European journal of orthodontics最新文献

{"title":"Sheldon Friel lecture 2026. Trials, quackery and social media: was it all a waste of time.","authors":"Kevin OBrien","doi":"10.1093/ejo/cjag071","DOIUrl":"https://doi.org/10.1093/ejo/cjag071","url":null,"abstract":"<p><strong>Background: </strong>Over the past 40 years, randomized trials have become the mainstay of evidence-based orthodontics.</p><p><strong>Materials and methods: </strong>This paper represents the content of the Sheldon Friel lecture presented in 2026 at the Congress of the European Orthodontic Society. I outline the value of randomized trials and revisit the findings of some of the main studies I have completed. We must also consider the development of patient-relevant outcomes and core outcome sets. While we recognize the value of trials, we must also recognize that evidence-based care is undermined by claims from the orthodontic fringe.</p><p><strong>Conclusions: </strong>Tension currently exists between the evidence-based orthodontic approach and the low-quality evidence provided by the orthodontic fringe. This paper provides an overview of these two views. The solution to this dilemma lies in carrying out high-level research and making the findings relevant and understandable to our patients.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 6","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting orthodontic appointment adherence in adolescents and parents using an extended behavioral model.","authors":"Maryam Elyasi, Babak Bohlouli, Akriti Tiwari, Maryam Amin","doi":"10.1093/ejo/cjag065","DOIUrl":"10.1093/ejo/cjag065","url":null,"abstract":"<p><strong>Background: </strong>Poor adherence in orthodontic care is a complex issue involving both children and their parents. The study aimed to expand the theory of planned behavior (TPB) by integrating sense of coherence (SOC) to predict appointment attendance in adolescent orthodontic patients.</p><p><strong>Materials and methods: </strong>This prospective cohort study recruited adolescents from the University of Alberta Graduate Orthodontic Clinic. Baseline questionnaires captured sociodemographic data, TPB constructs, and SOC. Appointment attendance and oral hygiene were monitored over 1 year. Structural equation modeling (SEM) was used to examine relationships between TPB constructs and appointment adherence, with model fit assessed using χ2, chi-square/degrees of freedom ratio (CMIN/DF), root mean square error of approximation (RMSEA), and comparative fit index (CFI).</p><p><strong>Results: </strong>A total of 168 adolescent-parent pairs participated, and 57% of participants missed at least one appointment during the first year of treatment. SEM demonstrated moderate model fit (CMIN/DF = 1.74; RMSEA = 0.06; CFI = 0.84). Within the TPB constructs, only perceived behavioral control (PBC) significantly predicted intention (P < 0.05), whereas attitude and subjective norm were not significant predictors. SOC did not significantly predict intention, TPB constructs, or appointment adherence in either the adolescent or parent models. Intention also failed to significantly predict actual attendance.</p><p><strong>Conclusion: </strong>Within the expanded TPB-SOC framework, PBC was the sole psychosocial predictor of orthodontic appointment-adherence intention. However, neither intention nor SOC translates into actual clinical attendance. The moderate model fit indicates that psychosocial constructs alone are insufficient to fully explain orthodontic appointment adherence. To build more effective adherence models, future research and clinical strategies must look beyond psychology and account for structural, logistical, and environmental barriers.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 6","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of different TAD patterns in clear aligner therapy for maxillary incisor retraction after premolar extraction.","authors":"Xu Zhang, Zhizun Wang, Ruiting Ren, Delong Li, Wei Zheng, Li Mei, Yu Li","doi":"10.1093/ejo/cjag060","DOIUrl":"https://doi.org/10.1093/ejo/cjag060","url":null,"abstract":"<p><strong>Objective: </strong>The integration of temporary anchorage devices (TADs) to aid clear aligner therapy (CAT) represents an evolving strategy that has gained expanding application over the past decade. This retrospective cohort study aimed to investigate the treatment outcomes of CAT cases involving maxillary incisor retraction following premolar extraction, managed with assistance of various TAD patterns.