Orthodontic Treatment Research Articles

Three-dimensional evaluation of maxillofacial symmetry improvement following orthognathic surgery in patients with asymmetrical jaw deformities.

The aim of this study was to clarify the three-dimensional changes in maxillofacial morphology following orthognathic surgery using 3D-CT in patients with asymmetrical jaw deformities. The subjects were 30 patients with asymmetrical jaw deformities. Three-dimensional images taken preoperatively and 6months postoperatively were re-aligned using image processing software with the horizontal plane, coronal plane, and midsagittal plane as reference axes. Thirty-nine measurements including 28 distances, nine angles, and two volumes were recorded, and differences between preoperative and postoperative measurements and percentage differences between paired measurements on the deviated and unevolved sides were calculated. Translational and rotational movements of the maxillary dentition and mandibular body and the mandibular ramus internally rotating contributed to improved symmetry of the maxillofacial morphology, but the degree and proportion of these changes varied from case to case and mild asymmetry remained even after surgery. 3D-CT analysis of maxillofacial morphology is essential to accurately evaluate the asymmetry of hard and soft tissue morphology in the maxillofacial region and the degree of improvement after orthognathic surgery, and the tooth movement during preoperative orthodontic treatment should be determined taking into account the movement of the upper and lower jaws during orthognathic surgery.

Ischemic Risks Induced by Larger Orthodontic Forces on Dental Pulp and Neuro-Vascular Bundle in Reduced Periodontium

Background/Objectives: There are few data about the ischemic risks induced by the large orthodontic forces during periodontal breakdown in dental pulp and neuro-vascular bundle (NVB) and none on the individual tissular stress distribution, despite their great importance for orthodontic treatment planning. Our aim was to assess, by a numerical analysis, the biomechanical behavior of dental pulp and the NVB during a simulated horizontal periodontal breakdown (1–8 mm), under 2–4 N of applied orthodontic forces and five movements (rotation, translation, tipping, intrusion, and extrusion). Additionally, the ischemic and degenerative-resorptive risks were assessed. Methods: The analysis involved 72 3D models of nine patients, totaling 720 simulations. The models were CBCT-based, having the second lower premolar and surrounding periodontium, and they suffered 1 mm of gradual horizontal periodontal breakdown (up to 8 mm loss). Results: Both forces displayed a similar qualitative stress distribution in all five movements, but with a quantitative increase (doubling of stress amounts for 4 N when compared with 2 N). The highest amounts of stress were displayed at 8 mm of periodontal loss, which is lower than the 16 KPa of the maximum hydrostatic pressure. The NVB stress was higher than the pulpal stress. Rotation was the most stressful, closely followed by tipping, intrusion, and extrusion. Conclusions: A total of 4 N of applied force seems to not induce any ischemic or degenerative-resorptive risks for healthy intact teeth, in up to 8 mm of periodontal breakdown. Intrusion and extrusion determined the highest visible tissular deformation in the NVB, with potential ischemic and resorptive-generative risks for previously traumatized/injured teeth (i.e., occlusal trauma). Rotation and translation (in particular) showed the highest coronal and radicular pulpal stress with potential ischemic and resorptive-generative risks for previously injured/traumatized dental pulp (i.e., direct-indirect pulp capping). It seems that 4 mm of periodontal breakdown could signal a clinical stress increase with potential ischemic and degenerative-resorptive risks for the previously traumatized/injured tissues.

Actitud de odontopediatras y ortodoncistas ante el tratamiento ortodóncico de pacientes con necesidades especiales.

