Exosome-based engineering strategies for the diagnosis and treatment of oral and maxillofacial diseases.

Oral and maxillofacial diseases are one of the most prevalent diseases in the world, which not only seriously affect the health of patients' oral and maxillofacial tissues, but also bring serious economic and psychological burdens to patients. Therefore, oral and maxillofacial diseases require effective treatment. Traditional treatments have limited effects. In recent years, nature exosomes have attracted increasing attention due to their ability to diagnose and treat diseases. However, the application of nature exosomes is limited due to low yield, high impurities, lack of targeting, and high cost. Engineered exosomes can be endowed with better comprehensive therapeutic properties by modifying exosomes of parent cells or directly modifying exosomes, and biomaterial loading exosomes. Compared with natural exosomes, these engineered exosomes can achieve more effective diagnosis and treatment of oral and maxillary system diseases, and provide reference and guidance for clinical application. This paper reviews the engineering modification methods of exosomes and the application of engineered exosomes in oral and maxillofacial diseases and looks forward to future research directions.

Maxillary molar distalization treated with clear aligners combined with mini-implants and angel button using different traction force: a finite element study.

OBJECTIVES: To evaluate the biomechanical system of molar distalization with clear aligner therapy (CAT) combined with angel button using interradicular mini-implants (IRMIs) with varying elastic forces. MATERIALS AND METHODS: FE models including maxilla, complete maxillary dentition, periodontal ligaments (PDL), composite attachments, mini-implants (MI), and dedicated orthodontic aligner, were constructed. Three groups were created in accordance with the sagittal position of MI. Elastic forces (0 N,1 N,1.5 N,2 N) were applied. RESULTS: CAT without elastics caused labial tipping and intrusion of the anterior teeth. Initial labial tipping and the von Mises stress of the maxillary anterior teeth decreased as the elastic forces increased.

Recent advances in glass-ceramics: Performance and toughening mechanisms in restorative dentistry.

The use of glass-ceramics in the medical field has grown significantly since the 1980s. With excellent aesthetic properties, semi-translucency, outstanding mechanical properties, corrosion resistance, wear resistance and great biocompatibility and workability glass-ceramics is one of the most commonly used materials in restorative dentistry and is widely used in veneers, inlays, onlays, all-ceramic crowns, and implant abutments. This review provides an overview of the research progress of glass-ceramics in restorative dentistry, focusing on the classification, performance requirements, toughening mechanisms and their association with clinical performance, as well as the manufacturing and fabrication of glass-ceramics in restorative dentistry. Finally, the developments and prospects of glass-ceramics in restorative dentistry are summarized and discussed.

The Effect of Antibacterial-Osteogenic Surface Modification on the Osseointegration of Titanium Implants: A Static and Dynamic Strategy.

Titanium (Ti) and its alloys are widely used biomaterials in bone repair. Although these biomaterials possess stable properties and good biocompatibility, the high elastic modulus and low surface activity of Ti implants have often been associated with infection, inflammation, and poor osteogenesis. Therefore, there is an urgent need to modify the surface of Ti implants, where changes in surface morphology or coatings loading can confer specific functions to help them adapt to the osseointegration formation phase and resist bacterial infection. This can further ensure a healthy microenvironment for bone regeneration as well as the promotion of immunomodulation, angiogenesis, and osteogenesis. Therefore, in this review, we evaluated various functional Ti implants after surface modification, both in terms of static modifications and dynamic response strategies, mainly focusing on the synergistic effects of antimicrobial activities and functionalized osteogenic. Finally, the current challenges and future perspectives are summarized to provide innovative and effective solutions for osseointegration and bone defect repair.

Biosafety and chemical solubility studies of multiscale crystal-reinforced lithium disilicate glass-ceramics.

