International Orthodontics最新文献

{"title":"Effectiveness and efficiency of indirect bonding techniques: An umbrella review with meta-analysis of the pooled findings","authors":"Ziad Mohamad Alhafi ,&nbsp;Mohammad Y. Hajeer ,&nbsp;Mohammad Khursheed Alam ,&nbsp;Safwan Jaber ,&nbsp;Samer T. Jaber","doi":"10.1016/j.ortho.2025.101036","DOIUrl":"10.1016/j.ortho.2025.101036","url":null,"abstract":"<div><h3>Objectives</h3><div>This umbrella review aimed to critically evaluate the available evidence regarding the accuracy, bond failure rate, working and chairside time, and oral hygiene associated with the indirect bonding of orthodontic brackets.</div></div><div><h3>Material and methods</h3><div>An electronic search was performed using the following databases: Cochrane Library, Scopus®, Web of Science™, EMBASE®, PubMed®, SciELO, and LILACS. The search was for systematic reviews published between January 1968 and January 2025. There were no restrictions on language or date of publication. The process of screening, study selection, data extraction, and methodological quality assessment using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2) was performed by two independent authors. The most reliable evidence was identified using the Jadad decision algorithm. Data were combined and analyzed using random-effects meta-analysis.</div></div><div><h3>Results</h3><div>Out of 66 studies eligible for assessment, 15 were selected for full-text assessment. Seven systematic reviews were included, five of which contained meta-analyses. According to the AMSTAR-2 tool, the included reviews varied in methodological quality from moderate to critically low, with four receiving the lowest rating, thus limiting the overall certainty of the available evidence. The meta-analysis of the pooled findings showed acceptable transfer accuracy for indirect bonding methods, with no significant difference compared to direct bonding. The bracket bond failure rate was also comparable in both techniques. Indirect bonding technique was associated with shorter chairside time but longer total working time. Finally, there is no reliable evidence in the current literature about oral hygiene and indirect bonding.</div></div><div><h3>Conclusions</h3><div>Based on the available evidence from the systematic reviews, within the limitations of the available evidence, direct and indirect bonding techniques did not significantly differ in bracket placement accuracy, bonding failure rate, and oral hygiene. Indirect bonding may require less chairside time but a longer overall working time than direct bonding.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101036"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513961","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":"Evaluation of validity and reliability of quantitative Cervical Vertebral Maturation Index (QCVMI): A cross-sectional study","authors":"Abinaya Somaskandhan,&nbsp;Selva Arockiam,&nbsp;Uma Maheswari,&nbsp;Devaki Vijayalakshmi","doi":"10.1016/j.ortho.2025.101035","DOIUrl":"10.1016/j.ortho.2025.101035","url":null,"abstract":"<div><h3>Objective</h3><div>Various methods have been employed to determine skeletal maturity, based on height, weight, frontal sinus development, dental calcification sexual maturation and biomarkers. This study aimed to evaluate the validity and reliability of the Quantitative Cervical Vertebral Maturation Index (QCVMI) in assessing skeletal maturity and compare it with established radiographic maturity indicators, including Fishman's Skeletal Maturity Index, Hassal and Farman's CVMI, Modified MP3 Method, Baccetti's CVMI and correlation between QCVMI and mandibular growth increments.</div></div><div><h3>Material and methods</h3><div>A cross-sectional study was conducted on 120 patients. Lateral cephalograms and hand-wrist radiographs were analysed using Digimizer software. Agreement analysis was performed using Bland-Altman plots, while inter- and intra-rater reliability was assessed using Intraclass Correlation Coefficients (ICC). Lin's Concordance Correlation Coefficient (CCC) and the Bradley-Blackwood test were used for comparative assessment. ROC curve analysis determined diagnostic accuracy, and Pearson correlation coefficients and regression analysis assessed the relationship between QCVMI and mandibular growth increments.</div></div><div><h3>Results</h3><div>QCVMI demonstrated excellent agreement with Fishman's SMI, very good agreement with the Modified MP3, and good agreement with Hassal and Farman's CVMI and Baccetti's CVMI. High intra- and inter-rater reliability confirmed its reproducibility. ROC analysis showed QCVMI had the highest diagnostic accuracy compared to Fishman's SMI. A strong correlation was observed between QCVMI and mandibular growth increments, indicating its predictive efficacy for growth spurts.