The Angle Orthodontist[JOURNAL]
Sun
200 papers
How does self-esteem influence oral health-related quality of life during the occlusal transition from childhood to adolescence: a 4-year follow-up.
Carneiro DPA, Cruz TCL, Santos PRD … +3 more , de Menezes CC, Meneghim MC, Vedovello SAS
Angle Orthod · 2026 Feb · PMID 41679741 · Full text
OBJECTIVES: To evaluate the influence of self-esteem on oral health-related quality of life (OHRQoL) in the occlusal transition from childhood to adolescence. MATERIALS AND METHODS: This longitudinal observational study...
OBJECTIVES: To evaluate the influence of self-esteem on oral health-related quality of life (OHRQoL) in the occlusal transition from childhood to adolescence. MATERIALS AND METHODS: This longitudinal observational study involved 785 children, ranging from mixed to permanent dentition, over a 4-year follow-up period. OHRQoL was assessed using the Child Perceptions Questionnaire (CPQ) for two age groups: 8 to 10 years for those in mixed dentition and 11 to 14 years for permanent dentition. Clinical variables related to malocclusion were evaluated using the Dental Aesthetic Index (DAI), and children's self-esteem was measured using the Global Negative Self-Evaluation (GSE). Poisson regression analyses were conducted, with regression models adjusted to estimate relative risks and their respective 95% confidence intervals. A significance level of P < .20 was used for individual analyses, with an overall significance set at 5%. RESULTS: Individuals with low self-esteem had an 11%, 12%, 21%, and 20% higher risk of reporting a negative impact on OHRQoL in functional limitation, emotional well-being, social well-being, and total OHRQoL, respectively (P < .05). CONCLUSIONS: Self-esteem may contribute to decreased OHRQoL in the transition from childhood to adolescence. The findings suggest that the need for orthodontic treatment does not significantly alter this relationship in childhood and does not affect OHRQoL.
Orthodontic treatment positively influences behavior and perception on age recognition.
Kim S, Lee JH, Kim JJ … +3 more , Lee KJ, Kim KH, Chung CJ
Angle Orthod · 2026 Feb · PMID 41672459 · Full text
OBJECTIVES: To investigate how smiles and occlusion influence behavioral response and the perception of age. MATERIALS AND METHODS: Adult laypeople (N = 80; 19-84 years) were asked to "estimate the age" and "select the y...
OBJECTIVES: To investigate how smiles and occlusion influence behavioral response and the perception of age. MATERIALS AND METHODS: Adult laypeople (N = 80; 19-84 years) were asked to "estimate the age" and "select the younger and healthier face" from pretreatment (pre-Tx) and posttreatment (post-Tx) neutral (N) and smiling (S) face photographs of female orthodontic patient models (N = 18; 25-66 years), along with eye tracking. A survey was conducted to monitor subjective perceptions of age. Age estimation toward peers and nonpeers was compared among young (19-39 years), middle-aged (40-59 years), and older adult (≥60 years) participants. RESULTS: Greater numbers of post-Tx faces were rated as younger than the actual age when compared with pre-Tx faces (P < .001). Post-Tx/S was most frequently selected as looking younger and healthier (P < .001). Fixation time on the mouth region was significantly higher for S than for N during the tasks (P < .001). For older adults, increase in the ratio of being estimated as younger following Tx was significantly higher for peers than for nonpeers (P < .05). CONCLUSIONS: Individuals with ideal occlusion and smiling were more likely to be perceived as younger by others, indicating a positive influence of orthodontic treatment on age perception. Older adults may benefit from orthodontic treatment for improving their smiles and for being judged younger by others.
Orthodontic treatment changes in bone mineral density distribution of maxillary alveolar bone in adolescent patients.
Banks T, Walcutt E, Wade A … +8 more , Lim Y, Yoon S, Kao CW, Fields HW, Hsieh SJ, Palomo JM, Hong C, Kim DG
Angle Orthod · 2026 Feb · PMID 41672457 · Full text
OBJECTIVES: To examine whether clinical cone-beam computed tomography (CBCT) images can be used to assess three-dimensional bone mineral density (BMD) distribution changes in the alveolar bone (AB), reflecting the biolog...