Introduction: Patients with special needs often experience a high incidence and severity of malocclusions, which can negatively impact their quality of life. They also frequently encounter challenges in accessing orthodontic treatments. Objectives: This study evaluates the attitudes of pediatric dentists and orthodontists towards providing orthodontic treatment to patients with special needs and analyzes the main challenges faced in treating these patients. Materials and Methods: A survey was conducted among 38 dentists with postgraduate training in pediatric dentistry, orthodontics, or both. The survey included 9 questions about their experiences and perceptions regarding the dental and orthodontic treatment of patients with special needs, as well as their professional attitudes. Results: The sample included 38 participants, with 39.57% men and 60.53% women. Most had 5-10 years (36.8%) or 10-20 years (23.7%) of experience. Training was divided equally among orthodontics (34.21%), pediatric dentistry (34.21%), and both fields (31.57%). Of the respondents, 68.4% infrequently treated patients with special needs, and 71.1% provided occasional treatment. None refused orthodontic treatment; 65.8% would attempt it if necessary. The primary challenges were lack of patient cooperation and low demand for such treatments. A majority (73.7%) believed the benefits of treatment outweighed the drawbacks, and 81.6% expressed willingness to treat these patients with additional training. Conclusions: Enhanced training for both professionals and the families of patients with special needs is crucial for improving access to orthodontic care, which is significantly beneficial for these patients' quality of life

A COMPARATIVE STUDY OF THE SURFACE OF FACTORY AND HAND-MADE LOOPS ON TITANIUM-MOLYBDENUM ORTHODONTIC ARCHWIRE

The most important part of the brackets, used in orthodontic treatment, is the archwire, which, when activated, generate light and long-lasting biomechanical forces that make the teeth move. Different manufacturers offer ready-made expensive solutions for orthodontists - archwire with loops along the length of the wire of different shape, which increases the cost of treatment. However, orthodontic practice is strictly individual, depending on the patient’s orthodontic problems, the stages and methods of treatment.Orthodontists often have to choose between expensive archwires with pre-made loops or using an archwire that they can manually bend in the right places depending on the patient’s individual characteristics and specific needs. In this case, the orthodontist’s decision depends on preserving the quality of the archwire surface. The surface roughness of the orthodontic archwire plays an important role in the bracket-archwire complex and is an essential factor that determines the effectiveness of the guided movement of the teeth along the arch. Surface roughness not only affects the efficiency of sliding mechanics, due to frictional effects, but also corrosion behaviour and aesthetics. A comparison of the surface characteristics of Ti-Mo archwire - with factory and hand-made loops is made. The surface of the archwire in the bending zones of the loops was investigated by SEM analysis and Surface roughness analysis. The analysis of the results shows that manual bending practically does not change the surface of the archwire, does not introduce additional defects that increase the contact friction, as well as create conditions for faster deterioration of properties and the undesirable breakage of the archwire. Research results give orthodontists confidence that the manual bending process does not degrade the quality of the archwire surface. The hand-bent archwire preserves the possibility of trouble-free movement in the braces when tightening or loosening during the different stages of treatment.

Avoid overstepping the bounds of evidence: the role of the orthodontist in managing pediatric Obstructive Sleep Apnea

IntroductionPediatric Obstructive Sleep Apnea (OSA) is a common sleep-related breathing disorder often linked to distinct craniofacial features and malocclusions. While orthodontic treatments, particularly maxillary expansion and mandibular advancement, have been suggested for managing this condition, the results remain controversial and are based on low-quality evidence. This paper aims to summarize the ongoing debates on this topic by reviewing relevant literature and highlighting the role of the orthodontist in diagnosing and managing OSA in daily clinical practice.Discussion and conclusionsAccording to the present review, there is insufficient evidence to either confirm or deny the effectiveness of oral appliances for treating pediatric OSA due to significant methodological limitations, such as small sample sizes, inadequate control groups, short study durations, and a lack of long-term follow-up. Additionally, this condition cannot be diagnosed solely based on craniofacial morphology, but an interdisciplinary evaluation is strictly required. In addition, orthopedic treatment may be considered only as an adjunct therapy for children with craniofacial anomalies increasing the risk for OSA, and the combination of multiple therapeutic approaches may be necessary to achieve effective treatment outcomes.

