were placed in culture plates, treated with natural saliva, and incubated at 37°C for 24 hours. After saliva removal, BHI broth was added, and samples were incubated for another 24 hours. Samples were then washed with PBS, fixed with 4% formaldehyde, and stained with crystal violet. Spectrophotometric analysis was performed. Results confirmed homogeneous nCu incorporation. Discs with nCu showed lower absorbance, indicating reduced biofilm growth, particularly at higher nCu concentrations. No significant differences were observed between the two nCu concentrations. Incorporating nCu into the adhesive reduced biofilm growth, suggesting its potential to minimize biofilm formation around brackets compared to conventional adhesives.

牙槽周围细菌生物膜的形成是正畸治疗中导致龋齿的主要原因。患者对口腔卫生方案的依从性差，需要独立于患者合作的预防性解决方案。铜，以其抗菌和“防污”特性而闻名，可以防止生物膜的形成或有助于微生物的去除。纳米技术的进步提高了铜的效能，使其能够以纳米颗粒（nCu）的形式生产，与宏观或微观尺度的形式相比，具有优越的性能。纳米颗粒还提供可控的释放和持续的效果，使其成为开发生物活性牙科材料的理想选择。本研究将nCu加入正畸胶粘剂中，并在体外评估其抗菌膜活性。用含和不含两种nCu浓度的胶粘剂制作圆盘（直径8 mm，高度1 mm）。通过SEM-EDX确认纳米颗粒的掺入。将圆盘置于培养板中，用天然唾液处理，37℃孵育24小时。唾液去除后，加入BHI肉汤，再孵育24小时。用PBS洗涤，4%甲醛固定，结晶紫染色。分光光度法分析。结果证实了nCu的均匀掺入。含nCu的圆盘吸光度较低，表明生物膜生长减少，特别是在较高的nCu浓度下。两种nCu浓度之间无显著差异。将nCu加入粘合剂中可以减少生物膜的生长，这表明与传统粘合剂相比，它有可能最大限度地减少支架周围生物膜的形成。

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引用次数: 0

89 - Effects of rapid maxillary expansion on airway, polysomnography parameters, and quality of life in children with obstructive sleep apnea 上颌快速扩张对阻塞性睡眠呼吸暂停患儿气道、多导睡眠图参数和生活质量的影响

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.093

Bruno Almeida Rezende , Rafael Guedes Azzi , Rodrigo Romano da Silva , Bruno Frasão Gribel , André Henrique Almeida

Background

Obstructive sleep apnea (OSA) in children is a prevalent sleep disorder characterized by recurrent upper airway obstruction during sleep. Untreated OSA is associated with cognitive impairment, behavioral issues, and cardiovascular complications. Rapid maxillary expansion (RME) has been proposed in patients with constricted maxilla as a treatment option to improve airway dimensions and respiratory function in affected children. However, evidence on its effectiveness remains inconclusive.

Objective

This study aimed to evaluate the effects of RME on polysomnographic outcomes, airway morphometric changes QoL in children aged 6 to 13 years with OSA and maxillary atresia.

Methods

A prospective longitudinal study was conducted with children aged 7 to 12 y enrolled in a Post Graduation Institution Orthodontic Clinic in Minas Gerais, Brazil. Participants were diagnosed with moderate to severe maxillary atresia and OSA (apnea-hypopnea index - AIH >1) through home polysomnography. The intervention involved RME using Hyrax appliance, following an activation protocol until overcorrection was achieved. Assessments were performed before RME (T1) and six months post-expansion (T2). Variables analyzed included polysomnographic data, airway volume (Computed Tomography), and QoL (Peds-QL 4.0 and OSA-18). This study was approved by the Research Ethics Committee of Faculdade de Ciências Médicas de Minas Gerais (Report n. 6.113.613)

Results

Data analysis focused on changes in AIH, oxygen saturation, airway volume, and QoL scores. Preliminary evidence suggests that RME may improve QoL and airway patency in the nasal cavity and nasopharynx. However, there was no significant improvement in polysomnographic parameters.

