European journal of orthodontics最新文献

{"title":"Dynamics of salivary stress-related biomarkers in children with malocclusion and risk for sleep problems and sleep-disordered breathing: a cross-sectional study.","authors":"Shugo Manase, Aiko Ito, Fumitaka Kobayashi, Kana Sakono, Saki Tanaka, Ayaka Suga, Hiroshi Tomonari","doi":"10.1093/ejo/cjag004","DOIUrl":"https://doi.org/10.1093/ejo/cjag004","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep problems in children can affect neuroendocrine regulation and craniofacial development. Although malocclusion may contribute to airway impairment and altered growth patterns, the associations between sleep-related symptoms and physiological stress markers remain unclear. This study examined salivary stress-related biomarkers and craniofacial morphology in children with malocclusion who were at elevated risk for sleep problems and sleep-disordered breathing (SDB).</p><p><strong>Materials and methods: </strong>Seventy-five children aged 7-12 years completed the Japanese Sleep Questionnaire for Elementary Schoolers (JSQ-ES). Children with total scores ≥80 were classified as high risk for general sleep problems, and those with SDB subscale scores ≥10 as high risk for SDB. Unstimulated saliva was analysed for oxytocin, melatonin, cortisol, and chromogranin A. Lateral cephalograms were evaluated for 34 variables. Statistical analyses included Shapiro-Wilk, t-tests or Mann-Whitney U-tests, and Pearson's or Spearman's correlations (P < .05).</p><p><strong>Results: </strong>Fourteen children (18.7%) were classified as high risk for general sleep problems and 38 (50.7%) as high risk for SDB. Oxytocin concentration was lower in the high-risk sleep problems group (P = .041) and correlated negatively with JSQ-ES total score (ρ = -0.250). No biomarker differences were observed by SDB risk. Children at high risk for sleep problems showed a greater mandibular plane angle, while higher SDB scores were associated with anteroposterior skeletal discrepancies.</p><p><strong>Conclusions: </strong>Children at elevated risk for general sleep problems showed reduced salivary oxytocin and greater vertical skeletal divergence, whereas those at elevated SDB risk exhibited anteroposterior craniofacial differences without biomarker alterations.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431764","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":"Interceptive orthodontics in practice: a 5-year population-based study.","authors":"Anna Westerlund, Sara Waldenstrom, Emilia Karttunen, Frida Lindström, Maja Oscarson, Khadija Rezaee, Rahaf Safar, Jennifer To, Sara Bjorns, Klara Leffler","doi":"10.1093/ejo/cjaf113","DOIUrl":"https://doi.org/10.1093/ejo/cjaf113","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the scope and short-term outcomes of interceptive orthodontic treatment delivered by general dental practitioners (GDPs) under the supervision of specialist orthodontists within a publicly funded healthcare system.</p><p><strong>Subjects and methods: </strong>This retrospective cohort study included all patients aged ≤18 years who received publicly funded interceptive orthodontic treatment in Region Västra Götaland, Sweden, during 2020-2024; the pediatric population (0-18 years) was approximately 400 000. In total, 22 000 cases were identified from electronic records. Analyses focused on four appliances: Activator, Extraoral Traction, Quad Helix, and Removable Plate. Detailed outcome assessment was performed for all cases from year 2020 (n = 4400), with extraction of age, sex, treatment indication, treatment duration, number of visits, and appliance-specific outcomes.</p><p><strong>Results: </strong>In total, 21 946 treatments were registered over 5 years. The most common appliances were Removable Plates (n = 10 511), Activators (n = 6455), Quad Helix (n = 3164), and Extraoral Traction (n = 1816). On average, 4389 interceptive treatments were delivered annually, accounting for nearly 100 000 visits. Treatments were typically initiated in the late mixed dentition (mean age, 10.2-11.2 years; range, 8-13 years), with equal gender distribution. Mean treatment duration ranged from 11 months (Quad Helix) to 20 months (Activator). Success rates were highest for Quad Helix (82%) and Removable Plates (65%), while lower rates were recorded for Extraoral Traction (57%) and Activators (56%). Failures were mainly linked to poor compliance.