Cephalometric Evaluation of Facial Height Ratios and Growth Patterns: A Retrospective Cohort Study

(1) Background: This retrospective cohort study aimed to investigate the cephalometric evaluation of facial height ratio (FHR) and growth patterns. (2) Methods: We assessed facial height ratios, the y-axis to SN angle, and growth patterns in 94 participants from Timis County using digital cephalograms. Angle’s classification guided the categorization of participants. We digitally traced and analyzed cephalograms using the WebCeph imaging software. We conducted the statistical analysis using Python version 3.11.9. We performed the following statistical tests: Welch’s t-test or ANOVA (analysis of variance), Mann–Whitney U test or the Kruskal–Wallis test, χ2 test or Fisher’s, and logistic regression. (3) Results: Significant correlations were observed between FHR and craniofacial development, especially in hypodivergent growth patterns. Among the molar classes, the most predominant growth pattern in Class I was normodivergent (61.5%), followed by hypodivergent (33.3%). In Class II, hypodivergent growth was the most common (52%), with a smaller proportion of normodivergent cases (30.8%). Class III was characterized by a mix of growth patterns, with hypodivergent being predominant (14.7%). Across all groups, the y-axis to SN angle remained within normal limits, and a strong negative correlation with Jarabak’s ratio was found (r = −0.72, p < 0.001). This shows the importance of using holistic assessment methods in orthodontic practice. (4) Patients from Timis County mostly have a hypodivergent growth pattern across all types of malocclusions. Understanding these patterns is essential for comprehensive orthodontic treatment planning. We need to conduct further research to investigate the implications of these findings on treatment outcomes and patient care.

Changes in Upper Airway Space in a Patient with Pycnodysostosis Following Primary Surgery and Orthodontic Treatment: A 12-Year Follow-Up Case Report

Pycnodysostosis (PDS) is an autosomal recessive form of osteosclerotic skeletal dysplasia characterized by craniofacial anomalies, a high-arched palate, and a narrowed pharyngeal space due to mandibular and maxillary deficiencies. These structural anomalies in the upper airway predispose PDS patients to obstructive sleep apnea (OSA). OSA can be managed in PDS patients using either a conservative (non-surgical and multidisciplinary) approach or surgical interventions. Given the craniofacial anomalies associated with PDS, orthodontic treatment aims to address the maxillary transverse deficit and retrognathia. Currently, there is no evidence regarding the impact of orthodontic therapy on OSA levels among PDS patients. This study reports the long-term morphological and functional changes in the upper airway of a PDS patient following adenotonsillectomy and uvulopalatoplasty at an early age (3.6 years) and orthodontic camouflage in late mixed dentition (10 years). Polysomnographies (PSGs), nuclear magnetic resonance (NMR), and lateral cephalograms taken before and after ENT surgery and orthodontic treatment were analyzed. Lateral X-rays were evaluated for changes in the posterior airway space (PAS), while polysomnographies provided the apnea–hypopnea index (AHI). The NMR scans were segmented to measure the perimeter and radius of the upper airway. The findings of this study indicate that improvements following uvulopalatoplasty (UPP) were partial and temporary. Nonetheless, orthodontic therapy and the use of elastics did not appear to influence the PAS or AHI. Future studies with larger cohorts are needed to evaluate the long-term effectiveness of the UPP procedure. This study was conducted in accordance with the CARE guidelines.

Case-based learning in undergraduate orthodontic education: A cross sectional study

Introduction Student centric learning approaches have been reported to be effective in introducing higher order cognitive skills required by the health professionals. However, learners’ perceptions must be constructively aligned with new learning interventions to achieve a positive impact on their learning. The aim of this study was to explore the learning experiences of undergraduate dental students with case-based learning in orthodontics. Methods A case-based learning model was introduced on orthodontic diagnosis and treatment planning for final year students on a Bachelor of Dentistry programme toward the end of their academic year. A survey was conducted to explore the perceptions and experiences of the participants. The research instrument was based on a previously validated questionnaire and included information on demographics and consisted of 12 items aimed at evaluating the benefits and challenges of cased based learning. Results All 67 students in the final-year cohort participated in study, yielding a response rate of 100 percent. Participants across the board perceived CBL to be an effective strategy to learn the subject content and helpful in improving the students’ skills in orthodontic diagnosis, treatment planning and team-working. CBL did not pose any significant challenges or barriers to student learning. Conclusion Participants reported high acceptance of CBL in orthodontic teaching and learning and a positive impact on their educational experiences. CBL was perceived to be an appropriate strategy to enhance the diagnostic, treatment planning and team-working skills of dental students.

