Korean Journal of Orthodontics最新文献

{"title":"Development of Leading Enhancement Assistive Planning: A three-dimensional malocclusion classification system for orthodontic treatment with clear aligners.","authors":"HeeJeong Jasmine Lee, Reuben Axel Wee Ming How, Kok Beng Gan, Asma Ashari, Alizae Marny Fadzlin Syed Mohamed, Rohaya Megat Abdul Wahab","doi":"10.4041/kjod25.214","DOIUrl":"10.4041/kjod25.214","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate the Leading Enhancement Assistive Planning (LEAP) system, a deep learning-based tool for automated malocclusion classification from three-dimensional (3D) intraoral scans, integrated into orthodontic computer-aided design (CAD) workflows to support clinical diagnosis and treatment planning.</p><p><strong>Methods: </strong>This study used 841 anonymized 3D intraoral scans in standard tessellation language (STL) format, annotated by expert orthodontists, comprising 125 unique multilabel combinations across 4 main classes and 11 binary subclasses. The preprocessing pipeline converted STL meshes into standardized voxel grids, which served as inputs to a 3D convolutional neural network based on a modified EfficientNet architecture. A hierarchical classification architecture enabled simultaneous prediction of main-class and subclass malocclusions. Model performance was assessed using accuracy, precision, recall, and F1-score metrics on a held-out test set. Integration into orthodontic CAD software was demonstrated to provide real-time diagnostic feedback.</p><p><strong>Results: </strong>The LEAP system achieved robust classification performance across 15 orthodontic labels treated as independent binary classification tasks, with a macro-averaged accuracy of 87.6%, precision of 86.6%, recall of 87.5%, and an F1-score of 87.1%. Hierarchical classification yielded clinically interpretable predictions for complex, overlapping malocclusions. The voxel-based pipeline supported resolutions of up to 256 × 256 × 256 with graphics processing unit acceleration for efficient inference. Integration into orthodontic CAD platforms was successfully demonstrated, enabling automated malocclusion classification at the point of care.</p><p><strong>Conclusions: </strong>LEAP is an accurate, efficient, and scalable artificial intelligence-assisted system for classifying malocclusions from 3D dental scans. Its integration into orthodontic CAD software offers standardized, real-time diagnostic support, potentially improving workflow efficiency and consistency. The LEAP system may enhance diagnostic accuracy, reduce variability, and serve as a valuable decision-support tool in orthodontic practice.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":" ","pages":"347-359"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated skeletal maturity staging from handwrist radiographs using deep learning models: A decision support system based on Fishman's indicators.","authors":"Yeşim Kaya, Berrin Çelik, Mehmet Zahid Genç, Mahmut Emin Çelik","doi":"10.4041/kjod25.157","DOIUrl":"10.4041/kjod25.157","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop an automated system for skeletal maturity staging using deep learning (DL) models of hand-wrist radiographs based on Fishman's method.</p><p><strong>Methods: </strong>In total, 2,318 hand-wrist radiographs of patients aged 8-19 years were retrospectively analyzed. Each radiograph was labeled by experts according to Fishman's method. This assessment was based on 11 skeletal maturity indicators (SMIs) across six anatomical regions, including the sesamoid bone, third and fifth fingers, and radius. Five different DL models (Faster R-CNN, FCOS, RetinaNet, SSD, and YOLOv7) were trained and evaluated. The model performance was assessed using commonly accepted metrics, including mean average precision (mAP), accuracy, precision, recall, and F1-score. In addition, k-fold cross-validation (k = 5) was applied to ensure the robustness of the results.</p><p><strong>Results: </strong>The models achieved mAP values ranging from 0.81 to 0.93, indicating the effective detection of the relevant SMIs. The Faster R-CNN demonstrated the highest overall performance (mAP = 0.93, accuracy = 0.73, precision = 0.74, localization recall = 0.99, and F1-score = 0.83). For individual SMIs, the Faster R-CNN model achieved classification accuracies ranging from 0.45 to 0.90. Similar trends were observed for precision, recall, and F1-score. The ground-truth annotations and model predictions were also presented for visual comparison.