Clinical Oral Investigations最新文献

{"title":"Correction to: Brief orofacial myofunctional therapy and tongue pressure as prediction factors for open bite correction: a randomized clinical trial.","authors":"Thagid Yasmin Leal, Daniela Garib, Henrique Eto, Raquel Rosa, Felicia Miranda, Asenate Soares, Ana Paula Fukushiro, Giédre Berretin-Felix","doi":"10.1007/s00784-025-06536-6","DOIUrl":"10.1007/s00784-025-06536-6","url":null,"abstract":"","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"439"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991385","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}

{"title":"The impact of methylphenidate on oral health parameters, salivary flow rate, and quality of life in children with attention-deficit/hyperactivity disorder: a cross-sectional study.","authors":"İrem Gümüşkaya Kılıç, Hatice Ünver, Betül Kargül, Ecem Akbeyaz Şivet","doi":"10.1007/s00784-025-06528-6","DOIUrl":"10.1007/s00784-025-06528-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate and compare the effects of methylphenidate on oral health, salivary flow rate, and quality of life in children with Attention-Deficit/Hyperactivity Disorder (ADHD), focusing on differences between short-release methylphenidate (SRM) and long-release methylphenidate (LRM) formulations.</p><p><strong>Materials and methods: </strong>A total of 99 children participated in this cross-sectional study (ADHD: n = 49; divided into SRM (n = 27) and LRM (n = 22) subgroups based on medication type; control: n = 50). Dental caries was assessed using the DMFT/dft indices and the International Caries Detection and Assessment System (ICDAS), while oral hygiene was evaluated using the Plaque Index (PI), Gingival Index (GI), and Bleeding on Probing (BOP). Unstimulated salivary flow rates were measured. Salivary Streptococcus mutans and Lactobacillus levels were quantified using quantitative real-time polymerase chain reaction (qPCR). Quality of life was assessed with the Child Perceptions Questionnaire (CPQ) and KIDSCREEN-10. Logistic regression analyses examined associations between oral health outcomes, ADHD status, and medication type.</p><p><strong>Results: </strong>The ADHD group, especially SRM users, showed significantly higher DMFT scores, poorer oral hygiene, and reduced salivary flow rates compared to controls. Regression models further identified increased BOP and decreased salivary flow as predictors of ADHD and SRM use. qPCR confirmed higher Streptococcus mutans levels in SRM users. Quality of life was lower in ADHD children, particularly older SRM users.</p><p><strong>Conclusions: </strong>Children with ADHD receiving methylphenidate exhibited poorer oral health and reduced quality of life, especially with SRM formulations.</p><p><strong>Clinical relevance: </strong>Clinicians should be aware that children-particularly those receiving SRM-are more likely to present with reduced salivary flow, increased plaque accumulation, and gingival inflammation. Regular dental monitoring, reinforcement of oral hygiene practices, and dietary counseling should be integrated into the care plans of these patients.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"440"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991459","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}

{"title":"Does proper flossing performance translate into effective plaque removal?","authors":"Katja Jung, Björn Böttge, Mathis Kullmann, Carolina Ganss","doi":"10.1007/s00784-025-06505-z","DOIUrl":"10.1007/s00784-025-06505-z","url":null,"abstract":"<p><strong>Objectives: </strong>Interdental hygiene plays a crucial role in maintaining oral health, yet the effectiveness of dental floss remains a subject of debate. Thus, this study aimed to assess whether improved flossing technique relates to improved cleaning efficacy.</p><p><strong>Materials and methods: </strong>A total of 37 adults (23.1 ± 3.2 years) participated. After habitual toothbrushing, plaque was disclosed and an intraoral scan was performed; afterwards, habitual flossing was videotaped, followed by a second intraoral scan of disclosed plaque. Participants then watched an instruction video. After one week of practice, flossing was again videotaped and intraoral scans were taken before and after flossing. On defined regions on images obtained from the four scans, plaque coverage was assessed with a three-level score (0: none, 1: <50%, 3: ≥50%). Proximal Surface Plaque Index (PSPI) was calculated as mean from all scores. A flossing performance score (FPS) was generated from the percentage of interdental spaces that were correctly flossed (interdental space reached, floss correctly applied and vertical movements; 0: totally imperfect, 3: perfect flossing). Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed, values are given as median [95% CI].</p><p><strong>Results: </strong>FPS improved distinctly after instruction (2.0 [1.48;2.54] vs. 2.83 [2.45;2.95]; (p < .001), but not plaque removal (difference PSPI before/after: 0.17 [0.04;0.25] vs. 0.21 [0.13;0.25]; p = .112). Plaque removal was not correlated with PSPI.</p><p><strong>Conclusion: </strong>These findings suggest that even with correct technique, flossing may not substantially reduce plaque levels.</p><p><strong>Clinical relevance: </strong>The results align with previous studies questioning the efficacy of flossing and highlight the need for further investigation into interdental cleaning approaches.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"438"},"PeriodicalIF":3.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation sequencing improves pathogen identification in odontogenic abscesses, could this affect clinical outcomes?","authors":"Felix Benjamin Warwas, Felix Thol, Martin A Sieber, Nikolai Spuck, Franz-Josef Kramer, Nils Heim","doi":"10.1007/s00784-025-06504-0","DOIUrl":"10.1007/s00784-025-06504-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the diagnostic performance of gene-based bioinformatic analysis via next-generation sequencing (NGS) compared to conventional culture and microscopy in identifying microorganisms and antibiotic resistances in odontogenic abscesses. Additionally, the influence of selected clinical indicators including prior antibiotic therapy, in-hospital antibiotic treatment, and detection of antibiotic resistance on length of stay (LOS) was analysed.</p><p><strong>Materials and methods: </strong>In patients undergoing extraoral incision and drainage of odontogenic abscesses at the Department of Oral and Maxillofacial Plastic Surgery, University Hospital Bonn, two microbiological swabs (NGS and conventional) were taken intraoperatively from each patient. Microbial profiles and resistance patterns were assessed and correlated with clinical data.</p><p><strong>Results: </strong>Bacteria were identified in 100% of NGS swabs compared to 68.1% in conventional swabs (p < 0.001). NGS detected a median of 8 bacterial genera per sample versus 1 via conventional methods, primarily due to superior detection of anaerobes (median 7 vs. 0). Both methods equally identified aerobic genera (median 1 each). Fungal organisms and antibiotic resistances were also more frequently detected using NGS (p < 0.001). Prior antibiotic therapy was associated with a significantly reduced LOS (p = 0.030). Neither the type of in-hospital antibiotic regimen nor the presence of resistance influenced LOS.</p><p><strong>Conclusions: </strong>NGS substantially enhances the detection of polymicrobial communities, including anaerobes and fungi, and identifies antibiotic resistances more effectively than conventional diagnostics in odontogenic abscesses.</p><p><strong>Clinical relevance: </strong>NGS offers rapid, comprehensive pathogen profiling and resistance testing, supporting quick establishment of tailored antimicrobial therapy.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"430"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different light-curing modes and curing times on degree of conversion and microhardness of three different bulk-fill composites: an in vitro study.","authors":"Faiza Javed, Rajendra Kumar Tewari, Sharique Alam, Shahid Husain, Faisal Hasan","doi":"10.1007/s00784-025-06510-2","DOIUrl":"10.1007/s00784-025-06510-2","url":null,"abstract":"<p><strong>Objectives: </strong>This in vitro study aims to compare the effect of different light curing modes and curing times on the degree of conversion (DC) and microhardness (MH) of three different bulk fill composites at two different depths.</p><p><strong>Materials and methods: </strong>A total of 224 cylindrical specimens (4 mm height, 6 mm diameter) were prepared using four composites: SDR Plus, Ever X Posterior (EXP), Beautifil Bulk Restorative (BBR), and Tetric N Ceram (TNC). Each material group (n = 56) was subdivided into four curing subgroups based on light-curing mode (Low Power or High Power) and exposure time (20-30 s). Following curing, all samples were stored at 37 °C for 24 h. From each subgroup, seven specimens were allocated for DC testing using Raman spectroscopy and seven for MH testing using the Vickers microhardness test.