</p><p><strong>Subjects and methods: </strong>Adult premolar extraction CAT cases were included in this retrospective cohort study. The maxillary central incisors (U1) were grouped based on the TAD pattern for their retraction: Non-TAD (n = 54), posterior TADs only (P-TADs; n = 50), or combined anterior and posterior TADs (AP-TADs; n = 46). Pretreatment and post-treatment CBCTs quantified U1 lingualization, intrusion, retroclination and potential side effects such as apical root resorption (ARR), pulp chamber reduction and palatal dehiscence incidence.</p><p><strong>Results: </strong>P-TADs and AP-TADs patterns achieved greater U1 lingualization than the Non-TAD group. Vertical control differed markedly: AP-TADs achieved U1 intrusion (1.07 ± 1.64 mm), whereas P-TADs and Non-TAD showed U1 extrusion (-0.46 ± 1.12 mm and -1.51 ± 1.29 mm, respectively). U1 retroclination was over 10° in all three groups. AP-TADs exhibited greater ARR (1.31 ± 0.91 mm) and a higher proportion of Grade III ARR than the other groups. In regression analysis, the intrusion achieved was the strongest independent predictor of ARR. Pulp chamber reduction and palatal dehiscence incidence was similar among groups.</p><p><strong>Limitations: </strong>Residual confounding may persist due to the inherent limitations of retrospective study designs.</p><p><strong>Conclusions: </strong>In CAT cases involving maxillary incisor retraction following premolar extraction, P-TADs and AP-TADs patterns were associated with notable clinical treatment outcomes. These preliminary findings may provide prognostic indication for the management of such cases in the future.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal sinus morphology and maturation determination.","authors":"Hatice Kök","doi":"10.1093/ejo/cjag059","DOIUrl":"https://doi.org/10.1093/ejo/cjag059","url":null,"abstract":"<p><strong>Aim: </strong>To determine the relationship between frontal sinus morphometric measurements and established maturation indicators obtained from hand-wrist and lateral cephalometric radiographs, and to evaluate the diagnostic performance of frontal sinus morphometric measurements in discriminating growth and developmental stages.</p><p><strong>Materials and methods: </strong>This retrospective study analysed radiographs of 240 patients aged 9-19 years who underwent simultaneous hand-wrist and cephalometric imaging. Patients were categorized into six cervical vertebral maturation stages (CVS), with 20 females and 20 males in each stage. Hand-wrist (HWS), cervical vertebra (CVS), and dental maturation (DS) stages were assessed. Frontal sinus measurements included maximum height (FSHeight), maximum width (FSWidth), frontal sinus index (FSIndex), area (FSArea), and perimeter (FSPerimeter). Spearman's Rho assessed correlations, and ROC analysis evaluated diagnostic performance with cut-off-based accuracy rates. Reliability was examined using the Kappa coefficient, Kendall's tau-b, and intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>After Benjamini-Hochberg false discovery rate (FDR) correction, no significant correlations were found between HWS or DS stages and FSHeight in male patients, or between CVS or DS stages and FSIndex. In females, FSArea showed the highest discriminatory performance for classifying the transition from pre-pubertal to pubertal stage (AUC = 0.794; P < 0.001). In males, FSWidth showed the strongest discriminatory performance (AUC = 0.817; P < 0.001). For the transition from the pubertal to post-pubertal stage, FSWidth showed the highest discriminatory performance (AUC = 0.846; P < 0.001), and all frontal sinus measurements were statistically significant in both sexes.</p><p><strong>Conclusion: </strong>Frontal sinus morphometry showed high reliability and meaningful associations with age and maturation indicators. However, as AUC values ranged from moderate to good (0.655-0.846) and diagnostic performance varied by sex, maturation system, and transition stage, frontal sinus morphometry should be regarded as a supplementary rather than a standalone or definitive indicator of skeletal maturation, pending longitudinal validation.