Pub Date : 2026-02-04DOI: 10.1016/j.ortho.2026.101146
Yuchen Liu, Tingting Zhao, Nannan Wang, Jing Zhou, Hong He, Carlos Flores-Mir, Fang Hua
This case report describes a two-phase orthodontic treatment of an 11-year-old adolescent patient with a Class II malocclusion. Before orthodontic treatment, the patient exhibited adenoid hypertrophy, mouth breathing, and snoring. He was referred to an otolaryngologist and diagnosed with paediatric obstructive sleep apnoea (PedOSA), which was treated with tonsillectomy and adenoidectomy. Thereafter, given that the patient was at the pubertal growth peak and preferred aesthetic appliances, clear aligner functional therapy was selected for orthodontic treatment. During the first phase (mandibular advancement), deep overjet and Class II molar relationship were improved using clear aligners with solid occlusal blocks, resulting in significant improvement in the patient's facial profile. In the second phase (comprehensive orthodontics), alignment and levelling of the dentition were performed. After approximately three years of treatment, all treatment objectives were achieved. This case suggests that CA with solid occlusal blocks, as a novel option, can be used for growing Class II malocclusion patients. The improvement in the facial profile appeared to result from a combination of minor skeletal changes and significant dentoalveolar compensation.
{"title":"Treatment of a skeletal Class II malocclusion growing patient using clear aligners with solid occlusal blocks: A case report.","authors":"Yuchen Liu, Tingting Zhao, Nannan Wang, Jing Zhou, Hong He, Carlos Flores-Mir, Fang Hua","doi":"10.1016/j.ortho.2026.101146","DOIUrl":"https://doi.org/10.1016/j.ortho.2026.101146","url":null,"abstract":"<p><p>This case report describes a two-phase orthodontic treatment of an 11-year-old adolescent patient with a Class II malocclusion. Before orthodontic treatment, the patient exhibited adenoid hypertrophy, mouth breathing, and snoring. He was referred to an otolaryngologist and diagnosed with paediatric obstructive sleep apnoea (PedOSA), which was treated with tonsillectomy and adenoidectomy. Thereafter, given that the patient was at the pubertal growth peak and preferred aesthetic appliances, clear aligner functional therapy was selected for orthodontic treatment. During the first phase (mandibular advancement), deep overjet and Class II molar relationship were improved using clear aligners with solid occlusal blocks, resulting in significant improvement in the patient's facial profile. In the second phase (comprehensive orthodontics), alignment and levelling of the dentition were performed. After approximately three years of treatment, all treatment objectives were achieved. This case suggests that CA with solid occlusal blocks, as a novel option, can be used for growing Class II malocclusion patients. The improvement in the facial profile appeared to result from a combination of minor skeletal changes and significant dentoalveolar compensation.</p>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2S","pages":"101146"},"PeriodicalIF":1.9,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126798","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 : 2026-02-02DOI: 10.1016/j.ortho.2026.101142
Marco Serafin, Elisa Boccalari, Luca Fracci, Alberto Caprioglio
Aim: This study tested whether conventional 2D incisor mandibular plane angle (IMPA) can be used interchangeably with a rigorously defined 3D one.
Material and methods: This single-centre retrospective study included 169 CBCT scans. Synthetic lateral cephalograms were generated from DICOM data to calculate the conventional 2D IMPA between the Go-Me mandibular plane and the lower central incisor long axis. The 3D IMPA used the axes of teeth 3.1 and 4.1 projected three-dimensionally to the orthogonal plane to GoL-GoR-Me and the higher angle was selected. Normality of paired differences was assessed using the Shapiro-Wilk test. Systematic bias was evaluated with a paired t-test. Association between 2D and 3D IMPA was assessed using Pearson's correlation and linear regression. Agreement was quantified by Bland-Altman analysis. Classification agreement within the 85-95° range was evaluated using Cohen's kappa and McNemar's test.
Results: Mean 2D and 3D IMPA were 95.29±8.98° and 95.75±9.42°, respectively, with a mean paired 3D-2D difference of 0.46° (paired t-test, P=0.084). Correlation was strong (r=0.931), and linear regression yielded R2=0.867. Bland-Altman bias was 0.46° (95%LoA -6.29° to +7.21°). Classification agreement across the 85-95° range was 83.43% (κ=0.636; McNemar P=0.345).
Conclusions: 2D and 3D IMPA showed negligible mean bias, excellent association, and substantial diagnostic concordance. Routine cases may rely on 2D IMPA without material loss of information, whereas in torque-critical, anatomically constrained, or borderline cases the observed ±7° dispersion argues for 3D assessment.