Luteolin inhibits orthodontic tooth movement and relapse

Luteolin is a natural flavonoid compound that widely exists in human food. Studies have demonstrated luteolin has powerful anti-inflammatory properties and can affect bone remodeling in an inflammatory environment. This study aimed to investigate the effect of luteolin on orthodontic tooth movement (OTM) and relapse after OTM. Male Sprague Dawley rats were randomly divided into 3 groups (n= 8): OTM, 50 mg/kg/d luteolin, and 100 mg/kg/d luteolin. Then, 50 g of orthodontic force was applied to all animals. A saline solution or corresponding concentration of luteolin was given orally. For the OTM experiment, after 14 days of force application, rats were killed, the maxilla was dissected, and then microcomputed tomography, histologic staining, and western blotting were performed. For the relapse experiment, the spring was removed, and a silicone impression was made to record the relapse status. Compared with the OTM alone group, systemic administration of luteolin inhibited OTM and tooth relapse (P<0.05). Increased bone volume, reduced osteoclast activity, and a decrease in osteoclastogenesis-related protein expression were observed in luteolin-treated groups. These effects may be attributed to the inhibition of the nuclear factor-kappa B pathway. Luteolin can significantly inhibit OTM and relapse after OTM. Thus, luteolin is a prospective candidate for enhancing tooth anchorage and preventing relapse in orthodontic treatment.

Finite element analysis of maxillary orthodontic therapies with variable alveolar bone grafts under occlusal forces in patient with unilateral cleft lip and palate

ObjectiveTo investigate the biomechanical effects of maxillary orthodontic treatment on different alveolar bone grafting positions loaded with occlusal forces in an unilateral cleft lip and palate (UCLP) patient.MethodsFinite element analysis was employed to simulate clinical scenarios more accurately by loading with occlusal forces on 8 bone-grafted models during maxillary orthodontic treatment. Displacement and von Mises stress pattern during maxillary protraction, expansion, and combined protraction and expansion were analyzed.ResultsThe seven bone-grafted models exhibited significantly smaller horizontal displacements at the non-cleft side landmarks during maxillary protraction and expansion compared to non-bone grafted models. Additionally, alveolar cleft bone grafted in the upper 1/3 and middle 1/3 exhibited greater asymmetry displacement and stress under maxillary protraction and expansion.ConclusionThe study highlights the necessity of considering occlusal forces in finite element study on orthodontic therapies for UCLP patients. The upper 1/3 and middle 1/3 bone graft conditions may require secondary bone graft supplementation to ensure the effectiveness of maxillary orthodontic treatment.

Masticatory function between chewing with and without wearing clear thermoplastic appliances

BackgroundClear thermoplastic materials are used in a variety of oral appliances. In some situations, patients may wear clear thermoplastic appliances while eating. However, the effect of wearing clear thermoplastic appliances on chewing efficiency is unknown. This study aimed to evaluate the differences in masticatory function between chewing with and without wearing clear thermoplastic retainers over a 6-month period, and its associated factors.MethodsThirty patients who received upper and lower clear retainers after debonding fixed appliances were examined for objective and subjective masticatory function at retainer delivery (T0), 3-month (T1), and 6-month follow-ups (T2) in two conditions: with and without wearing their retainers while chewing. The objective method used multiple sieves reported as the median particle size (MPS). The food intake ability (FIA) test served as the subjective method. Paired t-test was used to compare the outcomes between chewing with and without retainers at each evaluation time point. Repeated measures ANOVA followed by the Bonferroni post-hoc test was used to compare the outcomes between the three evaluating time points. Multivariable linear regression analysis was performed to assess whether age, sex, and extraction/non-extraction was associated with these effects.ResultsThe MPS was significantly greater when chewing with retainers compared with chewing without them at T0 (P < 0.05), however, it was not significantly greater at T1 and T2 (P > 0.05). The MPS with and without the retainers tend to decrease between T0, T1 and T2. In particular, the MPS while chewing with retainers significantly decreased between T0 and T1. The total FIA score and FIA subscores for hard and soft food were significantly lower when eating with retainers at T0 (P < 0.05), however, all FIA scores when eating without retainers did not significantly change between T0, T1, and T2. No significantly associated factors were identified.ConclusionsWearing clear retainers while chewing decreases objective and subjective masticatory function immediately after completing orthodontic treatment. However, this significantly improved to levels comparable to chewing without retainers after a 3-month follow-up. Age, sex, and extraction/non-extraction treatment were not associated with the difference in masticatory function while chewing with and without wearing the retainers.

