Orthodontics & Craniofacial Research最新文献

{"title":"Acute Effects on Masticatory Muscle Activity and Swallowing Following Increases in Occlusal Vertical Dimension Using Bite Blocks","authors":"Ian Raby,&nbsp;Victor Rojas,&nbsp;Andres Celis,&nbsp;Rocío Aguirre,&nbsp;Felipe H. Palma,&nbsp;Manuel Carrasco","doi":"10.1111/ocr.70128","DOIUrl":"10.1111/ocr.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate acute changes in tongue pressure and electromyographic (EMG) activity of the masseter and temporalis muscles during swallowing with incremental increases in occlusal vertical dimension (OVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This pilot experimental study included 22 healthy adults. Swallowing was assessed at the basal OVD and with incremental increases of 2, 4, and 6 mm using hard wax stops under two conditions: saliva swallowing (SS) and yogurt swallowing (YS). Tongue pressure was measured with a Flexiforce A-201 sensor, and EMG activity of the masseter and temporalis muscles was recorded using EMG Works 4.0.7 (Delsys, USA). Each participant performed three swallows per condition, and the average of the three trials was used for analysis. Comparisons between conditions were made using ordinary least squares linear regression, with a significance level of <i>p</i> &lt; 0.05 and 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences in EMG activity were observed for the temporalis or masseter muscles across the different OVD conditions during SS (<i>p</i> &gt; 0.05). Tongue pressure increased significantly between basal OVD and 4- and 6-mm OVDs during SS (<i>p</i> &lt; 0.05) and between all OVDs during YS (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A short-term increase in OVD up to 6 mm was not associated with statistically significant acute changes in EMG activity and produced only minor adaptive variations in tongue pressure. These findings indicate that no immediate neuromuscular disturbances were detected under the experimental conditions tested; however, given the pilot design, no conclusions can be drawn regarding long-term safety or equivalence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Study Registration Number</h3>\u0000 \u0000 <p>CEC202030</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"867-876"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777756","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":"Optimizing Maxillary Anterior Teeth Intrusion in Clear Aligner Therapy: A Finite Element Analysis of Attachment Efficacy","authors":"Chandani Shah,&nbsp;Puneet Batra,&nbsp;Nikhillesh Vaiid","doi":"10.1111/ocr.70131","DOIUrl":"10.1111/ocr.70131","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Maxillary anterior intrusion with clear aligner therapy remains biomechanically challenging and clinically unpredictable. This study aimed to evaluate the biomechanical response of anterior intrusion under different clear-aligner attachment configurations using a three-dimensional finite element model incorporating a quasi-dynamic canine anchorage system.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A patient-derived finite element model of the maxillary dentition was reconstructed from CBCT data. A 0.75-mm polyurethane aligner and composite attachments were modelled across five attachment configurations: posterior attachments only (GP1), posterior with lateral incisor attachments (GP2), posterior with central and lateral incisor attachments (GP3), premolar attachments only (GP4), and a canine anchorage group (GP5). Displacement-controlled intrusion was simulated at five incremental levels (0.5–2.5 mm). Outcome measures included vertical tooth displacement, Von Mises stress distribution in teeth, periodontal ligament (PDL) and alveolar bone, attachment deformation, inclination changes, and anchorage-corrected biomechanical responses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Intrusion displacement increased progressively with activation across all groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.001; partial &lt;i&gt;η&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0.991). GP3 produced the greatest incisor displacement across increments (0.46–2.28 mm), closely followed by GP5 (0.44–2.21 mm). Attachment-deficient configurations (GP1 and GP4) showed significantly lower displacement (0.32–1.62 mm). Peak tooth Von Mises stress increased from approximately 146 MPa at 0.5 mm intrusion to 312 MPa at 2.5 mm intrusion, with GP3 demonstrating the highest stress transmission and GP5 showing slightly reduced but more evenly distributed stresses. PDL stress gradients increased linearly with intrusion depth (&lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; &gt; 0.99), while attachment deformation and engagement efficiency were highest in GP3 and GP5. Anchorage-augmented mechanics in GP5 redistributed loading toward the canines, increasing the Anchorage Stability Index and reducing excessive incisor stress peaks.