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Background: Artificial intelligence (AI) is increasingly utilized in orthodontics for diagnosis, treatment planning, and clinical management. Nevertheless, considerable variation persists in orthodontists' knowledge, attitudes, utilization patterns, recommendations, and concerns regarding AI. The aim of this scoping review was to synthesize survey-based evidence on orthodontists' perceptions and experiences with artificial intelligence. Methods: A systematic literature search was performed in PubMed, Embase, Scopus, and Web of Science to identify survey-based studies evaluating AI awareness, applications, attitudes, recommendations, and concerns among orthodontists, residents, postgraduate students, and academicians. Results: Seven studies involving a total of 1772 participants were included. Overall, postgraduate students and practicing clinicians demonstrated relatively limited knowledge of AI, whereas academicians exhibited a higher level of awareness. Although routine clinical implementation of AI remains limited, it was most frequently applied-or perceived as beneficial-in cephalometric and cone beam computed tomography (CBCT) analysis, orthognathic surgery planning, and treatment outcome prediction. The majority of participants supported the promotion of AI and the integration of AI education into orthodontic curricula. However, concerns persisted regarding insufficient technical expertise, high costs, ethical and legal challenges, reduced patient engagement, and the potential for diagnostic or procedural errors. Consistent variations related to age and professional role were observed across studies among academicians, postgraduate students, orthodontists, and residents. Conclusions: This scoping review seems to suggest a growing interest in and generally positive attitudes toward AI among orthodontists and trainees. However, the evidence base is limited to a small number of studies, heterogeneous and predominantly based on cross-sectional survey data. For these reasons, findings should be interpreted cautiously. Variability in knowledge and use persists, and integration into practice remains inconsistent. Further research is needed to support effective and evidence-based implementation.

Clear aligner therapy (CAT) has transformed contemporary orthodontic practice; however, evidence regarding its adoption and clinical use among specialist orthodontists remains scarce. This study investigated CAT practices among Iranian specialist orthodontists. This study forms part of the Cardiff University International Aligner Survey: Orthodontists" Practices and Perceptions. A web-based cross-sectional survey of specialist orthodontists in Iran was conducted from October 2025 to January 2026. A voluntary, anonymous English-language questionnaire assessed demographics, CAT usage patterns, adjuncts, training, preferred malocclusions and patient age groups, monitoring and retention protocols, and perceived advantages and limitations. A total of 142 specialists (16%-20% estimated response rate) responded (83 male, 59 female). Most were aged 30-39 years (47.2%), had 11-20 years of experience (40.8%), and worked in private practice (59.9%). CAT was used by 69% of respondents; 35.9% treated <10 new CAT cases annually, while 7.7% treated >50. For 51.4%, CAT comprised about 10% of their caseload; only 2.8% reported CAT use in >50% of cases. CAT was used mainly in adults and least in mixed dentition/adolescents (P&#x2009;<&#x2009;0.001). Preferred indications were mild crowding (<4&#x2005;mm; 81.6%), spacing/diastema (63.1%), anterior crossbite (44.3%), and mild open bite (1-2&#x2005;mm; 38.6%). CAT was favoured for single-extraction or space-opening cases rather than complex extractions or orthognathic surgery. About 8.5% reported using a hybrid approach, consisting of CAT in one arch combined with fixed appliance therapy in the opposing arch. Elastics were the most common adjunct. Intraoral 3D scanners were the most common method (68.1%) for taking records among respndents (n = 141). Approximately, 49.3% and 19% of aligners were provided by local manufacturers or produced in-office, respectively. Most orthodontists recognised biomechanical limitations of CAT (agree and strongly agree), with 73.3% reporting limited control of tooth movement, 77.5% inadequate torque expression, 88.7% difficulty achieving certain tooth movements, and 88.8% a limited scope for complex cases. Furthermore, 68.1% believed CAT may require longer treatment times than fixed appliances, and 83.1% agreed that CAT often necessitates greater interproximal reduction than fixed appliance therapy. CAT was mainly used for mild malocclusions, supported by expanding local aligner manufacturers and in-office aligner production.