OBJECTIVES: To examine whether clinical cone-beam computed tomography (CBCT) images can be used to assess three-dimensional bone mineral density (BMD) distribution changes in the alveolar bone (AB), reflecting the biological outcomes of orthodontic treatment in adolescent patients. MATERIALS AND METHODS: CBCT images of 40 patients (28 females and 12 males; initial mean age = 14.42 ± 1.34 years, range, 11.9-17 years) taken before and after orthodontic treatment with full fixed appliances (treatment duration = 20.50 ± 4.03 months) were collected retrospectively. The AB at maxillary first molar locations (FDI 16 and 26) was digitally isolated using imaging software. A frequency plot of gray values proportional to BMD was developed for each AB region. The mean as well as the fifth percentile low and high gray values (low5 and high5) were computed. Changes in AB morphological parameters and cervical vertebral gray values of the same patient were also compared. A paired test was used to compare the parameters before and after orthodontic treatment. RESULTS: The gray values of the AB and cervical vertebrae significantly increased after orthodontic treatment (P < .02). Changes in AB parameters before and after orthodontic treatment showed significant but weak positive linear relationships with changes in cervical vertebral parameters (0.12 < r2 < 0.48, P < .04). CONCLUSIONS: Rapid growth and bone mineralization in adolescent patients partially contribute to increased AB BMD following orthodontic treatment. These findings provide baseline information for planning orthodontic treatment specific to adolescents.
Aesthetic efficacy of resin infiltration on post-orthodontic white spot lesions using different conditioning methods: 24-month randomized control follow-up.
Karaman E, Alan Unsal K, Oz AZ … +2 more , Oz AA, Ercin O
Angle Orthod · 2026 Feb · PMID 41672455 · Full text
OBJECTIVES: To assess color and fluorescence changes in post-orthodontic white spot lesions (WSLs) using different surface conditioning methods from prior to resin infiltration to a 24-month follow-up. MATERIALS AND METH...
OBJECTIVES: To assess color and fluorescence changes in post-orthodontic white spot lesions (WSLs) using different surface conditioning methods from prior to resin infiltration to a 24-month follow-up. MATERIALS AND METHODS: Thirty patients, each with a minimum of four WSLs with ICDAS (International Caries Detection and Assessment System) II code 1 and 2 after bracket debonding were included. After baseline (T0), the lesions were randomly divided into four groups: regular brushing, 15% HCl (hydrogen chloride) gel, 37% H3PO4 (phosphoric acid) gel, and Er:YAG (erbium-doped yttrium aluminium garnet) laser. Icon resin infiltration was applied. In the treatment groups, color and fluorescence were reexamined just after the resin infiltration treatment (T1), and after 6 (T2) and 24 months (T3). RESULTS: There were no significant fluorescence or color changes between the treatment groups for the different time intervals. The control group showed a significantly lower color change from T0 to T2 and T0 to T3 than all the treatment groups whereas, at T2-T3, the control group showed the greatest improvement. CONCLUSIONS: Resin infiltration caused greater esthetic improvement and more revival of the lost fluorescence than daily brushing. HCl gel, H3PO4 gel, and Er:YAG laser are adequate conditioning methods for resin infiltration of post-orthodontic WSLs with ICDAS II code 1 and 2.
A three-arm parallel split-mouth randomized controlled trial comparing injectable platelet-rich fibrin and low-level laser therapy on the rate of orthodontic tooth movement and canine angulation during en-masse retraction.
Balakrishnan S, Ravuru D, Singaraju GS … +3 more , Ganugapanta VR, Perala J, Mandava P
Angle Orthod · 2026 Feb · PMID 41667059 · Full text
OBJECTIVES: To compare the effects of injectable platelet-rich fibrin (I-PRF) and low-level laser therapy (LLLT) on the rate and pattern of orthodontic tooth movement, including canine angulation and rotation during en-m...
OBJECTIVES: To compare the effects of injectable platelet-rich fibrin (I-PRF) and low-level laser therapy (LLLT) on the rate and pattern of orthodontic tooth movement, including canine angulation and rotation during en-masse retraction. MATERIALS AND METHODS: A single-center, single-blind, split-mouth randomized controlled trial was conducted in 33 female patients with Class I bimaxillary protrusion. Patients were assigned into three clusters: I-PRF vs control, LLLT vs control, and I-PRF vs LLLT. After premolar extraction and initial alignment, en-masse retraction was initiated using 150g force nickel-titanium coil springs. I-PRF (0.5 mL/site) was administered at T0 and T1 (2 weeks). LLLT (650 nm, 8 J/cm2, 100 mW Ga-Al-Ar diode laser) was applied at T0, T2 (4 weeks), and T3 (8 weeks). Control sites received no intervention. Digital study models were obtained at T1 (2 weeks), T2 (4 weeks), T3 (8 weeks), and T4 (12 weeks) to measure space closure and canine rotation. canine angulation was assessed on orthopantomograms at T0 and T4. Data were analyzed using mixed-design analysis of variance. RESULTS: Both I-PRF and LLLT significantly enhanced space closure compared to control (P < .001). LLLT showed the greatest retraction (3.02 ± 0.24 mm), followed by I-PRF (2.82 ± 0.27 mm) and control (1.99 ± 0.42 mm). Group differences were large (η2p = 0.62), and time × group interactions were moderate. Anchorage loss was higher in both intervention groups. CONCLUSIONS: Both adjuncts accelerated en-masse retraction effectively, with LLLT demonstrating a modest but sustained clinical advantage over I-PRF.
