Pub Date : 2025-10-17DOI: 10.1016/j.ajodo.2025.09.012
Darshan N. Desai, Tony Weir, Maurice J. Meade
Introduction
The study aimed to determine the center of rotation and the type of orthodontic tooth movement (OTM) of the mandibular central incisors (Cis) and lateral incisors (Lis), and the efficacy of achieving planned labiolingual incisor inclination changes after nonextraction space closure (NESC) with the Invisalign (Align Technology, Santa Clara, Calif) appliance.
Methods
Digital study models of initial, planned, and achieved treatment outcomes were obtained from the Invisalign treatment planning facility, ClinCheck. Vectors analogous to the long axes of the incisors were generated using Geomagic Control X (version 2022.0: 3D Systems, Cary, NC) metrology software. Intersecting vectors represented the incisors’ center of rotation, whereas measurement of the vectors to a reference y-plane enabled determination of incisor labiolingual inclination.
Results
A total of 166 mandibular incisors from 42 patients satisfied the inclusion criteria. The achieved mean (standard deviation) OTMs were 41.4% (23.6) of those planned. Translation was the least successful OTM, with 7.6% of Cis and 8.3% of Lis translating as planned. Planned retroclination resulted in overexpression of 151% for CIs and 165% for Lis. The accuracy of planned proclination was low, with only 16.7% of CIs and 25.8% of Lis proclining as planned, whereas the remainder retroclined instead.
Conclusions
Less than half of the planned OTM for the mandibular incisors during NESC was achieved. Planned retroclination was overexpressed, and most of planned proclination resulted in retroclination. Clinicians should consider these findings when planning NESC treatment with the Invisalign appliance.
简介:本研究旨在确定下颌中切牙(Cis)和侧切牙(Lis)的旋转中心和正畸牙齿运动类型(OTM),以及使用Invisalign (Align Technology, Santa Clara, Calif .)矫治器在非拔牙间隙关闭(NESC)后实现计划唇舌切牙倾斜改变的效果。方法:从Invisalign治疗计划设施ClinCheck获得初始、计划和实现治疗结果的数字研究模型。使用Geomagic Control X(版本2022.0:3D Systems, Cary, NC)计量软件生成类似于门牙长轴的矢量。交叉向量代表切牙的旋转中心,而测量向量到参考y平面可以确定切牙的唇舌倾斜度。结果:42例患者166个下颌骨切牙符合纳入标准。达到的平均(标准偏差)OTMs为计划的41.4%(23.6)。翻译是最不成功的OTM, 7.6%的ci和8.3%的li按计划翻译。计划逆行导致CIs过表达151%,Lis过表达165%。计划腹倾的准确性较低,只有16.7%的CIs和25.8%的Lis按计划腹倾,而其余的则是逆行。结论:在NESC中,只有不到一半的下颌切牙达到了计划的OTM。计划性后倾过表达,计划性后倾多数导致后倾。临床医生在计划使用Invisalign器械治疗NESC时应考虑这些结果。
{"title":"Planned and achieved orthodontic tooth movement and labiolingual inclination changes of mandibular incisors during nonextraction space closure with clear aligners: A retrospective cohort study","authors":"Darshan N. Desai, Tony Weir, Maurice J. Meade","doi":"10.1016/j.ajodo.2025.09.012","DOIUrl":"10.1016/j.ajodo.2025.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The study aimed to determine the center of rotation and the type of orthodontic tooth movement (OTM) of the mandibular central incisors (Cis) and lateral incisors (Lis), and the efficacy of achieving planned labiolingual incisor inclination changes after nonextraction space closure (NESC) with the Invisalign (Align Technology, Santa Clara, Calif) appliance.</div></div><div><h3>Methods</h3><div>Digital study models of initial, planned, and achieved treatment outcomes were obtained from the Invisalign treatment planning facility, ClinCheck. Vectors analogous to the long axes of the incisors were generated using Geomagic Control X (version 2022.0: 3D Systems, Cary, NC) metrology software. Intersecting vectors represented the incisors’ center of rotation, whereas measurement of the vectors to a reference y-plane enabled determination of incisor labiolingual inclination.</div></div><div><h3>Results</h3><div>A total of 166 mandibular incisors from 42 patients satisfied the inclusion criteria. The achieved mean (standard deviation) OTMs were 41.4% (23.6) of those planned. Translation was the least successful OTM, with 7.6% of Cis and 8.3% of Lis translating as planned. Planned retroclination resulted in overexpression of 151% for CIs and 165% for Lis. The accuracy of planned proclination was low, with only 16.7% of CIs and 25.8% of Lis proclining as planned, whereas the remainder retroclined instead.</div></div><div><h3>Conclusions</h3><div>Less than half of the planned OTM for the mandibular incisors during NESC was achieved. Planned retroclination was overexpressed, and most of planned proclination resulted in retroclination. Clinicians should consider these findings when planning NESC treatment with the Invisalign appliance.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 1","pages":"Pages 99-109"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.ajodo.2025.09.018
Sercan Akyalcin
{"title":"Handbook of Orthodontics, Third Edition","authors":"Sercan Akyalcin","doi":"10.1016/j.ajodo.2025.09.018","DOIUrl":"10.1016/j.ajodo.2025.09.018","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"168 6","pages":"Pages 783-784"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.ajodo.2025.09.011
Christie Shen , Shaonan Zhou , Qianqian Wang , S. Jay Bowman , Chun-Hsi Chung , Chenshuang Li
Introduction
A limited amount of maxillary molar distalization can be achieved with sequential molar distalization with clear aligner therapy (CAT), accompanied by significant distal crown tipping. Thus, combining CAT with temporary skeletal anchorage devices (TSADs) has been proposed, but a detailed evaluation is lacking.
