International Orthodontics最新文献

{"title":"The influence of protective coatings on corrosion resistance in orthodontic magnets: A systematic review of in vitro studies","authors":"Jack Slaymaker,&nbsp;Emile Rossouw,&nbsp;Dimitrios Michelogiannakis","doi":"10.1016/j.ortho.2025.101080","DOIUrl":"10.1016/j.ortho.2025.101080","url":null,"abstract":"<div><h3>Objective</h3><div>This review evaluates the effectiveness of protective coatings in enhancing the corrosion resistance of neodynium-iron-boron (Nd₂Fe₁₄B) and samarium cobalt (SmCo₅) magnets in orthodontics.</div></div><div><h3>Methods</h3><div>In accordance with PRISMA guidelines, a structured search was conducted on PubMed, EMBASE, Web of Science, and the Cochrane Library. Eligible studies included peer-reviewed research on corrosion resistance, cytotoxicity, or durability of coated magnets. Twelve studies were assessed for bias using the QUIN tool.</div></div><div><h3>Results</h3><div>Coatings such as zirconium dioxide (ZrO₂), zirconium nitride (ZrN), diamond-like carbon (DLC), silanization, parylene, and PTFE enhanced corrosion resistance, limited ion release, and maintained mechanical function. ZrO₂ and ZrN had the highest resistance, while DLC provided superior durability. Parylene and epoxy resin showed lower mechanical stress resilience. The predominance of in vitro data limits clinical application.</div></div><div><h3>Conclusions</h3><div>Coatings enhance the durability and safety of rare-earth magnets in orthodontics. However, limited in vivo evidence and inconsistencies in testing are challenges. Future research should focus on long-term studies and multifunctional coatings optimizing corrosion resistance, biocompatibility, and mechanical performance.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101080"},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259562","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}

{"title":"Comparison of differential and conventional rapid maxillary expansion on upper airway dimensions in children with bilateral complete cleft lip and palate: A CBCT-based secondary analysis of a clinical trial","authors":"Denise Caffer ,&nbsp;Daniela Garib ,&nbsp;Carolina Faber ,&nbsp;Alexandre Meireles Borba ,&nbsp;Luiz Volpato ,&nbsp;Rita de Cássia Moura Carvalho Lauris ,&nbsp;Araci Malagodi de Almeida ,&nbsp;Rafael Guerra Lund","doi":"10.1016/j.ortho.2025.101063","DOIUrl":"10.1016/j.ortho.2025.101063","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to compare the changes in upper airway dimensions produced by conventional expanders (CE) and differential expanders (DE, which display two parallel jackscrews) in children with bilateral cleft lip and palate (BCLP).</div></div><div><h3>Materials and methods</h3><div>The initial clinical trial sample included 50 patients with complete BCLP who were treated with RME before the secondary bone graft procedure at a single centre—Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP). The patients were divided into two groups. Group DE were treated with differential expanders, while Group CE received Hyrax expansion during pre-bone graft orthodontics. Pre-expansion (T1) and six months post-expansion (T2) cone-beam computed tomography (CBCT) images were analysed to assess upper airway dimensions, including the nasal cavity, nasopharynx, oropharynx, and total pharyngeal space. Intergroup comparisons were performed using independent T-tests (α<!--> <!-->=<!--> <!-->0.004).</div></div><div><h3>Results</h3><div>Of the initial 50 patients, the final Group DE consisted of 20 patients with a mean age of 9.07<!--> <!-->years while the CE group included 19 patients (13 males and 6 females), with a mean initial age of 9.19<!--> <!-->years. No statistically significant differences were observed between the changes of the two groups in the analysed variables, indicating that both expanders had similar effects on increasing upper airway dimensions.</div></div><div><h3>Conclusion</h3><div>Both CE and DE effectively increase upper airway dimensions in BCLP patients. These findings support that the choice of expander should be guided by the dental upper arch shape and the clinician's preferences.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101063"},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259540","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}

