Comparison of treatment effects between clear aligners and fixed appliances in patients treated with miniscrew-assisted molar distalization.

OBJECTIVES: The biomechanics in achieving molar distalization may differ between fixed appliances and clear aligners in the control of tooth movement. The objective of this study was to compare the treatment effects between clear aligners (CA) and fixed appliances (FA) in patients treated with miniscrew-assisted molar distalization. METHODS: The sample consisted of 46 subjects with mild-to-moderate crowding. A total of 22 patients treated with clear aligners (age, 25.66 ±â€…6.11 years old) and 24 patients treated with fixed appliances (age, 24.04 ±â€…4.95 years old) for miniscrew-assisted molar distalization were included in this study. The dental and skeletal changes were evaluated by the pre- and post-treatment lateral cephalograms. RESULTS: Significant changes were found with the vertical variables SN-OP angle (2.24 ±â€…3.22°, P < .05) and SN-MP angle (0.73 ±â€…1.15°, P < .05) for the FA group when compared with the CA group (SN-OP angle 0.41 ±â€…2.26° and SN-MP angle -0.21 ±â€…1.38°, P > .05). Both treatment groups achieved a 2-3 mm. molar distalization with significant intrusion of the upper molars. The CA group showed significantly less distal tipping of molars (U6^PP angle -2.29 ±â€…3.29° and L6^MP angle -2.92 ±â€…2.49°, P < .05) compared to the FA group (-5.24 ±â€…4.28° and -5.53 ±â€…5.03°, P < .05). In addition, significant retraction and lingual inclination of the upper and lower incisors were found in both groups. LIMITATIONS: The changes of tooth position were evaluated by 2D lateral cephalograms, not 3D measurements. CONCLUSIONS: Compared to fixed appliances, clear aligners seemed to have better control of vertical dimension and distal tipping of molars in patients treated with miniscrew-assisted molar distalization.

[The use of fixed expanders with orthodontic miniscrews support in children with mesial occlusion]. / Ispol'zovanie nes"emnykh rasshiritelei s vnutrikostnoi oporoi u detei s mezial'noi okklyuziei.

OBJECTIVE: Prevention of the development of pronounced skeletal abnormalities in patients with mesial occlusion. MATERIALS AND METHODS: Biometric analysis of control and diagnostic models of dentition was performed in 60 patients with dental anomalies before and after treatment in 3 mutually perpendicular planes to identify violations in the formation of dental arches by sagittal and transversal dimensions, and alveolar processes - by vertical dimensions (methods of A. Pont, G. Korkhaus). Measurements of 23 parameters of TRG and sections of CBCT were carried out using the modified Nad-Ars technique with analysis of skeletal parameters before and after treatment. Treatment was carried out using dilators for the upper jaw in combination with a facial mask and further dynamic observation using active retention devices. RESULTS: The results of treatment showed an increase in the length of the anterior segment of the upper dental arch by 2.8±0.55 mm (p<0.05 mm); expansion in the area of temporary molars by 2.85±0.65 mm (p<0.05); in the area of permanent molars by 2.75±0.55 mm (p<0.05); in the area of the apical basis of HF by 3.82±0.45 mm (p<0.05). The length of the lower dental arch in the anterior segment has not changed. Analysis of TRG parameters showed a significant increase in the values of

Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic treatment versus Invisalign: a randomised clinical trial.

BACKGROUND: We evaluated anxiety, pain, and oral-health-related quality of life in individuals treated with conventional fixed appliances (Group A) and clear aligners (Group B) for moderate malocclusion during the initial phase of orthodontic treatment. METHODS: Sixty individuals, separated into Group A (n = 30) and Group B (n = 30), were included in the study. They completed the Anxiety Levels, Oral Health Impact Profile-14, and Oral Health Related Quality of Life - United Kingdom/Surveys after the application of attachments on days 0 (T1), 10 (T10), and 20 (T20). Their pain levels were evaluated with the Visual Analogue Scale on days 0, 2, and 6 in the 2nd and 6th hours and on the 1st, 3rd, 7th, 14th, and 21st days. RESULTS: Per the VAS questionnaire, pain levels in the 2nd hour, 6th hour, 1st day, and 3rd day were significantly lower in Group B than in Group A. In the OHIP-14 survey results, the comparison between Group A and Group B showed a significant difference only on the 1st day. The STAI and OHRQoL-UK survey results did not differ significantly between the groups. CONCLUSIONS: We found no significant difference between the two groups in terms of anxiety levels, and pain among individuals in Group A was higher than in Group B only at the beginning of the treatment. No significant differences were observed in terms of individuals' quality of life. TRIAL REGISTRATION: NCT06133296 (retrospectively registered)- Registration Date:15/11/2023.

Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review.

OBJECTIVE: To critically appraise and assess the currently observed evidence about the difference in orthodontic treatment duration between clear aligners and fixed appliances in crowding cases. MATERIALS AND METHODS: An electronic search without limitations was conducted from inception to June 2023 covering nine databases: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID and ProQuest. Randomized controlled trials (RCTs) and matched non-randomized studies were included in this systematic review. Risk of Bias was assessed via Cochrane's tool (RoB 2) for RCTs and ROBINS-I tool for non-randomized studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was employed to evaluate the overall quality of evidence. RESULTS: Out of the 3537 articles initially identified, ten eligible studies were included in this systematic review; six were RCTs. Only one study offered extraction-based treatment, while the other nine adopted non-extraction treatments. According to the GRADE, there is low evidence that treatment duration in mild to moderate crowding cases with clear aligners is similar to that in fixed orthodontic appliances. Meta-analysis was not administered due to high inconsistency. CONCLUSIONS: Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases. Further well-performed RCTs, especially in severe cases, are required. CLINICAL RELEVANCE: Time efficiency is an essential outcome measure for clinical orthodontic practice. While the type of appliance used is a critical determinant of treatment duration, orthodontists should be aware of other factors that can significantly impact treatment time, such as patient and treatment-related factors.

Impact of treament with orthodontic aligners on the oral health-related quality of life.

BACKGROUND: There is an increasing interest in information on the effects of orthodontic aligners on the oral health-related quality of life (OHRQoL) of people. AIM: To compare the impact of orthodontic aligners versus conventional fixed appliances on OHRQoL, using a validated tool and controlling for sociodemographic and clinical variables. METHOD: Sixty-one individuals participated in this study. Group 1 (G1) consisted of 33 individuals under treatment with orthodontic aligners and Group 2 (G2) comprised 28 individuals under treatment with conventional fixed appliances. OHRQoL was evaluated with the Oral Health Impact Profile (OHIP-14) in which 14 items are distributed across seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The higher the score, the more negative is the perception of the individual regarding his/her OHRQoL. Descriptive statistics, Mann-Whitney test, and Poisson regression were performed. Effect Size (ES) and Minimal Clinically Important Difference (MCID) were also determined. RESULTS: Participants' mean age was 30.69 years. Individuals in G1 had a significantly lower score for physical pain and the total score of OHIP-14 compared to individuals in G2 (p < 0.05). The ES was large (ES = 0.74) for physical pain and moderate (ES = 0.46) for the total score. The ES was moderate for physical disability (ES = 0.50). The difference between groups for physical pain (1.30) and for physical disability (0.90) was greater than the MCID (0.87 and 0.88, respectively). Poisson regression showed that G2 individuals showed a score for physical pain 1.39 times higher than those of G1 in the adjusted model (OR = 1.39, [1.03-1.89], p = 0.031). CONCLUSION: Those under treatment with orthodontic aligners have a more positive perception of OHRQoL compared to those wearing fixed appliances.

The effectiveness of water jet flossing and interdental flossing for oral hygiene in orthodontic patients with fixed appliances: a randomized clinical trial.

BACKGROUND: Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment. METHODS: A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software. RESULTS: The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group. CONCLUSION: Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.

A 10-year-old boy with class II oligodontia treated with buccal fixed appliances and agenesis space closure of the four second premolars: Case report No. 230075 - Titularisation Collège Européen Orthodontie (CEO), European College of Orthodontics.

The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.