Methods
This retrospective study evaluated pretreatment and postanterior retraction cone-beam computed tomography (CBCT) images and intraoral scans of adult patients treated with CAT + infrazygomatic TSADs with at least 1 mm of programmed maxillary first molar distalization. Achieved tooth movement shown on the CBCT and intraoral scan was compared with the prescribed ClinCheck tooth movement.
Results
This study included 38 sides from 21 patients (17 females and 4 males; aged 28.71 ± 4.16 years at pretreatment). At the crown level, approximately 1 mm of molar distalization was achieved (maxillary first molar, 1.05 mm [−0.8, 3.6] based on intraoral scans, 0.80 mm [−1.1, 3.4] based on CBCTs; maxillary second molar, 0.95 mm [−1.8, 4.4] based on intraoral scans, 1.25 mm [−1.9, 3.7] based on CBCTs), which is significantly lower than the prescribed movement (maxillary first molar, 3.05 mm [1.0, 5.6]; maxillary second molar: 3.05 mm [0.9, 6.1]). Limited crown distal tipping and mesial-out rotation, but significant buccal expansion and intrusion of the maxillary molars were also observed. In addition, a negative correlation was detected between the amount of prescribed molar distal movement and the distalization efficacy.
Conclusions
TSADs did not significantly improve the efficacy of maxillary molar distalization with CAT but provided more bodily movement and intrusion of the molars.
{"title":"Maxillary molar distalization with clear aligner therapy and infrazygomatic temporary skeletal anchorage devices","authors":"Christie Shen , Shaonan Zhou , Qianqian Wang , S. Jay Bowman , Chun-Hsi Chung , Chenshuang Li","doi":"10.1016/j.ajodo.2025.09.011","DOIUrl":"10.1016/j.ajodo.2025.09.011","url":null,"abstract":"<div><h3>Introduction</h3><div>A limited amount of maxillary molar distalization can be achieved with sequential molar distalization with clear aligner therapy (CAT), accompanied by significant distal crown tipping. Thus, combining CAT with temporary skeletal anchorage devices (TSADs) has been proposed, but a detailed evaluation is lacking.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated pretreatment and postanterior retraction cone-beam computed tomography (CBCT) images and intraoral scans of adult patients treated with CAT + infrazygomatic TSADs with at least 1 mm of programmed maxillary first molar distalization. Achieved tooth movement shown on the CBCT and intraoral scan was compared with the prescribed ClinCheck tooth movement.</div></div><div><h3>Results</h3><div>This study included 38 sides from 21 patients (17 females and 4 males; aged 28.71 ± 4.16 years at pretreatment). At the crown level, approximately 1 mm of molar distalization was achieved (maxillary first molar, 1.05 mm [−0.8, 3.6] based on intraoral scans, 0.80 mm [−1.1, 3.4] based on CBCTs; maxillary second molar, 0.95 mm [−1.8, 4.4] based on intraoral scans, 1.25 mm [−1.9, 3.7] based on CBCTs), which is significantly lower than the prescribed movement (maxillary first molar, 3.05 mm [1.0, 5.6]; maxillary second molar: 3.05 mm [0.9, 6.1]). Limited crown distal tipping and mesial-out rotation, but significant buccal expansion and intrusion of the maxillary molars were also observed. In addition, a negative correlation was detected between the amount of prescribed molar distal movement and the distalization efficacy.</div></div><div><h3>Conclusions</h3><div>TSADs did not significantly improve the efficacy of maxillary molar distalization with CAT but provided more bodily movement and intrusion of the molars.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 2","pages":"Pages 140-154"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.ajodo.2025.09.017
Wenxuan Su , Yupin Zhang , Qingxun Meng , Xu Zhang , Yixuan Lv , Xueming Shi , Zhengyang Li
Introduction
This retrospective study aimed to evaluate the morphology of the alveolar bone and to assess the incidence of fenestration and dehiscence during presurgical orthodontic decompensation in patients with skeletal Class III malocclusion.
