{"title":"Factors influencing pterygomaxillary suture split after miniscrew-assisted rapid palatal expansion in late adolescents and young adults: A cone-beam computed tomography study.","authors":"Niansu Ruan, Fang Hua, Hui Xiong, Hong He","doi":"10.1016/j.ajodo.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.013","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the factors influencing the pterygomaxillary suture split (PMSS) after miniscrew-assisted rapid palatal expansion (MARPE) in late adolescents and young adults using cone-beam computed tomography.</p><p><strong>Methods: </strong>Preexpansion (T0) and postexpansion (T1) cone-beam computed tomography images of 82 MARPE patients (mean age, 20.7 ± 3.7 years; range, 15.2-32.4 years) were analyzed. Vertical (SN-GoGn angle) and horizontal (ANB angle) skeletal relationships were assessed at T0. Associations between PMSS incidence and variables including age, sex, midpalatal suture maturation (MPSM) stage, palate length (PL), expansion magnitude, and midpalatal suture opening pattern were evaluated. Statistical analyses included Spearman's correlation test and the Wilcoxon signed rank test.</p><p><strong>Results: </strong>PMSS was observed in half of the subjects after MARPE. Inferior PMSS demonstrated a moderate positive correlation with posterior palatal expansion (ρ = 0.561, P <0.001). Conversely, inferior PMSS showed significant negative correlations with MPSM stage (ρ = -0.555, P <0.001), age (ρ = -0.286, P <0.05), and the ANB angle (ρ = -0.316, P <0.05). No significant correlations were observed between PMSS and the posterior palatal expansion to anterior palatal expansion ratio, sex, PL, or SN-GoGn angle. The magnitude of inferior PMSS was significantly greater than that of superior PMSS (P <0.001), whereas left and right PMSS magnitudes were symmetrical (P >0.05).</p><p><strong>Conclusions: </strong>Among late adolescents and young adults treated with MARPE, posttreatment PMSS magnitude showed a moderate positive correlation with posterior palatal expansion magnitude, a moderate negative correlation with MPSM stage, and weak negative correlations with both age and ANB angle. The bilateral PMSS magnitudes were symmetrical, with significantly greater magnitudes inferiorly than superiorly. Sex, PL, vertical skeletal pattern, and midpalatal suture opening pattern were not significantly associated with PMSS magnitude.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Planned and achieved orthodontic tooth movement and labiolingual inclination changes of mandibular incisors during nonextraction space closure with clear aligners: A retrospective cohort study.","authors":"Darshan N Desai, Tony Weir, Maurice J Meade","doi":"10.1016/j.ajodo.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.012","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to determine the center of rotation and the type of orthodontic tooth movement (OTM) of the mandibular central incisors (Cis) and lateral incisors (Lis), and the efficacy of achieving planned labiolingual incisor inclination changes after nonextraction space closure (NESC) with the Invisalign (Align Technology, Santa Clara, Calif) appliance.</p><p><strong>Methods: </strong>Digital study models of initial, planned, and achieved treatment outcomes were obtained from the Invisalign treatment planning facility, ClinCheck. Vectors analogous to the long axes of the incisors were generated using Geomagic Control X (version 2022.0: 3D Systems, Cary, NC) metrology software. Intersecting vectors represented the incisors' center of rotation, whereas measurement of the vectors to a reference y-plane enabled determination of incisor labiolingual inclination.</p><p><strong>Results: </strong>A total of 166 mandibular incisors from 42 patients satisfied the inclusion criteria. The achieved mean (standard deviation) OTMs were 41.4% (23.6) of those planned. Translation was the least successful OTM, with 7.6% of Cis and 8.3% of Lis translating as planned. Planned retroclination resulted in overexpression of 151% for CIs and 165% for Lis. The accuracy of planned proclination was low, with only 16.7% of CIs and 25.8% of Lis proclining as planned, whereas the remainder retroclined instead.</p><p><strong>Conclusions: </strong>Less than half of the planned OTM for the mandibular incisors during NESC was achieved. Planned retroclination was overexpressed, and most of planned proclination resulted in retroclination. Clinicians should consider these findings when planning NESC treatment with the Invisalign appliance.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christie Shen, Shaonan Zhou, Qianqian Wang, S Jay Bowman, Chun-Hsi Chung, Chenshuang Li
