This prospective pilot study evaluated the clinical feasibility of autogenous tooth bone graft powder (ATBGP) for surgically assisted labial alveolar augmentation during orthodontic treatment, by assessing radiographic alveolar changes and patient-reported outcomes. Eleven adults with thin labial alveolar bone in the mandibular anterior region underwent surgically assisted alveolar augmentation with ATBGP, involving 52 teeth. Cone-beam computed tomography (CBCT) was performed at baseline and 0, 3, and 6 months postoperatively to assess alveolar bone parameters. Postoperative pain, function, and satisfaction were evaluated using a visual analog scale (VAS). Alveolar bone thickness and area increased at all postoperative time points, while alveolar crest height decreased (p<0.05). Labial bone defects decreased markedly, and sagittal root position improved. Mild root resorption was detected but remained within the physiological range. Most patients reported mild postoperative symptoms and high satisfaction. These findings suggest that ATBGP may represent a feasible, autogenous grafting material for surgically assisted alveolar augmentation in the mandibular anterior region, enabling biological reuse of extracted teeth and potentially reducing reliance on xenografts during orthodontic treatment. Larger randomized studies with longer follow-up are needed to confirm durability and safety.

Effect of premolar extractions on occlusal contacts and chewing efficiency: A case-control study.

Interleukin-33 and superoxide dismutase 3 mediates co-achieved tooth movement acceleration and root protection.

Cells residing in, and on, the calcified periodontal bone matrix experience numerous mechanical stimuli daily. The nature of the mechanical stimuli depends on whether the mechanical triggers are physiological, e.g., arising from masticatory forces, distributed via a healthy periodontal ligament to the alveolar bone, or represent "error-loads", e.g., arising during orthodontic tooth movement or around dental implants. Mechanosensitive osteocytes mediate osteoclast and osteoblast recruitment and activity in the presence of unloading, but "error loads" can directly activate signaling pathways in osteoblasts, thereby directing osteoblast activity and accumulating the bone mass essential for a functional masticatory system. Mitogen-activated protein kinases (MAPKs) play a pivotal role in regulating osteoblast growth, differentiation, and survival. This scoping review investigates which MAPKs are rapidly (within minutes) activated in osteoblasts in response to different types of mechanical stimuli. In the discussion, we tie the activation of MAPKs to altered osteoblast number and activity and the production of signaling factors. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we identified studies linking MAPKs, osteoblasts, and mechanical stress. The review included 33 in vitro studies. The findings revealed that extracellular signal-regulated kinases ERK1/2, p38, and JNK were rapidly activated in osteoblasts in response to various mechanical stimuli. Fluid flow forces, representing shear stress such as those present during mastication or orthodontic movement, activated all three MAPK branches. Substrate stretch, applied to simulate strain from mastication, induced a broad spectrum of responses. Hydrostatic pressure, often applied to reflect compression from implant loading or mastication, triggered all known MAPK pathways within an hour. In contrast, more selective stimuli such as low-intensity pulsed ultrasound and hypotonic pressure preferentially activated ERK1/2. Regardless of the stimulus, ERK1/2 was usually, and rapidly activated within minutes. In conclusion, diverse mechanical stimuli, including shear stress, substrate strain, and hydrostatic pressure, frequently, and rapidly, upregulate ERK1/2 signaling in osteoblasts. Given ERK1/2's established role in promoting osteoblast proliferation and differentiation, this early activation may help explain the localized bone formation observed under mechanical loading during orthodontic treatment, dental implant integration, or alveolar bone remodeling.

