International Orthodontics最新文献

{"title":"Accuracy of combining intraoral and facial scan in a single digital model of an orthodontic patient utilizing corresponding measurements on the model and on real photographs: A prospective cross-sectional study","authors":"Michail Vasoglou ,&nbsp;Ioanna Pouliezou ,&nbsp;Konstantinos Apostolopoulos ,&nbsp;Georgios Vasoglou","doi":"10.1016/j.ortho.2025.101015","DOIUrl":"10.1016/j.ortho.2025.101015","url":null,"abstract":"<div><h3>Objectives</h3><div>To validate the accuracy of integration of intraoral scan to the facial scan acquired by the EM3D application, utilising the Blue Sky Plan 4 software, creating a digital model of an orthodontic patient, by comparing the same linear measurements on real photographs and images from the digital model of the patient.</div></div><div><h3>Material and methods</h3><div>Thirty patients (20 females and 10 males; age range 12–30<!--> <!-->years) undergoing orthodontic treatment with fixed appliances were recruited in this prospective cross-sectional study from December 2024 to February 2025. Five facial landmarks were marked on each patient: Tragion right, Cheilion right and left, Subnasale and Pronasale. Intraoral scan and facial scan were performed at the same appointment. Facial scan was conducted using an iPhone 13 Pro with the EM3D face scanning application which utilizes the iPhone's TrueDepth camera technology while the patient was smiling. The STL (Stereolithography) and OBG (Object) files (acquired from intraoral and facial scan respectively) were combined in a digital model using the Blue Sky Plan 4 software. Lateral and frontal photographs of the patient's face, while smiling, were also acquired. Eight linear measurements (Tragion right – bracket #11, Tragion right – incisal #11, Cheilion right – #13, Cheilion left – #13, Subnasale – #11, Subnasale – #21, Pronasale – #11, Pronasale – #21) were digitally performed on the real and digital photographs of the patients using the facial landmarks and certain points on teeth and braces. Paired sample <em>t</em>-test and Wilcoxon signed-rank test were used for statistical analysis.</div></div><div><h3>Results</h3><div>Significantly statistical difference was detected only in one (Cheilion right – #13) measurement (<em>P</em> <!-->=<!--> <!-->0.004).</div></div><div><h3>Conclusion</h3><div>Combining intraoral and facial scan using a special software provides a clinically useful digital model of an orthodontic patient for diagnosis, treatment planning and outcome assessment.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101015"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922787","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":"Knoop microhardness, surface roughness, and cytotoxicity analysis of arginine-modified experimental orthodontic resins: An in vitro study","authors":"Pérola Costa Bitencourt Santos ,&nbsp;Analia Gabriella Borges Ferraz Facury ,&nbsp;Lenita Marangoni Lopes ,&nbsp;Mário Alexandre Coelho Sinhoreti ,&nbsp;Daniel Navarro da Rocha ,&nbsp;Lourenço Correr-Sobrinho ,&nbsp;Ana Rosa Costa ,&nbsp;José Guilherme Neves","doi":"10.1016/j.ortho.2025.101014","DOIUrl":"10.1016/j.ortho.2025.101014","url":null,"abstract":"<div><h3>Aim</h3><div>The study aimed to evaluate the impact of incorporating 2.5%, 5%, and 7% arginine on the hardness, roughness, and cytotoxicity of 3M™ Transbond™ XT.</div></div><div><h3>Material and methods</h3><div>A total of 48 samples were divided into four groups (<em>n</em> <!-->=<!--> <!-->12): G1 – commercial resin 3M™ Transbond™ XT (TXT); G2 – TXT<!--> <!-->+<!--> <!-->2.5% arginine; G3 – TXT<!--> <!-->+<!--> <!-->5% arginine; and G4 – TXT<!--> <!-->+<!--> <!-->7% arginine. The hardness analysis was performed by a microhardness tester. The measurements of roughness were performed by a surface roughness measuring instrument. The surface morphology analysis was analyzed by digital images obtained with a scanning electron microscope (SEM). For the in vitro cytotoxicity test, dental pulp mesenchymal cells underwent a cell viability reduction assay. For statistical analysis, ANOVA (one-way/two-way) was used, followed by Tukey's test post hoc (<em>P</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>There was a reduction in the hardness of experimental resins compared to 3M™ Transbond™ XT commercial resin (<em>P</em> &lt; 0.05). There was no difference between concentrations of 2.5% and 5%, but there was the largest reduction in resin with 7% arginine (<em>P</em> &lt; 0.05). Surface roughness analysis showed there was no statistical difference between the samples (P ≥ 0.05). SEM also did not demonstrate changes in the surface roughness of the resins. All groups exhibited good cell viability at each timepoint. After 48h, an increase was observed for groups contaning arginine <!--> <!--> <!--> (<em>P</em> &lt; 0.05).<strong><em>Conclusion:</em></strong> Surface hardness was modified with when arginine incorporation - to the Transbond™ XT resin formulation. No differences were observed for surface roughness. Due to the initial cytotoxicity of the resins, precautions regarding satisfactory photopolymerization and the distance of application in relation to the gingival tissues must be adopted.