Robotic Applications in Orthodontics: Changing the Face of Contemporary Clinical Care.

The last decade (2010-2021) has witnessed the evolution of robotic applications in orthodontics. This review scopes and analyzes published orthodontic literature in eight different domains: (1) robotic dental assistants; (2) robotics in diagnosis and simulation of orthodontic problems; (3) robotics in orthodontic patient education, teaching, and training; (4) wire bending and customized appliance robotics; (5) nanorobots/microrobots for acceleration of tooth movement and for remote monitoring; (6) robotics in maxillofacial surgeries and implant placement; (7) automated aligner production robotics; and (8) TMD rehabilitative robotics. A total of 1,150 records were searched, of which 124 potentially relevant articles were retrieved in full. 87 studies met the selection criteria following screening and were included in the scoping review. The review found that studies pertaining to arch wire bending and customized appliance robots, simulative robots for diagnosis, and surgical robots have been important areas of research in the last decade (32%, 22%, and 16%). Rehabilitative robots and nanorobots are quite promising and have been considerably reported in the orthodontic literature (13%, 9%). On the other hand, assistive robots, automated aligner production robots, and patient robots need more scientific data to be gathered in the future (1%, 1%, and 6%). Technological readiness of different robotic applications in orthodontics was further assessed. The presented eight domains of robotic technologies were assigned to an estimated technological readiness level according to the information given in the publications. Wire bending robots, TMD robots, nanorobots, and aligner production robots have reached the highest levels of technological readiness: 9; diagnostic robots and patient robots reached level 7, whereas surgical robots and assistive robots reached lower levels of readiness: 4 and 3, respectively.

[Progress on clinical application of orthodontic-implant combined therapy].

For complex implant cases, simple implantation could not achieve the desired therapeutic effect, and a multidisciplinary approach has become a general trend. Orthodontic treatment before implantation creates favorable conditions for subsequent implantation by increasing restoring three-dimensional space, improving occlusion of patients. It also stimulates the increase of autologous soft and hard tissue while biological potential of periodontal ligament is fully developed. The choice of operation time is vital to keep the level of soft and hard tissue at the implantation site, which improves the curative effect of implantation in terms of function and aesthetics. In this article, the orthodontic-implant combined therapy is briefly reviewed focusing on the three-dimensional space optimization, implant site enhancement by orthodontic extrusion and delayed orthodontic space opening.

[A multidisciplinary approach for accelerated orthodontics]. / Une approche pluridisciplinaire pour l'accélération des traitements en orthodontie.

An increasing number of adult patients are seeking orthodontic treatment and several surgical and non-surgical methods have been developed to reduce the overall treatment time. Two randomized controlled clinical trials, performed in our University Hospital, demonstrated that the piezocision surgery - minimally invasive corticotomies - decreased the overall orthodontic treatment time by 43 % - effect during 4 to 6 months after the surgery - without any further clinical and radiological adverse effects. In addition, the use of a custom-made orthodontic system - brackets and arches - optimized the acceleration in the fine-tuning phase of orthodontic treatment. Finally, the combination of the two techniques is therefore relevant to maximize the reduction of the orthodontic treatment time. Fundamentally, our preclinical studies in rats have highlighted the biological phenomena underlying piezocision with an important bone demineralization and osteoclast recruitment associated with a predominant expression of the RANKL-OPG duo.

La demande des patients adultes pour entreprendre des traitements orthodontiques est en augmentation constante; cependant, la longueur des traitements reste souvent un frein. Dès lors, plusieurs techniques chirurgicales et non chirurgicales ont été mises au point afin de réduire le temps de traitement orthodontique. Deux études cliniques contrôlées randomisées, réalisées au sein de notre hôpital universitaire, ont démontré que la technique de piézocision - corticotomies minimalement invasives - permet de réduire jusqu'à 43 % le temps de traitement orthodontique - au cours des 4 à 6 mois après l'intervention - et ce, sans effets secondaires tant sur le plan clinique que radiologique. De plus, l'utilisation d'un système orthodontique customisé - employant des attaches et des arcs sur mesure - permet d'optimiser l'accélération du déplacement dentaire dans la phase de finition du traitement orthodontique. Finalement, la combinaison des deux techniques est donc pertinente pour maximaliser la réduction du temps de traitement en orthodontie. Par ailleurs, sur le plan fondamental, nous avons étudié, dans des essais précliniques chez le rat, les phénomènes biologiques sous-jacents à la piézocision à savoir une déminéralisation osseuse et un recrutement d'ostéoclastes plus important associés à une expression prédominante du duo RANKL-OPG.