</p><p><strong>Conclusions: </strong>All evaluated DL models, particularly Faster R-CNN, showed strong potential for the reliable and automated detection of Fishman's SMIs. This approach may serve as a valuable clinical decision-support tool for orthodontists in growth assessment and treatment planning.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":"56 5","pages":"335-346"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in oral health-related quality of life and self-esteem after fixed orthodontic treatment.","authors":"Jung-Sub An, Hye-Young Sim, Min-Ho Jung","doi":"10.4041/kjod25.356","DOIUrl":"10.4041/kjod25.356","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations of fixed orthodontic treatment with oral health-related quality of life (OHRQoL) and self-esteem (SE) in relation to sex and premolar extraction status.</p><p><strong>Methods: </strong>Adult patients undergoing fixed orthodontic treatment at a private orthodontic practice from 2010 to 2021 were included. Pre- and posttreatment OHRQoL and SE were evaluated using the Orthognathic Quality of Life Questionnaire (OQLQ) and Rosenberg Self-Esteem Scale (RSE), respectively. Outcomes were compared by sex and premolar extraction status.</p><p><strong>Results: </strong>A total of 358 patients (mean age: 26.98 years), including 250 female patients (69.8%) and 206 patients (57.5%) who underwent premolar extraction, were evaluated in this study. Before treatment, male patients had higher OHRQoL and SE than female patients (OQLQ score: 20.25 vs. 25.77, <i>P</i> < 0.001; RSE score: 31.99 vs. 30.06, <i>P</i> < 0.001). After treatment, OHRQoL improved in both sexes (<i>P</i> < 0.001) and SE improved in female patients (<i>P</i> < 0.001), although the between-sex difference was not significant. Male patients maintained higher OHRQoL and SE than female patients posttreatment (OQLQ score: 12.56 vs. 16.79, <i>P</i> < 0.001; RSE score: 32.44 vs. 30.94, <i>P</i> = 0.001). Pretreatment OHRQoL and SE in the extraction group were lower than those in the non-extraction group (OQLQ score: 25.82 vs. 21.78, <i>P</i> = 0.005; RSE score: 30.21 vs. 31.23, <i>P</i> = 0.018), but these differences became non-significant posttreatment (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>After orthodontic treatment, OHRQoL improved in both sexes and SE improved in female patients, although the clinical significance of these changes was uncertain. In the extraction group, OHRQoL and SE were initially lower than those in the non-extraction group but showed no significant intergroup differences after treatment.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":" ","pages":"386-395"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of operator experience level on clinical outcomes of indirect- and direct-bonding techniques: A single-center, open-label, quasi-randomized controlled clinical trial.","authors":"Kana Kono, Saori Tanizaki, Atsuro Fujisawa, Takashi Murakami, Noriaki Kawanabe, Masahiro Nakamura, Mitsuhiro Hoshijima, Satoru Hayano, Takashi Izawa, Hiroshi Kamioka","doi":"10.4041/kjod25.213","DOIUrl":"10.4041/kjod25.213","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical outcomes of indirect- and direct-bonding techniques for bracket placement in orthodontic treatment, focusing on the influence of operator experience.</p><p><strong>Methods: </strong>A total of 153 patients were quasi-randomly assigned to the indirect- or direct-bonding group, of whom 124 were analyzed. Clinical outcomes in the two groups were compared and further stratified by operator experience (1-3 years vs. 4-6 years). The evaluated parameters included total treatment duration, chair time, discomfort during bonding (visual analogue scale scores), plaque control record, bracket failures, intentional reattachments, and post-treatment occlusal index (Cast-Radiograph Evaluation [CR-Eval] scores).</p><p><strong>Results: </strong>In procedures performed by operators with 1-3 years of experience, the indirect-bonding group demonstrated significantly shorter treatment duration, shorter chair time, fewer intentional reattachments, and better post-treatment occlusal outcomes than the direct-bonding group. However, the number of bracket failures was significantly higher in the indirect-bonding group, regardless of operator experience. In procedures performed by operators with 4-6 years of experience, most parameters showed no significant intergroup differences.