International Orthodontics最新文献

{"title":"Evaluation of shear bond strength, adhesive remnant index, and degree of conversion of orthodontic composite adhesives: An in vitro study using human premolars","authors":"Rehab A. Khalil ,&nbsp;Mohamed S. El-Okaily ,&nbsp;Ghada A. Alkaranfilly","doi":"10.1016/j.ortho.2025.101074","DOIUrl":"10.1016/j.ortho.2025.101074","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the shear bond strength (SBS), adhesive remnant index (ARI), and degree of conversion (DC) of four different orthodontic adhesives.</div></div><div><h3>Material and methods</h3><div>Sixty maxillary first premolars were randomly divided into four groups (<em>n</em> <!-->=<!--> <!-->15) according to the type of adhesive used: group I, Grengloo™ (GG), group II, Trulock® (TL), group III, CuRAY-Eclipse® (EC), and group IV, Master-Dent® (MD). The SBS was tested using a universal testing machine, and the ARI scores were evaluated by using a stereomicroscope. For assessing the DC, 5 cured and 5 uncured specimens were prepared for each group. FTIR (Fourier Transform Infrared) spectrometer was used to evaluate the DC for each composite. The SBS data were analysed by the Welch one-way ANOVA test, followed by Games-Howell post hoc test. ARI index scores were analysed by the Kruskal-Wallis test, followed by Dunn's post hoc test. The DC data were analysed by using the one-way ANOVA test, followed by Tukey's post hoc test. The significance level was set at <em>P</em> <!-->&lt;<!--> <!-->0.05 within all tests.</div></div><div><h3>Results</h3><div>There was a significant difference in the mean SBS (<em>P</em> <!-->&lt;<!--> <!-->0.001) between the tested groups (PES: 0.684, 95% CI [0.460 to 0.757]). GG had a statistically significantly higher mean SBS (19.63<!--> <!-->±<!--> <!-->4.44<!--> <!-->MPa) than the other adhesives. EC had a significantly higher mean SBS (14.15<!--> <!-->±<!--> <!-->5.28<!--> <!-->MPa) than MD (9.98<!--> <!-->±<!--> <!-->1.81<!--> <!-->MPa). There was no significant difference in mean SBS between TL (11.96<!--> <!-->±<!--> <!-->3.34<!--> <!-->MPa) and EC or between TL and MD. There was a significant difference in ARI scores (<em>P</em> <!-->&lt;<!--> <!-->0.001) between the tested adhesives (PES[H]: 0.262, 95% CI [0.100 to 0.510]). The predominant mode of bond failure in GG, TL, and EC was cohesive failure, while MD revealed bond failure at the enamel/adhesive interface. There was a significant difference (<em>P</em> <!-->=<!--> <!-->0.010) in the DC values between the tested composites (PES: 0.518, 95% CI [0.202 to 0.640]). GG (83.66<!--> <!-->±<!--> <!-->2.48%) had a significantly higher mean DC than MD (74.57<!--> <!-->±<!--> <!-->5.47%). There was no significant difference in the mean values of the DC between GG, TL (77.02<!--> <!-->±<!--> <!-->2.42%), and EC (78.36<!--> <!-->±<!--> <!-->3.23%), or between TL, EC, and MD.</div></div><div><h3>Conclusion</h3><div>GG had the highest SBS. All the tested adhesives showed adequate and acceptable SBS and DC for clinical practice. All the adhesives revealed cohesive bond failure, except MD exhibited bond failure at the enamel/adhesive interface. The DC was influenced by the composite type. GG had the highest DC and was significantly higher than MD.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101074"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223354","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":"Effect of variations in mini-screw diameter, length, tapering, and thread depth on stress-strain distribution and displacement in alveolar bone: A three-dimensional finite element analysis","authors":"Hamed Rahimi ,&nbsp;Salva Khosroshahian ,&nbsp;Faham Vjihi","doi":"10.1016/j.ortho.2025.101068","DOIUrl":"10.1016/j.ortho.2025.101068","url":null,"abstract":"<div><h3>Background</h3><div>Optimizing orthodontic mini-screw design is critical for primary stability. This study investigated the effects of macroscopic parameters—including length, diameter, taper, and thread depth—on stress distribution in surrounding alveolar bone using three-dimensional finite element analysis (FEA) immediately after orthodontic loading.</div></div><div><h3>Methods</h3><div>We designed a standard mini-screw (8<!--> <!-->mm length, 1.6<!--> <!-->mm diameter, 0.25<!--> <!-->mm thread depth, 1° taper with V-shaped threads) and systematically altered each parameter to create eight additional models. Each mini-screw embedded in bone was subjected to a 2<!--> <!-->N static shear load. The stress distribution in the bone and mini-screw, as well as mini-screw displacement under shear loading, were calculated to evaluate primary stability for each design.</div></div><div><h3>Results</h3><div>Reducing diameter by 0.2<!--> <!-->mm increased maximum von Mises stress by 47% in bone and 33% in the mini-screw, whereas increasing diameter by 0.2<!--> <!-->mm decreased stress by 10% in both. Other design parameters had smaller effects under shear loading. Maximum bone stress consistently occurred at the mini-screw entry site and around the first thread.