International Orthodontics最新文献

{"title":"Does resin removal with different burs after orthodontic debonding influence hydrogen peroxide diffusion, bleaching efficacy, and enamel alterations during tooth bleaching? An in-vitro study","authors":"Byron Carpio-Salvatierra ,&nbsp;Mayra Alejandra Nuñez Aldaz ,&nbsp;Deisy Cristina Ferreira Cordeiro ,&nbsp;Michael Willian Favoreto ,&nbsp;Maria José Burbano-Balseca ,&nbsp;Paulo Vitor Farago ,&nbsp;Alessandro D. Loguercio","doi":"10.1016/j.ortho.2025.101060","DOIUrl":"10.1016/j.ortho.2025.101060","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the influence of different burs for residual resin removal after orthodontic debonding on hydrogen peroxide (H₂O₂) concentration into the pulp chamber, bleaching efficacy and physical changes on the enamel surface following in-office tooth bleaching.</div></div><div><h3>Material and methods</h3><div>Sixty premolars subjected to bracket installation and debonding were randomized into five groups (<em>n</em> <!-->=<!--> <!-->12): no bleaching (control), only bleaching, Carbide bur<!--> <!-->+<!--> <!-->bleaching (CB), Diamond FF bur<!--> <!-->+<!--> <!-->bleaching (DB) and Zirconia bur<!--> <!-->+<!--> <!-->bleaching (ZB). All groups, except the control, received bleaching (H₂O₂ 35%). The H₂O₂ concentration (μg/mL) in the pulp chamber was measured using a UV-Vis spectrophotometer. Bleaching efficacy was assessed by a digital spectrophotometer (ΔE_ab, ΔE₀₀, and WI_D) before and after 7 days of bleaching. Enamel surface alterations were analysed by FE-SEM. All data were submitted to statistical analysis (α<!--> <!-->=<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>The groups submitted to resin removal with CB and ZB post-orthodontic debonding showed a lower H₂O₂ concentration when compared to the Only Bleaching group after bleaching procedure (<em>P</em> <!-->&lt;<!--> <!-->0.02). No significant differences were observed in bleaching efficacy between groups submitted to different burs when compared to the Only bleaching group (<em>P</em> <!-->&gt;<!--> <!-->0.05) across evaluated parameters.</div></div><div><h3>Conclusions</h3><div>The use of CB and ZB burs to remove residual resin post-orthodontic debonding results in lower H₂O₂ concentration. However, bleaching efficacy was unaffected by bur type. Notably, ZB burs provided superior enamel surface preservation.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101060"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160265","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":"Palatal bone thickness in adult patients with different facial patterns: A retrospective cross-sectional CBCT study for orthodontic miniscrew planning","authors":"Luis Alejandro Guanoluiza Pineida ,&nbsp;Marjory Elizabeth Vaca Zapata ,&nbsp;Mauricio Aguirre Balseca ,&nbsp;Karina Maria Salvatore Freitas ,&nbsp;Alex Dario Ganan","doi":"10.1016/j.ortho.2025.101058","DOIUrl":"10.1016/j.ortho.2025.101058","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective orthodontic anchorage control plays a crucial role in achieving successful treatment outcomes, particularly in cases involving significant tooth movements. Temporary anchorage devices (TADs) placed in the midpalatal region have become widely used due to their ability to provide absolute skeletal anchorage without depending on patient compliance. However, anatomical variables such as palatal bone thickness and possible variations according to facial pattern are essential considerations during treatment planning.</div></div><div><h3>Objective</h3><div>To evaluate and compare palatal bone thickness in adult patients with different facial patterns, using cone-beam computed tomography (CBCT), with the aim of identifying possible anatomical differences that may influence TAD placement.</div></div><div><h3>Material and methods</h3><div>This retrospective, cross-sectional, observational study analyzed 90 CBCT scans obtained between 2022 and 2025 from patients aged 18 to 45 years. The sample was evenly divided into three groups according to facial pattern (30 mesofacial, 30 brachyfacial, and 30 dolichofacial), with equal distribution between sexes and comparable ages. Linear measurements of palatal bone thickness were performed at multiple anteroposterior and lateral reference points using the 3D Slicer 5.8.1 software. Intergroup comparison was performed with Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>A progressive decrease in palatal bone thickness was observed from anterior to posterior regions across all facial types. No statistically significant differences were found between the groups at any measured location (<em>P</em> <!-->&gt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>The results suggest that facial pattern does not significantly influence palatal bone thickness in the evaluated regions. Therefore, clinical decisions regarding TAD placement should prioritize individual anatomical characteristics over facial patterns.