AJO-DO clinical companion最新文献

{"title":"Nonsurgical treatment of open bite with mandibular deviation and thin gingival biotype combined with periodontally accelerated osteogenic orthodontics and autologous platelet-rich fibrin","authors":"Siqi Chen, Jiaozhuang Shi, Mingzhu Zhang, Yali Liu","doi":"10.1016/j.xaor.2026.06.001","DOIUrl":"10.1016/j.xaor.2026.06.001","url":null,"abstract":"<div><ul><li><span>•</span><span><div>Periodontally accelerated osteogenic orthodontics combined with autologous platelet-rich fibrin effectively improves periodontal support, ensuring safe tooth movement.</div></span></li><li><span>•</span><span><div>Precise biomechanical adjustment achieves nonsurgical correction of anterior open bite and mandibular deviation.</div></span></li><li><span>•</span><span><div>This treatment strategy manages complex cases with a thin gingival biotype, dentition defects, and deleterious oral habits.</div></span></li></ul></div><div><div>Adequate alveolar bone volume is an important prerequisite for orthodontic tooth movement. Patients with a thin gingival biotype and insufficient alveolar bone thickness and height are particularly susceptible to complications during orthodontic treatment, especially when substantial movement of the mandibular anterior teeth is required. These complications include alveolar bone fenestrations, dehiscence, gingival soft-tissue recession, and the formation of interdental black triangles. This case report describes an adult woman presenting with a skeletal Class I malocclusion, hyperdivergence, mandibular deviation, and an anterior open bite (AOB), further complicated by a right posterior crossbite, loss of the mandibular left first molar, and a thin gingival biotype. The patient was treated using a comprehensive approach that combined periodontally accelerated osteogenic orthodontics with autologous platelet-rich fibrin for alveolar bone augmentation, orthodontic therapy with precise biomechanical control, and myofunctional training. After 28 months of treatment, the outcomes demonstrated successful midline alignment and AOB correction using the edentulous space. Marked improvement in the functional and esthetic consequences of skeletal deviation through dental compensation was also observed, along with the elimination of deleterious tongue habits. At the 18-month follow-up, no significant root resorption or gingival recession was observed, and the patient exhibited stable periodontal and esthetic outcomes. This case report supports the efficacy of the described treatment protocol for correcting an AOB while minimizing periodontal complications.</div></div><div>Adequate alveolar bone volume is an important prerequisite for orthodontic tooth movement. Patients with a thin gingival biotype and insufficient alveolar bone thickness and height are particularly susceptible to complications during orthodontic treatment, especially when substantial movement of the mandibular anterior teeth is required. These complications include alveolar bone fenestrations, dehiscence, gingival soft-tissue recession, and the formation of interdental black triangles. This case report describes an adult woman presenting with a skeletal Class I malocclusion, hyperdivergence, mandibular deviation, and an anterior open bite (AOB), further complicated by a right posterior crossbite, loss of the mandibular left first","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 402-416"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162586","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":"Weight-related considerations for orthodontic treatment: A quantitative survey study","authors":"Elmira Hezarkhani, Thao Quynh Ngo, Aliha Younus, Chris Wiesen, Laura Anne Jacox","doi":"10.1016/j.xaor.2026.07.004","DOIUrl":"10.1016/j.xaor.2026.07.004","url":null,"abstract":"<div><ul><li><span>•</span><span><div>Most surveyed orthodontists do not consider weight during treatment planning.</div></span></li><li><span>•</span><span><div>Younger orthodontists reported adjusting care more often based on patient weight.</div></span></li><li><span>•</span><span><div>Fear of offending patients is a major barrier to weight-related counseling.</div></span></li><li><span>•</span><span><div>Most orthodontists reported limited training on weight-related interventions.</div></span></li><li><span>•</span><span><div>Findings suggest incorporating weight-related education in orthodontic curricula.</div></span></li></ul></div><div><h3>Introduction</h3><div>Excess weight in growing patients accelerates skeletal and dental development, impacting craniofacial dimensions, with relevance to orthodontic care and treatment timing. Although the prevalence of obesity continues to rise, it is unclear whether orthodontists take a patient’s weight into consideration during treatment planning, whether orthodontists provide weight-related counseling, and whether weight-related interventions are taught during dental school and residency.