{"title":"Fixed orthodontics in a Class II Division 2 young adult with Brodie's occlusion and three-dimensional anomalies using a Herbst appliance and miniscrew: A case report","authors":"Yunlin Guan ,&nbsp;Wei Liu ,&nbsp;Ting Sang ,&nbsp;Jun Wu ,&nbsp;Shiyun Peng","doi":"10.1016/j.ortho.2025.101078","DOIUrl":"10.1016/j.ortho.2025.101078","url":null,"abstract":"<div><div>In this case report, we described the successful treatment of a 17-year-old male with Class II Division 2 and a Brodie occlusion, with bilateral scissor bite, maxillomandibular transverse discrepancy, deep overbite and Class II molar relationship, using a fixed Herbst appliance. The treatment was carried out in two phases. In the first phase, the Herbst appliance was used to advance the mandible, correcting the sagittal relationship while simultaneously improving transverse and vertical discrepancies, with minimal reliance on patient compliance. In the second phase, fixed appliances combined with temporary anchorage devices (TADs) were employed to refine tooth alignment, coordinate the arches, and achieve a stable occlusion. Following treatment, all objectives were achieved, including complete correction of the bilateral scissors-bite, normalization of overjet and overbite, coordinated arch forms, and bilateral Class I molar relationships. The patient's facial profile and smile aesthetics were notably improved. Stability was confirmed after a 3-year retention period. This case highlights the effectiveness of Herbst therapy followed by TAD-assisted orthodontics in achieving functional correction, aesthetic enhancement, and long-term stability in patients with Brodie bite and complex three-dimensional discrepancies.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101078"},"PeriodicalIF":1.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259559","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}

{"title":"Multidisciplinary orthodontic and prosthetic treatment of an eleven-year-old patient with a solitary median maxillary central incisor: A case report","authors":"Miltiadis A. Makrygiannakis ,&nbsp;Nikolaos Gogolas ,&nbsp;Platon-Timotheos Perdikaris ,&nbsp;Alexandros Kostis ,&nbsp;Athanasios E. Athanasiou ,&nbsp;Eleftherios G. Kaklamanos","doi":"10.1016/j.ortho.2025.101069","DOIUrl":"10.1016/j.ortho.2025.101069","url":null,"abstract":"<div><div>Solitary median maxillary central incisor (SMMCI) syndrome is a rare developmental disorder in which a patient presents with only one upper central incisor located in the midline, along with some other features – such as deviant sella turcica and pituitary gland morphology, panhypopituitarism, hypothyroidism, and hypoplasia of the inner genitals – that may or may not be present. Although some authors consider it a mild manifestation of holoprosencephaly, others classify it as a distinct entity. The aim of this case report is to describe the orthodontic treatment of an 11-year-old female patient with SMMCI. The patient presented with early permanent dentition, Class II, division 2, subdivision (left) malocclusion on a Class I skeletal pattern, a solitary median maxillary central incisor, and moderate crowding in the lower dental arch. Orthodontic treatment was carried out using fixed appliances, involving the creation of space for an additional maxillary central incisor and the correction of Class II malocclusion through the application of intermaxillary elastics. By the end of treatment, Class I canine and molar relationships had been achieved, the overjet and overbite became optimal, and a one-wing Maryland bridge was placed in the area of the left maxillary central incisor. Regarding retention, a lower fixed retainer from canine to canine and upper and lower vacuum-formed appliances were used. In conclusion, this case report highlights the importance of coordinated care among dental specialists for effectively treating solitary median maxillary central incisor cases.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101069"},"PeriodicalIF":1.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253245","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}

