Orthodontic Treatment Planning Research Articles

INNOVACIONES DE IA, EN EL DIAGNÓSTICO Y LA PLANIFICACIÓN DEL TRATAMIENTO EN ORTODONCIA

Digital dentistry, initiated in 1973 by Professor François Duret, has evolved considerably in orthodontics, through the use of digital flow and artificial intelligence (AI). These technologies enable accurate diagnosis, prognosis and treatment. AI has greatly improved the efficiency of diagnosis and treatment planning in orthodontics, with increasing applications due to advances in algorithms, processing and data availability. Objective: Evaluate AI applications for diagnosis, orthodontic treatment planning and improving patient satisfaction. Conclusion: The integration of AI into orthodontics has significantly transformed the way treatment is diagnosed, planned and administered, offering notable advantages in terms of precision and efficiency. However, its use presents challenges, such as the need for specialized training, prior professional experience to determine reference standards and the integration of these technologies into clinical practice. As technology continues to advance, the tools used will be improved and the current limitations overcome.

INNOVACIONES DE IA, EN EL DIAGNÓSTICO Y LA PLANIFICACIÓN DEL TRATAMIENTO EN ORTODONCIA

Digital dentistry, initiated in 1973 by Professor François Duret, has evolved considerably in orthodontics, through the use of digital flow and artificial intelligence (AI). These technologies enable accurate diagnosis, prognosis and treatment. AI has greatly improved the efficiency of diagnosis and treatment planning in orthodontics, with increasing applications due to advances in algorithms, processing and data availability. Objective: Evaluate AI applications for diagnosis, orthodontic treatment planning and improving patient satisfaction. Conclusion: The integration of AI into orthodontics has significantly transformed the way treatment is diagnosed, planned and administered, offering notable advantages in terms of precision and efficiency. However, its use presents challenges, such as the need for specialized training, prior professional experience to determine reference standards and the integration of these technologies into clinical practice. As technology continues to advance, the tools used will be improved and the current limitations overcome.

Treatment acceptance in adult patients with anterior open bite: A National Dental Practice-Based Research Network study

Orthodontists have many techniques to treat anterior open bites and must involve patients in making treatment decisions. This study aimed to investigate orthodontic treatment plan acceptance by United States adults with anterior open bites and to identify associations between treatment acceptance and patient demographics and dentofacial characteristics. A prospective, observational cohort study enrolled the patients of 91 orthodontic providers. A total of 345 adults were included in the sample. Provider personal and practice demographics were captured. Patient demographics, treatment goals, dentofacial characteristics, and reasons for not accepting the recommended plans were recorded. Adjusted regression models were used to identify associations between patient characteristics and the likelihood of accepting the most highly recommended plan. Approximately 78% of patients accepted the most highly recommended treatment plan. 60% of the patients who were recommended surgical plans accepted them. Patients with a history of orthodontics and a concave profile were more likely to accept the most highly recommended plan. Insurance coverage for orthognathic surgery was associated with a higher acceptance rate for surgery. Severe crowding was associated with a lower acceptance of surgery. The most common reasons for declining the recommended plan were not wanting jaw surgery and considering the treatment to be too invasive, risky, and/or costly. Patient acceptance is less common at higher levels of invasiveness of treatment. Prior orthodontic treatment, concave profile, and insurance coverage for surgery were associated with accepting treatment. Most patients accepted a surgical plan when it was the most recommended option.

A questionnaire study regarding knowledge, attitude and usage of artificial intelligence and machine learning by the orthodontic fraternity of Northern India

AimThe aim of the questionnaire study was to determine the knowledge, attitude, and perception of orthodontists regarding the role of artificial intelligence in dentistry in general and orthodontics specifically, and to determine the use of artificial intelligence by the orthodontist. MethodsThis cross-sectional study was done among the orthodontists of Northern India (clinicians, academicians, and postgraduates) through a web-based electronic survey using Google Forms. The study was designed to obtain information about AI and its basic usage in daily life, in dentistry, and in orthodontics from the participants. The options given were set specifically according to the Likert scale to maintain the correct format. The questionnaire was validated by one AI expert and one orthodontic expert, followed by pretesting in a smaller group of 25 orthodontists 2 weeks before circulation. A total of 100 orthodontists and postgraduate students responded to the pretested online questionnaire link for 31 questions in four sections sent via social media websites in a period of 3 months. ResultsThe majority of the participants believe that AI could be useful in diagnosis and treatment planning and could revolutionize dentistry in general. 84 % of the orthodontic academicians and clinicians, including PG students, consider AI a useful tool for boosting performance and delivering quality care in orthodontics, and 72 % see AI as a partner rather than a competitor in the foreseeable future of dentistry. 90 % of the participants believe that the incorporation of AI into CBCT analysis can be a valuable addition to diagnosis and treatment planning. 86 % of total participants agree that AI can be helpful in decision-making for orthognathic surgery, and 84 % find AI useful for bone age assessment. ConclusionsIt was observed that academicians are more aware of AI terminologies and usage as compared to PG students and clinicians. There is a consensus that AI is a useful tool for diagnosis and treatment planning, boosting performance and quality care in orthodontics. In spite of these facts, 62.5 % of clinicians and 40 % of PG students are still not using AI for cephalometric analysis (p = 0.033).