</div></div><div><h3>Conclusions</h3><div>Mini-screw diameter is the most influential factor affecting primary stability, particularly regarding maximum von Mises stress. Our findings highlight the importance of optimizing diameter and structural design at the bone entry site, providing practical guidance for clinical selection and mini-screw design improvements.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101068"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223357","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":"Predicting treatment pathways in Class II malocclusion patients using machine learning: A comparative study of four algorithms for classifying camouflage, growth modulation, and surgical decisions","authors":"Mukesh Kumar,&nbsp;Sumit Kumar,&nbsp;Malvika Agarwal,&nbsp;Ekta Yadav,&nbsp;Sougandhika Gandi","doi":"10.1016/j.ortho.2025.101070","DOIUrl":"10.1016/j.ortho.2025.101070","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to develop a machine-learning model to assist in treatment decision-making for surgery, camouflage, and growth modulation in Class II malocclusion patients and to evaluate its validity and reliability.</div></div><div><h3>Material and methods</h3><div>A total of 506 Class II malocclusion patients were included in the study, with patients randomly assigned to a training set (405) and a test set (101). Four machine-learning (ML) models – logistic regression (LR), decision tree (DT), random forest (RF), and support vector machine (SVM) – were trained to predict the most suitable treatment approach: camouflage, growth modulation (GM), or surgery. The accuracy of treatment decisions was evaluated for each model, along with 95% confidence intervals (CIs). Additionally, the McNemar's test was used to assess the statistical significance of model performance.</div></div><div><h3>Results</h3><div>The AUC-PR values indicate that SVM and RF are the best-performing models, both achieving 1.00 for GM, 0.92 for camouflage, and 0.82 for surgery, demonstrating strong classification capabilities across all classes. LR performs well for GM (0.97<strong>)</strong> but struggles with camouflage and surgery (both 0.66), indicating inconsistencies. The DT has the lowest overall performance, with 0.62 for GM and camouflage, and 0.55 for surgery, suggesting weaker classification reliability. Given these results, SVM and RF emerge as the most effective models, offering the best balance of precision and recall across all classes.</div></div><div><h3>Conclusions</h3><div>Support vector machine and random forest demonstrate strong classification for growth modulation with high precision and recall, while camouflage remains stable until 80% recall before precision declines. Surgery involves greater trade-offs between precision and recall. This study further supports that ANB, Nasolabial angle, SNA, H angle, Age, Mandibular plane angle can be used as strong predictors in assessing patient's treatment needs.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101070"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223358","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":"Accuracy of digital vs. manual cephalometric tracing: A systematic review","authors":"Shankargouda Patil ,&nbsp;Alia Choudhary ,&nbsp;Harriet Young ,&nbsp;Quinton Ashton ,&nbsp;Aasha Patel ,&nbsp;Reji Mathew ,&nbsp;Frank W. Licari ,&nbsp;Tarek El-Bialy","doi":"10.1016/j.ortho.2025.101064","DOIUrl":"10.1016/j.ortho.2025.101064","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review aimed to assess the accuracy of digital cephalometric tracing with manual hand tracing.</div></div><div><h3>Methods</h3><div>PubMed, SCOPUS and Web of Science databases were searched for relevant articles. After an initial search, which revealed 279 potentially relevant articles, their titles and abstracts were screened. After screening, 23 full-text articles were assessed in depth. Fifteen publications were removed from the analysis considering the predetermined inclusion criteria. The quality of the methodology of the selected 9 studies was analyzed using 12-point criteria, which included study design, measurement, and statistical analysis.</div></div><div><h3>Results</h3><div>The data thus collected was analyzed for reliable and reproducible variables. All studies were carried out on the digital format of lateral cephalograms. The analysis included both angular and linear measurements. The results brought about statistically significant differences in certain methods and were clinically acceptable even though they were minimal. A few measured variables were the cephalogram quality, lip posture, positioning, and difficulty in locating landmarks.</div></div><div><h3>Conclusions</h3><div>This review concluded that digital cephalometric tracing was equally reliable as tracing manually, with a moderate quality of evidence. This study also suggested that the literature presented here was accurate enough for clinical application. Thus, digital cephalometric analyses can potentially improve the workflow in clinical and research settings saving time and effort.