目的：探讨常规的二维门牙下颌平面角（IMPA）与严格定义的三维门牙平面角（IMPA）是否可以互换使用。材料和方法：这项单中心回顾性研究包括169个CBCT扫描。根据DICOM数据生成合成侧位头颅图，计算Go-Me下颌平面与下中切牙长轴之间的常规二维IMPA。三维IMPA采用3.1和4.1齿轴三维投影到与ggo - gor - me正交平面，并选择较高的角度。使用Shapiro-Wilk检验评估配对差异的正态性。采用配对t检验评价系统偏倚。利用Pearson相关和线性回归评估二维和三维IMPA之间的相关性。一致性通过Bland-Altman分析进行量化。使用Cohen's kappa和McNemar's检验评估85-95°范围内的分类一致性。结果：2D、3D的平均IMPA分别为95.29±8.98°和95.75±9.42°，3D-2D的平均配对差为0.46°（配对t检验，P=0.084）。相关性强（r=0.931），线性回归R2=0.867。Bland-Altman偏差为0.46°（95%LoA -6.29°至+7.21°）。85-95°范围内的分类一致性为83.43% （κ=0.636; McNemar P=0.345）。结论：二维和三维IMPA显示可忽略的平均偏倚，良好的相关性和大量的诊断一致性。常规病例可依赖二维IMPA而无实质性信息丢失，而在扭矩临界、解剖受限或边缘病例中，观察到的±7°弥散可用于三维评估。
{"title":"Validating conventional 2D IMPA against 3D one: is it still a trustworthy angle? A retrospective CBCT-based diagnostic agreement study.","authors":"Marco Serafin, Elisa Boccalari, Luca Fracci, Alberto Caprioglio","doi":"10.1016/j.ortho.2026.101142","DOIUrl":"https://doi.org/10.1016/j.ortho.2026.101142","url":null,"abstract":"<p><strong>Aim: </strong>This study tested whether conventional 2D incisor mandibular plane angle (IMPA) can be used interchangeably with a rigorously defined 3D one.</p><p><strong>Material and methods: </strong>This single-centre retrospective study included 169 CBCT scans. Synthetic lateral cephalograms were generated from DICOM data to calculate the conventional 2D IMPA between the Go-Me mandibular plane and the lower central incisor long axis. The 3D IMPA used the axes of teeth 3.1 and 4.1 projected three-dimensionally to the orthogonal plane to GoL-GoR-Me and the higher angle was selected. Normality of paired differences was assessed using the Shapiro-Wilk test. Systematic bias was evaluated with a paired t-test. Association between 2D and 3D IMPA was assessed using Pearson's correlation and linear regression. Agreement was quantified by Bland-Altman analysis. Classification agreement within the 85-95° range was evaluated using Cohen's kappa and McNemar's test.</p><p><strong>Results: </strong>Mean 2D and 3D IMPA were 95.29±8.98° and 95.75±9.42°, respectively, with a mean paired 3D-2D difference of 0.46° (paired t-test, P=0.084). Correlation was strong (r=0.931), and linear regression yielded R<sup>2</sup>=0.867. Bland-Altman bias was 0.46° (95%LoA -6.29° to +7.21°). Classification agreement across the 85-95° range was 83.43% (κ=0.636; McNemar P=0.345).</p><p><strong>Conclusions: </strong>2D and 3D IMPA showed negligible mean bias, excellent association, and substantial diagnostic concordance. Routine cases may rely on 2D IMPA without material loss of information, whereas in torque-critical, anatomically constrained, or borderline cases the observed ±7° dispersion argues for 3D assessment.</p>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2S","pages":"101142"},"PeriodicalIF":1.9,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114576","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 : 2026-02-02DOI: 10.1016/j.ortho.2026.101144
Saleh M Baqandwan, Nehal F Albelasy, Waleed Eldars, Marwa A Tawfik
Background: The objective of this study was to evaluate the antimicrobial activity, bacterial adhesion, and surface morphology of orthodontic elastomeric ligatures coated with titanium dioxide nanoparticles (TiO2 NPs) at different concentrations over 4 weeks.
Material and methods: TiO2 NPs were synthesized via hydrothermal synthesis and applied at 5% and 10% on elastomeric ligatures (Ormco®) using a sol-gel dip-coating method. In all, 720 ligatures were divided into control (uncoated), 5%, and 10% TiO2 NPs groups. The primary objectives were to assess antimicrobial activity against Streptococcus mutans via agar diffusion immediately after coating and after 48 hours, 2 weeks, and 4 weeks of immersion in artificial saliva at 37°C, and to quantify bacterial adhesion as CFU. The secondary objectives included evaluation of surface morphology and roughness using SEM. Statistical analysis was performed using two-way ANOVA with Bonferroni correction.
Results: Both TiO2 NP coated groups showed significantly higher antibacterial activity and lower bacterial adhesion than controls (P<0.001). In the 10% group, inhibition zones decreased by 6.8mm (95% CI: 4.9-8.7) at 48 hours, 10.6mm (95% CI: 8.7-12.5) at 2 weeks, and 24.7mm (95% CI: 22.8-26.6) at 4 weeks; 5% group showed smaller reductions (8.3mm, 13.9mm, 21.5mm). Bacterial adhesion declined by 9933 CFU (95% CI: 9113-10,754) for 10% and 6477 CFU (95% CI: 5656-7297) for 5%. The 10% coating consistently had the strongest antibacterial effect and lowest CFUs, though efficacy decreased over time. SEM revealed increased surface roughness, especially in the 10% group.
Conclusions: TiO2 NPs coatings, particularly at 10%, enhance short-term antibacterial properties of orthodontic ligatures. However, the antimicrobial benefits decrease over time due to coating degradation and exposure to saliva. Higher nanoparticle concentrations increase surface roughness, which may affect long-term biofilm resistance. Optimizing nanoparticle dispersion and coating durability is essential for sustained clinical effectiveness.
