搜索结果：Turkish journal of orthodontics

Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging. We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure. The Global Burden of Disease (GBD) 2023 study, a multinational collaborative research study, quantified burden due to 375 diseases including CVD burden and identified drivers of change from 1990 to 2023 using all available data and statistical models. GBD 2023 estimated the population-level burden of diseases in 204 countries and territories from 1990 to 2023. CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD. As of 2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in 1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally. As of 2023, age-standardized CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest in high SDI settings. The number of CVD deaths increased globally from 13.1 million (95% UI: 12.2 to 14.0 million) in 1990 to 19.2 million (95% UI: 17.4 to 20.4 million) in 2023. The number of prevalent cases of CVD more than doubled since 1990, with 311 million (95% UI: 294 to 333 million) prevalent cases of CVD in 1990 and 626 million (95% UI: 591 to 672 million) prevalent cases in 2023 globally. A total of 79.6% (95% UI: 75.7% to 82.5%) of CVD burden is attributable to modifiable risk factors 347 million [95% UI: 318 to 373 million] DALYs in 2023). Globally, high systolic blood pressure, dietary risks, high low-density lipoprotein cholesterol, and air pollution were the modifiable risks responsible for most attributable CVD burden in 2023. Since 1990, changes in exposure to modifiable risk factors have had mixed effects on CVD burden, with increases in high body mass index, high fasting plasma glucose, and low physical activity leading to higher burden, while reductions in tobacco usage have mitigated some of these increases. Population growth and population aging were the main drivers of the increasing burden since 1990, adding 128 million (95% UI: 115 to 139 million) and 139 million (95% UI: 126 to 151 million) CVD DALYs to the increase in CVD burden since 1990. CVD remains the leading cause of disease burden and death worldwide with the greatest burden in low, low-middle, and middle SDI regions. Large variation exists in CVD burden even for countries at similar levels of development, a gap explained substantially by known, modifiable risk factors that are inadequately controlled. The decades-long increase in CVD burden was the result of population growth, population aging, and increased exposure to a subset of risk factors led by metabolic risks. Countries will need to adopt effective health system and public health strategies if they are to progress in achieving global goals to reduce the burden of CVD.

For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. Gates Foundation and Bloomberg Philanthropies.