</div></div><div><h3>Conclusion</h3><div>QCVMI is a valid and reliable skeletal maturity assessment tool, demonstrating strong agreement with established indicators while enhancing objectivity and reproducibility. It effectively predicts mandibular growth spurts, making it valuable for orthodontic treatment planning.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101035"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144351534","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":"3D longitudinal changes in palatal morphology in growing subjects: A retrospective study","authors":"Judith Oropeza Araque ,&nbsp;Marianne Saade ,&nbsp;Srikant Natarajan ,&nbsp;Bhoomi Kotak ,&nbsp;Melih Motro ,&nbsp;Goli Parsi","doi":"10.1016/j.ortho.2025.101033","DOIUrl":"10.1016/j.ortho.2025.101033","url":null,"abstract":"<div><h3>Introduction</h3><div>The palate plays a crucial role in oral functions such as speech, breathing, and mastication. Understanding its development during growth is essential for diagnosis and treatment planning. This study aimed to assess changes in palatal depth, width, volume, and surface area at ages 8, 12, and 18.</div></div><div><h3>Material and methods</h3><div>This retrospective analysis of palatal characteristics was performed on dental casts obtained at 3 time points: 8, 12, and 18 years of age from untreated cases obtained from the Forsyth Twin Growth Study database collected from 1959–1975. The casts were scanned then eleven landmarks were plotted and a 3D analysis was performed to obtain the anterior and posterior widths and depths, surface area, and volume. Repeated measures ANOVA and posthoc Bonferroni's test were performed to evaluate the changes at different ages.</div></div><div><h3>Results</h3><div>Thirty subjects (16 females and 14 males) were included in this study. There was a statistically significant increase in volume and posterior depth among all age groups for both sexes. Surface area exhibited early growth from age 8 to 12 in males, plateauing after 12 years, while anterior depth significantly increased from ages 12 to 18 in both sexes. Anterior width grew significantly in females during the same period, with no significant changes in males. Posterior width showed a gradual increase with no significant difference between 8 and 12 years or 12 and 18 years.</div></div><div><h3>Conclusions</h3><div>There were consistent incremental changes in the palate's volume and posterior depth. The anterior width of the palate did not show consistent growth, as it only significantly increased dimensions from 12 to 18 years of age in females, whereas the surface area plateaued in males after 12 years, and posterior width changes were non-significant.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101033"},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331134","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":"Protraction of bilateral mandibular molars into the first molar extraction sites using long arm hooks with clear aligners of an adult Class II Division 2 with crowding: A case report","authors":"Hio Cheng Ieong,&nbsp;Yang Cao,&nbsp;Chen Zhou,&nbsp;Weicai Wang","doi":"10.1016/j.ortho.2025.101029","DOIUrl":"10.1016/j.ortho.2025.101029","url":null,"abstract":"<div><div>Protraction of mandibular bilateral second molars to substitute for the extracted first molars is challenging in clear aligner treatment due to biological and biomechanical limitations. This case report presents a 28-year old female patient with poor prognoses for the mandibular bilateral first molars, a mesially impacted mandibular left third molar, and crowding in both the upper and lower arches. After the extraction of mandibular bilateral first molars, long-distance mandibular molar protraction was achieved using clear aligners with a novel protraction appliance, “the long arm hook”. At the end of the treatment, a Class I canine and molar relationship and good root parallelism were achieved. The combination of long arm hooks and clear aligners has proven to be clinically effective for the protraction of mandibular molars, thereby expanding the scope of clear aligner treatment.