International Orthodontics最新文献

{"title":"A finite element analysis of stress distribution on maxillofacial skeleton and temporomandibular joint articular disc under intermaxillary loading after simulated bone anchored maxillary protraction","authors":"Supratim Kundu ,&nbsp;Ankur Gupta ,&nbsp;Pravin Kumar ,&nbsp;Anjana Rajagopalan ,&nbsp;Navleen Kaur Bhatia ,&nbsp;Rinkle Sardana ,&nbsp;Vinay Kumar Chugh","doi":"10.1016/j.ortho.2025.101139","DOIUrl":"10.1016/j.ortho.2025.101139","url":null,"abstract":"<div><h3>Introduction</h3><div>Bone-anchored maxillary protraction (BAMP) is an effective therapeutic approach for managing developing skeletal Class III malocclusion. This study aimed to determine the stress distribution in the circum-maxillary sutures, temporomandibular articular disc and mandibular condyle, as well as the displacement of key craniofacial landmarks during BAMP.</div></div><div><h3>Methods</h3><div>A three-dimensional linear finite element (FE) model of the skull, articular disc and anchor plate was developed. Using this model, Class III intermaxillary loads of 150<!--> <!-->g, 250<!--> <!-->g and 400<!--> <!-->g were applied through anchorage plates at angulations of 10°, 20° and 30°. Stress distribution in the circum-maxillary sutures, articular disc and condylar head was evaluated. Additionally, displacement of the anterior nasal spine (ANS), posterior nasal spine (PNS), pogonion and condylion in the anteroposterior and vertical directions was assessed.</div></div><div><h3>Results</h3><div>Increasing force magnitude and angulation resulted in greater maxillary displacement and elevated stresses at circummaxillary sutures. Von Mises and principal stress analyses demonstrated that moderate forces (150–250<!--> <!-->g) produced favourable displacement with comparatively lower stress concentrations in the TMJ region, whereas higher forces (400<!--> <!-->g) generated increased stresses at the condylar head and articular disc.</div></div><div><h3>Conclusion</h3><div>Within the limitations of a linear static model, moderate force levels and smaller angulations appear to offer a biomechanically favourable balance between skeletal advancement and TMJ loading during BAMP therapy. These findings represent immediate mechanical responses and should be interpreted cautiously. Future studies incorporating muscle forces, soft tissues, and time-dependent remodelling are warranted.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101139"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924081","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":"Influence of maxillomandibular ratio dynamics on post-pubertal sagittal classification: A retrospective historical cohort study","authors":"Rodrigo Oyonarte ,&nbsp;Mónica Valeria Castro ,&nbsp;Mackarena Sáez ,&nbsp;Florencia Arancibia ,&nbsp;Valeria Ramírez ,&nbsp;Andreu Puigdollers","doi":"10.1016/j.ortho.2025.101109","DOIUrl":"10.1016/j.ortho.2025.101109","url":null,"abstract":"<div><h3>Background</h3><div>Cephalometric measurements, like the ANB or the Wits, enable sagittal skeletal classification; however, they can be affected by compensations, and the maxillomandibular differential may be subject to radiographic magnification. The maxillomandibular ratio (MxMdR) could provide a dynamic, magnification-independent intermaxillary sagittal assessment.</div></div><div><h3>Aims</h3><div>To describe the MxMdR throughout facial development and assess its impact on determining post-pubertal sagittal classification.</div></div><div><h3>Material and methods</h3><div>Retrospective cohort study of 224 untreated individuals (AAOF-Craciofacial Growth Collection), including 1301 profile radiographs from 9 centers (1950s–1970s) with records spanning at least five stages of cervical maturation (CVS 1-6), classified based on final ANB and Wits (97 Class I, 82 Class II, 45 Class III). Measurements included the ANB, SNA, SNB, SN-GoGn, anterior facial height ratio, Wits, maxillary length, mandibular length, and MxMdR. Statistical analysis involved descriptive statistics, mixed models to assess developmental variations, and LASSO regression to identify early-stage predictors for the post-pubertal ANB angle.</div></div><div><h3>Results</h3><div>No significant differences were observed between sexes in sagittal measurements. MxMdR decreased progressively and significantly during growth, showing a class-specific distribution similar to ANB, while Wits decreased in Class III, remained stable in Class I, and increased in Class II individuals. LASSO regression identified initial ANB and MxMdR as key predictors for the post-pubertal ANB.