Comprehensive, comparable, and timely estimates of demographic metrics-including life expectancy and age-specific mortality-are essential for evaluating, understanding, and addressing trends in population health. The COVID-19 pandemic highlighted the importance of timely and all-cause mortality estimates for being able to respond to changing trends in health outcomes, showing a strong need for demographic analysis tools that can produce all-cause mortality estimates more rapidly with more readily available all-age vital registration (VR) data. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is an ongoing research effort that quantifies human health by estimating a range of epidemiological quantities of interest across time, age, sex, location, cause, and risk. This study-part of the latest GBD release, GBD 2023-aims to provide new and updated estimates of all-cause mortality and life expectancy for 1950 to 2023 using a novel statistical model that accounts for complex correlation structures in demographic data across age and time. We used 24 025 data sources from VR, sample registration, surveys, censuses, and other sources to estimate all-cause mortality for males, females, and all sexes combined across 25 age groups in 204 countries and territories as well as 660 subnational units in 20 countries and territories, for the years 1950-2023. For the first time, we used complete birth history data for ages 5-14 years, age-specific sibling history data for ages 15-49 years, and age-specific mortality data from Health and Demographic Surveillance Systems. We developed a single statistical model that incorporates both parametric and non-parametric methods, referred to as OneMod, to produce estimates of all-cause mortality for each age-sex-location group. OneMod includes two main steps: a detailed regression analysis with a generalised linear modelling tool that accounts for age-specific covariate effects such as the Socio-demographic Index (SDI) and a population attributable fraction (PAF) for all risk factors combined; and a non-parametric analysis of residuals using a multivariate kernel regression model that smooths across age and time to adaptably follow trends in the data without overfitting. We calibrated asymptotic uncertainty estimates using Pearson residuals to produce 95% uncertainty intervals (UIs) and corresponding 1000 draws. Life expectancy was calculated from age-specific mortality rates with standard demographic methods. For each measure, 95% UIs were calculated with the 25th and 975th ordered values from a 1000-draw posterior distribution. In 2023, 60·1 million (95% UI 59·0-61·1) deaths occurred globally, of which 4·67 million (4·59-4·75) were in children younger than 5 years. Due to considerable population growth and ageing since 1950, the number of annual deaths globally increased by 35·2% (32·2-38·4) over the 1950-2023 study period, during which the global age-standardised all-cause mortality rate declined by 66·6% (65·8-67·3). Trends in age-specific mortality rates between 2011 and 2023 varied by age group and location, with the largest decline in under-5 mortality occurring in east Asia (67·7% decrease); the largest increases in mortality for those aged 5-14 years, 25-29 years, and 30-39 years occurring in high-income North America (11·5%, 31·7%, and 49·9%, respectively); and the largest increases in mortality for those aged 15-19 years and 20-24 years occurring in Eastern Europe (53·9% and 40·1%, respectively). We also identified higher than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 5-14 years (87·3% higher in GBD 2023 than GBD 2021 on average across countries and territories over the 1950-2021 period) and for females aged 15-29 years (61·2% higher), as well as lower than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 50 years and older (13·2% lower), reflecting advances in our modelling approach. Global life expectancy followed three distinct trends over the study period. First, between 1950 and 2019, there were considerable improvements, from 51·2 (50·6-51·7) years for females and 47·9 (47·4-48·4) years for males in 1950 to 76·3 (76·2-76·4) years for females and 71·4 (71·3-71·5) years for males in 2019. Second, this period was followed by a decrease in life expectancy during the COVID-19 pandemic, to 74·7 (74·6-74·8) years for females and 69·3 (69·2-69·4) years for males in 2021. Finally, the world experienced a period of post-pandemic recovery in 2022 and 2023, wherein life expectancy generally returned to pre-pandemic (2019) levels in 2023 (76·3 [76·0-76·6] years for females and 71·5 [71·2-71·8] years for males). 194 (95·1%) of 204 countries and territories experienced at least partial post-pandemic recovery in age-standardised mortality rates by 2023, with 61·8% (126 of 204) recovering to or falling below pre-pandemic levels. There were several mortality trajectories during and following the pandemic across countries and territories. Long-term mortality trends also varied considerably between age groups and locations, demonstrating the diverse landscape of health outcomes globally. This analysis identified several key differences in mortality trends from previous estimates, including higher rates of adolescent mortality, higher rates of young adult mortality in females, and lower rates of mortality in older age groups in much of sub-Saharan Africa. The findings also highlight stark differences across countries and territories in the timing and scale of changes in all-cause mortality trends during and following the COVID-19 pandemic (2020-23). Our estimates of evolving trends in mortality and life expectancy across locations, ages, sexes, and SDI levels in recent years as well as over the entire 1950-2023 study period provide crucial information for governments, policy makers, and the public to ensure that health-care systems, economies, and societies are prepared to address the world's health needs, particularly in populations with higher rates of mortality than previously known. The estimates from this study provide a robust framework for GBD and a valuable foundation for policy development, implementation, and evaluation around the world. Gates Foundation.

In developed countries, orthodontists utilize social media platforms as a pivotal component of their marketing strategies. However, there exists a gap in understanding the broader perspective of healthcare professionals on the utilization of social media in healthcare service delivery. Therefore, this study aims to evaluate the perceptions of healthcare professionals in Turkey regarding the integration of social media within healthcare service delivery. This cross-sectional study, conducted between January and February 2023, surveyed 378 members of the Turkish Orthodontic Society. The survey consisted of two parts: a demographic questionnaire with 28 items and a 21-item "Social Media Marketing Activities Scale," developed with input from three experts. Data analysis will include an explanatory factor analysis. This study provides a snapshot of orthodontists' perspectives on social media marketing practices. When participants' views of patient communication through social media were examined, 19.8% said they "thought it was right" and 80.2% said they "thought it was wrong". The treatment and treatment alternatives shared with patients through social media were implemented in 16.5% of cases and not implemented in 83.5% of cases. When examining the social media accounts used by participants to communicate with patients, 56.8% used personal accounts, 43.2% used professional accounts, and when analyzing the social media accounts they used for promotional purposes, 15.8% had personal accounts, 84.2% of them used professional accounts. More than half (59.8%) of orthodontists believed that communicating with patients on social media could cause legal problems. The majority of orthodontists (88.7%) followed their competitors. The prevalence of participants' use of social media posts for advertising purposes was low, and it was determined that the main reason for this was the prohibition of advertising in the provision of health services.