</div></div><div>Excess weight in growing patients accelerates skeletal and dental development, impacting craniofacial dimensions, with relevance to orthodontic care and treatment timing. Although the prevalence of obesity continues to rise, it is unclear whether orthodontists take a patient’s weight into consideration during treatment planning, whether orthodontists provide weight-related counseling, and whether weight-related interventions are taught during dental school and residency.</div><div><h3>Methods</h3><div>To address these gaps, a nationwide cross-sectional survey was developed, pretested, and distributed to practicing members of the American Association of Orthodontists. Descriptive and bivariate analyses were applied.</div></div><div>To address these gaps, a nationwide cross-sectional survey was developed, pretested, and distributed to practicing members of the American Association of Orthodontists. Descriptive and bivariate analyses were applied.</div><div><h3>Results</h3><div>Of the total participants (N = 213; response rate = 4.3%), 82.1% reported that an elevated body mass index did not influence their treatment planning or outcomes. Over 90% of orthodontists do not measure patients’ height and weight, which are required to calculate body mass index. Half of the participants disagreed with orthodontists playing a role in patients achieving weight loss goals, 91.1% would not discuss weight issues unless patients brought it up, and 65.3% were not interested in advising patients on weight loss. Fear of offending patients, appearing judgmental, and insufficient training, knowledge, time, and trained personnel were cited as major barriers to providing weight-related counseling. Importantly, most orthodontists received limited weight-related instruction during dental school and residency.</div></div><div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 366-377"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145194","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":"October 2026","authors":"","doi":"10.1016/j.xaor.2026.09.001","DOIUrl":"10.1016/j.xaor.2026.09.001","url":null,"abstract":"","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Page 510"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145190","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":"Orthodontic camouflage of skeletal Class III malocclusion with mandibular second molar extractions and infrazygomatic crest bone screw anchorage","authors":"Chris H. Chang,&nbsp;Sophia P.W. Shu,&nbsp;Kristine Y. Chang,&nbsp;Wilbur Eugene Roberts","doi":"10.1016/j.xaor.2026.06.007","DOIUrl":"10.1016/j.xaor.2026.06.007","url":null,"abstract":"<div><ul><li><span>•</span><span><div>Camouflage treatment managed Class III patients who declined orthognathic surgery.</div></span></li><li><span>•</span><span><div>Lower second molar extraction corrected negative overjet effectively.</div></span></li><li><span>•</span><span><div>Infrazygomatic crest (IZC) screws provided reliable anchorage for retraction.</div></span></li></ul></div><div><div>A 21-year-old female presented with a chief complaint of a protruded lower lip and an unattractive facial profile. She was diagnosed with a symmetrical skeletal Class III malocclusion and a high mandibular plane angle. Clinical examination revealed a negative overjet and a bilateral full-cusp Class III malocclusion. Treatment involved the extraction of both mandibular second molars and the use of a custom Insignia appliance (Glendora, Calif) with passive self-ligating brackets. Posterior anchorage and space closure were achieved using Class III elastics and infrazygomatic crest bone screws. After 34 months of active treatment, the skeletal Class III malocclusion was corrected to a Class I relationship with improved dental alignment, resolution of the negative overjet, and enhanced facial esthetics. The American Board of Orthodontics Discrepancy Index, which indicates the baseline case complexity, was 59. The treatment outcome, evaluated using the American Board of Orthodontics Cast-Radiograph Evaluation, yielded a score of 13 at completion. Treatment outcomes were satisfactory and stable at the 4-year follow-up.</div></div><div>A 21-year-old female presented with a chief complaint of a protruded lower lip and an unattractive facial profile. She was diagnosed with a symmetrical skeletal Class III malocclusion and a high mandibular plane angle. Clinical examination revealed a negative overjet and a bilateral full-cusp Class III malocclusion. Treatment involved the extraction of both mandibular second molars and the use of a custom Insignia appliance (Glendora, Calif) with passive self-ligating brackets. Posterior anchorage and space closure were achieved using Class III elastics and infrazygomatic crest bone screws. After 34 months of active treatment, the skeletal Class III malocclusion was corrected to a Class I relationship with improved dental alignment, resolution of the negative overjet, and enhanced facial esthetics. The American Board of Orthodontics Discrepancy Index, which indicates the baseline case complexity, was 59. The treatment outcome, evaluated using the American Board of Orthodontics Cast-Radiograph Evaluation, yielded a score of 13 at completion. Treatment outcomes were satisfactory and stable at the 4-year follow-up.