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Tooth autotransplantation (TA) is a proven and effective treatment option for children with missing teeth; however, it is seldom performed in the United States due in part to the lack of knowledge about its practicality and costs. In this study the authors sought to analyze and compare costs of TA with the most common tooth replacement options being used. A comprehensive literature review and expert panel were used to establish treatment clinical pathways. Procedural costs were calculated using the CDT 2024: Current Dental Terminology codes, and their corresponding fees from FAIR Health data and the American Dental Association Survey of Dental Fees. Time costs, which were defined as work time lost per appointment for families, were calculated using the US Bureau of Labor Statistics hourly wage data and number of visits. A cost model was constructed comparing the cost of maxillary anterior TA in patients aged 8 through 25 years with the associated costs of implant-supported prosthesis, resin-bonded fixed partial denture, and orthodontic space closure. Implant-supported prosthesis without or with orthodontics was more costly (procedural costs: $9,186-$15,279) than TA with limited or comprehensive orthodontics (procedural costs: $6,134-$10,355). Resin-bonded fixed partial denture without orthodontic treatment was the least costly (procedural costs: $4,455; time costs: $437). Orthodontic space closure (procedural costs: $9,295; time costs: $2,187) was found to be more costly than TA with limited orthodontics but less costly than TA with comprehensive orthodontics. TA is a practical tooth replacement option for families, and dental care professionals should consider TA for pediatric patients who require tooth replacement in the maxillary anterior region.

Introduction Growth assessment is a fundamental process in orthodontics as accurate determination of skeletal maturity guides the timing of treatment intervention. Biochemical and radiographic indicators can be used to evaluate growth status during adolescence. Insulin-like growth factor-1 (IGF-1) serves as a reliable biochemical marker of active growth, while the cervical vertebral maturation index (CVMI) provides a radiographic assessment of skeletal maturity. Vitamin D plays a vital role in bone metabolism and skeletal development. It may also influence growth mediators such as IGF-1. This study aims to assess and correlate levels of vitamin D with both IGF-1 and CVMI in 10-14-year-old patients. Method Patients who visited the Department of Orthodontics and Dentofacial Orthopaedics at Ranjeet Deshmukh Dental College and Research Centre of 10 to 14 years age were included in the study, provided they were not suffering from any systemic or endocrine disorders and had not consumed any vitamin D supplements. According to the established inclusion and exclusion criteria, a total of 50 subjects were selected for the study. Cervical vertebral maturation stages were assessed on a lateral cephalogram, which is routinely taken for orthodontic treatment. Two milliliters of blood samples were collected under all aseptic conditions with parental consent for assessment of IGF-1 by ELISA (DRG Diagnostics IGF-1 kit in Lisa Plus Elisa microplate reader) and vitamin D level by using ichroma vitamin D neo fluorescence Immunoassay. Results  There was a statistically significant difference in vitamin D levels across CVMI stages (χ² = 14.813, p = 0.005). Mean vitamin D levels increased from Stage 2 (11.97 ± 0.96 ng/ml) to Stage 4 (24.54 ± 4.76 ng/ml), followed by a slight decline in Stage 5 (23.05 ± 4.88 ng/ml) and Stage 6 (19.10 ng/ml). Mean IGF-1 levels showed a consistent increasing trend: Stage 2 (19.57 ± 0.90 µg/dl), Stage 3 (24.77 ± 2.56 µg/dl), Stage 4 (28.78 ± 2.49 µg/dl), Stage 5 (29.25 ± 2.84 µg/dl), and Stage 6 (33.80 µg/dl). This demonstrates a progressive rise in IGF-1 levels with skeletal maturation. Considering the overall sample, there was a weak to moderately positive correlation between vitamin D and IGF-1 levels (ρ = 0.428). Conclusion Levels of vitamin D had significant variations among CVMI stages. IGF-1 showed a consistent increase with advancing stages of CVMI, reflecting its positive association with pubertal growth and skeletal maturation. Correlation analysis revealed a weak to moderately positive correlation between vitamin D and IGF-1 levels. Therefore, IGF-1 is a more reliable indicator of skeletal maturation as compared to vitamin D, while vitamin D may still play a supportive role in growth-related biologic processes and skeletal development.