{"title":"Patient-reported outcome measures of accelerated upper canine retraction with low-amperage electrical stimulation: A randomized controlled trial","authors":"Mohammad N. Kheshfeh ,&nbsp;Mohammad Y. Hajeer ,&nbsp;Mohammad Khursheed Alam ,&nbsp;Mhd Firas Al Hinnawi ,&nbsp;Youssef Latifeh","doi":"10.1016/j.ortho.2025.101077","DOIUrl":"10.1016/j.ortho.2025.101077","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Interest in accelerating orthodontic tooth movement has been increasing, with a particular focus on methods that prioritize high-quality patient-reported outcomes. Among these, low-amperage electrical stimulation (LAES) emerges as a promising technique. However, the patient-reported outcome measures related to its intraoral application remain largely unexplored.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;This randomized controlled trial evaluated the clinical tolerance and patient-reported outcomes of an intraoral LAES device during maxillary canine retraction. Pain perception during the early phase (A1–A3) was designated as the primary outcome. Secondary outcomes included discomfort, swallowing, chewing, and speech difficulties, analgesic use, overall satisfaction, and willingness to recommend the procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and Trial design&lt;/h3&gt;&lt;div&gt;A two-arm randomized controlled clinical trial with a 3-month follow-up. Thirty-six adults (17–28&lt;!--&gt; &lt;!--&gt;years) with Class II Division 1 malocclusion requiring bilateral maxillary first premolar extraction were randomized to LAES (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;18) or control (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;18). Patient-reported outcomes were recorded at nine time points (A1–C3). Pain (primary outcome) was analysed using a linear mixed-effects model, with clinical significance defined a priori as ±20&lt;!--&gt; &lt;!--&gt;mm on the 100-mm VAS. Equivalence was assessed using the two one-sided tests procedure with 90% confidence intervals. Secondary outcomes were summarized descriptively with between-group mean differences and 90%/95% CIs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Pain scores were lower in the LAES group at several early assessments (notably A1–A3), but between-group differences did not exceed the ±20&lt;!--&gt; &lt;!--&gt;mm clinical threshold. Equivalence was not confirmed at A1 and A2 but was supported from A3 onward. Discomfort was greater in the LAES group during initial intervals, with confidence intervals exceeding the equivalence margin, indicating clinically relevant short-term limitations. Swallowing and chewing difficulties remained mild and clinically negligible. Speech difficulty was significantly higher in the LAES group during the first week but declined thereafter, consistent with adaptation. Analgesic intake was minimal in both groups. Despite these transient drawbacks, satisfaction was high, and all participants indicated willingness to recommend the procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Harms&lt;/h3&gt;&lt;div&gt;No systemic adverse events occurred during the trial; one patient experienced palatal abrasion that resolved without sequelae.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The LAES device was safe and generally well tolerated. While it did not provide clinically meaningful reductions in pain, it was associated with greater early discomfort and speech difficulty, both of which diminished with continued use. Patient satisfaction remained high, suggesting good overall acceptabi","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101077"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223355","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}

{"title":"Are answers obtained from artificial intelligence models for information purposes repeatable?","authors":"Yasemin Tunca ,&nbsp;Volkan Kaplan ,&nbsp;Murat Tunca","doi":"10.1016/j.ortho.2025.101071","DOIUrl":"10.1016/j.ortho.2025.101071","url":null,"abstract":"<div><h3>Introduction</h3><div>The objective of this study was to assess the repeatability of orthodontic responses generated by multiple large language models across repeated time points.</div></div><div><h3>Methods</h3><div>This experimental study assessed the answers provided by ChatGPT-3.5, ChatGPT-4.0, Gemini, and Gemini-Advanced to 40 frequently asked orthodontic questions. Each model was prompted with the same questions at three time points (T0: day 0, T1: day 7, and T2: day 14). Two blinded orthodontic experts independently evaluated responses using a 3-point accuracy scale. Cohen's Kappa and ICC were applied to assess inter-rater agreement and repeatability, respectively. In addition, Friedman test with Bonferroni post-hoc analysis and Spearman correlation were used for temporal comparisons.</div></div><div><h3>Results</h3><div>Cohen's Kappa values between raters ranged from 0.624 to 0.749, indicating substantial inter-rater agreement. ICC values for repeatability ranged from 0.666 (Gemini) to 0.960 (ChatGPT-3.5). Friedman test results revealed significant differences in model accuracy at T0 and T2 (<em>P</em> <!-->&lt;<!--> <!-->0.001). Post-hoc analysis showed ChatGPT-3.5 differed significantly from Gemini and Gemini Advanced. Spearman correlations between time points were positive but weak (ρ<!--> <!-->=<!--> <!-->0.284 to 0.383, <em>P</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The study revealed statistically significant differences in repeatability among AI models. Despite high accuracy, some models exhibited limited consistency over time. These findings underscore the importance of evaluating both accuracy and temporal stability when integrating AI systems into clinical orthodontic communication.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101071"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223359","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}