Knowledge, attitude, and practice of adolescents and parents toward malocclusion and orthodontic treatment

Malocclusion is the misalignment of teeth and jaws, affecting oral health and appearance. This study aimed to examine the knowledge, attitude, and practice (KAP) of both adolescents and parents toward malocclusion. This web-based cross-sectional study was conducted at Tianjin between July 2019 and July 2022, enrolled adolescents and their parents. The structural equation model (SEM) was used to analyze the interactions between KAP. A total of 478 adolescents and 380 parents were included. For knowledge, the scores were 6.95 ± 2.69 for adolescents and 7.07 ± 2.90 for parents (possible range, 0–12). For attitude, the scores were 36.96 ± 7.86 for adolescents and 33.26 ± 9.20 for parents (possible range, 13–65). For practice, the scores were 39.88 ± 7.85 for adolescents and 25.75 ± 8.56 for parents (possible range, 11–55). In parents, knowledge, practice, being a service personnel and production personnel, and acquiring knowledge through the Internet were associated with receiving orthodontic treatment. The SEM showed that knowledge directly affected attitudes (β = 0.551, P < 0.001) and practices (β = 1.122, P < 0.001). But attitudes did not affect practices (β=-0.003, P = 0.923). Adolescents and parents demonstrate unsatisfactory levels of knowledge, attitudes, and practices toward malocclusion. Improvements can be made by focusing on enhancing knowledge and encouraging proactive practices.

The effects of professional expertise on perceptions of treatment need in patients with class II division 1 malocclusion: a comparison between orthodontists, general dentists, and lay people in Germany.

This study aimed to compare the perception of practitioners with varying levels of expertise and laypeople regarding the orthodontic treatment need and facial harmony in patients with increased anterior overjet. Three groups of observers (orthodontists, general dentists, and laypeople, in total n = 48) were asked to rate on images-using a10-point visual analog scale (VAS)-the facial harmony and treatment need of asample of 8patients with classII division1 malocclusion and overjets of 2, 4, 6, and 8 mm. Statistically significant differences were observed between the three groups of observers regarding patients with an overjet of 4 mm and above (p < 0.001). Treatment need was perceived at an overjet of 4 mm by orthodontists and 6 mm by general dentists, whereas laypeople did not perceive aneed for treatment in any of the groups (p < 0.001). Regarding perception of facial harmony, orthodontists had the lowest threshold (4 mm overjet), while dentists followed at agreater overjet of 6 mm or more (p < 0.001). Astatistically significant correlation between the noticed facial harmony and the perceived orthodontic treatment need was found in all observers (p < 0.001). The perceived orthodontic treatment need for classII division1 malocclusion increased with increasing professional expertise.

Comparison of two treatment modalities in the management of gingival enlargement during orthodontic treatment: a randomized clinical trial.

This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment. forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months. Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups. Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months. laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

Evaluation of Rate of Space Closure Between Platelet Rich Plasma (Prp) Injection and Piezocision in Bimaxillary Protrusion Cases

Aim: Reducing orthodontic treatment duration is a significant concern for both patients and clinicians, as prolonged treatments can lead to complications like dental caries, root resorption, and decreased patient compliance. This study aims to compare the effectiveness of two minimally invasive techniques—Piezocision and platelet-rich plasma (PRP) injection—in accelerating orthodontic tooth movement during space closure in patients with bimaxillary protrusion. Methods: Sixteen patients diagnosed with Angle's Class I bimaxillary protrusion requiring extraction of first premolars were randomly assigned to two groups. Group A (n = 8) underwent Piezocision-assisted orthodontic treatment, while Group B (n = 8) received submucosal PRP injections. In both groups, one side of the maxillary arch served as the experimental side, and the contralateral side served as the control. Measurements of space closure were taken at the initiation of retraction (T₀) and after 90 days (T₁). Results: Both Piezocision and PRP significantly enhanced the rate of space closure compared to their control sides. However, Piezocision demonstrated a statistically faster rate of tooth movement than PRP injection. The mean difference in space closure between the Piezocision and PRP groups at T₁ was significant (p &lt; 0.001). Conclusion: While both Piezocision and PRP injections effectively accelerated orthodontic tooth movement, Piezocision proved to be more efficient in reducing treatment time. Clinicians may consider Piezocision as a preferred method for patients seeking expedited orthodontic treatment.