{"title":"Antimicrobial activity, bacterial adhesion, and surface morphology of TiO<sub>2</sub> nanoparticle-coated orthodontic elastomeric ligatures: An in vitro study.","authors":"Saleh M Baqandwan, Nehal F Albelasy, Waleed Eldars, Marwa A Tawfik","doi":"10.1016/j.ortho.2026.101144","DOIUrl":"https://doi.org/10.1016/j.ortho.2026.101144","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to evaluate the antimicrobial activity, bacterial adhesion, and surface morphology of orthodontic elastomeric ligatures coated with titanium dioxide nanoparticles (TiO<sub>2</sub> NPs) at different concentrations over 4 weeks.</p><p><strong>Material and methods: </strong>TiO<sub>2</sub> NPs were synthesized via hydrothermal synthesis and applied at 5% and 10% on elastomeric ligatures (Ormco®) using a sol-gel dip-coating method. In all, 720 ligatures were divided into control (uncoated), 5%, and 10% TiO<sub>2</sub> NPs groups. The primary objectives were to assess antimicrobial activity against Streptococcus mutans via agar diffusion immediately after coating and after 48 hours, 2 weeks, and 4 weeks of immersion in artificial saliva at 37°C, and to quantify bacterial adhesion as CFU. The secondary objectives included evaluation of surface morphology and roughness using SEM. Statistical analysis was performed using two-way ANOVA with Bonferroni correction.</p><p><strong>Results: </strong>Both TiO<sub>2</sub> NP coated groups showed significantly higher antibacterial activity and lower bacterial adhesion than controls (P<0.001). In the 10% group, inhibition zones decreased by 6.8mm (95% CI: 4.9-8.7) at 48 hours, 10.6mm (95% CI: 8.7-12.5) at 2 weeks, and 24.7mm (95% CI: 22.8-26.6) at 4 weeks; 5% group showed smaller reductions (8.3mm, 13.9mm, 21.5mm). Bacterial adhesion declined by 9933 CFU (95% CI: 9113-10,754) for 10% and 6477 CFU (95% CI: 5656-7297) for 5%. The 10% coating consistently had the strongest antibacterial effect and lowest CFUs, though efficacy decreased over time. SEM revealed increased surface roughness, especially in the 10% group.</p><p><strong>Conclusions: </strong>TiO<sub>2</sub> NPs coatings, particularly at 10%, enhance short-term antibacterial properties of orthodontic ligatures. However, the antimicrobial benefits decrease over time due to coating degradation and exposure to saliva. Higher nanoparticle concentrations increase surface roughness, which may affect long-term biofilm resistance. Optimizing nanoparticle dispersion and coating durability is essential for sustained clinical effectiveness.</p>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2S","pages":"101144"},"PeriodicalIF":1.9,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114536","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 : 2026-02-02DOI: 10.1016/j.ortho.2026.101140
Aliyyah Hamiduddin, Robert Aszkler, Stephen Warunek, William Tanberg, Thikriat Al-Jewair
Objectives: The aims of this study were to evaluate the treatment quality, duration and accuracy of 3D-printed custom brackets (LightForce™, LF) and clear aligners (Invisalign®, CA) in comparison to conventional brackets (3M™ Victory Series™, CB).
Methods: This retrospective study included 94 subjects who underwent comprehensive orthodontic treatment with one of three modalities: LightForce™ custom brackets (LightForce™, Burlington, MA; LF; n=37), clear aligners (Invisalign®, Align Tech, San Jose, CA; CA; n=33), or conventional brackets (3M™ Victory Series™, Solventum, Saint Paul, MN; CB; n=24). Data were collected at pre-treatment (T0), planned final tooth position via LightPlan or ClinCheck (TP), and immediately post-treatment (T1). Overall treatment quality was evaluated using the ABO Cast-Radiograph evaluation (C-R Eval). Treatment duration was recorded in months. Treatment accuracy was assessed by comparing the planned TP and achieved T1 arch width changes at maxillary and mandibular canines, first premolars and first molars.
Results: There was no significant difference in the total C-R Eval scores between the groups. Treatment duration was significantly shorter in the LF (15.89 months) and CA (14.39 months) groups compared to the CB (27.79 months) (P<0.001). There was a significant difference between LF and CA groups in TP-T1 of the maxillary inter-canine width (LF=0.87mm, CA=0.23mm, P-Adj=0.013).
Conclusions: Treatment quality was comparable between LF, CA and CB in mild to moderate crowding cases. Treatment duration was significantly shorter in LF and CA in comparison to CB. However, variations in provider experience may have influenced treatment outcomes. CA demonstrated accuracy in arch width predictions, whereas LF showed accuracy in predicting maxillary and mandibular inter-premolar and mandibular intermolar widths only.
{"title":"Treatment outcomes of 3D-printed custom brackets and clear aligners in adolescents and young adults with simple to moderate malocclusions: A retrospective study.","authors":"Aliyyah Hamiduddin, Robert Aszkler, Stephen Warunek, William Tanberg, Thikriat Al-Jewair","doi":"10.1016/j.ortho.2026.101140","DOIUrl":"https://doi.org/10.1016/j.ortho.2026.101140","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of this study were to evaluate the treatment quality, duration and accuracy of 3D-printed custom brackets (LightForce™, LF) and clear aligners (Invisalign®, CA) in comparison to conventional brackets (3M™ Victory Series™, CB).</p><p><strong>Methods: </strong>This retrospective study included 94 subjects who underwent comprehensive orthodontic treatment with one of three modalities: LightForce™ custom brackets (LightForce™, Burlington, MA; LF; n=37), clear aligners (Invisalign®, Align Tech, San Jose, CA; CA; n=33), or conventional brackets (3M™ Victory Series™, Solventum, Saint Paul, MN; CB; n=24). Data were collected at pre-treatment (T0), planned final tooth position via LightPlan or ClinCheck (TP), and immediately post-treatment (T1). Overall treatment quality was evaluated using the ABO Cast-Radiograph evaluation (C-R Eval). Treatment duration was recorded in months. Treatment accuracy was assessed by comparing the planned TP and achieved T1 arch width changes at maxillary and mandibular canines, first premolars and first molars.</p><p><strong>Results: </strong>There was no significant difference in the total C-R Eval scores between the groups. Treatment duration was significantly shorter in the LF (15.89 months) and CA (14.39 months) groups compared to the CB (27.79 months) (P<0.001). There was a significant difference between LF and CA groups in T<sub>P</sub>-T<sub>1</sub> of the maxillary inter-canine width (LF=0.87mm, CA=0.23mm, P-Adj=0.013).</p><p><strong>Conclusions: </strong>Treatment quality was comparable between LF, CA and CB in mild to moderate crowding cases. Treatment duration was significantly shorter in LF and CA in comparison to CB. However, variations in provider experience may have influenced treatment outcomes. CA demonstrated accuracy in arch width predictions, whereas LF showed accuracy in predicting maxillary and mandibular inter-premolar and mandibular intermolar widths only.</p>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2S","pages":"101140"},"PeriodicalIF":1.9,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114560","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}
Objectives: This study aimed to investigate the association between maxillary canine impaction and non-syndromic hypodontia, and to explore the contribution of specific missing-tooth patterns and craniofacial skeletal characteristics.