Influence of different malocclusion traits on overall orthodontic treatment duration.
Abu Arqub S, Gandhi V, AlOmari E … +3 more , Kuo CL, Upadhyay M, Yadav S
Angle Orthod · 2026 Feb · PMID 41638603 · Full text
OBJECTIVES: To identify pretreatment malocclusion traits that may influence treatment duration and to assess the correlation between these factors and overall treatment duration. MATERIALS AND METHODS: This retrospective...
OBJECTIVES: To identify pretreatment malocclusion traits that may influence treatment duration and to assess the correlation between these factors and overall treatment duration. MATERIALS AND METHODS: This retrospective study included 1430 patients who completed orthodontic treatment between July 2013 and March 2022. A comprehensive evaluation of patient records was conducted, and data related to the initial malocclusion and its associated traits were extracted, including 13 parameters such as Angle's classification, overjet, overbite, open bite, and crowding. RESULTS: Severe overjet (>9 mm) and reverse overjet were significantly associated with longer treatment duration. Increased overbite was also associated with longer treatment duration, with deep impinging overbite requiring an additional 6 months compared with an average overbite (P < .001). Bilateral posterior crossbite significantly increased mean treatment duration by 4.76 months (P < .001). Additionally, a midline shift > 3 mm was associated with a 2.3-month increase in mean treatment duration (P = .009). CONCLUSIONS: Severe malocclusion traits including increased overjet, reverse overjet, deep overbite, and open bite were strongly linked to longer treatment duration. Similarly, crowding, crossbites, and midline shifts also contributed to extended treatment duration. The presence of missing or impacted teeth, particularly impacted canines and central incisors, led to significant delays in treatment.
Effect of facial divergence and other biological factors on anchorage control and overbite in extraction cases.
Dzingle J, Gandhi V, Tadinada A … +2 more , Yadav S, Upadhyay M
Angle Orthod · 2026 Feb · PMID 41633571 · Full text
OBJECTIVES: To compare and quantify anchorage loss during space closure following premolar extraction in matched groups of different facial types. MATERIALS AND METHODS: Variables such as facial divergency, age, sex, and...
OBJECTIVES: To compare and quantify anchorage loss during space closure following premolar extraction in matched groups of different facial types. MATERIALS AND METHODS: Variables such as facial divergency, age, sex, and crowding were considered for cephalometric analysis. Pearson's correlation coefficient was used to determine the strength of the relationship between anchorage loss and facial divergence. Multiple regression analyses were used to investigate the factors associated with variability of anchorage loss. RESULTS: Average treatment duration was 41.90 ± 12.97 months. The mean anchorage loss was 3.30 ± 1.99 mm, 3.47 ± 1.95 mm, and 3.01 ± 2.39 mm for hypodivergent, normodivergent, and hyperdivergent patients, respectively. No significant differences in the amount of anchorage loss were found among the three facial groups and between sexes. Increasing age and crowding were significantly negatively associated with anchorage loss (P = .02 and < .001, respectively). CONCLUSIONS: Facial divergence does not significantly impact anchorage loss in orthodontic cases involving extractions. Horizontal anchorage loss decreases the mandibular plane angle, but the magnitude may not be clinically relevant. Vertical anchorage loss does not significantly change the mandibular plane angle in premolar extraction cases.
Evaluation of wear amounts of different composite resin attachments used in clear aligner treatment over a 6-month period: a retrospective study.
Akcan CA, Aksoz G, Gorucu-Coskuner H … +2 more , Akarsu-Guven B, Atik E
Angle Orthod · 2026 Feb · PMID 41633570 · Full text
OBJECTIVES: To compare surface wear among three different attachment composite resins over a 6-month follow-up period. MATERIALS AND METHODS: Intraoral scanning was performed on 28 participants immediately after initial...