Does 3D simulation impact clinical reasoning for orthodontic treatment planning of impacted maxillary canines?

Clinical reasoning is an essential competence to develop in the diagnosis and treatment planning of impacted maxillary canines to ensure good treatment outcomes. It involves skills of radiographic interpretation and mental visualization. To master these, postgraduate students learn to interpret 2D and 3D X-rays to locate these canines accurately. This process demands the creation of mental models of the impaction and resolving it either by envisioning the canine's movement to its correct position or considering its removal. To facilitate this cognitive exercise, a 3D-printed simulator, derived from Cone Beam Computed Tomography scans, serves as a tool to allow students to experiment with various movement simulations, helping them select the most viable treatment approach.This project aimed to assess the differences in expert and novice orthodontists’ clinical reasoning for impacted maxillary canines, and whether the addition of a 3D simulator would affect their reasoning. Thirteen (13) novices randomly assigned to a control and intervention group and three (3) experts took part in a Think-Aloud exercise to diagnose and treatment plan a case of bilaterally impacted maxillary canines. Experts and intervention group novices had the 3D simulator in addition to standardized patient records. Their responses were recorded and analyzed according to a coding scheme reflecting the clinical reasoning process. While experts demonstrated quick clinical judgment and found the 3D simulator redundant, novices were more uncertain and required additional cues. Novices using the 3D simulator described more elaborate treatment plans and had increased awareness of potential complications as compared to the control group.

Predicting Outcome in Clear Aligner Treatment: A Machine Learning Analysis.

Background/Objectives: Machine learning (ML) models predicting the risk of refinement (i.e., a subsequent course of treatment being necessary) in clear aligner therapy (CAT) were developed and evaluated. Methods: An anonymized sample of 9942 CAT patients (70.6% females, 29.4% males, age range 18-64 years, median 30.5 years), as provided by DrSmile, a large European CAT provider based in Berlin, Germany, was used. Three different ML methods were employed: (1) logistic regression with L1 regularization, (2) extreme gradient boosting (XGBoost), and (3) support vector classification with a radial basis function kernel. In total, 74 factors were selected as predictors for these methods and are consistent with clinical reasoning. Results: On a held-out test set with a true-positive rate of 0.58, the logistic regression model has an area under the ROC curve (AUC) of 0.67, an average precision (AP) of 0.73, and Brier loss of 0.22; the XGBoost model has an AUC of 0.67, an AP of 0.74, and Brier loss of 0.22; and the support vector model has a recall of 0.61 and a precision of 0.64. The logistic regression and XGBoost models identify predictors influencing refinement risk, including patient compliance, interproximal enamel reduction (IPR) and certain planned tooth movements, for example, lingual translation of maxillary incisors being associated with the lowest risk of refinement and rotation of mandibular incisors with the highest risk. Conclusions: These findings suggest moderate, well-calibrated predictive accuracy with both regularized logistic regression and XGBoost and underscore the influence the identified factors have on the risk of refinement in CAT, emphasizing their importance in the careful planning of orthodontic treatment and the potential for shorter treatment times, less patient discomfort, and fewer clinic visits. Identification of at-risk individuals could support tailored clinical decision-making and enable targeted interventions.

