Orthodontic Treatment Outcome Research Articles

Innovative and simple technique of stabilizing the lingual retainer wire before bonding

Long-term stability of orthodontic treatment outcome is attained through retention. Fabrication and bonding of the lingually bonded retainer on the lingual tooth surface are a technique-sensitive and time-consuming procedure. Stabilizing the lingual retainer wire on the tooth surface throughout the bonding procedure is a challenging task for the operator. This article introduces a new simplified technique of stabilizing the lingual retainer wire before bonding.

Postural balance in the comprehensive rehabilitation of adolescents with cleft lip and palate and maxillofacial anomalies: A literature review

BACKGROUND: Patients with cleft lip and palate experience significant jaw relationship disorders and pathological bite formation, leading to changes in the motor activity of chewing muscles and postural balance disturbances. Most studies on postural control are conducted on patients with skeletal dentofacial anomalies and deformities without cleft lip and palate. The state of postural balance in children with cleft lip and palate requiring long-term complex medical rehabilitation, including bone-reconstructive operations on the jaw bones, remains poorly understood.
 AIM: To analyze publications dedicated to the evaluation of postural balance in adolescents with cleft lip and palate combined with jaw relationship disorders and pathological bite formation.
 MATERIALS AND METHODS: The article includes an analysis and review of several studies that investigated the state of postural balance in adolescents with cleft lip and palate, particularly at the final stages of growth and formation of the musculoskeletal system. Scientific articles published in various medical journals, monographs, dissertations, and materials from scientific symposiums related to this topic were used in the literature review. PubMed, Medline, Scopus, Web of Science, and RSCI were searched without language restrictions. The search depth was 23 years, and 64 studies were selected.
 RESULTS: The article analyzes literature data related to theories of the mechanism of mutual influence between postural balance and the dentofacial apparatus (disorders and pathological bite formation). The state of postural balance is influenced by various factors, including the craniosacral system and anomalies of the cervical spine. Patients with cleft lip and palate, hemifacial microsomia, and other craniofacial dysostoses with growth disorders of jaw bones experience an imbalance in the entire “descending” chain, causing postural disturbances, increased plantar pressure, increased foot rigidity, and changes in photogrammetry indicators, which should be considered when developing an individual rehabilitation program for these patients. The treatment of these patients without considering postural balance disorders can lead to temporomandibular joint pathologies, unstable results of the conservative orthodontic treatment of bite pathologies, and bone-reconstructive operations on jaws.
 CONCLUSIONS: The study highlights the ways of adaptation of the musculoskeletal system in the presence of occlusal relationship disorders and emphasizes the need to evaluate this influence comprehensively for the treatment of these patients. The limitations of the presented studies should be emphasized: insufficient sample size, lack of control groups and prospective studies, limited types of examination, and lack of studies dedicated to more severe anomalies of craniofacial development.

Applying artificial intelligence to predict the outcome of orthodontic treatment

Objectives: The study aimed to train an algorithm to predict facial and dental outcomes following orthodontic treatment using artificial intelligence (AI). In addition, the accuracy of the algorithm was evaluated by four distinct groups of evaluators. Material and Methods: The algorithm was trained using pre-treatment and post-treatment frontal smiling and intraoral photographs of 50 bimaxillary patients who underwent all first bicuspid extraction and orthodontic treatment with fixed appliances. A questionnaire was created through Google form and it included 10 actual post-treatment and AI-predicted post-treatment images. The accuracy and acceptability of the AI-predicted outcomes were analyzed by four groups of 140 evaluators (35 orthodontists, 35 oral maxillofacial surgeons, 35 other specialty dentists, and 35 laypersons). Results: The Style-based Generative Adversarial Network-2 algorithm used in this study proved effective in predicting post-treatment outcomes using pre-treatment frontal facial photographs of bimaxillary patients who underwent extraction of all first bicuspids as part of their treatment regimen. The responses from the four different groups of evaluators varied. Laypersons exhibited greater acceptance of the AI-predicted images, whereas oral maxillofacial surgeons showed the least agreement. The base of the nose and the chin demonstrated the most accurate predictions, while gingival visibility and the upper lip-to-teeth relationship exhibited the least prediction accuracy. Conclusion: The outcomes underscore the potential of the method, with a majority of evaluators finding predictions made by the AI algorithm to be generally reliable. Nonetheless, further research is warranted to address constraints such as image tonicity and the proportional accuracy of the predicted images.