</div></div><div><h3>Conclusions</h3><div>MxMdR evolves differently across skeletal classes, correlating with the final sagittal classification at all developmental stages. Including it alongside the initial ANB improves predictions of post-pubertal relationships. The MxMdR serves as a valuable, magnification-independent tool for early skeletal assessment, complementing traditional diagnostic methods.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101109"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145753523","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 pharmacological agents for acceleratory orthodontic tooth movement and subsequent relapse: A randomized controlled animal study","authors":"Samar Ali Hamed ,&nbsp;Mohammad Hasan Mohammad ,&nbsp;Mohamed E. Grawish ,&nbsp;Ahmed Maher Fouda ,&nbsp;Mona Abdelaziz Montasser","doi":"10.1016/j.ortho.2025.101112","DOIUrl":"10.1016/j.ortho.2025.101112","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the effects of submucosal injections of acceleratory orthodontic materials and the subsequent relapse rate. No previous study has compared the effects of different acceleratory agents on post-retention relapse. Orthodontic tooth movement (OTM) in rats was evaluated over 4 weeks, followed by 2 weeks of retention and 2 weeks of relapse.</div></div><div><h3>Material and methods</h3><div>Randomization: The trial included 105 rats divided randomly with a blinded second author into five equal groups. Interventions: Group I (negative control) rats weren’t subjected to OTM or any acceleratory agents. Group II (positive control) rats underwent OTM without receiving any tested injectable materials. Groups III, IV, and V received the same OTM as Group II, accompanied by injections of corticosteroid, vitamin D, and PGE₂, respectively. The primary outcome: Tooth movement was measured at predetermined intervals, and histological assessments were performed after euthanasia. Statistical analysis was done using One-way ANOVA then post-hoc Tukey and paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>During the acceleration phase, incisor movement was fastest in the corticosteroid group, followed by vitamin D, PGE₂, positive control, and negative control (<em>P</em> <!-->&lt;<!--> <!-->0.001). In contrast, relapse was lowest in the negative control, positive control, and PGE₂ groups, and higher in vitamin D and corticosteroid groups (<em>P</em> <!-->&lt;<!--> <!-->0.001). Histological findings were in the same line with the dental measurements. No harms were detected.</div></div><div><h3>Conclusion</h3><div>Local application of corticosteroid, vitamin D, and PGE₂ enhanced orthodontic tooth movement. While corticosteroid produced the greatest acceleration, PGE₂ was associated with the least subsequent relapse.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101112"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775887","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":"Facial soft tissue changes in patients following rapid maxillary expansion in children: A systematic review","authors":"Nafisa Marium Molla ,&nbsp;Raisa Queiroz Catunda ,&nbsp;Karla Carpio Horta ,&nbsp;Heesoo Oh ,&nbsp;Manuel O. Lagravère","doi":"10.1016/j.ortho.2025.101107","DOIUrl":"10.1016/j.ortho.2025.101107","url":null,"abstract":"<div><h3>Background</h3><div>Non-surgical rapid maxillary expansion (RME) has been widely investigated regarding skeletal effects, although fewer studies have assessed the associated soft tissue changes, which is an important factor to consider, as orthodontic treatment aims to achieve occlusal harmony and an aesthetically pleasing soft tissue balance. This systematic review examines the existing literature on facial soft tissue changes following rapid maxillary expansion (RME) in children with a maxillary transverse deficiency.</div></div><div><h3>Material and methods</h3><div>A systematic search was conducted up to July 2025 in four major databases, including Embase (via Ovid), Medline (via Ovid), PubMed, Cochrane Library, and Google Scholar. Studies focused on children receiving RME were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for the Risk of Bias in Non-randomized Studies of Interventions. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines.</div></div><div><h3>Results</h3><div>Of the 1379 articles found, 15 included PICOS-based inclusion criteria: five randomized controlled trials, four cohort studies, and six controlled clinical trials. Alar width (0.5 to 2.21<!--> <!-->mm), alar base width (0.17 to 2.81<!--> <!-->mm), and nasolabial angle (0.9 degrees) increased significantly after RME treatment. Five studies were found to have a low risk of bias, seven had a moderate risk of bias, one had a serious risk of bias, and two had some concerns.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that RME results in variable soft tissue facial changes over time. The findings resulted statistically significant for alar width, alar base width, and nasolabial angle, showing changes in the facial soft tissues after non-surgical rapid maxillary expansion, especially in the nasal area. These results, which are directly related to the anatomical effects of the rapid maxillary expansion, need careful consideration by clinicians as the skeletal and the consequent soft tissue changes may be influenced by different factors, i.e. patient age, appliance activation and follow-up duration.</div><div>PROSPERO reference number: CRD42024505738.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101107"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684806","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":"Association between gonial angle and bone thickness in the infrazygomatic crest and mandibular buccal shelf regions for mini-screw insertion in adults: A retrospective study","authors":"Fatemeh Alirezaei ,&nbsp;Reza Ghorbanipour ,&nbsp;Behzad Chalaki ,&nbsp;Ehsan Moudi ,&nbsp;Maysam Mirzaie ,&nbsp;Seyed Ali Seyed Majidi","doi":"10.1016/j.ortho.2025.101137","DOIUrl":"10.1016/j.ortho.2025.101137","url":null,"abstract":"<div><h3>Introduction</h3><div>Temporary anchorage devices (TADs) improve orthodontic biomechanics, with the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS) as common extra-alveolar sites. Skeletal morphology, especially gonial angle as a vertical facial dimension indicator, may influence bone availability. This study investigated the correlation between IZC and MBS bone thickness and gonial angle using cone-beam computed tomography (CBCT).</div></div><div><h3>Methods</h3><div>CBCT scans from September 2019 to September 2021 were analysed. Bone thickness in IZC and MBS regions was measured at standardized reference points on predefined coronal and axial planes. Participants were consecutively selected from a radiology archive according to inclusion/exclusion criteria. Normality was checked with Kolmogorov–Smirnov test, and correlations were assessed using Spearman's test (<em>P</em> <!-->&lt;<!--> <!-->0.05) in SPSS v22.</div></div><div><h3>Results</h3><div>A total of 120 adult CBCT scans were evaluated (≥<!--> <!-->18<!--> <!-->years). The mean gonial angle was 120.5° (95% CI: 119.0–122.0). IZC thickness decreased cranially, showing no significant correlation with gonial angle (<em>P</em> <!-->&gt;<!--> <!-->0.05); the maximum thickness was 5.01<!--> <!-->±<!--> <!-->1.65<!--> <!-->mm at the mesiobuccal root of the maxillary first molar. In the MBS region, bone thickness, depth, and angulation increased posteriorly and all showed significant inverse correlations with gonial angle (<em>P</em> <!-->&lt;<!--> <!-->0.05). Maximum MBS thickness was 7.12<!--> <!-->±<!--> <!-->2.31<!--> <!-->mm at the distal root of the mandibular second molar; minimum thickness was 1.53<!--> <!-->±<!--> <!-->0.94<!--> <!-->mm at the mesial root of the first molar.</div></div><div><h3>Discussion and conclusion</h3><div>The distal mandibular second molar offers the most favourable site for extra-alveolar TAD placement due to greater thickness, depth, and angulation. Inverse correlation with gonial angle suggests improved primary stability in patients with reduced vertical facial height. IZC thickness is less affected by gonial angle, but careful angulation is required to avoid sinus perforation. Individualized CBCT assessment is crucial for optimizing TAD placement, enhancing biomechanical outcomes, and minimizing procedural risks.