Journal of the World Federation of Orthodontists最新文献

{"title":"Orthodontic management of severe open bite in a growing patient using miniscrew-supported appliances: A case report","authors":"Niki Arveda ,&nbsp;Francesca Cremonini ,&nbsp;Martina Rumpianesi ,&nbsp;Federico Oliani ,&nbsp;Emanuele Paoletto ,&nbsp;Luca Lombardo","doi":"10.1016/j.ejwf.2025.08.003","DOIUrl":"10.1016/j.ejwf.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Anterior open bite can negatively impact facial aesthetics, as well as cause functional impairment and social challenges. We present the case of an adolescent patient with a severe anterior open bite.</div></div><div><h3>Methods</h3><div>After an initial phase of expansion using an expander on palatal mini-screw implants, the patient was treated with a fixed buccal appliance and intermaxillary elastics. Skeletal anchorage was used to achieve effective posterior control. Finally, minor finishing was performed with aligners, and the case was completed with multiple restorations of the teeth.</div></div><div><h3>Results</h3><div>The combination of a fixed appliance and intermaxillary elastics resulted in the extrusion and retroclination of the maxillary incisors, leading to bite closure. Successful results were achieved, with good occlusion, improved facial aesthetics, and stability maintained over the 2-year retention period.</div></div><div><h3>Conclusions</h3><div>Temporary anchorage devices offer reliable anchorage for posterior vertical control. With appropriate treatment planning -taking into account incisor display, growth potential and biomechanics- this approach can serve as a non-surgical alternative for managing severe open bite cases.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 54-61"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276270","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":"Deep learning-based system for automated staging of lower molar maturation","authors":"Fernando Biskupovic ,&nbsp;Flavia Rosenberg ,&nbsp;Luz María Searle ,&nbsp;Pamela Ramírez ,&nbsp;María Jesús Larrañaga ,&nbsp;Sebastián Maldonado ,&nbsp;Carla Vairetti ,&nbsp;Rodrigo Oyonarte","doi":"10.1016/j.ejwf.2025.08.004","DOIUrl":"10.1016/j.ejwf.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Assessing a patient’s maturation status is essential for treatment planning in dentofacial orthopedics. Dental development, as classified by Demirjian’s method into eight stages, is a reliable indicator of skeletal maturity relative to the pubertal growth spurt. Automating this assessment may improve efficiency by reducing subjectivity and supporting timely orthodontic interventions.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted using segmented panoramic radiographs to classify the maturation stages of lower second and third molars. These classifications served as training data for machine learning models using four convolutional neural network (CNN) architectures: Xception, ResNet, MobileNet, and Inception. Model performance was evaluated on three datasets: second and third molars combined (ST), second molars only (S), and third molars only (T). Gradient-weighted Class Activation Mapping (Grad-CAM) was employed to visualize model attention.</div></div><div><h3>Results</h3><div>A total of 1805 images were analyzed. Inception achieved the best performance in both the ST dataset (accuracy 0.96, precision 0.86, recall 0.85, and F1 score 0.85) and the S dataset (accuracy 0.98, precision 0.92, recall 0.91, and F1 score 0.89). For the T dataset, ResNet performed the best (accuracy 0.96, precision 0.94, recall 0.95, and F1 score 0.81). Inter-examiner agreement was high, with a mean kappa coefficient of 0.94. Grad-CAM heat maps confirmed that the model focused on relevant dental structures.</div></div><div><h3>Conclusions</h3><div>The proposed deep learning system, especially the Inception model, demonstrated high accuracy and strong agreement with experts when classifying dental maturation stages. These findings support its use as a complementary diagnostic tool to aid clinical decision-making in growth assessment.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 31-37"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276267","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":"Effects of maxillary expansion on hearing outcomes in patients with cleft lip and palate: A systematic review","authors":"Hamza Parvez Siddiqui ,&nbsp;Karthik Sennimalai ,&nbsp;Madhanraj Selvaraj ,&nbsp;Abhijeet Jaiswal","doi":"10.1016/j.ejwf.2025.09.004","DOIUrl":"10.1016/j.ejwf.