Digital setup accuracy for moderate crowding correction with fixed orthodontic appliances: a prospective study

ObjectivesTo evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances.Subjects and MethodsTwenty-five adult patients (18 to 24 years old) with class I malocclusion and moderate crowding were prospectively enrolled and received treatment on both jaws through the straight-wire technique. Prior to treatment commencement, a semi-automatic digital setup simulating the predicted treatment outcome was performed for each patient through Orthoanalyzer software (3Shape®, Copenhagen, Denmark) to obtain the prediction model. This was compared to the final outcome model through 3D superimposition methods. Metric variables and inspection of color-coded distance maps were used to detect how accurately the digital setup predicts the actual treatment outcome.ResultsThe mean absolute distances (MAD) between the superimposed dental arches of the predicted and the final models were: 0.77 ± 0.13 mm following superimposition on the palate, 0.52 ± 0.06 mm following superimposition on the maxillary dental arch, and 0.55 ± 0.15 mm following superimposition on the mandibular dental arch. The MAD at the palatal reference area was 0.09 ± 0.04 mm. Visualization of color-coded distance maps indicated that the digital setup accurately predicted the final teeth position in a few cases. Almost half of the cases had posteriorly wider upper and lower dental arches and palatally/lingually positioned or inclined anterior teeth, whereas the rest still showed errors within 2–3 mm, distributed over the entire dental arches with no distinct pattern.ConclusionsThe accuracy of semi-automatic prediction of the labial fixed appliance treatment outcome in Class I cases with moderate crowding is not yet sufficient. While average measures showed deviations less than 1 mm, examination of individual color-coded distance maps revealed significant disparities between the simulated and the actual results.

Can esthetically pleasing aligners change the root morphologies? – A narrative review

Background: The occurrence of root resorption (RR) is an unavoidable result of orthodontic treatment. Finding a straightforward approach to its prevention remains a challenge. It is a tragic occurrence when radiographically detected, even though it is rarely severe. The application of force starts a sequence of biological mechanisms. Although we are well aware of how and when it is provoked, we are unable to foresee what will happen in the end. In the past few years, clear aligner therapy has become very popular. Although not much data has been established describing RR after this treatment. Aim: The following review determines the effect of aligner therapy on the resorption of roots leading to the shortening of root length. Methods: Research publications were searched on search engines such as Scopus, PubMed, and Google Scholar using terms such as “RR,” “risk factors of RR” and “effects of clear aligner therapy on RR.” These publications were then collected. Results: For this review, 30 articles were collected and further used to formulate this review. Conclusion: (1) Most affected teeth were the maxillary central and lateral incisors post aligner therapy. (2) Multiple factors that influenced RR were gender, malocclusion, the severity of crowding, type of tooth movement, and close approximation of root toward the cortical plate (3) Clear aligner therapy is comparable to LightForce fixed orthodontics appliances but surpasses heavy-force orthodontic appliances in the terms of the risk associated with developing RR.

