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Assessing colour stability of direct printed and thermoformed aligners: An in vitro study on aesthetics longevity 评价直接印刷和热成型对准器的颜色稳定性:美学寿命的体外研究
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-05 DOI: 10.1016/j.ortho.2025.101105
Bhavani Priya Perumalla, Pradeep Kandikatla, Arun Bhupathi, Anoosha Manda, Praveen Kumar Varma, Hari Babu

Objective

To evaluate and compare the colour stability of direct-printed and thermoformed clear aligners after exposure to common staining agents.

Methods

Clear aligners fabricated using two direct-printed resins, TC85 and TA28 (Graphy Inc., Seoul, Republic of Korea), and one thermoformed aligner, Erkodur (Erkodent, Germany), were tested for colour stability in coffee, curcumin, and 0.2% chlorhexidine mouthwash, with distilled water as control. A total of 132 specimens (n = 11 per group) were immersed in the respective solutions at 37 °C for 7 days. Colour variation (ΔE*) was measured using a spectrophotometer, while molecular and surface changes were analysed using attenuated total reflectance–Fourier transform infrared (ATR-FTIR) spectroscopy and scanning electron microscopy (SEM). Data were analysed using two-way ANOVA with Tukey's post hoc test (P < 0.001).

Results

Thermoformed aligners demonstrated significantly greater colour stability (ΔE* = 2.56; 95% CI: 2.27–2.85; P < 0.001), smoother surface morphology, and superior chemical integrity compared to direct-printed aligners — TC85 (ΔE* = 9.82; 95% CI: 9.53–10.11) and TA28 (ΔE* = 3.59; 95% CI: 3.30–3.88).

Conclusions

Direct-printed aligners exhibited inferior optical and surface properties, influenced by material composition and printing technology. PETG-based thermoformed aligners showed enhanced colour and structural stability, suggesting superior long-term aesthetics performance.

Clinical significance

Discolouration and increased surface roughness in clear aligners can compromise aesthetics, patient compliance, and biomechanical efficiency, underscoring the importance of material selection in aesthetics orthodontic therapy.
目的评价和比较直接印刷和热成型透明对准器在常用染色剂作用下的颜色稳定性。方法采用两种直接印刷树脂TC85和TA28(韩国首尔的Graphy公司)和一种热成型树脂Erkodur(德国的Erkodent公司)制备的透明对准剂,以蒸馏水为对照,在咖啡、姜黄素和0.2%氯己定漱口水中测试其颜色稳定性。132个标本(每组11个)分别在37℃的溶液中浸泡7天。使用分光光度计测量颜色变化(ΔE*),同时使用衰减全反射-傅里叶变换红外(ATR-FTIR)光谱和扫描电子显微镜(SEM)分析分子和表面变化。数据分析采用双因素方差分析和Tukey事后检验(P < 0.001)。结果与直接打印的牙齿矫正剂- TC85 (ΔE* = 9.82; 95% CI: 9.53-10.11)和TA28 (ΔE* = 3.59; 95% CI: 3.30-3.88)相比,热成型牙齿矫正剂表现出更大的颜色稳定性(ΔE* = 2.56; 95% CI: 2.27-2.85; P < 0.001),更光滑的表面形貌和更好的化学完整性。结论受材料组成和印刷工艺的影响,直接打印的对准器光学性能和表面性能较差。基于聚乙二醇的热成型对准器显示出增强的颜色和结构稳定性,表明优越的长期美学性能。临床意义:透明矫正器的变色和表面粗糙度增加会影响美观性、患者依从性和生物力学效率,这强调了美学正畸治疗中材料选择的重要性。
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引用次数: 0
Comparative evaluation of optical property changes in direct printed aligners using two resins: An in vivo investigation 两种树脂直接打印对准器光学性能变化的比较评价:一项体内研究
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-05 DOI: 10.1016/j.ortho.2025.101106
Subashree Rohinikumar, Shanthini Priya Arumugam, Balaji Krishnan, TM Parameswaran, Krishnakumar Mahalakshmi, Aswini Soundharya Sekar

Objective

Understanding the behaviour of different printable resins under clinical simulation is essential for optimal material selection. The study aims to evaluate and compare the optical behaviour of aligners printed using directed printed resins, TA 28 and TC 85.