Digital Model in Orthodontics: Is It Really Necessary for Every Treatment Procedure? A Scoping Review

Digital models and three-dimensional technology in orthodontics have become an integral part of everyday clinical practice. Nevertheless, there is currently no consensus regarding in which cases a digital model is really necessary. Therefore, this scoping review aims to identify and assess which orthodontic procedures require a digital model. This review’s reporting was based on PRISMA guidelines. A literature search was undertaken using five electronic databases on 17 February 2024. A total of 87 studies met the inclusion criteria and were qualitatively analyzed by three reviewers. The following aspects of orthodontic treatment were identified and discussed with regard to digital model application: diagnosis, treatment procedures, retention, and outcome evaluation in orthodontics. Based on the studies assessed, despite some limitations regarding radiation exposure justification and the accuracy of the integration methods of 3D data, there is evidence that digital models lead to more accurate orthodontic diagnosis and treatment planning. In cases of impacted canines, aligner treatment, mini-implants insertion (when angle definition and orientation are essential), and primary care for cleft lip and palate, a partial digital model produced by an integration of some of the 3D data (face scan, intraoral scan, CBCT) that we can acquire is beneficial. A full digital model that combines all the 3D information should be used in orthognathic surgery cases, in which prediction and accurate performance are highly advocated.

Imaging and 3D Analysis Based on Two or More Three-Dimensional CBCT Recordings before and after Orthodontic Treatment and Maxillofacial Therapy

Cone beam computed tomography (CBCT) has emerged as a crucial radiographic technique for orthodontic diagnosis and treatment planning, particularly for cases requiring the assessment of complex anatomical relationships. In the first part of the study, we examined metric characteristics measured on 3D cranial models of patients before and after surgery. In the second part, we conducted more complex data processing, analyzing a set of 12 cranial feature points using Procrustes analysis to quantify and visually represent surgical modifications. The third part involved comparing 3D facial surfaces using Iterative Closest Point (ICP) alignment and nearest point-to-point distances. Additionally, we tested point configurations in the facial soft tissues. The study included a group of orthodontic patients from whom CBCT data and 3D facial scans were obtained during treatment. The results demonstrated that each method could assess preoperative and postoperative changes to varying degrees. They also highlighted potential gender differences in surgical modifications that warrant further investigation and consideration during surgical planning. The aim of our study was to compare 3D visualizations of skull and facial models before and after surgery, to assess the degree of relative agreement or similarity, and to identify any morphological differences.

Single Nucleotide Polymorphisms in RUNX2 and BMP2 contributes to different vertical facial profile.

The vertical facial profile is a crucial factor for facial harmony with significant implications for both aesthetic satisfaction and orthodontic treatment planning. However, the role of single nucleotide polymorphisms (SNPs) in the development of vertical facial proportions is still poorly understood. This study aimed to investigate the potential impact of some SNPs in genes associated with craniofacial bone development on the establishment of different vertical facial profiles. Vertical facial profiles were assessed by two senior orthodontists through pre-treatment digital lateral cephalograms. The vertical facial profile type was determined by recommended measurement according to the American Board of Orthodontics. Healthy orthodontic patients were divided into the following groups: "Normodivergent" (control group), "Hyperdivergent" and "Hypodivergent". Patients with a history of orthodontic or facial surgical intervention were excluded. Genomic DNA extracted from saliva samples was used for the genotyping of 7 SNPs in RUNX2, BMP2, BMP4 and SMAD6 genes using real-time polymerase chain reactions (PCR). The genotype distribution between groups was evaluated by uni- and multivariate analysis adjusted by age (alpha = 5%). A total of 272 patients were included, 158 (58.1%) were "Normodivergent", 68 (25.0%) were "Hyperdivergent", and 46 (16.9%) were "Hypodivergent". The SNPs rs1200425 (RUNX2) and rs1005464 (BMP2) were associated with a hyperdivergent vertical profile in uni- and multivariate analysis (p-value < 0.05). Synergistic effect was observed when evaluating both SNPs rs1200425- rs1005464 simultaneously (Prevalence Ratio = 4.0; 95% Confidence Interval = 1.2-13.4; p-value = 0.022). In conclusion, this study supports a link between genetic factors and the establishment of vertical facial profiles. SNPs in RUNX2 and BMP2 genes were identified as potential contributors to hyperdivergent facial profiles.

Feasibility of 3 Tesla MRI for the assessment of mid-palatal suture maturation: a retrospective pilot study.