Conclusion

This study contributes to the understanding of orthodontic interventions as adjunctive therapy for pediatric OSA. Further research is needed to optimize treatment outcomes and to determine the long-term impact of RME on sleep-disordered breathing.

背景：儿童阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，其特征是睡眠期间反复出现上呼吸道阻塞。未经治疗的OSA与认知障碍、行为问题和心血管并发症有关。快速上颌扩张术（RME）已被提出用于上颌狭窄患者，作为改善气道尺寸和呼吸功能的治疗选择。然而，关于其有效性的证据仍然没有定论。目的探讨RME对6 ~ 13岁OSA合并上颌闭锁患儿多导睡眠图结果、气道形态变化及生活质量的影响。方法对在巴西米纳斯吉拉斯州一所研究生院正畸诊所登记的7 ~ 12岁儿童进行前瞻性纵向研究。通过家庭多导睡眠图诊断为中重度上颌闭锁和OSA（呼吸暂停低通气指数- AIH >；1）。干预包括使用Hyrax器械进行RME，遵循激活方案，直到实现过矫。评估在RME前（T1）和扩张后6个月（T2）进行。分析的变量包括多导睡眠图数据、气道容积（计算机断层扫描）和生活质量（Peds-QL 4.0和OSA-18）。本研究获得Ciências米纳斯吉拉斯州医学院研究伦理委员会批准（报告号：6.113.613）。结果数据分析重点关注AIH、氧饱和度、气道容积和生活质量评分的变化。初步证据表明RME可改善患者的生活质量，改善鼻腔和鼻咽部气道通畅。然而，多导睡眠图参数没有明显改善。结论本研究有助于认识正畸干预作为儿童阻塞性睡眠呼吸暂停的辅助治疗。需要进一步的研究来优化治疗结果，并确定RME对睡眠呼吸障碍的长期影响。

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引用次数: 0

90 - Effects of structured telephone call and chewing gum on trait anxiety in orthodontic patients with separator placement 有组织的电话和嚼口香糖对放置隔离器的正畸患者特质焦虑的影响

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.094

Cheong Joo Ming Cheong , Mohamad Shafiq Mohd Ibrahim

Anxiety is a common side effect during orthodontic treatment that can negatively impact patient cooperation and treatment success. Non-pharmacological interventions may help reduce anxiety levels in these patients. The objectives of this study were to investigate the differences in self-reported trait anxiety levels among patients undergoing orthodontic separator placement across postprocedural structured telephone call, sugar-free chewing gum and control groups. Sixty healthy female orthodontic patients aged 20-40 years were randomly assigned to one of the three groups. The intervention groups received either a structured telephone call or sugar-free chewing gum for 5 minutes, 24 hours after separator placement. Trait anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI) before separator placement, immediately after, at 24 hours, and daily for seven days. One-way repeated measures ANOVA was used to compare the effects of the interventions on the mean trait anxiety level over time. A significant effect of time was found (F(8,50) = 2.59, p = 0.019), indicating that trait anxiety decreased over time. The interaction between time and group was also significant (F(16,102) = 2.11, p = 0.013). Pairwise comparisons of the group and time interaction revealed that both telephone and chewing gum groups experienced significant reductions in trait anxiety, particularly from day 5 to day 7. In contrast, the control group showed no significant changes over time, with anxiety levels significantly higher than those of the intervention groups during the same period (p < 0.05). No significant differences were found between the telephone call and chewing gum groups at any time point. In conclusion, both structured telephone call and chewing gum effectively reduced anxiety in patients with orthodontic separator placement compared to no intervention. These non-invasive strategies can be integrated into orthodontic practice to enhance patient comfort.

