Artificial intelligence as a prediction tool for orthognathic surgery assessment.

INTRODUCTION: An ideal orthodontic treatment involves qualitative and quantitative measurements of dental and skeletal components to evaluate patients' discrepancies, such as facial, occlusal, and functional characteristics. Deciding between orthodontics and orthognathic surgery remains challenging, especially in borderline patients. Advances in technology are aiding clinical decisions in orthodontics. The increasing availability of data and the era of big data enable the use of artificial intelligence to guide clinicians' diagnoses. This study aims to test the capacity of different machine learning (ML) models to predict whether orthognathic surgery or orthodontics treatment is required, using soft and hard tissue cephalometric values. METHODS: A total of 920 lateral radiographs from patients previously treated with either conventional orthodontics or in combination with orthognathic surgery were used, comprising n = 558 Class II and n = 362 Class III patients, respectively. Thirty-two measures were obtained from each cephalogram at the initial appointment. The subjects were randomly divided into training (n = 552), validation (n = 183), and test (n = 185) datasets, both as an entire sample and divided into Class II and Class III sub-groups. The extracted data were evaluated using 10 machine learning models and by a four-expert panel consisting of orthodontists (n = 2) and surgeons (n = 2). RESULTS: The combined prediction of 10 models showed top-ranked performance in the testing dataset for accuracy, F1-score, and AUC (entire sample: 0.707, 0.706, 0.791; Class II: 0.759, 0.758, 0.824; Class III: 0.822, 0.807, 0.89). CONCLUSIONS: The proposed combined 10 ML approach model accurately predicted the need for orthognathic surgery, showing better performance in Class III patients.

Utilização da ancoragem esquelética na distalização de molares superiores / Use of skeletal anchorage in distal movement of maxillary molars

A correção da má oclusão de classe II constitui um procedimento comum na prática ortodôntica. Um dos métodos para sua correção compreende a distalização de dentes posteriores superiores. Com esse fim, diversos tipos de aparelhos podem ser empregados, inclusive a ancoragem esquelética com os dispositivos de ancoragem temporária (DAT). O objetivo do presente artigo foi abordar a utilização desses dispositivos na região do tuber da maxila com finalidade de distalização dos dentes posteriores superiores. Concluiu-se que o emprego dos dispositivos temporários de ancoragem foi eletivo para a distalização dos molares e manutenção da ancoragem durante a mecânica subsequente.