Methods
The study included 60 patients with skeletal Class III high-angle malocclusion who had completed presurgical orthodontic treatment. Lateral cephalograms and cone-beam computed tomography images were obtained before (T0) and after (T1) the presurgical orthodontics. The labial inclination angles of the mandibular central incisors were measured using lateral cephalograms. Cone-beam computed tomography images evaluated alveolar bone thickness and height along the roots of the target teeth and assessed the incidence of fenestration and dehiscence. Statistical analyses were conducted using paired t tests, chi-square tests, and binary logistic regression.
Results
From T0 to T1, decompensatory movements of the mandibular central incisors resulted in a reduction in alveolar bone thickness and vertical height. Most teeth exhibited bone loss of 2 mm apical to the cementoenamel junction. The prevalence of labial bone defects increased significantly, rising from 51.7% to 73.3% in the mandibular left central incisor and from 51.7% to 76.7% in the mandibular right central incisor. Greater decompensation angles were linked to higher risks of fenestration and dehiscence at T1. When the probability of bone defect occurrence was set at 50%, the thresholds for changes in the IMPA and L1-NB were found to be 5.47° and 5.91°, respectively.
Conclusions
The threshold for decompensation of the mandibular central incisors is relatively low in patients with skeletal Class III high-angle because of the anatomically thin alveolar bone. Exceeding this threshold increases the risk of bone defects. Therefore, careful evaluation of the periodontal condition is essential when establishing treatment objectives to prevent adverse periodontal outcomes.
{"title":"Impact of presurgical orthodontic decompensation on alveolar bone morphology and defects in patients with skeletal Class III high-angle malocclusion","authors":"Wenxuan Su , Yupin Zhang , Qingxun Meng , Xu Zhang , Yixuan Lv , Xueming Shi , Zhengyang Li","doi":"10.1016/j.ajodo.2025.09.017","DOIUrl":"10.1016/j.ajodo.2025.09.017","url":null,"abstract":"<div><h3>Introduction</h3><div>This retrospective study aimed to evaluate the morphology of the alveolar bone and to assess the incidence of fenestration and dehiscence during presurgical orthodontic decompensation in patients with skeletal Class III malocclusion.</div></div><div><h3>Methods</h3><div>The study included 60 patients with skeletal Class III high-angle malocclusion who had completed presurgical orthodontic treatment. Lateral cephalograms and cone-beam computed tomography images were obtained before (T0) and after (T1) the presurgical orthodontics. The labial inclination angles of the mandibular central incisors were measured using lateral cephalograms. Cone-beam computed tomography images evaluated alveolar bone thickness and height along the roots of the target teeth and assessed the incidence of fenestration and dehiscence. Statistical analyses were conducted using paired <em>t</em> tests, chi-square tests, and binary logistic regression.</div></div><div><h3>Results</h3><div>From T0 to T1, decompensatory movements of the mandibular central incisors resulted in a reduction in alveolar bone thickness and vertical height. Most teeth exhibited bone loss of 2 mm apical to the cementoenamel junction. The prevalence of labial bone defects increased significantly, rising from 51.7% to 73.3% in the mandibular left central incisor and from 51.7% to 76.7% in the mandibular right central incisor. Greater decompensation angles were linked to higher risks of fenestration and dehiscence at T1. When the probability of bone defect occurrence was set at 50%, the thresholds for changes in the IMPA and L1-NB were found to be 5.47° and 5.91°, respectively.</div></div><div><h3>Conclusions</h3><div>The threshold for decompensation of the mandibular central incisors is relatively low in patients with skeletal Class III high-angle because of the anatomically thin alveolar bone. Exceeding this threshold increases the risk of bone defects. Therefore, careful evaluation of the periodontal condition is essential when establishing treatment objectives to prevent adverse periodontal outcomes.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 2","pages":"Pages 189-201"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.ajodo.2025.09.015
Yoon Sik Park , Eun-Hack Andrew Choi , Feras Jamal H Alwaznah , Harim Kim , Yoon Jeong Choi , Kee-Joon Lee , Hyung-Seog Yu , Sung-Hwan Choi
Introduction
This study analyzed the influence of the 3-dimensional (3D) root apex position on the traction duration of unilateral impacted maxillary canines, compared with the cusp tip position.