焦虑是正畸治疗过程中常见的副作用，会对患者的合作和治疗成功产生负面影响。非药物干预可能有助于降低这些患者的焦虑水平。本研究的目的是调查在术后结构化电话、无糖口香糖和对照组中放置正畸分离器的患者自我报告的特质焦虑水平的差异。60例20 ~ 40岁的健康女性正畸患者随机分为三组。在隔离装置放置24小时后，干预组接受了一个结构化的电话或无糖口香糖5分钟。使用状态-特质焦虑量表（STAI）评估特质焦虑水平，在隔板放置前、放置后立即、24小时、连续7天每天进行评估。采用单因素重复测量方差分析比较干预措施对平均特质焦虑水平的影响。时间的影响显著（F（8,50） = 2.59,p = 0.019），表明特质焦虑随时间的推移而降低。时间与组间的交互作用也显著（F（16102） = 2.11,p = 0.013）。对小组和时间互动的两两比较显示，电话组和嚼口香糖组的特质焦虑都显著减少，尤其是从第5天到第7天。相比之下，对照组的焦虑水平随时间变化无明显变化，其焦虑水平显著高于干预组同期水平（p < 0.05）。在任何时间点，打电话组和嚼口香糖组之间都没有发现显著差异。综上所述，与不进行干预相比，有组织的电话和嚼口香糖都能有效地减少放置正畸分离器的患者的焦虑。这些非侵入性策略可以整合到正畸实践中，以提高患者的舒适度。

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引用次数: 0

14 - Accuracy of digital indirect bonding using different bracket transfer methods and a novel shape memory polymer tray material 14 -使用不同支架转移方法和新型形状记忆聚合物托盘材料的数字间接粘接精度

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.018

Mohammed Elnagar , Sara Kahng , Budi Kusnoto , Veerasathpurush Allareddy , Maria Viana , Flavio Snachez

This study aims to evaluate the transfer accuracy of three digital indirect bonding (IDB) techniques: 3D printed resin, CAD-driven silicone, and a novel 3D printed shape memory polymer (SMP) Tera Harz TC-85DAC resin. Brackets were digitally placed on pre-existing patient models, and transfer trays were produced for each material. The IDB was performed for each technique. Bracketed models were scanned and superimposed to measure accuracy in both linear and angular dimensions. A one-sample t-test was conducted to assess any significant error in bracket placement. A repeated measures ANOVA, with Greenhouse-Geisser correction, was conducted to assess mean differences between the three techniques in linear and angular dimensions. The results showed that the bar material had the greatest frequency of bracket placement errors. Premolars had the highest frequency of bracket placement errors, specifically with the bar technique. Overall, the SMP technique demonstrated the greatest accuracy in linear and angular dimensions compared to the bar and silicone methods. The standard for clinical acceptability was set to <0.5mm and <2°. All methods were clinically acceptable in the linear directions, but none were acceptable in the angular measurements. The SMP resin material shows promising results as a novel IDB tray material. Further development of the SMP material is needed for in vivo testing, and future studies should evaluate transfer tray design to control deviations in angular dimensions. Mastering the indirect bonding technique will enable orthodontists to streamline clinical workflow, reduce costs, and increase patient satisfaction.

本研究旨在评估三种数字间接键合（IDB）技术的传递精度：3D打印树脂，cad驱动硅树脂和新型3D打印形状记忆聚合物（SMP） Tera Harz TC-85DAC树脂。支架以数字方式放置在预先存在的患者模型上，并为每种材料制作转移托盘。对每种技术进行IDB。对括号内的模型进行扫描和叠加，以测量线性和角尺寸的精度。进行单样本t检验以评估括号放置的任何显著错误。采用温室-盖瑟校正的重复测量方差分析来评估三种技术在线性和角度维度上的平均差异。结果表明，杆类材料的支架放置误差频率最高。前磨牙有最高频率的托槽放置错误，特别是与棒技术。总体而言，与棒材和硅胶方法相比，SMP技术在线性和角尺寸上具有最高的精度。临床可接受性标准设定为0.5mm和2°。所有方法在线性方向上均为临床可接受的，但在角度测量上均不可接受。SMP树脂材料作为一种新型IDB托盘材料显示出良好的效果。SMP材料的进一步发展需要进行体内测试，未来的研究应该评估转移托盘的设计，以控制角度尺寸的偏差。掌握间接粘接技术将使正畸医生能够简化临床工作流程，降低成本，提高患者满意度。