The risk of endocarditis is caused by Streptococcus viridans, which is found in the mouth and can cause dental issues. Men over 45 are at higher risk of endocarditis, and orthodontic appliances can disrupt mouth bacteria, increasing the risk of endocarditis and oral streptococci. Good oral hygiene and checkups can prevent complications, and patients in orthodontic treatment should be monitored for heart conditions and educated on oral hygiene. A 31-year-old male with known aortic valve disease was admitted for infective endocarditis and was treated with intravenous ceftriaxone. Fixed orthodontic appliances increase the risk of endocarditis and oral Streptococci, but patients can reduce these risks by maintaining oral hygiene and adhering to home oral hygiene routines; regular professional dental cleanings can also help maintain oral health during fixed orthodontics.

This clinical report describes the interdisciplinary treatment of a patient with hypoplastic amelogenesis imperfecta (AI) and an anterior open occlusal relationship. Prior to referral to the prosthodontics department, she had undergone active orthodontic treatment for 5 years. As she presented with skeletal, functional, and esthetic concerns, orthodontic treatment alone was insufficient to address her complex treatment goals. Given the complexity, optimal comprehensive management necessitated an interdisciplinary approach involving orthodontics, endodontics, periodontal therapy, orthognathic surgery, and definitive rehabilitation with minimum preparation adhesively bonded complete coverage restorations. A 5-year follow-up confirmed the stability of the results, with the patient reporting no further issues.

Skeletal Class III malocclusion represents a significant challenge in orthodontics due to its impact on facial aesthetics and function, particularly in patients with limited residual growth. Bone-anchored maxillary protraction (BAMP) with miniplates has emerged as an effective alternative to conventional orthopaedic approaches, providing greater skeletal effects with less dentoalveolar compensation. This study reports the clinical management of a patient with limited growth potential and skeletal Class III malocclusion, treated with miniplate-assisted maxillary protraction followed by aligner therapy. A 9-year-8-month-old female patient, presenting with maxillary retrusion and mild mandibular protrusion (SNA=79.2°, SNB=80.8°, ANB=-1.6°, AO-BO=-11.1mm), was treated with four Bollard miniplates and Class III elastics for 9 months. The orthopaedic phase resulted in significant maxillary advancement (SNA increased to 85.1°), improved sagittal relationship (ANB increased to 3.5°), and improved Wits score from -11.1mm to 1.8mm, with minimal changes in mandibular position. Structural overlays demonstrated that the maxillary advancement achieved during the orthopaedic phase was accompanied by vertical mandibular development during the orthodontic phase, thereby favourably redirecting the initial hypodivergent pattern and improving facial balance. Subsequent orthodontic refinement was performed with clear aligners, totalling 130 aligners in multiple refinement stages, leading to Class I relationships in the canines and molars, improved intercuspation, and correction of midline deviation. Although aligner therapy required multiple refinements, satisfactory functional and aesthetic results were obtained without the need for orthognathic surgery in this case. Maxillary protraction assisted by miniplates followed by aligner therapy was effective for the treatment of this case of skeletal Class III malocclusion.

To compare the incidence of bond failures and white spot lesions (WSLs) between brackets bonded with either light-cured resin-modified glass ionomer cement (GC Fuji Ortho LC) or light-cured composite resin (3M Transbond Plus Color Change Adhesive) after 18 months of treatment. 90 patients were allocated to the trial, and 84, with a mean age of 16.7 ± 2.6 years, were analyzed. The cross-mouth method was employed in each patient, in which two diagonal quadrants (e.g., upper right and lower left, or vice versa) were randomly assigned to the FujiOrtho group, and the opposite diagonal quadrants to the Transbond group. All patients were monitored for an average of 18 months for bond failure and WSL incidence. Multilevel mixed Poisson regression with robust standard errors was used to compare the groups. Overall, failure rates were 12.9% in the FujiOrtho group and 2.1% in the Transbond group, with an adjusted relative risk (aRR) of 6.21 (95% CI: 3.89-9.94), adjusted for age, sex, maxilla/mandible, tooth position, and treating orthodontist. Overall, WSL incidence was 8.3% in the FujiOrtho group and 8.8% in the Transbond group, with an aRR of 0.95 (95% CI: 0.80-1.13). Transbond Plus demonstrated a significantly lower bond failure rate compared to GC FujiOrtho LC, with a 3.6 times reduced risk of bracket failure. There were neither statistically nor clinically significant differences in the incidence of WSLs between the two groups.