</div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 466-478"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145439","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":"Bodily mesial movement of maxillary molars through the maxillary sinus using nickel-titanium archwires","authors":"Shuntaro Iwaki,&nbsp;Ikuo Yonemitsu,&nbsp;Takashi Ono","doi":"10.1016/j.xaor.2026.06.002","DOIUrl":"10.1016/j.xaor.2026.06.002","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;The light, continuous orthodontic force produced by the improved superelastic nickel-titanium alloy archwire may be associated with the successful bodily movement of the maxillary molars.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;New bone formation around the root apex and deformation of the maxillary sinus floor were observed.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Root resorption was mainly observed in the palatal root, which moved through the maxillary sinus.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Tooth movements, which involve roots protruding into the maxillary sinus, are accompanied by various side effects, such as tipping or root resorption. To date, an optimal force system for such cases has not been established. Herein, we describe a case in which tooth movement was successfully achieved using improved superelastic nickel-titanium alloy archwires (ISW), resulting in favorable clinical and radiographic outcomes. The patient was a 22-year-old female with a chief complaint of maxillary anterior protrusion. Cone-beam computed tomography (CBCT) showed root protrusion of the first and second maxillary molars into the maxillary sinus. The treatment involved the extraction of the maxillary first premolars and retraction of the anterior teeth. The maxillary molars were planned to be moved bodily 3.0 mm mesially within the sinus. The ISW was used as the working archwire throughout the treatment period. The active treatment period lasted 2 years and 3 months, during which the planned bodily movement of the maxillary molars was successfully achieved. Posttreatment CBCT revealed new bone formation and remodeling of the sinus floor around the apices of the teeth that had moved within the maxillary sinus, including the right canine. The ISW provides light, continuous orthodontic forces, along with high damping and shock-absorption properties, likely contributing to the induction of bone remodeling within the sinus and bodily tooth movement with root resorption within the normal range.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Tooth movements, which involve roots protruding into the maxillary sinus, are accompanied by various side effects, such as tipping or root resorption. To date, an optimal force system for such cases has not been established. Herein, we describe a case in which tooth movement was successfully achieved using improved superelastic nickel-titanium alloy archwires (ISW), resulting in favorable clinical and radiographic outcomes. The patient was a 22-year-old female with a chief complaint of maxillary anterior protrusion. Cone-beam computed tomography (CBCT) showed root protrusion of the first and second maxillary molars into the maxillary sinus. The treatment involved the extraction of the maxillary first premolars and retraction of the anterior teeth. The maxillary molars were planned to be moved bodily 3.0 mm mesially within the sinus. The ISW was used as the working archwire throughout the treatment period. The","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 417-427"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ionizing radiation in pediatric cone-beam computed tomography: Would you scan your own child for orthodontic diagnosis?","authors":"Hasan Camcı","doi":"10.1016/j.xaor.2026.06.004","DOIUrl":"10.1016/j.xaor.2026.06.004","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;The use of cone-beam computed tomography (CBCT) in orthodontics has been increasingly widespread.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;In recent years, there has been a remarkable increase in the number of publications involving the use of CBCT.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;What factors should be carefully considered when establishing a “genuine” indication for CBCT, particularly in pediatric patients, to minimize exposure to ionizing radiation?&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Why have researchers increasingly turned to CBCT in recent years? Can this trend be attributed solely to scientific quality?