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引用次数: 0

78 - Differences in perceived orthodontic need, satisfaction with dental aesthetics, and influence of social media between Brazilians and Finns 78 -巴西人和芬兰人在感知正畸需求、牙齿美学满意度和社交媒体影响方面的差异

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.082

Anne Linnea Närhi , Gil Gasparello , Krista Hylkilä , Lucas Campos , Orlando Tanaka , Anna-Sofia Silvola

Patient perception and satisfaction with their dental aesthetics varies in different populations, and the use of social media may affect the patient values. This study aims to compare the self-perceived orthodontic treatment need, satisfaction with dental aesthetics, and the influence of social media between Brazilian and Finnish populations. A total of 730 participants (365 Brazilians and 365 Finns) of mean age 26.76 ± 7.25 years in the Brazilian and 27.03 ± 11.25 years in the Finnish group participated the survey. In the standardized questionnaire, the self-perceived orthodontic treatment need, and satisfaction with dental aesthetics were assessed using a Visual Analogue Scale (VAS). The influence of social media was assessed through questions separated from the Social Media Use Scale (SMUS) regarding time spent on social media, playing with filters and comparison of individual appearance and life experiences to others. Independent Student t-tests and Pearson correlation were conducted. Brazilians reported a significantly higher self-perceived orthodontic treatment need (p < 0.001), but no statistical difference was found in satisfaction with dental aesthetics (p = 0.438) compared to Finns. Time spent on social media was higher among Brazilians (p = 0.029). In addition, Brazilians were more likely to use filters (p < 0.001) and compare their appearance (p = 0.011) and life experiences to others (p < 0.001) than Finns. The self-perceived orthodontic treatment need showed a negative correlation with satisfaction with dental aesthetics (r = -0.476) indicating that those less satisfied with their dental aesthetics felt a greater need for treatment. Social media influence as playing with filters, comparing appearance, and life experiences showed no or weak influence on satisfaction with dental aesthetics and self-perceived orthodontic treatment need (r < 0.20). Brazilians reported a higher perceived need for orthodontic treatment, though satisfaction with dental aesthetics did not differ between groups. Social media had no or a weak influence on satisfaction with and perceived orthodontic treatment need.

不同人群患者对口腔美学的认知和满意度不同，社交媒体的使用可能会影响患者的价值观。本研究旨在比较巴西和芬兰人群自我认知的正畸治疗需求、牙齿美学满意度以及社交媒体的影响。共有730名参与者（365名巴西人和365名芬兰人）参加了这项调查，巴西人和芬兰人的平均年龄分别为26.76±7.25岁和27.03±11.25岁。在标准化问卷中，采用视觉模拟量表（Visual Analogue Scale， VAS）评估自我认知的正畸治疗需求和口腔美学满意度。社交媒体的影响是通过从社交媒体使用量表（SMUS）中分离出来的问题来评估的，这些问题包括在社交媒体上花费的时间、玩过滤器以及个人外表和生活经历与他人的比较。进行独立学生t检验和Pearson相关分析。巴西人报告的自我正畸治疗需求显著高于芬兰人（p < 0.001），但与芬兰人相比，对牙齿美观的满意度没有统计学差异（p = 0.438）。巴西人在社交媒体上花费的时间更高（p = 0.029）。此外，巴西人比芬兰人更有可能使用过滤器（p < 0.001），并将自己的外表（p = 0.011）和生活经历与其他人进行比较（p < 0.001）。自我感知的正畸治疗需求与口腔美观满意度呈负相关（r = -0.476），表明口腔美观满意度越低的患者对治疗的需求越大。社交媒体的影响，如玩滤镜、比较外表和生活经历，对牙齿美学满意度和自我感知的正畸治疗需求没有或很弱的影响（r < 0.20）。巴西人对正畸治疗的需求更高，但对牙齿美观的满意度在两组之间没有差异。社交媒体对正畸治疗需求的满意度和感知的影响没有或很弱。