{"title":"Evaluation of shear bond strength, adhesive remnant index, and degree of conversion of orthodontic composite adhesives: An in vitro study using human premolars","authors":"Rehab A. Khalil ,&nbsp;Mohamed S. El-Okaily ,&nbsp;Ghada A. Alkaranfilly","doi":"10.1016/j.ortho.2025.101074","DOIUrl":"10.1016/j.ortho.2025.101074","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the shear bond strength (SBS), adhesive remnant index (ARI), and degree of conversion (DC) of four different orthodontic adhesives.</div></div><div><h3>Material and methods</h3><div>Sixty maxillary first premolars were randomly divided into four groups (<em>n</em> <!-->=<!--> <!-->15) according to the type of adhesive used: group I, Grengloo™ (GG), group II, Trulock® (TL), group III, CuRAY-Eclipse® (EC), and group IV, Master-Dent® (MD). The SBS was tested using a universal testing machine, and the ARI scores were evaluated by using a stereomicroscope. For assessing the DC, 5 cured and 5 uncured specimens were prepared for each group. FTIR (Fourier Transform Infrared) spectrometer was used to evaluate the DC for each composite. The SBS data were analysed by the Welch one-way ANOVA test, followed by Games-Howell post hoc test. ARI index scores were analysed by the Kruskal-Wallis test, followed by Dunn's post hoc test. The DC data were analysed by using the one-way ANOVA test, followed by Tukey's post hoc test. The significance level was set at <em>P</em> <!-->&lt;<!--> <!-->0.05 within all tests.</div></div><div><h3>Results</h3><div>There was a significant difference in the mean SBS (<em>P</em> <!-->&lt;<!--> <!-->0.001) between the tested groups (PES: 0.684, 95% CI [0.460 to 0.757]). GG had a statistically significantly higher mean SBS (19.63<!--> <!-->±<!--> <!-->4.44<!--> <!-->MPa) than the other adhesives. EC had a significantly higher mean SBS (14.15<!--> <!-->±<!--> <!-->5.28<!--> <!-->MPa) than MD (9.98<!--> <!-->±<!--> <!-->1.81<!--> <!-->MPa). There was no significant difference in mean SBS between TL (11.96<!--> <!-->±<!--> <!-->3.34<!--> <!-->MPa) and EC or between TL and MD. There was a significant difference in ARI scores (<em>P</em> <!-->&lt;<!--> <!-->0.001) between the tested adhesives (PES[H]: 0.262, 95% CI [0.100 to 0.510]). The predominant mode of bond failure in GG, TL, and EC was cohesive failure, while MD revealed bond failure at the enamel/adhesive interface. There was a significant difference (<em>P</em> <!-->=<!--> <!-->0.010) in the DC values between the tested composites (PES: 0.518, 95% CI [0.202 to 0.640]). GG (83.66<!--> <!-->±<!--> <!-->2.48%) had a significantly higher mean DC than MD (74.57<!--> <!-->±<!--> <!-->5.47%). There was no significant difference in the mean values of the DC between GG, TL (77.02<!--> <!-->±<!--> <!-->2.42%), and EC (78.36<!--> <!-->±<!--> <!-->3.23%), or between TL, EC, and MD.</div></div><div><h3>Conclusion</h3><div>GG had the highest SBS. All the tested adhesives showed adequate and acceptable SBS and DC for clinical practice. All the adhesives revealed cohesive bond failure, except MD exhibited bond failure at the enamel/adhesive interface. The DC was influenced by the composite type. GG had the highest DC and was significantly higher than MD.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101074"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223354","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}

{"title":"Effect of variations in mini-screw diameter, length, tapering, and thread depth on stress-strain distribution and displacement in alveolar bone: A three-dimensional finite element analysis","authors":"Hamed Rahimi ,&nbsp;Salva Khosroshahian ,&nbsp;Faham Vjihi","doi":"10.1016/j.ortho.2025.101068","DOIUrl":"10.1016/j.ortho.2025.101068","url":null,"abstract":"<div><h3>Background</h3><div>Optimizing orthodontic mini-screw design is critical for primary stability. This study investigated the effects of macroscopic parameters—including length, diameter, taper, and thread depth—on stress distribution in surrounding alveolar bone using three-dimensional finite element analysis (FEA) immediately after orthodontic loading.</div></div><div><h3>Methods</h3><div>We designed a standard mini-screw (8<!--> <!-->mm length, 1.6<!--> <!-->mm diameter, 0.25<!--> <!-->mm thread depth, 1° taper with V-shaped threads) and systematically altered each parameter to create eight additional models. Each mini-screw embedded in bone was subjected to a 2<!--> <!-->N static shear load. The stress distribution in the bone and mini-screw, as well as mini-screw displacement under shear loading, were calculated to evaluate primary stability for each design.</div></div><div><h3>Results</h3><div>Reducing diameter by 0.2<!--> <!-->mm increased maximum von Mises stress by 47% in bone and 33% in the mini-screw, whereas increasing diameter by 0.2<!--> <!-->mm decreased stress by 10% in both. Other design parameters had smaller effects under shear loading. Maximum bone stress consistently occurred at the mini-screw entry site and around the first thread.</div></div><div><h3>Conclusions</h3><div>Mini-screw diameter is the most influential factor affecting primary stability, particularly regarding maximum von Mises stress. Our findings highlight the importance of optimizing diameter and structural design at the bone entry site, providing practical guidance for clinical selection and mini-screw design improvements.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101068"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223357","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}