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effectiveness and efficiency of clear aligners and fixed appliances in the presurgical orthodontic treatment of skeletal Class III malocclusion: a retrospective study.","authors":"Zhuo Ping Bai, Zhi Wei, Xiao Qi Zhang, Qing Song Jiang, Yi Yang, Jia Chen Huo, Ujjwal Pyakurel, Hu Long, Wen Li Lai, Yan Wang","doi":"10.1093/ejo/cjag069","DOIUrl":"https://doi.org/10.1093/ejo/cjag069","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effectiveness and efficiency of clear aligners (CA) with fixed appliances (FA) during presurgical orthodontics for combined orthodontic-orthognathic treatment of skeletal Class III malocclusion.</p><p><strong>Materials and methods: </strong>In this single-centre retrospective cohort, 95 patients (16-36 years) treated between 2019 and 2021 were stratified by appliance and extraction status: FA nonextraction (n = 24), FA extraction (n = 28), CA nonextraction (n = 24), and CA extraction (n = 19). The prespecified primary effectiveness outcome was maxillary incisor decompensation (ΔU1-SN); the key efficiency outcome was recorded presurgical duration. Adjusted within-stratum CA-FA contrasts used HC3 robust linear models with Benjamini-Hochberg correction across the secondary-outcome family.</p><p><strong>Results: </strong>CA were associated with shorter recorded duration in both strata (nonextraction -143.6 days, P = .020; extraction -263.0 days, P = .0005) and fewer follow-up visits (-8.41 and -13.52; both P < .001). A prespecified sensitivity analysis adding each CA patient's aligner delivery wait left the extraction association intact (-231.7 days, P = .0023) but rendered the nonextraction association marginal (-117.6 days, P = .055). CA showed greater maxillary incisor decompensation in both strata (primary outcome, raw P: nonextraction +4.63°, P = .027; extraction +4.37°, P = .044, marginal). No secondary effectiveness outcome survived correction, and a simulated surgical readiness index showed no difference.</p><p><strong>Conclusions: </strong>In this retrospective cohort, CA were associated with shorter recorded presurgical treatment, fewer visits and greater maxillary incisor decompensation than FA. The nonextraction duration association became marginal once the delivery wait was incorporated, whereas the extraction-stratum association was largely preserved. Prospective controlled studies are needed to confirm these findings.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microplastics and orthodontic aligners: another hype?","authors":"Theodore Eliades, Despina Koletsi","doi":"10.1093/ejo/cjag061","DOIUrl":"https://doi.org/10.1093/ejo/cjag061","url":null,"abstract":"","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated prediction of hand-wrist maturation stage from lateral cephalometric and panoramic radiographs using a deep learning approach.","authors":"Merve Edik, Fatma Çelebi, Meryem Etöz","doi":"10.1093/ejo/cjag054","DOIUrl":"10.1093/ejo/cjag054","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to predict hand-wrist developmental stages, the most reliable indicator of skeletal maturation, from panoramic radiographs (PRs) and lateral cephalometric radiographs (LCRs) using deep learning and to compare the two methods. The goal was to provide a rapid and objective method for growth assessment in orthodontic planning without additional radiation exposure.</p><p><strong>Methods: </strong>A total of 3703 patients who underwent hand-wrist radiographs (HWRs), PRs, and LCRs prior to orthodontic treatment were retrospectively analyzed. HWRs were classified according to Björk's 9-stage system and reduced to 5- and 3-group schemes. YOLOv5 was used for automated reference point detection, and the extracted regions were classified using a multimodal deep learning framework. EfficientNet-B0 was used for 9-stage classification, and EfficientNet-B4 was used for 5- and 3-group classifications. Clinical variables (age, gender) were included, and hybrid loss strategies addressed class imbalance while preserving sequential stage relationships. Performance metrics included accuracy, recall, mAP@0.5, balanced accuracy, Cohen's Kappa coefficient, and detailed error analysis; 5-fold cross-validation and ensemble learning were used to improve robustness.