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引用次数: 0

81 - Digital protocol for occlusal adjustment to optimize orthodontic treatment outcomes 调整咬合以优化正畸治疗结果的数字方案

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.085

Katia Jael Jaldin Sandoval , Coffiel Morales M.Jimena , Morales M. Jimena Torrez Willy

Achieving a stable, functional, and balanced occlusion is critical for the long- term success of orthodontic treatment, especially during the finishing phase where precise occlusal contacts determine stability. Traditional occlusal adjustment techniques, although widely practiced, depend heavily on the clinician's experience, often resulting in variability in outcomes and limited reproducibility. With the emergence of digital technologies, there is an opportunity to implement more standardized, predictable, and minimally invasive adjustment protocols. This study aimed to design and evaluate a digital protocol for occlusal adjustment using intraoral scanning and CAD/CAM planning to enhance the final phase of orthodontic treatment. A prospective clinical study was conducted involving 110 orthodontic patients treated by 25 orthodontists with varying levels of digital training. Digital workflows enabled accurate identification of premature contacts and virtual simulation of selective grinding. Data collection included pre- and post-treatment occlusal mappings, structured surveys, and interviews to assess the clinicians’ familiarity with digital systems and the perceived value of the protocol. Results showed a significant reduction in premature contacts and occlusal discrepancies post-adjustment. Over 80% of orthodontists reported increased confidence and efficiency after digital training, while 93% of patients expressed higher satisfaction due to the precision and non-invasive nature of the approach. In conclusion, the proposed digital protocol contributes to more accurate, consistent, and clinically favorable occlusal outcomes. Training clinicians in digital technologies is essential to optimize results and ensure the long-term functional success of orthodontic interventions.

实现稳定，功能和平衡的咬合对于正畸治疗的长期成功至关重要，特别是在咬合接触精确决定稳定性的完成阶段。传统的咬合调整技术虽然被广泛应用，但在很大程度上依赖于临床医生的经验，往往导致结果的可变性和有限的可重复性。随着数字技术的出现，有机会实施更加标准化、可预测和微创的调整协议。本研究旨在设计和评估使用口腔内扫描和CAD/CAM计划进行咬合调整的数字方案，以提高正畸治疗的最后阶段。一项前瞻性临床研究涉及110名正畸患者，由25名接受不同程度数字培训的正畸医生治疗。数字化工作流程实现了对过早接触的准确识别和选择性磨削的虚拟仿真。数据收集包括治疗前和治疗后的咬合映射、结构化调查和访谈，以评估临床医生对数字系统的熟悉程度和方案的感知价值。结果显示，调整后的过早接触和咬合差异显著减少。超过80%的正畸医生表示，经过数字化培训后，他们的信心和效率都有所提高，而93%的患者表示，由于该方法的准确性和非侵入性，他们的满意度更高。总之，提出的数字方案有助于更准确、一致和临床有利的咬合结果。对临床医生进行数字技术培训对于优化结果和确保正畸干预的长期功能成功至关重要。

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引用次数: 0

50 - Comparison between intermaxillary elastics and buccal shelf miniscrews in the treatment of Class III malocclusion 上颌间弹性与颊架微型螺钉治疗III类错牙合的比较

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.054

Tayla Mileski , Rafael DRM , Paula Cotrin , Karina Freitas , Fabricio Valarelli

Intermaxillary elastics are one of the most widely used methods for Class III compensatory treatment. However, their application often leads to undesirable side effects, potentially compromising smile aesthetics. More recently, skeletal anchorage has gained popularity as an alternative approach, particularly for mandibular molar distalization in Class III correction.

Objective

To compare cephalometric data of patients with Class III malocclusion using intermaxillary elastics or skeletal anchorage.