The objective of the study was to compare the accuracy and fit of direct-printed and thermoformed aligners. The in vitro study included a pre-treatment scan as a reference model. Thirteen successive treatment stages were digitally planned and exported as STL files. Based on the treatment plan, 39 aligners were manufactured for three groups: Group 1, direct-printed aligners with TA-28 resin; Group 2, thermoformed polyurethane (PU) aligners; and Group 3, thermoformed polyethylene terephthalate glycol-modified (PET-G) aligners. All aligners were subsequently scanned, and the resulting STL files were superimposed on the baseline models. The dimensional accuracy and fit of the aligners were evaluated. The groups were compared using the Kruskal-Wallis test, followed by Dunn-Bonferroni post-hoc comparisons, with significance set at p&#x2264;0.05. Intra-rater and inter-rater reliability were evaluated via intraclass correlation coefficients. Group 1 exhibited greater dimensional accuracy, as evidenced by the lowest mean deviation compared with Groups 2 and 3 (p<0.001). Pairwise comparisons indicated significant differences between Group 1 and Group 2 and between Group 1 and Group 3 (p<0.001); however, no significant difference was found between Groups 2 and 3 (p=0.489). Landmark-based deviation analysis indicated that Group 1 demonstrated the least deviation across all nine evaluated anatomical landmarks (p<0.001). Group 3 showed slightly greater deviations than Group 2 for most landmarks. Direct-printed aligners fabricated using TA-28 resin exhibited significantly higher dimensional accuracy and a better fit than thermoformed aligners manufactured from PU and PET-G.

The present study aims to examine and classify the localization of canine teeth impacted in the maxilla for various reasons, their relationship with adjacent structures, and the developing pathologies by using cone beam computed tomography (CBCT). CBCT images taken for various reasons from 175 patients with maxillary impacted canine teeth that met the research criteria were examined. Demographic characteristics of the patients such as age and gender were recorded. The maxillary impacted canine teeth were examined by using CBCT in terms of their locations, relationship with the maxillary sinus, nasal floor and nasopalatine canal (NPC), relationship with adjacent teeth and the associated pathologies. A total of 209 maxillary impacted canine teeth of 175 patients were examined. Of the patients included in the study, 37.3% were male, while 62.7% were female. The mean age was found as 35 (age range 18-70). The rate of unilateral impacted canine teeth was 67.5% and 52.6% of the canine teeth were found to be located on the right side of the maxilla. Canine teeth were palatally impacted in 79% and 89% were found to be in a mesioangular position. The rate of canine teeth associated with the nasal cavity floor was found to be 7%, the rate of canine teeth with roots extending into the maxillary sinus was 6%, and the rate of canine teeth associated with NPC was found to be 15%. When the relationship of maxillary impacted canine teeth with the surrounding anatomical structures was examined, maxillary impacted canine teeth of male were found to have a higher relationship with the nasal cavity floor. The rate of pathologies associated with maxillary impacted canine teeth was found to be 22.5%. The most common pathologies were intracoronal resorption in maxillary canine teeth (8%) and root resorption in lateral incisors (7%). The results of the present study show that maxillary impacted canine teeth can remain for many years without causing pathology. However, it is crucial to evaluate them comprehensively by using CBCT when orthodontic or surgical intervention is planned.

To determine and compare the effects on differentiation, proliferation, and morphology of dental pulp-derived mesenchymal stem cells (DPSC) and preosteoblasts (pre-OBs) (Saos-2) that are either cocultured or treated with conditioned medium (CM) in vitro. In this experimental in vitro study, DPSC and Saos-2 cells were cocultured either directly-allowing physical contact-or indirectly, using a transwell system. These coculture systems were compared to treatment with CM from these cells over varying time periods. Morphological changes were evaluated using light microscopy, while cell proliferation was assessed with the resazurin colorimetric assay. Osteoblastic differentiation was analyzed by Alizarin Red staining and by quantifying changes in Runt-related transcription factor 2 (RUNX2), osterix (OSX), and osteocalcin (OCN) gene expression via real-time RT-PCR. All experiments were performed in triplicate and data analyzed by Student's t-test, ANOVA, or Mann-Whitney U test. Treatment with CM reduced the cell numbers for both cell types, whereas direct and indirect coculture led to an increase in cell numbers after 8 days of treatment. Morphologically, these treatments induced the formation of more elongated cells with greater cellular extensions compared to control groups. All experimental groups exhibited calcium nodule formation and increased relative expression of RUNX2, OSX, and OCN, consistent with induction of osteogenic differentiation. The results of this study suggest that both direct and indirect coculture of Saos-2 and DPSC cells, as well as treatment with CM, are effective in inducing morphological changes, proliferation, and osteoblastic differentiation. These strategies may therefore serve as useful tools for research into regenerative therapies aimed at repairing bone defects.