Evaluación de los cambios faciales y dentoalveolares en pacientes tratados con Twin block Modificado: resultados preliminares / Evaluation of facial and dentoalveolar changes in patients treated with modified twin block: preliminary results

Introducción: el déficit de crecimiento mandibular es un aspecto muy importante en los pacientes en crecimiento, ya que genera diferentes tipos de patología a nivel facial, bucal y funcional. Objetivo: el propósito de este trabajo es dar a conocer resultados de la investigación realizada sobre los cambios faciales, alveolares y dentales que se producen en tratamientos sobre pacientes en crecimiento con Twin Block Modificado (TBM), combinado con aparatología fija multibrackets para el acabado dentario final. Material y método: la población estudiada son 24 pacientes, 16 de sexo femenino (66,6%), y 8 de sexo masculino (33,33%), con edades comprendidas entre los 12 y 15 años, que presentaron un valor del ángulo ANB de clase II (ángulo formado por el punto A - punto Na - punto B). Se utilizaron las telerradiografías laterales de cráneo iniciales y finales del mencionado grupo, habiéndose creado un método específico de 26 medidas para realizar la investigación. Resultados: en los resultados obtenidos de la muestra se ha observado un claro aumento de los valores del crecimiento mandibular, tanto verticales como horizontales, como los valores que evalúan la posición sagital horizontal de los dientes inferiores del grupo estudiado. Conclusiones: los resultados muestran una relevante diferencia a favor de tratar con TBM a los pacientes que se encuentren en crecimiento con la mandíbula en una posición posterior respecto al maxilar. (AU)

Introduction: Mandibular growth deficiency is a very important condition in patients who are still growing, as it can lead to different types of pathology at the facial, mouth and functional level. Objective: The purpose of this work is to publicize the results of the research that the doctoral candidate is carrying out on the facial, alveolar and dental changes that occurin treatments on growing patients with Modified Twin Block (from this moment abbreviated as TBM). Material and method: The population studied is 24 patients, 16 female (66.6%), and 8 male (33.33%), aged between 12 and 15 years, who presented a value of the class II ANB angle (angle formed by point A - point Na - point B). The initial and final lateral skull radiographs of the aforementioned group were used, having created a specific method of 27 measurements to carry out the research. Results: In the results obtained from the sample, a clear increase in the values of mandibular growth, both vertical and horizontal, has been observed, as well as the values that evaluate the horizontal sagittal position of the lower teeth of the group studied. Conclusions: The results show a relevant difference in favor of treating with TBM patients who are growing with the mandible in a posterior position with respect to the maxilla. (AU)

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

OBJECTIVES: To evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances. SUBJECTS AND METHODS: Twenty-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. RESULTS: The 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. CONCLUSIONS: The 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.

Influence of malocclusion on OHRQoL in adolescents in initial orthodontic treatment phase.

OBJECTIVES: Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances. METHODS: 85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN). RESULTS: The initial type of malocclusion affected the children's OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains "Oral symptoms" and "Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015). CONCLUSIONS: At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values. CLINICAL RELEVANCE: The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child's satisfaction and overall quality of life.

Comparative assessment of two-phase class II treatment with Activator or Bionator followed by fixed appliances: A retrospective controlled before-and-after study.

AIM: Two-phase treatment for children with Class II malocclusion with several functional appliances is still performed by many orthodontists, while the Activator and the Bionator appliances are two of the most popular ones. Aim of this study was to compare the skeletal and dentoalveolar effects of treatment with these two appliances. METHODS: Class II children treated with Activator or Bionator in the first phase, followed by a phase of fixed appliances were included. Skeletal and dentoalveolar parameters were assessed from lateral cephalograms and analysed with linear regressions at 5%. RESULTS: A total of 89 patients (mean age 10.0 years; 47% female) were included. During the first phase, Bionator increased less the SNB (difference in mean treatment-induced changes [MD] -0.7°; 95% confidence interval [CI] -1.3 to -0.2°; P=0.01) and decreased less the ANB angle (MD 0.6°; 95% CI 0 to 1.1°; P=0.03) compared to Activator. Activator slightly increased the facial axis and Bionator reduced it (MD -1.6°; 95% CI -2.3 to -0.8°; P<0.001). Compared to Activator, the Bionator retroclined more the upper incisors (MD -2.4°; 95% CI -4.6 to -0.2°; P=0.03) and increased more the interincisal angle (MD 2.9°; 95% CI 0.5 to 5.4°; P=0.02). After the second phase (6.2 years after baseline), the only differences were a reduced facial axis (MD -1.3°; 95% CI -2.2 to -0.3°; P=0.008) and an increased maxillary rotation (MD 0.9°; 95% CI 0 to 1.8°; P=0.04) with Bionator compared to Activator. CONCLUSION: Similar dentoalveolar effects were seen overall with two-phase treatment with either appliance, with Bionator being associated with more vertical increase compared to Activator.