Methods
Thirty-one cone-beam computed tomography scans were analyzed. Each normally erupted canine was mirrored across the midsagittal plane to create an image of its enantiomorph. The distances were measured between the root apices of the impacted canine and the enantiomorphic contralateral normally erupted canine, as well as between their cusp tips and tooth angulations. Each distance variable was further subdivided into vertical displacement, horizontal displacement, mesiodistal (MD) displacement, and labiopalatal displacement, whereas the angulation variable was divided into MD tip difference and torque difference. The correlation between each measurement and the traction duration was analyzed.
Results
The position of the root apex showed no significant correlation with traction duration. However, the 3D displacement, horizontal displacement, and labiopalatal displacement of the cusp tip (P <0.001), vertical displacement of the cusp tip (P <0.01), and the 3D angulation difference and MD tip difference between tooth axes (P <0.05) showed a significantly positive correlation with traction duration. Multiple regression analysis showed that the 3D displacement of the cusp tip explains approximately 55.4% of the variance in traction duration, increasing by 1.2 months per 1 mm.
Conclusions
Although root apex position does not affect traction duration in unilateral impacted maxillary canines, the 3D displacement of the cusp tip is a key determinant, with more significant palatal displacement and a higher vertical position associated with longer traction duration.
{"title":"Is apex position a determining factor in the orthodontic traction duration of unilateral impacted maxillary canines? A cone-beam computed tomography–based 3-dimensional study","authors":"Yoon Sik Park , Eun-Hack Andrew Choi , Feras Jamal H Alwaznah , Harim Kim , Yoon Jeong Choi , Kee-Joon Lee , Hyung-Seog Yu , Sung-Hwan Choi","doi":"10.1016/j.ajodo.2025.09.015","DOIUrl":"10.1016/j.ajodo.2025.09.015","url":null,"abstract":"<div><h3>Introduction</h3><div>This study analyzed the influence of the 3-dimensional (3D) root apex position on the traction duration of unilateral impacted maxillary canines, compared with the cusp tip position.</div></div><div><h3>Methods</h3><div>Thirty-one cone-beam computed tomography scans were analyzed. Each normally erupted canine was mirrored across the midsagittal plane to create an image of its enantiomorph. The distances were measured between the root apices of the impacted canine and the enantiomorphic contralateral normally erupted canine, as well as between their cusp tips and tooth angulations. Each distance variable was further subdivided into vertical displacement, horizontal displacement, mesiodistal (MD) displacement, and labiopalatal displacement, whereas the angulation variable was divided into MD tip difference and torque difference. The correlation between each measurement and the traction duration was analyzed.</div></div><div><h3>Results</h3><div>The position of the root apex showed no significant correlation with traction duration. However, the 3D displacement, horizontal displacement, and labiopalatal displacement of the cusp tip (<em>P</em> <0.001), vertical displacement of the cusp tip (<em>P</em> <0.01), and the 3D angulation difference and MD tip difference between tooth axes (<em>P</em> <0.05) showed a significantly positive correlation with traction duration. Multiple regression analysis showed that the 3D displacement of the cusp tip explains approximately 55.4% of the variance in traction duration, increasing by 1.2 months per 1 mm.</div></div><div><h3>Conclusions</h3><div>Although root apex position does not affect traction duration in unilateral impacted maxillary canines, the 3D displacement of the cusp tip is a key determinant, with more significant palatal displacement and a higher vertical position associated with longer traction duration.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 2","pages":"Pages 168-176"},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-11DOI: 10.1016/j.ajodo.2025.08.006
Oriane Daraze , Marianne Moussallem , Elie Khoury , Adib Kassis , Joseph Ghoubril
Introduction
This study aimed to assess the predictability and accuracy of treatment virtual simulation when compared with the final outcome in patients treated with the extraction of maxillary first premolars according to the type of anchorage.
Methods
A total of 62 patients were selected, based on the extraction of at least the maxillary first premolar in patients with Angle Class I or II malocclusion. Notably, 40 were treated with the maximal anchorage technique, whereas the 22 others were treated with the reciprocal anchorage technique for space closure. The study models were scanned with a 3Shape D500 desktop scanner. Digital setups were constructed according to their respective treatment plans. Digital measurements of the intercanine, interpremolar, and intermolar width on scans 1, 2, and 3 and the variation on each superimposition in the sagittal, transversal, and vertical plane of the following teeth: maxillary first right molar (16), maxillary first left molar (26), maxillary right canine (13), and maxillary left canine (23).