Orthodontic-induced gingival enlargement (OIGE) affects approximately 15-30% of patients undergoing orthodontic treatment and remains largely unpredictable, often relying on subjective clinical assessments made after irreversible tissue changes have occurred. S100A4 is a well-characterized marker of activated fibroblasts involved in pathological tissue remodeling. This was a cross-sectional precision biomarker study that analyzed gingival tissue samples from three groups: healthy controls (n = 60), orthodontic patients without gingival enlargement (n = 31), and patients with clinically diagnosed OIGE (n = 61). Immunohistochemical analysis quantified S100A4-positive fibroblasts, type I collagen synthesis, and microvascular density. Advanced statistical analyses included multivariate logistic regression, machine learning-based validation, causal mediation analysis, and survival modeling for risk stratification. The density of S100A4-positive fibroblasts was significantly higher in OIGE patients (245.8 ± 38.7 cells/mm2) compared to orthodontic controls (165.3 ± 29.4 cells/mm2) and healthy individuals (98.2 ± 18.5 cells/mm2) (p < 0.001; η2 = 0.891). Multivariate analysis confirmed S100A4 as an independent predictor of OIGE (OR = 1.028 per cell/mm2; 95%CI 1.021-1.035; p < 0.001). Machine learning validation demonstrated high predictive accuracy (AUC = 0.946). Survival analysis identified distinct risk strata: individuals with S100A4 densities > 180 cells/mm2 had a 78% probability of developing OIGE within 24months, compared to 12% for those with < 130 cells/mm2. S100A4 demonstrates 95% predictive accuracy for OIGE, supporting its role in personalized risk stratification and early preventive interventions during a defined therapeutic window. This study presents the first validated precision biomarker in orthodontics with the potential to prevent an estimated 180,000-360,000 OIGE cases globally each year.

This study aimed to compare the accuracy of orthodontic tooth movements achieved with three-dimensionally (3D) printed aligners (Noxi, Sweden&Martina, Due Carrare, Padova, Italy) using a12 h/day protocol with that of thermoformed aligners (F22 aligner, Sweden&Martina, Due Carrare, Padova, Italy) using a22 h/day protocol. Of the 40 white adult patients (12men and 28women, mean age30.1 years) undergoing orthodontic treatment with aligners selected based on specific inclusion criteria, 20patients were treated with Noxi aligners using a12 h/day protocol (study group), and the remaining 20patients were treated with F22 aligners using a22 h/day protocol (control group). Pretreatment, ideal posttreatment (as planned in the setup), and real posttreatment digital models were analyzed using VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). Angular and linear measurements were evaluated to measure mesiodistal tipping, vestibulolingual tipping, and rotational movements for 1120 teeth. Data were compared to evaluate treatment accuracy for each tooth, with statistical analysis of the results. No statistically significant differences in accuracy emerged between the study group (64.2%) and the control group (65.4%) for any type of tooth movement or tooth category. In the study group, vestibulolingual tipping showed the highest predictability (69.63%), followed by mesiodistal tipping (65.38%) and rotation (60.5%). In the control group, the vestibulolingual and mesiodistal movements showed the highest predictability, with amean accuracy of about 67%, followed by rotation (62.3%). Despite the reduced collaboration request, the group treated with Noxi aligners did not show any significant differences compared to the group treated with F22 aligners with regard to percentage accuracy for all analyzed orthodontic movements.

The aim of this retrospective observational study was to evaluate the prevalence and distribution of dental anomalies in orthodontic patients with different malocclusions. Pretreatment diagnostic records of 766 orthodontic patients were retrospectively evaluated in a single-center setting. Dental anomalies were classified according to sex, orthodontic malocclusion type (Class I, n = 122; Class II, n = 568; Class III, n = 76), and jaw localization. Statistical analyses were performed using Fisher's exact test, Yates' correction, and Pearson's chi-square test. No statistically significant association was found between sex and the prevalence of dental anomalies (P = 0.739). At least one dental anomaly was detected in 71.8% of the patients. Root dilaceration was the most frequently observed anomaly (35%). The prevalence rates of numerical, dimensional, shape, eruption, and structural anomalies were 13.97%, 4.04%, 53.91%, 24.15%, and 30.67%, respectively. No significant difference in the prevalence of dental anomalies was observed among different malocclusion groups (P = 0.055). Dental anomalies were frequently observed in this orthodontic population. The prevalence and distribution of anomalies varied according to anomaly type and jaw localization, highlighting the importance of radiographic evaluation in orthodontic patients. These findings may support earlier detection of diagnostic challenges and more individualized treatment planning in routine orthodontic practice. Early identification of dental anomalies may facilitate comprehensive orthodontic treatment planning and help prevent potential functional and structural complications.