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101014"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922786","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":"2025-12-01","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":"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":"2025-12-01","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":"Vertical changes following alignment of palatally displaced maxillary lateral incisors with the Invisalign® appliance: A retrospective study","authors":"Zahraa Albarki,&nbsp;Tony Weir,&nbsp;Maurice J. Meade","doi":"10.1016/j.ortho.2025.101037","DOIUrl":"10.1016/j.ortho.2025.101037","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to examine the efficacy of planned vertical positioning of palatally displaced maxillary lateral incisors (PDMLI) in patients treated with an initial series of Invisalign® (Align Technology, Santa Clara, Calif) aligners.</div></div><div><h3>Methods</h3><div>The pre-treatment digital models, and models representing the planned and achieved treatment outcomes of adult patients, prescribed an initial series of Invisalign® aligners were analysed, using Geomagic Control X® (version 2017.0.3; 3D Systems, Rock Hill, SC). Clinical significance was determined according to the American Board of Orthodontics Objective Grading System.</div></div><div><h3>Results</h3><div>A total of 63 patients, comprising 90 PDMLIs, met the inclusion criteria. The mean (SD) difference between the planned and achieved vertical position of PDMLIs following wear of the initial series of aligners was 0.40 (0.5) mm. A clinically significant discrepancy between planned and achieved was observed in 39 (43.3%) PDMLIs. Extrusion was less accurately achieved than intrusion, particularly when accompanied by planned intrusion of the adjacent central incisor. Linear regression analysis showed that age, sex, presence of an attachment, and amount of planned root torque did not significantly influence the accuracy of vertical positioning (<em>P</em> <!-->&gt;<!--> <!-->0.05), whereas planned antero-posterior movement of the PDMLI crown did (<em>P</em> <!-->&lt;<!--> <!-->0.01).</div></div><div><h3>Conclusions</h3><div>The achieved vertical position of PDMLIs following an initial series of Invisalign® treatment differed significantly from the planned position with 43.3% showing a clinically significant difference. The amount of antero-posterior movement was significantly related to the efficacy in achieving the planned vertical movement.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101037"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570351","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 feldspathic veneer surface treatments on colour stability after debonding of orthodontic brackets: An in vitro study","authors":"Flavio Copello ,&nbsp;Kevin Barnes ,&nbsp;Cecilia Sued Leao ,&nbsp;Jasmine Hariri ,&nbsp;Proma Ahmed ,&nbsp;Guilherme Anziliero Arossi ,&nbsp;Eduardo Franzotti Sant’Anna","doi":"10.1016/j.ortho.2025.101011","DOIUrl":"10.1016/j.ortho.2025.101011","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyse the colour stability of feldspathic porcelain veneers treated with different surface preparation methods after bonding and debonding orthodontic brackets.</div></div><div><h3>Material and methods</h3><div>Twenty-five feldspathic porcelain veneers samples were divided into groups according to surface treatment procedures: (S) glaze-layer retained; (SHF) hydrofluoric acid etch; (SOXA) sandblasting; (SB) diamond burs; (C) control. Specimens were primed using silane and brackets were bonded. After removal of brackets, colour stability (NBS score National Bureau of Standards Score) was determined following coffee staining for 21 days. Group comparisons at each time point (T0 and T1) were performed using one-way ANOVA, followed by Tukey's HSD test for pairwise comparisons when a significant difference was detected. To evaluate the effect of time within each surface treatment group (T0 vs. T1), a paired <em>t</em>-test was performed.</div></div><div><h3>Results</h3><div>No significant interclass difference was identified between overall colour stability for the four test groups (S, SHF, SOXA and SB). All test groups showed a statistically significant increase in colour change compared to the control.</div></div><div><h3>Conclusions</h3><div>Surface treatment resulted in a significant decrease in colour stability with no statistical difference between treatments. Regardless of surface preparation method, bonding and debonding of orthodontic bracket results in decreased colour stability of feldspathic porcelain veneers.