OBJECTIVES: To compare surface wear among three different attachment composite resins over a 6-month follow-up period. MATERIALS AND METHODS: Intraoral scanning was performed on 28 participants immediately after initial bonding of attachments (T0), and at 1 (T1), 3 (T2), and 6 months (T3) after starting aligner treatment. In Group 1 (N = 154 attachments), Tokuyama Estelite Universal Flow; in Group 2 (N = 166 attachments), Filtek Z350 XT Universal Restorative; and in Group 3 (N = 161 attachments), G-ænial Universal Injectable resins were used for bonding the attachments. The surface wear depth on attachments was measured using superimposed digitized models. Kruskal-Wallis and Friedman tests were used with a significance set at 5%. RESULTS: As treatment progressed, surface wear increased significantly in all groups (P < .001). The wear amount for Group 3 was significantly greater than that for Groups 1 and 2 at the 3-month period (P < .001). Regarding T0-T3 surface wear, Group 2 (0.03 mm) and Group 3 (0.0609 mm) exhibited significantly greater wear than Group 1 (0.0243 mm; P = .024 and P < .001). Surface wear was also significantly greater in Group 3 than in Group 2 (P < .001). No significant difference was observed in T3-T0 wear values between conventional and optimized attachments within each group. CONCLUSIONS: The wear of orthodontic attachments was greatly influenced by the type of composite resin. During the third and sixth months of the clinical period, G-ænial Universal Injectable resin demonstrated significantly greater surface wear than other resins. After 6 months, Tokuyama Estelite Universal Flow displayed the least surface wear.
Short-term morphological changes of vacuum-formed retainers with different gingival margin designs: a randomized clinical trial.
Staderini E, Balacco M, Alessandri-Bonetti A … +3 more , Tepedino M, Esposito R, Gallenzi P
Angle Orthod · 2026 Feb · PMID 41633569 · Full text
OBJECTIVES: To investigate the morphological and dimensional changes in vacuum-formed retainers (VFRs) after intraoral aging of 3 months and 6 months and to compare changes between VFRs with conventional and modified gin...
OBJECTIVES: To investigate the morphological and dimensional changes in vacuum-formed retainers (VFRs) after intraoral aging of 3 months and 6 months and to compare changes between VFRs with conventional and modified gingival margin design. MATERIALS AND METHODS: Forty-one patients were randomly assigned to two groups: conventional design (CD) and modified design (MD). Preuse and postuse digital models of each VFR were imported to Geomagic Control software to assess the morphological and dimensional changes. RESULTS: In vivo, VFRs underwent significant changes over time. After 3 months, slight expansion of the VFRs was detected, while after 6 months, slight contraction was observed, despite not all parameters resulting in statistically significant differences. No statistically significant differences were found between the CD and MD groups. CONCLUSIONS: Intraoral aging affects the dimensional stability of VFRs. The gingival margin design did not impact the morphological and dimensional stability of VFRs over the observed period.
Factors important to historically underrepresented applicants in ranking orthodontic programs.
Patterson AM, Philips CB, Carrico CK … +3 more , Smith CS, Shroff B, Lindauer SJ
Angle Orthod · 2026 Jan · PMID 41565359 · Full text
OBJECTIVES: To investigate whether significant differences existed in the influence among factors considered during the selection process when ranking orthodontic programs and to understand how an individual's race or et...
OBJECTIVES: To investigate whether significant differences existed in the influence among factors considered during the selection process when ranking orthodontic programs and to understand how an individual's race or ethnic background might affect what factors were more important than others. MATERIALS AND METHODS: A survey was distributed to orthodontic residents to assess overall preferences and differences in desirability of various factors between historically underrepresented racial and ethnic (HURE) and non-HURE applicants. RESULTS: A total of 115 individuals initiated the survey, and 98 were included for analysis. Sixteen respondents were considered HURE applicants. "Clear aligner therapy training," "good quality of clinical faculty," and "high number of cases started" had the highest mean desirability overall. The most important factors influencing program rank order were "satisfied current residents," "low cost," and "having multiple techniques and treatment philosophies taught." HURE respondents rated "diversity of training of faculty" (P = .0154), "racial and ethnic diversity of current and former residents" (P = .0007), "racial and ethnic diversity of faculty" (P = .0002), "racial and ethnic diversity of patient population" (P = .0131), "male : female ratio of residents" (P = .0225), "participation in care of Medicaid patients" (P = .0251), and "dental school-based program" (P = .0493) higher than their non-HURE counterparts. CONCLUSIONS: Clinical factors are the most important to program applicants. However, HURE applicants place greater importance than non-HURE applicants on characteristics that promote inclusivity and representation of individuals of similar racial and ethnic backgrounds (peers, mentors, and patients).
Long-term assessment of condyle-fossa relationship in skeletal Class II patients with idiopathic condylar resorption after combined orthodontic and orthognathic treatment.
Lv Z, Zhu Y, Chung M … +4 more , Zhang W, Liu J, Gu Y, Jiang L
Angle Orthod · 2026 Jan · PMID 41520942 · Full text
OBJECTIVES: To assess the relationship between the condyle and fossa in idiopathic condylar resorption (ICR) patients with severe Class II skeletal deformities who achieved stable functional and esthetic outcomes. MATERI...