There has been a tremendous leap in resin composite technology over the last two decades. "The rapid pace of product development means that detailed clinical data on individual materials are often limited, even when improved versions are regularly introduced". This clinical investigation examined the effectiveness of a recently created resin composite for back teeth, which is universal supra-nano spherical filled, using revised United States Public Health Service (USPHS) standards. In order to conduct a clinical evaluation and comparison of two resin composites - Omnichroma, a universal supra-nano spherical filled resin composite, and Harmonize, a universal nanohybrid composite resin in Class I posterior restorations over the course of 6 months. A randomized, double-blind, split-mouth clinical trial was conducted in 50 patients, each requiring two Class I occlusal restorations. In each patient, one cavity was restored with a universal supra-nano spherical composite resin (Omnichroma, n = 50) and the other with a universal nanohybrid composite resin (Harmonize, n = 50). A self-etch, light-cured adhesive (Bond Force) was used for all restorations. Using modified USPHS criteria for retention, color match, marginal adaptation, surface texture, anatomic form (wear), postoperative sensitivity, and secondary caries, two calibrated evaluators, who were blinded to the materials, evaluated the restorations at 1 week (baseline), 1 month, 3 months, and 6 months. Use of Fisher's exact test (&#x3b1; = 0.05) was used for the analysis of categorical data. Frequencies and percentages were calculated, and Fisher's exact test was used for intergroup comparisons at each recall interval. A 100% recall at 1 week, 1 month, 3 months, and 6 months was achieved since all 50 patients were present at every recall session. When it came to clinical performance, both Omnichroma and Harmonize were on par. values of Bravo (clinically acceptable) and Alpha (excellent) were given to the majority of restorations, while no Charlie (failure) values were recorded. For each memory metric, there were no statistically significant differences between the two materials (P > 0.05). Within the 6-month follow-up period, Omnichroma and Harmonize composite resins demonstrated comparable and clinically acceptable performance in Class I posterior restorations.

Transformer-based architectures have rapidly gained prominence in medical imaging due to their ability to model long-range dependencies and global contextual information more effectively than convolutional neural networks. In dentistry, their applications have expanded across diagnostic, predictive, and generative tasks, yet no comprehensive synthesis has systematically evaluated their performance and clinical relevance. This systematic review provides an up-to-date assessment of Transformer-based models in dental imaging and diagnostics. A structured search of Medline, Embase, Web of Science, Scopus, and Cochrane databases was performed for studies published from 2020 to August 2025, following the PRISMA-DTA guidelines for diagnostic test accuracy systematic reviews and a PROSPERO-registered protocol (CRD420251142603). Eligible studies applied Transformer-based architectures to dental clinical tasks and reported quantitative performance outcomes. Two independent reviewers conducted article screening, data extraction, and bias assessment, resolving discrepancies through consensus. A total of 112 studies met the inclusion criteria. We found 91 hybrid convolutional neural network (CNN)-Transformer architectures and 23 pure Transformer models for dental image segmentation, classification, anomaly detection, and multimodal fusion tasks. In subgroup analyses, hybrid CNN-Transformer models consistently outperformed pure Transformer architectures. A significant 5-8% performance gap was observed between internal and external validation. These hybrid models demonstrated higher accuracy in tooth and anatomical segmentation, caries and lesion detection, orthopedic and orthodontic analysis, implant localization, and craniomaxillofacial assessment. Generative and predictive applications, such as 3D crown and bone reconstruction, dental age and sex estimation, artifact reduction, and implant position prediction, have achieved promising technical performance in controlled experimental settings, supporting further clinical translational research. Key advantages included enhanced global feature representation, improved robustness in heterogeneous imaging conditions, and the ability to incorporate multimodal inputs. However, major limitations remain: the scarcity of large annotated datasets, heterogeneous evaluation protocols, and limited prospective or real-world validation. Transformer-based models represent a significant methodological advance for dental AI, with superior technical performance in controlled experimental studies of dental imaging and diagnostic tasks. However, their clinical translation remains at an early stage. Broader clinical adoption requires not only standardized datasets, harmonized benchmarks and explainability frameworks, but also rigorous prospective multi-center clinical validation, regulatory and ethical evaluation, and real-world workflow integration assessment.