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101029"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262120","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":"Mandibular molar protraction using round Australian wire and miniscrew anchorage with modified corticision in an adult with first molar loss: A case report","authors":"Qingjuan Shi ,&nbsp;Qinglian Zhang ,&nbsp;Hong Zheng,&nbsp;Yi Wang","doi":"10.1016/j.ortho.2025.101032","DOIUrl":"10.1016/j.ortho.2025.101032","url":null,"abstract":"<div><div>A 27-year-old adult female presented with the chief complaint of bilateral mandibular first molar absence and strongly preferred to use wisdom teeth rather than prosthetic replacements. Treatment was carried out using a round Australian wire fixed orthodontic technique. The second and third molars were mesially moved with a bilateral terminal helical loop combined with curved tip-back bends in Australian wire. Miniscrew anchorage was placed in the mandibular premolar area to assist in the protraction of the second and third molars. Additionally, a modified cortical drilling technique was employed to accelerate tooth movement. A neutral molar relationship was established while maintaining the patient's facial profile.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101032"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262069","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":"Three-dimensional assessment of mini-implant supported maxillary canine retraction with and without power arm in class II division 1 patients: A split-mouth randomized trial","authors":"Anas Nedal Kassas,&nbsp;Ahmed Mohamed Kamel,&nbsp;Mohammad Hasan Mohammad,&nbsp;Maher Abd El-Salam Fouda,&nbsp;Mona Abdelaziz Montasser","doi":"10.1016/j.ortho.2025.101030","DOIUrl":"10.1016/j.ortho.2025.101030","url":null,"abstract":"<div><h3>Introduction</h3><div>The primary objectives of this trial were to compare the mechanics of direct sliding (DS) and power arm sliding (PAS) methods for canine retraction in regard to the rate of retraction, rotation, and tipping. The secondary objectives included the evaluation of canine mobility, mini-implant stability, and pain.</div></div><div><h3>Material and methods</h3><div>This split-mouth study was conducted over a 12-month intervention period on young adult patients with Class II Division 1 malocclusion requiring extraction of the maxillary first premolars, recruited between July 2023 and January 2024. Retraction methods were randomly assigned to sides by coin toss. Closed coil springs applying 150<!--> <!-->g retraction forces were stretched to the canine bracket hook on one side and the power arm on the contralateral side. Digital models were analysed to measure canine retraction rate, tipping, and rotation. Canine mobility and mini-implant stability were assessed with the periotest. The pain was evaluated using a visual analogue scale. Data were analysed using two-way mixed ANOVA, and intraclass correlation test. Blinding was only used during data analysis.</div></div><div><h3>Results</h3><div>Twenty patients (aged 18.35<!--> <!-->±<!--> <!-->2.85) were included. The total retraction rate was greater in DS (4.42<!--> <!-->±<!--> <!-->0.75<!--> <!-->mm) compared to PAS (2.93<!--> <!-->±<!--> <!-->0.56<!--> <!-->mm) with <em>P</em> <!-->&lt;<!--> <!-->0.001. Tipping and rotation were significantly higher in DS compared to PAS with <em>P</em> <!-->&lt;<!--> <!-->0.001, <em>P</em> <!-->=<!--> <!-->0.031, respectively. No statistically significant differences were observed between the 2 methods regarding mini-implant stability, and pain. However, canine mobility revealed a significant difference only during the first and second months (<em>P</em> <!-->=<!--> <!-->0.005, P<!--> <!-->=<!--> <!-->0.003, respectively) with higher periotest values recorded in the PAS group. No harm was observed during the trial.</div></div><div><h3>Conclusions</h3><div>The DS method resulted in a faster rate of retraction than the PAS method. However, the PAS method effectively reduced both tipping and rotation, facilitating a more controlled bodily movement during canine retraction.</div><div>Trial registration in Clinical-Trial.gov under identification number <span><span>NCT06352996</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101030"},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168881","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 tooth movement in alveolar bone augmentation area: A systematic review of animal studies","authors":"Si-Min Wang ,&nbsp;Jia He ,&nbsp;Wen-Yu Chuo ,&nbsp;Lin Wu","doi":"10.1016/j.ortho.2025.101031","DOIUrl":"10.1016/j.ortho.2025.101031","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review aims to evaluate the optimal timing for orthodontic tooth movement (OTM) following alveolar bone augmentation, the types of alveolar bone graft materials used, and the associated animal models.