Int Orthod. 2025 Mar 18;23(3):100995. doi: 10.1016/j.ortho.2025.100995. Online ahead of print.

ABSTRACT

INTRODUCTION: To compare the in-vitro accuracy of guided palatal miniscrew insertion comparing expert and inexpert clinicians.

MATERIAL AND METHODS: Twenty-one synthetic bone models, derived from a single master model, were acquired to simulate the clinical act of miniscrew insertion. Digital planning and CAD/CAM surgical guide manufacturing were executed by matching the CBCT of the master model with its corresponding STL file. The insertion of two palatal miniscrews in the anterior paramedian region was planned. The operators (mean age 35 years±5 years; 11 males and 9 females) were divided into two sub-groups (inexperienced and experienced), and the miniscrews inserted using a standardized procedure. Linear and angular discrepancies between planned and inserted miniscrew positions were then evaluated at the level of head and tip point by superimposing the reference model (derived from digital planning) with the 20 working models (derived from scanning after miniscrew insertion). Absolute accuracy and comparison between the sub-groups were assessed using a one-sample Wilcoxon test (P<0.05).

RESULTS: Regardless of experience, a statistically significant difference in all investigated measurements was found. However, no statistically significant differences were detected between the two sub-groups, except for the sagittal discrepancy at the head, with the inexperienced group being less accurate (P=0.002).

CONCLUSIONS: The use of a CAD/CAM surgical guide ensures comparable accuracy between inexperienced and experienced clinicians, excepting some outlier discrepancies among the inexpert subjects. Although there are differences in accuracy between the planned and achieved miniscrew position, these differences do not appear to be clinically significant.

PMID:40106941 | DOI:10.1016/j.ortho.2025.100995

J Clin Orthod. 2024 Dec;58(12):745-757.

NO ABSTRACT

PMID:40064042

Prog Orthod. 2025 Mar 3;26(1):9. doi: 10.1186/s40510-025-00556-4.

ABSTRACT

BACKGROUND: To establish consensus of skeletal anchorage versus conventional anchorage in treating: 1. Maxillary transverse deficiency in growing and adult patients, 2. Class II skeletal disharmony due to mandibular retrusion in growing patients, 3. Class III skeletal disharmony in growing patients.

METHODS: A four-rounds modified Delphi method was conducted. A steering committee performed a literature selection and compiled a list of 33 statements. An international panel of 25 experts in orthodontics agreed to participate. In each round, panelists were asked to rate their level of agreement with each statement using a 5-point Likert scale and provide comments. Statements that reached consensus were either accepted or rephrased. Statements that did not reach consensus were either rephrased, rejected, or split into two statements or merged with another.

RESULTS: After the four rounds, 24 statements achieved consensus while 9 were rejected. The distribution of consensus statements was as follows: Maxillary transverse deficiency: 4 statements; Class II skeletal disharmony: 10 statements; Class III skeletal disharmony: 10 statements.

CONCLUSIONS: This modified Delphi consensus study aimed to provide guidance for orthodontists in choosing between skeletal and conventional anchorage for various treatment conditions. The study generated 24 consensus statements across three key domains. While the Delphi method provides valuable expert opinions, future studies, including randomized controlled trials, are needed to confirm these findings and address remaining uncertainties. Such efforts will aid in refining orthodontic treatment protocols and enhancing patient outcomes.

PMID:40025259 | DOI:10.1186/s40510-025-00556-4

Int Orthod. 2025 Feb 17;23(3):100989. doi: 10.1016/j.ortho.2025.100989. Online ahead of print.

ABSTRACT

The aim of this study was to describe the successful treatment of an anterior open bite in an adult Class II hyperdivergent patient. A 31-year-old female presented for orthodontic treatment, seeking an aesthetic solution to correct her anterior open bite and lower crowding to enhance her smile. As an initial step, all third molars were extracted to facilitate the forward rotation of the mandible and the initial closure of the open bite. Subsequently, clear aligner therapy (F22 aligners, Due Carrare, Italy) was initiated, with aligners changed every 15 days in combination with Class II elastics. Bite closure was achieved through programmed interproximal reduction (IPR) and the retroclination of anterior teeth. At the end of treatment, the open bite was successfully closed, a Class I relationship was obtained on the right side, and an edge-to-edge Class II relationship persisted on the left due to underlying skeletal asymmetry. Additionally, incisor exposure during smiling was improved. This clinical case demonstrates that clear aligners can effectively compensate a functional anterior open bite by promoting mandibular forward rotation and incisor retroclination.