To investigate the effect of deferred timing of therapeutic extraction on the rate of space closure during en masse anterior retraction. Twenty-six patients (aged 16-24 years) with bimaxillary protrusion, crowding <3 mm, requiring bilateral extraction of four first premolars were recruited. Permuted block randomization was done. Allocations were concealed in opaque envelopes which were numbered and sealed. Each patient's right and left quadrant was randomly assigned for premolar extraction. The extraction of the contralateral side was deferred until the commencement of retraction. The primary outcome was the rate of space closure, and the secondary outcomes were anchorage loss and canine rotation. Blinding was applied only during the outcome assessment. The independent t-test and Intraclass correlation tests were used for statistical evaluation. Twenty-four patients completed the study. The mean rate of space closure over a period of 4 months was found to be significantly higher for the recently extracted site (0.818&#xb1;0.208) when compared with healed site(0.426&#xb1;0.184)(p<0.001). The tipping of the canine was also significantly higher for the former (6.042&#xb0;&#xb1;1.398&#xb0;) than the latter (5.125&#xb0;&#xb1;1.035&#xb0;) (p<0.05). However, the amounts of anchorage loss and canine rotation were insignificant. No adverse effects were noted. The rate of space closure at the recent extraction site was faster than that at the healed site. There was no significant difference in the mesial movement of anchorage molars or rotation of canines into the extraction site. The tipping of canines was significantly greater in the recent extracted quadrant. The results of this trial indicate a clinical recommendation to initiate orthodontic retraction immediately following therapeutic extractions and offer a practical, non-invasive, safe procedure for increasing the rate of tooth movement.

This study aimed to evaluate the accuracy of airway volume measurements obtained from cone beam computed tomography (CBCT) images using various software programmes, with a focus on assessing the performance of NemoStudio compared to other tools. The estimated volumes were compared with the volume of the solid model's cavity filled with water (gold standard). A single 3D-printed airway model was created based on CBCT data and scanned 10 times under identical conditions. Volume measurements were performed using semi-automatic segmentation in 4 software programmes (NemoStudio, NNT Viewer, ITK-SNAP, and 3D Slicer). The results were compared to the gold standard using repeated measures analysis of variance, Bland-Altman plots, and post hoc comparisons. Nemo Studio demonstrated a systematic bias and higher variability compared to the gold standard, resulting in lower accuracy than the other software programmes. ITK-SNAP and 3D Slicer showed the highest agreement with the gold standard, while NNT Viewer also exhibited acceptable performance. Statistical analyses revealed significant differences in the accuracy of volume measurements among the software tools (P&#x2009;<&#x2009;.001). Bland-Altman plots highlighted Nemo Studio's broader limits of agreement, emphasizing its deviation from the gold standard. Variability in airway volume measurement accuracy underscores the need for careful software selection and methodological standardization. Further refinement of segmentation algorithms is essential for improved consistency and reliability in clinical applications. This study provides the first evaluation of NemoStudio's volumetric accuracy for CBCT-based airway measurements, offering novel insights into software reliability and the impact of algorithm selection in clinical and academic settings.