ORTHODONTIC EXTRUSION TECHNIQUE AS A METHOD FOR ALVEOLAR BONE VOLUME INCREASE BEFORE DENTAL IMPLANTATION. CLINICAL CASE

Objectives: Tooth extraction and replacement with dental implant represents a common treatment choice, when teeth are hopeless. We presented a clinical case, the treatment of which was carried out by the method of orthodontic extrusion technique. This technique can increase alveolar bone level and also soft tissue level. The increased amount of alveolar bone can improve primary implant stability and be compared with bone regeneration techniques. The purpose of presenting this clinical case is to emphasize the efficiency of orthodontic extrusion. Methods and materials: A 45-year-old female patient referred by the general dentist regarding cosmetic defect and tooth mobility in the area of the anterior upper teeth. During the examination, her upper right central incisor was found to be mobile, with diastema and slight congestion in the anterior teeth Photographs, CT and X-ray studies of the patient were used. The patient was bonded with .018 slot Roth prescription ceramic brackets (Dentaurum, Germany). After achieving the optimal results of orthodontic treatment and the necessary extrusion of the upper right central incisor, the tooth was removed and replaced with a dental implant. After six months, the patient had a crown with a screw fixation of zirconium dioxide with ceramic application Results: As a result of orthodontic extrusion, clinically significant increase in alveolar bone and gingival tissue was reported. This resulted significant qualitative and quantitative improvements in the implant site. As the clinical case was in aesthetic zone, we could also rehabilitate beautiful smile of patient and increase her self-esteem. Conclusions: Summing up the above and the results of the treatment of this patient, we can definitely say that orthodontic extrusion technique is effective for implant site development. As we have described, this can effectively move the facial gingival margin and allow for esthetic restoration of implant placed in the extruded tooth position without any bone graft.

Torque control of anterior teeth by clear aligners

Appropriate torque control of anterior teeth is of great significance to obtain ideal orthodontic treatment outcome. Clear aligners are less effective in torque control of anterior teeth due to their special application mode and material properties. Therefore, it is important to investigate how to improve the torque control of anterior teeth by using clear aligners, with the expectation of providing guidance for clinicians. This article discussed the methods to control the torque of anterior teeth by using traditional fixed appliances, the efficiency of clear aligner in controlling the torque of anterior teeth, the difficult points of clear aligner in controlling the torque of anterior teeth and the therapeutic methods to better control the torque of anterior teeth by using clear aligners.

Use of an intraoral scanner to evaluate orthodontic treatment for dental malocclusion in a dog.

In human dental practice, intraoral scanners (IOSs) are increasingly used to evaluate the oral cavity. However, there have been no reports concerning evaluation of the canine oral cavity using IOSs in veterinary dentistry. In this case, optical impressions obtained with an IOS were used for 3-D evaluation of the orthodontic treatment outcome. Additionally, few reports have addressed the optimal orthodontic force for canine teeth. Therefore, this case explored whether sufficient tooth movement into the extraction site could be achieved with a lighter orthodontic force than previously reported. An 8-month-old spayed female dog. A retained right maxillary third deciduous incisor (503) caused distoversion of the right maxillary third permanent incisor (103), leading to dental malocclusion that involved contact between 103 and the right mandibular canine teeth. All retained deciduous teeth were extracted. Mesial tipping movement of 103 into the extraction site of 503 was achieved with light orthodontic force using an elastomeric chain. An IOS was used to construct 3-D optical impression data from oral stone models taken before and after treatment, and tooth movement was evaluated. The results showed that 103 had sufficient tipping movement and no anchorage loss; comfortable occlusion was achieved. In addition to crown length extension, labioversion and mesioversion of maxillary incisors (other than 103) were observed. Detailed intraoral evaluation with optical impressions was beneficial in the orthodontic treatment of a dog. Light orthodontic force may be sufficient for movement into the extraction site.

The second molar dilemma in orthodontics: to bond or not to bond?

To compare orthodontic treatment (OT) outcome in adolescents undergoing nonextraction fixed OT with or without bonding of second molars using the score of the American Board of Orthodontics Cast Radiograph Evaluation (C-R-Eval). This study included healthy adolescents with skeletal Class I or mild Class II/Class III malocclusion, normal or deep overbite (OB), and mild-to-moderate dental crowding (<5 mm) who underwent nonextraction fixed OT with ("bonded" group) or without ("not-bonded" group) bonding of second molars. Patient treatment records, pre- and posttreatment digital models, lateral cephalograms, and orthopantomograms were assessed. The evaluated outcomes included leveling of the curve of Spee (COS), OB, control of incisor mandibular plane angle (IMPA), number of emergency visits (related to poking wires and/or bracket failure of the terminal molar tubes), treatment duration, and C-R-Eval. Treatment variables were compared across time points and among groups. The sample included 30 patients (mean age 16.07 ± 1.80 years) in the bonded group and 32 patients (mean age 15.69 ± 1.86 years) in the not-bonded group. The mean overall C-R-Eval score was significantly higher (P < .001) in the not-bonded group (25.25 ± 3.98) than in the bonded group (17.70 ± 2.97). There were no significant differences in mean changes of COS, OB, IMPA, or treatment duration among groups. The mean number of emergency visits was significantly higher in the bonded (3.3 ± 0.6) than the not-bonded group (1.9 ± 0.4) (P < .001). Bonding of second molars enhances the outcome of nonextraction fixed OT as demonstrated by the C-R-Eval without increasing treatment duration, irrespective of more emergency visits.