Material and methods

Study consisted of two groups Group 1 – aligners printed using TC 85 and Group 2 – aligners printed using TA 28 resin. Aligners were designed using Direct Aligner Designer (DAD) software and fabricated with a uniform 0.5 mm thickness. Patients with Class I molar relationships, mild crowding, minimal rotation, and no history of periodontal disease were included in this study. Maxillary intraoral scans were performed using the Aoralscan 3 scanner. Aligners were printed using TA-28 and TC-85 resins and post-cured for 24 minutes with the Tera Harz Cure THC unit (405 nm UV LED). Aligners were air-dried and patients were instructed to wear the aligner for 14 days for 20–22 hrs. Control (unused) samples were fabricated alongside for comparison.

Results

Shapiro–Wilk test confirmed normal data distribution; thus, paired and independent t-tests were applied. Intragroup comparisons showed statistically significant changes (p < 0.001) in all colour parameters (L*, a*, b*) after 14 days of wear in both groups. Intergroup analysis revealed no significant difference in L* values for unused (p = 0.07) or used aligners (p = 0.89). However, a* and b* values differed significantly between the groups (p < 0.001). The mean colour difference (ΔE) between groups was not statistically significant in either condition (p = 0.592).

Conclusion

Aligners printed with TC-85 and TA-28 resins exhibited clinically acceptable colour stability after intraoral use, with ΔE values within aesthetic thresholds. TA-28 showed slightly greater colour change, which may reflect differences in material composition and could inform clinical material selection.
目的了解不同可打印树脂在临床模拟下的行为,对优化材料选择至关重要。该研究旨在评估和比较使用定向打印树脂ta28和tc85打印的对准器的光学性能。材料和方法研究分为两组,第一组是用tc85打印的矫形器,第二组是用ta28树脂打印的矫形器。使用Direct Aligner Designer (DAD)软件设计矫直器,并以均匀的0.5 mm厚度制作。该研究纳入了I级磨牙关系,轻度拥挤,最小旋转,无牙周病史的患者。使用Aoralscan 3扫描仪进行上颌口内扫描。使用TA-28和TC-85树脂打印校准器,并使用Tera Harz Cure THC单元(405 nm UV LED)后固化24分钟。将矫正器风干,指导患者佩戴矫正器14天,持续20-22小时。对照(未使用的)样品制作在一起进行比较。结果shapiro - wilk检验证实数据呈正态分布;因此,采用配对和独立t检验。组内比较显示,两组在磨损14天后,所有颜色参数(L*、a*、b*)的变化均有统计学意义(p < 0.001)。组间分析显示未使用(p = 0.07)和已使用(p = 0.89)校准器的L*值无显著差异。然而,a*和b*值在两组间差异显著(p < 0.001)。两组间的平均色差(ΔE)均无统计学意义(p = 0.592)。结论TC-85和TA-28树脂打印的牙内矫正器在口腔内使用后具有临床可接受的颜色稳定性,其ΔE值在美学阈值内。TA-28的颜色变化稍大,可能反映了材料成分的差异,可以为临床材料选择提供参考。
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引用次数: 0
Shear bond strength of orthodontic metal brackets using Assure® Plus with and without Pro Seal®: An in vitro study 使用Assure®Plus和不使用Pro Seal®的正畸金属托槽的剪切结合强度:一项体外研究
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-05 DOI: 10.1016/j.ortho.2025.101103
Maria Doughan, David Greene, Flavio Copello, Dina Stappert

Objective

To evaluate the shear bond strength (SBS) of orthodontic brackets bonded with Assure Plus® alone and in combination with Pro Seal®, and to assess the adhesive remnant index (ARI) scores following bracket debonding.

Material and methods

This in vitro experimental study included forty-two extracted human premolar teeth, randomly assigned to two bonding groups: the control group (Assure Plus®) and the test group (Assure Plus® with Pro Seal®). After bonding, all specimens were stored at 37 ̊C for 24 h before SBS testing. The Shapiro–Wilk test was used to assess normality, and group comparisons were performed using the Mann–Whitney U test (α = 0.05).

Results

The control group demonstrated a mean SBS of 11.20 ± 2.51 MPa and a mean peak load of 90.09 ± 20.21 N, while the test group (Assure Plus® with Pro Seal®) showed a mean SBS of 10.62 ± 3.56 MPa and a mean peak load of 85.47 ± 32.61 N. The Mann-Whitney U test revealed no statistically significant differences between the groups for either SBS (P = 0.094) or peak load (P = 0.134). Both groups exceeded the clinically acceptable SBS threshold of 6–8 MPa. ARI scores were identical between groups, with 95% of samples scoring 2 and 5% scoring 1, indicating adhesive failures with more than 50% of the adhesive remaining on the tooth surface.