</p><p><strong>Conclusions: </strong>The indirect-bonding technique improved treatment efficiency and quality, with potential advantages for less-experienced operators. However, attention to technique is essential to minimize bracket failures. These findings support the incorporation of indirect bonding in clinical training programs.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":" ","pages":"360-371"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and clinical characteristics of patients who underwent clear aligner therapy: A multicenter cohort study.","authors":"Keun-Chul Cho, Hong-Sik Park, Kwang-Hyo Choi, Hyeok Ji, Hyo-Won Ahn, Seung-Hak Baek","doi":"10.4041/kjod25.244","DOIUrl":"10.4041/kjod25.244","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the demographic and clinical characteristics of patients who underwent clear aligner therapy in Korea.</p><p><strong>Methods: </strong>This retrospective descriptive multicenter study included 1,068 patients who completed Invisalign treatment under four orthodontists. The variables included age, sex, region, problem list, previous orthodontic treatment, aligner option, extraction pattern, treatment duration, refinement number, and change interval.</p><p><strong>Results: </strong>Females outnumbered males (65.2% vs. 34.8%, <i>P</i> < 0.001). Only 10.8% had a history of previous orthodontic treatment. Skeletal Class I and II malocclusions were more common than Class III (45.2% and 41.8% vs. 13.0%, respectively). The First option was mainly used in children under 10, while among patients aged 10-19 years, 88.5% received the Comprehensive option. Adults (≥ 20 years) were treated with either the Lite or Comprehensive option. Nonextraction treatment was more frequent than extraction (86.0% vs. 14.0%). All extraction cases used the Comprehensive option. In First cases, girls had a shorter total treatment duration than boys (19.7 months vs. 21.6 months, <i>P</i> < 0.05). However, no significant sex differences were observed in Lite, Comprehensive-nonextraction, or Comprehensive-extraction cases. In males, the proportion of cases requiring no or only one refinement was lower in Comprehensive-extraction cases than in Comprehensive-nonextraction cases (32.7% vs. 54.0%, <i>P</i> < 0.01). The change interval tended to be longer in Lite and Comprehensive-extraction cases compared to First and Comprehensive-nonextraction cases (12.0 and 10.3 days vs. 8.3 and 8.8 days).</p><p><strong>Conclusions: </strong>Treatment duration, refinement number, and aligner change interval showed variations according to treatment groups. Further studies using initial malocclusion severity indices, treatment outcome indices, and compliance evaluations are needed.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":" ","pages":"372-385"},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct-printed aligners in orthodontics: Integrating digital design, materials science, and clinical biomechanics.","authors":"Yoo Jin Kim, Gabriel Miranda, Ki Beom Kim","doi":"10.4041/kjod25.368","DOIUrl":"10.4041/kjod25.368","url":null,"abstract":"<p><p>The transition from thermoformed aligners (TFAs) to direct-printed aligners (DPAs) represents an important development in contemporary clear aligner therapy. The inherent limitations of TFAs, including material thinning, geometric distortion, inconsistent force delivery, and limited predictability for complex tooth movements, have driven the development of DPAs, which use shape memory polymers (SMPs) and eliminate the thermoforming process. This narrative review synthesizes current evidence on the transition from TFAs to DPAs, focusing on advances in materials science, digital design, biomechanical performance, and clinical application. <i>In vitro</i> studies have shown that TFAs undergo substantial thickness reduction and degradation of mechanical properties after thermoforming, resulting in excessive initial forces and pronounced force decay that may compromise physiological tooth movement. In contrast, DPAs are fabricated using SMPs, which exhibit favorable viscoelastic behavior and can deliver light, continuous forces within physiological ranges with minimal force decay over clinically relevant wear periods. Additive manufacturing also enables advanced biomechanical design features, including localized thickness variation, reinforcement zones, pressure and relief areas, extended trimlines, and direct integration of auxiliaries into the aligner shell. Emerging clinical evidence and illustrative case applications suggest that these capabilities may improve torque expression, rotational control, extrusion efficiency, posterior expansion, and anchorage management while reducing reliance on bonded attachments and the number of aligners required. Although current findings suggest that DPAs may offer improved biomechanical control, predictability, and sustainability compared with TFAs, further research is needed to refine design protocols and evaluate their long-term cytotoxicity, intraoral aging behavior, and environmental impact.