Orthodontic finishing errors detected in board-approved cases: common types and prediction.

To report and rank orthodontic finishing errors recorded in the clinical phase of the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) examination and correlate pretreatment case complexity with orthodontic treatment outcomes. This single-center cross-sectional survey collected retrospective data from the clinical phase of BBO examinations between 2016 and 2023. The quality of orthodontic clinical outcomes of each case was assessed by means of the Cast-Radiograph Evaluation (CRE), while case complexity was evaluated using the Discrepancy Index (DI), both tools provided by the American Board of Orthodontics. Survey items were analyzed using descriptive statistics, and a correlation analysis between total CRE and DI scores (p<0.05) was also performed. A total of 447 orthodontic records was included. Orthodontic finishing errors were often observed, and no case was completely perfect. In the total CRE score, an average of 15 points was discounted for each case. Most frequently found issues involved problems with alignment, buccolingual inclination, marginal ridge, and occlusal relationship. The median DI score for initial case complexity was 22.0 (range 10.0 - 67.0). There was no significant correlation between the DI and CRE scores (p=0.106). Orthodontic finishing errors are inevitable, even in well-finished board-approved cases. Rotation, excessive buccolingual inclination, and discrepancies in marginal ridges are the most frequently observed areas of concern, in that order. Moreover, while case complexity, determined by DI, can impact orthodontic planning and pose challenges for clinicians, the study did not consider it a determining factor in predicting treatment outcomes.

Low translational and rotational movements with 2-point stainless-steel retainers over aperiod of 1and 3years.

Long-term stabilization of orthodontic treatment outcomes is an everyday challenge in orthodontics. The use of permanently attached lingual retainers has become gold standard. However, in some cases, patients with fixed lingual retainers show retainer-associated side effects. Aiming to reduce these side effects, clinical knowledge about how tooth and arch form stability adaption takes place over time is important to improve long-term retention protocols. Therefore, the present study aimed to investigate occlusion stability and risks for anewly developing malocclusion in atime-dependent manner in patients being treated with permanent 2‑point steel retainers. In this retrospective cohort study, atotal of 66consecutive patients with round stainless-steel retainers were analyzed for postorthodontic occlusion changes after 1year (group1, n = 33) and 3years (group2, n = 33). Digital Standard Tessellation Language (STL) datasets of the lower jaw were obtained before retainer insertion (T0), and after a1-(T1) or 3‑year (T2) retention period. Using superimposition software, T1and T2 situations were compared to T0 regarding rotational and translational changes in tooth positions in all three dimensions. Occlusion changes were low in both groups. The investigated lower canines were nearly stable in the 1‑ and 3‑year group, although aretention-time-dependent increase in tooth position change of the central and lateral incisors could be observed. The present data provide evidence for time-dependent development of posttherapeutic occlusal adaption limited to central and lateral incisors in patients treated with a2-point retainer. The observed occlusal changes should be interpreted as an occlusal adaption process rather than severe posttreatment changes associated with the orthodontic retainer.