Results
For the virtual setup compared with the final outcome scan, it was found to be reliable for simulations of intercanine, interpremolar, and intermolar width using the reciprocal anchorage technique (P = 0.889, P = 0.212, and P = 0.059, respectively) but not for the maximal anchorage (P = 0.003, for the intercanine width and P <0.001 for the interpremolar and intermolar width). Regarding the reliability of the virtual setup scan in the 3 directions, the virtual scan was found to be reliable for predicting the following movements: (1) sagittal movements of the 4 selected teeth using reciprocal anchorage, (2) vertical movements of 13 and 23 using both anchorage techniques, and (3) transversal movement of the 4 selected teeth using both anchorage techniques. The differences between the final outcome scan and virtual setup scan were not significantly different from 0, with P >0.05.
Conclusions
This study supported the use of virtual setups for the purpose of guiding treatment and visualizing potential outcomes of patients treated with maxillary first premolar extraction with the reciprocal anchorage technique.
{"title":"Accuracy of maxillary digital setup predictions of patients treated with maxillary first premolar extractions: A retrospective study","authors":"Oriane Daraze , Marianne Moussallem , Elie Khoury , Adib Kassis , Joseph Ghoubril","doi":"10.1016/j.ajodo.2025.08.006","DOIUrl":"10.1016/j.ajodo.2025.08.006","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to assess the predictability and accuracy of treatment virtual simulation when compared with the final outcome in patients treated with the extraction of maxillary first premolars according to the type of anchorage.</div></div><div><h3>Methods</h3><div>A total of 62 patients were selected, based on the extraction of at least the maxillary first premolar in patients with Angle Class I or II malocclusion. Notably, 40 were treated with the maximal anchorage technique, whereas the 22 others were treated with the reciprocal anchorage technique for space closure. The study models were scanned with a 3Shape D500 desktop scanner. Digital setups were constructed according to their respective treatment plans. Digital measurements of the intercanine, interpremolar, and intermolar width on scans 1, 2, and 3 and the variation on each superimposition in the sagittal, transversal, and vertical plane of the following teeth: maxillary first right molar (16), maxillary first left molar (26), maxillary right canine (13), and maxillary left canine (23).</div></div><div><h3>Results</h3><div>For the virtual setup compared with the final outcome scan, it was found to be reliable for simulations of intercanine, interpremolar, and intermolar width using the reciprocal anchorage technique (<em>P</em> = 0.889, <em>P</em> = 0.212, and <em>P</em> = 0.059, respectively) but not for the maximal anchorage (<em>P</em> = 0.003, for the intercanine width and <em>P</em> <0.001 for the interpremolar and intermolar width). Regarding the reliability of the virtual setup scan in the 3 directions, the virtual scan was found to be reliable for predicting the following movements: (1) sagittal movements of the 4 selected teeth using reciprocal anchorage, (2) vertical movements of 13 and 23 using both anchorage techniques, and (3) transversal movement of the 4 selected teeth using both anchorage techniques. The differences between the final outcome scan and virtual setup scan were not significantly different from 0, with <em>P</em> >0.05.</div></div><div><h3>Conclusions</h3><div>This study supported the use of virtual setups for the purpose of guiding treatment and visualizing potential outcomes of patients treated with maxillary first premolar extraction with the reciprocal anchorage technique.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"168 6","pages":"Pages 718-728"},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.ajodo.2025.09.008
Fabio Savoldi , Kieran Daniel Tsang , Lynton Edviano Loo , Tsz Yan Leung , Yanqi Yang , Min Gu
Introduction
Idiopathic osteosclerosis (IO), also known as “dense bone island,” is a localized and well-defined radiopaque lesion often close to the radicular area of teeth. The present study investigated whether IO affected orthodontic tooth movement and root resorption during the closure of extraction spaces.
Methods
A total of 1624 pretreatment and posttreatment panoramic radiographs were retrospectively screened. Forty adolescents and young adults who received orthodontic treatment with symmetrical mandibular premolar extraction and presented with unilateral IO were selected. Extraction space width, tooth length, and tooth angulation were measured pretreatment and posttreatment. The tooth was also identified as passing through or not passing through the lesion. Changes in tooth length and angulation between the IO side and non-IO side were compared using the Wilcoxon signed rank test. The prevalence of teeth passing through and not passing through was compared using the binomial exact test.
Results
The size of the closed extraction space was similar on both sides (P = 0.605). Teeth on the IO side showed root resorption (P = 0.706) and angulation changes (P = 0.568) similar to those on the non-IO side. Among teeth having a clinically relevant movement, roots passed through the IO in 88% of the radiographs (95% confidence interval, 69.8%-97.6%, P <0.001).
Conclusions
In young patients undergoing fixed orthodontic treatment with premolar extractions, IO may not considerably affect changes in dental angulation, root resorption, and the extent of tooth movement during closure of extraction spaces. However, approximately 12% of teeth may encounter difficulties in passing through the lesion.