Management of missing anterior teeth can pose significant challenges for the orthodontist, as the maxillary incisors are key to esthetic orthodontic treatment planning. Two treatment modalities for patients that are unilaterally missing a maxillary lateral incisor that offer definitive functional and esthetic natural-tooth replacements for patients, regardless of age, are orthodontic canine substitution (OCS) and autotransplantation (AT) of a lower incisor. Using validated indices and an electronic questionnaire, the purpose of the study was to assess, objectively and subjectively, whether AT of a lower incisor or unilateral OCS offers patients who present with a unilateral missing maxillary lateral incisor a better esthetic result. An orthodontist, periodontist, restorative dentist, and prosthodontist evaluated intraoral frontal images of 55 patients who were missing a single maxillary lateral incisor and were treated with unilateral OCS (25) or AT of a lower incisor (30) using the Pink and White Esthetic Indices. In addition, the specialists evaluated 30 finished orthodontic cases with no missing teeth as controls. An electronic survey was distributed to orthodontists, general dentists, and laypeople to gauge subjective opinions on the esthetic results of OCS versus AT. Lower incisor autotransplantation and unilateral orthodontic canine substitution had statistically significant lower esthetic scores than cases without missing teeth. The scores of AT and OCS were not significantly different from one another. Electronic survey data showed that dental providers find finished orthodontic cases the most esthetic, followed by lower incisor AT and unilateral OCS. Laypeople find unilateral OCS significantly more esthetic than both control and AT cases. Compared to unilateral OCS, lower incisor AT offers comparable esthetic outcomes and should be considered in cases of unilateral missing maxillary lateral incisors. This study demonstrated that orthodontic space closure and dental autotransplantation can be acceptable treatment solutions for growing patients with a unilateral missing maxillary lateral incisor. Esthetic outcomes in the maxillary anterior region can impact the psychological status of a patient during an important developmental stage.

BACKGROUND &amp; OBJECTIVE: Craniofacial anthropometry involves the measurement of various soft and hard tissue characteristics of the head and face and is considered an important preclinical record for the diagnosis of growth and development and for orthodontic treatment planning. This study aims to determine the means of facial growth parameters and their correlation with somatic growth in a sample of growing children of the Pakistani population. METHODOLOGY: This cross-sectional study was conducted at various schools of Lahore, Pakistan, with an age range of 3-14 years. Data were collected by taking facial measurements using a digital Vernier caliper and a geometric divider to the nearest 1mm. To measure height and weight, a Martin anthropometer and an electronic scale were used. Data were entered and analyzed for description using SPSS version 25. A post-stratification Pearson correlation test was applied to general body growth and facial parameters. RESULTS: Mean upper face height, lower face height, total face height, and face width for the sample were 53.08±5.561 mm, 53.05±5.407 mm, 106.25±9.022 mm, and 118.07±9.281 mm, respectively. Mean weight and height for ages 3–14 years were 31.61±13.1 kg and 133.22±17.3 cm. Facial parameters correlated significantly with height and weight. CONCLUSION: A stronger correlation was seen between facial width and weight in both genders (r = 0.737-0.739), whereas the correlation between height and total facial height was observed only in girls (r = 0.710).

To overcome the reliance on subjective clinical judgment and the inadequacy of international indices in reflecting Chinese orthodontic expertise and patient characteristics, the Chinese Stomatological Association developed an expert consensus on orthodontic treatment outcome evaluation. This first systematically calibrated framework tailored to Chinese populations was established through an extensive process: comprehensive literature review, analysis of the Peer Assessment Rating (PAR) and the American Board of Orthodontics Objective Grading System (ABO-OGS) indices and a large-scale subjective-objective correlation study involving 65 standing committee members evaluating 216 completed cases. The resulting 3D evaluation system encompasses occlusal relationships, root and bone health and facial profile harmony. Occlusal assessment includes six core indicators: incisor horizontal overlap, vertical overlap, sagittal relationship, alignment, occlusal contact and buccal lingual inclination. Root and bone health evaluation mandates CBCT-based assessment of root resorption, fenestration and dehiscence, the first mandatory inclusion of 3D radiographic evaluation in orthodontic outcome standards. Facial profile analysis comprises five cephalometric measurements (ANB, MP/SN, Sn-GPos, UL-E and Bs-GPos) evaluated using a standardised difference method. Each dimension provides detailed specifications for evaluation materials, objective indicators, measurement methods, scoring criteria and a five-grade classification (excellent, good, fair, poor and worst) based on total deduction scores aligned with expert consensus percentiles. This consensus aims to standardise clinical practice, establish a scientific foundation for treatment quality control and specialist certification, provide morphological evaluation criteria for research and enhance orthodontic care quality in China. Despite being focused on static morphology, the framework is designed to accommodate future integration of functional assessment and long-term stability evaluation.