OBJECTIVES: To assess the relationship between the condyle and fossa in idiopathic condylar resorption (ICR) patients with severe Class II skeletal deformities who achieved stable functional and esthetic outcomes. MATERIALS AND METHODS: ICR patients receiving orthodontic-orthognathic treatment with more than 2 years of follow-up were included in this retrospective study. Post-treatment changes in Y-axis-B of less than 2 mm were considered indicative of achieving a stable treatment outcome. Anterior joint space (AJS), superior joint space (SJS), and posterior joint space (PJS) on computed tomography (CT) and magnetic resonance images (MRI) were measured. RESULTS: After screening, a total of 20 patients with 40 condyles were included. 12 patients were included in the Stable group and eight patients were included in the Relapse group. In the Stable group, mean AJS, SJS, and PJS linear measurements during follow-up on CT images were 1.82 ± 0.34, 1.78 ± 0.38, and 1.81 ± 0.33 mm, respectively. Ratio of AJS:SJS:PJS was 1.0:0.97:1.0. Mean AJS, SJS, and PJS linear measurements on MRI images were 1.71 ± 0.50, 1.82 ± 0.50, and 1.70 ± 0.51 mm, respectively. Ratio of AJS:SJS:PJS was 1.0:1.06:1.0. In the Relapse group, no constant ratio of joint spaces was found on CT or MRI images. CONCLUSIONS: A relationship exists between the condyle and fossa in ICR patients with stable treatment outcomes, as the AJS:SJS:PJS ratio was close to 1:1:1. This condyle-fossa relationship provides clinicians with an assessment criterion and may be an alternative treatment goal for patients with ICR.
Pharyngeal airway changes following maxillary advancement by distraction osteogenesis among patients with cleft lip and palate: a systematic review and meta-analysis.
Shakti P, Singh A, Purohit A … +3 more , Taneja S, Kumar J, Raghavan S
Angle Orthod · 2026 Jan · PMID 41520935 · Full text
OBJECTIVES: To evaluate the impact of maxillary advancement by distraction osteogenesis (DO) on the pharyngeal airway including the following parameters in patients with cleft lip and palate (CLP), with a secondary focus...
OBJECTIVES: To evaluate the impact of maxillary advancement by distraction osteogenesis (DO) on the pharyngeal airway including the following parameters in patients with cleft lip and palate (CLP), with a secondary focus on long-term changes ≥1 year: palatal pharyngeal space, superior posterior pharyngeal space, middle pharyngeal space, inferior pharyngeal space, epiglottic pharyngeal space, velar angle, velar length, and need ratio. MATERIALS AND METHODS: A comprehensive search was conducted in Medline through PubMed, Scopus, Cochrane databases, Embase, and Directory of Open Access Journals through October 2024. Studies were assessed for pharyngeal airway changes at three time points: pre-DO (T1), post-DO (T2), and ≥1-year post-DO (T3). Quality was assessed using the National Institute of Health tool for before-after (pre-post) studies with no control group. Meta-analysis was conducted using Cochrane Review Manager (RevMan) Version 5.3. A random effect model assessed the mean difference (MD) in parameters representing the pharyngeal airway at T1, T2, and T3. GRADE criterion assessed the certainty of evidence. The protocol is officially registered with PROSPERO (CRD42023444533). In this systematic review, we followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS: The meta-analysis included 10 studies with 135 patients. The included studies ranged from fair to good quality. Significant increases were observed in pharyngeal space post-DO, particularly in superior and middle pharyngeal regions. Slight relapse was noted after 1 year, but overall, airway improvement remained significant. Evidence certainty by GRADE assessment revealed high to moderate evidence except for need ratio (low). CONCLUSIONS: Maxillary advancement by DO significantly improves pharyngeal airway in CLP patients, with minimal relapse after 1 year.
Impact of conflict-induced stress on dental and skeletal development in children and adolescents.
Lugassy D, Asbi T, Meinster I … +4 more , Shibli JA, Davidovitch M, Shpack N, Haim D
Angle Orthod · 2026 Jan · PMID 41494620 · Full text
OBJECTIVES: To investigate the impact of living in a war zone on acceleration of skeletal maturation and development of permanent teeth. MATERIALS AND METHODS: A total of 272 Israeli children and adolescents aged 9-15 ye...