To evaluate the 3-year clinical performance of additively manufactured (AM) hybrid composite short-span implant-supported restorations fabricated through tilting stereolithography (TSLA) within a fully digital workflow. This retrospective clinical study included 218 patients rehabilitated with 278 implant-supported restorations fabricated from a ceramic-filled hybrid composite material using TSLA technology. The restorations comprised 207 single crowns (SCs) and 71 fixed partial dentures (FPDs), supported by 360 implants. All rehabilitations were produced through a complete digital workflow. Primary outcomes included marginal adaptation, occlusal and interproximal contact quality, and chromatic integration, assessed at delivery by two independent evaluators using a 5-point scoring system. Secondary outcomes included restoration survival and restoration success during follow-up. Kaplan-Meier survival analysis was performed. At delivery, both evaluators assigned predominantly excellent or satisfactory scores for marginal adaptation, occlusal contacts, interproximal contacts and chromatic integration, with no significant differences between restoration types (p > 0.05). During follow-up, 3 biological complications (1.1%) and 19 prosthetic complications (6.8%) were recorded, including 7 cases of abutment screw loosening, 6 decementations and 6 restoration fractures. Two implants failed during early healing, while three patients were lost to follow-up during the third year. Kaplan-Meier analysis revealed a cumulative restoration survival rate of 97.8% and an overall restoration success rate of 92.0% after 3 years. Within the limitations of this short-term study, TSLA-manufactured hybrid composite restorations demonstrated favourable clinical accuracy, high survival rates and acceptable short-term clinical performance. Hybrid composite restorations fabricated through TSLA may represent a promising option for definitive short-span implant-supported rehabilitations within contemporary digital prosthodontic workflows.

Pycnodysostosis is a rare genetic disorder associated with craniofacial anomalies that promote the occurrence of obstructive sleep apnea (OSA). We report the 15-year longitudinal follow-up of a patient with severe OSA treated with continuous positive airway pressure (CPAP). From the age of 2 years, the patient presented severe OSA confirmed by polysomnography and CPAP was initiated. Throughout follow-up, adherence was excellent (&#x2265;90%). Despite multidisciplinary follow-up and the addition of a dental prosthesis aimed at targeted expansion of the oral cavity, persistent maxillo-mandibular retrognathia was still present at age 17 years along with OSA persistence. This case highlights the importance of early and periodic follow-up and evaluation of alternative therapeutic approaches to improve upper airway patency in children with craniofacial syndromes such as pycnodysostosis.