</p><p><strong>Conclusion: </strong>The results from this large cohort study on interceptive orthodontics provide real-world evidence that although success rates were lower than in randomized trials, the outcomes reflect routine care conditions. The findings highlight the importance of compliance, appliance selection, and treatment timing. The dataset offers a foundation for future longitudinal evaluations of long-term outcomes and cost-effectiveness.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218991","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":"The impact of space closure versus space opening and prosthetic rehabilitation treatment on a young person's quality of life, aesthetics, and self-esteem in hypodontia: a longitudinal prospective study.","authors":"Ama Johal, Rabia Dean, Mandana Amin, Shakeel Shahdad, Ferranti Wong","doi":"10.1093/ejo/cjag003","DOIUrl":"10.1093/ejo/cjag003","url":null,"abstract":"<p><strong>Background: </strong>The present research study uniquely aimed to evaluate the impact of undergoing orthodontic and restorative treatment on a young person's oral health-related quality of life (QoL), self-esteem and aesthetics in relation to the management of hypodontia.</p><p><strong>Materials and methods: </strong>A prospective longitudinal hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. The following questionnaires were completed both prior (T0) and after the completion of treatment by either space closure or opening and restorative rehabilitation (T1) treatment: child perception questionnaire, Bristol condition specific questionnaire for hypodontia (BCS), child health questionnaire and the Oral Aesthetic Subjective Impact Scale. The outcome variables was the end of treatment measurements, all of which were continuous in nature. The analysis was performed using analysis of covariance.</p><p><strong>Results: </strong>A total of 26 participants were lost to follow up. At the completion of treatment (T1), 71 participants completed all four questionnaires. In this cohort, there were 31 participants in the space opening and 40 in the space closure group. For both groups, improvements were observed in both QoL, self-esteem and dental aesthetics. Whilst Overall, there was no statistically significant difference detected in a number of outcomes between the two groups differences were detected in the majority of domains of the BCS, favourable towards space closure (P < .03).</p><p><strong>Conclusions: </strong>Treatment in participants with a range of hypodontia severity appears to have a significant positive impact, both psychologically and in terms of aesthetics. Furthermore, with the exception of the BCS, no difference in the outcomes was detected irrespective of whether participants underwent either orthodontic space closure or space opening, with subsequent prosthetic replacement.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389784","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":"Effectiveness of self-ligating versus conventional brackets for treatment of bimaxillary protrusion: a single-centre randomized clinical trial.","authors":"Trudee Hoyte, Anil Ali, Akini James, David Bearn","doi":"10.1093/ejo/cjag013","DOIUrl":"https://doi.org/10.1093/ejo/cjag013","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare treatment duration between self-ligating and conventional brackets, determine factors influencing treatment duration and compare the quality of orthodontic care with both bracket systems in a bimaxillary protrusion population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and methods: &lt;/strong&gt;Participants were randomly allocated into the Smart Clip™ self-ligation bracket group or the Victory Series™ conventional ligation bracket group, both with MBT prescription (3M-Unitek, Monrovia, California, USA). Both extraction and nonextraction cases were included. Primary outcome measures included (i) overall treatment duration, (ii) levelling and aligning duration, (iii) Space closure and finishing duration, and (iv) number of appointments and other treatment related factors. The secondary outcomes assessed the quality of care. These occlusal outcomes included incisor inclination, ABO CR-EVAL, patient perception using the Index of Treatment Need and three validated questionnaires before, during and after treatment, measuring patient satisfaction with treatment and patient experience. Independent sample t-test and chi-square tests were conducted to assess differences in groups. Descriptive statistics and parametric tests were conducted. Also, nonparametric tests were carried out where appropriate. This clinical trial was ongoing during the COVID-19 pandemic, therefore, the effect of the pandemic on the trial was also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 109 participants were enrolled. They