Materials and Methods

The sample included 38 patients with Class III malocclusion. Group 1: 10 patients treated with fixed appliances (Roth prescription) and skeletal anchorage with extra-alveolar miniscrews in the buccal shelf. Group 2: 14 patients treated with fixed appliances (Class III Biofunctional prescription) and intermaxillary elastics. Group 3: 14 patients treated with fixed appliances (Roth prescription) and intermaxillary elastics. Initial and final lateral cephalograms were traced and compared using ANOVA and Tukey tests.

Results

At treatment end, upper molars were more mesially angulated in the Biofunctional group than in the Buccal Shelf and Roth groups. Lower incisors were more upright and retruded in the Buccal Shelf group than in the other groups. Greater extrusion of lower incisors was seen in the Biofunctional group than in the Buccal Shelf group.

Conclusion

Class III elastic treatments with the Biofunctional prescription resulted in greater counterclockwise occlusal plane rotation than skeletal anchorage. Skeletal anchorage in the buccal shelf led to more upright and retruded lower incisors compared to elastics.

上颌间弹性是最广泛使用的III类代偿治疗方法之一。然而，它们的应用往往会导致不良的副作用，潜在地损害微笑的美观。最近，骨锚作为一种替代方法越来越受欢迎，特别是在III类矫正中用于下颌磨牙远端。目的比较上颌间弹性支架与骨支具治疗III类错牙合患者的头颅测量资料。材料与方法对38例III类错颌畸形患者进行分析。第1组：10例患者采用固定矫治器（Roth处方）和牙槽外微螺钉在颊架进行骨支抗。第二组：14例患者使用固定矫治器（III类生物功能处方）和上颌间弹性矫治器。第三组：14例患者采用固定矫治器（罗斯处方）和上颌间弹力器治疗。采用方差分析和Tukey检验对初始和最终侧位脑电图进行追踪和比较。结果治疗结束时，生物功能组上颌磨牙成角较颊架组和罗斯组明显。颊架组下门牙较其他组更直、更后缩。生物功能组比颊架组下门牙有更大的挤压。结论使用生物功能处方进行III类弹性治疗后，牙合平面逆时针旋转幅度大于骨支抗。骨锚定在颊架导致更多的直立和后缩的下门牙相比，弹性。

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引用次数: 0

84 - Effect of orthodontic aligners on periodontal health in patients with and without trisomy 21 正畸矫正器对21三体患者和非21三体患者牙周健康的影响

IF 3.2 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of the World Federation of Orthodontists

Pub Date : 2025-12-01 DOI: 10.1016/j.ejwf.2025.07.088

Cristiane Travalão Tripoli Paes Barbosa , Wericon Pedro Santos , Daniele Gregório , Roberto Bespalez Neto , Thaís Maria Freire Fernandes , Paula Vanessa Pedron Oltramari

Effect of Orthodontic Aligners on Periodontal Health in Patients With and Without Trisomy 21 Introduction: Patients with Down Syndrome (T21) have a higher susceptibility to periodontal disease due to dental anomalies and difficulties with oral hygiene, which promote plaque accumulation. These patients often require orthodontic treatment to correct malocclusions and skeletal issues, which can be challenging. Orthodontic aligners are an alternative to traditional braces, offering benefits such as better hygiene and comfort.

Objective: To assess the periodontal condition of patients with T21 during treatment with orthodontic aligners.

Material and Methods: The study included 30 patients (ages 11-35), divided into two groups: T21 (n=10, treated prospectively) and CONTROL (n=20, accessed retrospectively). Both groups used Invisalign™ aligners and had their periodontal condition assessed before treatment and after 60, 120, 180, and 365 days, using the Gingival Bleeding Index (GBI) and Plaque Index (PI). Statistical analysis was performed using the Shapiro-Wilk, Chi-Square, Fisher, Mann-Whitney, ANOVA, and independent t-tests (p<0.05).