</p><p><strong>Results: </strong>All the materials achieved acceptable (> 80%) bottom-to-top Vickers hardness ratio in high power (HP) mode for both curing times. However, in the low power (LP) mode, EXP could not achieve this ratio at 20 s and BBR failed to achieve this ratio in both curing times. BBR could not achieve an acceptable DC (> 55%) in both curing modes and both curing times. EXP did not demonstrate acceptable DC in LP mode at 20 s curing time, while SDR showed acceptable DC in both curing modes and both curing times.</p><p><strong>Conclusion: </strong>Compliance with manufacturers' instructions yielded acceptable outcomes in most cases. Each bulk fill material has different requirements pertaining to curing intensity and time to achieve desirable microhardness and degree of conversion. Clinicians should be aware of the curing protocol for the specific bulk fill materials.</p><p><strong>Clinical relevance: </strong>BBR consistently exhibited low degrees of conversion, even when the applied energy density exceeded the manufacturer's recommended levels. Further research is warranted to establish optimized curing protocols for giomer-based composites and to investigate the long-term impact of the degree of conversion on the mechanical properties and clinical durability of these restorations.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"437"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945427","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}

{"title":"Medication-Related osteonecrosis of the jaw involving dental implants: A 16-Year observational study in a single cancer center.","authors":"Raphael de Lima Chaparin, Yuri de Lima Medeiros, Rui Figueiredo, Graziella Chagas Jaguar, Rodrigo Nascimento Lopes, André Caroli Rocha, Fabio Abreu Alves","doi":"10.1007/s00784-025-06519-7","DOIUrl":"10.1007/s00784-025-06519-7","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the clinicoradiological features and treatment approaches of MRONJ in cancer patients rehabilitated with osseointegrated implants.</p><p><strong>Materials and methods: </strong>Medical records of 147 patients who developed MRONJ over a 16-year period were evaluated. Demographic data, type of antiresorptive medication (AR) used, route of administration, frequency, and time of use were collected. Staging, clinical and imaging characteristics, and treatment for MRONJ were also collected.</p><p><strong>Results: </strong>A total of 25 patients (17%) presented with implants in the region affected by MRONJ, of whom 23 (92%) underwent implant placement prior to the initiation of AR. The total number of affected implants was 42 and most had an external hexagon connection (n = 25, 59.5%). Among these patients, 28 MRONJ areas were identified, most of which were classified as stage 2 (n = 17, 60.7%) and located in the posterior mandible (n = 16, 57.1%). Pain (n = 17, 68%) and the presence of osteolytic areas (n = 21, 84%) were the most commonly observed clinical and imaging characteristics. Surgical treatment was the preferred approach in 84% (n = 21) of cases.</p><p><strong>Conclusions: </strong>MRONJ involving implants occurred mainly in patients rehabilitated before AR, with frequent involvement of the posterior mandible, pain, and osteolytic areas on radiological imaging. Surgical intervention showed a high rate of clinical success.</p><p><strong>Clinical relevance: </strong>Implants placed prior to AR may act as local risk factors for MRONJ in cancer patients, underscoring the need for careful evaluation of existing implants before starting treatment.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"436"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945296","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}