Nonsurgical improvement of severe upper airway obstruction in infants with Robin sequence and cleft palate using Stanford orthodontic airway plate treatment.

Severe respiratory distress of neonates with Robin sequence is traditionally managed by surgery. Stanford orthodontic airway plate treatment (SOAP) is a nonsurgical option. The study aimed to determine whether SOAP can improve polysomnography parameters of neonates with Robin sequence. Polysomnography of neonates with Robin sequence treated with SOAP at a single hospital were retrospectively analyzed. Patients without polysomnography at all 4 time points (pre, start of, mid, and posttreatment) were excluded. Data were analyzed using a linear mixed effects model. Sixteen patients were included. All patients had cleft palate. The median age (minimum, maximum) at the start of treatment was 1.1 months (0.3, 5.1) with the treatment duration of 4.5 months (3.5, 6.0). The mean obstructive apnea-hypopnea index (95% confidence interval) decreased from 39.3 events/h (32.9, 45.7) to 12.2 events/h (6.7, 17.7) (P < .001), obstructive apnea index decreased from 14.1 (11.2, 17.0) events/h to 1.0 (-1.5, 3.5) events/h (P < .001), and oxygen nadir increased from 79.9% (77.4, 82.5) to 88.2% (85.5, 90.8) (P < .001) between pre and start of treatment. Respiratory improvements were sustained during and after the treatment. All patients avoided mandibular distraction osteogenesis or tracheostomy following SOAP. As being a rare diagnosis, the number of participants was, as expected, low. However, the current study shows that SOAP can improve polysomnography parameters, demonstrating its potential utility before surgical interventions for neonates with Robin sequence and cleft palate experiencing severe respiratory distress. Choo H, Sidell DR, Kim J-W, Ahn H-W, Day HS, Sullivan SS. Nonsurgical improvement of severe upper airway obstruction in infants with Robin sequence and cleft palate using Stanford orthodontic airway plate treatment. J Clin Sleep Med. 2024;20(11):1807-1817.

Comparison Change of Pre and Post-Treatment in Vermilion Height and Lip Area in Adult Class II Division I Malocclusion Treated with Premolar Extraction

Aim: This study aimed to evaluate the alterations in vermilion height and lip area before and after fixed orthodontic treatment in adult patients with Class II Division I malocclusion who underwent premolar extractions. Assessments were conducted using frontal photographs and measurements from lateral cephalograms focusing on dentoalveolar and soft tissue parameters. Methods: Twenty-three adult patients with Class II skeletal malocclusion were selected from the records of the Department of Orthodontics and Dentofacial Orthopedics at AJ Institute of Dental Sciences, Mangalore. Pre-treatment and post-treatment lateral cephalograms and frontal photographs were obtained. Cephalograms were captured using a standardized KODAK 8000c digital cephalostat (69 kVp, 12 mA, 2 s), ensuring accurate patient positioning. The same investigator manually traced the cephalograms to minimize observer variability. Measurements were computed both manually and digitally for comparison purposes. Results: The study found a significant increase in the thickness from the cervical portion of the upper incisors to the upper lip after treatment (mean post-treatment: 15.77±2.28 mm; pre-treatment: 14.95±1.90 mm; P=0.006). Conversely, the thickness from the lower incisors to the upper lip decreased significantly post-treatment (mean post-treatment: 15.46±2.72 mm; pre-treatment: 17.26±2.19 mm; P&lt;0.001). Additionally, there was a significant increase in vermilion height (St-Me) and lower facial height (N-Me) after treatment, with mean differences of 3.58 mm (P&lt;0.001) and 1.18 mm (P=0.04), respectively. Conclusion: Orthodontic treatment involving premolar extractions in Class II Division I malocclusion patients led to significant soft tissue changes, particularly in lip thickness and vermilion height. Other parameters did not exhibit statistically significant differences.