Lithium disilicate (Li2 Si2 O5 ) glass-ceramics are currently a more widely used all-ceramic restorative material due to their good mechanical properties and excellent aesthetic properties. However, they have a series of problems such as high brittleness and low fracture toughness, which has become the main bottleneck restricting its development. Therefore, in order to compensate for these shortcomings, we propose to prepare a reinforced glass-ceramics with better mechanical properties and to test the biosafety and chemical solubility of the material. Li2 Si2 O5 whiskers were synthesized by a one-step hydrothermal method, and multi-scale crystal-enhanced Li2 Si2 O5 glass-ceramics were prepared by reaction sintering. The biosafety of multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics was investigated by in vitro cytotoxicity test, rabbit pyrogen test, mice bone marrow micronucleus test, skin sensitization test, sub-chronic systemic toxicity test, and chronic systemic toxicity test. Additionally, the chemical solubility of multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics was investigated. The test results showed that the material was non-cytotoxic, non-thermogenic, non-mutagenic, non-sensitizing, and non-systemic. The chemical solubility, determined to be 377 ± 245 µg/cm2 , complied with the ISO 6872 standard for the maximum solubility of ceramic materials. Multi-scale crystal-reinforced Li2 Si2 O5 glass-ceramics' biosafety and chemical solubility met current normative criteria, and they can move on to mechanical property measurements (such as flexural strength test, fatigue life test, friction and wear property study, etc.) and bonding property optimization, which shows promise for future clinical applications.

Carbon Dot-Based Photo-Cross-Linked Gelatin Methacryloyl Hydrogel Enables Dental Pulp Regeneration: A Preliminary Study.

An essential factor in tooth nutritional deficits and aberrant root growth is pulp necrosis. Removing inflammatory or necrotic pulp tissue and replacing it with an inert material are the most widely used therapeutic concepts of endodontic treatment. However, pulp loss can lead to discoloration, increased fracture risk, and the reinfection of the damaged tooth. It is now anticipated that the pulp-dentin complex will regenerate through a variety of application methods based on human dental pulp stem cells (hDPSC). In order to create a photo-cross-linked gelatinized methacrylate hydrogel, GelMA/EUO-CDs-E (ECE), that is biodegradable and injectable for application, we created a novel nanoassembly of ECE based on eucommia carbon dots (EUO-CDs) and epigallocatechin gallate (EGCG). We then loaded it onto gelatin methacryloyl (GelMA) hydrogel. We have evaluated the material and examined its in vivo and in vitro angiogenesis-promoting potential as well as its dentin differentiation-enabling characteristics. The outcomes of the experiment demonstrated that GelMA/ECE was favorable to cell proliferation and enhanced hDPSC's capacity for angiogenesis and dentin differentiation. The regeneration of vascular-rich pulp-like tissues was found to occur in vivo when hDPSC-containing GelMA/ECE was injected into cleaned human root segments (RS) for subcutaneous implantation in nude mice. This suggests that the injectable bioscaffold is appropriate for clinical use in pulp regenerative medicine.

Recent advances in composite hydrogels: synthesis, classification, and application in the treatment of bone defects.

Bone defects are often difficult to treat due to their complexity and specificity, and therefore pose a serious threat to human life and health. Currently, the clinical treatment of bone defects is mainly surgical. However, this treatment is often more harmful to patients and there is a potential risk of rejection and infection. Hydrogels have a unique three-dimensional structure that can accommodate a variety of materials, including particles, polymers and small molecules, making them ideal for treating bone defects. Therefore, emerging composite hydrogels are considered one of the most promising candidates for the treatment of bone defects. This review describes the use of different types of composite hydrogel in the treatment of bone defects. We present the basic concepts of hydrogels, different preparation techniques (including chemical and physical crosslinking), and the clinical requirements for hydrogels used to treat bone defects. In addition, a review of numerous promising designs of different types of hydrogel doped with different materials (e.g., nanoparticles, polymers, carbon materials, drugs, and active factors) is also highlighted. Finally, the current challenges and prospects of composite hydrogels for the treatment of bone defects are presented. This review will stimulate research efforts in this field and promote the application of new methods and innovative ideas in the clinical field of composite hydrogels.

Evaluation of biomechanics using different traction devices in distalization of maxillary molar with clear aligners: a finite element study.