&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;The use of cone-beam computed tomography (CBCT) in orthodontics has increased substantially over recent years. Although CBCT provides valuable 3-dimensional (3D) diagnostic information, its use in pediatric patients requires careful justification because it involves exposure to ionizing radiation. Children are more radiosensitive than adults, and the cumulative effects of radiation exposure should be considered when prescribing imaging procedures. This narrative review critically examines the current use of CBCT in pediatric orthodontics from clinical, radiological, and ethical perspectives. Current evidence and international guidelines consistently emphasize that CBCT should not be used routinely when conventional clinical examinations and 2-dimensional imaging provide sufficient diagnostic information. The diagnostic benefits of CBCT must be weighed against potential radiation risks, particularly in situations in which 3D imaging is used primarily for research purposes or to obtain additional anatomic detail without influencing treatment decisions. Advances in low-dose and ultra-low-dose CBCT protocols have reduced radiation exposure; however, dose reduction does not eliminate the need for strict justification. CBCT should be prescribed only when the expected 3D information directly influences diagnosis, treatment planning, or clinical outcomes and when no suitable lower-dose or nonionizing alternative is available. Furthermore, ethical self-reflection may support more responsible imaging decisions, encouraging clinicians and researchers to consider whether they would recommend the same examination for their own child or close relative. Adherence to the principles of justification, optimization, and dose minimization remains essential to ensure safe and ethically sound CBCT use in pediatric orthodontics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The use of cone-beam computed tomography (CBCT) in orthodontics has increased substantially over recent years. Although CBCT provides valuable 3-dimensional (3D) diagnostic information, its use in pediatric patients requires careful justification because it involves exposure to ionizing radiation. Children are more radiosensitive than adults, and the cumulative effects of radiation exposure should be considered when pre","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 357-365"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145441","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":"Orthodontic correction of a complete maxillary canine–first premolar transposition","authors":"Diego Junior da Silva Santos,&nbsp;Deise Caldas Kühlman,&nbsp;Flavia Artese,&nbsp;José Augusto Mendes Miguel","doi":"10.1016/j.xaor.2026.06.008","DOIUrl":"10.1016/j.xaor.2026.06.008","url":null,"abstract":"<div><div>Tooth transposition is the positional interchange of adjacent teeth, with a prevalence of 0.33%, often linked to genetic factors or supernumerary or retained deciduous teeth. In complete transpositions, both crowns and roots are displaced; in incomplete transpositions, only the crowns are affected. This case report describes an 11-year-old white female patient undergoing orthodontic treatment because of concerns regarding the complete transposition of the maxillary left canine and the maxillary left first premolar. The report highlights the realignment of these teeth to their proper anatomic positions. Despite the risks of periodontal compromise and prolonged treatment duration, the parents chose to correct the transposition, aiming to reduce the need for restorative procedures after treatment. The segmented mechanics were carefully planned and tailored to minimize risks and side effects. The transposition was corrected orthodontically over 25 months, but the treatment was completed in 48 months by moving the teeth to their desired positions without any detrimental effects on the adjacent teeth. Despite the long treatment time, all objectives were achieved. Transposed teeth can be brought into their correct positions, with feasible results, if the canine is not fully erupted. Otherwise, maintaining the transposition is appropriate if the involved teeth are fully erupted and completely aligned in the transposed position.</div></div><div>Tooth transposition is the positional interchange of adjacent teeth, with a prevalence of 0.33%, often linked to genetic factors or supernumerary or retained deciduous teeth. In complete transpositions, both crowns and roots are displaced; in incomplete transpositions, only the crowns are affected. This case report describes an 11-year-old white female patient undergoing orthodontic treatment because of concerns regarding the complete transposition of the maxillary left canine and the maxillary left first premolar. The report highlights the realignment of these teeth to their proper anatomic positions. Despite the risks of periodontal compromise and prolonged treatment duration, the parents chose to correct the transposition, aiming to reduce the need for restorative procedures after treatment. The segmented mechanics were carefully planned and tailored to minimize risks and side effects. The transposition was corrected orthodontically over 25 months, but the treatment was completed in 48 months by moving the teeth to their desired positions without any detrimental effects on the adjacent teeth. Despite the long treatment time, all objectives were achieved. Transposed teeth can be brought into their correct positions, with feasible results, if the canine is not fully erupted. Otherwise, maintaining the transposition is appropriate if the involved teeth are fully erupted and completely aligned in the transposed position.