Conclusion

The combination of Pro Seal® and Assure Plus®, as recommended for bonding to atypical enamel surfaces, produced bond strengths comparable to Assure Plus® alone. These findings support its use as a clinically acceptable bonding protocol in orthodontic practice.
目的评价单独使用Assure Plus®和联合使用Pro Seal®的正畸托槽的剪切粘接强度(SBS),并评价托槽脱粘后的粘接残余指数(ARI)评分。材料与方法本体外实验研究包括42颗拔除的人前磨牙,随机分为两组:对照组(Assure Plus®)和试验组(Assure Plus®with Pro Seal®)。粘接后,37℃保存24 h,进行SBS测试。正态性采用Shapiro-Wilk检验,组间比较采用Mann-Whitney U检验(α = 0.05)。结果对照组平均SBS为11.20±2.51 MPa,平均峰值负荷为90.09±20.21 N;试验组(Assure Plus®+ Pro Seal®)平均SBS为10.62±3.56 MPa,平均峰值负荷为85.47±32.61 N。Mann-Whitney U检验显示,两组SBS (P = 0.094)和峰值负荷(P = 0.134)差异均无统计学意义。两组均超过临床可接受的6-8 MPa的SBS阈值。两组间的ARI评分相同,95%的样本得分为2分,5%的样本得分为1分,表明粘接剂失效,超过50%的粘接剂残留在牙齿表面。结论Pro Seal®和Assure Plus®的结合,推荐用于非典型牙釉质表面的结合,产生的结合强度可与单独使用Assure Plus®相媲美。这些发现支持其作为临床可接受的粘接协议在正畸实践。
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引用次数: 0
Facial soft tissue changes in patients following rapid maxillary expansion in children: A systematic review 儿童上颌快速扩张后患者面部软组织的改变:一项系统综述
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-05 DOI: 10.1016/j.ortho.2025.101107
Nafisa Marium Molla , Raisa Queiroz Catunda , Karla Carpio Horta , Heesoo Oh , Manuel O. Lagravère

Background

Non-surgical rapid maxillary expansion (RME) has been widely investigated regarding skeletal effects, although fewer studies have assessed the associated soft tissue changes, which is an important factor to consider, as orthodontic treatment aims to achieve occlusal harmony and an aesthetically pleasing soft tissue balance. This systematic review examines the existing literature on facial soft tissue changes following rapid maxillary expansion (RME) in children with a maxillary transverse deficiency.

Material and methods

A systematic search was conducted up to July 2025 in four major databases, including Embase (via Ovid), Medline (via Ovid), PubMed, Cochrane Library, and Google Scholar. Studies focused on children receiving RME were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for the Risk of Bias in Non-randomized Studies of Interventions. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines.

Results

Of the 1379 articles found, 15 included PICOS-based inclusion criteria: five randomized controlled trials, four cohort studies, and six controlled clinical trials. Alar width (0.5 to 2.21 mm), alar base width (0.17 to 2.81 mm), and nasolabial angle (0.9 degrees) increased significantly after RME treatment. Five studies were found to have a low risk of bias, seven had a moderate risk of bias, one had a serious risk of bias, and two had some concerns.