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101058"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128381","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":"2026-03-01","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":"2026-03-01","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":"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":"2026-03-01","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":"Expert consensus-derived evaluation criteria for orthodontic treatment outcomes using a novel ranking method: A retrospective dental cast analysis study","authors":"Huanhuan Chen,&nbsp;Hanwei Zheng,&nbsp;Yue Lai,&nbsp;Wei Li,&nbsp;Chenda Meng,&nbsp;Tianyi Wang,&nbsp;Guangying Song,&nbsp;Bing Han,&nbsp;Tianmin Xu","doi":"10.1016/j.ortho.2025.101057","DOIUrl":"10.1016/j.ortho.2025.101057","url":null,"abstract":"<div><h3>Objective</h3><div>This retrospective expert consensus study (PKUSSIRB No.202058145) aimed to establish expert consensus-derived evaluation criteria for orthodontic treatment outcomes using the Merge Ranking Method on post-treatment dental casts.</div></div><div><h3>Material and methods</h3><div>From patients treated at the Department of Orthodontics from January 2018 to December 2022, 216 cases were randomly selected for evaluation by 65 orthodontic experts using the Merge Ranking Method. Concurrently, nine objective indicators of the 216 post-treatment dental casts were measured by three researchers. The consistency analysis of experts’ subjective evaluation and researchers’ objective measurement was conducted, respectively. Through subjective-to-objective correlation analysis and regression analysis, the objective indicators significantly correlated with experts’ subjective evaluations were selected, their weights were determined, and the threshold values of grading evaluation were screened.</div></div><div><h3>Results</h3><div>The 65 orthodontic experts demonstrated: (1) moderate pairwise consistency (mean Spearman's ρ<!--> <!-->=<!--> <!-->0.560, 95% bootstrap CI: 0.556-0.564), (2) significant group-level concordance across two independent panels (Kendall's W<!--> <!-->=<!--> <!-->0.544–0.606, all <em>P</em> <!-->&lt;<!--> <!-->0.001), and (3) near-perfect cross-panel reliability for 24 overlapping cases (Kendall's τ-b<!--> <!-->=<!--> <!-->0.833–0.880, <em>P</em> <!-->&lt;<!--> <!-->0.001), confirming panel homogeneity for subsequent analyses. Inter-rater reliability among the three researchers showed excellent consistency (mean ICC<!--> <!-->=<!--> <!-->0.835, 95% CI: 0.788–0.882, range: 0.736–0.920), paralleled by high intra-rater reliability (mean ICC<!--> <!-->=<!--> <!-->0.832, 95% CI: 0.806–0.858, range: 0.715–0.948) across all 216 cases. Six objective indicators (occlusal relationship, overbite, alignment, overjet, occlusal contact, and buccal-lingual inclination) significantly predicted expert evaluations in a regression model (cumulative R² <!-->=<!--> <!-->0.598, <em>P</em> <!-->&lt;<!--> <!-->0.001). The threshold values for grading orthodontic treatment outcomes as Excellent, Good, Fair, Poor, and Worst were screened to be 1.846, 2.454, 3.492, and 4.312, respectively.</div></div><div><h3>Conclusions</h3><div>This expert consensus study demonstrated moderate consistency in subjective orthodontic outcome evaluation, with the occlusal relationship emerging as the primary quality determinant. The developed Merge Ranking Method addressed conventional ranking limitations through its innovative two-stage approach: initial segmented evaluation reduced expert fatigue, while subsequent dynamic adjustments improved borderline case classification.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101057"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145128379","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":"2026-03-01","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":"Fixed orthodontics in a Class II Division 2 young adult with Brodie's occlusion and three-dimensional anomalies using a Herbst appliance and miniscrew: A case report","authors":"Yunlin Guan ,&nbsp;Wei Liu ,&nbsp;Ting Sang ,&nbsp;Jun Wu ,&nbsp;Shiyun Peng","doi":"10.1016/j.ortho.2025.101078","DOIUrl":"10.1016/j.ortho.2025.101078","url":null,"abstract":"<div><div>In this case report, we described the successful treatment of a 17-year-old male with Class II Division 2 and a Brodie occlusion, with bilateral scissor bite, maxillomandibular transverse discrepancy, deep overbite and Class II molar relationship, using a fixed Herbst appliance. The treatment was carried out in two phases. In the first phase, the Herbst appliance was used to advance the mandible, correcting the sagittal relationship while simultaneously improving transverse and vertical discrepancies, with minimal reliance on patient compliance. In the second phase, fixed appliances combined with temporary anchorage devices (TADs) were employed to refine tooth alignment, coordinate the arches, and achieve a stable occlusion. Following treatment, all objectives were achieved, including complete correction of the bilateral scissors-bite, normalization of overjet and overbite, coordinated arch forms, and bilateral Class I molar relationships. The patient's facial profile and smile aesthetics were notably improved. Stability was confirmed after a 3-year retention period. This case highlights the effectiveness of Herbst therapy followed by TAD-assisted orthodontics in achieving functional correction, aesthetic enhancement, and long-term stability in patients with Brodie bite and complex three-dimensional discrepancies.