{"title":"Predicting treatment pathways in Class II malocclusion patients using machine learning: A comparative study of four algorithms for classifying camouflage, growth modulation, and surgical decisions","authors":"Mukesh Kumar,&nbsp;Sumit Kumar,&nbsp;Malvika Agarwal,&nbsp;Ekta Yadav,&nbsp;Sougandhika Gandi","doi":"10.1016/j.ortho.2025.101070","DOIUrl":"10.1016/j.ortho.2025.101070","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to develop a machine-learning model to assist in treatment decision-making for surgery, camouflage, and growth modulation in Class II malocclusion patients and to evaluate its validity and reliability.</div></div><div><h3>Material and methods</h3><div>A total of 506 Class II malocclusion patients were included in the study, with patients randomly assigned to a training set (405) and a test set (101). Four machine-learning (ML) models – logistic regression (LR), decision tree (DT), random forest (RF), and support vector machine (SVM) – were trained to predict the most suitable treatment approach: camouflage, growth modulation (GM), or surgery. The accuracy of treatment decisions was evaluated for each model, along with 95% confidence intervals (CIs). Additionally, the McNemar's test was used to assess the statistical significance of model performance.</div></div><div><h3>Results</h3><div>The AUC-PR values indicate that SVM and RF are the best-performing models, both achieving 1.00 for GM, 0.92 for camouflage, and 0.82 for surgery, demonstrating strong classification capabilities across all classes. LR performs well for GM (0.97<strong>)</strong> but struggles with camouflage and surgery (both 0.66), indicating inconsistencies. The DT has the lowest overall performance, with 0.62 for GM and camouflage, and 0.55 for surgery, suggesting weaker classification reliability. Given these results, SVM and RF emerge as the most effective models, offering the best balance of precision and recall across all classes.</div></div><div><h3>Conclusions</h3><div>Support vector machine and random forest demonstrate strong classification for growth modulation with high precision and recall, while camouflage remains stable until 80% recall before precision declines. Surgery involves greater trade-offs between precision and recall. This study further supports that ANB, Nasolabial angle, SNA, H angle, Age, Mandibular plane angle can be used as strong predictors in assessing patient's treatment needs.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101070"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223358","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}

{"title":"Accuracy of digital vs. manual cephalometric tracing: A systematic review","authors":"Shankargouda Patil ,&nbsp;Alia Choudhary ,&nbsp;Harriet Young ,&nbsp;Quinton Ashton ,&nbsp;Aasha Patel ,&nbsp;Reji Mathew ,&nbsp;Frank W. Licari ,&nbsp;Tarek El-Bialy","doi":"10.1016/j.ortho.2025.101064","DOIUrl":"10.1016/j.ortho.2025.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review aimed to assess the accuracy of digital cephalometric tracing with manual hand tracing.</div></div><div><h3>Methods</h3><div>PubMed, SCOPUS and Web of Science databases were searched for relevant articles. After an initial search, which revealed 279 potentially relevant articles, their titles and abstracts were screened. After screening, 23 full-text articles were assessed in depth. Fifteen publications were removed from the analysis considering the predetermined inclusion criteria. The quality of the methodology of the selected 9 studies was analyzed using 12-point criteria, which included study design, measurement, and statistical analysis.</div></div><div><h3>Results</h3><div>The data thus collected was analyzed for reliable and reproducible variables. All studies were carried out on the digital format of lateral cephalograms. The analysis included both angular and linear measurements. The results brought about statistically significant differences in certain methods and were clinically acceptable even though they were minimal. A few measured variables were the cephalogram quality, lip posture, positioning, and difficulty in locating landmarks.</div></div><div><h3>Conclusions</h3><div>This review concluded that digital cephalometric tracing was equally reliable as tracing manually, with a moderate quality of evidence. This study also suggested that the literature presented here was accurate enough for clinical application. Thus, digital cephalometric analyses can potentially improve the workflow in clinical and research settings saving time and effort.</div><div>PROSPERO – registration number (CRD42024537255).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101064"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222652","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}