The maxilla occupies a key position in dentofacial orthopaedics, since its transversal development can be directly influenced by orthodontic therapy. The maturation stages of the mid-palatal suture, which are obtained from cone-beam computed tomography images (CBCT), present an addition to clinical decision-making in transversal discrepancies of the upper jaw. In an endeavour to reduce ionizing radiation in adolescents and young adults, who are particularly susceptible to long term stochastic irradiation effects, we investigated the feasibility of 3 Tesla (3T) MRI in detecting the maturation stages of the mid-palatal suture. A collective of 30 patients aged 24-93years with routine neck MRI at 3T, underwent an additional three-dimensional isotropic T1 weighted study sequence of the midface. Image evaluation was performed on axial, multi-planar formatted reconstructions of the dataset aligned to the midline axis of the palate, and curved reconstructions aligned to the concavity of the palate. Inverted images helped to achieve an image impression similar to the well-known CBCT appearance. All datasets were reviewed by three readers and mid-palatal maturation was scored twice according to Angelieri et al. Intra- and inter-rater agreement were evaluated to measure the robustness of the images for clinical evaluation. 3T MRI deemed reliable for the assessment of mid-palatal suture maturation and hence for the appraisal of the hard palate and its adjacent sutures. The data of this pilot study display the feasibility of non-ionizing cross-sectional MRI for the determination of sutural maturation stages. These findings underline the potential of MRI for orthodontic treatment planning, further contributing to the avoidance of unnecessary radiation doses.

Diagnostic evaluation of skeletal cephalometric parameters and photograph-Based soft tissue parameters in Malwa Population

The primary goal of orthodontic diagnostic and treatment planning is to create a balanced and aesthetically attractive face. During the decades-long period of cephalometric dominance, the "aesthetic" of the face was predominantly used to describe the profile as observed on a lateral cephalogram However, the paradigm has now shifted to soft tissue-based diagnosis and treatment planning. This creates the need for soft tissue-based analysis especially on photographs considering its evaluation of myriad populations. To evaluate the skeletal cephalometric parameters and photograph-based soft tissue parameters in the Malwa population. The study was conducted using 50 lateral cephalometric radiographs and 50 profile photographs. Data were analyzed for probability distribution using the Shapiro-Wilk test. Descriptive statistics were performed and data were presented as median and inter-quartile range. Correlation between the variables was assessed using Spearman’s correlation coefficient. P value &amp;#60; .05 was considered statistically significant. Our reported values of both photographic and lateral cephalogram parameters are different not only from the international population, but also different values are observed from the not only Indian population, but also from various subsets of the Indian population. Therefore, the average value of lateral profile photographic parameters as well as cephalometric parameters in my study can be used as floating norms for the Malwa population.

Evaluation of reliability of salivary alkaline phosphatase in comparison to other methods of assessing the skeletal maturation

Evaluation of skeletal maturation is crucial to growth determination which in turn influences orthodontic treatment planning. Various methods employed for assessment are chronological age, hand wrist maturation, cervical vertebral maturation, and dental calcification. Recently, salivary Bone specific alkaline phosphatase (BALP) have been introduced due to its role in the bone mineralization process. To test the alternate hypothesis that salivary alkaline phosphatase is a reliable indicator of skeletal maturity in comparison with other methods of assessment of skeletal maturation. Total 112 subjects were selected out of 150 subjects on the basis of inclusion and exclusion criteria, for participation in the study. For each subject, personal details including chronological age was noted. Height and weight measurements were done for calculation of body mass index (BMI). Further, Lateral Cephalogram and Orthopantomogram were obtained for assessment of cervical vertebrae maturation stages and Demirjian index. Then, an unstimulated salivary sample was collected for evaluation of alkaline phosphatase activity by colorimetric method. The data obtained was analyzed using SPSS software. The results of the present study showed that the highest correlation for skeletal maturation assessment was found with alkaline phosphatase activity. The hypothesis is accepted. Salivary Alkaline Phosphatase proved to be reliable biomarker for assessment of skeletal maturation.

Design of smart magnetic thin-sheet structure based wireless sensors-array arrangement for intraoral-pressure sensing approach

During orthodontic treatments, orthodontists want to simultaneously measure different kinds of intraoral pressure of a patient to determine a suitable orthodontic treatment plan for the patient. To achieve this, an intraoral pressure sensors-array with a specific arrangement in the oral cavity is needed. Hence, in this paper, we design a smart magnetic thin-sheet structure based wireless sensors-array arrangement for intraoral-pressure sensing for orthodontics to determine the above suitable treatment plan. In general, the sensors-array consists of multiple sensing modules. Each module consists of two parts: the first part is a transmitting/receiving electromagnet which is connected to a reference electromagnet in a balanced inductance bridge configuration while the second part is a smart magnetic thin-sheet structure based high-permeable sensing diaphragm. A voltage input is applied to the reference electromagnet and transmitting/receiving electromagnet, while the voltage output is measured from the transmitting/receiving electromagnet, respectively (the transmitting/receiving electromagnet can transmit the magnetic flux as well as receive or sense the change of magnetic flux). When the sensing diaphragm (which is placed in proximity to the transmitting/receiving electromagnet) undergoes a displacement, the gap between the sensing diaphragm and transmitting/receiving electromagnet changes. This subsequently changes surrounding magnetic flux, and consequently results in a change in magnetic reluctance between the sensing diaphragm and transmitting/receiving electromagnet. Thus, the voltage output of the transmitting/receiving electromagnet is changed accordingly. Based on this operation principle, furthermore, we use multiple transmitting/receiving electromagnets to form a compact (specifically arranged) sensors-array. The results show that specifically arranged sensors-array can provide measurement results in multiple points in the oral cavity to the orthodontists, as a simplified decision-making reference for the orthodontists to determine the clinical treatment plan for patients.