</div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 479-492"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery-first approach combined with clear aligner therapy for skeletal Class III malocclusion","authors":"Hyeok Ji,&nbsp;Min-Su Kwon,&nbsp;Seung-Hak Baek","doi":"10.1016/j.xaor.2026.07.003","DOIUrl":"10.1016/j.xaor.2026.07.003","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;The surgery-first approach can be successfully combined with clear aligners to treat skeletal Class III malocclusion.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;A fully digital workflow can enable precise surgical-orthodontic coordination.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Immediate transition to clear aligners after surgical wafer removal appeared to shorten the treatment duration and facilitate the continuity of orthodontic control.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Various types of attachments can be used to achieve precise control of tooth movement during postsurgical orthodontic treatment.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;The objective of this case report was to introduce the concept of combining the surgery-first approach (SFA) with clear aligner therapy for the treatment of skeletal Class III malocclusion, using 3-dimensional (3D) virtual surgical planning and 3D virtual setup technology. A 36-year-old male presented with a retrusive maxilla (SNA, 78.3°), a slightly prognathic mandible (SNB, 81.3°), skeletal Class III malocclusion (ANB, −2.9°), and menton deviation to the left (2.7 mm). He sought immediate improvement in facial esthetics at the start of treatment and preferred an esthetic appliance. In stage 1, SFA was performed to achieve a skeletal Class I pattern and correct the midline discrepancy. The 3D virtual surgical planning involved Le Fort I osteotomy for advancement and total impaction of the maxilla, as well as bilateral sagittal split ramus osteotomy for asymmetrical mandibular setback. Intermaxillary fixation was achieved using orthodontic miniscrews and 3D-printed wafers. At 6 weeks after surgery, stage 2 commenced with 30 clear aligners to align the teeth, coordinate the maxillary and mandibular arches, and improve occlusal interdigitation, facilitated by the regional acceleratory phenomenon. Stage 3 involved 12 additional clear aligners for occlusal detailing. A skeletal Class I pattern (SNA, 80.7°; SNB, 79.3°; ANB, 1.5°), normal overbite/overjet, and midline correction were achieved. The total treatment duration was 11 months. The treatment outcome was well maintained at the 6-month retention follow-up. Accurate prediction of postsurgical mandibular rotation and immediate transition to clear aligners appeared to shorten the treatment duration and facilitate continuity of orthodontic control.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The objective of this case report was to introduce the concept of combining the surgery-first approach (SFA) with clear aligner therapy for the treatment of skeletal Class III malocclusion, using 3-dimensional (3D) virtual surgical planning and 3D virtual setup technology. A 36-year-old male presented with a retrusive maxilla (SNA, 78.3°), a slightly prognathic mandible (SNB, 81.3°), skeletal Class III malocclusion (ANB, −2.9°), and menton deviation to the left (2.7 mm). He sought immediate improvement in facial esthetics at the start of treatment ","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 493-509"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145192","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":"Lingual orthodontic camouflage of high-angle Class II malocclusion with temporomandibular joint osteoarthrosis","authors":"Tingting Ai,&nbsp;Qixing Chen,&nbsp;Bingshuang Zou","doi":"10.1016/j.xaor.2026.06.005","DOIUrl":"10.1016/j.xaor.2026.06.005","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Nonsurgical orthodontics is a viable option for certain patients with 3-dimensional skeletal discrepancies and temporomandibular joint osteoarthrosis.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;A customized lingual system allows controlled retraction during extraction treatment.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Palatal miniscrews enhance anchorage and aid in vertical control.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Posterior occlusal buildups reduce functional shift and support vertical control.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;Skeletal Class II malocclusion with a steep mandibular plane presents a significant challenge for nonsurgical orthodontic treatment, especially when accompanied by additional complexities. This case report describes a 22-year-old female patient with a convex profile, gummy smile, retrognathic mandible, hyperdivergent pattern, mandibular deviation, unbalanced occlusion, and temporomandibular joint (TMJ) osteoarthrosis (TMJOA). After consulting with a TMJ specialist, an extraction-based orthodontic treatment plan was chosen. A ribbonwise customized lingual system with anterior vertical slots was used to achieve precise tooth movement. Bilateral palatal miniscrews were placed to increase the anchorage and facilitate counterclockwise mandibular rotation through vertical control, whereas posterior occlusal buildups were added to minimize the mandibular functional shift. Tooth movement and 3-dimensional (3D) mandibular repositioning improved facial esthetics and the occlusal relationship. Throughout the treatment, the patient’s TMJ remained stable, contributing to the achievement of favorable treatment outcomes. This report demonstrates the effectiveness of a comprehensive lingual orthodontic approach in managing severe 3D skeletal craniofacial discrepancies associated with TMJOA. Long-term follow-up is required to validate the stability of the results obtained via this approach.