{"title":"Maxillary molar distalization with clear aligner therapy and infrazygomatic temporary skeletal anchorage devices.","authors":"Christie Shen, Shaonan Zhou, Qianqian Wang, S Jay Bowman, Chun-Hsi Chung, Chenshuang Li","doi":"10.1016/j.ajodo.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.011","url":null,"abstract":"<p><strong>Introduction: </strong>A limited amount of maxillary molar distalization can be achieved with sequential molar distalization with clear aligner therapy (CAT), accompanied by significant distal crown tipping. Thus, combining CAT with temporary skeletal anchorage devices (TSADs) has been proposed, but a detailed evaluation is lacking.</p><p><strong>Methods: </strong>This retrospective study evaluated pretreatment and postanterior retraction cone-beam computed tomography (CBCT) images and intraoral scans of adult patients treated with CAT + infrazygomatic TSADs with at least 1 mm of programmed maxillary first molar distalization. Achieved tooth movement shown on the CBCT and intraoral scan was compared with the prescribed ClinCheck tooth movement.</p><p><strong>Results: </strong>This study included 38 sides from 21 patients (17 females and 4 males; aged 28.71 ± 4.16 years at pretreatment). At the crown level, approximately 1 mm of molar distalization was achieved (maxillary first molar, 1.05 mm [-0.8, 3.6] based on intraoral scans, 0.80 mm [-1.1, 3.4] based on CBCTs; maxillary second molar, 0.95 mm [-1.8, 4.4] based on intraoral scans, 1.25 mm [-1.9, 3.7] based on CBCTs), which is significantly lower than the prescribed movement (maxillary first molar, 3.05 mm [1.0, 5.6]; maxillary second molar: 3.05 mm [0.9, 6.1]). Limited crown distal tipping and mesial-out rotation, but significant buccal expansion and intrusion of the maxillary molars were also observed. In addition, a negative correlation was detected between the amount of prescribed molar distal movement and the distalization efficacy.</p><p><strong>Conclusions: </strong>TSADs did not significantly improve the efficacy of maxillary molar distalization with CAT but provided more bodily movement and intrusion of the molars.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nour Hobani, Mohammad Qali, Mohammed Alshanbari, Chenshuang Li, Nipul Tanna, Rodrigo Neiva, Jonathan Korostoff, Normand Boucher
{"title":"CBCT analysis of maxillary buccal bone thickness and height after conventional orthodontic treatment with standardized archwires: A retrospective study.","authors":"Nour Hobani, Mohammad Qali, Mohammed Alshanbari, Chenshuang Li, Nipul Tanna, Rodrigo Neiva, Jonathan Korostoff, Normand Boucher","doi":"10.1016/j.ajodo.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.08.011","url":null,"abstract":"<p><strong>Introduction: </strong>Modification of the dental arch form with buccal expansion to improve tooth alignment and to fill buccal corridors is common with orthodontic treatment. The purpose of this study is to assess the consequence of using broad preformed archwires for maxillary posterior arch development on the surrounding periodontium during routine orthodontic treatment.</p><p><strong>Methods: </strong>A retrospective cone-beam computed tomography study was conducted of 44 consecutively treated adult orthodontic patients with bonded edgewise orthodontic appliances, resulting in a wider arch form. The measurements of interest were made on cone-beam computed tomography radiographs at pretreatment and posttreatment for the maxillary first premolars, second premolars, and mesiobuccal and distobuccal roots of first molars. The parameters were: (1) buccal alveolar bone height, (2) buccal alveolar bone thickness, (3) transverse width, (4) root inclination, and (5) the presence or absence of dehiscences and fenestrations.</p><p><strong>Results: </strong>The percentage of fenestrations and dehiscences in the maxilla at pretreatment was 50.8%, and it increased by 11.3% at posttreatment. The transverse width change was statistically significant posttreatment. When the maxillary posterior dental arch forms were expanded, the following tendencies were observed: (1) an increase in buccal alveolar bone height (bone loss), and (2) a reduction of buccal alveolar bone thickness.</p><p><strong>Conclusions: </strong>The routine practice of orthodontic arch expansion with preformed archwires results in adverse alterations in the dimensions of the buccal alveolar bone.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenxuan Su, Yupin Zhang, Qingxun Meng, Xu Zhang, Yixuan Lv, Xueming Shi, Zhengyang Li