</div></div><div><h3>Material and methods</h3><div>A systematic search was conducted across PubMed, Web of Science, Cochrane Library, Scopus, and grey literature databases, covering studies from January 1st, 2014, to November 30th, 2024. Studies addressing combined alveolar bone augmentation and OTM were selected, with outcomes such as OTM rate, bone formation, and root resorption assessed through imaging or histological methods. A control group was required in animal experiments. There were no language restrictions. Article screening and data extraction were performed independently by two reviewers. The SYRCLE risk-of-bias tool was used to evaluate study quality.</div></div><div><h3>Results</h3><div>Fourteen animal studies were included, with subjects comprising dogs, rats, mice, and rabbits. The graft materials predominantly consisted of allografts, xenografts, and alloplasts. The applied orthodontic force ranged from 10<!--> <!-->g to 150<!--> <!-->g, with OTM performed at intervals of 0 to 3<!--> <!-->months. Methodologies included model measurements, imaging, and histological analyses.</div></div><div><h3>Conclusion</h3><div>OTM can be performed during the bone weaving stage, however, the use of alveolar bone grafts generally impedes OTM. Alloplasts are associated with less root resorption. Animal models should closely mirror human characteristics, considering factors such as sex, age, defect location and size, type of tooth movement, and force magnitude. Overall, the quality of the studies is suboptimal, and further well-designed animal and human studies are needed.</div><div>This systematic review has been registered with PROSPERO (CRD42025642198).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101031"},"PeriodicalIF":1.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168850","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":"Biocompatibility of direct printed clear aligners: A systematic review of in vitro studies","authors":"Claire-Adeline Dantagnan ,&nbsp;Sylvie Babajko ,&nbsp;Ali Nassif ,&nbsp;André Porporatti ,&nbsp;Jean-Pierre Attal ,&nbsp;Elisabeth Dursun ,&nbsp;Jean-François Nguyen ,&nbsp;Julia Bosco","doi":"10.1016/j.ortho.2025.101028","DOIUrl":"10.1016/j.ortho.2025.101028","url":null,"abstract":"<div><h3>Objective</h3><div>Three-dimensional printing of aligners has gained in popularity as an alternative to thermoformed aligners. Only few studies evaluate the biological effects of these new materials. This systematic review aims to investigate the residual monomers leaching from direct printed clear aligners and their possible toxic effects.</div></div><div><h3>Search methods</h3><div>A search was conducted on several databases in accordance with PRISMA guidelines. In vitro, in vivo and clinical studies in English were included. The risk of bias of in vitro studies was assessed by QUIN Tool, for in vivo studies with the SYRCLE tool and for clinical studies with the RoB-2 tool.</div></div><div><h3>Results</h3><div>In all, 524 articles were initially identified and nine were included in the qualitative analysis. All the included studies were in vitro research with a moderate risk of bias. Seven studies were focused on cell toxicity and two on monomer release. Although mixed results are described, 3D printed aligners could present a slight cytotoxicity. Compared with thermoformed aligners, direct printed aligners had higher cytotoxicity levels. No estrogenic effects and no trace of Bisphenol A (BPA) release were detected from printed aligners when investigated but a leaching of Urethane Dimethacrylate (UDMA) have been reported in all studies. Post-curing was an important step to obtain satisfactory biocompatibility of printed aligners.</div></div><div><h3>Conclusions</h3><div>There is no consensus on the absence of cytotoxic effects of direct printed aligners but the release of some potentially active monomers including UDMA requires further investigations on long-term effects on patients’ health.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101028"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147397","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":"Mandibular canal angle, length and curvature in the three facial growth patterns and their association with vertical dysplasia indicators in adult patients: A retrospective cross-sectional 2D cephalometric study","authors":"Madhanraj Selvaraj,&nbsp;Piramanayagam Varshitha,&nbsp;Bhaskar Nivethitha,&nbsp;Balasubramanian Madhan","doi":"10.1016/j.ortho.2025.101026","DOIUrl":"10.1016/j.ortho.2025.101026","url":null,"abstract":"<div><h3>Objective</h3><div>The study compared the cephalometric mandibular canal (MC) morphology in different facial growth patterns and its association with other common vertical dysplasia indicators (VDI).