The study aimed to assess how variations in the golden proportion (GP) influence aesthetic perception among three groups: orthodontic patients, orthodontists and restorative dentists. It sought to determine a range of aesthetic tolerance for lateral incisors and canines, addressing gaps in previous literature. Our cross-sectional study included 128 participants (orthodontic patients and clinicians). Standardised smile photographs were digitally altered from a range of 52%-77% at 5% intervals. Participants rated photos on a five-point Likert scale. The range was determined by analysing scores using the interquartile range (IQR), focusing on photographs with a median &#x2265;3 and outliers were then removed. Kruskal-Wallis and Mann-Whitney U tests compared groups, while Spearman correlation evaluated gender and experience. Patients accepted a broader range of GP (52%-77%) compared to orthodontists (62%-67%), operative dentists (57%-72%) and prosthodontists (62%-72%). Between-group differences were significant for the majority of photographs (p&#x2009; < 0.05), with male photographs reaching high significance (p < 0.001). Post hoc analysis confirmed consistent differences between patients and professionals (p < 0.001), while fewer differences existed among professional groups, showing weak to moderate agreement (rb&#x2009;=&#x2009;0.257-0.396). Gender (p > 0.05, except for two images: p = 0.013, R&#x2009;=&#x2009;0.255) and clinical experience (p > 0.05) did not significantly influence aesthetic preferences. The study concludes that the GP is more applicable as a range rather than a fixed value. Patients showed a wider aesthetic preference than clinicians. The patients' perceptions were closer to restorative dentists than orthodontists (p < 0.001), likely reflecting differing clinical objectives. The inter-professional agreement observed supports the need for a multidisciplinary approach in aesthetic treatment planning. The clinical significance of the study lies in its potential to improve treatment outcomes in both aesthetic dentistry and orthodontics. The study highlights the need for a flexible, range-based approach while using the GP to achieve diverse aesthetic demands. The importance of interdisciplinary collaboration between restorative dentists and orthodontists in procedures such as space closures and teeth remodelling is emphasised, ultimately improving aesthetic and functional outcomes. It also acknowledges the variability in aesthetic perception among different cultural and ethnic backgrounds.

The assessment of orthodontic treatment needs often involves subjective judgment, particularly when using esthetic indices such as the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). This cross-sectional diagnostic agreement study evaluated whether large language models (LLMs) could provide consistent and reliable IOTN-AC scores comparable to those assigned by expert orthodontists. Three experienced orthodontists (with 8-15 years of clinical experience) independently scored 147 standardized frontal intraoral photographs using the IOTN-AC at two time points (Time 1 and Time 2). Five LLMs (GPT-4.0, GPT-o3, Claude, Manus, and Grok) were used to evaluate the dataset. Agreement and reliability were assessed using intraclass correlation coefficients (ICCs), Pearson and Spearman correlation values, mean absolute error (MAE), and match analyses (exact, near, and group matches). The orthodontists showed moderate inter-rater reliability (ICC = 0.649; 95% confidence interval [CI], 0.563-0.742). Among the LLMs, GPT-4.0 showed the highest agreement with expert scores (ICC = 0.771; 95% CI, 0.697-0.855), followed by GPT-o3 (ICC = 0.663). GPT-4.0 also yielded the strongest correlation (r = 0.773; P < 0.001) and the lowest MAE (1.09). In the match analyses, GPT-4.0 achieved the highest exact match (28.6%), near-match (47.6%), and group match (66.0%) rates. The remaining models showed lower performance across all metrics. Multimodal LLMs, particularly GPT-4.0, demonstrated substantial agreement with expert orthodontists in IOTN-AC scoring. These findings suggest that LLMs may serve as adjunct tools in assessments for orthodontic treatment needs. However, clinical decision-making should continue to rely on expert judgment.