Conclusions

Our findings suggest that RME results in variable soft tissue facial changes over time. The findings resulted statistically significant for alar width, alar base width, and nasolabial angle, showing changes in the facial soft tissues after non-surgical rapid maxillary expansion, especially in the nasal area. These results, which are directly related to the anatomical effects of the rapid maxillary expansion, need careful consideration by clinicians as the skeletal and the consequent soft tissue changes may be influenced by different factors, i.e. patient age, appliance activation and follow-up duration.
PROSPERO reference number: CRD42024505738.
背景非手术快速上颌扩张术(RME)对骨骼的影响已经被广泛研究,尽管很少有研究评估相关的软组织变化,这是一个重要的考虑因素,因为正畸治疗的目的是实现咬合和谐和美观的软组织平衡。本文系统回顾了上颌横向缺陷儿童快速扩张(RME)后面部软组织变化的现有文献。材料与方法系统检索截至2025年7月的Embase(通过Ovid)、Medline(通过Ovid)、PubMed、Cochrane Library和b谷歌Scholar四大数据库。研究的重点是接受RME的儿童。使用随机试验的修订Cochrane偏倚风险工具和非随机干预研究的ROBINS-I偏倚风险工具评估偏倚风险。本综述遵循了系统评价和荟萃分析(PRISMA)指南推荐的方案。结果在1379篇文献中,15篇纳入picos纳入标准:5项随机对照试验、4项队列研究和6项对照临床试验。鼻翼宽度(0.5 ~ 2.21 mm)、鼻翼基部宽度(0.17 ~ 2.81 mm)、鼻唇角(0.9°)在RME治疗后显著增加。五项研究发现有低偏倚风险,七项有中等偏倚风险,一项有严重偏倚风险,两项有一些担忧。结论RME可导致面部软组织随时间的变化。鼻翼宽度、鼻翼底宽度和鼻唇角均有统计学意义,显示非手术上颌快速扩张后面部软组织的变化,尤其是鼻腔区域。这些结果与上颌快速扩张的解剖学效应直接相关,需要临床医生仔细考虑,因为骨骼和随之而来的软组织变化可能受到不同因素的影响,如患者年龄、矫治器激活和随访时间。普洛斯彼罗参考编号:CRD42024505738。
{"title":"Facial soft tissue changes in patients following rapid maxillary expansion in children: A systematic review","authors":"Nafisa Marium Molla ,&nbsp;Raisa Queiroz Catunda ,&nbsp;Karla Carpio Horta ,&nbsp;Heesoo Oh ,&nbsp;Manuel O. Lagravère","doi":"10.1016/j.ortho.2025.101107","DOIUrl":"10.1016/j.ortho.2025.101107","url":null,"abstract":"<div><h3>Background</h3><div>Non-surgical rapid maxillary expansion (RME) has been widely investigated regarding skeletal effects, although fewer studies have assessed the associated soft tissue changes, which is an important factor to consider, as orthodontic treatment aims to achieve occlusal harmony and an aesthetically pleasing soft tissue balance. This systematic review examines the existing literature on facial soft tissue changes following rapid maxillary expansion (RME) in children with a maxillary transverse deficiency.</div></div><div><h3>Material and methods</h3><div>A systematic search was conducted up to July 2025 in four major databases, including Embase (via Ovid), Medline (via Ovid), PubMed, Cochrane Library, and Google Scholar. Studies focused on children receiving RME were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for the Risk of Bias in Non-randomized Studies of Interventions. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines.</div></div><div><h3>Results</h3><div>Of the 1379 articles found, 15 included PICOS-based inclusion criteria: five randomized controlled trials, four cohort studies, and six controlled clinical trials. Alar width (0.5 to 2.21<!--> <!-->mm), alar base width (0.17 to 2.81<!--> <!-->mm), and nasolabial angle (0.9 degrees) increased significantly after RME treatment. Five studies were found to have a low risk of bias, seven had a moderate risk of bias, one had a serious risk of bias, and two had some concerns.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that RME results in variable soft tissue facial changes over time. The findings resulted statistically significant for alar width, alar base width, and nasolabial angle, showing changes in the facial soft tissues after non-surgical rapid maxillary expansion, especially in the nasal area. These results, which are directly related to the anatomical effects of the rapid maxillary expansion, need careful consideration by clinicians as the skeletal and the consequent soft tissue changes may be influenced by different factors, i.e. patient age, appliance activation and follow-up duration.</div><div>PROSPERO reference number: CRD42024505738.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101107"},"PeriodicalIF":1.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684806","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
Ex vivo evaluation of the antimicrobial properties, physical and mechanical characteristics, and cytotoxicity of orthodontic cement containing silibinin against Streptococcus mutans biofilm 含水飞蓟宾正畸骨水泥对变形链球菌生物膜的抗菌性能、物理力学特性和细胞毒性的体外评价。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-02 DOI: 10.1016/j.ortho.2025.101108
Sara Saeid Parizi , Rashin Bahrami , Maryam Pourhajibagher , Abbas Bahador

Background and objectives

White spot lesions are common complications around orthodontic brackets, caused by Streptococcus mutans. The main aim of this study was to evaluate the antimicrobial properties of orthodontic light-cured resin-modified glass ionomer cement (RMGIC) containing silibinin against S. mutans biofilm. Secondary objectives included assessing the physicomechanical properties (such as shear bond strength and fluoride release) and the cytotoxicity of the modified RMGIC.

Material and methods

The liquid component of the RMGIC was combined with varying concentrations of silibinin (0%, 1%, 2%, and 5%). The antimicrobial effect was assessed using the biofilm inhibition test, measuring colony-forming units (CFU)/mL. Shear bond strength (SBS) was determined using a universal testing machine, while adhesive remnant index (ARI) scores were evaluated under a stereomicroscope. Fluoride release was measured at 1, 7, 15, and 30 days using the pH/ion meter. Cytotoxicity was assessed using an indirect MTT assay on human gingival fibroblast (HGF) cells.