were randomized in a 1:1 ratio; 13 were excluded (poor attendance prior to and poor attendance due to the COVID-19 pandemic). Forty-nine participants were analysed in the conventional bracket group and 47 in the self-ligating group. The overall mean age was 13 years. The groups were similar pre-treatment, and no statistical significance was found between the groups for treatment duration, duration of key stages and number of appointments (P &gt; 0.05). The mean duration of treatment was 24.34 months for the conventional bracket group and 25.83 months for the self-ligating bracket group. ABO CR-EVAL showed a better quality of finish in the self-ligating bracket group. This, however, was not significant statistically. In both the conventional and self-ligating groups, the post-treatment U1-PP and L1-MP angles were consistent with the reported norms for this population. In extraction and nonextraction cases the self-ligating bracket retroclined the upper (9.2°in extraction and 2.2°in nonextraction cases) and lower incisors (7.3° in extraction and 3.9° in nonextraction cases) more than conventional bracket. In nonextraction cases these differences were not statistically significant (P &gt; 0.05). Pre to post-treatment, there was a highly statistically significant improvement in the IOTN aesthetic component in both groups (P &lt; 0.01).There was a significant difference between groups for pre-IOTN aesthetic assessment. The COVID-19 pandemic had no ","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389739","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":"Glass ionomer open exposure and closed exposure of palatally displaced canines: a randomised controlled trail comparing postoperative pain perception and complications.","authors":"Anna Dahlén, Viktoria Tagesson, Damon Taheri, Ken Hansen, Larisa Krekmanova, Julia Naoumova","doi":"10.1093/ejo/cjag011","DOIUrl":"10.1093/ejo/cjag011","url":null,"abstract":"<p><strong>Background: </strong>The most common surgical interventions for palatally displaced canines (PDCs) are open and closed exposure, yet there is no consensus on which exposure technique is preferable.</p><p><strong>Objectives: </strong>To compare glass ionomer open exposure (GOPEX) with closed exposure (CE) in terms of patient-reported outcomes, surgical duration, and complications.</p><p><strong>Trial design: </strong>The trial design was a single centre, randomised controlled trial, with a 1:1 allocation of two parallel groups.</p><p><strong>Methods: </strong>Patients aged ≤18 years, with a unilateral PDC in sector 2-5, requiring surgical exposure were randomly allocated to GOPEX or CE. Patient-reported outcomes were collected through a questionnaire completed over the phone daily from the day of exposure until symptom resolution. Surgery duration, recorded by the operator, and complications within four weeks, was obtained from the patient's record. The outcome assessor and the individual conducting the follow-up calls were blinded to group allocation. Repeated measures analyses were used for data collected at multiple time points. Mann-Whitney U-test, chi-square test or Fisher's exact test, as appropriate was used for other between-group comparisons.</p><p><strong>Results: </strong>Of the 92 patients randomised, 83 completed the intervention: 43 in the GOPEX group (13.8 ± 1.5 years) and 40 in the CE group (13.6 ± 1.2 years). Throughout the full postoperative period, the groups did not differ significantly in pain levels, percentage of pain-free patients, analgesic use, or chewing difficulty. During the first postoperative week, however, the GOPEX group reported higher pain (fold change 1.78; 95% CI: 1.07-2.99; P = 0.028). Fewer GOPEX patients were pain-free at one week, and they consumed more analgesics on postoperative days 4 and 5. Surgery duration was similar between groups, and complications were rare and comparable.</p><p><strong>Conclusions: </strong>Although the GOPEX group reported more pain during the first postoperative week, overall pain scores and analgesic consumption across the full postoperative period did not differ between groups. No significant differences were found in surgery duration or complications.</p><p><strong>Trial registration: </strong>www.researchweb.org/is/sverige, registration number: 279469.