Elemental composition, corrosion resistance and mechanical properties of computer-aided design and computer-aided manufacturing fixed retainers versus conventional fixed retainers.

PURPOSE: To investigate the elemental composition, corrosion resistance, and mechanical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) retainers versus conventional fixed retainers (FRs). METHODS: Eight different retainer wires were investigated. Energy dispersive X-ray spectroscopy was used to determine the elemental composition. Leakage was analysed according to ISO 10271:2020 guidelines. Hardness was tested using the Vickers method with a load of 0.3 kg. The tensile force and tensile strength were evaluated. Multiple comparisons among wires of hardness, tensile force, and strength were conducted using the Welch t-test, with Bonferroni correction. RESULTS: Nickel was present in all wires. The CAD-CAM-FR wire, which contained more nickel than the other wires, had no measurable leakage. The gold-plated wires had the highest total leakage, but did not exceed the ISO standard limit. The hardness of the stainless-steel twisted wires was the highest and that of the CAD-CAM-FR wire was the lowest. The tensile strength of the CAD-CAM-FR wire was significantly lower than that of the other wires and similar to the other twisted-wire retainers. CONCLUSION: The CAD-CAM-FR wire is likely to have high corrosion resistance and flexibility due to its low hardness.

Comparison of efficacy of thermoplastic retainer with round and rectangular bonded lingual wire retainer in the mandible two years after orthodontic treatment: a randomised controlled trial.

OBJECTIVE: To analyse three protocols in maintaining the stability of orthodontic therapy results and their effect on gingival health. MATERIALS AND METHODS: Sixty-six subjects (pre-therapeutic age 11-18 years; 68% female) randomly allocated into three retention groups of equal size were analysed. The first group had a 0.673 × 0.268 mm (0.027 × 0.011 inches) rectangular braided steel retention wire bonded to the lingual surfaces of all mandibular teeth from canine to canine, and the second group had a 0.406 mm (0.016 inches) round twisted steel wire. The third group was the control, without wires, and only with vacuum-formed retainers. All three groups had vacuum-formed removable retainers in the maxilla. The frequency of wire detachment/breakage/loss of retainer, the occurrence of crowding of mandibular incisors, and changes in intercanine width and gingival health were monitored. RESULTS: Incidence and severity of relapse differed between groups (p = 0.001 and 0.049) being most common in the removable retainer group (incidence 68.2%; severity 0.7 ± 1.0 mm), followed by the round wire group (36.4%; 0.5 ± 1.2 mm) and rectangular wire group (13.6%; 0.1 ± 0.1 mm). The intercanine width decreased more without a bonded retainer (incidence 68.2%; severity 0.5 ± 0.7 mm) and with the round wire more (45.5%; 0.5 ± 0.7 mm) than with the rectangular (27.3%; 0.1 ± 0.3 mm). The difference was significant for incidence (p = 0.025), but not severity. Detaching of the wires/breakage/loss of retainer was similar. There were no significant differences in the accumulation of biofilm, calculus and gingivitis between appliances. CONCLUSION: A rectangular wire is the most effective in retention, and the impact of retention appliances on gingival health is similar. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05121220. Registered 02 October 2021 - Retrospectively registered. CLINICAL RELEVANCE: Studying guidelines for reducing relapse, proper use of materials and appliances, the behavior of retention wires according to their profile in the retention phase, and possibilities of maintaining oral health will contribute to improving the stability of orthodontic therapy results.

Civil liability of orthodontists and aligner manufacturers in the treatment with orthodontic aligners.

INTRODUCTION: The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists' lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. OBJECTIVE: This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. CONCLUSIONS: The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.