Automatic 3-dimensional quantification of orthodontically induced root resorption in cone-beam computed tomography images based on deep learning

Orthodontically induced root resorption (OIRR) is a common and undesirable consequence of orthodontic treatment. Traditionally, studies employ manual methods to conduct 3-dimensional quantitative analysis of OIRR via cone-beam computed tomography (CBCT), which is often subjective and time-consuming. With advancements in computer technology, deep learning-based approaches have gained traction in medical image processing. This study presents a deep learning-based model for the fully automatic extraction of root volume information and the localization of root resorption from CBCT images. In this cross-sectional, retrospective study, 4534 teeth from 105 patients were used to train and validate an automatic model for OIRR quantification. The protocol encompassed several steps: preprocessing of CBCT images involving automatic tooth segmentation and conversion into point clouds, followed by segmentation of tooth crowns and roots via the Dynamic Graph Convolutional Neural Network. The root volume was subsequently calculated, and OIRR localization was performed. The intraclass correlation coefficient was employed to validate the consistency between the automatic model and manual measurements. The proposed method strongly correlated with manual measurements in terms of root volume and OIRR severity assessment. The intraclass correlation coefficient values for average volume measurements at each tooth position exceeded 0.95 (P<0.001), with the accuracy of different OIRR severity classifications surpassing 0.8. The proposed methodology provides automatic and reliable tools for OIRR assessment, offering potential improvements in orthodontic treatment planning and monitoring.

Assessment of clinical and laboratory parameters of oral сavity in patients with orthodontic systems

equipment (braces) on the biochemical parameters of oral fluid. Materials and methods. The study involved patients aged 18 to 22 years who are undergoing orthodontic treatment with a bracket system. Thegroup of examined persons was 25 people. The control group included 15 practically healthy people without braces. All patients underwent dental status assessment (Green – Vermillion hygiene index – simplified IG-Y; PMA inflammation index), laboratory examination of oral fluid before and after controlled oral hygiene. The biochemical analysis included determination of the acid-base balance in the oral fluid using a pH meter, assessment of free radical oxidation by chemiluminogram parameters by biochemiluminescence and by levels of molecular products of lipid peroxidation (diene and triene conjugates, Schiff bases), activity of the enzyme alkaline phosphatase, concentrations of total protein and lactate. Results and discussions. In patients undergoing orthodontic treatment with a bracket system, an insufficient level of oral hygiene and inflammatory manifestations in the gums of moderate severity were revealed. The level of the acid-base balance of the oral fluid before controlled hygiene was equal to 6.8±0.19, that is, below the range of normal pH values in the oral cavity. After hygiene, the pH of the oral fluid returned to the norm of 7.1±0.2. In patients with braces, activation of free radical oxidation and an increase in lipoperoxidation parameters – triene conjugates and Schiff bases, increased activity of alkaline phosphatase, total protein and lactate levels took place.Cоnclusion. After hygienic treatment of the oral cavity, the biochemical parameters did not differ statistically significantly from the control data.

Relationship between orthodontic treatment and bone densit

The aim of this study is to examine the change in bone density around the apex of mandibular anterior teeth in groups formed based on malocclusion types after orthodontic treatment. A total of 18 individuals were included in the study, grouped according to malocclusion types (Class I, Class II, and Class III). This retrospective study analyzed the bone density around the apex of mandibular anterior teeth using fractal analysis on panoramic images. Bone density increased around the apex of mandibular anterior teeth in individuals with Class I, Class II, and Class III malocclusions after orthodontic treatment. Statistically significant differences were found in the change of bone density before and after orthodontic treatment among the malocclusion groups. The greatest change in bone density was observed in the Class III group, while the least change was in the Class I group. The fractal analysis method is a technique that facilitates the diagnosis of minimal changes occurring in patients undergoing orthodontic treatment. Potential changes in teeth and adjacent tissues should be carefully evaluated, and orthodontic treatments should be planned in accordance with these evaluations.