OBJECTIVES: To investigate the impact of living in a war zone on acceleration of skeletal maturation and development of permanent teeth. MATERIALS AND METHODS: A total of 272 Israeli children and adolescents aged 9-15 years participated in this study. The Gaza group included 106 participants from the Gaza envelope area (within 7 km of the Gaza Strip border), while the central group consisted of 166 participants from central Israel. Skeletal maturation and dental development were assessed using lateral cephalometric and panoramic radiographs, respectively. RESULTS: Significant differences were observed in all maturation variables, including skeletal maturation as well as maturation of the upper and lower second molars (right and left) and upper canines. The Gaza envelope group exhibited more advanced and accelerated maturation than the central group (P < .0005). Positive correlations were identified among tooth maturation, chronological age, and skeletal development (0.519 < r < 0.599). Linear regression analysis revealed that the maturation of the lower left second molar accounted for 47.8% of variance in skeletal maturation. CONCLUSIONS: In this study, we confirm that children living under the stress of a conflict zone exhibited earlier skeletal maturation and accelerated eruption of permanent second molars and upper canines than their peers. The early eruption of second molars and canines, particularly the lower left second molar, may serve as a predictive marker for pubertal progression.
Relationship between body dysmorphic disorder, depression, and malocclusion severity in adolescents.
Camcı H, Geniş Ö
Angle Orthod · 2026 Feb · PMID 41494617 · Full text
OBJECTIVES: To investigate the relationship between body dysmorphic disorder (BDD), orthodontic parameters, and the level of depression. MATERIALS AND METHODS: A total of 205 adolescents (142 females, 63 males; aged 12-1...
OBJECTIVES: To investigate the relationship between body dysmorphic disorder (BDD), orthodontic parameters, and the level of depression. MATERIALS AND METHODS: A total of 205 adolescents (142 females, 63 males; aged 12-18) completed the Body Dysmorphic Disorder Questionnaire (BDDQ) and the Beck Depression Inventory (BDI). Orthodontic parameters, including skeletal malocclusion type, maxillary and mandibular anterior crowding, and Index of Treatment Need (IOTN) scores, were recorded. Associations were analyzed using appropriate statistical methods. RESULTS: BDDQ positivity was observed in 69.8% (n = 143) of participants. BDDQ-positive individuals had significantly higher BDI scores compared to BDDQ-negative individuals (P < .001). No significant group differences were found in terms of age, crowding, IOTN scores, or skeletal malocclusion type. However, correlation analysis showed a weak but statistically significant negative association between malocclusion type and BDDQ positivity (r = -0.146, P = .042), and a moderate positive correlation between BDDQ positivity and BDI scores (r = 0.317, P < .001). CONCLUSIONS: BDD was significantly associated with depression levels. Although most orthodontic variables showed no direct relationship with BDD, malocclusion type demonstrated a weak but significant correlation.
Does administration of injectable platelet-rich fibrin impact the overall treatment duration in orthodontic extraction cases? A randomized controlled trial.
Sonar KM, Nimbai RJ, Angel SL … +5 more , Samrit VD, Balachandran R, Yadav VS, Chaudhari PK, Duggal R
Angle Orthod · 2026 Jan · PMID 41494615 · Full text
OBJECTIVES: To assess the acceleratory effect of locally administered injectable platelet-rich fibrin (i-PRF) on overall treatment duration (OTD) and root resorption. MATERIALS AND METHODS: Patients with anterior crowdin...
OBJECTIVES: To assess the acceleratory effect of locally administered injectable platelet-rich fibrin (i-PRF) on overall treatment duration (OTD) and root resorption. MATERIALS AND METHODS: Patients with anterior crowding requiring extraction of all four first premolars were randomized into i-PRF and control groups, both treated with fixed appliances. The i-PRF group received submucosal injection of i-PRF distal to all canines on the buccal and palatal sides, and canine retraction was performed using sectional mechanics. A second i-PRF injection was administered in the anterior interradicular region, followed by alignment up to 0.018 × 0.025″ stainless steel and space closure with NiTi closed coil springs (150 g). Control patients underwent the same protocol without i-PRF injections. Treatment duration was calculated; root resorption was assessed using cone-beam computed tomography, and volumetric analysis was accomplished using MIMICS software. RESULTS: All 30 enrolled patients (17 females, 13 males; mean age 16.6 ± 2.7 years) completed the study, with 15 patients in each group. The mean OTD was 338.6 ± 37.8 days for the i-PRF group and 374.3 ± 49.3 days for the control group (P = .107). The percentage root volume loss for the central incisor was 3% and 4% in the intervention and control groups (P = .122), respectively, and 5% and 6% for the lateral incisor in the intervention and control groups (P = .767). Both the treatment duration and root volume loss in both groups were statistically and clinically nonsignificant. CONCLUSIONS: The use of i-PRF did not significantly reduce OTD or affect root resorption compared with the control group.
Dento-facial changes and oral health-related quality of life assessment in management of anterior crossbite in mixed dentition: a randomized clinical trial.
Salem AS, Albelasy NF, El-Bialy AA
Angle Orthod · 2026 Feb · PMID 41435871 · Full text
OBJECTIVES: To compare the effectiveness of clear aligner (CA) vs removable inclined plane (RP) in improving the dentofacial changes and oral health-related quality of life (OHRQoL) in children with anterior crossbite in...