Results: The T21 group showed a higher incidence of periodontal pockets at the start of the study (p=0.038) and consistently higher plaque indices at all follow-up periods (p<0.05). No significant difference in gingival bleeding was observed between the groups (p>0.05).

Conclusion: Orthodontic aligners are a viable option for patients with T21, as they facilitate oral hygiene and help reduce the risk of periodontal complications. The study emphasizes the importance of a multidisciplinary approach to optimize clinical outcomes and improve the quality of life for these patients.

介绍：唐氏综合征（T21）患者由于牙齿异常和口腔卫生困难，对牙周病的易感性更高，这促进了牙菌斑的积累。这些患者通常需要正畸治疗来纠正咬合错误和骨骼问题，这可能是具有挑战性的。正畸矫正器是传统牙套的替代品，提供更好的卫生和舒适等好处。目的：评价T21患者在使用正畸矫正器治疗时的牙周状况。材料与方法：本研究纳入30例患者，年龄11-35岁，分为两组：T21组（n=10，前瞻性治疗）和对照组（n=20，回顾性调查）。两组患者均使用Invisalign™矫正器，并在治疗前、治疗后60、120、180和365天分别使用牙龈出血指数（GBI）和菌斑指数（PI）评估牙周状况。统计学分析采用Shapiro-Wilk、Chi-Square、Fisher、Mann-Whitney、ANOVA和独立t检验（p<0.05）。结果：T21组在研究开始时牙周袋发生率较高（p=0.038），在所有随访期间菌斑指数均保持较高（p=0.038;0.05）。两组牙龈出血发生率比较，差异无统计学意义（p < 0.05）。结论：正畸矫正器对于T21患者是一种可行的选择，因为它们促进口腔卫生并有助于降低牙周并发症的风险。该研究强调了多学科方法对优化临床结果和改善这些患者生活质量的重要性。

{"title":"84 - Effect of orthodontic aligners on periodontal health in patients with and without trisomy 21","authors":"Cristiane Travalão Tripoli Paes Barbosa , Wericon Pedro Santos , Daniele Gregório , Roberto Bespalez Neto , Thaís Maria Freire Fernandes , Paula Vanessa Pedron Oltramari","doi":"10.1016/j.ejwf.2025.07.088","DOIUrl":"10.1016/j.ejwf.2025.07.088","url":null,"abstract":"<div><div>Effect of Orthodontic Aligners on Periodontal Health in Patients With and Without Trisomy 21 Introduction: Patients with Down Syndrome (T21) have a higher susceptibility to periodontal disease due to dental anomalies and difficulties with oral hygiene, which promote plaque accumulation. These patients often require orthodontic treatment to correct malocclusions and skeletal issues, which can be challenging. Orthodontic aligners are an alternative to traditional braces, offering benefits such as better hygiene and comfort.</div><div><strong>Objective:</strong> To assess the periodontal condition of patients with T21 during treatment with orthodontic aligners.</div><div><strong>Material and Methods:</strong> The study included 30 patients (ages 11-35), divided into two groups: T21 (n=10, treated prospectively) and CONTROL (n=20, accessed retrospectively). Both groups used Invisalign™ aligners and had their periodontal condition assessed before treatment and after 60, 120, 180, and 365 days, using the Gingival Bleeding Index (GBI) and Plaque Index (PI). Statistical analysis was performed using the Shapiro-Wilk, Chi-Square, Fisher, Mann-Whitney, ANOVA, and independent t-tests (p<0.05).</div><div><strong>Results:</strong> The T21 group showed a higher incidence of periodontal pockets at the start of the study (p=0.038) and consistently higher plaque indices at all follow-up periods (p<0.05). No significant difference in gingival bleeding was observed between the groups (p>0.05).</div><div><strong>Conclusion:</strong> Orthodontic aligners are a viable option for patients with T21, as they facilitate oral hygiene and help reduce the risk of periodontal complications. The study emphasizes the importance of a multidisciplinary approach to optimize clinical outcomes and improve the quality of life for these patients.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 427"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0