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Attachment configuration and anchorage control substantially influence biomechanical efficiency during aligner-mediated anterior intrusion. Comprehensive anterior attachments maximize force transmission, while physiologic canine anchorage enhances load distribution and biomechanical stability. These findings provide biomechanical guidance for optimizing aligner protocols in deep-bite correction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"856-866"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777846","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":"Effectiveness of Platelet Rich Plasma in Reducing Oronasal Fistula and Scar Width in Primary Cleft Lip and Palate Repair—A Systematic Review and Meta-Analysis","authors":"Thiagasirpi Mani,&nbsp;Naveen Munusamy,&nbsp;Prema Anbarasu,&nbsp;Sri Harini Muruganandam,&nbsp;Harish Ponniah,&nbsp;Saravana Kumar Subramanian","doi":"10.1111/ocr.70147","DOIUrl":"10.1111/ocr.70147","url":null,"abstract":"<div>\u0000 \u0000 <p>This review aimed to investigate platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) efficiency in reducing oronasal fistula during primary cleft lip and palate repair. An extensive search of PubMed, Google Scholar, Global Index Medics (WHO), PubMed Scopus, Cochrane Central, Proquest was performed up to march 2025. Eligible studies included prospective RCTs and non-randomized controlled trials in human subjects. Patients aged 6–24 months undergoing primary cleft lip and palate repair were involved. Interventions involved intraoperative use of PRP/PRF compared with controls without PRP/PRF. The primary outcome was occurrence of oronasal fistula; secondary outcomes were scar width, wound infection and postoperative bleeding with wound dehiscence. Study selection followed PRISMA guidelines, and the risk of bias was determined with the ROB-2 and ROBINS-I method of assessment. Seven studies met the required criterion and were qualitatively synthesized. Evidence suggested that PRP/PRF application was associated with a lower incidence of oronasal fistula and reduced scar width compared with controls. Additional benefits included accelerated wound healing and faster recovery. The use of autologous PRP was also reported to decrease the need for further surgical interventions. However, the certainty of evidence was limited due to small sample sizes and methodological heterogeneity. PRP and PRF show promising benefits in cleft lip and palate repair, particularly decreased fistula formation and reduced scar width. Nevertheless, current evidence is of low to very low certainty. Larger, well-designed randomized trials are required to validate the results obtained.</p>\u0000 <p><b>Trial Registration:</b> PROSPERO registration no. CRD420251032421</p>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"801-813"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982596","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":"Authorial Influence in Orthodontic Scholarship: A Comparative Analysis of Authors Impact Across Three Leading Orthodontic Journals","authors":"Sarah Abu Arqub,&nbsp;Tvisha Patel,&nbsp;Alexandria Adler,&nbsp;Jennifer Crumpton,&nbsp;Lauren E. Adkins,&nbsp;Dalya Al-Moghrabi,&nbsp;Nikolaos Pandis,&nbsp;Nikhillesh Vaiid","doi":"10.1111/ocr.70134","DOIUrl":"10.1111/ocr.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To perform an authorship-focused bibliometric analysis of highly cited authors who published in the American Journal of Orthodontics and Dentofacial Orthopaedics (AJODO), Angle Orthodontist (AO), and European Journal of Orthodontics (EJO). Furthermore, to evaluate the effect of journal type on bibliometric indices, and identify predictors of total citations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A bibliometric analysis using Dimensions Analytics and Scopus (inception—April 2025) identified authors with &gt; 100 citations who published in the AJODO, AO, and the EJO. Extracted data included author-level metrics (total citations, citations per document, publication count, h-index, field-weighted citation impact (FWCI), collaboration, number of coauthors) and regional and institutional information. Descriptive statistics, regression analysis, and variable importance analysis were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Authors with &gt; 100 citations were common in AO (<i>n</i> = 230), followed by AJODO (<i>n</i> = 133) and EJO (<i>n</i> = 68). Compared with AJODO, authors publishing in AO and EJO had significantly lower total citations (incidence rate ratio (IRR) 0.52 and 0.57, <i>p</i> &lt; 0.001), citations per document (0.52 and 0.54, <i>p</i> &lt; 0.001), number of publications (0.47 and 0.51, <i>p</i> &lt; 0.001), h-index (coefficients −15 and −18, <i>p</i> &lt; 0.001), and number of coauthors (IRR 0.38 and 0.46, <i>p</i> &lt; 0.001). No significant differences were observed between journals for collaboration or FWCI. Citations by documents and h-index were the strongest predictors of citation counts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although most highly cited authors were from AO, AJODO authors had higher citations, publications, and h-index. Authorial influence is multidimensional, and robust evaluation requires a combination of citation metrics, productivity measures, and context-specific assessments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"909-916"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869198","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":"Three-Dimensional Analysis of Perioral Soft and Hard Tissue Changes After Non-Surgical Orthodontic Treatment in Class III Patients","authors":"Jung Jin Park,&nbsp;Ki-Ho Park,&nbsp;Gyu-Tae Kim,&nbsp;Su-Hyun Lee,&nbsp;Young-Guk Park,&nbsp;Jae Hyun Park","doi":"10.1111/ocr.70146","DOIUrl":"10.1111/ocr.