{"title":"Effect of dense bone islands on orthodontic tooth movement and root resorption during space closure with fixed orthodontic appliances: A longitudinal study on panoramic radiography","authors":"Fabio Savoldi , Kieran Daniel Tsang , Lynton Edviano Loo , Tsz Yan Leung , Yanqi Yang , Min Gu","doi":"10.1016/j.ajodo.2025.09.008","DOIUrl":"10.1016/j.ajodo.2025.09.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Idiopathic osteosclerosis (IO), also known as “dense bone island,” is a localized and well-defined radiopaque lesion often close to the radicular area of teeth. The present study investigated whether IO affected orthodontic tooth movement and root resorption during the closure of extraction spaces.</div></div><div><h3>Methods</h3><div>A total of 1624 pretreatment and posttreatment panoramic radiographs were retrospectively screened. Forty adolescents and young adults who received orthodontic treatment with symmetrical mandibular premolar extraction and presented with unilateral IO were selected. Extraction space width, tooth length, and tooth angulation were measured pretreatment and posttreatment. The tooth was also identified as passing through or not passing through the lesion. Changes in tooth length and angulation between the IO side and non-IO side were compared using the Wilcoxon signed rank test. The prevalence of teeth passing through and not passing through was compared using the binomial exact test.</div></div><div><h3>Results</h3><div>The size of the closed extraction space was similar on both sides (<em>P</em> = 0.605). Teeth on the IO side showed root resorption (<em>P</em> = 0.706) and angulation changes (<em>P</em> = 0.568) similar to those on the non-IO side. Among teeth having a clinically relevant movement, roots passed through the IO in 88% of the radiographs (95% confidence interval, 69.8%-97.6%, <em>P</em> <0.001).</div></div><div><h3>Conclusions</h3><div>In young patients undergoing fixed orthodontic treatment with premolar extractions, IO may not considerably affect changes in dental angulation, root resorption, and the extent of tooth movement during closure of extraction spaces. However, approximately 12% of teeth may encounter difficulties in passing through the lesion.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 1","pages":"Pages 75-86.e6"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.ajodo.2025.08.017
Daniele Manfredini , Sanjivan Kandasamy
In an attempt to solve the potential confusion around the temporomandibular disorders (TMDs) practice, a group of expert researchers and clinicians, on behalf of the International Network for Orofacial Pain and Related Disorders Methodology of the International Association for Dental, Oral, and Craniofacial Research, developed a consensus document on the standards of care for TMD management. The document is a list of 10 key points that include 3 statements on general concepts and etiology, 3 on diagnosis, 3 on treatment, and 1 on cautionary and conclusive remarks for the patient. The key points have the potential to assist both general and specialist dental practitioners to advance their understanding and facilitate the provision of conservative and appropriate treatment. Indeed, when it comes to pain, we need to look beyond the teeth. Decades of research in pain physiology, chronicity, genetics, and comorbidity, to name a few, have allowed a better appreciation of the complexities associated with one’s TMD-related pain experience. Technical interventions, whether dental or surgical, typically play only a minor role in the broader management of any TMD pain. The paradigm shift from a dental to a medical model of disease has been well embraced and supported by the global community of orofacial pain specialists who are formally trained and who have been consistently applying these principles in line with established evidence-based clinical practices for years. This information is now available to everyone.
{"title":"Temporomandibular disorders: Do we finally have a consensus standard of care for dissemination?","authors":"Daniele Manfredini , Sanjivan Kandasamy","doi":"10.1016/j.ajodo.2025.08.017","DOIUrl":"10.1016/j.ajodo.2025.08.017","url":null,"abstract":"<div><div>In an attempt to solve the potential confusion around the temporomandibular disorders (TMDs) practice, a group of expert researchers and clinicians, on behalf of the International Network for Orofacial Pain and Related Disorders Methodology of the International Association for Dental, Oral, and Craniofacial Research, developed a consensus document on the standards of care for TMD management. The document is a list of 10 key points that include 3 statements on general concepts and etiology, 3 on diagnosis, 3 on treatment, and 1 on cautionary and conclusive remarks for the patient. The key points have the potential to assist both general and specialist dental practitioners to advance their understanding and facilitate the provision of conservative and appropriate treatment. Indeed, when it comes to pain, we need to look beyond the teeth. Decades of research in pain physiology, chronicity, genetics, and comorbidity, to name a few, have allowed a better appreciation of the complexities associated with one’s TMD-related pain experience. Technical interventions, whether dental or surgical, typically play only a minor role in the broader management of any TMD pain. The paradigm shift from a dental to a medical model of disease has been well embraced and supported by the global community of orofacial pain specialists who are formally trained and who have been consistently applying these principles in line with established evidence-based clinical practices for years. This information is now available to everyone.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 1","pages":"Pages 8-11"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.ajodo.2025.09.006
Qianglan Zhai , Mengjuan Cui , Yijiao Fu , Xingtai Huang , Zhengliang Wang , Qingwen Wu , Ning Cong , Chao Liu
Introduction
Nasal septum deviation (NSD) is one of the contributing factors to impaired nasal function and dentofacial developmental abnormalities. Although cone-beam computed tomography (CBCT) is clinically valuable for NSD diagnosis, manual interpretation remains labor-intensive and expertise-dependent.