PMID:39965467 | DOI:10.1016/j.ortho.2025.100989

Int Orthod. 2025 Feb 7;23(2):100984. doi: 10.1016/j.ortho.2025.100984. Online ahead of print.

ABSTRACT

This case report describes the successful non-extraction orthodontic treatment of a 13-year-old female patient affected by a Class II Division 2 malocclusion, maxillary constriction and a unilateral impacted maxillary canine. The miniscrew-assisted palatal expansion (MAPA) system was used for precise palatal miniscrew placement, achieving bicortical engagement. A hybrid T-Rex rapid palatal expander was then employed to achieve both skeletal expansion and molar distalization without requiring patient compliance. After that, tooth 2.3 was surgically exposed and orthodontically repositioned with a miniscrew-supported extrusion cantilever on a fixed vestibular appliance and piggyback mechanics. The orthodontic treatment was completed in a total of 31 months, yielding satisfactory intraoral results. Precise digital planning for palatal miniscrew insertion was instrumental in achieving bicortical anchorage, enabling the efficient use of a single multipurpose, miniscrew-supported palatal appliance.

PMID:39922093 | DOI:10.1016/j.ortho.2025.100984

Int Orthod. 2025 Jan 15;23(2):100965. doi: 10.1016/j.ortho.2024.100965. Online ahead of print.

ABSTRACT

This case report describes a complex full-step asymmetrical Class II division 1 high-angle in an adult patient treated by extraction of compromised first molars with a preadjusted lingual appliance. Since the patient presented severe sagittal and vertical discrepancies combined with an Izard orthofrontal profile with upper lip protrusion, an extraction camouflage was performed with the twofold aim of obtaining ideal occlusal relationship and profile improvement, correcting occlusal plane cant by selective intrusion with interradicular miniscrews. Appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of solving successfully severe sagittal and vertical discrepancies with significant asymmetric component in adult patient without surgical treatment by means of a completely invisible technique, with the extraction of the most compromised teeth in both arches. This report also underlines the need for careful planning during both diagnostic and treatment phases, with appropriate skeletal anchorage management, in order to obtain the best results.

PMID:39818043 | DOI:10.1016/j.ortho.2024.100965

J Clin Orthod. 2024 Oct;58(10):633-644.

NO ABSTRACT

PMID:39799594

J Clin Orthod. 2024 Nov;58(11):697-709.

NO ABSTRACT

PMID:39799603

Int Orthod. 2024 Nov 27;23(1):100954. doi: 10.1016/j.ortho.2024.100954. Online ahead of print.

ABSTRACT

This article describes one adult bilateral full-step class II case with severe initial upper incisors retroclination successfully treated by a completely invisible lingual appliance. A non-extraction treatment to compensate for the severe sagittal discrepancy was made possible following the excellent patient cooperation with intermaxillary elastics, combined with upper arch en-masse effective distalization with miniscrews. The application of an auxiliary torque spring was essential to increase upper incisors torque during class II mechanics. This case report shows the possibility of obtaining a full-step class II correction in an hypodivergent adult patient with a completely invisible appliance, taking advantage for the patient cooperation, for a more straightforward and faster non-extraction case resolution. It also underlines on the other hand the importance of successfully controlling incisors torque with auxiliaries in cases of severe retroclination in an adult class II malocclusion, in combination with the simultaneous distalization mechanics for monolateral full-step class II correction, by means of a completely invisible appliance.

PMID:39608335 | DOI:10.1016/j.ortho.2024.100954

J Clin Orthod. 2024 Septemeber;58(9):565-566.

NO ABSTRACT

PMID:39509600