Stability, survival, patient satisfaction, and cost-minimization of CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a 2-year follow-up of a two-centre randomized controlled trial.

BACKGROUND: CAD/CAM (computer-aided design/computer-aided manufacturing) fixed retainers (FRs) as an alternative to multistranded FRs to maintain orthodontic treatment outcome. OBJECTIVES: The primary aim was to compare CAD/CAM versus conventional multistranded FRs in terms of stability until 2 years. Secondary outcomes were failure rates, patient satisfaction, and cost-minimization. TRIAL DESIGN: 2-arm parallel, two-centre randomized controlled trial. METHODS: Patients were randomized to CAD/CAM or conventional FRs in both arches, in a 1:1 ratio and blocks of four. Allocation concealment was secured by using sequentially numbered envelopes. Patients were blinded. FRs were bonded at the end of treatment, and patients were recalled after 12 and 24 months. First-time retainer failures were recorded and digital impressions were taken. Arch widths and lengths, as well as Little's Irregularity Index (LII), were measured. Additionally, patients answered satisfaction questionnaires. Linear mixed models were applied for measurements and patient satisfaction. Survival analyses were estimated with Kaplan-Meier curves, along with Cox-regression modelling. Cost-minimization analysis was undertaken. RESULTS: One hundred and eighty-one patients were randomized (98 in Centre 1, and 83 in Centre 2): 90 in CAD/CAM and 91 in conventional group. One hundred and fifty three patients attended T24 follow-up. There were no significant differences in LII and arch dimensions between groups for failure-free patients. Within 24 months, 34% maxillary CAD/CAM FRs and 38% maxillary conventional FRs failed, along with 42% mandibular CAD/CAM FRs and 40% mandibular conventional FRs, with no significant difference in survival between groups (hazard ratios conventional to CAD/CAM: maxillary arch: 1.20 [P = 0.46], mandibular arch: 0.98 [P = 0.94]). There were no significant differences in patient satisfaction between groups. No harms were observed. Cost-minimization analysis showed that CAD/CAM FRs were slightly cheaper than conventional FRs. CONCLUSIONS: There were no clinically significant differences in LII, arch widths, and lengths between CAD/CAM and conventional FRs after 24 months. There were no differences in failures and patient satisfaction between groups. CAD/CAM FRs were slightly cheaper than conventional FRs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04389879.

Thirteen-year-old female patient with Class II division 1 malocclusion and hypodivergent facial pattern treated with buccal fixed appliance. Case report no 230052. European College of Orthodontics. Commission of affiliation and titularisation.

DATE OF BIRTH: 24/09/1998; sex: female. PRE-TREATMENT DOCUMENTS: 13 years 5 months old; 07/03/2012. DIAGNOSIS: Skeletal Class I with biretrusion, hypodivergent facial pattern; angle's Class II division 1 with overbite; moderate dento-maxillary discrepancy; maxillary incisor malposition. TREATMENT PLANNING: Bimaxillary buccal fixed appliance with Class II elastics. Active treatment duration: 25 months. POST-TREATMENT DOCUMENTS: 15 years 7 months old; 09/05/2014. POST-RETENTION DOCUMENTS: (minimum 1 year) 16 years 9 months old; 08/07/2015. Retention period: unlimited.

Class II subdivision treatment and stability with asymmetric Herbst appliance: A case report.

Non-surgical treatment of Class II subdivision may involve complex mechanics or asymmetric tooth extraction in its resolution. This report demonstrates the result and the short-term stability of Class II subdivision treated with asymmetrically installed Herbst appliance followed by conventional fixed orthodontic appliance. The approach allowed the correction of the unilateral Class II molar relationship and increased overjet, as well as the deviation of dental midlines, with improvement in lip posture and facial profile. The results remained stable two years after treatment, confirming the treatment success.

Content analysis of AI-generated (ChatGPT) responses concerning orthodontic clear aligners.

