Search Results (192)

Background: Class II malocclusion is one of the most common and challenging orthodontic problems, often requiring complex, lengthy treatment and sometimes involving extractions or surgery. While conventional fixed appliances have been the gold standard, the increasing demand for aesthetic and comfortable treatment alternatives has made clear aligners a prevalent choice. Understanding the specific biomechanics, limitations, and successful clinical strategies for using aligners—especially in managing vertical dimension and achieving skeletal correction (mandibular advancement)—is crucial for expanding non-invasive treatment options and improving outcomes for a broad range of Class II patients. Objective: The objective of this review is to examine the effectiveness and clinical approaches of clear aligners in Class II correction across different age groups, with particular attention to vertical control, mandibular advancement methods, and the predictability of tooth movements in both growing and fully mature patients. Materials and Methods: This review narratively discusses the most relevant clinical findings and practical strategies for managing Class II malocclusions with clear aligners. Particular attention is given to the integration of auxiliary devices, such as elastics, attachments, and temporary anchorage devices (TADs), which can enhance biomechanical control. Results: The combination of aligners with mini-implants and attachments resulted in a consequent decrease in excessive overjet, improvement in facial profile, and long-term stability supported by fixed retention. In growing patients, correction benefited from mandibular advancement protocols and control of molar extrusion, allowing for preservation of the mandibular plane angle. Movement predictability showed higher reliability in anterior torque movements, whereas maxillary incisor intrusion remained less predictable. Conclusions: Clear aligners, especially when supported by auxiliary device, such as mini-implants and attachments, offer a reliable and aesthetic alternative to conventional orthodontic treatment for Class II malocclusions. However, certain tooth movements may still be less predictable, highlighting the need for careful planning, individualized biomechanics, and ongoing technological improvements. Full article

Objectives: This study aimed to evaluate the available evidence on the use of orthodontic mini-implants (MIs) as temporary anchorage devices (TADs), with particular focus on how insertion angulation may influence clinical outcomes. A clinical case report was also included to complement the review findings. Methods: A systematic review was performed following PRISMA guidelines and a focused PICO question. Searches in PubMed, Web of Science, and Scopus, supplemented by manual screening of reference lists. Duplicates, systematic reviews, and studies outside the PICO scope were excluded. An observational analysis of CBCT and intraoral images, and a clinical case report, were evaluated with a standardized protocol for angulation classification based on anatomical landmarks and angular measurements. Results: Ten studies met the eligibility criteria. Most reported high survival rates, with stability defined by the absence of TAD mobility or loss. CBCT-derived data from two studies, together with one clinical case, demonstrated maintenance of alveolar bone. Improved outcomes were occasionally associated with changes in insertion angulation. Vertical positioning was more frequently linked to complications in shorter TADs, while horizontal placement preserved bone but introduced hygiene-related difficulties. Conclusions: TAD success and bone preservation may depend on insertion angulation, TAD size, and soft tissue conditions. Further standardized prospective studies are needed to validate these findings, particularly regarding intermediate diagonal insertion angles (between vertical and horizontal) extending from palatal to buccal, as observed in our clinical case, which is not yet reported in the literature. Full article

In this study, the properties of electrophoretically deposited (EPD) coatings on orthodontic implants made from Ti-6Al-4V alloy were evaluated during simulated implantation trials on animal bones. Three types of chitosan-based coatings were prepared using EPD: titanium nitride microparticles (TiNPs), titanium nitride nanoparticles (TiNNPs), and boron nitride particles (BNPs). Each of these coatings was also modified by adding a polylactic acid (PLA) layer using a dip-coating technique to compare their properties with and without this additional layer. The coatings were analysed using optical microscopy, confocal microscopy, and scanning electron microscopy (SEM) with elemental analysis. Surface roughness measurements of the coated implants were also conducted to highlight differences that could significantly influence the type and strength of the bone-implant interface, directly affecting the stability of the implant as an anchorage unit. Eventually, to evaluate the antibacterial properties of the EPD coatings, their antibacterial activity against both Gram-positive and Gram-negative bacteria strains was tested. Scanning electron observations confirmed the homogenous distribution of micro- and nanoparticles in all coatings. The highest surface roughness values were observed in layers containing titanium nitride nanoparticles (TiNNPs) and chitosan. The presence of an additional dip-coating PLA layer improved the adhesion, and its effect on the surface roughness depended on the particle size. While the antibacterial properties of the coatings show promising results, achieving optimal adhesion of the coatings to implants remains a challenge that requires further development. Full article