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101137"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976407","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":"The effect of orthodontic extraction protocol on vertical skeletal relationships: A retrospective study","authors":"Martina Ferrillo ,&nbsp;Kieran Daly ,&nbsp;Nikolaos Pandis ,&nbsp;Padhraig S. Fleming","doi":"10.1016/j.ortho.2025.101133","DOIUrl":"10.1016/j.ortho.2025.101133","url":null,"abstract":"<div><h3>Introduction</h3><div>Extractions may be helpful in the relief of crowding and in incisal retraction. While extractions may help to control the vertical dimension, their effect is not clear-cut. Four premolar extractions (FPE) may be more potent in reducing the vertical dimension than two upper premolar extractions (UPE), although research to support this contention is lacking.</div></div><div><h3>Objectives</h3><div>The aim of this study is to evaluate the effect of orthodontic extraction protocols on vertical skeletal relationships.</div></div><div><h3>Material and methods</h3><div>A retrospective study involving participants either undergoing UPE or FPE-based treatment and non-extraction-based controls was performed. All cephalometric outcome measures were assessed before (T0) and after (T1) orthodontic treatment. The effect of extraction pattern on vertical skeletal dimension in terms of mandibular planes angle (MMPA) and anterior facial height (AFH) was assessed using a multivariable analysis.</div></div><div><h3>Results</h3><div>A total of 168 patients (86 males, 82 females) with a mean age of 13.69<!--> <!-->±<!--> <!-->5.03<!--> <!-->years were included. The MMPA reduced marginally in all three groups. Based on multivariable analysis adjusted for age, lower crowding at baseline, sex, and MMPA at baseline, the extraction pattern did not exert a significant effect on post-treatment MMPA (UPE group: coef.<!--> <!-->=<!--> <!-->−0.31; 95% CI: −1.06, 0.43, <em>P</em> <em>=</em> <!-->0.40; FPE group: coef.<!--> <!-->=<!--> <!-->−0.40; 95% CI: −1.75, 0.96; <em>P</em> <!-->=<!--> <!-->0.56) compared to non-extraction protocols. Similarly, the extraction pattern did not have a significant effect on post-treatment AFH (UPE group: coef.<!--> <!-->=<!--> <!-->0.50; 95% CI: −0.73, 1.73, <em>P</em> <!-->=<!--> <!-->0.42; FPE group: coef.<!--> <!-->=<!--> <!-->1.59; 95% CI: −0.65, 3.83; <em>P</em> <!-->=<!--> <!-->0.16).</div></div><div><h3>Conclusions</h3><div>Based on the findings of the present retrospective study, neither statistically nor clinically significant differences in the vertical skeletal relationships were introduced across UPE, FPE, and non-extraction groups. Post-treatment MMPA and AFH were significantly associated solely with their pre-treatment values.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101133"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834912","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":"Anchorage control with mandibular miniscrews in an adult severe high-angle Class II case treated by preadjusted lingual appliance, premolar extractions and orthognathic surgery","authors":"Enrico Albertini ,&nbsp;Adamo Monari ,&nbsp;Paolo Albertini ,&nbsp;Anna Colonna ,&nbsp;Luca Lombardo ,&nbsp;Ugo Baciliero","doi":"10.1016/j.ortho.2025.101113","DOIUrl":"10.1016/j.ortho.2025.101113","url":null,"abstract":"<div><div>This case report describes a complex full-step Class II high-angle case in an adult patient treated with lingual straight-wire appliance, premolar extractions and orthognathic surgery. With the twofold aim of obtaining ideal occlusal relationship and aesthetic improvement, surgical treatment with appropriate biomechanical strategies, including anchorage control during extraction space closure, are needed to achieve the planned results. This case report demonstrates the possibility of solving successfully severe sagittal, transverse and vertical discrepancies in an adult patient with surgical treatment by means of a completely invisible technique. This report also underlines the need for precise biomechanical control, including set-up overcorrections and miniscrews to manage anchorage control, in cases of extraction in lingual orthodontics. A refinement with composite reconstructions was performed at the end to obtain the best aesthetic and functional result.