Journal of the World Federation of Orthodontists最新文献

{"title":"83 - E-book digital technological innovations applied to diagnosis and planning in orthodontics","authors":"Rebeca Schwab De Freitas ,&nbsp;Roberta Tarkany Basting","doi":"10.1016/j.ejwf.2025.07.087","DOIUrl":"10.1016/j.ejwf.2025.07.087","url":null,"abstract":"<div><div>Orthodontics has been transformed by digital technologies, such as Cone Beam Computed Tomography and artificial intelligence, providing more accurate diagnoses and personalized treatments, although its adoption still faces financial and educational challenges. Tools such as 3D modeling and virtual planning software are essential for optimizing treatments and improving result predictability. This paper presented an e-book on technological innovations in orthodontics in the course \"TSA - Everything About Self-Ligating Systems,\" evaluating its impact on learning, student satisfaction, and motivation to implement the discussed technologies. The e-book \"Digital Technological Innovations Applied to Diagnosis and Planning in Orthodontics\" was developed to assist orthodontists in understanding and implementing digital technologies, being used in the online course \"TSA - Everything About Self-Ligating Systems.\" Based on a review of recent literature, the material combines technical text, visual resources, and practical strategies, addressing technologies such as Cone Beam Computed Tomography, 3D modeling, and artificial intelligence, while also encouraging the adoption of these innovations in clinical practice. The developed e-book was sent to 200 students of the online course \"TSA - Everything About Self-Ligating Systems,\" and 105 responded to the survey. The majority of participants (73.4%) are orthodontists with more than five years of experience, and 68.6% already use the technologies covered in the material. The main barriers to adopting technologies are high costs (72.4%) and lack of training (38.1%). The e-book motivated 99% of participants to explore and implement these innovations, with 89.5% believing that they improve diagnostic accuracy. Satisfaction with the content and design was high, with 78.1% rating the information as very clear and 88.6% considering the design excellent.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 427"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"54 - Comparison of the positive and negative effects of breastfeeding in mexican infants, from newborns to 3 years old","authors":"Adrián Raúl Garcia Gama ,&nbsp;Alan Adrian Garcia Gonzalez","doi":"10.1016/j.ejwf.2025.07.058","DOIUrl":"10.1016/j.ejwf.2025.07.058","url":null,"abstract":"<div><div>Breastfeeding, as the primary source of nutrition for newborns, is accepted worldwide because it provides ideal nutrients for growth and development, including water, proteins, sugars, fats, immunoglobulins, and minerals. Since ancient times, many civilizations, such as the Egyptians, Mayans, and Incas, have practiced breastfeeding. It remains the ideal form of nutrition for infants and is highly recommended. One common question concerns the optimal duration of breastfeeding. The World Health Organization (WHO) recommends an average of two years of breastfeeding for children in extreme situations of malnutrition or war. In Mexico, the recommendation is an average of one year, although two years is also accepted. Breastfeeding is often combined with bottle feeding and weaning. To determine whether the effects of breastfeeding and bottle feeding are positive or negative for growth and development. To establish the ideal duration for fostering different functions, such as breathing, swallowing, chewing, and speaking. 1,000 photographs of patients were taken to observe facial and oral effects caused by different feeding methods. Data collection focused on facial and oral changes resulting from various feeding methods. Photograph evaluations and comparisons were made regarding dental arches and malocclusions. From the studied feeding methods, it was found that 85% of children fed through breastfeeding maintained balanced facial and oral characteristics, within normal parameters of swallowing and breathing. They did not develop habits, and their dentition was balanced. The remaining 15% of the sample showed some facial changes that are not related to feeding, such as in the case of infants with respiratory alterations due to allergies. Meanwhile, the group of patients fed with a bottle showed a dependency on this method. Sixty-eight percent developed a bottle habit due to the use of it for many hours a day and during the night. Fifty-six percent experienced an increase in carious lesions, loss of arch length, dental protrusion, and bone collapse. The facial profile is retrognathic with lip incompetence. Data from patient photographs, including mouth and profile images, were analyzed to determine the most beneficial method and duration of feeding for optimal development.