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to examine three-dimensional (3D) changes in perioral soft tissue after nonsurgical orthodontic treatment of Class III patients using a 3D structured light scanner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 32 Korean patients with skeletal Class III malocclusion who underwent nonsurgical orthodontic treatment with temporary skeletal anchorage devices (TSADs). Two-dimensional lateral cephalograms and 3D facial scans were taken before treatment and immediately after debonding. Seven hard-tissue landmarks were identified in the cephalometric images, and 29 perioral soft-tissue landmarks were identified in the 3D facial images. Changes in the 3D coordinates of these landmarks (<i>x</i>, <i>y</i>, <i>z</i>) were assessed by superimposing post-treatment images onto pre-treatment images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After treatment, the maxillary central incisor tips moved significantly forward (1.43 mm), while the mandibular central incisors moved backward (−2.61 mm). Upper lip landmarks (1) moved forward significantly, while lower lip landmarks (8, 9, 13, 14, 8′, 9′, LLP) moved backward significantly. There was also significant downward and backward movement at Pg′ and Gn′.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Orthodontic treatment resulted in maxillary incisor proclination and lingual uprighting of the mandibular incisors, with downward and backward movement of Pg' and Gn'. No significant soft tissue changes occurred in the transverse axis. The upper lip moved forward, while the lower lip and chin (Pg′, Gn′) shifted backward and downward. The subnasale and the area under the nostrils remained relatively stable, while the lip angle moved posteriorly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"972-982"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982712","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":"Double-Axis Maxillary Skeletal Expander Suggests Higher Expansion Efficiency in Early Activation: A Finite Element Analysis","authors":"Kaviya Kanokpongsak,&nbsp;Prajak Jariyapongpaiboon,&nbsp;Sorapon Na Lampang,&nbsp;Phetcharat Dhammayannarangsi,&nbsp;Nicha Ungvijanpunya,&nbsp;Thanaphum Osathanon,&nbsp;Pornchai Jansisyanont,&nbsp;Nuttapol Limjeerajarus,&nbsp;Chalida Nakalekha Limjeerajarus","doi":"10.1111/ocr.70007","DOIUrl":"10.1111/ocr.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Conventional single-axis maxillary skeletal expanders (MSE) have some drawbacks, such as limited control over maxillary expansion and possible asymmetric expansion between the anterior nasal spine (ANS) and posterior nasal spine (PNS). This report introduces a double-axis maxillary skeletal expander (DAMSE) concept to overcome these drawbacks and enhance the efficiency of maxillary skeletal expansion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Five different DAMSE designs were compared with a conventional single-axis MSE. Finite element analysis was performed to analyse their expansion efficiency, stress magnitude and distribution occurring in a simplified bone model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DAMSE outperformed the single-axis MSE and provided better control over ANS and PNS expansion. During early activation, the highest expansion efficiency (31.7%) was achieved by DAMSE Model V, 13% more efficient than the single-axis MSE. This efficiency was increased to 100.8% by combining the DAMSE Model V with midpalatal suture surgery. However, with the simplified bone model, the current study could not demonstrate that DAMSE can resolve the issue of asymmetric expansion between ANS and PNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An appropriately designed DAMSE can be a promising tool for maxillary expansion treatment. DAMSE offers more efficient treatment than the conventional single-axis MSE while maintaining similar levels of patient comfort and invasiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"829-839"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699212","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":"Three-Dimensional Assessment of Upper Airway Morphology and Sleep-Disordered Breathing Risk in Unilateral Craniofacial Microsomia: A Pilot Study","authors":"Akila Aiyar,&nbsp;Peter Stoustrup,&nbsp;Thomas Klit Pedersen,&nbsp;Xiaowen Niu","doi":"10.1111/ocr.70130","DOIUrl":"10.1111/ocr.