Research into the etiology of maxillary canine impaction (MCI) has focused primarily on the transverse dimensions of the maxilla in the premolar and molar regions. The aim of this study was to evaluate and compare premaxillary width, height, depth, and volume -assessed using cone-beam computed tomography (CBCT)- among individuals with palatal MCI, buccal MCI, and normally erupted maxillary canines. This retrospective study utilized CBCT records of patients with MCI. A total of 45 subjects were divided into three groups of 15 subjects each. Group I (palatal canine impaction), Group II (buccal canine impaction), and Group III (control group of normally erupted canines). Premaxillary width, height, depth, and volume were measured in axial, coronal, and sagittal planes using Horos software. All measurements were performed by a single calibrated examiner. One-way ANOVA with Tukey post-hoc analysis was applied; statistical significance was set at p<0.05. Premaxillary height, depth, and volume were significantly greater in both palatal canine impaction (Group I) and buccal canine impaction (Group II) groups compared to controls (Group III). The increase was greatest in Group I, and this difference among the three groups was statistically significant (p=0.04 for height, 0.0005 for depth, and 0.04 for volume). Premaxillary width did not differ significantly among groups (p=0.38). Post-hoc analysis revealed that premaxillary depth was significantly greater in both palatal and buccal impaction groups than in controls (p=0.021 and 0.002, respectively), while premaxillary volume was significantly greater in the palatal than in the buccal canine impaction group (p=0.03). The findings of this study suggest that three-dimensional premaxillary morphology, as assessed by CBCT -particularly increased depth and volume- may be associated with MCI, with a more pronounced effect in palatal impaction. Premaxillary width did not demonstrate a significant association. These results indicate that localized anterior maxillary skeletal characteristics, rather than transverse maxillary deficiency alone, may influence the eruptive pathway of maxillary canines. These findings represent associations and do not establish causality. Prospective studies with larger sample sizes are warranted to validate these findings and to explore their clinical implications for early orthodontic intervention.

Orthodontic tooth movement (OTM) is a complex process involving periodontal tissue remodeling, and safe strategies to accelerate OTM remain a research focus. DMXAA (Vadimezan), a non-toxic immune-modulating drug with established clinical trial data, stimulates the secretion of pro-inflammatory cytokines potentially relevant to OTM, which involves immune-mediated bone remodeling. A murine OTM model was established in C57BL/6 mice, receiving local subperiosteal injections of DMXAA. Tooth movement distance, bone volume fraction, and osteoclast parameters were quantified via Micro-CT and histology. The mechanism was dissected using RNA-sequencing of bone marrow-derived macrophages (BMDMs), sEV proteomics, and functional osteoclastogenesis assays. Macrophage depletion and Rab13 knockdown models were employed to verify specificity. Local DMXAA administration significantly enhance orthodontic tooth movement and rate in mice under orthodontic force application, accompanied by reduced alveolar bone volume and increased osteoclast numbers on the compressive force side. DMXAA induced macrophage accumulation at the force-applied site, polarizing them toward M1-like pro-inflammatory phenotypes characterized by high secretion of CCL5 and CXCL10. Furthermore, small extracellular vesicles derived from DMXAA-treated macrophages, which were enriched with Rab13 protein, contributed to osteoclast fusion and maturation, thereby accelerating OTM. DMXAA accelerates OTM through a dual mechanism: chemokine-driven osteoclast differentiation and sEV-Rab13-mediated osteoclast fusion. These findings highlight the Rab13-sEV axis as a novel therapeutic target for modulating the periodontal microenvironment and enhancing orthodontic efficiency. Our results elucidated a novel mechanism by which DMXAA accelerated orthodontic tooth movement and suggested it as a potential therapeutic agent to optimize orthodontic treatment.