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 417"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"86 - Effectiveness of twin block appliance based on daily wear time - A systematic review","authors":"Ana Lúcia Ferreira ,&nbsp;Patrícia Oliveira ,&nbsp;Joana Borga ,&nbsp;João Botelho ,&nbsp;Iman Bugaighis ,&nbsp;Pedro Mariano Pereira","doi":"10.1016/j.ejwf.2025.07.090","DOIUrl":"10.1016/j.ejwf.2025.07.090","url":null,"abstract":"<div><div>There is currently no consensus in the literature concerning the daily wear time (DWT) protocol of Twin Block appliance (TBA) treatment. This systematic review aimed to determine whether scientific evidence proves that the full-time (FT) DWT protocol using TBA is more effective in treating Class II malocclusions related to mandibular retrognathism than the part-time (PT) protocol. This systematic review was registered with PROSPERO (CRD42023464575). A search was conducted using the central electronic database (PubMed/MEDLINE, LILACS, EMBASE, SciELO and Scopus), in addition to grey literature until July 2024. Abstracts that fulfilled the selection criteria, as well as the original articles, were reviewed. Randomized control trials and non-randomized intervention studies assessing differences between PT vs FT DWT were eligible for inclusion in this review. Two studies fulfilled the selection criteria. DWT, measured objectively using microsensors, was lower than the recommended protocols. One study found a similar effect of PT and FT DWT on the sagittal and vertical skeletal changes, while the other investigation noticed a significant skeletal measurements improvement in the FT group. Although overjet significantly decreased following treatment in both studies, only one study showed that the FT group presented a significant overjet reduction compared to the PT group. Soft tissue changes were only analyzed by one of the studies, but no statistically significant differences were observed between the PT and FT groups. Due to the small number of studies and contradictory results, it is impossible to conclude which DWT protocol is more effective. The lack of robust scientific evidence implies that the original recommendation of the originator himself, William Clark, for FT use of TBA should be maintained.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 427-428"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Comprehensive Facial Soft Tissue Landmark Detection and Analysis Using Frontal View Photographs","authors":"Sahel Hassanzadeh-Samani ,&nbsp;Zeynab Pirayesh ,&nbsp;Parisa Motie ,&nbsp;Mohammad Soroush Ghorbanimehr ,&nbsp;Arash Farzan ,&nbsp;Hossein Mohammad-Rahimi ,&nbsp;Mohammad Behnaz ,&nbsp;Saeed Reza Motamedian","doi":"10.1016/j.ejwf.2025.07.732","DOIUrl":"10.1016/j.ejwf.2025.07.732","url":null,"abstract":"<div><h3>Background</h3><div>Facial soft tissue analysis plays a vital role in orthodontics, orthognathic surgeries, and forensic anthropology. This study aimed to determine a standardized midline to assess the reliability of symmetry analysis in frontal view photographs. Additionally, it evaluated the consistency of soft tissue landmark detection and analysis between different observers and over time.</div></div><div><h3>Methods</h3><div>A power analysis determined the need for a total of 50 standardized frontal-view photographs. These photographs were obtained from Iranian patients aged 9–40 who were undergoing orthodontic treatment. Thirty-seven standardized landmarks were annotated across the face, facilitating 73 distinct facial analyses. Five midlines were compared to identify the most reliable one for symmetry assessments. A Python-based automated framework was created to calculate the analyses based on landmarks’ x and y coordinates. Inter-observer and intra-observer reliability were assessed using Intraclass Correlation Coefficient (ICC) and Mean Absolute Deviation (MAD) metrics.</div></div><div><h3>Results</h3><div>Among the 5 midlines for symmetry analysis, the perpendicular of the interpupillary line passing through the glabella was found to be the most reliable. Overall, the analyses demonstrated relatively good reliability. However, certain landmark points, specifically Gonion (Go), Malar Eminence (ME), Zygion (Zy'), Frontotemporale (Ft'L), and Trichion (Tr'), exhibited lower reliability. Consequently, the reliability of specific analyses, including Bizygomatic width/Facial width, Nasal bridge width/ Endocanthions’ distance, and horizontal symmetry of Go', N', and Zy' was reduced.