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New Approaches and Technologies in Orthodontics—2nd Edition

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 13269

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Dr. Vincenzo Grassia

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Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
Interests: tooth movement; Tads; interdisciplinary approach; clear aligner
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Dr. Fabrizia d'Apuzzo

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Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
Interests: biology of orthodontic tooth movement; vibrational spectroscopies; orofacial pain; temporomandibular joint disorders
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Prof. Dr. Letizia Perillo

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Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio, 6, 80138 Naples, Italy
Interests: early treatment; nonextraction treatment; dentofacial orthopedics; cleft; genetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In 2020, the Special Issue "New Approaches and Technologies in Orthodontics" was released. We received 18 excellent papers, and you can access the full text via the link below:

https://www.mdpi.com/journal/jcm/special_issues/dentofacial_orthodontics.

In the last few years, new diagnostic and therapeutic approaches have been developed in orthodontics. New tools such as intraoral scanners, digital models, and cone beam computerized tomography have gradually become widely used, improving diagnoses, especially of impacted teeth, dental transpositions, and facial anomalies. The recent literature has also highlighted the important role of biomarkers in characterizing biological changes in tooth movement before and during treatment. Patients are focusing more on treatment time and aesthetics, so techniques to accelerate orthodontic movement, such as corticotomy, pulsed-light and mechanical vibrations, and clear aligners to improve aesthetics, are being used more frequently.

The aim of this Special Issue is to assess the scientific evidence of diagnostic and treatment innovations in orthodontics to expand our knowledge and support both scientific and clinical outcomes.

Thus, for the second edition of the Special Issue of Journal of Clinical Medicine (PubMed indexed ISSN 2077-0383; IF = 3.9), we are delighted to invite investigators to submit original research articles (trials, cohort studies, and case-control and cross-sectional studies), literature reviews (narrative or systematic reviews and meta-analyses), and high-quality case reports, all focusing on new orthodontic techniques or clinical solutions.

Dr. Vincenzo Grassia
Dr. Fabrizia d'Apuzzo
Prof. Dr. Letizia Perillo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

orthodontics
biomechanics
early treatment
dentofacial orthopedics
nonextraction treatment
miniscrews
clear aligners
cleft lip and palate
TMJ disorders
orofacial pain

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Related Special Issue

New Approaches and Technologies in Orthodontics in Journal of Clinical Medicine (20 articles)

Published Papers (8 papers)

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Research

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9 pages, 1647 KiB

Open AccessArticle

Impact of Dental Midline Shift on the Perception of Facial Attractiveness in Young Adults

by Babak Sayahpour, Sara Eslami, Ralf Usherenko, Abdolreza Jamilian, Mauricio Gonzalez Balut, Nicolas Plein, Vincenzo Grassia and Ludovica Nucci

J. Clin. Med. 2024, 13(13), 3944; https://doi.org/10.3390/jcm13133944 - 5 Jul 2024

Viewed by 955

Abstract

Background/Objectives: The aim of this study was to quantify the threshold of a dental midline shift that would compromise facial attractiveness and indicate a need for treatment from the points of view of laypeople and dental professionals. Methods: Whole-face natural photographs of a male and a female model were digitally manipulated to create various degrees of upper and lower dental midline shifts through bodily movement of the upper or lower midlines as well as alteration of the axial inclination of the upper teeth. The samples were then assessed by two groups of observers (laypeople (LP) and dental professionals (DP)). Results: The lower midline shift did not negatively affect the DP and LP’s perceptions of smile attractiveness. The first significant loss of attractiveness was registered by the DP with an upper midline shift of 1 mm in the female model. However, the LP registered this at 2 mm. The DP registered the necessity of treatment at a threshold of 2 mm in the female model and 3 mm in the male model. LP identified the need for treatment at 3 mm for both males and females. The female model was judged more critically than her male counterpart by both female and male observers. Conclusions: DP assess the midline deviation more critically than LP. Both DP and LP were more sensitive to midline deviations in the female model regardless of their own gender. Both groups registered the need for treatment at a higher threshold than the reduction in smile attractiveness. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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11 pages, 3350 KiB