Background: A promising improvement in orthodontic diagnostics is the use of convolutional neural networks (CNNs) to predict skeletal maturity using dental radiographic data, namely the calcification phases of the lower canine. Objectives: The purpose of this study is to improve the prediction of skeletal growth maturation through the use of sophisticated deep learning techniques, particularly CNNs, in the analysis of orthopantomography developmental markers. Methods: The CNN was trained and validated using the suggested model, which enables precise assessment of skeletal maturity across data collected from patients undergoing orthodontic and dental evaluations. By using a multiclass classification framework to classify the various stages of skeletal maturation. Results: CNN model predicting the development of the lower canine from the second molar provided a test accuracy of 97.50%, the model made it possible to automatically interpret radiographic features that were previously evaluated manually. Conclusions: CNN models can be trained to correctly identify the lower canine calcification stage, this helped clinicians with treatment planning and timing, especially with regard to growth modification, implant, prosthodontics approach and its clinical applicability. It guarantees ethical imaging procedures and optimizes clinical workflows by doing away with the necessity for further imaging. Full article

Background: Class II is considered one of the most common malocclusions, influencing 37% of schoolchildren in Europe and 33% of orthodontic patients in the United States. When this type of malocclusion is combined with increased overjet with proclined teeth and maxillary excess, then moving maxillary molars distally is suggested. According to the recent literature, modern appliances that lack patient cooperation can be combined with temporary anchorage devices to provide absolute and skeletal anchorage while supporting the non-compliance appliances to eliminate their side effects, such as anterior and posterior anchorage loss along with maxillary molar inclination and rotation. To counteract these limitations, the Advanced Molar Distalization Appliance (amda^®), a non-compliance appliance for maxillary molar distalization supported by two mini-implants (MIs) with anterior abutments, was recently developed. Methods: In this preliminary prospective clinical trial, eight consecutive patients treated with the amda^® are evaluated through lateral cephalometric radiographs, while its application, construction, and anchorage is presented and discussed. The evaluation of dentoalveolar and skeletal changes has been made with 14 variables measured on the pre- and post-cephalometric radiographs before and immediately after maxillary molar distalization (T₀ and T₁, respectively), along with cephalometric superimpositions by the structural method. Results: In total, the mean distal molar movement was 4.2 ± 1.37 mm, the mean distal tipping was 1.7 ± 1.9 degrees, and the vertical movement was 1.6 ± 2.6 mm. Conclusions: The amda^® seems to provide an ideal option for treating patients with Class II malocclusion, achieving bodily movement of the maxillary molars with only minimal distal tipping and no anchorage loss. Full article

Background/Objectives: Tooth autotransplantation is a natural tooth replacement method that preserves the periodontal ligament, supporting root development and alveolar bone remodeling. Unlike dental implants, autotransplanted teeth maintain sensory function and adapt better to the mouth. Although once overlooked, new surgical, imaging, and regenerative advances have revived interest in this technique. This narrative review explores the renewed interest in tooth autotransplantation by assessing its benefits, success rates, technological advancements, and role in modern dentistry while evaluating its advantages, limitations, and potential impact on dental care. Methods: A narrative approach was used to provide a comprehensive and descriptive overview of current knowledge on tooth autotransplantation. A literature search was conducted in PubMed, Scopus, and Google Scholar using keywords such as “tooth autotransplantation”, “biological tooth replacement”, “periodontal ligament”, and “dental implants alternative”. English-language articles published between 2000 and 2025 were included, covering clinical trials, reviews, and relevant case reports. Selection focused on studies discussing biological mechanisms, clinical techniques, technological advances, and treatment outcomes. Results: Success rates range from 80% to 95%, with better predictability in younger patients with immature donor teeth. Long-term viability depends on preserving the PDL and performing atraumatic extractions. However, challenges such as root resorption, ankylosis, and appropriate case selection remain significant considerations. Technological advancements, including CBCT, 3D-printed surgical guides, and biomimetic storage media, have improved surgical precision and clinical outcomes. Conclusions: Tooth autotransplantation is an effective and cost-effective alternative to dental implants, particularly for growing patients or when implants are not suitable. While success depends on surgical skill and proper case selection, improvements in imaging and regenerative techniques have made outcomes more predictable. Future advances in bioengineering, AI-based planning, and regenerative therapies are likely to expand their use in modern dentistry. Full article