</div></div><div><h3>Conclusion</h3><div>This study presents a comprehensive collection of soft tissue landmarks, facial analyses, and their corresponding inter- and intra-observer reliability. Furthermore, the most reliable facial midline for symmetry analysis was determined. This study demonstrated that certain indices defined in three dimensions have lower reliability when drawn in 2-dimensional images, affecting the reliability of derived analyses.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 334-343"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"67 - Dental autotransplantation in cleft lip and palate patients: a narrative review with systematic steps","authors":"Adriana De Alcantara Cury Saramago ,&nbsp;Katarine Vasquez Lage ,&nbsp;Bernardo Vecchiati ,&nbsp;Juliana Lucas Monteiro ,&nbsp;Cláudia Trindade Mattos ,&nbsp;Vanessa Couto","doi":"10.1016/j.ejwf.2025.07.071","DOIUrl":"10.1016/j.ejwf.2025.07.071","url":null,"abstract":"<div><div>Cleft lip and palate (CLP) are congenital anomalies with high prevalence in both the Brazilian and global populations. These conditions have a multifactorial etiology, and their treatment requires a multidisciplinary approach involving physicians, dentists, psychologists, nutritionists, and speech therapists, as they affect anatomy, speech, swallowing, and social interaction. Various types of clefts exist, some extending to the alveolar ridge, which may be associated with congenital tooth agenesis, impacting both function and aesthetics. Agenesis is the most common dental anomaly in patients with CLP, necessitating traditional orthodontic treatment, such as upper tooth movement and, occasionally, extractions in the lower arch, to achieve proper occlusion. An alternative approach is the use of dental autotransplantation to replace missing teeth, particularly when extractions (often of premolars) are indicated, providing a potential donor tooth. This study aims to review the outcomes of dental autotransplantation in the rehabilitation of CLP patients through a narrative review with systematic steps. A comprehensive search of the PubMed database yielded 341 articles, and as a result, 12 met the eligibility criteria. Data extraction, qualification and/or risk of bias, and analysis of the articles were performed to address the research question. The average success rate, considering the stability, vitality preservation, and absence of complications of the transplanted tooth, was 89.4% in the selected articles. Most of them were case reports, although comparative observational studies were also included. It is expected that this review will inform and encourage professionals to consider this multidisciplinary solution for the patients addressed. We can conclude and suggest that dental autotransplantation is a viable treatment option for patients with agenesis in the context of CLP patients.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 421-422"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"53 - Comparison of efficacy of two indices (ARI and BARI) in assessing the orthodontic bond failure","authors":"Saad Asad ,&nbsp;Abeeha Abeeha Noor ,&nbsp;Kinza Raza ,&nbsp;Sana Munawar ,&nbsp;Saad Asad","doi":"10.1016/j.ejwf.2025.07.057","DOIUrl":"10.1016/j.ejwf.2025.07.057","url":null,"abstract":"<div><div>During orthodontic treatment if bracket failure occurs, it adversely affects the treatment outcome, prolongs treatment time, expenses and promotes patient discomfort. For quantifying such failures, indices such as the Adhesive Remnant Index (ARI) and Bracket Adhesive Remnant Index (BARI) have been used. Aim of this study is thus to compare the efficacy of ARI and BARI in assessing orthodontic bond failure patterns. This study was designed as a comparative, observational, in-vivo study. Sample size was calculated using Epi Info version 7.2 for matched pair designs. Inclusion criteria: Patients aged 12–30 years undergoing fixed orthodontic treatment, good oral hygiene, no enamel surface defects and provided informed consent. Failed brackets were carefully removed, and the enamel surface was examined under dental loupes (5x magnification) by a calibrated examiner. The ARI (0–3) and BARI (0–5) scoring were used to measure the residual adhesive present on enamel following debonding. Mean ARI score was 1.06 ± 0.88, and BARI score was 2.34 ± 1.69. There was a significant difference between ARI and BARI scores (p &lt; 0.001) recorded for the failed brackets. It is thus concluded that the BARI index was more sensitive to detect the remnants of the adhesive than ARI.