{"title":"Chewing with a cleft palate: a randomized controlled trial. Effect of timing of surgical closure of the palate on mastication in infants with clefts.","authors":"C H A L Guillaume, M M R Verhoeven, A M Eligh, S J Haverkamp, R M J C Eijkemans, M Kon, A B Mink van der Molen, C C Breugem","doi":"10.1007/s00784-025-06467-2","DOIUrl":"10.1007/s00784-025-06467-2","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effect of surgical timing of palatal closure on overall masticatory function in infants with cleft lip and/or palate (CL/P).</p><p><strong>Materials and methods: </strong>In this randomized controlled trial, 60 children with cleft lip and/or palate (CL/P) were assessed at the Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands. Participants were randomly assigned to early closure (Group A: 6-8 months) or late closure (Group B: 10-12 months). Chewing function was evaluated at 9, 13, and 17 months of age using the Mastication Observation and Evaluation (MOE) instrument, which scores eight components of mastication.</p><p><strong>Results: </strong>No statistically significant differences were found in total MOE scores between groups at any time point. However, at 17 months, Group B showed significantly better lateral tongue movement than Group A (mean = 2.72, SD = 0.53 vs. mean = 2.45, SD = 0.51; p = .047).</p><p><strong>Conclusions: </strong>Early palatal closure (6-8 months) does not improve overall mastication compared to late closure (10-12 months) in the first 17 months of life.</p><p><strong>Clinical relevance: </strong>Research on mastication in children with CL/P is limited. This study provides novel insights into functional outcomes of palatal surgery, supporting evidence-based refinement of cleft treatment protocols.</p><p><strong>Trial registration number: </strong>The CLEFED study was approved by the Medical Ethics Committee of the University Medical Center Utrecht, The Netherlands (registration no: NTR3275). Date of registration: November 2011.</p><p><strong>Trial register: </strong>https://www.trialregister.nl/trial/3125 (trial number: NTR3275).</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"432"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral mucosal lesions in children with severe asthma and acute respiratory viral infections.","authors":"Anna Berestova, Tamara Savina, Irina Semenycheva, Sultanbek Kozhemov","doi":"10.1007/s00784-025-06515-x","DOIUrl":"10.1007/s00784-025-06515-x","url":null,"abstract":"<p><strong>Background/purpose: </strong>This study investigated the clinical and histological characteristics of oral mucosal lesions in children with acute respiratory viral infections (ARVI) and Asthma (BA)-conditions that frequently coexist and exacerbate mucosal damage.</p><p><strong>Materials and methods: </strong>The rationale for the study stems from the lack of comprehensive data on the combined impact of these diseases on oral health. A total of 200 children aged 5-12 years were examined in a hospital setting and divided into 4 equal groups: children with ARVI (Group 1), children with Asthma (Group 2), children with both conditions (Group 3), and healthy children (control Group 4). The experimental design included clinical assessment, mucosal biopsy, histological examination, and quality-of-life evaluation using validated questionnaires.</p><p><strong>Results: </strong>Results showed that children in Group 3 (ARVI + BA) exhibited significantly more severe mucosal damage, including pronounced hyperemia (3.0 ± 0.5), increased erosions (4.5 ± 1.1), and higher pain scores (3.5 ± 0.6) compared to Groups 1 and 2. The control group (Group 4) showed minimal changes. Histological analysis revealed greater epithelial atrophy and inflammatory infiltration in Group 3.</p><p><strong>Conclusions: </strong>These findings highlight the need for tailored therapeutic approaches in children with coexisting ARVI and Asthma to mitigate oral mucosal damage and improve overall health outcomes. The study addressed the lack of comprehensive data on the combined effects of ARVI and asthma on oral health, with findings revealing more pronounced mucosal damage in children with both conditions compared to those with only one.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"434"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945299","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}

{"title":"Assessing the accuracy, repeatability, and consistency of ChatGPT 4o in treatment planning for tooth-supported fixed prostheses: a comparative analysis of simple and complex clinical cases.","authors":"Özer İşisağ, Kevser Karakaya","doi":"10.1007/s00784-025-06521-z","DOIUrl":"10.1007/s00784-025-06521-z","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to evaluate the effectiveness of ChatGPT 4o in planning tooth-supported fixed prostheses by examining the accuracy, repeatability, and consistency of its responses across various prosthodontic cases.