</div></div><div><h3>Material and methods</h3><div>Pretreatment lateral cephalograms of 111 individuals (18–40 years) were categorised as normodivergent (ND), hypodivergent (HypoD), and hyperdivergent (HyperD) growth patterns based on SNGoGn. The mandibular canal angle (MCA) and VDI were estimated using cephalometric software. The mandibular canal length (MCL) and mandibular canal curvature (MCC) were calculated using the B-spline curve fitting method. The statistical analyses included comparing the MC variables across the three growth patterns and assessing their correlations with other VDI. Linear models were used to evaluate the multivariate effects of growth pattern, age and sex on MC variables.</div></div><div><h3>Results</h3><div>The HyperD group showed the highest median MCA (150°) followed by ND (146°) and HypoD (141°), with all intergroup differences significant at <em>P</em> <!-->&lt;<!--> <!-->0.001. There was no statistically significant difference in the MCL between the groups (ND<!--> <!-->=<!--> <!-->57<!--> <!-->±<!--> <!-->4.3, HypoD<!--> <!-->=<!--> <!-->58.2<!--> <!-->±<!--> <!-->4.5, HyperD<!--> <!-->=<!--> <!-->57.9<!--> <!-->±<!--> <!-->5.1<!--> <!-->mm). The MCC radius was higher in HyperD (44.9<!--> <!-->±<!--> <!-->8.7<!--> <!-->mm) than in ND (39.1<!--> <!-->±<!--> <!-->11.7, <em>P</em> <!-->=<!--> <!-->0.034) and HypoD group (38.7<!--> <!-->±<!--> <!-->8.5<!--> <!-->mm, <em>P</em> <!-->=<!--> <!-->0.026), implying a less curved MC in HyperD group. The age and sex of the individual did not have any significant impact on the MC variables. While MCA demonstrated moderate to high correlation with many VDI, the other two were not correlated with most.</div></div><div><h3>Conclusion</h3><div>The mandibular canal angle and curvature are potential cephalometric indicators of facial growth patterns, with the former being more robust and practical for routine clinical applications.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101026"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115304","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":"Retention of pubertal cervical vertebral maturation stages in adults (20–45 years). Limitations of cervical vertebral maturation in growth status assessment: A cross-sectional study","authors":"Erum Amin ,&nbsp;Sajid Ali ,&nbsp;Rana Faiza ,&nbsp;Marium Jamil ,&nbsp;Qasim Khalid ,&nbsp;Umar Hussain ,&nbsp;Nikoloas Pandis","doi":"10.1016/j.ortho.2025.101027","DOIUrl":"10.1016/j.ortho.2025.101027","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the retention of pubertal cervical vertebral maturation (CVM) stages in adults and assess the association of vertical and sagittal skeletal patterns on this retention.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted on pre-treatment records of 489 adult participants (286 females and 203 males) aged 20 to 45. Inclusion criteria were clear lateral cephalometric radiographs and the absence of systemic conditions or previous orthodontic treatment affecting skeletal maturation. Skeletal sagittal and vertical patterns were recorded. Associations between CVM stages and sex, skeletal sagittal, and vertical pattern were analysed using inverse probability weighting (IPW)-adjusted ordinal logistic regression for age.</div></div><div><h3>Results</h3><div>The mean age was 26.09 (4.84) years. CS4 was retained in 8.59% and CS5 in 19.63%. Age varied significantly across stages (<em>P</em> <!-->=<!--> <!-->0.01) with participants in CS5 being older. A significant sex difference was observed (<em>P</em> <!-->=<!--> <!-->0.01) with more males in CS6 and more females in CS5. Skeletal class was significantly associated with CVM stages (<em>P</em> <!-->=<!--> <!-->0.001) with Class III subjects more likely to exhibit less mature CVM stages. However, the vertical pattern was not significantly associated with CVM stages (<em>P</em> <!-->=<!--> <!-->0.63). Ordinal logistic regression showed that Class III participants had a significantly lower likelihood of attaining CS6 (OR<!--> <!-->=<!--> <!-->0.30, 95% CI: 0.16–0.54, <em>P</em> <!-->&lt;<!--> <!-->0.001) while vertical pattern and sex were not significant predictors after age adjustment.</div></div><div><h3>Conclusion</h3><div>A higher proportion of adults did not attain the post-pubertal CVM stage, especially in Class III malocclusion, raising concerns about CVM's reliability. Multiple growth indicators in combination with physical appearance should be used for skeletal maturation assessment.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101027"},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089196","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}