Open AccessArticle

Predicting Outcome in Clear Aligner Treatment: A Machine Learning Analysis

by Daniel Wolf, Gasser Farrag, Tabea Flügge and Lan Huong Timm

J. Clin. Med. 2024, 13(13), 3672; https://doi.org/10.3390/jcm13133672 - 24 Jun 2024

Viewed by 1286

Abstract

Background/Objectives: Machine learning (ML) models predicting the risk of refinement (i.e., a subsequent course of treatment being necessary) in clear aligner therapy (CAT) were developed and evaluated. Methods: An anonymized sample of 9942 CAT patients (70.6% females, 29.4% males, age range 18–64 years, median 30.5 years), as provided by DrSmile, a large European CAT provider based in Berlin, Germany, was used. Three different ML methods were employed: (1) logistic regression with L1 regularization, (2) extreme gradient boosting (XGBoost), and (3) support vector classification with a radial basis function kernel. In total, 74 factors were selected as predictors for these methods and are consistent with clinical reasoning. Results: On a held-out test set with a true-positive rate of 0.58, the logistic regression model has an area under the ROC curve (AUC) of 0.67, an average precision (AP) of 0.73, and Brier loss of 0.22; the XGBoost model has an AUC of 0.67, an AP of 0.74, and Brier loss of 0.22; and the support vector model has a recall of 0.61 and a precision of 0.64. The logistic regression and XGBoost models identify predictors influencing refinement risk, including patient compliance, interproximal enamel reduction (IPR) and certain planned tooth movements, for example, lingual translation of maxillary incisors being associated with the lowest risk of refinement and rotation of mandibular incisors with the highest risk. Conclusions: These findings suggest moderate, well-calibrated predictive accuracy with both regularized logistic regression and XGBoost and underscore the influence the identified factors have on the risk of refinement in CAT, emphasizing their importance in the careful planning of orthodontic treatment and the potential for shorter treatment times, less patient discomfort, and fewer clinic visits. Identification of at-risk individuals could support tailored clinical decision-making and enable targeted interventions Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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Review

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26 pages, 4998 KiB

Open AccessReview

Surface Electromyography in Dentistry—Past, Present and Future

by Grzegorz Zieliński and Piotr Gawda

J. Clin. Med. 2024, 13(5), 1328; https://doi.org/10.3390/jcm13051328 - 26 Feb 2024

Cited by 9 | Viewed by 1874

Abstract

Surface electromyography (sEMG) is a technique for measuring and analyzing the electrical signals of muscle activity using electrodes placed on the skin’s surface. The aim of this paper was to outline the history of the development and use of surface electromyography in dentistry, to show where research and technical solutions relating to surface electromyography currently lie, and to make recommendations for further research. sEMG is a diagnostic technique that has found significant application in dentistry. The historical section discusses the evolution of sEMG methods and equipment, highlighting how technological advances have influenced the accuracy and applicability of this method in dentistry. The need for standardization of musculoskeletal testing methodology is highlighted and the needed increased technical capabilities of sEMG equipment and the ability to specify parameters (e.g., sampling rates, bandwidth). A higher sampling rate (the recommended may be 2000 Hz or higher in masticatory muscles) allows more accurate recording of changes in the signal, which is essential for accurate analysis of muscle function. Bandwidth is one of the key parameters in sEMG research. Bandwidth determines the range of frequencies effectively recorded by the sEMG system (the recommended frequency limits are usually between 20 Hz and 500 Hz in masticatory muscles). In addition, the increased technical capabilities of sEMG equipment and the ability to specify electromyographic parameters demonstrate the need for a detailed description of selected parameters in the methodological section. This is necessary to maintain the reproducibility of sEMG testing. More high-quality clinical trials are needed in the future. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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16 pages, 514 KiB

Open AccessReview

Patient-Reported Outcomes of Maxillomandibular Surgery for Obstructive Sleep Apnea Treatment: A Scoping Review

by Inês Francisco, Catarina Nunes, Anabela Baptista Paula, Filipa Marques, Madalena Prata Ribeiro, Mariana McEvoy, Mariana Santos, Catarina Oliveira, Carlos Miguel Marto, Gianrico Spagnuolo, Eunice Carrilho, Raquel Travassos and Francisco Vale