Methods
Our study included 330 CBCT scans diagnosed with either NSD or non-NSD to develop an automated 2-stage artificial intelligence (AI) framework integrating real-time detection and classification for NSD screening. In the first stage, the YOLOv11 (You Only Look Once) object detection algorithm was employed to detect the region of interest containing the nasal septum. In the second stage, 3 convolutional neural network architectures, ResNet, EfficientNet, and MobileNet, were evaluated for classifying CBCT images into NSD and normal categories.
Results
Among the YOLOv11 variants, YOLOv11n demonstrated superior performance with a precision of 0.996, a recall of 1.000, an mAP50 of 0.995, and an mAP50-95 of 0.873. For the classification task, Mobile_small emerged as the top-performing model, achieving an area under the curve of 0.817, an area under the precision-recall curve of 0.845, and an accuracy of 0.749. An AI-assisted diagnostic tool was developed based on YOLOv11n and MobileNet models and validated on 50 internal and 50 external CBCT scans. With AI assistance, orthodontists’ diagnostic accuracy increased by 20.12% and 21.49%, respectively, whereas average diagnosis time decreased by 23.75 seconds, improving efficiency by 53.92%.
Conclusions
The proposed system enables rapid NSD screening with diagnostic-level accuracy, demonstrating the viability of lightweight AI models for clinical CBCT analysis. AI-assisted diagnosis improves orthodontists’ accuracy and time efficiency in identifying NSD.
鼻中隔偏曲(NSD)是导致鼻功能受损和牙面发育异常的因素之一。尽管锥形束计算机断层扫描(CBCT)在临床上对NSD诊断有价值,但人工解释仍然是劳动密集型的,并且依赖于专业知识。方法:我们的研究包括330个诊断为NSD或非NSD的CBCT扫描,以开发一个自动化的两阶段人工智能(AI)框架,整合NSD筛查的实时检测和分类。在第一阶段,使用YOLOv11 (You Only Look Once)目标检测算法检测包含鼻中隔的感兴趣区域。在第二阶段,对3种卷积神经网络架构ResNet、EfficientNet和MobileNet进行评估,将CBCT图像分为NSD和正常类别。结果:在YOLOv11变体中,YOLOv11n的识别精度为0.996,召回率为1.000,mAP50为0.995,mAP50-95为0.873。对于分类任务,Mobile_small成为表现最好的模型,曲线下面积为0.817,精度-召回率曲线下面积为0.845,准确率为0.749。基于YOLOv11n和MobileNet模型开发了一种人工智能辅助诊断工具,并在50次内部和50次外部CBCT扫描中进行了验证。在人工智能辅助下,正畸医生的诊断准确率分别提高了20.12%和21.49%,平均诊断时间减少了23.75秒,效率提高了53.92%。结论:该系统能够实现诊断级准确性的NSD快速筛查,证明了轻量级AI模型用于临床CBCT分析的可行性。人工智能辅助诊断提高了正畸医生识别NSD的准确性和时间效率。
{"title":"Automated assessment of nasal septum deviation using cone-beam computed tomography images based on artificial intelligence: Development and multicenter validation","authors":"Qianglan Zhai , Mengjuan Cui , Yijiao Fu , Xingtai Huang , Zhengliang Wang , Qingwen Wu , Ning Cong , Chao Liu","doi":"10.1016/j.ajodo.2025.09.006","DOIUrl":"10.1016/j.ajodo.2025.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Nasal septum deviation (NSD) is one of the contributing factors to impaired nasal function and dentofacial developmental abnormalities. Although cone-beam computed tomography (CBCT) is clinically valuable for NSD diagnosis, manual interpretation remains labor-intensive and expertise-dependent.</div></div><div><h3>Methods</h3><div>Our study included 330 CBCT scans diagnosed with either NSD or non-NSD to develop an automated 2-stage artificial intelligence (AI) framework integrating real-time detection and classification for NSD screening. In the first stage, the YOLOv11 (You Only Look Once) object detection algorithm was employed to detect the region of interest containing the nasal septum. In the second stage, 3 convolutional neural network architectures, ResNet, EfficientNet, and MobileNet, were evaluated for classifying CBCT images into NSD and normal categories.</div></div><div><h3>Results</h3><div>Among the YOLOv11 variants, YOLOv11n demonstrated superior performance with a precision of 0.996, a recall of 1.000, an mAP50 of 0.995, and an mAP50-95 of 0.873. For the classification task, Mobile_small emerged as the top-performing model, achieving an area under the curve of 0.817, an area under the precision-recall curve of 0.845, and an accuracy of 0.749. An AI-assisted diagnostic tool was developed based on YOLOv11n and MobileNet models and validated on 50 internal and 50 external CBCT scans. With AI assistance, orthodontists’ diagnostic accuracy increased by 20.12% and 21.49%, respectively, whereas average diagnosis time decreased by 23.75 seconds, improving efficiency by 53.92%.</div></div><div><h3>Conclusions</h3><div>The proposed system enables rapid NSD screening with diagnostic-level accuracy, demonstrating the viability of lightweight AI models for clinical CBCT analysis. AI-assisted diagnosis improves orthodontists’ accuracy and time efficiency in identifying NSD.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 1","pages":"Pages 56-66.e2"},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-07DOI: 10.1016/j.ajodo.2025.08.015