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Otological management in patients with cleft lip and/or palate has focused on early interventions such as ventilation tube placement. Improving palatal width and nasal airflow by maxillary expansion may enhance Eustachian tube function. Thus, we aimed to determine whether maxillary expansion therapy had any effect on hearing outcomes in cleft palate patients.</div></div><div><h3>Material and Method</h3><div>Electronic searches employing defined keywords relevant to hearing impairment and maxillary expansion with no restriction on publication year or status, in adolescent nonsyndromic cleft patients were undertaken in PubMed, Scopus, Web of Science, Ovid MEDLINE, EBSCOhost<strong>,</strong> The Cochrane Library, LILACS, OpenGrey, and Google Scholar until January 15, 2025. Two authors on the Covidence software performed data extraction. The Methodological Index for Nonrandomized Studies and the Cochrane Risk of Bias tool were utilized to assess the risk of bias of the included studies.</div></div><div><h3>Results</h3><div>The search retrieved 68 studies, of which four studies finally met the inclusion criteria that included 158 patients with cleft and 26 non-cleft participants. The improvement in hearing threshold varied from 3 to 21 decibels (dB) in the included final studies. Pure tone audiograms and tympanometry were largely used by studies with variations across the types of expanders employed for maxillary expansion. The risk of bias varied from moderate to high risk.</div></div><div><h3>Conclusion</h3><div>A preliminary analysis suggests that maxillary expansion may help improve hearing outcomes for patients with cleft palate, although the certainty of evidence by GRADE assessment was low to very low. More high-quality studies with randomized designs and extended follow-up are required to validate these conclusions and elucidate their clinical implications.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 46-53"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497136","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":"A split-mouth randomized controlled trial on leukocyte- and platelet-rich fibrin’s role in bone density, trabecular complexity, and canine retraction","authors":"Seema Gupta,&nbsp;Meghna M. Kothiwal,&nbsp;Adeel A. Bajjad,&nbsp;Chirag Sahgal,&nbsp;Anil Sharma,&nbsp;Kajol Kumari,&nbsp;Prarthana Bharadwaj","doi":"10.1016/j.ejwf.2025.07.733","DOIUrl":"10.1016/j.ejwf.2025.07.733","url":null,"abstract":"<div><h3>Background</h3><div>Orthodontic treatment often leads to alveolar bone loss, necessitating interventions to optimize bone preservation during canine retraction. This study evaluated the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in enhancing bone density (BD), trabecular architecture, and canine movement following first premolar extraction.</div></div><div><h3>Methods</h3><div>A single-center, split-mouth RCT (ClinicalTrials.gov: CTRI/2024/01/061503) enrolled 35 patients (20 males, 15 females; mean age: 18.8 ± 2.04 years males, 19.13 ± 1.96 years females) with Class I bimaxillary protrusion or Class II Division 1 malocclusion, requiring bilateral first premolar extractions (70 sites). Contralateral sockets were randomized (computer-generated sequence, 1:1 ratio) to L-PRF or natural healing (control) to reduce inter-patient variability. Bone density, trabecular patterns, and fractal dimension were evaluated via cone-beam computed tomography scans (ImageJ analysis), and canine movement measured monthly over 4 months using study models. Blinded evaluators analyzed outcomes using t-tests, mixed-model analysis, and Pearson correlations (<em>P</em> &lt; 0.05). Recruitment occurred January 2024–January 2025.</div></div><div><h3>Results</h3><div>All 70 sites were analyzed (no loss to follow-up). L-PRF significantly increased bone density (562.28 ± 13.63 HU vs. 533.00 ± 5.84 HU, <em>P</em> = 0.001, Cohen’s d = 2.79), fractal dimension (1.8 ± 0.12 vs. 1.52 ± 0.15, <em>P</em> = 0.001, Cohen’s d = 2.01), and canine movement (3.53 ± 0.23 mm vs. 2.71 ± 0.22 mm, <em>P</em> = 0.001, Cohen’s d = 3.48), but with greater tipping. Trabecular complexity improved significantly (<em>P</em> &lt; 0.05). No adverse events occurred.</div></div><div><h3>Conclusion</h3><div>L-PRF significantly enhanced bone density, trabecular architecture, and canine retraction over a follow-up period of four months, offering a promising adjunct to orthodontic treatment.