OBJECTIVES: To compare the effectiveness of clear aligner (CA) vs removable inclined plane (RP) in improving the dentofacial changes and oral health-related quality of life (OHRQoL) in children with anterior crossbite in the mixed dentition. MATERIALS AND METHODS: Twenty-four pseudo-Class III patients in the mixed dentition (8-12 years) were randomly allocated into two equal groups: the CA group treated with clear aligners, and the RP group treated with removable inclined planes. Lateral cephalometric analysis and OHRQoL questionnaires were conducted immediately before and after 4 months of intervention. The primary outcome included cephalometric changes, whereas the CPQ8-10 (children's perception questionnaire) was the secondary outcome. Data analysis included paired t-tests, independent t-tests, the Shapiro-Wilk test, the Wilcoxon signed-rank test, and the Mann-Whitney test. RESULTS: Significant differences were observed between the two groups for changes in U1-SN, IMPA, L1-NB angles, and L1-NB (mm) (P < .05). However, there was no significant difference in improving the OHRQoL of patients between the CA and RP groups (P > .05). CONCLUSIONS: Both treatment approaches resulted in similar improvement in the patients OHRQoL. However, the CA group resulted in more significant proclination of the upper incisors, while the RP group showed more significant retroclination of the lower incisors.
Evaluation of automated tooth landmark localization on digital models.
Kwon N, Ko DY, Park JA … +3 more , Kim JH, Pandis N, Lee SJ
Angle Orthod · 2026 Feb · PMID 41435865 · Full text
OBJECTIVES: To evaluate agreement between the tooth landmark localization patterns of artificial intelligence (AI) and those from human examiners. MATERIALS AND METHODS: Three-dimensional (3D) digital dental model images...
OBJECTIVES: To evaluate agreement between the tooth landmark localization patterns of artificial intelligence (AI) and those from human examiners. MATERIALS AND METHODS: Three-dimensional (3D) digital dental model images were obtained from 284 participants. On a total of 5583 permanent teeth, six landmarks per tooth were manually identified and annotated using custom-made 3D annotation software. To develop an AI model capable of automatically identifying tooth landmarks, a deep-learning algorithm was applied to a training dataset consisting of 4519 teeth. To select the optimal AI model, datasets of 556 and 508 teeth were used as validation and test datasets, respectively. For intraexaminer and interexaminer reliability tests, 280 teeth from 10 participants were randomly selected, and two human examiners identified the same six landmarks on two separate occasions. RESULTS: The mean error in tooth landmark localization of the AI model ranged from 0.01 mm to 1.68 mm. The intraclass correlation coefficient between the AI model and human examiner for all landmarks was excellent, ranging from 0.97 to 1.0. The landmark localization error from the AI model was smaller than human interexaminer differences for mesial and distal proximal points. However, errors for the cusp tip and facial axis points were greater in the AI model than the interexaminer differences. CONCLUSIONS: AI exhibited localization accuracy for tooth landmarks comparable with that of human examiners for specific measurements related to tooth size. Nonetheless, its accuracy still needs improvement to match that of orthodontic clinicians in identifying cusp tips and facial axis points.
Comparison between two bone anchored force systems for correction of skeletal Class II malocclusion in growing patients: a randomized controlled clinical trial, part 2: short-term dentoalveolar changes.
Mahmoud YM, Marzouk ES, El Ashwah AA … +2 more , Ismail HA, Abdel-Haffiez SH
Angle Orthod · 2025 Jul · PMID 41412156 · Full text
OBJECTIVES: To evaluate and compare dentoalveolar changes after orthopedic treatment of growing skeletal Class II patients using either pushing or pulling force mechanics anchored to bimaxillary miniplates in comparison...
OBJECTIVES: To evaluate and compare dentoalveolar changes after orthopedic treatment of growing skeletal Class II patients using either pushing or pulling force mechanics anchored to bimaxillary miniplates in comparison with deferred treatment control subjects. MATERIALS AND METHODS: A total of 39 patients (24 male, 15 female; mean age 11.59 ± 0.56 years) was equally and randomly allocated to one of three study groups: pushing group (A), pulling group (B), and control group (C). Dental changes were assessed using pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans. RESULTS: One patient dropped out; therefore, 13, 12, and 13 patients were analyzed in groups A, B, and C, respectively. In groups A and B, overjet decreased by 7.00 ± 1.35 mm and 8.17 ± 1.4 mm, respectively. No significant change was observed in axial inclination of the mandibular incisors in either of the intervention groups between T1 and T2. Axial inclination of the maxillary incisors decreased significantly in Group B by 3.75 ± 1.71°. The sagittal position of the mandibular first molar changed significantly in Group A (4.15 ± 1.28 mm) and Group B (4.00 ± 1.41 mm). Maxillomandibular basal arch width differences were greater than -0.39 ± 1.87 mm in all study groups. No significant transverse arch measurement changes were observed. CONCLUSIONS: The use of either pushing or pulling force mechanics using bimaxillary skeletal anchorage was effective in improving Class II dental relationships without dentoalveolar side effects. Pretreatment transverse discrepancy should be assessed to incorporate maxillary expansion into the treatment protocol for patients diagnosed with maxillary arch constriction.