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101113"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834915","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 physical adjunctive interventions on root resorption in accelerated orthodontic treatment: A systematic review and meta-analysis","authors":"Mohamad Radwan Sirri ,&nbsp;Mohamad Yaman Salahi Alasbahi ,&nbsp;Mohammad Osama Namera ,&nbsp;Salar Karim Khalil","doi":"10.1016/j.ortho.2025.101123","DOIUrl":"10.1016/j.ortho.2025.101123","url":null,"abstract":"<div><h3>Background</h3><div>Orthodontically induced root resorption (RR) is a frequent adverse effect that may compromise long-term tooth stability. Physical adjunctive interventions (PAIs), such as vibration, photobiomodulation, low-intensity pulsed ultrasound (LIPUS), and low-intensity electrical stimulation (LIES), have been proposed to accelerate tooth movement while potentially minimizing RR, but their efficacy remains unclear.</div></div><div><h3>Objective</h3><div>To systematically evaluate the effect of PAIs on RR during orthodontic treatment based on evidence from randomized controlled trials (RCTs).</div></div><div><h3>Materials and methods</h3><div>Databases included PubMed, Scopus, Web of Science, Embase, and CENTRAL up to May 2025, supplemented by Google Scholar, TRIP, OpenGrey, PQDT Open, and hand-searching of orthodontic journals. No restrictions were applied on language or publication status. Eligibility included human randomized controlled trials comparing non-surgical physical adjunctive interventions with conventional orthodontic treatment and reporting quantitative orthodontically induced root resorption. Two reviewers independently performed screening, data extraction, and RoB 2 assessment; RR harms were evaluated with a modified McHarm tool, and certainty was appraised using the GRADE approach. Meta-analysis was conducted when appropriate. PROSPERO registration CRD420251116993.</div></div><div><h3>Results</h3><div>Twenty-two RCTs (<em>n</em> <!-->=<!--> <!-->534) were included. Evidence certainty was low to very low. Vibration and LIES showed no significant effect. LIPUS reduced root length loss during canine retraction by 0.015<!--> <!-->mm/week (<em>P</em> <!-->=<!--> <!-->0.042) and premolar volume loss by 0.53<!--> <!-->mm³ (<em>P</em> <!-->&lt;<!--> <!-->0.001). LED trays lowered premolar volume loss by 0.15<!--> <!-->mm³ (<em>P</em> <!-->&lt;<!--> <!-->0.001). Laser therapy reduced RR scores during En-masse retraction (<em>P</em> <!-->&lt;<!--> <!-->0.05). None of the PAIs increased RR compared with controls.</div></div><div><h3>Conclusions</h3><div>PAIs exhibit variable influence on RR. LIPUS and daily LED phototherapy show the most promising protective effects; however, current evidence remains limited by methodological weaknesses, small sample sizes, and short follow-up periods. Further well-designed RCTs are needed before widespread clinical adoption.</div><div>PROSPERO (Registration ID: CRD420251116993).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 2","pages":"Article 101123"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839653","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":"Multidisciplinary orthodontic and prosthetic treatment of an eleven-year-old patient with a solitary median maxillary central incisor: A case report","authors":"Miltiadis A. Makrygiannakis ,&nbsp;Nikolaos Gogolas ,&nbsp;Platon-Timotheos Perdikaris ,&nbsp;Alexandros Kostis ,&nbsp;Athanasios E. Athanasiou ,&nbsp;Eleftherios G. Kaklamanos","doi":"10.1016/j.ortho.2025.101069","DOIUrl":"10.1016/j.ortho.2025.101069","url":null,"abstract":"<div><div>Solitary median maxillary central incisor (SMMCI) syndrome is a rare developmental disorder in which a patient presents with only one upper central incisor located in the midline, along with some other features – such as deviant sella turcica and pituitary gland morphology, panhypopituitarism, hypothyroidism, and hypoplasia of the inner genitals – that may or may not be present. Although some authors consider it a mild manifestation of holoprosencephaly, others classify it as a distinct entity. The aim of this case report is to describe the orthodontic treatment of an 11-year-old female patient with SMMCI. The patient presented with early permanent dentition, Class II, division 2, subdivision (left) malocclusion on a Class I skeletal pattern, a solitary median maxillary central incisor, and moderate crowding in the lower dental arch. Orthodontic treatment was carried out using fixed appliances, involving the creation of space for an additional maxillary central incisor and the correction of Class II malocclusion through the application of intermaxillary elastics. By the end of treatment, Class I canine and molar relationships had been achieved, the overjet and overbite became optimal, and a one-wing Maryland bridge was placed in the area of the left maxillary central incisor. Regarding retention, a lower fixed retainer from canine to canine and upper and lower vacuum-formed appliances were used. In conclusion, this case report highlights the importance of coordinated care among dental specialists for effectively treating solitary median maxillary central incisor cases.