Results

The lowest bacterial colony count was observed in the chlorhexidine group (2.50 ± 1.60 × 105 CFU/mL; CI:95%), followed by the RMGIC containing 5% silibinin (2.87 ± 5.11 × 106 CFU/mL; CI:95%). Although the addition of silibinin at different concentrations reduced the SBS in a dose-dependent manner, there were no significant differences between the SBS of composite resin – the gold standard adhesive for bracket bonding – and that of RMGIC containing silibinin at any concentration (P = 0.70). The most common ARI scores in all groups were 1 and 2, and cohesive failure was the predominant mode of failure. The incorporation of silibinin into RMGIC did not alter the fluoride release pattern, and none of the silibinin concentrations exhibited cytotoxic effects on HGF cells.

Conclusion

RMGIC containing 5% silibinin effectively reduced S. mutans biofilm around orthodontic brackets without adversely affecting its physical-mechanical properties and showed no toxicity to HGF cells.
背景与目的:白斑病变是口腔正畸托槽周围常见的并发症,由变形链球菌引起。本研究的主要目的是评价含水飞蓟宾的正畸光固化树脂改性玻璃离子水合物(RMGIC)对变形链球菌生物膜的抗菌性能。次要目标包括评估改性RMGIC的物理力学性能(如剪切键合强度和氟化物释放)和细胞毒性。材料和方法:将RMGIC的液体组分与不同浓度的水飞蓟宾(0%、1%、2%和5%)混合。采用生物膜抑制试验,测定菌落形成单位(CFU)/mL,评估抗菌效果。剪切粘接强度(SBS)采用通用试验机测定,粘接残余指数(ARI)采用体视显微镜测定。在第1、7、15和30天使用pH/离子计测量氟化物释放。使用间接MTT法对人牙龈成纤维细胞(HGF)细胞进行细胞毒性评估。结果:细菌菌落计数以氯己定组最低(2.50±1.60×105 CFU/mL, CI:95%),其次为含有5%水飞蓟宾的RMGIC(2.87±5.11×106 CFU/mL, CI:95%)。虽然添加不同浓度的水飞蓟宾能以剂量依赖性的方式降低SBS,但复合树脂(支架粘接的金标准粘合剂)与含有水飞蓟宾的RMGIC在任何浓度下的SBS均无显著差异(P=0.70)。所有组中最常见的ARI评分为1分和2分,内聚性失败是主要的失败模式。水飞蓟宾在RMGIC中的掺入没有改变氟化物的释放模式,水飞蓟宾浓度对HGF细胞没有细胞毒性作用。结论:含5%水飞蓟宾的RMGIC可有效减少正畸托槽周围变形链球菌生物膜,且不影响其物理力学性能,对HGF细胞无毒性。
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引用次数: 0
Post-treatment aesthetic outcomes in palatally displaced canines exposed by open versus closed surgical technique: A prospective cohort study and a survey 开放与封闭手术技术暴露腭移位犬的治疗后美学结果:一项前瞻性队列研究和调查。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-02 DOI: 10.1016/j.ortho.2025.101104
Margitha Björksved , Bei Yang , Lars Hjalmarsson , Rune Lindsten , Anders Magnusson , Farhan Bazargani

Background

The multidisciplinary treatment of palatally displaced canines (PDCs) involves choosing between open and closed surgical exposure.

Aim

To compare post-treatment aesthetic outcomes between PDC exposed by open and by closed surgical exposure.

Methods

A digital survey was distributed to two respondent groups — orthodontists and laypeople — to evaluate PDC post-treatment appearance outcomes. The survey featured 62 series of three intra-oral post-treatment images taken at debonding and four years later, with 31 PDC cases per surgical exposure group. Patients were on average 13 years old at time of surgical exposure and were part of a multicentre RCT comparing clinical outcomes between the two exposure techniques. Both surgical exposure methods involved mucoperiosteal flaps and bone removal above the PDCs.

Results

The respondent groups’ ability to identify surgically exposed canines, as well as the ratings of “unexposed looking better than exposed canine,” achieved proportions below chance. Orthodontists demonstrated better identification ability than laypeople (P = 0.013), with higher odds of correctly identifying exposed canines, odds ratio (OR) of 3.2 (95% CI 1.5–7.1, P = 0.003) and rating “better-looking unexposed contralateral canines” in open exposure compared to closed exposure technique, OR of 4.3 (95% CI 1.8–10.2, P = 0.001).

Conclusions

The results support free preference in choosing surgical exposure methods, indicating that aesthetic factors are not the main consideration in clinical practice. However, orthodontists found the PDCs treated with the closed technique more appealing.