The present study compares the anti-plaque efficacy of two commercially available dentifrices containing natural salivary enzymes in patients undergoing fixed orthodontic therapy. This prospective, parallel- arm, double-blind, randomized controlled trial included 54 participants undergoing fixed orthodontic therapy who were diagnosed with moderate to severe gingivitis and were randomly allocated into three groups (n&#x2009;=&#x2009;18 per group). Group A received Dente 91&#xae; dentifrice, Group B received Enzycal 950&#x2122; dentifrice, and Group C served as the control group. Intergroup differences were analysed using one-way ANOVA followed by Bonferroni post hoc test. Within-group comparisons across multiple time points were assessed using repeated measures ANOVA with post hoc analysis, while paired t-test was used for comparisons between two-time intervals. Correlations between clinical and biochemical parameters were evaluated using Pearson's correlation test. Primary outcomes included clinical parameters- Plaque Index (PI), Gingival Index (GI), and Bleeding on probing (BOP) which were assessed at baseline, 6, 12, and 24 weeks. The secondary outcomes involved evaluation of salivary biomarkers namely Advanced Oxidative Protein Products (AOPP) and Myeloperoxidase (MPO) levels which were estimated at baseline and at 24 weeks. Statistical analysis demonstrated significant differences between and within the three experimental groups at different time intervals with the level of significance set at p&#x2009;<&#x2009;0.05. Both enzyme-based dentifrices (Groups A and B) showed significantly greater improvements in PI, GI, and BOP compared to the Group C (control) (p&#x2009;<&#x2009;0.05). The salivary biomarkers, AOPP significantly decreased in Groups A and B (p&#x2009;=&#x2009;0.0002), compared to Group C at 24th week study interval. Strong positive correlations were found between clinical indices (PI, GI, BOP) and AOPP (p&#x2009;<&#x2009;0.001) whereas MPO levels did not exhibit a significant correlation (p&#x2009;=&#x2009;0.76) with any of the measured clinical parameters at study time points. These findings suggest that enzyme-based dentifrices provide effective plaque control and may additionally contribute to reduction in oxidative stress, thereby offering dual benefits for patients undergoing orthodontic treatment. This clinical trial was prospectively registered on 21st July 2023 with the Clinical Trials Registry- India (CTRI/2023/07/055494).

A cross-sectional study conducted from April 2016 to April 2018 at the Government Medical College and Hospital in Chandigarh, India, investigated coronal and root caries prevalence and DMFT (Decayed, Missing, Filled Teeth) indices among urban, middle-income adults. Overall, 601 individuals examined, aged 21-50 years, divided into three age groups: 21-30 (G1, n&#x2009;=&#x2009;200), 31-40 (G2, n&#x2009;=&#x2009;201), and 41-50 (G3, n&#x2009;=&#x2009;200). Using WHO Oral Health Assessment criteria, a calibrated examiner assessed caries; data graphically analysed and with Kruskal-Wallis tests with pairwise tests (3 age group comparisons), independent samples Kruskal-Wallis test (male/female comparison), and Spearman's correlations. The overall mean DMFT score was 6.52 (95% CI, 6.16-6.88), rising from 5.12 in G1 to 8.12 in G3 (P&#x2009;<&#x2009;0.01). DMFT component scores were D&#x2009;=&#x2009;4.02, M&#x2009;=&#x2009;1.73, and F&#x2009;=&#x2009;0.77. Age-related increase in decayed teeth prevalence (86% in G1, 86.5% in G2, 89.5% in G3), missing teeth (36%, 54.5%, 73.5%), and filled teeth (25%, 35.5%, 35.5%) was observed. Root caries prevalence was low (3%-4.5%), with no significant age-related differences (P&#x2009;>&#x2009;0.05). Females had significantly higher mean rank for DMFT, decayed, missing, and filled teeth scores than males (P&#x2009;<&#x2009;0.05), but no gender differences were found for root caries (p&#x2009;=&#x2009;0.195). Age weakly correlated with DMFT (r&#x2009;=&#x2009;0.262, P&#x2009;<&#x2009;0.001) and filled teeth (r&#x2009;=&#x2009;0.093, P&#x2009;=&#x2009;0.023), but not with decayed teeth or root caries. The study highlights the need for early preventive interventions, especially for younger adults and females, to curb caries progression, though weak correlations limit clinical significance.

Mandibular advancement devices (MADs) are effective alternatives for obstructive sleep apnea (OSA), yet robust predictors of response are lacking, and the phenomenon of device-induced expiratory velopharyngeal obstruction (EVO) remains overlooked. This study conducted an exploratory clinical simulation to compare the efficacy and airway dynamics of a custom-fitted, maximally protrusive advanced MAD simulator versus a conventional edge-to-edge oral appliance (OA) during drug-induced sleep endoscopy (DISE). In this prospective observational study, 75 adults with OSA underwent target-controlled infusion DISE. Upper airway obstruction (VOTE classification) and EVO were assessed in supine and head-rotated positions under three conditions: baseline, conventional OA, and advanced MAD simulator. A monitored subset (n=18) underwent simultaneous home sleep apnea testing to quantify apnea-hypopnea index (AHI) and lowest oxygen saturation (SpO2). The primary outcome was the change in upper airway obstruction severity at each VOTE anatomical site. Compared to the conventional OA, the advanced MAD simulator resolved complete velum obstruction in 34.8% of cases (supine, P = 0.015) and achieved 80.0% resolution for epiglottic obstruction during head rotation (P < 0.001). Velum responders in the supine position were younger and had a lower body mass index (BMI) and lower baseline AHI compared to non-responders (P < 0.05). In the monitored subset, the advanced simulator reduced AHI and improved lowest SpO2 compared to the conventional OA (P < 0.05). The incidence of EVO was higher with the advanced device (64.0% vs 41.3% in supine, P < 0.001), showing no significant association with tongue pressure. While the advanced MAD simulator effectively resolves inspiratory obstruction at the velum and epiglottis, it significantly increases EVO. This exploratory simulation highlights a critical mechanical trade-off between inspiratory patency and expiratory resistance. These hypothesis-generating results warrant further longitudinal research to determine the net clinical impact on long-term treatment adherence and sleep quality.