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Unilateral craniofacial microsomia (UCM) presents varying unilateral deficiencies of the temporomandibular joint, mandibular ramus, masticatory muscles, and adjacent soft tissues and ear. Reduced mandibular and maxillary dimensions may decrease upper airway volume and may increase the risk of sleep-disordered breathing (SDB). This retrospective pilot study aimed to evaluate a novel three-dimensional (3D) method for assessing nasal cavity (NC) and pharyngeal airway (PA) dimensions in growing patients with UCM compared with healthy controls, and to explore the potential associations between airway dimensions and SDB risk using the pediatric Sleep Questionnaire (PSQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This retrospective case–control pilot study analysed Cone-beam computed tomography (CBCT) scans from 11 patients with UCM (mean age 12.7 ± 4.4 years) and 11 age-matched controls (mean age 12.1 ± 1.1 years). Two calibrated investigators performed airway measurements, including total and partial NC and PA volumes, minimal cross-sectional area (MCS), and hydraulic diameter. SDB risk in the UCM group was assessed using PSQ scores. Reliability was evaluated with intra-class correlation coefficients and Dahlberg's formula. Group differences were tested using unpaired <i>t</i>-tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with UCM showed significantly smaller NC volume (9714.9 ± 3032 mm³) than controls (12773.9 ± 1963 mm³; <i>p</i> &lt; 0.0001). PA volume and MCS did not differ significantly. Four of the eleven patients with UCM showed a high PSQ-based risk of SDB and tended to have smaller airway dimensions. Measurement reliability was acceptable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CBCT-based 3D assessment of upper airway morphology was feasible in patients with UCM. Patients with UCM demonstrated significantly reduced nasal cavity volume compared with controls. Exploratory analysis suggested that some patients may be at increased risk of SDB; however, these findings require confirmation in larger studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"926-936"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ocr.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942363","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":"Three Data-Driven Lip Soft-Tissue Phenotypes and Their Dento-Skeletal Associations in Orthodontic Patients: An Exploratory Unsupervised Learning Study","authors":"Xiaoqi Zhang,&nbsp;Lu Xing,&nbsp;Waseem AI-Gumaei,&nbsp;Xiaoqian Zhang,&nbsp;Hu Long,&nbsp;Minqi Li,&nbsp;Wenli Lai","doi":"10.1111/ocr.70138","DOIUrl":"10.1111/ocr.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conventional facial diagnosis emphasizes skeletal and dental measures while lip features are assessed piecemeal. We aimed to identify data-driven lip soft-tissue phenotypes using unsupervised machine learning and examine their associations with skeletal and dental characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective cross-sectional study, 10 lip measurements were extracted from standardized lateral cephalometric radiographs. Variables were <i>z</i>-score standardized and analysed using k-means clustering. Of 26 NbClust validation indices, 14 (53.8%) supported a three-cluster solution. Cluster stability was assessed by bootstrap resampling (B = 100) and 10-fold cross-validation. Post hoc feature importance was evaluated using PCA, Random Forest, SVM and XGBoost. A decision tree was trained and evaluated by 10-fold cross-validation repeated five times. Associations with craniofacial parameters were examined via within-class ANOVA, Cramér's <i>V</i> and hierarchical regression. Concordant pairings were defined as Cluster 1–Class I, Cluster 2–Class II and Cluster 3–Class III; all others were classified as discordant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three phenotypes emerged—Thin-Straight (<i>n</i> = 638), Protrusive-Convex (<i>n</i> = 644) and Thick-Concave (<i>n</i> = 389)—showing broad correspondence with skeletal Classes I, II and III, respectively (Cramér's <i>V</i> = 0.386; overall concordance 52.8%). Lip protrusion and thickness were the primary discriminators (4/4 method consensus for UL_EP_mm, Cm_Sn_Ls, SSD; 3/4 for ULT). Within each skeletal class, all lip variables differed significantly across phenotypes (all <i>p</i> &lt; 0.001; <i>η</i>² = 0.10–0.54 for lip variables), and lip phenotype independently predicted incisor inclination beyond skeletal covariates (Δ<i>R</i>²adj = 0.058–0.078, <i>p</i> &lt; 0.001). An interpretable decision tree achieved 88.0% cross-validated accuracy (macro-F1 = 0.876) for phenotype assignment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Unsupervised learning identified three reproducible lip soft-tissue phenotypes that complement conventional dentoskeletal description by capturing within-class soft-tissue heterogeneity. The framework is exploratory and requires prospective external validation and outcome-based studies before clinical triage application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"888-898"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840400","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":"Mandibular Response in Class II Division 1 Growing Subjects: Clear Aligners vs. Rapid Maxillary Expansion Therapy. A Controlled Pilot Study","authors":"De Razza Francesca Chiara,&nbsp;Lugli Letizia,&nbsp;Gazzani Francesca,&nbsp;Lachi Alessio,&nbsp;Pavoni Chiara,&nbsp;Cozza Paola,&nbsp;Lione Roberta","doi":"10.1111/ocr.70141","DOIUrl":"10.1111/ocr.