Clinical trial registration

Researchweb.org, ID: 278893.
背景:腭移位犬(PDCs)的多学科治疗涉及开放式和闭合性手术暴露的选择。目的:比较开放式和闭式PDC手术暴露后的美观效果。方法:一份数字调查分发给两组受访者-正畸医生和外行人-评估PDC治疗后的外观效果。该调查包括62组在脱粘时和四年后拍摄的三组口腔内治疗后图像,每个手术暴露组有31例PDC病例。手术暴露时患者的平均年龄为13岁,这是比较两种暴露技术临床结果的多中心随机对照试验的一部分。这两种手术暴露方法都涉及粘骨膜瓣和PDCs上方的骨切除。结果:受访者群体识别手术暴露的狗的能力,以及“未暴露的狗看起来比暴露的狗更好”的评级,达到了低于概率的比例。正畸医师的识别能力优于非专业人员(P=0.013),正确识别暴露犬的几率更高,优势比(OR)为3.2 (95% CI 1.5-7.1, P=0.003),与封闭暴露技术相比,开放暴露技术的“未暴露的对侧犬更漂亮”评分,OR为4.3 (95% CI 1.8-10.2, P=0.001)。结论:结果支持自由选择手术暴露方式,表明美观因素不是临床实践的主要考虑因素。然而,正畸医生发现封闭技术治疗PDCs更有吸引力。临床试验注册:Researchweb.org, ID: 278893。
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引用次数: 0
Prediction of unerupted canine and premolars width using artificial intelligence compared with Tanaka–Johnston and Moyers methods: A retrospective observational analytical study on Iranian population 人工智能预测未出牙和前磨牙宽度与Tanaka-Johnston和Moyers方法的比较:对伊朗人群的回顾性观察分析研究。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-20 DOI: 10.1016/j.ortho.2025.101094
Majid Mahmoudzadeh , Shabnam Yousefi , Maryam Farhadian , Ali Ashkan

Introduction

Accurate prediction of unerupted teeth widths significantly contributes to formulating optimal treatment plan during mixed dentition phase. The ability of artificial intelligence to identify hidden patterns and both linear and non-linear relationships can be particularly advantageous in this context.

Methods

In this retrospective observational study, pre-treatment dental casts of 336 orthodontic patients were scanned using a 3D scanner. The mesiodistal dimensions of each tooth were measured digitally, and the values for the left and right sides were averaged. These measurements, along with the patients’ sex, were then used to train machine learning and regression models with various architectures. The dimensions of teeth #1, #2, #6 and a binary value representing patients’ sex were used as input features to predict the sum of widths of teeth #3, #4, and #5 during the model training phase. The performance of the model was evaluated by calculating the mean absolute error (MAE) between the predicted values and the actual measurements obtained from the casts. Model performance was compared with Tanaka–Johnston equation and Moyers prediction tables.

Results

Among the tested models, the Support Vector Machine showed the highest accuracy in predicting lower arch tooth sizes, achieving a MAE of 0.65 mm and Standard Deviation (SD) of 0.82 mm. For the upper arch, the Linear Regression model performed best with a MAE of 0.64 mm and a SD of 0.80 mm.

Conclusion

Our findings demonstrate that machine learning-based regression techniques offer superior accuracy in predicting the dimensions of unerupted teeth compared to traditional methods, making them a valuable tool for treatment planning in mixed dentition.
介绍:准确预测未出牙宽度对混合牙列阶段制定最佳治疗方案有重要意义。在这种情况下,人工智能识别隐藏模式以及线性和非线性关系的能力尤其有利。方法:对336例正畸患者的治疗前牙模进行三维扫描。数字测量每颗牙齿的中远端尺寸,取左右两侧的平均值。然后,这些测量结果以及患者的性别被用于训练具有各种架构的机器学习和回归模型。在模型训练阶段,使用牙齿#1、#2、#6的尺寸和代表患者性别的二值作为输入特征来预测牙齿#3、#4和#5的宽度之和。通过计算模型预测值与实际测量值之间的平均绝对误差(MAE)来评价模型的性能。模型性能与Tanaka-Johnston方程和Moyers预测表进行比较。结果:在测试的模型中,支持向量机预测下牙弓尺寸的准确率最高,MAE为0.65mm,标准差(Standard Deviation, SD)为0.82mm。对于上弓,线性回归模型的MAE为0.64mm, SD为0.80mm。结论:我们的研究结果表明,与传统方法相比,基于机器学习的回归技术在预测未出牙的尺寸方面具有更高的准确性,使其成为混合牙列治疗计划的宝贵工具。
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引用次数: 0
Optimization of the effectiveness of lower canine retraction: A FEM comparison of different attachment systems with no attachments in clear aligners 优化下犬科内收的有效性:不同的附着系统与无附着在清晰对准器的有限元比较。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-20 DOI: 10.1016/j.ortho.2025.101090
Muskan Chanduka, Srirengalakshmi Muthuswamy Pandian, Aravind Kumar Subramanian, Nikhillesh Vaiid

Objective

The objective of this study is to assess the biomechanical efficacy of different attachment systems in facilitating the lower canine retraction using clear aligners by means of a finite element method (FEM) analysis.