Background/Objective: Orthodontic mini-implants (MI) create new niches that may alter the oral microbiota and modulate host immune responses. While clinical inflammation is not always evident, microbial and molecular changes may precede visible signs of peri-implant infection. This study investigated microbial shifts and inflammatory responses following MI placement, with a focus on Saccharibacteria, nitrate-reducing bacteria (NRB), and periodontopathogens. Methods: Saliva and peri mini-implant crevicular fluid (PMICF) samples were collected from eight orthodontic patients at baseline (T0), one week (T1), and one month (T2) after mini-implant placement. DNA was extracted from each saliva and PMICF sample and pooled across the eight patients for each time point. The pooled DNA were then subjected to 16S rRNA gene sequencing using the Oxford Nanopore MinION platform. Statistical analysis was performed to determine shifts in bacterial abundance, diversity, and co-occurrence patterns across the different sample types (saliva vs. PMICF) and time points. Results: Alpha diversity decreased in PMICF at T2, while it remained stable in saliva samples. Periodontopathogens (Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum) increased in PMICF at T2, while NRB and Saccharibacteria, along with a representative host bacterium (Schaalia odontolytica), remained relatively stable. Co-occurrence analysis showed antagonistic relationships between Saccahribacteria/NRB and periodontopathogens. IL-6 significantly decreased from T1 to T2, while CRP showed a non-significant downward trend. The expression of nitrate reductase genes narG and napA remained stable across time intervals. Conclusions: Despite no clinical inflammation, MI placement led to localized microbial shift and mild inflammatory responses. NRB and Saccharibacteria’s stability and antagonistic relationship to periodontopathogens may indicate that they could be involved in maintaining microbial homeostasis. These findings highlight possible early biomarkers and ecological strategies to support oral health in MI patients. Full article

Objective: This scoping review identifies and analyzes factors influencing the effectiveness of orthodontic mini-implants and temporary anchorage devices in orthodontic treatments, including clinical applications, success rates, and associated complications. Methods: A systematic search was conducted across EBSCOhost, Ovid Medline, PubMed, Scopus, and Web of Science for peer-reviewed, English-language human studies published between 2013 and 2023 that examined determinants of mini-implants/temporary anchorage devices success or failure. Inclusion/exclusion criteria were predefined, and screening was performed in duplicate. Thirty-six studies met criteria. Results: Placement site and peri-implant oral hygiene/soft-tissue health were the most consistent contributors to success. Optimal sites varied by indication, supporting individualized planning. Greater implant length generally improved stability but must be balanced against anatomic limits and patient comfort. Temporary anchorage devices supported diverse movements (e.g., molar distalization; posterior/anterior intrusion). Findings for loading protocol, patient age, bone quality, and operator experience were mixed, reflecting heterogeneity in primary stability, force magnitude/vector, and outcome definitions. Conclusion: Mini-implants/temporary anchorage devices success is multifactorial. Emphasis on site-specific selection, hygiene management, appropriate implant dimensions, and patient-specific modifiers can optimize outcomes and minimize complications. Future studies should report standardized outcomes and explicit loading parameters to enable granular analyses of movement-specific biomechanics and evidence-based decision-making. Full article

Background. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. Materials and Methods. This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. Results. Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. Conclusions. In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry. Full article

The Maxillary Skeletal Expander (MSE) is used for maxillary expansion in adolescents and young adults. Virtual planning using 3D models, CBCT and 3D printers help in case selection, appliance design and fabrication. Using the proposed digital workflow, the accuracy of the patient selection phase and appliance delivery are increased, and the required number of visits to the clinic is decreased. The MSE serves as a guide for the insertion of mini-implants, reducing the number of appointments needed for installation. (1) Introduction: Mini-Implant-Assisted Rapid Palatal Expansion (MARPE) appliances, like the MSE, decrease the side effects that regular tooth-anchored appliances have on dental and periodontal structures, especially for skeletally mature patients, combining palatal anchorage with dental support for guidance. The digital planning of the insertion sites, length and angulation of the mini screws, and the fabrication of the 3D-printed appliance that stands as a mini-implant insertion guide give an undeniable precision. (2) Materials and methods: The laboratory steps used in the digital design and fabrication, and clinical steps needed for the insertion protocol are described. (3) Discussions: The individual assessment of the anatomical structures and the use of virtual integrated dental impressions and CBCT increase the accuracy of diagnosis, appliance fabrication and treatment progress. Implementing a digital workflow for mini-implant-supported expansion is a real advantage for both dental teams and patients. (4) Conclusions: The wide range of advantages and the ease of the process support the introduction of this digital workflow in every orthodontic practice. Full article