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472747","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 treatment duration and complications between surgery-first and conventional orthognathic approaches: a retrospective study.","authors":"Mikko Lahtinen, Satu Strausz, Paula Salonen, Patricia Stoor, Anu Kiukkonen","doi":"10.1093/ejo/cjaf102","DOIUrl":"https://doi.org/10.1093/ejo/cjaf102","url":null,"abstract":"<p><strong>Objective: </strong>This study compares the surgery-first approach (SFA) and the conventional orthognathic approach (COA) in terms of total treatment duration and complications in patients with skeletal malocclusions.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 34 patients treated at Helsinki University Hospital, with 17 patients in each treatment group. The groups were matched by age, sex, and type of surgery. Treatment duration was assessed using statistical comparisons, and perioperative and postoperative complications were analyzed using logistic and Poisson regression models adjusted for age, sex, and surgery type.</p><p><strong>Results: </strong>SFA significantly reduced the total treatment duration compared to COA by eliminating the presurgical orthodontic phase (13.0 months vs. 27.67 months, P = 1.66×10-10). The groups were similar in terms of their difficulty scores according to the ICON scale (P > 0.05). However, the postsurgical orthodontic phase was significantly longer in the SFA group (11.72 months vs. 8.22 months, P = 6.18×10-13). Maxillary retrognathia was independently associated with a shorter total treatment duration, while open bite prolonged postsurgical orthodontic treatment, regardless of the surgical approach. Age was the only significant predictor of complications (P = 0.042), with older patients being at a greater risk.</p><p><strong>Conclusions: </strong>SFA is an effective alternative to COA, offering a shorter overall treatment duration while requiring longer postsurgical orthodontic management. While complication rates do not significantly differ between the approaches, older patients are at a higher risk of complications.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092411","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":"Tongue myofunctional performance, strength and functionality index in Class II and Class III dentofacial deformities.","authors":"Kizzy Silva Germano Nascimento-Moraes, Lucia Dantas Giglio, Francisco Veríssimo de Mello-Filho, Claudia Maria de Felício, Luciana Vitaliano Voi Trawitzki","doi":"10.1093/ejo/cjaf110","DOIUrl":"https://doi.org/10.1093/ejo/cjaf110","url":null,"abstract":"<p><strong>Background: </strong>Individuals with dentofacial deformities (DFD) present several orofacial myofunctional alterations. However, the characteristics of tongue position and motor performance, which are crucial for DFD assessment and treatment, remain poorly understood.</p><p><strong>Objectives: </strong>To assess orofacial myofunctional status and analyze tongue position, mobility, behavior during swallowing, and pressure/strength performance in patients with Class II and Class III DFD compared with control subjects, as well as to formulate a tongue functionality index.</p><p><strong>Methods: </strong>Fifty-six patients with DFD were divided into two groups: Class II DFD (CII, n = 26) and Class III DFD (CIII, n = 30). Nineteen healthy individuals composed the control group. All participants were evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol and the Iowa Oral Performance Instrument (IOPI) for tongue strength measurements. The tongue functionality index was obtained by summing the z-scores of the total tongue score and saliva-swallowing strength.</p><p><strong>Results: </strong>Patients with DFD showed lower total OMES scores (indicating worse performance), lower tongue performance scores, and reduced tongue strength during swallowing (P < .01). The tongue functionality index demonstrated excellent diagnostic accuracy and sensitivity, as well as good specificity, in differentiating the tongue status of patients with and without DFD.</p><p><strong>Conclusion: </strong>The individuals from groups CII and CIII exhibited global orofacial myofunctional alterations, impaired tongue position and motor ability, and reduced tongue strength during swallowing. The tongue functionality index may serve as a useful variable for predicting tongue functional status.