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Skeletal Class II malocclusion with a steep mandibular plane presents a significant challenge for nonsurgical orthodontic treatment, especially when accompanied by additional complexities. This case report describes a 22-year-old female patient with a convex profile, gummy smile, retrognathic mandible, hyperdivergent pattern, mandibular deviation, unbalanced occlusion, and temporomandibular joint (TMJ) osteoarthrosis (TMJOA). After consulting with a TMJ specialist, an extraction-based orthodontic treatment plan was chosen. A ribbonwise customized lingual system with anterior vertical slots was used to achieve precise tooth movement. Bilateral palatal miniscrews were placed to increase the anchorage and facilitate counterclockwise mandibular rotation through vertical control, whereas posterior occlusal buildups were added to minimize the mandibular functional shift. Tooth movement and 3-dimensional (3D) mandibular repositioning improved facial esthetics and the occlusal rela","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 440-452"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral canine transpositions treated with lever arm mechanics and palatal miniscrews","authors":"Johnny J.L. Liaw,&nbsp;Khaled Aboul Azm,&nbsp;Jae Hyun Park","doi":"10.1016/j.xaor.2026.02.002","DOIUrl":"10.1016/j.xaor.2026.02.002","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Treatment alternatives should be carefully evaluated for canine transposition.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;CBCT is crucial for the diagnosis and treatment monitoring in canine transposition.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Lever arm mechanics effectively facilitate root movement.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;This case report describes the orthodontic management of a rare complete bilateral maxillary canine–lateral incisor transposition in an 11-year-old female using lever-arm mechanics and palatal miniscrews, with emphasis on biomechanical strategies and clinical lessons learned. Cone-beam computed tomography revealed that the left canine was labially impacted, and the right canine was palatally impacted. Treatment aimed to restore normal tooth order without extractions, using palatal miniscrew anchorage, open-coil spring space creation, and cantilever lever-arm mechanics for root movement. Although the planned tooth positions were achieved, overexpansion during space creation and prolonged torque correction of the right canine root resulted in gingival recession, attachment loss, and incomplete torque recovery. At the 3-year follow-up, bilateral Class I occlusion and stable alignment with optimal overjet and overbite were maintained, but mild relapse and periodontal compromise persisted. This case report highlights that although lever-arm mechanics with palatal miniscrews can enable correction of even rare complete transpositions, such approaches carry significant biological and stability-related risks, underscoring the importance of recognizing treatment limits and carefully considering alternative strategies, including extraction, autotransplantation, and skeletal expansion, in complex transposition cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;This case report describes the orthodontic management of a rare complete bilateral maxillary canine–lateral incisor transposition in an 11-year-old female using lever-arm mechanics and palatal miniscrews, with emphasis on biomechanical strategies and clinical lessons learned. Cone-beam computed tomography revealed that the left canine was labially impacted, and the right canine was palatally impacted. Treatment aimed to restore normal tooth order without extractions, using palatal miniscrew anchorage, open-coil spring space creation, and cantilever lever-arm mechanics for root movement. Although the planned tooth positions were achieved, overexpansion during space creation and prolonged torque correction of the right canine root resulted in gingival recession, attachment loss, and incomplete torque recovery. At the 3-year follow-up, bilateral Class I occlusion and stable alignment with optimal overjet and overbite were maintained, but mild relapse and periodontal compromise persisted. This case report highlights that although lever-arm mechanics with palatal miniscrews can enable correction of even rare complete transpositions, such approaches carr","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"6 5","pages":"Pages 390-401"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149145195","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}