OBJECTIVES: To assess the accuracy of ChatGPT answers concerning orthodontic clear aligners. MATERIALS AND METHODS: A cross-sectional content analysis of ChatGPT generated responses to queries related to clear aligner treatment (CAT) was undertaken. A total of 111 questions were generated by three orthodontists based on a set of predefined domains and subdomains. The artificial intelligence (AI)-generated (ChatGPT) answers were extracted and their accuracy was determined independently by five orthodontists. The accuracy of answers was assessed using a prepiloted four-point scale scoring rubric. Descriptive statistics were performed. RESULTS: The total mean accuracy score for the entire set was 2.6 ± 1.1. It was noted that 58% of the AI-generated answers were scored as objectively true, 18% were selected facts, 9% were minimal facts, and 15% were false. False claims included the ability of CAT to reduce the need for orthognathic surgery (4.0 ± 0.0), improve airway function (3.8 ± 0.5), achieve root parallelism (3.6 ± 0.5), alleviate sleep apnea (3.8 ± 0.5), and produce more stable results compared to fixed appliances (3.8 ± 0.5). CONCLUSIONS: The overall level of accuracy of ChatGPT responses to questions concerning CAT was suboptimal and lacked citations to relevant literature. Ability of the software to offer current and precise information was limited. Therefore, clinicians and patients must be mindful of false claims and relevant facts omitted in the answers generated by ChatGPT.

Influence of casein phosphopeptide-amorphous calcium phosphate on the surface topography and composition of nickel-titanium archwires during orthodontic treatment with fixed appliances.

PURPOSE: To investigate the surface topography and nickel content of nickel-titanium (NiTi) archwires exposed to either routine oral hygiene or a prophylactic regimen with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) during orthodontic treatment. METHODS: This in vivo study involved 40 orthodontic patients with fixed appliances, who were randomly assigned to either a routine oral hygiene group or a CPP-ACP supplementary regimen group. Twenty new NiTi archwires served as controls. All archwires underwent scanning electron microscopy and energy-dispersive spectroscopy to evaluate their surface topography and elemental composition. The nickel content was quantified as a percentage of total weight and the Ni/Ti ratio, and statistical comparisons were made using pairwise tests. RESULTS: Wires exposed to fluoride toothpaste showed signs of pitting corrosion, deep grooves, and corrosion debris. In contrast, wires exposed to supplementary CPP-ACP exhibited smooth surface areas interspersed with microdefects and deposits. Statistically significant differences in nickel content were found between the new and retrieved archwires, as well as between wires exposed to routine oral hygiene and CPP-ACP (P < 0.001). The archwires exposed to CPP-ACP had the lowest nickel content (P < 0.001). CONCLUSION: The use of CPP-ACP holds promise for application as a safe anticariogenic agent with possible protective properties during orthodontic treatment.

Stability of class II correction with the Austro Repositioner associated with multi-brackets fixed appliances in dolichofacial patients.

BACKGROUND: The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with the Austro Repositioner associated with fixed appliances and its capacity to control the vertical dimension in dolichofacial patients. METHODS: A group of patients with Class II malocclusion due to mandibular retrognathism and a dolichofacial growth pattern treated with the Austro Repositioner combined with fixed appliances were compared to a matched untreated control group of subjects with Class II malocclusion. Evaluations were made on the basis of lateral cephalograms taken at T1 (initial records), T2 (end of treatment), and T3 (1 year after treatment). Statistical comparisons were performed with paired- and two-sample t tests. RESULTS: The experimental (treated) group comprised 30 patients, 14 boys and 16 girls, and the control group comprised 30 subjects (15 boys and 15 girls) with similar ages at T1, T2 and T3. In the treated group, a significant decrease in the ANB angle was found (- 3.79 ± 1.46; p < 0.001). No significant differences were found in the maxillary skeletal measurements. In contrast, the SNB angle showed a significant increase of 3.77 ± 1.49 in the treated group compared with a nonsignificant increase of 0.77 ± 1.55 in the control group (p = 0.002). Vertical changes showed a significant decrease in the FMA angle (- 3.36 ± 1.62), while the lower anterior facial height distance and the overbite increased significantly in the treated group, reflecting a change in vertical dimensions after treatment. No significant changes were observed in either the treated or control group during the one-year posttreatment period; thus, the treatment results remained stable. CONCLUSIONS: The Austro Repositioner combined with fixed appliances could be considered an optimal treatment modality in Class II dolichofacial patients.