The study aimed to mechanically evaluate the tooth displacement of molar distalization by clear aligners combined with micro-implant through different traction devices using finite element analysis. A three-dimensional finite element model of complete maxillary dentition was constructed. Simultaneously move the maxillary first and second molars 0.2 mm distally at the height of 4 mm and 6 mm of micro-implant, and 150 g force was applied to button, precision cut and angelbutton respectively. Initial tooth movement in six different conditions of anterior tooth and molars was analyzed and calculated with ANSYS software. All the upper anterior tooth exhibited uncontrolled labial tipping and intrusion upon the six conditions, and the central incisor showed the largest tendency of crown labial inclination. Among the absolute values of crown-root displacement difference of the anterior tooth in sagittal direction, the angelbutton was the smallest, which means the torque control ability was superior to others. However, button played a more accurate role in the sagittal and vertical control of canine. With the increase of micro-implant height, the torque control ability of anterior tooth was decreased, but the intrusion trend increased. The controlled distal inclination with extrusion of the first molar and uncontrolled distal inclination with intrusion of the second molar were observed, and the angelbutton had more effective horizontal and vertical control on molars, which was close to bodily movement than others. As a new type of traction device, angelbutton has excellent anchorage control effect in clear aligners therapy of molar distalization, which further realizes the accurate expression of orthodontic force.

A review of recent advances in biomedical applications of smart cellulose-based hydrogels.

In biomedical engineering, smart materials act as media to communicate physiological signals inspired by environmentally responsive stimuli with outer indicators for timely scrutiny and precise therapy. Various physical and chemical processes are applied in the design of specific smart functions. Hydrogels are polymeric networks consisting of hydrophilic chains and chemical groups and they have contributed their unique features in biomedical application as one of the most used smart materials. Numerous raw materials can form hydrogels, in which cellulose and its derivatives have been extensively exploited in biomedicine due to their high hydrophilicity, availability, renewability, biodegradability, biocompatibility, and multifunctional reactivity. This review collates cellulose-based hydrogels and their extensive applications in the biomedical domain, specifically benefiting from the "SMART" concept in their design, synthesis and device assembly. The first section discusses the physical and chemical crosslinking and electrospinning techniques used in the fabrication of smart cellulose-based hydrogels. The second section describes the performance of these hydrogels, and the final section is a comprehensive discussion of their biomedical applications.

Optimization of Surface-Engineered Micropatterns on Bacterial Cellulose for Guided Scar-Free Skin Wound Healing.

Bacterial cellulose (BC) has been widely used in tissue engineering due to its unique spatial structure and suitable biological properties. In this study, a small biologically active Arginine-Glycine-Aspartic acid-Serine (RGDS) tetrapeptide was incorporated on the porous BC surface followed by a low-energy CO2 laser etching operation. As a result, different micropatterns were established on the BC surface with RGDS only anchored on the raised platform surface of the micropatterned BC (MPBC). Material characterization showed that all micropatterned structures exhibited platforms with a width of ~150 µm and grooves with a width of ~100 µm and a depth of ~300 µm, which displayed distinct hydrophilic and hydrophobic properties. The resulting RGDS-MPBC could hold the material integrity, as well as the microstructure morphology under a humid environment. In-vitro and in-vivo assays on cell migration, collagen deposition, and histological analysis revealed that micropatterns led to significant impacts on wound healing progress compared to the BC without surface-engineered micropatterns. Specifically, the basket-woven micropattern etched on the BC surface exhibited the optimal wound healing outcome with the presence of fewer macrophages and the least scar formation. This study further addresses the potential of adopting surface micropatterning strategies to promote skin wounds towards scar-free outcomes.

Applications of Bacterial Cellulose-Based Composite Materials in Hard Tissue Regenerative Medicine.