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997094","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":"Incidence of auditory alterations following orthognatic surgery: a systematic review.","authors":"Angela Graciela Deliga Schroder, Aline Xavier Ferraz, Rodolfo Jorge Fortes Kubiak, Gabrielly Aparecida Eulalio Dos Santos, Ana Beatriz Pinheiro Cruz Lopes, Rosane Sampaio Santos, Vanessa Luisa Destro Fidêncio, Karinna Verissimo Meira Taveira, Cristiano Miranda de Araujo","doi":"10.1093/ejo/cjaf099","DOIUrl":"https://doi.org/10.1093/ejo/cjaf099","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Orthognathic surgery is an established procedure for correcting skeletal dentofacial deformities, with proven benefits for occlusion, facial esthetics, and airway function. Despite its overall safety, it can be associated with complications, including transient or persistent auditory alterations, such as otalgia, tinnitus, and Eustachian tube dysfunction. These changes may result from altered peritubal muscle tension, surgical trauma, postoperative edema, or pre-existing conditions, like serous otitis media.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To systematically review and quantitatively synthesize the incidence and types of auditory alterations following orthognathic surgery, evaluate their association with surgical intervention, and investigate the influence of postoperative time on symptom resolution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;A comprehensive search strategy was applied using the COCHRANE Library, EMBASE, PubMed/MEDLINE, LILACS, LIVIVO, Scopus, and Web of Science, complemented by gray literature searches via Google Scholar and ProQuest Dissertations. Reference lists of eligible studies were screened, and an expert was consulted for additional records. Searches were performed in June 2023 and updated in March 2025, with no restrictions on date or language.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Eligible studies included randomized controlled trials, nonrandomized trials, cohort studies, and cross-sectional studies assessing auditory function in nonsyndromic adults undergoing orthognathic surgery, using validated auditory tests or self-reported outcomes. Comparisons had to be made between pre- and postoperative assessments or with control groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two reviewers independently screened studies, extracted data, and assessed risk of bias. Individual study estimates were summarized descriptively, with odds ratios and proportions presented through graphical visualizations. Lollipop plots were used to display point estimates with corresponding 95% confidence intervals. Certainty of evidence was graded using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nine studies (n = 6-257 participants) were included. The reported incidence of postoperative auditory alterations varied widely, ranging from &lt;10% to &gt;60% across studies. Estimates for audiometric changes, middle-ear function, and otalgia were imprecise and inconsistent, with wide confidence intervals frequently crossing the null. While some studies described transient symptoms such as tinnitus, otalgia, and Eustachian tube dysfunction, these findings were not uniformly observed. Overall, the certainty of the evidence was rated as very low.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The available evidence does not demonstrate a consistent association between orthognathic surgery and auditory alterations. Although transient changes may occur in the early postoperative period, they tend to resolve spontaneousl","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997842","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":"Do we value the safety of our treatments? An empirical assessment of reporting of Harms in Randomized Controlled Trials in Orthodontics.","authors":"Ioanna Georganakis, Vasiliki Koretsi, Theodore Eliades, Despina Koletsi","doi":"10.1093/ejo/cjaf105","DOIUrl":"10.1093/ejo/cjaf105","url":null,"abstract":"<p><strong>Aim: </strong>To record reporting of harms by authors of randomized controlled trials (RCTs) in indexed orthodontic journals of the Q1 ranking, and explore associations between published reports and several publication characteristics.</p><p><strong>Materials and methods: </strong>RCTs from six (6) Q1 indexed orthodontic journals, namely the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), the European Journal of Orthodontics (EJO), the Angle Orthodontist (ANGLE), Progress in Orthodontics (PIOR), the Korean Journal of Orthodontics (KJO), and the Journal of the World Federation of Orthodontists (JWFO) from January 2020 to December 2024 were included. Data extraction was conducted for outcome and predictor variables such as reporting of harms or otherwise, and other publication characteristics including year of publication, journal, origin of authorship, number of authors, design of the RCT, registration, funding, reporting of patient reported outcome measures (PROMs). Statistical analyses included descriptive statistics, cross-tabulations, and univariable and multivariable logistic regression.