Esthetic evaluation of treatment strategies for missing maxillary lateral incisors.
Kooijmans LEL, Gresnigt MMM, Roos-Wilshaus SJM … +3 more , Schoone EMC, Kuitert R, Aydin B
Angle Orthod · 2026 Feb · PMID 41344723 · Full text
OBJECTIVES: To evaluate esthetic outcomes of four treatment options for missing maxillary lateral incisors-canine substitution, canine substitution with buildup, resin-bonded fixed dental prostheses (RBFDPs), and dental...
OBJECTIVES: To evaluate esthetic outcomes of four treatment options for missing maxillary lateral incisors-canine substitution, canine substitution with buildup, resin-bonded fixed dental prostheses (RBFDPs), and dental implant-and to compare with a control group with sound lateral incisors after orthodontic treatment. MATERIALS AND METHODS: A total of 144 digital intraoral photographs from clinical expert archives was analyzed, including the control group. Esthetic outcomes were assessed using ImageJ software based on the recurring esthetic dental (RED) proportion, vertical position, black triangles, gingival zenith, color, and apparent contact dimension (ACD). Statistical analyses were conducted to identify significant differences among groups. RESULTS: RED proportion was more favorable in both canine substitution groups than with RBFDPs. Vertical position favored RBFDP over canine substitution with buildup. Black triangles were less frequent in both canine substitution and the control group than with RBFDPs. Gingival zenith was less favorable in both canine substitution groups than the control and with RBFDPs. The control group showed best color outcomes, outperforming all treatment groups except for dental implant. ACD central-lateral incisors was better in the canine substitution with buildup and control group than canine substitution without buildup. ACD lateral incisor-canine was superior in both canine substitution and control groups than with RBFDPs and dental implants. CONCLUSIONS: No single treatment excelled across all parameters, emphasizing the need for individualized treatment plans based on patient priorities. Collaborative decision-making is crucial for optimizing esthetic outcomes.
Effectiveness of deciduous molar anchorage for rapid maxillary expansion: a systematic review and meta-analysis.
Serafin M, Vella M, Boccalari E … +1 more , Caprioglio A
Angle Orthod · 2026 Feb · PMID 41241386 · Full text
OBJECTIVES: To evaluate dentoskeletal effectiveness of deciduous molar anchorage in rapid maxillary expansion (RME) during mixed dentition. MATERIALS AND METHODS: A comprehensive search was conducted across PubMed, MEDLI...
OBJECTIVES: To evaluate dentoskeletal effectiveness of deciduous molar anchorage in rapid maxillary expansion (RME) during mixed dentition. MATERIALS AND METHODS: A comprehensive search was conducted across PubMed, MEDLINE, Scopus, and Cochrane Library databases from January 2000 to March 2025, adhering to PRISMA guidelines. Included studies comprised randomized controlled trials (RCTs) and non-RCTs assessing RME anchored to deciduous molars in patients with mixed dentition. Risk of bias (ROB) was assessed using ROB2 for RCTs and ROBINS-I for non-RCTs. Data were synthesized using a random-effects meta-analysis, focusing on dental and skeletal expansion. RESULTS: Seventeen studies (six RCTs, 11 retrospective) met the inclusion criteria. A meta-analysis of 12 studies demonstrated significant transverse changes in all evaluated areas: deciduous canines (4.27 mm), deciduous molars (5.51 mm), permanent molars (3.93 mm), and skeletal expansion (2.59 mm). Notably, dental expansion significantly exceeded skeletal expansion. Subgroup analyses comparing Haas and Hyrax expanders revealed no statistically significant differences in dentoskeletal expansion outcomes. However, heterogeneity across studies ranged from moderate to high. ROB assessments indicated moderate risk in all RCTs, whereas non-RCTs ranged from low to serious risk. Funnel plot inspection revealed no substantial asymmetry, suggesting a low likelihood of publication bias. CONCLUSIONS: This meta-analysis confirms that deciduous molar anchorage in RME significantly increases dentoskeletal transverse dimensions. No significant differences emerged between appliance designs (Haas vs Hyrax). Despite consistent expansion effectiveness, variability in study design and ROB must be considered when interpreting these results.
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