To address the issues of time-consuming manual tooth alignment, reliance on physician experience, and insufficient structural constraints in automated methods in traditional orthodontic treatment planning, this paper proposes an automated tooth alignment network model that integrates multi-source geometric information learning. First, this study uses tooth mesh data as input to construct a graph convolution-based network for extracting tooth geometric features, fully utilizing the topological connectivity and local geometric features of the tooth model to enhance the extraction of tooth morphological features. Then, an arch line prediction network is designed to guide the teeth to align orderly along the natural arch line by explicitly modeling the tooth alignment trajectory, thereby ensuring the anatomical rationality and aesthetics of the overall structure. Based on this, this study designs collision avoidance loss and arch alignment loss to reduce geometric conflicts between adjacent teeth and constrain the overall posture, making the alignment results more stable and realistic. To verify the effectiveness of the method, validation experiments were conducted on multiple sets of real dental arch data, and comparisons were made with mainstream methods such as tooth alignment network (TaligNet), parameterized spatial transformation network (PSTN), and Transformer-based network for tooth alignment (TANet). The results show that the proposed method improves the evaluation metrics to varying degrees, fully integrates global and local geometric information, improves tooth posture coordination and alignment smoothness, and provides efficient and standardized intelligent support for digital orthodontic treatment planning.

Changes in nasolabial folds following orthodontic treatment with four first bicuspid extraction in young and older adult females: an observational study

BMP9-Smad1/5/9 Signalling Mediates Osteogenic Differentiation and Alveolar Bone Remodelling in hPDLFs.

Predicting Perceived Profile Attractiveness From Cephalometric Measurements Using Machine Learning.

This study aimed to develop and validate a data-driven framework using a radial basis function (RBF) neural network to predict site-specific alveolar bone remodeling during mandibular incisor decompensation in patients with skeletal Class III malocclusion. This retrospective cohort study included 10 patients (39 mandibular incisors). Pre- and post-treatment cone-beam computed tomography scans were registered in three dimensions. A novel geometric framework quantified tooth movement using four parameters: rotation radius, chord length, rotation angle, and vertical displacement. An RBF neural network was trained to model the nonlinear relationship among pre-orthodontic morphology, tooth movement patterns, and post-treatment alveolar bone thickness. Model performance was evaluated using the mean squared error and coefficient of determination (R2). Distinct alveolar bone response patterns were identified. Compression-side resorption approached a biological limit near 0mm. Tension-side apposition exhibited spatially graded efficiency, increasing from approximately 0% at the cervical level to 50-60% at the apical level. The RBF-based predictive model achieved high accuracy (R2 = 0.7-0.9) and effectively captured the nonlinear interplay between movement types and local anatomical constraints. The established framework accurately quantifies and predicts site-specific alveolar bone responses. Bone remodeling is governed by the synergistic interaction between tooth movement patterns and intrinsic anatomical limitations. This framework enables preemptive risk assessment and supports personalized orthodontic treatment planning.

To investigate the prevalence of gingival recession in young adults and its association with orthodontic treatment and retention devices. In this large-scale cross-sectional study, 2,133 young adults aged 18 to 24 years were examined, comparing orthodontically treated individuals with untreated controls, one of the largest cohorts reported in this field. Orthodontic history, retainer presence and quality, and recession presence and location were recorded. Previous orthodontic treatment was associated with a significantly higher prevalence of gingival recession (24.7% vs 2.35% in treated and untreated individuals, respectively; P .001), representing a 10-fold difference. Among orthodontically treated patients, retainer use was associated with a 2-fold higher mandibular recession prevalence compared to those without retainers (19.4% vs 9.2%; P .003). No significant difference in recession prevalence was observed across retention time groups. The majority of recession sites were located in the mandibular anterior region. In this large scale-based sample, orthodontic treatment was associated with a markedly higher prevalence of gingival recession compared to untreated peers, and retainer use was further associated with increased mandibular recession. The clinical relevance is that regular periodontal monitoring during the retention phase is recommended, with particular attention to the mandibular anterior region. These findings highlight the importance of incorporating periodontal risk assessment into orthodontic treatment planning in order to decrease the risk of gingival recession.