Current trends in orthodontic journals listed in Journal Citation Reports. A bibliometric study.

INTRODUCTION: The aim of this study is to analyze articles published in orthodontic journals included in Journal Citation Reports (JCR) to determine current trends in orthodontic publishing. METHODS: Articles included in orthodontic journals in 2016 JCR and published during 2007-2017 were selected. After applying inclusion criteria, author-based parameters (article title, first author's name, institution and sex, number of authors, number of affiliations, first author's origin, and geographic origin), article-based parameters (article type, main topic, and research design), and the number of cites and self-cites were registered for each article. RESULTS: A total of 7119 articles were analyzed, and 842 different centers and 4483 different authors were identified. The percentage of female authors showed a tendency to increase over the decade; the most productive country was the United States (17.4%). Bone anchorage was the most recurrent topic (7.2%). More than three-fourths of articles (80.8%) proceeded from orthodontic departments belonging to public institutions, with a decreasing trend in nonacademic or private affiliations. Positive and negative correlations were found to exist between citation counts and other variables. CONCLUSIONS: American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, and European Journal of Orthodontics were the 3 main journals with regard to production volume, with the United States being the most productive country. The most recurrent topic was bone anchorage, and most of the studies were research articles with observational cross-sectional design. Study design, geographic origin of the articles, article type, and the main subject of the article may be predictive of citation numbers.

Evolution of Aesthetic Dentistry.

One of the main goals of dental treatment is to mimic teeth and design smiles in a most natural and aesthetic manner, based on the individual and specific needs of the patient. Possibilities to reach that goal have significantly improved over the last decade through new and specific treatment modalities, steadily enhanced and more aesthetic dental materials, and novel techniques and technologies. This article gives an overview of the evolution of aesthetic dentistry over the past 100 y from a historical point of view and highlights advances in the development of dental research and clinical interventions that have contributed the science and art of aesthetic dentistry. Among the most noteworthy advancements over the past decade are the establishment of universal aesthetic rules and guidelines based on the assessment of natural aesthetic parameters, anatomy, and physiognomy; the development of tooth whitening and advanced restorative as well as prosthetic materials and techniques, supported by the pioneering discovery of dental adhesion; the significant progress in orthodontics and periodontal as well as oral and maxillofacial surgery; and, most recently, the implementation of digital technologies in the 3-dimensional planning and realization of truly natural, individual, and aesthetic smiles. In the future, artificial intelligence and machine learning will likely lead to automation of aesthetic evaluation, smile design, and treatment-planning processes.

[Bone mechanobiology, an emerging field: a review]. / La mécanobiologie osseuse, un domaine émergeant : revue de littérature.

INTRODUCTION: Mechanobiology, at the interface between biology and biophysics, studies the impact of mechanical forces on tissues, cells and biomolecules. The application of orthodontic forces, followed by induced tooth displacement, is a striking example of its clinical application. OBJECTIVE: The purpose of this article was to compile a review of the literature on the subject of mechanobiology; from its detection at bone level to the presentation of stimulated intracellular pathways. MATERIALS AND METHODS: The literature search was conducted on the Pubmed database in April 2018, with associations of the terms "mechanobiology", "orthodontics", "cell culture", "physiopathology". RESULTS: Three major areas of research were selected: highlighting of the phenomenon and its application in the field of bone biology; the cellular effectors of mechanobiology and its clinical applications. The use of mechanobiology in dentofacial orthopedics opens up a new field of reflection for clinicians regarding future advances in orthodontics.