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101011"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882557","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":"Efficacy of artificial intelligence in radiographic dental age estimation of patients undergoing dental maturation: A systematic review and meta-analysis","authors":"Soheil Shahbazi ,&nbsp;Saharnaz Esmaeili ,&nbsp;Shahab Kavousinejad ,&nbsp;Farnaz Younessian ,&nbsp;Mohammad Behnaz","doi":"10.1016/j.ortho.2025.101010","DOIUrl":"10.1016/j.ortho.2025.101010","url":null,"abstract":"<div><h3>Background</h3><div>Dental age (DA) estimation, crucial for appropriate orthodontic and paediatric treatment planning, traditionally relies on the analysis of developmental stages of teeth. Artificial intelligence (AI) has been increasingly employed for DA estimation through dental radiographs. The current study aimed to systematically review the literature on the application of AI models for radiographic DA estimation among subjects undergoing dental maturation.</div></div><div><h3>Material and methods</h3><div>The electronic search was conducted through five databases, namely PubMed, Embase, Scopus, Web of Science, and Google Scholar, in July 2024. The search sought studies relying on AI models for DA estimation based on dental radiographs. Data were analysed using STATA software V.14 and heterogeneity was evaluated using I-squared statistics. A random-effects model was employed for meta-analysis. Publication bias was assessed using a funnel plot, Egger's test, Begg's test, and the trim-and-fill method. Heterogeneity was evaluated with a Galbraith plot, and sensitivity analysis tested robustness.</div></div><div><h3>Results</h3><div>Thirteen studies were deemed eligible for qualitative synthesis, seven of which were included in the meta-analysis. The mean absolute error varied from 0.6915 to 12.04, with accuracy between 0.404 and 0.959. Sensitivity ranged from 0.42 to 1.00, specificity ranged from 0.8014 to 0.982, and positive predictive value ranged from 0.43 to 0.90. The pooled accuracy of seven studies equalled 0.85 (95% CI: 0.79–0.91).</div></div><div><h3>Conclusion</h3><div>The present findings support the effectiveness of AI models in DA estimation of individuals under 25 years old based on their dental radiographs. However, further studies with larger sample sizes for both test and training datasets are suggested to validate the reliability and clinical applicability of AI in DA estimation.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101010"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894600","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":"2025-12-01","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":"Diagnostic accuracy of mandibular dental maturation stages for determination of growth spurt compared to the cervical vertebral maturation method: A systematic review and meta-analysis","authors":"Umar Hussain ,&nbsp;Eizza Niaz ,&nbsp;Tooba Zahoor ,&nbsp;Muhammad Abdullah Kamran ,&nbsp;Faizan Ul Hassan ,&nbsp;Rana Faiza ,&nbsp;Ferdous Bukhary ,&nbsp;Ali Hassan Qureshi ,&nbsp;Nikolaos Pandis ,&nbsp;Alessandra Campobasso","doi":"10.1016/j.ortho.2025.101034","DOIUrl":"10.1016/j.ortho.2025.101034","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the diagnostic accuracy for dental maturation stages of various mandibular teeth in detecting the growth spurt compared to the cervical vertebral maturation (CVM) method.</div></div><div><h3>Methods</h3><div>Eligibility criteria: observational studies assessing dental calcification stages of mandibular teeth for predicting pubertal CVM stages (CS3 and CS4), reporting cross-tabulation and involving healthy growing patients. Information sources: an unrestricted literature search of five databases was conducted up to February 2, 2024. Risk of bias: the quality assessment of the studies was conducted using the Joanna Briggs Institute (JBI). Synthesis of results: random-effects meta-analyses using sensitivity, specificity, and diagnostic odds ratio and their 95% confidence intervals (CIs) were performed, followed by subgroup analyses.</div></div><div><h3>Results</h3><div>Included studies: eighteen observational studies involving 3965 participants (38.91% male) were included. Synthesis of results: the diagnostic odds ratios (DORs) of tooth calcification stages were low, indicating that tooth mineralization provides no useful diagnostic information. Only in stage G of the second molar (DOR: 1.47 [95% CI: 0.49–4.41]) and stage C of the third molar (DOR: 1.7 [95% CI: 0.1–28.9]), the values were slightly higher than one, but they were statistically insignificant.</div></div><div><h3>Discussion</h3><div>Limitations of evidence: most of the studies published on this subject lack cross-tabulation, which prevents the calculation of diagnostic parameters and limits generalizability. The use of CVM as a gold standard can be suboptimal due to several limitations, including inferior inter-observer reliability, unreliability as an indicator of the pubertal growth peak, and retention of pubertal stages in one-fifth of individuals for over 20 years.</div></div><div><h3>Interpretation</h3><div>Tooth calcification stages are not a reliable indicator for predicting the pubertal growth spurt.</div></div><div><h3>Registration</h3><div>PROSPERO (CRD420250654430).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 4","pages":"Article 101034"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580797","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":"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":"2025-12-01","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}