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":"56 4","pages":"257-276"},"PeriodicalIF":2.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveling and alignment of ectopically erupted maxillary canines with continuous archwires: Insights from geometric morphometric analysis.","authors":"Linda Schwarz, Philipp Mitteröcker, Michael H Bertl","doi":"10.4041/kjod25.291","DOIUrl":"10.4041/kjod25.291","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the three-dimensional movements of ectopically erupted maxillary canines (EEMCs) during orthodontic leveling and alignment with continuous archwires.</p><p><strong>Methods: </strong>Eight patients with EEMCs were treated with a 0.014-inch CuNiTi archwire fully seated in self-ligating maxillary brackets. Seven intraoral scans were obtained per patient from baseline (T1) to 12 weeks thereafter (T2-T7). Geometric morphometric analysis incorporating principal component analysis (PCA) examined the (1) positional and angular changes of the EEMC and adjacent teeth and (2) alterations in the triangular relationship formed by the brackets of the lateral incisors, canines, and premolars.</p><p><strong>Results: </strong>The PCA revealed consistent EEMC extrusion, despite differences in the initial conditions, with the canines reaching apicocoronal alignment with the neighboring teeth after 12 weeks. All EEMCs showed uprighting. The triangular bracket configuration changed systematically, with the distance between the lateral incisor and premolar increasing as the canine was extruded.</p><p><strong>Conclusions: </strong>Despite the small sample size, this brief report revealed a consistent space-opening effect and EEMC uprighting during alignment.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":"56 4","pages":"327-334"},"PeriodicalIF":2.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of functional jaw orthopedics with maxillary expansion on palatal morphology, mandibular growth, airway dimensions, and oral function in Class II malocclusion: A randomized controlled trial.","authors":"Hana Cukaj Ademi, Alexei Zhurov, Maja Ovsenik, Bojana Krneta Dokic, Juan Martin Palomo, Stjepan Spalj","doi":"10.4041/kjod25.245","DOIUrl":"10.4041/kjod25.245","url":null,"abstract":"<p><strong>Objective: </strong>The skeletal pattern of a Class II malocclusion can increase the probability of problems with oronasal function. This study aimed to analyze the relationship between the clinical effects of dentofacial orthopedics and oral function in deficient mandibles with proclined maxillary incisors during puberty.</p><p><strong>Methods: </strong>Of 120 randomized participants, 63 with complete records were included in the final analysis (median age: 12 years; 38% females). Subjects were treated with the Sander bite jumping appliance (BJA; n = 34) or the twin block appliance (TB; n = 29) with a maxillary expansion jackscrew. The growth effect was monitored by comparisons with the findings in 63 historical untreated Class II cases. Palatal scans and cephalograms were analyzed before and at one-year intervals after treatment. Both the children and their parents reported oral symptoms and functional limitations (FLs).</p><p><strong>Results: </strong>Palatal volume increased in both appliance groups (BJA: 860.3 mm³ [95% confidence interval (CI): 481.6-1,150.1] and TB: 958.9 mm³ [95% CI: 555.1-1,446.3]) in comparison with the untreated group (287.0 mm³ [95% CI: 193.4-426.5]; <i>P</i> < 0.001). However, the treatment did not affect airways. In comparison with the untreated group, the treated groups showed greater mandibular length and reduced overjet (<i>P</i> ≤ 0.002). No linear correlations were found between changes in dentofacial, palatal, or airway characteristics and changes in oral function. However, the palatal volume of the treated children who experienced improvement in FLs increased more than that of those who showed no FL improvement (1,220.6 mm³ [95% CI: 772.6-1,616.4] and 760.5 mm³ [95% CI: 491.6-1,002.1]; <i>P</i> = 0.035).</p><p><strong>Conclusions: </strong>Both appliances promoted mandibular growth and increased oral space, but did not significantly influence the measured upper airway widths.