The two widely used methods for orthodontic tooth movement with sliding mechanics are elastomeric power chains (EPC) and nickel-titanium closed-coil springs (NCCS). To compare the rate of extraction space closure during canine retraction, degree of root resorption, dental plaque accumulation and gingival health using NCCS versus EPC in subjects undergoing first premolar extractions. Single-centered, prospective, split-mouth randomized controlled trial. For canine retraction, NCCS and EPCs were randomly allocated to the right and left quadrants of both maxillary and mandibular arches in 46 subjects. Canine retraction, root resorption, plaque accumulation and gingival health were recorded at four points in time. Within groups, pairwise comparison and between-group comparisons were done using Wilcoxon signed rank test. Generalized Estimating Equation (GEE) analysis was employed to identify the factors significantly influencing the rate of extraction space closure during canine retraction and the extent of root resorption. The study investigators, patients recruited, and assessors were not blinded during the trial due to the visible nature of the orthodontic appliances used. NCCS exhibited faster rates in total canine retraction and during the T0-T1 (p = 0.039) and T2-T3 (p = 0.003) intervals. Root resorption exhibited non-significant differences. Whereas, NCCS demonstrated higher plaque retention at T1 (p = 0.013), T2 (p = 0.016) and T3 (p = 0.033). GI differed significantly between groups, with higher values with NCCS at T1 (p = 0.046) and EPC at T2 (p = 0.039). Extraction space closure rate displayed a significant difference between the T1-T2 and T2-T3 stages with NCCS (p = 0.025). GEE showed a significant positive association of age with root resorption (β = 0.939, CI = 0.312, 1.565, p = 0.003). NCCS demonstrated a significantly higher rate of extraction space closure and plaque accumulation compared to EPC. However, no statistically significant differences were observed between the two groups with respect to root resorption and gingival health. Furthermore, the degree of root resorption was found to increase significantly with the advancing age. Registered at clinicaltrials.gov under the identifier NCT06567730 on 23rd August 2024.

Orthodontic treatment is often sought for aesthetic and psychosocial reasons, while the functional consequences of dental malocclusions remain less frequently integrated into clinical decision-making. To evaluate how the presence, type, and combinations of dental malocclusions affect masticatory performance using Indicator of Anatomical Malocclusion (IAM) with objective physiological measures of mastication. Masticatory performance was assessed using a two-colour chewing gum mixing test (20 chewing cycles; Hue-Check Gum), with colour homogeneity quantified as percentage mixing index (Mix%). Deficient performance was defined as Mix% < 85.44%. Malocclusion was characterized using Angle's classification, number of functional dental units, and IAM assessing craniofacial anomalies, dental number anomalies, crowding, anteroposterior, transverse, and vertical discrepancies. Associations between malocclusion and masticatory performance were explored using univariate followed by logistic regression analyses. The study included 345 patients (age 14.6 ± 6.9 years) seeking orthodontic consultation. 57.1% of participants exhibited deficient masticatory performance. Independent predictors of deficient mastication included IAM items related to dental number anomalies (OR = 2.59; 95% CI: 1.16-5.75), transverse discrepancies (OR = 1.91; 95% CI: 1.03-3.53), age (OR = 0.92; 95% CI: 0.88-0.96), and Angle Class II/III (OR = 1.65; 95% CI: 1.02-2.66). Subgroup analyses showed that transverse discrepancies increased deficiency in Class I malocclusion, while Class III participants exhibited high prevalence regardless of anomalies. The combination of transverse discrepancy and infraocclusion was associated with the highest prevalence of deficiency (75%). Using objective masticatory assessment, masticatory performance is associated with dental malocclusions characteristics, and the coexistence of specific traits as captured by the IAM. These findings support the integration of functional evaluation into orthodontic diagnosis. Interventional studies are needed to determine whether orthodontic treatment improves masticatory performance.