To compare skeletal ages determined using three different regression methods from measurements made on cervical vertebrae from lateral cephalometric radiographs (LCRs) with the skeletal age determined from hand-wrist radiographs (HWRs). LCRs and HWRs of 794 individuals (329 boys, 465 girls) aged 7-18 years were examined. The hand-wrist skeletal age of the participants was determined using the Greulich-Pyle (GP) atlas. Forty-four linear and nine angular morphometric measurements in the C2-C5 vertebrae were made in LCRs. Vertebral skeletal age (VSA) was determined in both sexes using Ridge, the least absolute shrinkage and selection operator (LASSO), and ElasticNet regression methods. The study results were evaluated using R2 (explainability power). Bland-Altman analysis was performed to determine the consistency of chronologic age (CA), GP age, and VSAs. LASSO regression showed the highest explainability power for VSA, with boys at 0.783 and girls at 0.741. In both sexes, the vertebral depth of concavities had high beta coefficients, and the posterior height of C3 vertebrae (TVup-TVlp) had the highest beta coefficient in boys in LASSO regression. The width of the limits of agreement in both CA and VSA graphs of GP age was wider in boys than in girls. The width of the limits of agreement of CA-VSAs was wider in girls than in boys. Although high R2 values were obtained, VSA showed no superiority over CA in the assessment of skeletal age, and no significant clinical advantage was observed. For the Turkish population, using GP age may be more accurate for determining skeletal age in orthodontic treatment planning.

The aim of this study was to compare the effects of two thermoforming machines on the gap width and thickness of passive aligners with the same nominal thickness from different manufacturers by using nano-computed tomography (CT). An intraoral scan of a patient with Angle's Class I malocclusion was conducted, and a 3D maxillary arch model was printed. The aligners (n=16) were fabricated using two thermoforming machines: Ministar machine (n=8) and a Plastpress machine (n=8). Each group was subdivided on the basis of aligner material: polyethylene terephthalate glycol (PET-G) (Group A) and thermoplastic polyurethane (TPU) (Group B). Sheets with a nominal thickness of 0.75 mm were used. Nano-CT was performed, and the rendered 3D models were sliced into central incisor, canine, and molar regions to assess gap width and aligner thickness in the buccal, incisal, and palatal regions. Comparing thermoforming machines, PET-G (p=0.010) and TPU (p=0.004) aligners showed significant differences in gap width in the molar region. Similar results were found for aligner thickness (TPU, p=0.05; PET-G, p=0.004). Comparing PET-G and TPU sheets thermoformed via the same machine, significant differences were observed only in the molar region (p=0.004), with no differences in the canine and incisor regions. Adaptation in the anterior region was greater than in that of the posterior region, whereas aligner thickness increased from posterior to anterior. Aligner material type significantly affected gap width and thickness only in the molar region, whereas the specific thermoforming machine did not substantially affect these characteristics.

This study aimed to evaluate proximal caries formation and Decay, Missing, Filled Teeth (DMFT) scores during clear aligner (CA) therapy compared with fixed orthodontic treatment. A total of 50 patients with a mean age of 19.9 years were divided into two equal groups (n=25) according to treatment method. Both CA and fixed appliance (FA) patients had low-to-medium levels of crowding. Caries formation and DMFT scores were assessed via radiographic and clinical examination before treatment (T0) and at the end of a six-month observation period (T1). The numbers of caries lesions and fillings was analyzed using a Two-Way Analysis of Variance with a significance level of 0.05. Significant statistical differences were found for both groups (p<0.001). The amount of proximal caries significantly increased in both groups, whereas the increase in non-proximal caries was only statistically significant in the FA group. DMFT scores also increased significantly in both groups, with the FA group showing a higher increase at the end of the observation period. Although CAs had an advantage in decreasing the overall risk of caries, no distinct advantage was found in reducing the risk of proximal caries lesions. The DMFT index was significantly higher in fixed orthodontic treatment patients than in CA treatment patients.

The present study aimed to evaluate the effect of rapid maxillary expansion (RME) and face mask treatment on the upper airway in patients with maxillary retrusion in two dimensions using digital cephalograms and volumetric evaluation using acoustic rhinometric measurements. A total of 22 individuals with a concave profile and skeletal and dental Class III malocclusion during growth and development with a mean age of 9.9&#xb1;1.38 years were included in the study. A bonded RME appliance and a petit face mask were adapted for the patients. Before treatment (T0) and after maxillary protraction (T1), lateral cephalometric films and acoustic rhinometric recordings were obtained. The dependent sample t-test was used for statistical evaluation. Cephalometric analysis revealed forward movement of the maxilla and backward downward rotation of the mandible. A significant increase was observed in the nasopharyngeal and oropharyngeal regions of the upper airway. Three-dimensional evaluation of the upper airway by acoustic rhinometry revealed only an increase in the volumes of the left nasal cavity after decongestant administration. A statistically significant increase in acoustic rhinometric measurements in nasal valves. When the correlation of the cephalometric findings of the nasopharyngeal region with the acoustic rhinometry findings was examined, no statistically significant relationship was found. As a result of this study, we observed an increase in the cephalometric measurements of the nasopharyngeal and oropharyngeal areas. A significant increase was observed in the minimal cross-sectional area measured by acoustic rhinometry.