Methods

A FEM was developed by utilizing intraoral scan data and CBCT data from an 18-year-old female with ideal occlusion. Four experimental groups were assessed: group 1 (unattached), group 2 (single vertical rectangular attachment), group 3 (double vertical rectangular attachments), and group 4 (optimized quarter-ellipsoid attachments). The study evaluated the stress distribution, plastic deformation and displacement of the crown and root during simulated canine retraction.

Results

Highest bodily translation (85–90%) was observed with optimized attachments (group 4) attaining nearly equal crown and root displacement. Tipping was observed in group 1, less of bodily movement was seen (60–65%) compared to group 2, which demonstrated better physiological translation (70–75%), while group 3 further enhanced efficiency to 75–80%. Group 4 exhibited the most uniform stress distribution, and plastic deformation was minimal (0.01 mm), suggesting superior force application and aligner stability.

Conclusion

The efficiency of canine retraction was considerably improved by optimized quarter-ellipsoid attachments, which resulted in minimal stress concentration and deformation. These findings substantiate the use of optimized attachments to improve the results of clear aligner treatment. Further clinical research is advised to verify these findings and investigate alternative attachment designs and materials to optimize aligner therapy.
目的:本研究的目的是通过有限元法(FEM)分析,评估不同附着系统在使用透明对准器促进下犬后收的生物力学效果。方法:利用一名18岁女性理想咬合患者的口内扫描资料和CBCT资料,建立有限元模型。实验分为四组:1组(未贴附)、2组(单垂直矩形贴附)、3组(双垂直矩形贴附)、4组(优化四分之一椭球贴附)。研究了模拟拔牙过程中牙冠和牙根的应力分布、塑性变形和位移。结果:使用优化的附着体(第4组),观察到最高的身体平移(85-90%),获得几乎相等的冠和根位移。在第一组中观察到小费,与第二组相比,看到的身体运动较少(60-65%),表现出更好的生理转化(70-75%),而第三组进一步提高了效率,达到75-80%。第4组的应力分布最均匀,塑性变形最小(0.01mm),表明矫直器的受力和稳定性较好。结论:优化后的四分之一椭球体附着体可显著提高犬科内收的效率,使应力集中和变形最小。这些发现证实了使用优化的附着体可以改善透明矫正器治疗的结果。建议进一步的临床研究来验证这些发现,并研究替代的附着设计和材料,以优化矫正器治疗。
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引用次数: 0
Assessing the effectiveness of smart retainers for orthodontic retention: A systematic review and meta-analysis 评估智能固位器对正畸固位的有效性:一项系统回顾和荟萃分析。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-20 DOI: 10.1016/j.ortho.2025.101093
Ashish Kumar Singh , Dhruv Ahuja , Puneet Batra , Yeshtha Chaudhary , Soumya Shekhar

Objective

To evaluate the effectiveness of smart retainers in enhancing patient compliance during the retention phase of orthodontic treatment through objective measurement and behavioural feedback mechanisms.

Methodology

A systematic search of PubMed, Scopus, Web of Science, EBSCOhost, and the Cochrane Library identified studies from the past 20 years. Eligible studies included randomized controlled trials, cohort studies, and observational designs assessing smart retainers with integrated sensors. Two independent reviewers conducted screening, data extraction, and quality assessment using the ROB-2 and JBI tool. Certainty of evidence for key outcomes (wear-time, relapse, periodontal indices) was assessed using the GRADE framework.

Results

Fifteen studies evaluated smart systems including TheraMon®, Smart Retainer®, DentiTrac®, and Air Aid®. TheraMon® demonstrated the highest tracking accuracy and ease of integration. Short-term compliance improved when patients were aware of monitoring, whereas reminder systems showed mixed effectiveness. Meta-analysis of eight studies (439 participants) showed no statistically significant improvement in wear-time (SMD = 0.21, 95% CI −0.39 to 0.81; MD = 0.49 h/day, 95% CI −0.61 to 1.59; I2 = 85–88%). Meta-regression indicated no significant association between study-level average wear-time and effect size (P = 0.337). Leave-one-out analysis confirmed robustness. One study linked extended wear-time to reduced relapse.