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 416-417"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"20 - Analysis of temporomandibular joint spaces in centric occlusion using cone beam computed tomography","authors":"Itzel Brambila Meza ,&nbsp;Luisa Gabriela Rodríguez Contreras ,&nbsp;Gianna Paola Escobedo Plata ,&nbsp;Laura Roxana Valenzuela Ruiz ,&nbsp;Antonio Estrada Valenzuela","doi":"10.1016/j.ejwf.2025.07.024","DOIUrl":"10.1016/j.ejwf.2025.07.024","url":null,"abstract":"<div><div><strong>Background:</strong> Centric relation is described as a stable and balanced position of the mandible, while centric occlusion is based on maximum contact between the teeth. These concepts are key to an accurate diagnosis in orthodontics. It has been suggested that condylar displacement can affect the diagnosis and treatment of malocclusions.</div><div><strong>Objectives:</strong> Temporomandibular joint (TMJ) spaces in centric occlusion were analyzed using cone beam computed tomography (CBCT) to evaluate their relationship with morphological and physiological variables in orthodontic patients.</div><div><strong>Methods:</strong> The study included 43 previously untreated patients (86 condyles) from the Autonomous University of Baja California. Joint spaces were evaluated in the sagittal, coronal, and transverse planes using CBCT and compared with the average values established by Ikeda. Skeletal variables were determined by cephalometry, classifying patients into classes I, II, and III.</div><div><strong>Results:</strong> The results showed that female patients and skeletal class II were more common. No significant differences were found within the joint spaces between skeletal classes or sex. However, condylar asymmetries were observed, with greater stability in the right condyle. The values obtained in this study differed from Ikeda's averages.</div><div><strong>Conclusions:</strong> It was concluded that there was no direct relationship between the morphological and physiological variables and joint spaces. This analysis highlights the importance of assessing condylar dimensions to improve diagnostic accuracy and orthodontic treatment. The observed asymmetries could be related to unilateral masticatory patterns or the cranial base.|</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 404"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"6 - A comparison of the accuracy of artificial intelligence versus orthodontic clinicians in identifying cephalometric landmarks","authors":"Yen Ming Lin ,&nbsp;Asa Auta ,&nbsp;Robert Ireland ,&nbsp;Richard Cure ,&nbsp;Jeremy Brown","doi":"10.1016/j.ejwf.2025.07.010","DOIUrl":"10.1016/j.ejwf.2025.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Accurate identification of cephalometric landmarks is essential for orthodontic diagnosis and treatment planning. Manual landmarking by orthodontic clinicians can be time-consuming and variable, particularly due to differences in experience. To address this, artificial intelligence (AI) algorithms have been developed to automate cephalometric analysis, aiming to improve efficiency, accuracy, and consistency.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the accuracy of selected skeletal and dental cephalometric landmarks and the resulting linear and angular measurements identified by commercial AI-based providers, compared to those obtained manually by orthodontic clinicians with varying experience against a reference standard.</div></div><div><h3>Methods</h3><div>Thirty-five lateral cephalometric radiographs from the IEEE ISBI Grand Challenge 2015 dataset were analysed. Ten landmarks were identified on each radiograph by nine calibrated orthodontic clinicians and four commercial AI providers. These were used to calculate nine cephalometric measurements, compared to a reference standard. Agreement among the clinicians was evaluated using the intraclass correlation coefficient (ICC). Friedman’s test, Wilcoxon signed ranks test with Bonferroni correction, and Bland-Altman plots with linear regression were used to test for differences between groups.</div></div><div><h3>Results</h3><div>ICC values showed six of nine measurements from human clinicians had excellent inter-rater reliability. However, Friedman’s test indicated significant differences between the human clinicians and AI providers against the reference standard for all measurements. Post hoc analysis confirmed these findings. Bland-Altman plots also showed reduced accuracy and consistency across groups.</div></div><div><h3>Conclusions</h3><div>Both AI algorithms and manual methods showed limited agreement with the reference standard. Further research is needed to improve the accuracy, reliability, and clinical use of AI in cephalometric analysis.