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":"56 4","pages":"277-289"},"PeriodicalIF":2.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dentoalveolar outcomes and the long-term stability of tooth-tissue-borne versus bone-tissue-borne rapid maxillary expansion in growing patients: A 5.8-year follow-up.","authors":"Mehmet Akin, Esra Ulusoy Mutluol, Tugce Esra Gunes, Mucahid Yildirim","doi":"10.4041/kjod25.304","DOIUrl":"10.4041/kjod25.304","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study evaluated the short- and long-term dentoalveolar effects and the long-term stability of tooth-tissue-borne (TTB) and bone-tissue-borne (BTB) rapid maxillary expansion (RME) appliances in growing patients.</p><p><strong>Methods: </strong>Individuals treated with TTB-RME (n = 20; 12 males, 8 females; mean age at T1: 12.44 ± 0.75 years) and those treated with BTB-RME (n = 20; 10 males, 10 females; mean age at T1: 12.86 ± 0.80 years), for a total sample of 40 patients, were retrospectively evaluated. Digital models were analyzed at four different time points: before treatment (T1), 3 months after expansion (T2), at the end of fixed orthodontic treatment (T3), and at long-term follow-up (T4). Maxillary arch width, palatal area, and palatal volume were measured. Longitudinal changes were analyzed using a mixed-design analysis of variance (ANOVA).</p><p><strong>Results: </strong>RME led to statistically significant increases in all evaluated parameters for both groups. A mixed-design ANOVA revealed significant main effects of time for all parameters (all <i>P</i> < 0.001) and significant main effects of Group for intercanine width, second interpremolar width, intermolar width, palatal area, and palatal volume (<i>P</i> < 0.05), whereas no significant Group × Time interaction was detected for any variable.</p><p><strong>Conclusions: </strong>Both TTB-RME and BTB-RME produced significant increases in maxillary transverse dimensions in growing patients, with no significant difference between the two appliances in the pattern of longitudinal changes.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":"56 4","pages":"290-303"},"PeriodicalIF":2.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and stability of maxillary arch expansion with clear aligners versus conventional slow maxillary expanders in growing patients: A multicenter prospective cohort study.","authors":"Ji-Yoon Kim, Un-Bong Baik, Dawoon Jeong, Yoon-Ji Kim","doi":"10.4041/kjod25.257","DOIUrl":"10.4041/kjod25.257","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and stability of maxillary arch expansion using clear aligners (CAs) and slow maxillary expanders (SMEs) in growing patients with maxillary transverse deficiency.</p><p><strong>Methods: </strong>This prospective multicenter cohort study included 48 growing patients (mean age, 9.3 ± 1.7 years; CA group: n = 24; SME group: n = 24) requiring maxillary expansion. The maxillary arch dimensions at the crown and gingival levels, arch perimeter, and molar buccolingual inclination were assessed at pretreatment (T0), post-expansion (T1), and post-retention (T2). The primary outcome was intermolar transverse expansion. A predefined non-inferiority analysis was performed to determine whether the expansion achieved with CAs was non-inferior to that achieved with SMEs within a clinically acceptable margin. Secondary analyses assessed the magnitude, pattern, and stability of the expansion through intra-and intergroup comparisons across time points.</p><p><strong>Results: </strong>The average duration of the expansion phase (T0-T1) was 8.9 ± 3.4 months in the CA group and 6.3 ± 6.1 months in the SME group, followed by a retention phase (T1-T2) of 8.8 ± 5.0 and 8.3 ± 5.7 months, respectively. Both groups showed significant increases in the arch dimensions at T0-T1 and T0-T2. The SME group showed a greater bodily expansion pattern in the molars at T0-T2, although this difference was not statistically significant (<i>P</i> = 0.26). Significantly greater expansion at the canine cusp tip was observed in the CA group. Age was a negative predictor of expansion at the canine region.</p><p><strong>Conclusions: </strong>Based on a predefined non-inferiority margin, the maxillary arch expansion achieved with CAs was not inferior to that obtained with SMEs in growing patients.</p>","PeriodicalId":51260,"journal":{"name":"Korean Journal of Orthodontics","volume":" ","pages":"304-315"},"PeriodicalIF":2.8,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}