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 20-30"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102688","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":"Orthodontic treatment with clear aligners in an adult obstructive sleep apnea patient with skeletal class II malocclusion, scissors bite, and a constricted mandibular arch: A case report","authors":"Wenfeng Li ,&nbsp;Ruoyu Li ,&nbsp;Yang Cao,&nbsp;Chen Zhou,&nbsp;Weicai Wang","doi":"10.1016/j.ejwf.2025.09.005","DOIUrl":"10.1016/j.ejwf.2025.09.005","url":null,"abstract":"<div><div>Orthodontic management of a 22-year-old male patient is detailed, featuring a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, significant mandibular arch constriction, and mild obstructive sleep apnea (OSA) is reported. Clear aligners were used to correct the scissors bite and effectively intrude the posterior teeth. The treatment objectives were successfully achieved, including the intrusion of right posterior teeth, uprighting of the severely tilted mandibular posterior teeth, correction of the deep bite, expansion of the dental arches, and enhancement of the oral cavity and upper airway volume, ultimately leading to the resolution of OSA in the adult patient, all without notable adverse effects. The therapeutic efficacy remained well sustained at the 24-month follow-up. This case report highlights the efficacy of clear aligners in treating patients with a skeletal Class II intermaxillary relationship, unilateral scissors bite, deep bite, severe arch constriction, and mild OSA.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"15 1","pages":"Pages 62-75"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446084","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":"74 - Diagnostic accuracy of ChatGPT-4 in recommending immunohistochemistry panels for salivary gland tumours","authors":"Valentina Alvarez Silberberg ,&nbsp;Maria Carolina Cuevas Nuñez ,&nbsp;Rodrigo Diaz Castañeda ,&nbsp;Alexandro Gudenschwager ,&nbsp;Maria Fernandez-Figueras","doi":"10.1016/j.ejwf.2025.07.078","DOIUrl":"10.1016/j.ejwf.2025.07.078","url":null,"abstract":"<div><h3>Purpose</h3><div>Salivary gland tumours pose a significant diagnostic challenge due to their histological diversity and overlapping pathological features. Immunohistochemistry (IHC) is a crucial tool in distinguishing these neoplasms, yet selecting the optimal IHC panel remains complex. Artificial intelligence (AI) applications, hold promise in improving diagnostic accuracy by recommending IHC markers. This study evaluates the diagnostic performance of ChatGPT-4 in recommending IHC markers for salivary gland tumours.</div></div><div><h3>Methods</h3><div>A free version of ChatGPT-4 was used to generate IHC panel recommendations for 21 salivary gland tumour types. A consensus panel of expert pathologists established reference IHC panels, serving as the gold standard for comparison. Chatbot responses were assessed using a structured scoring system measuring accuracy, completeness, and relevance. Cohen’s Kappa analysis quantified agreement between chatbot and pathologist recommendations. Sensitivity, specificity, and F1-scores evaluated diagnostic performance. Consistency across multiple chatbot queries was assessed using repeated measures ANOVA and Bland-Altman analysis. Performance was compared against a rule-based system following strict pathologist guidelines.</div></div><div><h3>Results</h3><div>The chatbot demonstrated moderate overall agreement (κ=0.53) with pathologists, with higher agreement for benign (κ=0.67) than malignant tumours (κ=0.40). Sensitivity was high (&gt;0.80) for benign tumours but lower for malignant neoplasms. The chatbot frequently recommended unnecessary markers, reducing specificity (&lt;0.50) for several malignancies. Stability analysis revealed variability in chatbot responses, particularly for complex tumour types. ChatGPT underperformed compared to the rule-based system, exhibiting higher rates of incorrect and missed markers.</div></div><div><h3>Conclusion</h3><div>AI-powered chatbots show potential in aiding IHC marker selection but currently lack the precision required for clinical implementation.