{"title":"Impact of presurgical orthodontic decompensation on alveolar bone morphology and defects in patients with skeletal Class III high-angle malocclusion.","authors":"Wenxuan Su, Yupin Zhang, Qingxun Meng, Xu Zhang, Yixuan Lv, Xueming Shi, Zhengyang Li","doi":"10.1016/j.ajodo.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.017","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study aimed to evaluate the morphology of the alveolar bone and to assess the incidence of fenestration and dehiscence during presurgical orthodontic decompensation in patients with skeletal Class III malocclusion.</p><p><strong>Methods: </strong>The study included 60 patients with skeletal Class III high-angle malocclusion who had completed presurgical orthodontic treatment. Lateral cephalograms and cone-beam computed tomography images were obtained before (T0) and after (T1) the presurgical orthodontics. The labial inclination angles of the mandibular central incisors were measured using lateral cephalograms. Cone-beam computed tomography images evaluated alveolar bone thickness and height along the roots of the target teeth and assessed the incidence of fenestration and dehiscence. Statistical analyses were conducted using paired t tests, chi-square tests, and binary logistic regression.</p><p><strong>Results: </strong>From T0 to T1, decompensatory movements of the mandibular central incisors resulted in a reduction in alveolar bone thickness and vertical height. Most teeth exhibited bone loss of 2 mm apical to the cementoenamel junction. The prevalence of labial bone defects increased significantly, rising from 51.7% to 73.3% in the mandibular left central incisor and from 51.7% to 76.7% in the mandibular right central incisor. Greater decompensation angles were linked to higher risks of fenestration and dehiscence at T1. When the probability of bone defect occurrence was set at 50%, the thresholds for changes in the IMPA and L1-NB were found to be 5.47° and 5.91°, respectively.</p><p><strong>Conclusions: </strong>The threshold for decompensation of the mandibular central incisors is relatively low in patients with skeletal Class III high-angle because of the anatomically thin alveolar bone. Exceeding this threshold increases the risk of bone defects. Therefore, careful evaluation of the periodontal condition is essential when establishing treatment objectives to prevent adverse periodontal outcomes.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoon Sik Park, Eun-Hack Andrew Choi, Feras Jamal H Alwaznah, Harim Kim, Yoon Jeong Choi, Kee-Joon Lee, Hyung-Seog Yu, Sung-Hwan Choi
{"title":"Is apex position a determining factor in the orthodontic traction duration of unilateral impacted maxillary canines? A cone-beam computed tomography-based 3-dimensional study.","authors":"Yoon Sik Park, Eun-Hack Andrew Choi, Feras Jamal H Alwaznah, Harim Kim, Yoon Jeong Choi, Kee-Joon Lee, Hyung-Seog Yu, Sung-Hwan Choi","doi":"10.1016/j.ajodo.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.015","url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed the influence of the 3-dimensional (3D) root apex position on the traction duration of unilateral impacted maxillary canines, compared with the cusp tip position.</p><p><strong>Methods: </strong>Thirty-one cone-beam computed tomography scans were analyzed. Each normally erupted canine was mirrored across the midsagittal plane to create an image of its enantiomorph. The distances were measured between the root apices of the impacted canine and the enantiomorphic contralateral normally erupted canine, as well as between their cusp tips and tooth angulations. Each distance variable was further subdivided into vertical displacement, horizontal displacement, mesiodistal (MD) displacement, and labiopalatal displacement, whereas the angulation variable was divided into MD tip difference and torque difference. The correlation between each measurement and the traction duration was analyzed.</p><p><strong>Results: </strong>The position of the root apex showed no significant correlation with traction duration. However, the 3D displacement, horizontal displacement, and labiopalatal displacement of the cusp tip (P <0.001), vertical displacement of the cusp tip (P <0.01), and the 3D angulation difference and MD tip difference between tooth axes (P <0.05) showed a significantly positive correlation with traction duration. Multiple regression analysis showed that the 3D displacement of the cusp tip explains approximately 55.4% of the variance in traction duration, increasing by 1.2 months per 1 mm.</p><p><strong>Conclusions: </strong>Although root apex position does not affect traction duration in unilateral impacted maxillary canines, the 3D displacement of the cusp tip is a key determinant, with more significant palatal displacement and a higher vertical position associated with longer traction duration.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oriane Daraze, Marianne Moussallem, Elie Khoury, Adib Kassis, Joseph Ghoubril