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study aimed to evaluate the skeletal and dental changes in two different groups of mixed dentition Class II division 1 patients treated with Clear Aligners and with Rapid Maxillary Expansion and to assess the post-treatment mandibular response in comparison with an untreated control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Method</h3>\u0000 \u0000 <p>33 subjects were recruited according to the following inclusion criteria: Caucasian ancestry, early mixed dentition with fully-erupted first permanent molars, bilateral Class II division 1, posterior transverse interarch discrepancy &lt; 5 mm, CSV1–2, no previous orthodontic treatment/congenitally missing or extracted teeth/craniofacial syndromes. The Aligner Group (AG = 13, 6 males, 7 females, 9.2 ± 0.8 years) was treated with Clear Aligners following a standardized sequential expansion protocol “molars move first” without extractions and other auxiliaries than attachments; the RME group (RG = 10 patients, 5 males, 5 females, 9.6 ± 0.7 years) was treated with RME banded on second primary molars; the Control Group (CG = 10, 6 males, 4 females, 9.6 ± 0.9 years) was followed up for 1 year without treatment. Panoramic radiographs and lateral cephalograms were collected pre-treatment (T0) and post-treatment (T1) (T1–T0 = 15.7 ± 1.3 months). The Kruskal–Wallis one-way test was used for the analysis of variance by ranks at T0 (baseline) and for the changes observed between T0 and T1 (<i>p</i> &lt; 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On the sagittal plane, no significant post-treatment differences in mandibular response were found between the three analysed groups. On the vertical plane, the CA group showed a statistically significant reduction of SN-GoMe when compared to the CG (<i>p</i> = 0.023) and to the RG (<i>p</i> = 0.067).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clear Aligners and RME did not influence the sagittal skeletal relationship in prepubertal Class II division 1 patients treated during early mixed dentition, compared to the untreated control group. On the vertical plane, patients treated with Clear Aligners showed a statistically significant reduction of SN-GoMe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Study Registration Number</h3>\u0000 \u0000 <p>Protocol Number E00176-2025</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"945-953"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960189","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 ‘Roller Coaster Effect’ in Clear Aligner Premolar Extraction Cases: Posterior Open Bite and Cephalometric Risk Factors","authors":"Yujia Zhuo,&nbsp;Feng Guo,&nbsp;Shuai Huang,&nbsp;Lang Lei","doi":"10.1111/ocr.70136","DOIUrl":"10.1111/ocr.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate the occurrence of the roller coaster effect (RCE) in premolar extraction cases treated with clear aligner therapy (CAT), and to identify cephalometric risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Sixty five patients treated with CAT after four first premolar extractions were retrospectively analysed, including 34 with mild crowding (Mi) and 31 with moderate–severe crowding (Mo-Se). Posterior functional cusp distances (FCDs) were measured at the second premolar, mandibular first molar mesiobuccal (MB) and distobuccal (DB) cusps, and second molar on pre- and post-treatment digital models using a standardised 3D coordinate system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As mesial molar movement was minimal in this cohort, post-treatment FCDs increased significantly in the Mi group at all posterior sites, with the greatest changes at the first molars (MB: 1.64 ± 1.39 mm; DB: 1.48 ± 1.55 mm; both <i>p</i> &lt; 0.001), while the Mo-Se group showed an increase only at the first molar MB cusp (<i>p</i> &lt; 0.001). Comparisons indicated greater FCDs increases in the Mi group than in the Mo-Se group (all <i>p</i> &lt; 0.05). Correlation analysis revealed positive associations between greater upper incisor proclination (U1-NA, U1-SN) and posterior FCDs increases. The regression analysis further identified a smaller ANB angle as an independent risk factor for RCE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Posterior FCDs served as a simple and clinically applicable indicator of RCE, most pronounced at the first molars and in mild crowding cases. Smaller ANB angles and increased maxillary incisor proclination were associated with higher RCE susceptibility, emphasising prudent case selection in extraction-based clear aligner therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"29 5","pages":"899-908"},"PeriodicalIF":2.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864309","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}