Methods: A case-control study was conducted using pretreatment orthodontic records from an initial clinical sample of 4078 patients aged 11-21 years, from whom 251 individuals with maxillary canine impaction (cases) and 753 age- and sex-matched controls were finally included. Dental agenesis was assessed for all patients. Statistical analyses included univariate and multivariable binary logistic regression to evaluate the association between impaction and the presence, severity, and patterns of non-syndromic hypodontia, as well as Chi-squared and Fisher's exact tests to explore associations with impaction characteristics.
Results: Hypodontia, when including third molars, showed a weak association with maxillary canine impaction (OR=1.39; 95% CI=1.00-1.93; P=0.050). In multivariable analysis, the association between the number of missing teeth and maxillary canine impaction varied according to skeletal Class II (OR=1.42; 95% CI=1.10-1.84; P=0.007) and skeletal Class III (OR=2.34; 95% CI=1.29-4.93; P=0.012), with no significant effects of tooth-specific agenesis patterns or vertical skeletal relationships. Among affected patients, laterality, impaction position, and the presence of local obstacles were not associated with hypodontia.
Conclusions: The findings suggest that the severity of non-syndromic hypodontia represents a meaningful predictor of maxillary canine impaction when considered in relation to skeletal malocclusion, whereas individual missing-tooth patterns are insufficient to explain this phenomenon and do not support classical aetiological theories of impaction. This trend may help clinicians identify high-risk patients earlier and refine treatment planning.
{"title":"Revisiting aetiological models of maxillary canine impaction and its association with non-syndromic hypodontia: a nested case-control study among French orthodontic patients.","authors":"Miléna Bazin, Olivia Kérourédan, Elsa Garot, Julien Van Gils, Anaïs Cavaré","doi":"10.1016/j.ortho.2026.101145","DOIUrl":"https://doi.org/10.1016/j.ortho.2026.101145","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the association between maxillary canine impaction and non-syndromic hypodontia, and to explore the contribution of specific missing-tooth patterns and craniofacial skeletal characteristics.</p><p><strong>Methods: </strong>A case-control study was conducted using pretreatment orthodontic records from an initial clinical sample of 4078 patients aged 11-21 years, from whom 251 individuals with maxillary canine impaction (cases) and 753 age- and sex-matched controls were finally included. Dental agenesis was assessed for all patients. Statistical analyses included univariate and multivariable binary logistic regression to evaluate the association between impaction and the presence, severity, and patterns of non-syndromic hypodontia, as well as Chi-squared and Fisher's exact tests to explore associations with impaction characteristics.</p><p><strong>Results: </strong>Hypodontia, when including third molars, showed a weak association with maxillary canine impaction (OR=1.39; 95% CI=1.00-1.93; P=0.050). In multivariable analysis, the association between the number of missing teeth and maxillary canine impaction varied according to skeletal Class II (OR=1.42; 95% CI=1.10-1.84; P=0.007) and skeletal Class III (OR=2.34; 95% CI=1.29-4.93; P=0.012), with no significant effects of tooth-specific agenesis patterns or vertical skeletal relationships. Among affected patients, laterality, impaction position, and the presence of local obstacles were not associated with hypodontia.</p><p><strong>Conclusions: </strong>The findings suggest that the severity of non-syndromic hypodontia represents a meaningful predictor of maxillary canine impaction when considered in relation to skeletal malocclusion, whereas individual missing-tooth patterns are insufficient to explain this phenomenon and do not support classical aetiological theories of impaction. This trend may help clinicians identify high-risk patients earlier and refine treatment planning.</p>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2S","pages":"101145"},"PeriodicalIF":1.9,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114600","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 : 2026-01-29DOI: 10.1016/j.ortho.2026.101141
Martha Mejia , Puneet Batra , Monica Dominguez , María del Rosario Montoya , Dhruv Ahuja , Silvia Z. Torres Cavallo , Adriana Reyes , Aditya Talwar
Objectives
To evaluate the effectiveness of the Rhinoplasty Appliance System (RAS) in improving alveolar arch morphology and nasolabial morphology in infants with bilateral cleft lip and palate (BCLP) before primary lip repair.
Material and methods
A multicentre prospective study was conducted on 20 non-syndromic infants with complete BCLP. Presurgical infant orthopaedics (PSIO) using RAS therapy was initiated within the first three-weeks of life and continued until primary cheiloplasty. Digital maxillary models and standardized extraoral photographs were obtained before and after the PSIO treatment. Study model analyses evaluated three-dimensional maxillary arch morphology, while extraoral photographs evaluated nasolabial parameters, including nostril width, columella height, prolabium height, nasal tip angle, and nasolabial angle. Reliability was tested using repeated measures, and descriptive statistics and paired t-tests were applied, with significance set at P < 0.05.