Alveolar bone resorption, driven by imbalanced osteogenesis and osteolysis, is a hallmark of periodontitis and orthodontic complications, yet molecular mechanisms coordinating stromal-immune crosstalk remain elusive. Here, we identify receptor tyrosine kinase-like orphan receptor 2 (ROR2) in alveolar bone-derived mesenchymal stem cells (ABMSCs) as a critical suppressor of inflammatory osteolysis. Using conditional knockout mice, we demonstrate that ROR2 deficiency in ABMSCs exacerbates alveolar bone loss by amplifying CXCL8 secretion, which enhances osteoclastogenesis while impairing osteogenic differentiation. Mechanistically, ROR2 sequesters interleukin-1 receptor-associated kinase 4 (IRAK4) via its Ig-like C2 domain, disrupting Myddosome assembly and downstream IRF7-driven CXCL8 transcription. Genetic ablation of IRAK4 in ROR2-deficient ABMSCs rescues pathological bone remodeling, restoring osteoblast-osteoclast equilibrium. Building on these findings, we engineer a thermosensitive chitosan/&#x3b2;-glycerophosphate hydrogel loaded with CXCL8-neutralizing antibodies, which effectively attenuates periodontitis-induced bone loss in vivo by suppressing osteoclast coverage and preserving osteogenic capacity. Our work unveils a ROR2/IRAK4/CXCL8 regulatory axis in ABMSCs that governs stromal-immune crosstalk during inflammatory osteolysis, offering a translatable strategy to recalibrate bone homeostasis in periodontal and orthodontic disorders.

Maxillary transverse deficiency (MTD) is conventionally evaluated using cone-beam computed tomography (CBCT), which entails increased radiation exposure, cost, and clinical workload. Frontal intraoral photographs are routinely obtained in orthodontic practice. Using CBCT-derived transverse measurements as reference standards, we developed, validated, and compared multiple deep learning (DL) models to assess the feasibility of identifying MTD from frontal intraoral photographs. This study included 826 internal and 192 external patients who underwent paired frontal intraoral photographs and CBCT. MTD was determined based on the University of Pennsylvania analysis (UPA) and Yonsei transverse analysis (YTA) labels. DenseNet 121, ResNet 18, EfficientNet B0/B3, and MobileNetV3 Small/Large were trained separately on photographs using UPA- and YTA-based labels. Five-fold cross-validation was employed, and performance was evaluated on the internal and external test sets using accuracy, precision, recall, and F1 scores, along with confusion matrices and areas under the receiver operating characteristic curves. DeLong's test assessed the differences between the models. In the external test set under the UPA labelling scheme, ResNet 18 achieved the highest accuracy (90.62%). Under the YTA labelling scheme, DenseNet 121 and ResNet 18 achieved the highest accuracy (96.88%). Across all internal and external test sets using both labelling schemes, DenseNet 121 and ResNet 18 yielded the best overall performance, and no statistically significant difference was observed between the two models (P > .05). The DL models demonstrated strong potential for analysing frontal intraoral photographs to detect MTD. These findings provide initial insights into the use of DL models to identify MTD from frontal intraoral photographs for orthodontic purposes. This study demonstrates the feasibility of using DL-based recognition of frontal intraoral photographs to identify MTD. As a cost-effective adjunctive tool, the proposed approach may assist clinicians in identifying MTD and help improve case selection for CBCT imaging.