BACKGROUND: Cartilage, bone, and teeth, as the three primary hard tissues in the human body, have a significant application value in maintaining physical and mental health. Since the development of bacterial cellulose-based composite materials with excellent biomechanical strength and good biocompatibility, bacterial cellulose-based composites have been widely studied in hard tissue regenerative medicine. This paper provides an overview of the advantages of bacterial cellulose-based for hard tissue regeneration and reviews the recent progress in the preparation and research of bacterial cellulose-based composites in maxillofacial cartilage, dentistry, and bone. METHOD: A systematic review was performed by searching the PubMed and Web of Science databases using selected keywords and Medical Subject Headings search terms. RESULTS: Ideal hard tissue regenerative medicine materials should be biocompatible, biodegradable, non-toxic, easy to use, and not burdensome to the human body; In addition, they should have good plasticity and processability and can be prepared into materials of different shapes; In addition, it should have good biological activity, promoting cell proliferation and regeneration. Bacterial cellulose materials have corresponding advantages and disadvantages due to their inherent properties. However, after being combined with other materials (natural/ synthetic materials) to form composite materials, they basically meet the requirements of hard tissue regenerative medicine materials. We believe that it is worth being widely promoted in clinical applications in the future. CONCLUSION: Bacterial cellulose-based composites hold great promise for clinical applications in hard tissue engineering. However, there are still several challenges that need to be addressed. Further research is needed to incorporate multiple disciplines and advance biological tissue engineering techniques. By enhancing the adhesion of materials to osteoblasts, providing cell stress stimulation through materials, and introducing controlled release systems into matrix materials, the practical application of bacterial cellulose-based composites in clinical settings will become more feasible in the near future.

Recent advances in carbon dots: synthesis and applications in bone tissue engineering.

Bone tissue engineering (BTE), based on the perfect combination of seed cells, scaffold materials and growth factors, has shown unparalleled potential in the treatment of bone defects and related diseases. As the site of cell attachment, proliferation and differentiation, scaffolds composed of biomaterials play a crucial role in BTE. Over the past years, carbon dots (CDs), a new type of carbon-based nanomaterial, have attracted extensive research attention due to their good biocompatibility, unique optical properties, and abundant functional groups. This paper reviews recent research progress in the use of CDs in the field of BTE. Firstly, different preparation methods of CDs are summarized. Then, the properties and categories of CDs applied in BTE are described in detail. Subsequently, the applications of CDs in BTE, including osteogenesis, fluorescence tracing, phototherapy and antibacterial activity, are presented. Finally, the challenges and future perspectives of CDs in BTE are briefly discussed to give a comprehensive picture of CDs. This review provides a theoretical basis and advanced design strategies for the application of CDs in BTE.

Finite element analysis of tooth movement under different retraction force and intrusive force in double-archwire lingual orthodontics system.

The objectives of this study were to evaluate the tooth movement tendency during space closure in maxillary anterior teeth by various combinations of retraction force and intrusive force in a double-archwire lingual orthodontic system. Mini-implant-double slot lingual orthodontics system models of the bilateral maxillary first premolar extraction cases were constructed. Three-dimensional finite element models of the maxilla were constructed with definite position mini-implants (8 mm) and power arms (6 mm). Different retraction forces(50gf、100gf、150gf)were applied with the help of a nickel-titanium closed coil spring on the plate side. Intrusive forces(0gf、50gf、100gf)were applied with the help of the mini-implant between the two central incisors, and the initial displacements of the maxillary anterior teeth were analyzed. Variable amounts of displacements like controlled tipping, uncontrolled tipping, lingual crown tipping, labial root tipping, extrusion and distal crown tipping were observed in all the models, and these tendencies increased as the magnitude of retraction force increased, and these tendencies decreased as the magnitude of intrusive force increased. When the intrusive force was greater than or equal to the retraction force, the maxillary central incisors showed the trend of lingual crown tipping and labial root tipping, resulting in uncontrolled tipping movement. In terms of horizontal changes, the increasing width of bilateral anterior teeth was observed, with canines showing the least increasing trend. Various combinations of retraction force and intrusive force in a double-archwire lingual orthodontic system provide a new choice for torque control of the anterior teeth. Although anterior mini-implants and elastics can achieve incisor intrusion and lingual root torque, they cannot achieve the expected torque without additional torque control methods.

Biosafety evaluation of Li2Si2O5whisker-reinforced glass-ceramics.