</p><p><strong>Materials and methods: </strong>1,140 responses were generated for 38 questions regarding simple and complex prosthetic cases, using case schemas from Fundamentals of Fixed Prosthodontics. Each question was asked 30 times at different times of day (morning, afternoon, and evening) to assess response consistency.</p><p><strong>Results: </strong>ChatGPT demonstrated high accuracy (97.08%) for simple fixed prostheses but struggled with complex cases, showing a low accuracy rate of 19.69%. Statistically significant differences were observed in the response accuracy between question categories, indicating that ChatGPT performs better with straightforward cases than with complex ones. Repeatability was high across all question types, though accuracy varied, especially in complex scenarios.</p><p><strong>Conclusions: </strong>The findings highlight ChatGPT's potential as an assistive tool in simple prosthodontic cases yet emphasize the need for clinician expertise in more complex treatment planning.</p><p><strong>Clinical relevance: </strong>While ChatGPT shows promise as a supplementary tool for dental education and practice, reliance on AI alone for intricate cases remains premature.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"433"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945434","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}

{"title":"Space closure after premolar extraction using clear aligners: a systematic review with meta-analysis.","authors":"Fernanda Vicioni-Marques, Caio Luiz Bitencourt Reis, Ana Paula Valladares de Almeida, Letícia Pinho Maia Paixão de Melo, Fábio Lourenço Romano, Mirian Aiko Nakane Matsumoto, Maria Bernadete Sasso Stuani","doi":"10.1007/s00784-025-06475-2","DOIUrl":"10.1007/s00784-025-06475-2","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of clear aligner treatment (CAT) in space closure following premolar extraction (SCaPE) and its resistance to unwanted tooth movement remain uncertain. This systematic review aims to evaluate the efficacy, predictability, and resistance to unwanted tooth movement by CAT for SCaPE.</p><p><strong>Methods: </strong>Pre-post studies, randomized, and non-randomized clinical trials were included. A comprehensive search was conducted in PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases up to November 12, 2024. Study quality was assessed using ROB-2 and ROBINS-I tools. Three independent reviewers performed data extraction. A meta-analysis compared predicted versus achieved maxillary tooth movements in similar studies using the Invisalign^® system. Standardized Paired Difference (SPD) with 95% Prediction Interval (95% PI) and Confidence Interval (95% CI) were used for effect size estimation. The GRADE tool evaluated the certainty of evidence.</p><p><strong>Results: </strong>Fourteen studies encompassing 510 participants were included. Four studies had a low risk of bias, while ten had a high risk of bias. The results from pre-post studies indicated that CAT was significantly less effective than predicted in achieving Anterior Teeth Retraction (SPD= -0.87; 95% CI = -1.15 to -0.60; 95% PI= -1.14 to -0.59; p < 0.001; number of studies = 4), resulting in more lingual tipping (SPD = 1.09; 95% CI = 0.46 to 1.73; 95% PI= -1.01 to 3.19; p = 0.001; number of studies = 3) and extrusion of anterior teeth (SPD = 0.88, 95% CI = 0.47 to 1.29; 95% PI= -0.16 to 1.92; p < 0.001; number of studies = 4) than predicted. The achieved distal tipping of canine (SPD = 1.42; 95% CI = 0.35 to 2.51; 95% PI= -2.5 to 5.40; p = 0.009; number of studies = 3) and mesial tipping of first molars (SPD = 1.68; 95% CI = 1.17 to 2.20; 95% PI = 0.34 to 3.01; p < 0.001; number of studies = 3;) were also greater than predicted. Clinical trials comparing CAT and fixed appliances provide limited evidence.</p><p><strong>Conclusion: </strong>The findings suggest that CAT may not be effective or predictable for SCaPE due to its limited capacity to promote the bodily movement of the teeth and control anchorage. Evidence indicates that fixed appliances might be superior to CAT. Limitations of the evidence include bias across studies, with the certainty of evidence ranging from low to very low. Future research should focus on improving prediction models and exploring the potential benefits of accessories to enhance CAT's effectiveness.</p><p><strong>Registration: </strong>Not registered.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 9","pages":"435"},"PeriodicalIF":3.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945356","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}