Results
Significant improvements were observed in both arch morphology and nasolabial parameters following RAS therapy. Arch changes included reductions in cleft width and improvements in premaxillary alignment (P < 0.001), while nasolabial improvements included reduced nasal tip angle (−7.46°, P < 0.001), increased nasolabial angle (+23.39°, P < 0.001), narrower nostril width (−5.84 mm, P < 0.001), and greater columella and prolabium height (P < 0.001).
Conclusion
In infants with BCLP, RAS therapy improved maxillary arch morphology and nasolabial parameters. RAS may offer a controlled and reproducible PSIO approach, enhancing premaxillary positioning, nasal symmetry, and readiness for lip repair while potentially reducing caregiver burden and in-person visits. Adoption of this technique in clinical practice may facilitate standardized early nasal and maxillary correction, improving surgical outcomes. Well-designed, randomized clinical trials with long-term follow-up are warranted to confirm these outcomes.
目的评价鼻整形器械系统（RAS）在双侧唇腭裂（BCLP）患儿一期唇部修复前改善牙槽弓形态和鼻唇形态的效果。材料与方法对20例完全性BCLP患儿进行了一项多中心前瞻性研究。术前婴儿骨科（PSIO）使用RAS治疗在出生后的前三周内开始，并持续到首次唇部成形术。在PSIO治疗前后分别获得数字上颌模型和标准化的口外照片。研究模型分析评估了三维上颌弓形态，而口外照片评估了鼻唇参数，包括鼻孔宽度、小柱高度、前唇高度、鼻尖角和鼻唇角。采用重复测量法检验信度，采用描述性统计和配对t检验，显著性设置为P <； 0.05。结果经RAS治疗后足弓形态和鼻唇参数均有明显改善。弓的改变包括腭裂宽度的减小和上颌前排列的改善（P < 0.001），而鼻唇的改善包括鼻尖角的减小（- 7.46°，P < 0.001），鼻唇角的增加（+23.39°，P < 0.001），鼻孔宽度的缩小（- 5.84 mm, P < 0.001），鼻小柱和前唇高度的增大（P < 0.001）。结论在BCLP患儿中，RAS治疗可改善上颌弓形态和鼻唇参数。RAS可以提供一种可控的、可重复的PSIO方法，增强上颌前定位、鼻对称和唇部修复的准备，同时潜在地减少护理人员的负担和面对面的就诊。在临床实践中采用该技术可促进标准化的早期鼻颌矫正，提高手术效果。经过精心设计的随机临床试验和长期随访证实了这些结果。
{"title":"Evaluation of presurgical infant orthopedics by the rhinoplasty appliance system with intraoral alveolar molding appliance in infants with bilateral cleft lip and palate: A preliminary study","authors":"Martha Mejia , Puneet Batra , Monica Dominguez , María del Rosario Montoya , Dhruv Ahuja , Silvia Z. Torres Cavallo , Adriana Reyes , Aditya Talwar","doi":"10.1016/j.ortho.2026.101141","DOIUrl":"10.1016/j.ortho.2026.101141","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of the Rhinoplasty Appliance System (RAS) in improving alveolar arch morphology and nasolabial morphology in infants with bilateral cleft lip and palate (BCLP) before primary lip repair.</div></div><div><h3>Material and methods</h3><div>A multicentre prospective study was conducted on 20 non-syndromic infants with complete BCLP. Presurgical infant orthopaedics (PSIO) using RAS therapy was initiated within the first three-weeks of life and continued until primary cheiloplasty. Digital maxillary models and standardized extraoral photographs were obtained before and after the PSIO treatment. Study model analyses evaluated three-dimensional maxillary arch morphology, while extraoral photographs evaluated nasolabial parameters, including nostril width, columella height, prolabium height, nasal tip angle, and nasolabial angle. Reliability was tested using repeated measures, and descriptive statistics and paired <em>t</em>-tests were applied, with significance set at <em>P</em> <!--><<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>Significant improvements were observed in both arch morphology and nasolabial parameters following RAS therapy. Arch changes included reductions in cleft width and improvements in premaxillary alignment (<em>P</em> <!--><<!--> <!-->0.001), while nasolabial improvements included reduced nasal tip angle (−7.46°, <em>P</em> <!--><<!--> <!-->0.001), increased nasolabial angle (+23.39°, <em>P</em> <!--><<!--> <!-->0.001), narrower nostril width (−5.84<!--> <!-->mm, <em>P</em> <!--><<!--> <!-->0.001), and greater columella and prolabium height (<em>P</em> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>In infants with BCLP, RAS therapy improved maxillary arch morphology and nasolabial parameters. RAS may offer a controlled and reproducible PSIO approach, enhancing premaxillary positioning, nasal symmetry, and readiness for lip repair while potentially reducing caregiver burden and in-person visits. Adoption of this technique in clinical practice may facilitate standardized early nasal and maxillary correction, improving surgical outcomes. Well-designed, randomized clinical trials with long-term follow-up are warranted to confirm these outcomes.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101141"},"PeriodicalIF":1.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076860","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 : 2026-01-27DOI: 10.1016/j.ortho.2025.101138
Wenhsuan Lu , Tianyi Xin , Liting Liu , Jade Teng , Bing Han , Xiaomo Liu , Si Chen , Xiaoyun Zhang
Objective
To explore the impact of contact between the upper central incisors’ roots and the incisive canal on retraction efficiency and root resorption during extensive orthodontic retraction.