Maxillary expansion is a common treatment in clinical orthodontics and can be performed in a wide age range using different methods. This bibliometric analysis aims to provide an overview of research on maxillary expansion. A literature search was performed in the Web of Science database, and publications related to maxillary expansion between 1970 and 2023 were included. Data, including titles, abstracts, keywords, countries, regions, and references, were exported and analyzed within the scope of the bibliometric indicators. The study was conducted on 2633 publications. Between 1970 and 2023, research on maxillary expansion showed a general upward trend in the number of publications. From the analyzed publications, we observed that rapid maxillary expansion (RME) was the most common type of maxillary expansion, accounting for 78% of all publications. Most publications originated from the United States (24.3%), and these articles were also the most cited (17180). Lorenzo Franchi contributed the most publications (85, 3.2%) and was cited 2830 times for maxillary expansion. The highest number of publications was from the University of Sao Paolo (119), and the most cited institution was the University of Florence (3287). The bibliometric indicators showed a rapid increase in the number of published works on the topic of maxillary expansion, particularly in recent years. Advances in patient evaluation (3D imaging, modeling) and application methods (mini-screws, clear aligners) appear to have helped to maintain the popularity of maxillary expansion. We also observed that maxillary expansion is associated with several other specialties in addition to dentistry.

The purpose of this study was to compare the effects of cherry juice, coffee, coke, gastric acid, and the thermo-aging procedure (TAP) on the shear bond strength (SBS) of APC II, APC flash-free, and conventional ceramic brackets. A total of 180 human premolar teeth were randomly divided into three major groups according to the type of ceramic bracket. Then, six subgroups (n=10) were established from each major group: Group 1: control; Group 2: only TAP; Group 3: 72 hours of cherry juice exposure + TAP; Group 4: 72 hours of coffee exposure + TAP; Group 5: 72 hours of coke exposure + TAP; and Group 6: 24 hours gastric acid exposure + TAP. SBS was assessed for each specimen using a universal test device, and the adhesive remnant index (ARI) was scored under a light microscope. Kruskal-Wallis and post-hoc Tamhane tests were used to analyze the data. Among the control groups, the highest SBS value belonged to conventional ceramic brackets (p<0.01). SBS values for all groups decreased as a result of each liquid and TAP. Gastric acid and coke had the greatest detrimental effects on SBS, while TAP had the least negative effects. The SBS values of APC II, APC flash-free, and conventional brackets were found to be statistically insignificant after different liquid exposures and TAP. TAP and various fluids had a negative impact on the SBS value of ceramic brackets. SBS values, however, were still higher than clinically acceptable (8-9 MPa) values, even after exposure to gastric acid and coke.

Orthodontic camouflage effectively addresses mild to moderate skeletal Class III malocclusion by repositioning the mandible and anterior teeth. However, recent findings suggest potential temporomandibular joint (TMJ) impact of the intermaxillary elastics frequently used in this treatment. This study aims to comprehensively assess changes in the TMJ and dentoskeletal relationship following Class III camouflage treatment, using a combination of CBCT and MRI. This clinical trial enrolled skeletal Class III malocclusion patients meeting eligibility criteria. Non-extraction camouflage treatment was administered, employing the straight wire technique with conventional Class III intermaxillary elastics. CBCT and MRI were conducted at baseline (T0) and after achieving normal occlusion (T1). Condylar position in three dimensions and dentoskeletal relationship were assessed from CBCT images using Dolphin&#xae; imaging software, while TMJ disc position and length were measured from MR images using MicroDicom software. Statistical analyses were performed with IBM&#xae; SPSS&#xae; software. The dataset comprised nine subjects, with a mean age of 24.3&#xb1;7.0 years. CBCT analyses indicated significant changes in dentoskeletal relationship, especially those of the mandible (increased ANB 2.32&#xb1;0.51&#xb0;, increased SN-MP 2.61&#xb1;1.05&#xb0;, decreased profile angle 5.40&#xb1;1.07&#xb0;), but nonsignificant changes in condylar position post-treatment (0.11&#xb1;0.15 mm). Similarly, MRI measurements demonstrated non-significant changes in both position (0.91&#xb1;1.61&#xb0;) and length (0.07&#xb1;0.37 mm) of the articular disc post-treatment. Class III camouflage treatment using conventional intermaxillary elastics significantly improves the dentoskeletal relationship without significant adverse effects on the condyle and articular disc of the TMJ.