[Do scoliotic patients need increased orthodontic treatment? A comparative study on 104 cases]. / Les patients scoliotiques ont-ils un besoin de traitement orthodontique augmenté ? Une étude comparative sur 104 cas.

INTRODUCTION: The diagnosis of scoliosis during orthodontic treatment is often attributed to orthodontic treatment, which may be a simple confounding factor. Do scoliotic patients require increased orthodontic treatment? Is the extent of their need for orthodontic treatment correlated with the severity of their scoliosis? MATERIAL AND METHOD: The authors conducted a comparative multicenter epidemiological study between a group of patients with a proven diagnosis of scoliosis objectified by the Cobb angle and a control group recruited from the general population. The endpoint was the Index Of Orthodontic Treatment Need (IOTN). The calculation of the number of subjects was made a priori. A statistical significance threshold of 5% was used for the statistical analysis. RESULTS: In this study, 104 patients were included: 36 patients (10 boys, 26 girls) with an average age of 12.1 years (+/-2.3 years) in the scoliosis group (mean Cobb angle = 21°) versus 69 patients (20 boys, 49 girls) with an average age of 12 years (+/-2.7 years) in the control group. Patients with scoliosis have a significantly higher need for orthodontic treatment than the general population. The study did not correlate the severity of scoliosis with the increased need for orthodontic treatment. DISCUSSION: Thus, the diagnosis of scoliosis during orthodontic treatment should not systematically result in the removal of the orthodontic appliance over-hastily held responsible for the scoliotic condition.

Evidence in Orthodontics related to qualitative research.

INTRODUCTION: Research in Orthodontics has historically followed the positivist model based on the direct relationship of cause and effect between diseases and their specific etiological factors. Despite the objectivity and the great potential of statistical procedures, quantitative methods have progressively been sharing space with other models that can encompass the multiplicity of factors that affect the health-disease process, which until such time was reduced to its biological dimension. OBJECTIVES: This study aims, through an integrative review, to identify orthodontics articles published over a 10-year period that have used, exclusively or not, some method of qualitative research, and analyze the main aspects of their content. METHODS: A survey was performed on Pubmed, Medline, Scopus, and Lilacs databases from 2007 to 2016 with a focus on the applicability of the qualitative methodology in orthodontic research. RESULTS: The 27 articles selected showed a trend to increase in publications, with the most recent four years concentrating almost 60% of them. Most studies were from Europe, particularly the UK, and the more frequent study objectives were related to the perception of people about the reasons for orthodontic treatment, about the aesthetic and psychosocial impact of malocclusion or orthodontic treatment, and the implications of these factors for their quality of life. CONCLUSIONS: Because of its potential to explore behaviours and socio-cultural attitudes sustained in subjectivity, qualitative research offers new possibilities for orthodontic studies and can be used in an exclusive or complementary way in relation to quantitative methods.

Evidence in Orthodontics related to qualitative research

ABSTRACT Introduction: Research in Orthodontics has historically followed the positivist model based on the direct relationship of cause and effect between diseases and their specific etiological factors. Despite the objectivity and the great potential of statistical procedures, quantitative methods have progressively been sharing space with other models that can encompass the multiplicity of factors that affect the health-disease process, which until such time was reduced to its biological dimension. Objectives: This study aims, through an integrative review, to identify orthodontics articles published over a 10-year period that have used, exclusively or not, some method of qualitative research, and analyze the main aspects of their content. Methods: A survey was performed on Pubmed, Medline, Scopus, and Lilacs databases from 2007 to 2016 with a focus on the applicability of the qualitative methodology in orthodontic research. Results: The 27 articles selected showed a trend to increase in publications, with the most recent four years concentrating almost 60% of them. Most studies were from Europe, particularly the UK, and the more frequent study objectives were related to the perception of people about the reasons for orthodontic treatment, about the aesthetic and psychosocial impact of malocclusion or orthodontic treatment, and the implications of these factors for their quality of life. Conclusions: Because of its potential to explore behaviours and socio-cultural attitudes sustained in subjectivity, qualitative research offers new possibilities for orthodontic studies and can be used in an exclusive or complementary way in relation to quantitative methods.