Lithium disilicate (Li2Si2O5) glass-ceramic is a commonly used dental ceramic material. In this study, Li2Si2O5whiskers were prepared by the hydrothermal method, mixed with Li2Si2O5glass powders, and Li2Si2O5whisker-reinforced glass-ceramics were prepared by reaction sintering. The biosafety of the new Li2Si2O5glass-ceramics were evaluated byin vitrocytotoxicity, hemolysis, oral mucosal irritation, acute systemic toxicity, and subacute systemic toxicity (oral route) tests according to ISO 7405/ISO 10993 standards. The cytotoxicity test results showed that the cell growth of the experimental group was good, and the cell number and morphology were not significantly different from those of the blank group (P> 0.05). The toxicity grading for both experimental and blank control groups were 0. The hemolysis rate of the material was 1.25%, which indicated that it did not cause hemolytic reaction. The material was non-irritating to the oral mucosa. In acute systemic toxicity test, animals in the experimental group showed increased body weight, moved freely, with no signs of poisoning. The food utilization rate and relative growth rate (change of the weight) of rats in the subacute systemic toxicity test were not statistically different from those of the control group (P> 0.05). Preliminary evaluation of the biosafety of the Li2Si2O5whisker-reinforced glass-ceramics showed that it met the existing regulatory standards, and further biosafety experiments can be conducted, following which the material may be expected to be applied in clinical practice.

External apical root resorption in orthodontic tooth movement: the risk factors and clinical suggestions from experts' consensus.

External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.

A simultaneous grafting/vinyl polymerization process generates a polycationic surface for enhanced antibacterial activity of bacterial cellulose.

Bacterial cellulose (BC) is a biosynthesized carbohydrate polymer with excellent biocompatibility and water holding capability. However, it lacks an inherent antibacterial activity that has limited its in-depth biomedical applications. This study investigated a novel strategy of adopting a simultaneous process to chemically anchor a quaternary ammonium salt (R-N(CH3)+) with a special vinyl group (2-methacryloyloxyethyl trimethylammonium chloride, METAC) onto the BC, and meanwhile, enhance the density of (R-N(CH3)+) via free radical vinyl polymerization. The results have confirmed the transition of BC surface from a negatively-charged surface to a polycationic surface via such a simultaneous reaction. As compared to chitin film (a representative of R-NH3+), the resulting METAC-grafted BC (a representative of high-density R- N(CH3)+) acquired excellent water absorbability (40 times of dry weight of the BC), 99% antibacterial activity against Escherichia coli and Staphylococcus aureus, a satisfactory in-vitro biocompatibility, and a better in-vivo wound healing outcome with an excellent in-vivo antibacterial efficacy. This study has exhibited potential in utilizing a facile method to prepare a bio-safe, adaptive antibacterial surface for various biomedical applications.

[Histological study of miniscrew implanted in lower mandibles of juvenile and adult Beagle dogs].

OBJECTIVE: To examine the histological discrepancies between juvenile and adult Beagle dogs at different concrescence times after miniscrew implants. METHODS: Miniscrew implants were performed in six juvenile Beagle dogs and six adult Beagle dogs. The space between the fourth premolar root and first molar root, and the spaces in distal and mesial of M1 root were picked up for the implants of the 48 miniscrews. The lower jaw specimens including the miniscrews were harvested 3 and 12 weeks after the implants for the histological examinations and bone implant contact (BIC) calculations. RESULTS: There was no miniscrew falling off or becoming loose. The miniscrews had favorable biological consistencies with the tissues around them. The osteoblasts and osteoclasts showed active functions in the peri-bones of the minisrews. The BIC became higher when the healing time was prolonged. The juvenile Beagle dogs had lower BIC than the adults 3 weeks after the implants. But the BIC of the juvenile dogs surpassed the adults 12 weeks after the implants. CONCLUSION: The osseointegration of the miniscrews is hindered by the poorer bone quality of the juvenile Beagle dogs. But the early osseointegration deficiency can be made up by the rapid development and growth of the bones of the juvenile dogs.

Surface engineering of spongy bacterial cellulose via constructing crossed groove/column micropattern by low-energy CO2 laser photolithography toward scar-free wound healing.