Materials and Methods
The retrospective study used cone-beam computed tomography (CBCT) data from 65 patients undergoing orthodontic extraction treatment with retraction of incisors (≥3 mm) between 2018 and 2023. All eligible cases during this period were consecutively included. CBCT scans were obtained before and after the treatment. The changes in root length (ΔRL), U1/PP, U1-IC distance, horizontal retraction distance of the incisal edge (HRD), and horizontal retraction distance of the alveolar ridge crest (HRD’) were compared between the contact and non-contact groups.
Results
Among the 65 included patients, approximately 30.77% of the cases exhibited contact between the upper central incisor roots and the incisive canal. The initial upper incisor to palatal plane angle (U1/PP) in the non-contact group was significantly greater than that in the contact group. However, the change of upper incisor to palatal plane angle (ΔU1/PP) following treatment showed no statistically significant difference between the two groups. The amount of root resorption in the contact group was significantly greater than that in the non-contact group, but there were no significant differences in HRD and HRD’ between the two groups.
Conclusion
Contact between the roots of the maxillary incisors and the incisive canal was associated with increased root resorption. Patients with smaller initial U1/PP values were more likely to experience such contact. Although retraction of the incisal edges and the alveolar ridge crest was not significantly affected, this type of contact may represent a biological compromise and should be avoided when possible.
{"title":"Impact of upper central incisor contact with incisive canal on root resorption and retraction efficiency: A retrospective CBCT study","authors":"Wenhsuan Lu , Tianyi Xin , Liting Liu , Jade Teng , Bing Han , Xiaomo Liu , Si Chen , Xiaoyun Zhang","doi":"10.1016/j.ortho.2025.101138","DOIUrl":"10.1016/j.ortho.2025.101138","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the impact of contact between the upper central incisors’ roots and the incisive canal on retraction efficiency and root resorption during extensive orthodontic retraction.</div></div><div><h3>Materials and Methods</h3><div>The retrospective study used cone-beam computed tomography (CBCT) data from 65 patients undergoing orthodontic extraction treatment with retraction of incisors (≥3<!--> <!-->mm) between 2018 and 2023. All eligible cases during this period were consecutively included. CBCT scans were obtained before and after the treatment. The changes in root length (ΔRL), <figure><img></figure>U1/PP, U1-IC distance, horizontal retraction distance of the incisal edge (HRD), and horizontal retraction distance of the alveolar ridge crest (HRD’) were compared between the contact and non-contact groups.</div></div><div><h3>Results</h3><div>Among the 65 included patients, approximately 30.77% of the cases exhibited contact between the upper central incisor roots and the incisive canal. The initial upper incisor to palatal plane angle (<figure><img></figure>U1/PP) in the non-contact group was significantly greater than that in the contact group. However, the change of upper incisor to palatal plane angle (ΔU1/PP) following treatment showed no statistically significant difference between the two groups. The amount of root resorption in the contact group was significantly greater than that in the non-contact group, but there were no significant differences in HRD and HRD’ between the two groups.</div></div><div><h3>Conclusion</h3><div>Contact between the roots of the maxillary incisors and the incisive canal was associated with increased root resorption. Patients with smaller initial <figure><img></figure>U1/PP values were more likely to experience such contact. Although retraction of the incisal edges and the alveolar ridge crest was not significantly affected, this type of contact may represent a biological compromise and should be avoided when possible.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101138"},"PeriodicalIF":1.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076861","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}
Temporary anchorage devices (TADs) improve orthodontic biomechanics, with the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS) as common extra-alveolar sites. Skeletal morphology, especially gonial angle as a vertical facial dimension indicator, may influence bone availability. This study investigated the correlation between IZC and MBS bone thickness and gonial angle using cone-beam computed tomography (CBCT).
Methods
CBCT scans from September 2019 to September 2021 were analysed. Bone thickness in IZC and MBS regions was measured at standardized reference points on predefined coronal and axial planes. Participants were consecutively selected from a radiology archive according to inclusion/exclusion criteria. Normality was checked with Kolmogorov–Smirnov test, and correlations were assessed using Spearman's test (P < 0.05) in SPSS v22.
Results
A total of 120 adult CBCT scans were evaluated (≥ 18 years). The mean gonial angle was 120.5° (95% CI: 119.0–122.0). IZC thickness decreased cranially, showing no significant correlation with gonial angle (P > 0.05); the maximum thickness was 5.01 ± 1.65 mm at the mesiobuccal root of the maxillary first molar. In the MBS region, bone thickness, depth, and angulation increased posteriorly and all showed significant inverse correlations with gonial angle (P < 0.05). Maximum MBS thickness was 7.12 ± 2.31 mm at the distal root of the mandibular second molar; minimum thickness was 1.53 ± 0.94 mm at the mesial root of the first molar.
Discussion and conclusion
The distal mandibular second molar offers the most favourable site for extra-alveolar TAD placement due to greater thickness, depth, and angulation. Inverse correlation with gonial angle suggests improved primary stability in patients with reduced vertical facial height. IZC thickness is less affected by gonial angle, but careful angulation is required to avoid sinus perforation. Individualized CBCT assessment is crucial for optimizing TAD placement, enhancing biomechanical outcomes, and minimizing procedural risks.