</div><div>PROSPERO – registration number (CRD42024537255).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101064"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222652","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":"Expression of autophagy and apoptosis during orthodontic tooth movement alveolar bone remodeling in rats with varied periodontal conditions","authors":"Yidan Zhang,&nbsp;Bowen Xu,&nbsp;Chuhan Peng,&nbsp;Linna Bai,&nbsp;Kai Yang","doi":"10.1016/j.ortho.2025.101076","DOIUrl":"10.1016/j.ortho.2025.101076","url":null,"abstract":"<div><h3>Objective</h3><div>Orthodontic treatment in periodontitis patients is challenging due to unpredictable bone remodeling and tissue damage. Therefore, this study aimed to investigate the effects of orthodontic force on periodontal ligament cell autophagy, apoptosis, and bone remodeling under various inflammatory states using a rat orthodontic tooth movement (OTM) model.</div></div><div><h3>Material and methods</h3><div>Seventy-five male Sprague – Dawley rats were used to establish OTM models for the periodontal health, active periodontitis, and stable periodontitis groups. Orthodontic force was applied at twelve weeks of age, with rats euthanized on days 0, 1, 3, 7, and 14 after force application. Microcomputed tomography quantified the OTM distance, alveolar bone crest resorption, and trabecular bone microarchitecture parameters. Immunohistochemistry and tartrate-resistant acid phosphatase staining evaluated the expression levels of inflammation, autophagy, apoptosis, osteogenesis, and osteoclast numbers in the periodontal ligament.</div></div><div><h3>Results</h3><div>The active periodontitis group exhibited the greatest OTM distance, alveolar bone resorption, and osteoclast activity, along with consistently high inflammatory factor expression. In this group, autophagy-related proteins increased on the tension side but decreased on the compression side, while apoptotic protein expression significantly rose. Osteokine levels were low, with an earlier peak decline observed in the active periodontitis group. The periodontal health group maintained high osteogenic activity, and the stable periodontitis group fell in between the two.</div></div><div><h3>Conclusions</h3><div>The inflammatory microenvironment in active periodontitis interacts with orthodontic force to disrupt the protective autophagy-apoptosis balance, coinciding with increased tissue destruction. Healthy, stable periodontium shows adaptive remodeling, emphasizing the importance of controlling inflammation before orthodontic treatment. This animal experimental procedure complies with the ARRIVE guidelines, and this research was approved by the Animal Ethics and Welfare Committee of the School of Stomatology, Capital Medical University (N^o̊ KQYY-202207-005).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101076"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223346","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":"Effect of varying thicknesses and temperature changes on shape memory behaviour in 3D DPA versus thermoformed clear aligner materials: An in vitro study","authors":"Venkata Durga Mahendra Tivanani,&nbsp;Swetha Reddy Dalli,&nbsp;Praveen Kumar Varma Datla,&nbsp;Anoosha Manda,&nbsp;Sai Keerthi Velagala,&nbsp;Padma Priya Cv","doi":"10.1016/j.ortho.2025.101073","DOIUrl":"10.1016/j.ortho.2025.101073","url":null,"abstract":"<div><h3>Background</h3><div>The present study evaluated the shape memory behaviour of TA-28 compared to PET-G at different thicknesses and temperatures.</div></div><div><h3>Methods</h3><div>Two materials were tested: thermoformed CA Pro (PET-G) and 3D-printed TA-28 (Graphy, Korea), in 0.5<!--> <!-->mm and 0.75<!--> <!-->mm thicknesses. A total of 160 aligner strips were fabricated and tested for shape recovery at 30<!--> <!-->°C, 37<!--> <!-->°C, 40<!--> <!-->°C, and 80<!--> <!-->°C. Each strip was bent at 100<!--> <!-->°C and recovery was measured over 60<!--> <!-->minutes using a protractor-based template.</div></div><div><h3>Results</h3><div>TA-28 exhibited significantly higher shape recovery than PET-G at all temperatures (<em>P</em> <!-->≤<!--> <!-->0.001). Recovery increased with temperature and was greatest for the 0.5<!--> <!-->mm TA-28 samples. At 37<!--> <!-->°C, TA-28 reached up to 60.7% recovery within 60<!--> <!-->minutes, while PET-G showed negligible change. Three-way ANOVA revealed significant interactions among material, thickness, and temperature (<em>P</em> <!-->=<!--> <!-->0.005).</div></div><div><h3>Conclusion</h3><div>TA-28 aligners demonstrate superior shape memory properties compared to PET-G, particularly at body temperature. TA-28 samples with 0.5<!--> <!-->mm thickness recovered faster and to a greater extent, offering more consistent force delivery.