Comparison of Facial Angular Measurements Between Males and Females Presenting at a Tertiary Care Hospital

Background and Objective: The effectiveness of orthodontic diagnosis and treatment planning is dependent on an accurate assessment of the patient's soft tissue profile. The objective of the study was to compare the facial angular measurements between males and females.Methods: The study comprised 100 volunteers (50 males and 50 females) ranging in age from 12 to 16 years. The respondents were chosen through convenience sampling technique from orthodontics department of children hospital Lahore. Cephalometric and photographic profile analysis was used, with angular measurements based on standard cephalometric and photographic records taken in natural head position. The study included four factors in total.Results: The mean cephalometric and photographic naso-frontal angle was 121.050 and 121.030 respectively, where as cephalometric and phographic measurement in females were 122.240 and 122.840 respectively.Conclusion: There was no significant difference in angular measurements between two genders.Keywords: Photographic analysis, Cephalometric analysis, Naso-labial angle, Naso-mental angle, Naso- frontal angle, Naso-facial angle

Dentální a skeletální indikátory růstového spurtu v ortodoncii

Aim: The aim was to confirm the correlation between chronological age, skeletal age according to X-ray picture of the hand and wrist, and the stages of teeth development, and to determine whether the assessment of teeth development can be used to establish the stage of growth of an individual. Material and method: 362 adolescents were included in the study; 180 boys between the age 11.5–15.5, 182 girls between the age 10.5–14.5. To assess teeth in OPG Demirjian’s classification was used. We assessed teeth 43, 44, 45 and 47 in the mandible, and 13, 14, 15, 17 and 18 in the maxilla. To assess radiographs of the hand and wrist Björk, Grave and Brown classification was applied. Results: The correlation of skeletal and dental age was proved. The highest correlation was found in lower permanent canine, both in girls and boys. S-stage in radiograph of the hand (the stage prior to the maximum growth spurt) corresponds to the stage of the lower canine root with parallel walls (G-stage according to Demirjian). Thus, in case OPG of lower permanent canine shows parallel walls of the root canal the maximum of growth spurt occurs within 0.5–1 year. The maximum growth spurt (MP3cap stage) and the following stages correspond to the situation when lower canine apex is closed (H-stage according to Demirjian). This can help us in the correct timing of orthodontic treatment. ORTODONCIE | ročník 33 | č. 2/2024 ODBORNÉ PRÁCE / ORGINAL ARTICLES Recenzovaný časopis České ortodontické společnosti 14 Conclusion: The assessment of the developmental stages of teeth, namely lower permanent canine, is used in the planning of orthodontic treatment, and can serve as

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. Discussion 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.

Study on decision-making for orthodontic treatment plans based on analytic hierarchy process

BackgroundOrthodontics is a common treatment for malocclusion and is essential for improving the oral health and aesthetics of patients. Currently, patients often rely on the clinical expertise and professional knowledge of doctors to select orthodontic programs. However, they lack their own objective and systematic evaluation methods to quantitatively compare different programs. Therefore, there is a need for a more comprehensive and quantitative approach to selecting orthodontic treatment plans, aiming to enhance their scientific validity and effectiveness.MethodsIn this study, a combination of the analytic hierarchy process (AHP) and semantic analysis was used to evaluate and compare different orthodontic treatment options. An AHP model and evaluation matrix were established through thorough research and semantic analysis of patient requirements. This model considered various treatment factors. Expert panels were invited to rate these factors using a 1–9 scale. The optimal solution was determined by ranking and comparing different orthodontic treatment plans using the geometric mean method to calculate the weights of each criterion.ResultsThe research indicates a higher preference for invisible correction compared to other orthodontic solutions, with a weight score that is 0.3923 higher. Factors such as comfort and difficulty of cleaning have been given significant attention.ConclusionThe Analytic Hierarchy Process (AHP) method can be utilized to effectively develop orthodontic treatment plans, making the treatment process more objective, scientific, and personalized. The design of this study offers strong decision support for orthodontic treatment, potentially improving orthodontic treatment outcomes in clinical practice and ultimately enhancing oral health and patients’ quality of life.