Conclusion

Smart retainers enhance objective wear-time monitoring, but current evidence does not confirm consistent compliance improvement. Some systems appear accurate and clinically feasible; however, pooled results are non-significant and heterogeneous. Benefits should be considered uncertain, and further well-designed, long-term RCTs are needed to establish their impact on relapse prevention and treatment stability.

Prospero registration

CRD420251029140.
目的:通过客观测量和行为反馈机制,评价智能固位器在正畸治疗固位期提高患者依从性的有效性。方法:对PubMed, Scopus, Web of Science, EBSCOhost和Cochrane图书馆进行系统搜索,确定了过去20年的研究。符合条件的研究包括随机对照试验、队列研究和评估集成传感器的智能固位器的观察性设计。两名独立的审稿人使用rob2和JBI工具进行筛选、数据提取和质量评估。使用GRADE框架评估关键结局(磨损时间、复发、牙周指数)证据的确定性。结果:15项研究评估了智能系统,包括TheraMon®,smart Retainer®,DentiTrac®和Air Aid®。TheraMon®展示了最高的跟踪精度和易于集成。当患者意识到监测时,短期依从性得到改善,而提醒系统的效果参差不齐。8项研究(439名参与者)的荟萃分析显示,磨损时间没有统计学意义上的改善(SMD=0.21, 95% CI -0.39至0.81;MD=0.49h/天,95% CI -0.61至1.59;I2=85-88%)。meta回归显示,研究水平平均磨损时间与效应大小之间无显著关联(P=0.337)。留一分析证实了稳健性。一项研究将延长佩戴时间与减少复发联系起来。结论:智能固位器增强了客观的磨损时间监测,但目前的证据并不能证实一致性的依从性改善。一些系统似乎是准确的和临床可行的;然而,合并结果是不显著的和异构的。获益应被认为是不确定的,需要进一步设计良好的长期随机对照试验来确定其对复发预防和治疗稳定性的影响。普洛斯彼罗注册:CRD420251029140。
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引用次数: 0
In vivo 3D apical displacement of mandibular incisors and canines within the symphyseal region: A CBCT-based linear measurement technique (mm) — Validation study in five patients 下颌切牙和犬齿联合区的体内三维根尖位移:基于cbct的线性测量技术(mm) - 5例患者的验证研究。
IF 1.9 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-20 DOI: 10.1016/j.ortho.2025.101086
Gaston Federico Coutsiers Morell, Kevin Chen, Carlos Flores-Mir

Objective

The objective of this study is to develop and validate a technique that orthodontic clinicians and researchers could use to measure lower anterior teeth apical displacement through CBCT reconstructions.

Material and methods

This is an in vivo study in which lower incisors, canines, and symphyses of five randomly selected patients were three-dimensional (3D) reconstructed through an automatic segmentation with a manual refinement process. All the images were generated from 0.3 mm voxel size cone-beam computed tomography (CBCT) imaging. A 3D coordinate system based on CBCT segmentation and landmarks allowed a spatial localization of the apices and quantification of their displacement during orthodontic treatment. The primary outcomes were the intra- and inter-reliabilities and the respective measurement errors.

Results

The overall results showcased good to excellent reliability for both intra- and inter-rater reliability analyses (9.91% and 7.33% measurement errors respectively).

Conclusion

The proposed technique could be used for 3D measurements of the apical displacement of lower anterior teeth during orthodontic treatment. The identified measurement error of less than 10% is not clinically relevant in most orthodontic situations.
目的:本研究的目的是开发和验证一种技术,使正畸临床医生和研究人员可以通过CBCT重建来测量下前牙的根尖位移。材料和方法:本研究是一项活体研究,随机选择5例患者,通过人工精细过程的自动分割,对下门牙、犬齿和联合进行三维重建。所有图像均由0.3mm体素大小的锥形束计算机断层扫描(CBCT)成像生成。基于CBCT分割和地标的三维坐标系统允许在正畸治疗过程中对根尖进行空间定位和量化其位移。主要结果是内部信度和相互信度以及各自的测量误差。结果:整体信度分析结果为良好至优异,测量误差分别为9.91%和7.33%。结论:该方法可用于正畸治疗中下前牙根尖位移的三维测量。在大多数正畸情况下,确定的测量误差小于10%与临床无关。
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引用次数: 0
期刊
International Orthodontics
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