The aim of this systematic review was to evaluate the clinical outcomes of skeletal anchorage, compared to conventional anchorage, in the treatment of skeletal Class III malocclusion in growing patients. A systematic review was conducted following PRISMA guidelines. A specific search strategy was developed for PubMed, Web of Science, Embase, and Cochrane searching for randomized controlled trials and non-randomized clinical trials. Eleven interventions were assessed, three employing conventional anchorage (group A) and eight skeletal anchorage (group B). Nine pre-treatment (T0) and post-treatment (T1) mean cephalometric outcomes were statistically polled (SNA, SNB, ANB, Wits, Overjet, Overbite, SNMP, IMPA, U1PP). In total, 196 studies were identified, 17 studies were included in the qualitative and quantitative analysis. In the skeletal anchorage group, a greater increase in both ANB (+2.511&#xb0;) and Wits (+4.691 mm) were observed and the increase in SNMP resulted well-controlled (+0.758&#xb0;). The conventional anchorage group showed higher dentoalveolar side effects: increase in U1PP (+5.624&#xb0;), decrease in IMPA (-0.866&#xb0;) and increase in overjet (+5.255 mm). Treatments exploiting skeletal anchorage determined a better correction of skeletal Class III, thanks to a combination of greater advancement of the maxilla and more enhanced retrusion of the mandible. In all treatment protocols exploiting dental anchorage, the increase in the inclination of the central incisor resulted significantly greater. Further longitudinal studies are required to evaluate the long-term effects of skeletal anchorage in growing patients.

In the socio-dental approach, the integration of normative oral health-related quality of life (OHRQoL) and behavioral propensity measures should be considered when assessing treatment needs and planning oral services. Therefore, this study aimed to evaluate the relationship between oral health impacts attributed to malocclusion and normative and self-perceived orthodontic treatment needs in adolescent patients and to determine the clinical, sociodemographic, and behavioral factors affecting their OHRQoL. This cross-sectional study was conducted using a convenience sample size of 105 adolescent patients aged 11-14 years who were referred to the Orthodontics Clinic in the Faculty of Dentistry, Istanbul. Data were collected using clinical examinations and a self-reported questionnaire, including the condition-specific Child Oral Impact on Daily Performances (CS-COIDP) attributed to malocclusion and sociodemographic, clinical, and behavioral factors. The index of complexity, outcome, and need (ICON), gingival index, and Decayed, Missing, Filled Teeth index was used to assess oral health status. Descriptive statistics and bivariate and multivariate regression analyses were used for the data analyses. A total of 70 patients (66.7%) reported at least one impact. Furthermore, 47% of the adolescents had very difficult and difficult complexity grades. The most affected performances were "emotional (52.4%) and smiling (40%)". No significant differences were found in the total CS-COIDP scores according to caries experience; however, the gingival status was associated with the total OHRQoL. Lower tooth brushing frequency, increased malocclusion complexity, and subjective treatment need were the most important predictors of worse OHRQoL, accounting for 39.3% of the variance in the scores. ( R2&#x2009;=&#x2009;0.422; p&#x2009;<&#x2009;0.001) CONCLUSIONS: Oral health professionals should consider oral behaviors, malocclusion complexity, and subjective treatment need when planning orthodontic treatment plans. Integrating ICON, CS-COIDP, and behavioral assessment will help identify adolescents who should be prioritized for treatment.