</p><p><strong>Results: </strong>A total of 183 RCTs were included. Twenty four percent of RCTs (44/183) did not report on harms in their publications. A significant association was detected between reporting of harms and journal of publication, with EJO published studies acknowledging pertinent harms almost in their entirety (49/51; 96.1% reported harms; P = .008). RCTs of American affiliated authors were the least likely to report harms (P = .02). Studies reporting on PROMs showed 2.73 higher odds for reporting harms compared with those that did not include PROMs (adjusted odds ratio, OR: 2.73; 95% CI: 1.04, 7.15; P = .04). There was strong evidence that RCTs with registered protocols presented higher odds for reporting harms than nonregistered trials (adjusted OR: 3.68; 95% CI: 1.62, 8.36; P = .002).</p><p><strong>Conclusions: </strong>Albeit progress has been made, a quarter of orthodontic RCTs still do not include harms in their assessment. Registration, inclusion of PROMs, origin of authorship and journal of publication were significant predictors of harms reporting.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12706765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762458","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":"Development and evaluation of an attention-gated U-net model for binary segmentation of teeth versus background in panoramic radiographs for orthodontic applications.","authors":"Miltiadis A Makrygiannakis, Apostolos Ntokos, Eleftherios G Kaklamanos","doi":"10.1093/ejo/cjaf114","DOIUrl":"https://doi.org/10.1093/ejo/cjaf114","url":null,"abstract":"<p><strong>Background: </strong>Panoramic X-rays (OPGs) play a crucial role in both pre- and post-treatment orthodontic evaluation. Binary segmentation of tooth versus background regions in these images is fundamental for dental image analysis, enabling automated diagnosis and improving treatment planning in orthodontics and general dentistry. Although various deep learning approaches have been investigated, standardized performance benchmarks on publicly available datasets remain limited. This study aims to establish a benchmark for binary semantic segmentation of tooth versus background regions as a basis for orthodontic applications by applying an attention-gated U-Net (Att-U-Net) architecture to a large, publicly accessible dataset.</p><p><strong>Material and methods: </strong>An Att-U-Net model was used to perform tooth versus background binary segmentation on the 'Teeth Segmentation on Dental X-ray Images' dataset, which includes 598 annotated OPGs. The dataset was divided into training (70%), validation (10%), and testing (20%) sets using stratified sampling to maintain a representative class distribution. The model was trained with a combined loss function that merges binary cross-entropy and dice loss to address class imbalance. Its performance was assessed using a comprehensive set of metrics, including the dice coefficient, mean IoU, precision, recall, and receiver operating characteristic AUC in the entire dataset, quintiles based on the tooth-to-background pixel ratio, and a subset of radiographs that can present challenges during artificial intelligence-based tooth segmentation. Finally, evaluations of the model's consistency and computational performance, as well as visual inspections, were conducted.</p><p><strong>Results: </strong>The Att-U-Net model demonstrated strong and accurate performance. Training and validation curves indicated stable convergence, with the model reaching a final dice coefficient of 0.911, a mean IoU of 0.838, and a pixel accuracy of 0.974 on the held-out test set. The model's sensitivity increased, and its overall performance saw a slight improvement in challenging segmentation cases. The inference times indicated that the model was both fast and highly stable. Visual inspection confirmed the high quantitative scores.</p><p><strong>Conclusion: </strong>The Att-U-Net model demonstrated robust and reliable performance, with the training process being stable and consistent. The high quantitative performance was complemented by qualitative analysis, which showed that the model produces precise and visually accurate segmentation masks, even in cases that pose challenges. This can be useful for OPG quality reviews and lays the groundwork for tackling more complex segmentation tasks and enhancing automated diagnosis systems in orthodontics.</p>","PeriodicalId":11989,"journal":{"name":"European journal of orthodontics","volume":"48 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149590","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}