</p><p><strong>Results: </strong>YOLOv5 detected tooth roots in PRs (accuracy 92.5%, recall 93.3%, mAP@0.5 = 0.942) and cervical vertebrae in LCRs (accuracy 98.9%, recall 99.9%, mAP@0.5 = 0.995). In PRs, the standard accuracy in 9-, 5-, and 3-stage classifications was 0.3648, 0.5307, and 0.7520, respectively, while in LCRs, the standard accuracy in 9-, 5-, and 3-stage classifications was 0.4350, 0.6336, and 0.8975, respectively.</p><p><strong>Conclusion: </strong>Deep learning can reliably automate skeletal maturation assessment across imaging methods and resolutions. Appropriately optimized models provide valuable decision support in orthodontic treatment, increasing efficiency and consistency.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for facial attractiveness assessment in orthodontics: model development and evaluation.","authors":"Platon-Timotheos Perdikaris, Miltiadis A Makrygiannakis, Apostolos Ntokos, Eleftherios G Kaklamanos","doi":"10.1093/ejo/cjag068","DOIUrl":"10.1093/ejo/cjag068","url":null,"abstract":"<p><strong>Background: </strong>Achieving valid and reproducible facial attractiveness assessment in orthodontic practice remains challenging. Artificial intelligence (AI) has shown potential in orthodontics and may help reduce inconsistencies in the evaluation of facial and smile aesthetics. This study aimed to develop and internally validate an AI model for assessing facial attractiveness in a Caucasian population.</p><p><strong>Materials and methods: </strong>The study sample was derived from a subset of the SCUT-FBP5500 V2 dataset and included Caucasian subjects, comprising 750 males and 750 females with human-rated facial attractiveness scores on a 1-5 scale. The model was based on a ResNet-50 backbone pretrained on ImageNet. Training was performed using the Adam optimizer (learning rate 0.0001) and mean squared error loss for up to 100 epochs. Stratified data splits of 70% for training, 10% for validation, and 20% for testing were created according to facial attractiveness score and sex. During training, data augmentation techniques, including resizing, random horizontal flipping, rotation, colour jittering, and tensor conversion, was applied, whereas the validation and test sets underwent resizing only. All experiments were conducted on a Linux-based system with an NVIDIA RTX 2080 GPU, using Python 3.12 and PyTorch v2.9. Model performance was assessed using MAE and RMSE across the test set, by sex, and across facial attractiveness-score quintiles.</p><p><strong>Results: </strong>The model demonstrated predictive performance on the test set, with an MAE of 0.215 (95% CI: 0.196-0.234) and an RMSE of 0.276 (95% CI: 0.251-0.300). Sex-specific analysis showed marginally better performance in males, with an MAE of 0.201 (95% CI: 0.177-0.225), compared with 0.228 (95% CI: 0.198-0.264) in females (P = 0.662). The highest accuracy was observed in the densely represented segment of the dataset, where the MAE was 0.156 (95% CI: 0.119-0.199). Error metrics varied across attractiveness-score ranges and were highest in the (3.02-3.63] range.</p><p><strong>Conclusions: </strong>The proposed model closely approximated human ratings of facial attractiveness and demonstrated predictive accuracy. These findings support the potential of AI-based tools to provide more consistent aesthetic assessments in orthodontics. Future research should include diverse populations to improve generalizability and clinical applicability.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-aided indirect bonding versus traditional direct bonding of orthodontic brackets: bonding accuracy and bonding failures. A split mouth randomized controlled trial.","authors":"Izabela Czolgosz, Paolo M Cattaneo, Malgorzata Sowinska, Marie A Cornelis","doi":"10.1093/ejo/cjag067","DOIUrl":"10.1093/ejo/cjag067","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of this randomized controlled trial were to compare the accuracy of computer-aided indirect bonding with conventional direct bonding, and to evaluate bracket survival.</p><p><strong>Methods: </strong>Consecutive patients were randomly allocated to two groups (blocks of four, online generated sequence) using a split-mouth design with a computer-aided indirect and a direct bonding method: group 1 (upper right and lower left quadrants: computer-aided indirect bonding; upper left and lower right quadrants: direct bonding) or group 2 (opposite situation). Modified ABO-OGS scores were calculated at the end of treatment. Bracket bonding failures, as well as bracket rebondings and finishing bends because of inaccurate bracket positioning were recorded at every visit. The primary outcome was bracket placement accuracy. The secondary outcome was bracket survival. Outcome assessment was blinded. To compare bracket placement accuracy, paired t-tests were used together with linear mixed models. For the survival analysis, a piecewise Cox model was used.