Bacterial cellulose (BC) is a bio-derived polymer, and it has been considered as an excellent candidate material for tissue engineering. In this study, a crossed groove/column micropattern was constructed on spongy, porous BC using low-energy CO2 laser photolithography. Applying the targeted immobilization of a tetrapeptide consisting of Arginine-Glycine-Aspartic acid-Serine (H-Arg-Gly-Asp-Ser-OH, RGDS) as a fibronectin onto the column platform surface, the resulting micropatterned BC (RGDS-MPBC) exhibited dual affinities to fibroblasts and collagen. Material characterization of RGDS-MPBC revealed that the micropattern was built by the column part with size of ~100 × 100 µm wide and ~100 µm deep, and the groove part with size of ~150 µm wide. Hydrating the MPBC did not result in the collapse of the integrity of the micropattern, suggesting its potential application in a highly hydrated wound environment. Cell culture assays revealed that the RGDS-MPBC exhibited an improved cytotoxicity to mouse fibroblasts L929, as compared to the pristine BC. Meanwhile, it was observed that the RGDS-MPBC was able to guide the ordered aggregation of human skin fibroblast (HSF) cells on the column platform surface, and no HSF cells were found in the groove channels. Over time, it was found that a dense network of collagen was gradually established across the groove channels. Furthermore, the in-vivo animal study preliminarily demonstrated the scar-free healing potential of the micropatterned BC materials. Therefore, this RGDS-MPBC material exhibited its advantages in guiding cell migration and collagen distribution, which could present a prospect in the establishment of "basket-woven" organization of collagen in normal skin tissue against the formation of dense, parallel aggregation of collagen fibers in scar tissue toward scar-free wound healing outcome.

Evaluation of Head and Cervical Spine Posture after Therapy with Maxillary Protraction Appliances / Evaluación de la Postura de la Cabeza y la Columna Cervical Después de la Terapia con Aparatos de Protracción Maxilar

SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.

El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.

Morphology changes of maxillary molar distalization by clear aligner therapy / Cambios de la morfología en la distalización de molares maxilares mediante terapia con alineadores transparentes

SUMMARY: To evaluate the skeletal, dento-alveolar and soft tissue morphology changes after maxillary molar distalization by clear aligner therapy and identify the significant efficacy of molar distalization,18 patients in conformity with the inclusion criteria were selected. Pre- and post-treatment Cone Beam Computed Tomography (CBCT) were examined to measure the angular and linear parameters. All subjects were completed non-extraction clear aligner treatment by distalizing molars. A paired-t test and independent-samples t-test were performed to observe the difference between before and after treatment and the difference between the first molar and second molar respectively. P-values <0.05 were considered statistically significant. Predicted movement rate was calculated by the formula: (actual movement(mm)/planned movement(mm)) x100%. Most variables of pre- and post-treatment showed no statistical difference(P<0.05), excepting SNA angle (P<0.05) and Upper lip/E-line linear (P<0.01) due to incisor retraction. The first and second molar revealed a translation movement without significant tipping and vertical movement. Clear aligners provided a high predictability (83.44 %) of distalization the maxillary first molar, and 85.14 % of the maxillary second molar. Clear aligners can effectively achieve distal displacement of molars.

RESUMEN: Se seleccionaron 18 pacientes, de acuerdo con los criterios de inclusión, para evaluar los cambios en la morfología esquelética, dentoalveolar y de los tejidos blandos después de la distalización de los molares maxilares, mediante la terapia con alineadores transparentes e así identificar la significativa eficacia de la distalización de los molares. Se examinó a través de tomografía computarizada de haz cónico (CBCT) antes y después del tratamiento para medir los parámetros angulares y lineales. Todos los sujetos completaron el tratamiento con alineadores transparentes sin extracción mediante la distalización de los molares. Se realizó una prueba t pareada y una prueba t de muestras independientes para observar la diferencia entre antes y después del tratamiento y la diferencia entre el primer molar y el segundo molar, respectivamente. Los valores de p<0,05 se consideraron estadísticamente significativos. La tasa de movimiento prevista se calculó mediante la fórmula: (movimiento real (mm)/movimiento planificado (mm)) x 100 %. La mayoría de las variables de pre y postratamiento no mostraron diferencia estadística (P<0,05), excepto el ángulo SNA (P<0,05) y el labio superior/línea E lineal (P<0,01) debido a la retracción del incisivo. El primer y segundo molar revelaron un movimiento de traslación sin inclinación significativa y movimiento vertical. Los alineadores transparentes proporcionaron una alta previsibilidad (83,44 %) de la distalización del primer molar superior y del 85,14 % del segundo molar superior. Los alineadores transparentes pueden lograr efectivamente el desplazamiento distal de los molares.