{"title":"Association between gonial angle and bone thickness in the infrazygomatic crest and mandibular buccal shelf regions for mini-screw insertion in adults: A retrospective study","authors":"Fatemeh Alirezaei , Reza Ghorbanipour , Behzad Chalaki , Ehsan Moudi , Maysam Mirzaie , Seyed Ali Seyed Majidi","doi":"10.1016/j.ortho.2025.101137","DOIUrl":"10.1016/j.ortho.2025.101137","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporary anchorage devices (TADs) improve orthodontic biomechanics, with the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS) as common extra-alveolar sites. Skeletal morphology, especially gonial angle as a vertical facial dimension indicator, may influence bone availability. This study investigated the correlation between IZC and MBS bone thickness and gonial angle using cone-beam computed tomography (CBCT).</div></div><div><h3>Methods</h3><div>CBCT scans from September 2019 to September 2021 were analysed. Bone thickness in IZC and MBS regions was measured at standardized reference points on predefined coronal and axial planes. Participants were consecutively selected from a radiology archive according to inclusion/exclusion criteria. Normality was checked with Kolmogorov–Smirnov test, and correlations were assessed using Spearman's test (<em>P</em> <!--><<!--> <!-->0.05) in SPSS v22.</div></div><div><h3>Results</h3><div>A total of 120 adult CBCT scans were evaluated (≥<!--> <!-->18<!--> <!-->years). The mean gonial angle was 120.5° (95% CI: 119.0–122.0). IZC thickness decreased cranially, showing no significant correlation with gonial angle (<em>P</em> <!-->><!--> <!-->0.05); the maximum thickness was 5.01<!--> <!-->±<!--> <!-->1.65<!--> <!-->mm at the mesiobuccal root of the maxillary first molar. In the MBS region, bone thickness, depth, and angulation increased posteriorly and all showed significant inverse correlations with gonial angle (<em>P</em> <!--><<!--> <!-->0.05). Maximum MBS thickness was 7.12<!--> <!-->±<!--> <!-->2.31<!--> <!-->mm at the distal root of the mandibular second molar; minimum thickness was 1.53<!--> <!-->±<!--> <!-->0.94<!--> <!-->mm at the mesial root of the first molar.</div></div><div><h3>Discussion and conclusion</h3><div>The distal mandibular second molar offers the most favourable site for extra-alveolar TAD placement due to greater thickness, depth, and angulation. Inverse correlation with gonial angle suggests improved primary stability in patients with reduced vertical facial height. IZC thickness is less affected by gonial angle, but careful angulation is required to avoid sinus perforation. Individualized CBCT assessment is crucial for optimizing TAD placement, enhancing biomechanical outcomes, and minimizing procedural risks.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101137"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976407","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 : 2026-01-12DOI: 10.1016/j.ortho.2025.101136
Stina Hansson , Rune Lindsten , Eva Josefsson , Leja Birk , Maja Ovsenik , Sofia Petrén , Anders Magnuson , Farhan Bazargani
Objectives
To compare the effects of quad helix (QH) anchored on permanent molars versus rapid maxillary expansion (RME) anchored on deciduous teeth on palatal morphology in early mixed dentition patients.
Trial design
A two-arm randomized controlled trial, together with a non-randomized normal bite data for comparison.
Methods
Seventy-one patients (mean age: QH = 9.3 years; RME = 9.4 years) with unilateral posterior crossbite were analysed. The QH group (n = 36) and RME group (n = 35) were evaluated at baseline (T0), post-retention (T2), and one-year post-treatment (T3). A third age- and sex-matched control group (n = 22; mean age = 9.1 years) served as a normative reference. Evaluated outcomes were 3D palatal measurements, as well as treatment success rate and total treatment duration.
Results
Both treatment groups showed significant increases in palatal surface area, projection plane area, and volume from T0 to T3. The RME group experienced a greater increase in palatal surface area (7.0%) compared to the QH group (4.2%) over the same period (P = 0.045). Palatal volume increased notably more in the RME group during active treatment (T0–T2), with an 11.2% gain versus 6.8% in the QH group (P = 0.046). By T3, palatal vault dimensions had normalized in both groups compared to the control group. The RME group completed treatment 97 days earlier than the QH group.
Conclusions
Treatment with either QH or RME resulted in normalized palatal vaults compared to the control group. RME had a significantly shorter treatment time but achieved similar success in correcting posterior crossbite as QH.
This trial was registered at ClinicalTrials.gov (ID NCT04458506) and Researchweb.org (project number 260581).