</div></div><div><h3>Clinical significance</h3><div>Directly 3D-printed TA-28 aligners may enhance treatment predictability, reduce patient discomfort, and provide sustained orthodontic force due to their temperature-responsive shape recovery. These findings support the use of smart materials in future orthodontic aligner design.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101073"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223356","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":"Comparison of mechanical properties of in-house manufactured fully customized lingual brackets versus prefabricated brackets: An in vitro study","authors":"Pedro Graziani Olímpio Pereira ,&nbsp;Silvio Augusto Bellini-Pereira ,&nbsp;Aron Aliaga-Del Castillo ,&nbsp;Karina Maria Salvatore Freitas ,&nbsp;Marcos Roberto de Freitas ,&nbsp;Daniela Garib ,&nbsp;Guilherme Janson","doi":"10.1016/j.ortho.2025.101067","DOIUrl":"10.1016/j.ortho.2025.101067","url":null,"abstract":"<div><h3>Objective</h3><div>This in vitro study aimed to compare the mechanical properties of fully customized lingual brackets (FCLBs) designed and manufactured in-house using open-source software with two commercially prefabricated lingual brackets.</div></div><div><h3>Material and methods</h3><div>The FCLBs were designed with Liberteeth 3D, a plug-in within the open-source software Blender 3D. The .stl files of the brackets were printed using a direct laser metal sintering machine. The comparison groups included prefabricated In-Ovation® L (IOL) and New STb™ brackets (STb). The sample included 24 lingual brackets, eight per group. The groups were compared in vitro regarding static and kinetic friction using a universal testing machine, and slot size and surface roughness were evaluated through scanning electron microscopy and non-contact laser profilometry. Intergroup comparisons were performed using Kruskal-Wallis and One-way Analysis of Variance tests.</div></div><div><h3>Results</h3><div>No differences in static and kinetic friction were found. All tested brackets showed slight deviations in slot sizes compared to the manufacturer's prescription. IOL brackets demonstrated a significantly smaller slot size in both height (MD: −32.17; CI: −56.66, −19.71; <em>P</em> <!-->=<!--> <!-->0.001) and width (MD: −137.31; CI: −188.46, −105.17; <em>P</em> <!-->&lt;<!--> <!-->0.001) compared with STb brackets. The FCLBs presented significantly greater surface slot roughness compared with the In-Ovation® (MD: −0.41; CI: −0.49, −0.34; <em>P</em> <!-->&lt;<!--> <!-->0.001) and New STb™ (MD: −0.39; CI: −0.47, −0.32; <em>P</em> <!-->&lt;<!--> <!-->0.001) brackets.</div></div><div><h3>Conclusions</h3><div>The design and manufacture of FCLBs using open-source software is feasible. However, the sintering and surface polishing processes require improvement to achieve optimal clinical outcomes in a future clinical perspective.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101067"},"PeriodicalIF":1.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207791","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":"Non-surgical treatment of severe anterior open bite, hyperdivergent pattern, and posterior crossbite in an adult with atrophy of the mandibular first molar extraction site: A case report","authors":"Ahmed S. Khalil,&nbsp;Sherief H. Abdel-Haffiez","doi":"10.1016/j.ortho.2025.101072","DOIUrl":"10.1016/j.ortho.2025.101072","url":null,"abstract":"<div><div>Anterior open bite presents a significant challenge in orthodontic treatment due to its multifactorial aetiology. Managing such cases in adult patients is further complicated when additional factors, such as posterior crossbite, are present. Space closure in an atrophic edentulous ridge poses an added challenge due to reduced alveolar bone width and the risk of periodontal compromise. The diagnostic and treatment details of the present case were documented in accordance with the CARE guidelines for clinical case reporting. This case report describes the successful non-surgical management of an 18-year-old female with severe anterior open bite, hyperdivergent facial morphology, bilateral posterior crossbite, and an atrophic mandibular first molar extraction site with a mesially and lingually tipped second molar. The patient declined orthognathic surgery, leading to the consideration of a comprehensive orthodontic approach in conjunction with Miniscrew-Assisted Rapid Palatal Expansion (MARPE) for transverse correction, skeletal anchorage for maxillary molar intrusion, and fixed orthodontic appliances for space closure and molar uprighting. Treatment resulted in a functional occlusion with Class I molar and canine relationships, normal overjet and overbite, and stable transverse correction. The patient received satisfactory facial aesthetics with a harmonious smile and was pleased with the results. The integration of skeletal anchorage enabled effective vertical and transverse correction in an adult patient without orthognathic surgery. Controlled uprighting with intrusion allowed for proper alignment of a tipped mandibular molar, followed by successful protraction across an atrophic ridge.