J. Clin. Med. 2024, 13(5), 1232; https://doi.org/10.3390/jcm13051232 - 21 Feb 2024

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Abstract

(1) Background: The present scoping review aims to scrutinize all existing patient-reported outcomes and assess the perspectives of obstructive sleep apnea patients after maxillomandibular surgery. (2) Methods: The review was carried out according to the extensions for scoping reviews using the PRISMA-ScR guidelines. Several databases were used to carry out the initial search. This study included randomized controlled trials, cohort studies, cross-sectional and case-control studies. The included studies considered patients with obstructive sleep apnea who were submitted to orthognathic surgery as the main subjects, and the patient’s perception of quality of life, satisfaction, treatment experience and side effects were assessed. (3) Results: From 1407 examined articles, a total of 16 were included. Most of the included studies used more than one questionnaire to assess quality of life, except for five articles. The most commonly referred instruments were the Epworth Sleepiness Scale, SF-36, the Functional Outcomes of Sleep and Ottawa Sleep Apnea. The most commonly assessed outcomes were sleep quality, daytime function, facial aesthetics, dental function and emotional health. (4) Conclusions: The number of variables that can be evaluated from a patient’s perspective are endless, as are the tools available to assess them. Not all of these tools, which are generally questionnaires, assess all the various outcomes, and some do not compare the pre- and post-surgical situations. Most of them are generic and lack specificity for obstructive sleep apnea. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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18 pages, 3151 KiB

Open AccessSystematic Review

Accuracy of Artificial Intelligence for Cervical Vertebral Maturation Assessment—A Systematic Review

by Wojciech Kazimierczak, Maciej Jedliński, Julien Issa, Natalia Kazimierczak, Joanna Janiszewska-Olszowska, Marta Dyszkiewicz-Konwińska, Ingrid Różyło-Kalinowska, Zbigniew Serafin and Kaan Orhan

J. Clin. Med. 2024, 13(14), 4047; https://doi.org/10.3390/jcm13144047 - 10 Jul 2024

Viewed by 1020

Abstract

Background/Objectives: To systematically review and summarize the existing scientific evidence on the diagnostic performance of artificial intelligence (AI) in assessing cervical vertebral maturation (CVM). This review aimed to evaluate the accuracy and reliability of AI algorithms in comparison to those of experienced clinicians. Methods: Comprehensive searches were conducted across multiple databases, including PubMed, Scopus, Web of Science, and Embase, using a combination of Boolean operators and MeSH terms. The inclusion criteria were cross-sectional studies with neural network research, reporting diagnostic accuracy, and involving human subjects. Data extraction and quality assessment were performed independently by two reviewers, with a third reviewer resolving any disagreements. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool was used for bias assessment. Results: Eighteen studies met the inclusion criteria, predominantly employing supervised learning techniques, especially convolutional neural networks (CNNs). The diagnostic accuracy of AI models for CVM assessment varied widely, ranging from 57% to 95%. The factors influencing accuracy included the type of AI model, training data, and study methods. Geographic concentration and variability in the experience of radiograph readers also impacted the results. Conclusions: AI has considerable potential for enhancing the accuracy and reliability of CVM assessments in orthodontics. However, the variability in AI performance and the limited number of high-quality studies suggest the need for further research. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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17 pages, 1571 KiB

Open AccessSystematic Review

Vertical Control in Molar Distalization by Clear Aligners: A Systematic Review and Meta-Analysis