{"title":"Accuracy of maxillary digital setup predictions of patients treated with maxillary first premolar extractions: A retrospective study.","authors":"Oriane Daraze, Marianne Moussallem, Elie Khoury, Adib Kassis, Joseph Ghoubril","doi":"10.1016/j.ajodo.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.08.006","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the predictability and accuracy of treatment virtual simulation when compared with the final outcome in patients treated with the extraction of maxillary first premolars according to the type of anchorage.</p><p><strong>Methods: </strong>A total of 62 patients were selected, based on the extraction of at least the maxillary first premolar in patients with Angle Class I or II malocclusion. Notably, 40 were treated with the maximal anchorage technique, whereas the 22 others were treated with the reciprocal anchorage technique for space closure. The study models were scanned with a 3Shape D500 desktop scanner. Digital setups were constructed according to their respective treatment plans. Digital measurements of the intercanine, interpremolar, and intermolar width on scans 1, 2, and 3 and the variation on each superimposition in the sagittal, transversal, and vertical plane of the following teeth: maxillary first right molar (16), maxillary first left molar (26), maxillary right canine (13), and maxillary left canine (23).</p><p><strong>Results: </strong>For the virtual setup compared with the final outcome scan, it was found to be reliable for simulations of intercanine, interpremolar, and intermolar width using the reciprocal anchorage technique (P = 0.889, P = 0.212, and P = 0.059, respectively) but not for the maximal anchorage (P = 0.003, for the intercanine width and P <0.001 for the interpremolar and intermolar width). Regarding the reliability of the virtual setup scan in the 3 directions, the virtual scan was found to be reliable for predicting the following movements: (1) sagittal movements of the 4 selected teeth using reciprocal anchorage, (2) vertical movements of 13 and 23 using both anchorage techniques, and (3) transversal movement of the 4 selected teeth using both anchorage techniques. The differences between the final outcome scan and virtual setup scan were not significantly different from 0, with P >0.05.</p><p><strong>Conclusions: </strong>This study supported the use of virtual setups for the purpose of guiding treatment and visualizing potential outcomes of patients treated with maxillary first premolar extraction with the reciprocal anchorage technique.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio Savoldi, Kieran Daniel Tsang, Lynton Edviano Loo, Tsz Yan Leung, Yanqi Yang, Min Gu
{"title":"Effect of dense bone islands on orthodontic tooth movement and root resorption during space closure with fixed orthodontic appliances: A longitudinal study on panoramic radiography.","authors":"Fabio Savoldi, Kieran Daniel Tsang, Lynton Edviano Loo, Tsz Yan Leung, Yanqi Yang, Min Gu","doi":"10.1016/j.ajodo.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.008","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic osteosclerosis (IO), also known as \"dense bone island,\" is a localized and well-defined radiopaque lesion often close to the radicular area of teeth. The present study investigated whether IO affected orthodontic tooth movement and root resorption during the closure of extraction spaces.</p><p><strong>Methods: </strong>A total of 1624 pretreatment and posttreatment panoramic radiographs were retrospectively screened. Forty adolescents and young adults who received orthodontic treatment with symmetrical mandibular premolar extraction and presented with unilateral IO were selected. Extraction space width, tooth length, and tooth angulation were measured pretreatment and posttreatment. The tooth was also identified as passing through or not passing through the lesion. Changes in tooth length and angulation between the IO side and non-IO side were compared using the Wilcoxon signed rank test. The prevalence of teeth passing through and not passing through was compared using the binomial exact test.</p><p><strong>Results: </strong>The size of the closed extraction space was similar on both sides (P = 0.605). Teeth on the IO side showed root resorption (P = 0.706) and angulation changes (P = 0.568) similar to those on the non-IO side. Among teeth having a clinically relevant movement, roots passed through the IO in 88% of the radiographs (95% confidence interval, 69.8%-97.6%, P <0.001).