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101078"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259559","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 differential and conventional rapid maxillary expansion on upper airway dimensions in children with bilateral complete cleft lip and palate: A CBCT-based secondary analysis of a clinical trial","authors":"Denise Caffer ,&nbsp;Daniela Garib ,&nbsp;Carolina Faber ,&nbsp;Alexandre Meireles Borba ,&nbsp;Luiz Volpato ,&nbsp;Rita de Cássia Moura Carvalho Lauris ,&nbsp;Araci Malagodi de Almeida ,&nbsp;Rafael Guerra Lund","doi":"10.1016/j.ortho.2025.101063","DOIUrl":"10.1016/j.ortho.2025.101063","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to compare the changes in upper airway dimensions produced by conventional expanders (CE) and differential expanders (DE, which display two parallel jackscrews) in children with bilateral cleft lip and palate (BCLP).</div></div><div><h3>Materials and methods</h3><div>The initial clinical trial sample included 50 patients with complete BCLP who were treated with RME before the secondary bone graft procedure at a single centre—Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP). The patients were divided into two groups. Group DE were treated with differential expanders, while Group CE received Hyrax expansion during pre-bone graft orthodontics. Pre-expansion (T1) and six months post-expansion (T2) cone-beam computed tomography (CBCT) images were analysed to assess upper airway dimensions, including the nasal cavity, nasopharynx, oropharynx, and total pharyngeal space. Intergroup comparisons were performed using independent T-tests (α<!--> <!-->=<!--> <!-->0.004).</div></div><div><h3>Results</h3><div>Of the initial 50 patients, the final Group DE consisted of 20 patients with a mean age of 9.07<!--> <!-->years while the CE group included 19 patients (13 males and 6 females), with a mean initial age of 9.19<!--> <!-->years. No statistically significant differences were observed between the changes of the two groups in the analysed variables, indicating that both expanders had similar effects on increasing upper airway dimensions.</div></div><div><h3>Conclusion</h3><div>Both CE and DE effectively increase upper airway dimensions in BCLP patients. These findings support that the choice of expander should be guided by the dental upper arch shape and the clinician's preferences.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101063"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259540","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 systematic review, meta-analysis, and trial sequential analysis on association of circulating vascular cell adhesion molecule-1 (VCAM-1) levels in obstructive sleep apnea adults: A possible link between cardiovascular disease and obstructive sleep apnea","authors":"Mohammad Moslem Imani ,&nbsp;Arya Imani ,&nbsp;Sattar Akbari ,&nbsp;Masoud Sadeghi ,&nbsp;Annette B. Brühl ,&nbsp;Serge Brand","doi":"10.1016/j.ortho.2025.101079","DOIUrl":"10.1016/j.ortho.2025.101079","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Obstructive sleep apnea (OSA), marked by recurrent upper airway obstruction during sleep, poses significant risks due to its association with cardiovascular diseases. This study systematically analyzed the link between circulating vascular cell adhesion molecule-1 (VCAM-1) levels and OSA, highlighting its role as a biomarker of endothelial dysfunction and its potential connection to cardiovascular disease.</div></div><div><h3>Material and methods</h3><div>The databases searched for the meta-analysis included PubMed/Medline, Scopus, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI), up to March 22, 2025. Effect sizes were calculated using the standard mean difference (SMD) with 95% confidence intervals (CIs), and advanced statistical techniques such as subgroup, meta-regression, and sensitivity analyses were employed to ensure the robustness of findings. Additional assessments included publication bias tests and trial sequential analysis to confirm adequate sample size and reliability.</div></div><div><h3>Results</h3><div>Of 406 identified records, 19 articles (28 studies) met inclusion criteria, revealing significantly higher VCAM-1 levels in OSA patients (SMD<!--> <!-->=<!--> <!-->1.90, 95% CI: 1.45–2.35; <em>P</em> <!-->&lt;<!--> <!-->0.00001). Subgroup analyses consistently showed elevated VCAM-1 level, with variations across ethnicity and OSA severity, while sensitivity analysis confirmed robustness despite high heterogeneity (I² <!-->=<!--> <!-->94%). Publication bias and trial sequential analysis highlighted reliability but emphasized cautious interpretation of results.</div></div><div><h3>Conclusions</h3><div>VCAM-1 shows potential as a biomarker for OSA, indicating systemic inflammation and endothelial dysfunction linked to cardiovascular risks. Its utility in early detection and treatment development is promising, but further research is needed to validate findings across populations and explore its connection to OSA-related comorbidities for innovative therapies.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"24 1","pages":"Article 101079"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259495","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}