by Tiffany H. Park, Christie Shen, Chun-Hsi Chung and Chenshuang Li

J. Clin. Med. 2024, 13(10), 2845; https://doi.org/10.3390/jcm13102845 - 11 May 2024

Viewed by 1663

Abstract

Background: Molar distalization is used to correct molar relationships or to create space for mild anterior crowding. However, whether clear aligners can provide proper vertical control with the sequential distalization strategy has been highly debated. Thus, the current study aimed to systematically review the amount of dentoskeletal changes in the vertical dimension that results from sequential molar distalization in clear aligner therapy without temporary anchorage devices (TADs). Methods: Registered with PROSPERO (CRD42023447211), relevant original studies were screened from seven databases and supplemented by a manual search by two investigators independently. Articles were screened against inclusion and exclusion criteria, and a risk of bias assessment was conducted for each included article. Relevant data were extracted from the included articles and meta-analysis was performed using RStudio. Results: Eleven articles (nine for maxillary distalization and two for mandibular distalization) were selected for the final review. All studies have a high or medium risk of bias. For maxillary molar distalization, the meta-analysis revealed 0.26 mm [0.23 mm, 0.29 mm] of maxillary first molar intrusion based on post-distalization dental model analysis, as well as 0.50 mm [−0.78 mm, 1.78 mm] of maxillary first molar intrusion and 0.60 mm [−0.42 mm, 1.62 mm] of maxillary second molar intrusion based on post-treatment lateral cephalometric analysis. Skeletally, there was a −0.33° [−0.67°, 0.02°] change in the SN-GoGn angle, −0.23° [−0.30°, 0.75°] change in the SN-MP angle, and 0.09° [−0.83°, 1.01°] change in the PP-GoGn angle based on post-treatment lateral cephalometric analysis. There was insufficient data for meta-analysis for mandibular molar distalization. Conclusions: No significant changes in vertical dimension were observed, both dentally and skeletally, after maxillary molar distalization with a sequential distalization strategy. However, further studies on this topic are needed due to the high risk of bias in the currently available studies. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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11 pages, 545 KiB

Open AccessSystematic Review

Evaluation of Aligners and Root Resorption: An Overview of Systematic Reviews

by Meiling Zhang, Peng Zhang, Jeong-Tae Koh, Min-Hee Oh and Jin-Hyoung Cho

J. Clin. Med. 2024, 13(7), 1950; https://doi.org/10.3390/jcm13071950 - 27 Mar 2024

Viewed by 1130

Abstract

Background: To evaluate the current evidence on clear aligners and root resorption using 3D and/or combined 2D and 3D methods from available systematic reviews and meta-analyses and to determine the relationship between root resorption and clear aligners using the AMSTAR 2 tool. Methods: A comprehensive literature search of systematic reviews investigating aligners and root resorption, published up until 31 December 2022, was conducted. The following electronic databases were searched: MEDLINE via PubMed, EMBASE, Google Scholar, Science Direct, Web of Science, Scopus, LIVIVO, and LILACS. There were no language restrictions. The inclusion criteria were restricted to studies focusing on root resorption utilizing either 3D methods exclusively or a combination of 2D and 3D techniques. Data were screened and analyzed for quality using the “A Measurement Tool to Assess Systematic Reviews (AMSTAR 2)” tool. Data extraction was conducted independently by two authors. The gathered information was categorized and synthesized narratively based on the primary findings elucidated within the reviews. Results: Out of a total of 1221 potentially eligible studies initially identified, 4 systematic reviews met the inclusion criteria following the exclusion of irrelevant studies. Among these, two systematic reviews (50%) were classified as low-quality, while the remaining two (50%) were deemed to be of critically low quality. Conclusions: Based on the findings of four systematic reviews, the root resorption rate was lower with the use of clear aligners than with fixed aligners. It is advisable to approach the interpretation of this conclusion with caution, as the quality of the available evidence is assessed to be very low. Higher quality systematic reviews are needed to substantiate this conclusion. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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21 pages, 2985 KiB

Open AccessSystematic Review

Celiac Disease-Related Enamel Defects: A Systematic Review

by Alessio Danilo Inchingolo, Gianna Dipalma, Fabio Viapiano, Anna Netti, Irene Ferrara, Anna Maria Ciocia, Antonio Mancini, Daniela Di Venere, Andrea Palermo, Angelo Michele Inchingolo and Francesco Inchingolo

J. Clin. Med. 2024, 13(5), 1382; https://doi.org/10.3390/jcm13051382 - 28 Feb 2024

Cited by 1 | Viewed by 2768

Abstract

Introduction: This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist’s role in early diagnosis. Materials and methods: Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available. Results: The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine’s classification, were predominant, and significant associations were observed between CD severity and enamel defect extent. Conclusions: The early recognition of oral lesions, particularly through Aine’s classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist’s crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues. Full article

(This article belongs to the Special Issue New Approaches and Technologies in Orthodontics—2nd Edition)

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