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 424"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705226","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":"75 - Diagnostic algorithm for localization and complexity assessment of impacted maxillary canines","authors":"Gunel Aliyeva ,&nbsp;Sura Seyfullayeva ,&nbsp;Alima Musayeva","doi":"10.1016/j.ejwf.2025.07.079","DOIUrl":"10.1016/j.ejwf.2025.07.079","url":null,"abstract":"<div><div>Accurate diagnosis and evaluation of treatment complexity in maxillary canine impaction are essential for effective orthodontic planning. This study aimed to determine the prevalence and causes of canine impaction and to develop a diagnostic scoring system to assess treatment difficulty based on clinical and radiological criteria. A retrospective analysis of 11,704 patient records from the “Ortho-1” clinic over 35 years identified 255 cases of impaction of tooth 13 (2.17%) and 290 cases of tooth 23 (2.47%). Bilateral impaction was found in 94 cases (0.8%). Statistical analysis was performed in 44 patients who completed orthodontic treatment for bilateral impaction. A diagnostic index was developed based on: 1.⁠ ⁠Angulation to the midline (1–3 points), 2.⁠ ⁠Vertical depth relative to three occlusal reference lines (1–3 points), 3.⁠ ⁠Mesiodistal displacement (0–2 points), 4.⁠ ⁠Presence of complicating factors such as supernumerary teeth, odontomas, cysts, or rotations (0–1 point). The total score defines treatment difficulty: • 2–3 points: mild, • 4–5: moderate, • 6–9: severe. A statistically significant correlation was found between the total score and treatment duration. Higher scores were associated with increased treatment time and risk of complications. The proposed algorithm allows for more precise localization of impacted canines, individualized prognosis, and optimized treatment planning.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 424"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705227","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":"68 - Dental VR for Clinical Education – Application in Bracket Bonding (DESSERT)","authors":"Kenko Jian-Hong Yu ,&nbsp;Yu-Hsiang Chang ,&nbsp;Tzu-Hsin Lee ,&nbsp;Hasegawa Sumi ,&nbsp;Yuan-Hou Chen","doi":"10.1016/j.ejwf.2025.07.072","DOIUrl":"10.1016/j.ejwf.2025.07.072","url":null,"abstract":"<div><h3>Background</h3><div>Enhancing learning in dental education is essential, particularly for clinical procedures like bracket bonding, where traditional methods face challenges such as infection control and material waste.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of integrating Virtual Reality (VR) into bracket bonding education to improve student engagement, streamline training, and enhance clinical skill development.</div></div><div><h3>Methods</h3><div>Thirty dental students from China Medical University participated in a one-hour lecture on bracket bonding techniques, followed by a VR-based bonding simulation. Teachers monitored activities in real-time, providing immediate feedback. At the semester’s end, students completed questionnaires to assess the course.</div></div><div><h3>Results</h3><div>Students showed improved accuracy and efficiency in bracket positioning and clinical practice. Feedback highlighted high satisfaction levels and provided insights for refining VR simulations. Teachers observed significant improvement in students’ clinical performance during the VR-based training.</div></div><div><h3>Conclusions</h3><div>VR-based bracket bonding training provided a controlled, infection-free learning environment that reduced material waste and improved clinical skills. This approach holds significant potential for broader implementation in dental education.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 422"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705200","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":"69 - Dentin hypersensitivity after interproximal enamel reduction in patients treated with clear aligners: Desensitizing effect of diode laser vs sodium fluoride","authors":"Ludovica Nucci ,&nbsp;Maria Giovanna Ferraioli ,&nbsp;Adriana Fiori ,&nbsp;Antonella De Simone ,&nbsp;Fabrizia d'Apuzzo ,&nbsp;Vincenzo Grassia","doi":"10.1016/j.ejwf.2025.07.073","DOIUrl":"10.1016/j.ejwf.2025.07.073","url":null,"abstract":"<div><h3>Background</h3><div>Interproximal enamel reduction (IPR) is a common procedure in orthodontic treatment with clear aligners, but it may lead to dentin hypersensitivity (DH) and changes in gingival health.</div></div><div><h3>Objective</h3><div>This study evaluated dentin hypersensitivity and gingival health after IPR in patients treated with clear aligners and compared the desensitizing effect of laser diode versus sodium fluoride.