</p><p><strong>Results: </strong>Thirty-seven patients were randomized to group 1 or group 2. Twenty-seven patients were analyzed for bracket survival, and 26 for ABO-OGS scores. There was no significant difference (P = 0.76, 95% CI: -1.18, 0.87) in mean modified ABO-OGS scores between both methods. Among the brackets bonded with computer-aided indirect bonding, 66 brackets (27%) needed rebonding or finishing bends because of inaccurate positioning. Fifty-six brackets bonded with direct bonding (23%) were rebonded or required finishing bends because of inaccurate bracket positioning. The bonding method did not appear to significantly influence the proportion of teeth needing rebonding/wire bending because of inaccurate bracket positioning. A total of 44 out of 532 brackets got debonded throughout treatment: 22 debonded brackets were totalized with each bonding method (8.3%). There was no statistically significant difference in survival between both bonding techniques. The hazard ratio (HR) computer-aided indirect bonding to direct bonding during the first year was estimated at 1.15 (P = 0.67, 95% CI: 0.61, 2.17). After the first year, the HR indirect to direct was estimated at 0.46 (P = 0.38, 95% CI: 0.09, 2.53). No harm was observed.</p><p><strong>Conclusions: </strong>There were no statistically significant differences in bonding accuracy and in bracket survival between computer-aided indirect and direct bonding methods.</p><p><strong>Registration: </strong>This trial was retrospectively registered on ClinicalTrials.gov (University of Aarhus Protocol Record 10101).</p><p><strong>Protocol: </strong>The protocol was not published before trial commencement.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does nasal airflow obstruction influence maxillary canine impaction? A fluid dynamics and quantitative tongue posture study.","authors":"Tomohiro Kizuki, Kei Maeo, Yukari Suzuki, Mayu Noda, Hitomi Kuramoto, Takamasa Kitamura, Yuki Akazawa, Hitomi Ishii, Ryuzo Kanomi, Tomonori Iwasaki","doi":"10.1093/ejo/cjag058","DOIUrl":"https://doi.org/10.1093/ejo/cjag058","url":null,"abstract":"<p><strong>Background/objectives: </strong>Maxillary buccal impacted canines (BIC) can cause root resorption of the adjacent incisors, making early detection critical. However, the etiological factors underlying BIC remain unclear. In this study, we aimed to investigate the association between nasal airflow status and tongue posture in patients with BIC.</p><p><strong>Methods: </strong>Ninety-three children with BIC were classified based on canine axis inclination into mild (n = 24, mean age: 9.24 years), moderate (n = 23, mean age: 9.12 years), and severe (n = 46, mean age: 9.67 years) impaction groups. A control group comprised 31 children without BIC (mean age: 9.66 years). Cone-beam computed tomography assessed maxillofacial morphology, maxillary and mandibular arch widths and molar inclination, intraoral airway volume (indicator of low tongue posture), and nasal airway pressure using computational fluid dynamics.</p><p><strong>Results: </strong>Maxillary first molar width was significantly smaller in the severe impaction group (32.4 mm) than in the control group (34.0 mm). Nasal airway pressure and intraoral airway volume were significantly greater in the severe impaction group (1328.2 Pa; 2.31 cm3) than in the control group (50.2 Pa; 0.53 cm3). Nasal airway obstruction and low tongue posture were significantly more prevalent in the severe impaction group (78.2% and 80.4%) than in the control group (9.6% and 22.5%).</p><p><strong>Limitations: </strong>Study limitations include the retrospective nature, restricted sample age, and lack of evaluation of genetic and local factors.</p><p><strong>Conclusions/implications: </strong>BIC are associated with dental arch morphology, nasal airway obstruction, and low tongue posture.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 5","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}