</p><p><strong>Conclusions: </strong>In young patients undergoing fixed orthodontic treatment with premolar extractions, IO may not considerably affect changes in dental angulation, root resorption, and the extent of tooth movement during closure of extraction spaces. However, approximately 12% of teeth may encounter difficulties in passing through the lesion.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Temporomandibular disorders: Do we finally have a consensus standard of care for dissemination?","authors":"Daniele Manfredini, Sanjivan Kandasamy","doi":"10.1016/j.ajodo.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.08.017","url":null,"abstract":"<p><p>In an attempt to solve the potential confusion around the temporomandibular disorders (TMDs) practice, a group of expert researchers and clinicians, on behalf of the International Network for Orofacial Pain and Related Disorders Methodology of the International Association for Dental, Oral, and Craniofacial Research, developed a consensus document on the standards of care for TMD management. The document is a list of 10 key points that include 3 statements on general concepts and etiology, 3 on diagnosis, 3 on treatment, and 1 on cautionary and conclusive remarks for the patient. The key points have the potential to assist both general and specialist dental practitioners to advance their understanding and facilitate the provision of conservative and appropriate treatment. Indeed, when it comes to pain, we need to look beyond the teeth. Decades of research in pain physiology, chronicity, genetics, and comorbidity, to name a few, have allowed a better appreciation of the complexities associated with one's TMD-related pain experience. Technical interventions, whether dental or surgical, typically play only a minor role in the broader management of any TMD pain. The paradigm shift from a dental to a medical model of disease has been well embraced and supported by the global community of orofacial pain specialists who are formally trained and who have been consistently applying these principles in line with established evidence-based clinical practices for years. This information is now available to everyone.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qianglan Zhai, Mengjuan Cui, Yijiao Fu, Xingtai Huang, Zhengliang Wang, Qingwen Wu, Ning Cong, Chao Liu
{"title":"Automated assessment of nasal septum deviation using cone-beam computed tomography images based on artificial intelligence: Development and multicenter validation.","authors":"Qianglan Zhai, Mengjuan Cui, Yijiao Fu, Xingtai Huang, Zhengliang Wang, Qingwen Wu, Ning Cong, Chao Liu","doi":"10.1016/j.ajodo.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.ajodo.2025.09.006","url":null,"abstract":"<p><strong>Introduction: </strong>Nasal septum deviation (NSD) is one of the contributing factors to impaired nasal function and dentofacial developmental abnormalities. Although cone-beam computed tomography (CBCT) is clinically valuable for NSD diagnosis, manual interpretation remains labor-intensive and expertise-dependent.</p><p><strong>Methods: </strong>Our study included 330 CBCT scans diagnosed with either NSD or non-NSD to develop an automated 2-stage artificial intelligence (AI) framework integrating real-time detection and classification for NSD screening. In the first stage, the YOLOv11 (You Only Look Once) object detection algorithm was employed to detect the region of interest containing the nasal septum. In the second stage, 3 convolutional neural network architectures, ResNet, EfficientNet, and MobileNet, were evaluated for classifying CBCT images into NSD and normal categories.</p><p><strong>Results: </strong>Among the YOLOv11 variants, YOLOv11n demonstrated superior performance with a precision of 0.996, a recall of 1.000, an mAP50 of 0.995, and an mAP50-95 of 0.873. For the classification task, Mobile_small emerged as the top-performing model, achieving an area under the curve of 0.817, an area under the precision-recall curve of 0.845, and an accuracy of 0.749. An AI-assisted diagnostic tool was developed based on YOLOv11n and MobileNet models and validated on 50 internal and 50 external CBCT scans. With AI assistance, orthodontists' diagnostic accuracy increased by 20.12% and 21.49%, respectively, whereas average diagnosis time decreased by 23.75 seconds, improving efficiency by 53.92%.</p><p><strong>Conclusions: </strong>The proposed system enables rapid NSD screening with diagnostic-level accuracy, demonstrating the viability of lightweight AI models for clinical CBCT analysis. AI-assisted diagnosis improves orthodontists' accuracy and time efficiency in identifying NSD.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}