</div></div><div><h3>Methods</h3><div>The study was a triple-blinded randomized controlled clinical trial. To be eligible for inclusion, patients had to respect for the following criteria: permanent dentition, good oral and general health. Previous history of hypersensitivity, enamel defects, cervical caries, periodontal disease, or pregnancy were excluded. A total of 45 patients with an orthodontic treatment plan including clear aligners and IPR (aged 14–63yrs) were randomly assigned to three groups: Group A (acidulated sodium fluoride gel: 0.33% NaF), Group B (diode laser: Soft Touch, 810 nm, 0,5W), and Group C (control, no treatment). In all groups, the response to air stimuli and the gingival indices were recorded before (T0) and immediately after IPR (T1), one week (T2), one month (T3), and three months post-treatment (T4). DH was assessed using a visual analog scale (VAS) by a blinded operator, while gingival health was evaluated using Silness and Löe Plaque and Gingivitis Indices.</div></div><div><h3>Results</h3><div>All groups showed an increase in DH immediately after IPR compared to baseline, which subsequently decreased at T2, T3, and T4. The laser group exhibited a statistically significant 10% reduction in DH, with rapid improvement one week post-treatment and sustained benefits over time. The gingival index improved or remained stable across all groups, with the laser group showing the most pronounced improvements. Moreover, the Plaque index was reduced in all groups.</div></div><div><h3>Conclusion</h3><div>The application of diode laser, after IPR, effectively reduced DH without adversely affecting gingival health. This finding supports the use of laser therapy to manage DH in orthodontic patients undergoing IPR.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 422"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705201","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":"60 - Considerations about Bisphenol-A release from orthodontic clear aligners: a systematic review","authors":"Diego Dos Santos Dias ,&nbsp;Karla Dias Castro Dias ,&nbsp;Natália dos Santos Dias ,&nbsp;Álvaro Teixeira Mattos","doi":"10.1016/j.ejwf.2025.07.064","DOIUrl":"10.1016/j.ejwf.2025.07.064","url":null,"abstract":"<div><div>The widespread adoption of clear orthodontic aligners has raised concerns regarding potential Bisphenol-A (BPA) release, a compound linked to endocrine disruption and adverse health outcomes. Despite preliminary in vitro studies suggesting trace BPA leaching from aligner materials, there remains a lack of comprehensive synthesis assessing the magnitude, clinical significance, and methodological consistency of these findings. This study aims to systematically evaluate and synthesize evidence on BPA release from clear orthodontic aligners. A systematic review was conducted in accordance with the PRISMA statement. Eligibility criteria included studies reporting BPA release from clear aligners only published within the last five years. Electronic databases including PubMed/MEDLINE and Cochrane Library were used with MeSH terms “Bisphenol A”, “Orthodontics” and “Orthodontic Appliances, Removable”. Study selection involved independent screening by two reviewers, with discrepancies resolved by consensus. Risk of bias was assessed using adapted quality appraisal tool for study selection, and data extraction captured study design, BPA quantification methods, exposure duration, and outcomes. The search results found five studies that met inclusion criteria, comprising four in vitro investigations and one ex vivo study. The studies consistently reported detectable BPA concentrations released over immersion periods of 24 hours to 10 days. Discussion emphasizes the need for standardized testing protocols to improve comparability. The evidence indicates that clear aligners can release trace amounts of BPA under laboratory and clinical conditions. However, due to limited clinical data, definitive conclusions regarding patient safety cannot be drawn. Further rigorous in vivo studies and harmonized laboratory protocols are warranted to assess exposure risk and long-term health implications.</div></div>","PeriodicalId":43456,"journal":{"name":"Journal of the World Federation of Orthodontists","volume":"14 6","pages":"Page 419"},"PeriodicalIF":3.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145705312","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}