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101072"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201708","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":"Interdisciplinary management of a skeletal class II, hyperdivergent patient accompanied by multiple missing teeth and severe overeruption with orthodontic assisted space redistribution and implant restoration","authors":"Tianyi Xie,&nbsp;Boxi Yan","doi":"10.1016/j.ortho.2025.101062","DOIUrl":"10.1016/j.ortho.2025.101062","url":null,"abstract":"<div><div>Long-term absence of posterior teeth often leads to significant overeruption of the antagonists, posing a substantial challenge for restorative treatment planning. This case report presents an interdisciplinary approach for a skeletal class II, hyperdivergent patient accompanied by missing maxillary second premolars (15,25), left maxillary second molar (27), mandibular first and second molars (36,37,46,47) and severe overeruption of maxillary first molars (16,17). The maxillary first molars were intruded using both buccal and palatal miniscrews while the existing maxillary spaces were closed. In the mandible, the existing spaces were strategically redistributed through the substitution of third molars for missing second molars, complemented by implant-supported restoration of the first molars. After 35 months of active treatment, well-aligned dentition, ideal intercuspation, and a notably improved facial profile were achieved, which remained stable during the 17 months follow-up. Overeruption resulting from long-standing absence of opposing teeth can be effectively managed through orthodontic intrusion with temporary anchorage devices. The strategic use of existing third molars for space redistribution offers a cost-effective, biologically conservative solution that preserves natural dentition.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101062"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201747","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 symphysis dimensions among various craniofacial patterns: A systematic review and meta-analysis","authors":"Muhammad Saood ,&nbsp;Qasim Khalid ,&nbsp;Wajiha Abbas ,&nbsp;Umer Hussain ,&nbsp;Marium Jamil ,&nbsp;Umar Hussain ,&nbsp;Alessandra Campobasso ,&nbsp;Junad Khan","doi":"10.1016/j.ortho.2025.101065","DOIUrl":"10.1016/j.ortho.2025.101065","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate and synthesize the available evidence on mandibular symphysis dimensions across different sagittal and vertical craniofacial skeletal patterns.</div></div><div><h3>Methods</h3><div>Eligibility criteria: cross sectional studies comparing mandibular symphysis dimensions among individuals with different sagittal and vertical skeletal patterns. Information sources: unrestricted literature search of six databases (PubMed, Scopus, Web of Science, LILACs, Cochrane and Google Scholar) was conducted up to April 2025 without language restriction. Risk of bias: the quality assessment of the included studies was conducted using Joanna Briggs Institute tool. Synthesis of results: random-effects meta-analyses were performed using mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was assessed using I² and Tau² statistics. Subgroup analyses were conducted based on ethnicity, imaging modality, and risk of bias. Publication bias was evaluated.</div></div><div><h3>Results</h3><div>Included studies: twenty-three cross-sectional studies involving 3313 participants (40.35% male) were included. Synthesis of results: class III subjects showed significantly greater symphysis area (MD<!--> <!-->=<!--> <!-->2.37[1.33, 3.41]), height (MD<!--> <!-->=<!--> <!-->0.75[0.27, 1.22]), and convexity (MD<!--> <!-->=<!--> <!-->3.59[0.69, 6.49]) compared to Class I. Hyperdivergent individuals had increased symphysis height (MD<!--> <!-->=<!--> <!-->1.31[0.53, 2.1]) and reduced width (MD<!--> <!-->=<!--> <!-->–1.25[–2.37,–0.12]), while hypodivergent individuals showed reduced height (MD<!--> <!-->=<!--> <!-->–0.68[–1.34,–0.03]) and increased width (MD<!--> <!-->=<!--> <!-->1.42[0.41, 2.42]). Subgroup analyses revealed ethnicity and risk of bias as significant modifiers, particularly in Class II and vertical pattern comparisons. No significant publication bias was detected.</div></div><div><h3>Discussion</h3><div>Limitations of evidence: the inclusion of mostly retrospective studies, presence of growing individuals, inadequate control for confounders, inconsistent age and sex reporting, and limited outcome data restricted the strength and scope of the meta-analysis. Interpretation: symphysis dimensions vary by skeletal pattern, with vertical growth type showing stronger associations than sagittal class.</div></div><div><h3>Registration</h3><div>PROPSERO (CRD420251049382).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101065"},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160266","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}