Orthodontic mini-implants are well-known anchorage devices and stand out as a particularly effective tool for ensuring maximum anchorage without relying on patient compliance. Therefore, it is necessary to understand what levels of torque strains remain in the physiological limits and can guarantee the stability of these mini-implants. The aim of this study was to investigate and measure the initial and final torque values of orthodontic mini-implants when placed perpendicular to the maxillary and mandibular bone surfaces. In our study, orthodontic mini-implants from different companies were inserted perpendicularly using different insertion torques on the plate of both maxillary and mandibular bones from pig specimens. The torque values were then analyzed. The results of this study highlight the need for continued research to analyze the ideal insertion torque of different types of mini-implants depending on the insertion area, in order to achieve clinical success of mini-implants. Full article

The biocompatibility of orthodontic archwires is crucial for ensuring patient safety and the long-term success of orthodontic treatment. This study evaluated the biocompatibility of stainless steel (SS) and nickel–titanium (Ni-Ti) orthodontic archwires, as well as stainless steel metal brackets, before and after the application of a graphene coating. The assessment was based on the materials’ effects on a fibroblast cell line and on the development of a foetal chicken egg embryo. Fibroblasts that had been in temporary contact with steel and NiTi archwires after CW-CVD (cold wall chemical vapour deposition) treatment exhibited changes in morphology in the presence of the material. The materials exhibited moderate cytotoxicity. For metal brackets, the treated samples caused stronger cytotoxic changes in the culture. Unlike graphene-coated implants, where cells were found to directly adhere to the surface, the embryonic tissues did not treat the non-graphene-coated implants as an adhesive material. This study suggests that depositing carbon-based coatings, including graphene, on stainless steel archwires may reduce the cytotoxicity of orthodontic components. Using graphene increases adhesion of the implant surface to membrane-derived cells and the embryonic yolk and does not inhibit the further development of the chicken egg embryo. Full article

Background/Objectives: Growth prediction may be used by the clinical orthodontist in growing individuals for diagnostic purposes and for treatment planning. This process appraises chronological age and determines the degree of skeletal maturity to calculate residual growth. In developmental deviations, overlooking such diagnostic details might culminate in erroneous conclusions, unstable outcomes, recurrence, and treatment failure. The present review aims to systematically present and explain the available means for predicting growth in humans. Traditional, long-known, popular methods are discussed, and modern digital applications are described. Materials and methods: A search on PubMed and the gray literature up to May 2025 produced 69 eligible studies on future maxillofacial growth prediction without any orthodontic intervention. Results: Substantial variability exists in the studies on growth prediction. In young orthodontic patients, the study of the lateral cephalometric radiography and the subsequent calculation of planes and angles remain questionable for diagnosis and treatment planning. Skeletal age assessment is readily accomplished with X-rays of the cervical vertebrae and the hand–wrist region. Computer software is being implemented to improve the reliability of classic methodologies. Metal implants have been used in seminal growth studies. Biochemical methods and electromyography have been suggested for clinical prediction and for research purposes. Conclusions: In young patients, it would be of importance to reach conclusions on future growth with minimal distress to the individual and, also, reduced exposure to ionizing radiation. Nevertheless, the potential for comprehensive prediction is still largely lacking. It could be accomplished in the future by combining established methods with digital technology. Full article

Background: Tooth agenesis, particularly hypodontia, poses a clinical and esthetic challenge in growing patients due to limitations in definitive implant placement before skeletal maturity. Traditional solutions such as removable prostheses or orthodontic space closure often fail to provide adequate long-term stability, function, and tissue preservation. In recent years, orthodontic mini-implants have emerged as a promising interim solution. This narrative review aims to synthesize current clinical evidence on the use of orthodontic mini-implants as temporary prosthetic abutments in children and adolescents with hypodontia or post-traumatic tooth loss. Methods: A literature search was conducted using PubMed and Google Scholar databases, covering studies published between January 2004 and March 2025. Inclusion criteria were clinical reports involving skeletally immature patients with congenital or traumatic tooth loss treated with mini-implants, with mandatory radiographic diagnostics and outcome data. Data extracted included patient demographics, etiology, implant site, imaging, follow-up, complications, and outcomes. A total of 17 studies comprising 42 cases were analyzed and summarized in tabular form. Results: Patients aged 6 to 16 years were treated primarily for agenesis of maxillary lateral or central incisors. The mean follow-up duration was 36.9 months. CBCT was used in 28.6% of cases. Mini-implants demonstrated high clinical success with stable soft tissue contours and preservation of alveolar volume. Complications were reported in 21.4% of cases and included crown debonding, minor infraocclusion, soft tissue irritation, and rare instances of osseointegration. Conclusions: Orthodontic mini-implants may provide a minimally invasive and reversible approach to interim tooth replacement in growing patients. Preliminary evidence suggests favorable outcomes in terms of stability, esthetics, and tissue preservation, but further prospective research is needed to validate their long-term effectiveness and standardize clinical application. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article