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 aim of this study was to evaluate the surface hardness, surface roughness, and chemical structure changes of four vacuum-formed retainer (VFR) materials after thermoforming. Four groups of VFR materials were evaluated: Taglus, Lumex-G, Atmos, and Duran. Each group consisted of 12 samples (n=12) that were thermoformed according to the manufacturer's guidelines. Surface roughness was measured using a high-precision profilometer, and hardness was assessed with a micro-Vickers hardness tester. Chemical structure analysis was conducted using Fourier transform infrared spectroscopy (FTIR), and surface morphology was examined using scanning electron microscopy (SEM). Hardness measurements demonstrated a general decrease across all groups following thermoforming. After thermoforming, surface roughness increased significantly in the Taglus and Lumex-G groups, whereas the Atmos and Duran groups maintained greater surface stability. FTIR demonstrated that all materials retained their chemical stability, and no significant changes in functional groups were detected. SEM results revealed more pronounced surface irregularities in the Taglus and Lumex-G groups. Polyethylene terephthalate glycol copolyester-based materials with high surface homogeneity, such as Atmos and Duran, may be recommended for clinical use due to their superior surface stability and chemical resilience. By contrast, the surface irregularities observed in Taglus and Lumex-G may compromise their long-term clinical performance.

Temporary anchorage devices (TADs) enhance the efficiency of fixed functional appliances (FFAs) by providing stable anchorage, improving skeletal and dental corrections, optimizing vertical control, and enhancing treatment outcomes for Class II and III malocclusions. TADs also help prevent the proclination of the lower incisors and the distalization of the molars, which are commonly observed with FFAs lacking skeletal anchorage. This study aims to analyze the displacement and stress distribution patterns generated in craniofacial structures and dentition using conjoined implants and intermaxillary elastics for growth modification in growing Class II patients. Finite element analysis was conducted using cone-beam computed tomography data from an 11-year-old patient with Class II Division 1 malocclusion. Mini-implants and miniplates were designed and assembled in SolidWorks, meshed using HyperMesh, and analyzed in Abaqus 6.14 to evaluate stress and displacement patterns under a 450 g orthopedic force applied via Class II elastics. In the mandible, the highest principal and von Mises stresses were observed on the posterior surface of the ramus, whereas in the maxilla, stress concentrations were noted lateral to the nasal aperture. Additional stress concentrations were identified in the region posterior to the glenoid fossa. The mandible was displaced anteroinferiorly as a whole, while the maxilla exhibited posterosuperior displacement. Dental movements included maxillary expansion with intrusion of the anterior teeth, and anterior displacement of the mandibular dentition, primarily resulting from bodily movement. The use of Class II elastics in combination with Temporary Anchorage Devices (TADs) produces greater stress and displacement in skeletal structures compared to the dentition. As a result, this treatment approach is more likely to produce substantial skeletal changes than dental alterations.

This study aimed to explore variations in enamel thickness to provide guidelines for optimal interproximal enamel reduction in an untreated population using cone-beam computed tomography (CBCT). CBCT scans of 100 orthodontic patients (51 Caucasian, 49 patients of Somalian descent; aged (12-18) were analyzed retrospectively. Enamel thickness was measured at the mesial and distal contact points of teeth from the second molar to the central incisor in both the maxillary and mandibular arches. Linear mixed models were employed to assess the effects of ethnicity, gender, anterior-posterior region, and mesial-distal proximal surfaces on enamel thickness. Fixed effects were estimated using the Kenward-Roger method, and a random intercept with an unstructured covariance matrix was included to account for within-subject variability. Ethnicity-specific residual variances were also modeled. Statistical significance was set at p<0.05. Enamel thickness varied significantly between Caucasians and Somalians in both the maxilla and mandible (p<0.001), with greater thickness observed in Caucasians. Gender-related differences were minimal; however, in the maxilla, distal surfaces of posterior teeth had greater enamel thickness in females compared to males (p=0.0478). Enamel thickness was consistently greater on distal surfaces of posterior teeth (p<0.001), while no significant differences were observed between mesial and distal surfaces in anterior teeth (p>0.05). Posterior teeth, particularly distal proximal surfaces of premolars and molars hold a great potential for enamel reduction, offering clinicians the most optimal site in orthodontic interventions.