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 399"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"8 - A facial maturation index based on cranium-to-face ratio as a predictor of skeletal maturity","authors":"Gabriela Trojahn ,&nbsp;Paula Balestrin ,&nbsp;Kelly Chiqueto ,&nbsp;Eduardo Ferreira ,&nbsp;Katherine Jaramillo Cevallos ,&nbsp;Sérgio Estelita Barros","doi":"10.1016/j.ejwf.2025.07.012","DOIUrl":"10.1016/j.ejwf.2025.07.012","url":null,"abstract":"<div><h3>Background</h3><div>Diagnostic methods to determine individual skeletal maturity have been reported to indicate treatment timing in orthodontics.</div></div><div><h3>Objective</h3><div>To evaluate the changes in cranium/face size ratio (Facial Maturation Index - FMI) between the skeletal maturity stages defined by cervical vertebral maturation (CVM).</div></div><div><h3>Methods</h3><div>The sample consisted of a set of lateral cephalograms selected from the records of 180 subjects from the Burlington Growth Center and the Forsyth Institute. For each lateral cephalogram, the face area (FA) and neurocranium area (NCA) were delimited and measured. The FMI was calculated by FA/NCA. The FMI was compared and correlated with the CVM stages using ANOVA and Spearman's correlation tests. ROC analysis evaluated the FMI diagnostic performance.</div></div><div><h3>Results</h3><div>The NCA was similar between all maturation stages. FA and FMI increased significantly with each advance in CVM stages. The female sample tended to have a lower facial growth rate and earlier facial growth acceleration, while males tended to have a longer growth spurt period. There was significant and positive correlation between FMI and CVM stages for female (0.768) and male (0.803) samples. Areas under ROC curves for FMI were 0.851 to female and 0.854 to male sample, showing good diagnostic performance of FMI for discriminating pre-peak maturation stage from peak and post-peak stages.</div></div><div><h3>Conclusion</h3><div>Changes in cranium-to-face ratio were strongly correlated with CVM maturation stages. The diagnostic performance of FMI shows that it is a clinically useful diagnostic aid for predicting facial growth.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 399"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term stability of molar position postdistalization: A systematic review and meta-analysis","authors":"Kutraaleeshwaran Velmurugan,&nbsp;Venkateswaran Ananthanarayanan,&nbsp;Sridevi Padmanabhan,&nbsp;Vignesh Kailasam","doi":"10.1016/j.ejwf.2025.07.734","DOIUrl":"10.1016/j.ejwf.2025.07.734","url":null,"abstract":"<div><h3>Background</h3><div>Molar distalization has generated additional attention with the advent of skeletal anchorage devices. However, relapse after distalization is one of the challenges and the quantum of relapse following distalization, especially over the long-term remains controversial. This systematic review and meta-analysis aim to evaluate the long-term vertical and sagittal stability of molars postdistalization.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in electronic databases (PubMed, Scopus, Ovid, Embase, Cochrane and LILACS) up to April 11, 2025. Studies assessing molar position changes after active distalization and during follow-up periods were included. Data extraction and risk of bias assessments were performed using the ROBINS-I tool for non-randomized studies. A meta-analysis was conducted to quantify relapse in vertical and sagittal dimensions.</div></div><div><h3>Results</h3><div>From the 2594 studies initially identified, six studies (all nonrandomized control trials) were included for the systematic review and five studies were included for the meta-analysis. All studies showed moderate risk of bias. The mean relapse in the sagittal plane was 1.58 ± 0.84 mm (35%) linearly and 2.98 ± 2.07° (53%) angularly. In the vertical plane, it relapsed by 1.44 ± 1.26 mm. Meta-analysis showed a net distalization in the molar position in long-term sagittal plane by 2.77 mm (95% CI 2.33–3.20) and 1° distally (95% CI −2.37° to 4.38°), and in the vertical plane by −0.65 mm (95% CI −2.27 to 0.96). The I² ranged from 60% to 98% indicating high heterogeneity. The relapse was minimal for the incisal, skeletal, and soft tissues parameters.</div></div><div><h3>Conclusions</h3><div>Long-term assessment following molar distalization demonstrated conclusive evidence of relapse in the sagittal and vertical direction. There was greater relapse in the vertical than in the sagittal direction. There was minimal literature assessing the relapse in the transverse direction. Hence, this systematic review advocates the need for long-term retention postdistalization.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Pages 355-366"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}