RESUMO Introdução: a pesquisa em Ortodontia tem, historicamente, seguido um modelo baseado na relação direta de causa e efeito entre doenças e seus fatores etiológicos específicos. Apesar da objetividade e do grande potencial de procedimentos estatísticos, métodos quantitativos têm, progressivamente, compartilhado espaço com outros modelos que podem englobar a multiplicidade de fatores que afetam o processo saúde-doença, o qual, até pouco tempo, era reduzido à sua dimensão biológica. Objetivos: esse estudo objetivou, por meio de uma revisão sistemática integrativa, identificar como tem sido aplicada a metodologia qualitativa em Ortodontia nos últimos 10 anos. Métodos: foi realizado um levantamento nas bases de dados Pubmed, Medline, Scopus e Lilacs, no período compreendido de 2007 a 2016, com um enfoque na aplicabilidade da metodologia qualitativa em pesquisas em Ortodontia. Resultados: os 27 artigos selecionados mostraram uma tendência ao aumento das publicações, com os últimos quatro anos concentrando quase 60% delas. A maioria dos estudos foi realizada na Europa, particularmente no Reino Unido, e os objetivos mais frequentes nos estudos foram relacionados à percepção das pessoas quanto aos motivos para o tratamento ortodôntico, o impacto estético e psicossocial da má oclusão e do tratamento ortodôntico, e sua relação com a qualidade de vida. Conclusões: devido ao seu potencial para explorar comportamentos e atitudes socioculturais sustentados na subjetividade, a pesquisa qualitativa oferece novas possibilidades para estudos ortodônticos e pode ser utilizada de forma exclusiva ou complementar aos métodos quantitativos.

[Adult orthodontics for a better prosthesis]. / L'orthodontie adulte pour une meilleure prothèse.

INTRODUCTION: Adult patients are seen more frequently in our orthodontic offices. Unlike the adolescent, the adult patient will often need a multidisciplinary approach due to tooth migrations secondary to extractions or periodontal disease. MATERIALS AND METHODS: This article will address the indications and orthodontic solutions to various restorative problems relative to the adult patient. Specific orthodontic mechanics aimed at facilitating and improving the prosthetic outcomes will be described and illustrated with clinical cases.

Authorship characteristics of orthodontic randomized controlled trials, systematic reviews, and meta-analyses in non-orthodontic journals with impact factor.

Background/Objective: This study was conducted to explore authorship characteristics and publication trends of all orthodontic randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses (MAs) published in non-orthodontic journals with impact factor (IF). Materials and methods: Appropriate research strategies were developed to search for all articles published until December 2015, without restrictions regarding language or publication status. The initial search generated 4524 results, but after application of the inclusion criteria, the final number of articles was reduced to 274 (SRs: 152; MAs: 36; and RCTs: 86). Various authorship characteristics were recorded for each article. Frequency distributions for all parameters were explored with Pearson chi-square for independence at the 0.05 level of significance. Results: More than half of the included publications were SRs (55.5 per cent), followed by RCTs (31.4 per cent) and MAs (13.1 per cent); one hundred seventy-eight (65 per cent) appeared in dental journals and 96 (35 per cent) were published in non-dental journals. The last decade was significantly more productive than the period before 2006, with 236 (86.1 per cent) articles published between 2006 and 2015. European countries produced 51.5 per cent of the total number of publications, followed by Asia (18.6 per cent) and North America (USA and Canada; 16.8 per cent). Limitations: Studies published in journals without IF were not included. Conclusions/Implications: Level-1 evidence orthodontic literature published in non-orthodontic journals has significantly increased during 2006-15. This indicates a larger interest of other specialty journals in orthodontic related studies and a trend for orthodontic authors to publish their work in journals with impact in broader fields of dentistry and medicine.