{"title":"Three-dimensional evaluation of palatal vault changes after unilateral posterior crossbite correction with quad helix or rapid maxillary expansion: A randomized controlled trial with 1-year follow-up","authors":"Stina Hansson , Rune Lindsten , Eva Josefsson , Leja Birk , Maja Ovsenik , Sofia Petrén , Anders Magnuson , Farhan Bazargani","doi":"10.1016/j.ortho.2025.101136","DOIUrl":"10.1016/j.ortho.2025.101136","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the effects of quad helix (QH) anchored on permanent molars versus rapid maxillary expansion (RME) anchored on deciduous teeth on palatal morphology in early mixed dentition patients.</div></div><div><h3>Trial design</h3><div>A two-arm randomized controlled trial, together with a non-randomized normal bite data for comparison.</div></div><div><h3>Methods</h3><div>Seventy-one patients (mean age: QH<!--> <!-->=<!--> <!-->9.3<!--> <!-->years; RME<!--> <!-->=<!--> <!-->9.4<!--> <!-->years) with unilateral posterior crossbite were analysed. The QH group (<em>n</em> <!-->=<!--> <!-->36) and RME group (<em>n</em> <!-->=<!--> <!-->35) were evaluated at baseline (T0), post-retention (T2), and one-year post-treatment (T3). A third age- and sex-matched control group (<em>n</em> <!-->=<!--> <!-->22; mean age<!--> <!-->=<!--> <!-->9.1<!--> <!-->years) served as a normative reference. Evaluated outcomes were 3D palatal measurements, as well as treatment success rate and total treatment duration.</div></div><div><h3>Results</h3><div>Both treatment groups showed significant increases in palatal surface area, projection plane area, and volume from T0 to T3. The RME group experienced a greater increase in palatal surface area (7.0%) compared to the QH group (4.2%) over the same period (<em>P</em> <!-->=<!--> <!-->0.045). Palatal volume increased notably more in the RME group during active treatment (T0–T2), with an 11.2% gain versus 6.8% in the QH group (<em>P</em> <!-->=<!--> <!-->0.046). By T3, palatal vault dimensions had normalized in both groups compared to the control group. The RME group completed treatment 97<!--> <!-->days earlier than the QH group.</div></div><div><h3>Conclusions</h3><div>Treatment with either QH or RME resulted in normalized palatal vaults compared to the control group. RME had a significantly shorter treatment time but achieved similar success in correcting posterior crossbite as QH.</div><div>This trial was registered at ClinicalTrials.gov (ID <span><span>NCT04458506</span><svg><path></path></svg></span>) and Researchweb.org (project number 260581).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101136"},"PeriodicalIF":1.9,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967495","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}
Patients with bimaxillary protrusion often seek orthodontic treatment to improve facial aesthetics. Treatment planning is complex and may involve premolar extractions or bi-jaw distalization using temporary anchorage devices (TADs) and third molar extractions. Choice of modality is partly subjective, particularly in borderline cases.
Objective
To assess pre-treatment arch forms, dentoskeletal, and soft-tissue characteristics for guiding treatment selection between bi-jaw distalization and premolar extraction in borderline bimaxillary protrusion. The secondary objective was to compare these characteristics between the two treatment groups.
Methodology
This retrospective pilot study included all patient records meeting inclusion criteria from January 2022 to December 2024. A total of 26 patients with borderline bimaxillary protrusion were analysed and categorized into two groups: bimaxillary distalization (n = 13) and premolar extraction (n = 13). Pre-treatment CBCT-derived digital models were used for 3D polynomial arch-form analysis, alongside cephalometric assessment. Groups were compared using chi-square tests for categorical data and Student's t-tests for continuous variables.
Results
Among 26 patients (9 males, 17 females; mean age 20.81 ± 3.72 years), square arch forms were more frequent in the bi-jaw distalization group (61.5%; 95% CI: 35.5–82.3). Cephalometric parameters did not differ significantly between groups (P > 0.05). Measurement reliability was high (ICC: 0.76–0.81).
Conclusion
Within this pilot retrospective study, arch form morphology was associated with treatment choice. Evaluating arch form alongside dento-skeletal and soft-tissue features may aid personalized planning for borderline bimaxillary protrusion. These observations are descriptive and non-causal; larger prospective studies are needed to validate pre-treatment arch forms.
{"title":"Assessment of pre-treatment diagnostic characteristics in patients with borderline bimaxillary protrusion: A pilot comparison of bi-jaw distalization versus premolar extraction","authors":"Rajaganesh Gautam , Dhruv Ahuja , Siddarth Shetty , M. Varadraj Ashith , Puneet Batra , G. Chandhini , Anshu Khera , Prasanna Mithra , Nandita Shenoy","doi":"10.1016/j.ortho.2025.101134","DOIUrl":"10.1016/j.ortho.2025.101134","url":null,"abstract":"<div><h3>Background</h3><div>Patients with bimaxillary protrusion often seek orthodontic treatment to improve facial aesthetics. Treatment planning is complex and may involve premolar extractions or bi-jaw distalization using temporary anchorage devices (TADs) and third molar extractions. Choice of modality is partly subjective, particularly in borderline cases.</div></div><div><h3>Objective</h3><div>To assess pre-treatment arch forms, dentoskeletal, and soft-tissue characteristics for guiding treatment selection between bi-jaw distalization and premolar extraction in borderline bimaxillary protrusion. The secondary objective was to compare these characteristics between the two treatment groups.</div></div><div><h3>Methodology</h3><div>This retrospective pilot study included all patient records meeting inclusion criteria from January 2022 to December 2024. A total of 26 patients with borderline bimaxillary protrusion were analysed and categorized into two groups: bimaxillary distalization (<em>n</em> <!-->=<!--> <!-->13) and premolar extraction (<em>n</em> <!-->=<!--> <!-->13). Pre-treatment CBCT-derived digital models were used for 3D polynomial arch-form analysis, alongside cephalometric assessment. Groups were compared using chi-square tests for categorical data and Student's t-tests for continuous variables.</div></div><div><h3>Results</h3><div>Among 26 patients (9 males, 17 females; mean age 20.81<!--> <!-->±<!--> <!-->3.72<!--> <!-->years), square arch forms were more frequent in the bi-jaw distalization group (61.5%; 95% CI: 35.5–82.3). Cephalometric parameters did not differ significantly between groups (<em>P</em> <!-->><!--> <!-->0.05). Measurement reliability was high (ICC: 0.76–0.81).</div></div><div><h3>Conclusion</h3><div>Within this pilot retrospective study, arch form morphology was associated with treatment choice. Evaluating arch form alongside dento-skeletal and soft-tissue features may aid personalized planning for borderline bimaxillary protrusion. These observations are descriptive and non-causal; larger prospective studies are needed to validate pre-treatment arch forms.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101134"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924080","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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