SPACE SEARCH FOR MINOR CROWDING CASES WITH EXPANSION PLATE IN PATIENTS WITH A HISTORY OF ANTIDEPRESSANT DRUG CONSUMPTION

Introduction: Gaining space in malocclusion cases using expansion plate removable orthodontic appliances. Depression is a mental health disorder that is treated with antidepressants. There is a correlation between a history of long-term antidepressant medication use and orthodontic treatment. Case: A 21-year-old female patient with a history of antidepressant medication complained of slightly advanced maxillary front teeth and crowded mandibular front teeth. Clinical examination revealed the first permanent molar relation Angle Class I modified Dewey type 2 malocclusion with malposition of individual teeth. Arch discrepancy analysis showed a space deficiency of 4 mm in the maxilla and 2.85 mm in the mandible. Case Management: The first stage used a removable orthodontic appliance for maxillary and mandibular expansion plates to obtain space deficiency. The expansion results showed that the maxillary dental arch was successfully expanded by 4.52 mm and the mandibular by 4 mm. Discussion: The slow-type expansion plate functions to expand the dental arch. Conclusion and Suggestion: Expansion plate removable orthodontic treatment effectively gains space in patients with a history of antidepressant drug use. Patients' cooperativeness in wearing the appliance influences the expansion plate removable orthodontic appliance treatment result.

ENHANCING ORTHODONTIC TREATMENT FOR PATIENTS WITH SWALLOWING AND SPEECH DISORDERS

Introduction. At the modern level, disorders of the functions of the tongue are considered by scientists in close relationship with the condition of the cranio-mandibular structures, posturological changes and various general somatic disorders of the human body.&#x0D; The purpose of this study was to improve the effectiveness of orthodontic treatment outcomes for patients with disorders of tongue functions based on data obtained from the systematic review of revelant literature and own clinical experience.&#x0D; Materials and Methods. The research involved an analysis of contemporary national and international literature spanning from 2000 to the present. Additionally, the study summarized the clinical experience gained from examining and treating 1024 patients with swallowing and speech disorders over the past 8 years.&#x0D; Results. The "Algorithm for investigating the state and position of the tongue during swallowing and speech functions" has been formulated. This algorithm encompasses stages of clinical and paraclinical analysis, evaluating factors such as the tongue position, the condition of supra- and sublingual spaces, pharyngeal airways, hyoid bone position, as well as using techniques such as photopalatography, electropalatography, and electromyography. The corrective method we offer for addressing improper tongue positioning during swallowing and speech involves enhancing the patient's overall somatic condition through recommendations for a healthy diet, an active lifestyle, and specific myogymnastics. It further focuses on normalizing the myodynamic balance between the external and internal muscle circles of the dento-jaw area. Controlled myogymnastics for the tongue is facilitated using a specially designed device.&#x0D; Conclusion. The developed algorithm for studying the condition and position of the tongue during swallowing and speech functions, along with the proposed corrective method, promises to enhance the effectiveness of diagnosing malocclusion associated with or caused by tongue function disorders. This approach contributes to the objectification of results in orthodontic treatment.

Factors influencing treatment outcomes assessed by the American Board of Orthodontics Objective Grading System (ABO-OGS)

BackgroundTreatment outcomes can be influenced by various factors. This study aimed to determine the association between predisposing patient- and treatment-related factors (demographic, cephalometric parameters, skeletal relationships, Discrepancy Index (DI), extractions, treatment type and duration) and treatment outcomes measures according to the American Board of Orthodontics Objective Grading System index (ABO-OGS).MethodsCompleted cases (N = 100) were included in this cross-sectional study. One calibrated examiner assessed DI, pretreatment lateral cephalometric parameters and ABO-OGS. Patient data, including sex, age, types of malocclusion, extractions, treatment type, and duration, were also collected. Intraexaminer reliability for each measurement was evaluated using the intraclass correlation coefficients. Multiple linear regression analysis, using the backward elimination method with a significance level (α) of 0.05, was used to determine which factors significantly influenced the ABO-OGS score.ResultsFrom the study, the overall mean ABO-OGS score was 11.36 points. Factors influencing the ABO-OGS score were pretreatment Wits values (p value = .000), L1-NB (°) (p value = .023) and treatment duration (p value = .019). Subjects with lower negative values of Wits and L1-NB (°) tended to have higher ABO-OGS scores. Additionally, the ABO-OGS score tended to be higher for subjects with longer treatment times.ConclusionsThe majority of treated subjects had satisfactory orthodontic treatment outcomes assessed by the ABO-OGS. The pretreatment severity of skeletal discrepancies determined by the Wits parameter, the degree of retroclined lower incisors and longer treatment duration negatively impacted the treatment outcomes.