Comparative evaluation and co-relation in variation of curve of Spee and curve of Wilson in Class II div. 1, Class II div. 2, and Class III as against Class I malocclusion in central India population- an in vitro study

Introduction Getting acceptable cosmetic results in the soft tissues of the face serves as the foundation for orthodontic treatment planning. Also, in order to achieve healthy static and dynamic occlusal interactions, the teeth must be positioned within the basal bone at the correct position, angle, and inclination. To avoid periodontal issues, provide stability, and achieve a functional occlusion, it is essential to ascertain the individual’s dental arch form before starting of treatment and thus to utilise the mechanics that follow throughout the treatment. Objectives To evaluate and compare variation in Curve of Spee and Curve of Wilson in Class II Div.-1, Class II-Div-2 and Class-III as against Class I malocclusion in central India population. Methodology Irreversible hydrocolloid impression will be taken with perforated metal stock trays and stone cast will be poured. This will be scanned using CAD CAM machine and curve of Spee and Wilson will be measured using reverse engineering. Expected Result It will assist us in treatment planning for preventing periodontal issues, assuring stability, and achieving functional occlusion by evaluating and comparing the Spee and Wilson curves in Class II Divison-1, Class II Divison-2, and Class-III malocclusion with Class-I malocclusion. Conclusion Every single patient receiving orthodontic treatment has the COS, which is crucial to achieving a stable occlusion. Almost every patient who receives orthodontic treatment eventually experiences the Spee Curve. Since there aren’t many studies examining the relationship between the Curves of Spee and Wilson, their impact on dentoskeletal morphology, and their role in occlusal stability.

The Influence of Orthodontic Treatment on Periodontal Health between Challenge and Synergy: A Narrative Review.

By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients with periodontal issues. Concerns about the patient's appearance, such as uneven gingival margins or functional issues caused by inflammatory periodontal diseases, should be accounted for when designing orthodontic treatment plans. Furthermore, orthodontics may increase the chances of saving and recovering a degraded dentition in cases of severe periodontitis. Today, general dentists, dontists, and orthodontists play integrative roles that enable them to achieve the best possible results for their patients. This review will improve the results of interdisciplinary treatments and increase cooperation between dental specialists by drawing attention to the essential connection between orthodontics and periodontics in regular clinical practice.

Evaluation of different approaches for sagittal skeletal discrepancy assessment

Introduction The accurate assessment of the sagittal jaw relationship between the maxilla and mandible plays a pivotal role in orthodontic diagnosis and treatment planning. Researchers have introduced both linear and angular measurements to establish a precise method for evaluating sagittal base discrepancies. Aim The aim was to assess the different approaches for sagittal skeletal discrepancy assessment. Material and methods The study included 180 pretreated lateral cephalometric radiographs of Egyptian orthodontic patients of both sexes with varying skeletal malocclusion patterns from the Orthodontic Department clinic at Tanta University. These radiographs were meticulously traced onto lead acetate paper using a 0.5 mm lead pencil and an LED tracing screen for adequate illumination. A total of 60 cephalometric radiographs were grouped based on the ANB angle into three skeletal categories: group 1 (class I, ANB° 2°–4°), group 2 (class II, ANB° &gt;4°), and group 3 (class III, ANB° &lt;2°). To analyze the data, each linear and angular parameter (including ANB°, Wits appraisal, AF-BF distance, APDI angle, Beta angle, Yen angle, and W angle) was compared among these three skeletal groups using the F test (analysis of variance), to compare between more than two groups, for normally distributed quantitative variable. Additionally, the Spearman coefficient test was employed to examine the correlations between various linear and angular measurements studied. Results All the performed parameters ANB, Yen, W, Beta, Wits appraisal, and AF-BF distance showed significantly differences for skeletal classes I, II, III. APDI angle differed significantly between both classes I and III and also classes II and III, but did not differ significantly between classes I and II. Strong correlations were found among the studied parameters except between Wits appraisal and AF-BF distance which showed nonsignificant correlation. Conclusion The previous parameters are equally important in terms of diagnosis and reliability, allowing them to serve as alternative analyses under challenging circumstances.