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101069"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253245","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":"Patient-reported outcome measures of accelerated upper canine retraction with low-amperage electrical stimulation: A randomized controlled trial","authors":"Mohammad N. Kheshfeh ,&nbsp;Mohammad Y. Hajeer ,&nbsp;Mohammad Khursheed Alam ,&nbsp;Mhd Firas Al Hinnawi ,&nbsp;Youssef Latifeh","doi":"10.1016/j.ortho.2025.101077","DOIUrl":"10.1016/j.ortho.2025.101077","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Interest in accelerating orthodontic tooth movement has been increasing, with a particular focus on methods that prioritize high-quality patient-reported outcomes. Among these, low-amperage electrical stimulation (LAES) emerges as a promising technique. However, the patient-reported outcome measures related to its intraoral application remain largely unexplored.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;This randomized controlled trial evaluated the clinical tolerance and patient-reported outcomes of an intraoral LAES device during maxillary canine retraction. Pain perception during the early phase (A1–A3) was designated as the primary outcome. Secondary outcomes included discomfort, swallowing, chewing, and speech difficulties, analgesic use, overall satisfaction, and willingness to recommend the procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and Trial design&lt;/h3&gt;&lt;div&gt;A two-arm randomized controlled clinical trial with a 3-month follow-up. Thirty-six adults (17–28&lt;!--&gt; &lt;!--&gt;years) with Class II Division 1 malocclusion requiring bilateral maxillary first premolar extraction were randomized to LAES (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;18) or control (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;18). Patient-reported outcomes were recorded at nine time points (A1–C3). Pain (primary outcome) was analysed using a linear mixed-effects model, with clinical significance defined a priori as ±20&lt;!--&gt; &lt;!--&gt;mm on the 100-mm VAS. Equivalence was assessed using the two one-sided tests procedure with 90% confidence intervals. Secondary outcomes were summarized descriptively with between-group mean differences and 90%/95% CIs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Pain scores were lower in the LAES group at several early assessments (notably A1–A3), but between-group differences did not exceed the ±20&lt;!--&gt; &lt;!--&gt;mm clinical threshold. Equivalence was not confirmed at A1 and A2 but was supported from A3 onward. Discomfort was greater in the LAES group during initial intervals, with confidence intervals exceeding the equivalence margin, indicating clinically relevant short-term limitations. Swallowing and chewing difficulties remained mild and clinically negligible. Speech difficulty was significantly higher in the LAES group during the first week but declined thereafter, consistent with adaptation. Analgesic intake was minimal in both groups. Despite these transient drawbacks, satisfaction was high, and all participants indicated willingness to recommend the procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Harms&lt;/h3&gt;&lt;div&gt;No systemic adverse events occurred during the trial; one patient experienced palatal abrasion that resolved without sequelae.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The LAES device was safe and generally well tolerated. While it did not provide clinically meaningful reductions in pain, it was associated with greater early discomfort and speech difficulty, both of which diminished with continued use. Patient satisfaction remained high, suggesting good overall acceptabi","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101077"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223355","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}