Automated artificial intelligence-based three-dimensional comparison of orthodontic treatment outcomes with and without piezocision surgery.

This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)-automated tools. Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI-automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial-distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared. The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth. The open source-automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.

Predicting early orthodontic treatment results and development of the dentofacial system without orthodontic treatment in 3-12-year-old children

Relevance. Prognosis of the dentofacial system (DS) development in children with dentofacial deformities (DD) is an urgent medical and social problem since the prognosis of the DS development will allow timely prescription and provision of adequate therapy, which will significantly reduce the risks of severe DD development in children. Machine learning methods have proven to be a reliable tool for predicting a patient's health status and evaluating the effectiveness of treatment methods. Therefore, it seems interesting to use this modern toolkit to build predictive models that allow us to assess the change in the condition of DS in children with DD after orthodontic treatment (OT) at different ages or without OT.Purpose. The study aimed to build a set of predictive models for assessing the severity of the dentofacial system condition in 3.5-4-year-old children after and without orthodontic treatment.Material and methods. The study used the data on the DS of children aged 3-5 years (n=50), 6-9 years (n=100), 10-12 years (n=100) and 13-17 years (n =100). The author's program was developed in Python 3.11 using the sklearn, pandas, and xgb libraries in Anaconda to build the predictive models.Results. We developed nine models of the DS condition in children aged 3-12 years, three of which make predictions for the DS development after the OT (one - in the group of 3 – 5-year-old children, the second – in the group of 6 – 9-year-old children and the third – in the group of 10 – 12-year-olds) and six models predict the development of the DS without OT. Three out of 6 models predict DS development without OT at 3-5 years: the first makes a prediction of the DS condition for 6-9 year-olds; the second – for 10-12 year-olds; the third – for 13-17-year-olds. The accuracy of the models ranges from 82 to 86%. Two models out of 6 predict the DS development for children with DD who did not receive OT at 6-9 years old: one – at 10-12 years old, the second – at 13-17 years old. The accuracy of the models ranges from 92 to 97%. The sixth model makes predictions of the DS condition in children aged 13-17 years who did not receive OT at the age of 10-12 years. The accuracy of the model is 94%. In addition, we built three models that predict the DS condition in 3.5-4 years after the OT: the first model predicts for 3–5-year-old children; the second – for 6–9-year-olds; and the third - for children of 10–12 years old. The accuracy of the models ranges from 82 to 90%.Conclusion. All obtained models will be used to build a web application for predicting the DS state severity in children after the orthodontic treatment and without the latter.

A study on the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction

Objective: To investigate the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction. Methods: From January 2012 to December 2021, forty treated orthodontic patients with anterior disc displacement without reduction (unilateral/bilateral) and no obvious articular cartilage absorption were selected from Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were (17.5±3.8) years old (12-25 years old), including 8 males and 32 females. Twenty patients who had completed arthroscopic temporomandibular joint disc reduction were included in the control group, and twenty patients with untreated temporomandibular joint disc were included in the experimental group. Model measurement (including overjet, etc.), cephalometric analysis (including ANB angle, which was formed by subspinale, nasion and supramental, etc.) and temporomandibular joint magnetic resonance imaging (including measurement of the condyle height of the displacement sides) were used to compare the difference of two groups. Objective grading system was used to evaluate the efficacy of orthodontic treatment. Results: The overjet of the experimental group and the control group after orthodontic treatment was (2.19±0.76) and (1.92±0.94) mm, respectively. Both two groups achieved ideal overjet with no statistical difference (t=1.02, P=0.314). The ANB angle difference before and after treatment in the control group (-1.97°±2.87°) was greater than that in the experimental group (0.09°±1.82°), and the difference was statistically significant (t=2.72, P=0.010). The variation of condyle height before and after treatment was (0.30±1.11) mm in the experimental group and (0.82±1.25) mm in the control group, with no statistical significance (t=1.80, P=0.076). The post-treatment objective grading system scores of the experimental group and the control group were 21.00 (16.00, 24.00) and 21.00 (17.00, 25.00), respectively, which had no statistical difference (U=0.24, P=0.808). Conclusions: In orthodontic patients with anterior disc displacement without reduction and no obvious articular cartilage absorption, whether displaced discs are repositioned after arthroscopic surgery has no significant effect on the orthodontic treatment outcome.