Şirin Hatipoğlu , Esra Çifçi Özkan , Fatma Aslı Konca Taşova , Özge Özdal Zincir
Introduction
This study aimed to evaluate the accuracy, reliability, and comprehensibility of information about surgically-assisted rapid palatal expansion provided by language models based on artificial intelligence (AI).
Methods
A cross-sectional content analysis was conducted on the responses to surgically-assisted rapid palatal expansion-related questions by ChatGPT-4 (OpenAI LLC, San Francisco, Calif), Gemini (Alphabet Inc, Mountain View, Calif), and Copilot (Microsoft, Redmond, Wash). In total, 115 questions (categorized into 11 domains) were created by 3 orthodontists and 1 oral and maxillofacial surgeon. The accuracy of the answers generated by the AI language models was independently evaluated by the same experts via a 5-point Likert scale. To test the relationships among categorical variables, when the sample size assumption was met, the Pearson chi-square test was used. However, when the sample size assumption was not met, Fisher’s exact test was applied. Analyses were performed in SPSS (version 27; IBM, Armonk, NY).
Results
The responses of the AI types presented a general homogeneous distribution, with no statistically significant difference between the types of AI and the types of responses (P >0.05). Although there were no significant differences, ChatGPT-4 had the highest objectively true rate. In contrast, Gemini produced answers with more balanced accuracy, whereas Copilot had the highest number of false answers.
Conclusions
These findings reveal that the accuracy of AI-supported language models in providing medical information may vary according to subject matter.
{"title":"The role of artificial intelligence in providing accurate and reliable information on surgically-assisted rapid palatal expansion: A cross-sectional study","authors":"Şirin Hatipoğlu , Esra Çifçi Özkan , Fatma Aslı Konca Taşova , Özge Özdal Zincir","doi":"10.1016/j.ajodo.2025.08.015","DOIUrl":"10.1016/j.ajodo.2025.08.015","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the accuracy, reliability, and comprehensibility of information about surgically-assisted rapid palatal expansion provided by language models based on artificial intelligence (AI).</div></div><div><h3>Methods</h3><div>A cross-sectional content analysis was conducted on the responses to surgically-assisted rapid palatal expansion-related questions by ChatGPT-4 (OpenAI LLC, San Francisco, Calif), Gemini (Alphabet Inc, Mountain View, Calif), and Copilot (Microsoft, Redmond, Wash). In total, 115 questions (categorized into 11 domains) were created by 3 orthodontists and 1 oral and maxillofacial surgeon. The accuracy of the answers generated by the AI language models was independently evaluated by the same experts via a 5-point Likert scale. To test the relationships among categorical variables, when the sample size assumption was met, the Pearson chi-square test was used. However, when the sample size assumption was not met, Fisher’s exact test was applied. Analyses were performed in SPSS (version 27; IBM, Armonk, NY).</div></div><div><h3>Results</h3><div>The responses of the AI types presented a general homogeneous distribution, with no statistically significant difference between the types of AI and the types of responses (<em>P</em> >0.05). Although there were no significant differences, ChatGPT-4 had the highest objectively true rate. In contrast, Gemini produced answers with more balanced accuracy, whereas Copilot had the highest number of false answers.</div></div><div><h3>Conclusions</h3><div>These findings reveal that the accuracy of AI-supported language models in providing medical information may vary according to subject matter.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"169 1","pages":"Pages 31-41.e3"},"PeriodicalIF":3.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}