Multinational study on profile preference of laypersons.

This study aimed to assess the facial profile preferences of lay people in seven locations from different countries and whether their place of residence, sex, age, race, education, or income influenced the decision. After altering the lip and nose in 1 mm increments in the sagittal and sagittal/vertical directions, 50 profile silhouettes with white-like facial features were rated by evaluators. The soft tissue values were integrated into the profiles, and profile preferences were identified for each location. An ANOVA with post hoc Tukey test was used to compare the differences in mean preference in each location. A multivariable regression model was used to assess the effect of the demographics of the evaluator on preference. Thirteen profiles were ultimately analyzed. The mean for profile preference was significantly different across locations (P< 0.0001). For evaluators in the United States and Lebanon, the most preferred profile had the original lip and original nose. In Switzerland and South Africa, retrusive lips, and a small and less upturned nose was most preferred. In Japan and Saudi Arabia, the most preferred profile had the original lip and a protrusive nose that was less upturned. A protrusive lip with a small, upturned nose was preferred in Turkey. Profile change (P< 0.0001), location (P< 0.0001), sex (P< 0.0001), and race (P=0.02) were significant confounders; in contrast, age, education, and income were not significant. Profile preference is different among the seven locations. For the most part, lay people prefer profiles within one SD from white norms. Also, an upturned nose is the least favored in most of the locations. Sex and race are also significant confounders. An orthodontic treatment plan decision is affected by an individual's preference for their facial appearance. This study helps clinicians understand how racial and regional differences may affect patients' preferences and, therefore, their expectations for orthodontic treatment results.

Sella Turcica Bridging and its Association with Dental Anomalies - An Update

: The Sella turcica is an anatomical structure shaped explicitly like a saddle, located within the middle cranial fossa on the intracranial surface of the sphenoid bone. This structure is commonly observed on lateral cephalograms, frequently employed for orthodontic diagnosis. The Cephalometric radiographs utilize various landmarks as reference points to examine craniofacial structures and Sella Turcica (ST) is the most significant and reliable cranial landmark. The Sella point, located at the midpoint of the ST structure, is a cranial base point that accommodates the pituitary gland. The cephalometric analysis relies on this factor to identify pituitary gland-related pathologies, making it a valuable source of information for craniofacial syndromes. Facial structure development exhibits comparable characteristics to the Sella turcica. Glandular abnormalities possess the potential to be linked to functional disorders, which can result in altered hormonal levels affecting dental growth. Comprehensive understanding of the radiological anatomy and variations help assess growth and identify changes in various anomalies or pathological conditions. Additionally, it can assist in predicting the potential outcome of orthodontic treatment. The objective of this review is to determine and update whether a correlation exists between the bridging of Sella turcica and various dental anomalies related to the shape, size, structure, number, and eruption of teeth. In conclusion, it was noted that Sella turcica bridging is frequently observed in orthodontic patients measuring a clear correlation between dental anomalies and Sella bridging. Key words: Sella Turcica Bridging; Dental Anomalies; Genetics; Lateral Cephalogram; Orthodontist.

Adult patient expectations and satisfaction: Can they be influenced by viewing the three-dimensional predicted outcome before fixed orthodontic treatment of dental crowding?

Investigating the possible changes in patients' expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment. A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup-created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)-of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients' satisfaction with the achieved changes was completed (T2). Patients' expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing (x¯=5.54 and x¯= 6.71), speech (x‾ =5.93 and x¯= 6.93), and oral hygiene improvement (x‾= 7.93 and x¯=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance (x¯= 9.12 and x¯= 9.60 at T1 and T2, respectively), and teeth engagement (x¯= 8.92 and x¯= 9.40 at T1 and T2, respectively) CONCLUSIONS: Watching the predicted alignment outcome increased patients' expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after viewing the predicted plan. However, these results were not clinically significant.