This study evaluated and compared the perceptions of general dentists, pediatric dentists, and orthodontists regarding the need for transverse maxillary expansion for Class I malocclusions with posterior crossbite. An electronic survey consisting of digitally manipulated intraoral images depicting 8 clinical scenarios was distributed to 10,000 general dentists, 8734 pediatric dentists, and 2400 orthodontists. A total of 566 practitioners responded (2.7% response rate): 85 general dentists, 339 pediatric dentists, and 142 orthodontists. For each case, participants assessed the need for expansion, type of expansion, and referral preferences. Statistical analyses included chi-square tests and multivariable logistic regression, which were adjusted for specialty, years of experience, and geographic region. Significant differences in perception were observed in 6 of the 8 cases (P < 0.05), primarily influenced by specialty training. Orthodontists demonstrated significantly higher odds of recommending expansion than general dentists, particularly in more complex presentations. Pediatric dentists more frequently opted for referral rather than treatment. Neither years of practice nor geographic region significantly influenced diagnostic decisions. Survey reliability demonstrated moderate to substantial agreement across repeated cases (&#x3ba; = 0.424 to 0.677), and power analysis indicated sufficient sample size and effect sizes for most scenarios. These findings suggest that specialty training strongly influences the perceived need for transverse maxillary expansion, highlighting a potential need for enhanced orthodontic diagnostic education in dental and pediatric residency programs to promote consistency in the diagnosis and management of transverse discrepancies across dental specialties.

This study explored the extent to which orthodontists experience work-related musculoskeletal disorders (WMSDs) and burdensome working conditions, assessed job satisfaction, and identified factors associated with job satisfaction. Data were collected by means of a web-based survey comprising 64 items addressing general and professional characteristics, work-related musculoskeletal complaints, and five subscales addressing working conditions, stress, private circumstances, coping ability, and job satisfaction. Descriptive statistics, reliability analyses, and bivariate and multivariable linear regression analyses were performed. In total, 115 orthodontists participated. Almost three-quarters (73.0%) reported at least one WMSD, with the shoulders, neck, and lower back being the most frequently affected anatomical regions. While orthodontists reported a moderate burden from working conditions and private circumstances, most experienced low levels of stress, demonstrated high coping ability, and reported high job satisfaction. In bivariate analyses, fewer WMSDs, lower perceived burden from working conditions and stress, and higher coping ability were associated with greater job satisfaction. In the multivariable model, working conditions, practice ownership, and coping ability explained 25.2% of the variance in job satisfaction. Greater job satisfaction was most strongly associated with more favourable working conditions, owning a practice, and higher coping ability. Although lower perceived stress and fewer work-related musculoskeletal disorders were associated with job satisfaction in unadjusted analyses, they did not remain independent predictors in the multivariable model. These findings suggest that both organizational and individual factors contribute to professional satisfaction among orthodontists. However, additional determinants not examined in this study are likely to play a role.

Aims The rise of social media has facilitated new forms of orthodontic marketing with legitimate concerns among laypeople and professionals concerning the veracity of publicly available information. We aimed to understand orthodontists' perceptions of social media marketing of orthodonticsMethods Qualitative study using one-to-one interviews on online video-conferencing software. A sampling matrix was used to obtain representative views from specialist orthodontists in the UK. Qualitative data were collected using a topic guide, until saturation was reached, and analysed using an interpretive approach with thematic analysis.Results Twelve participants were interviewed with three emergent themes and 12 sub-themes. Key findings included the observation that an uneven playing field existed within orthodontics on social media. Unsafe expectations and misinformation were cited, and a need to standardise social media marketing in orthodontics was highlighted. Pivotal factors influencing orthodontists' perceptions and experiences of social media marketing in orthodontics were identified with highly pervasive misinformation and potentially harmful content, and a need for greater orthodontic representation, guidance and self-regulation being cited.Conclusions Orthodontists and patients require awareness of pitfalls of social media marketing to prevent risks of harm and inappropriate treatment.

To characterize current lingual orthodontic (LO) practice among orthodontists in France, assess how the emergence of clear aligner (CA) therapy has influenced its clinical use and document clinicians' perspectives on the future of LO. A survey using a 39-item questionnaire was administered via the SurveyMonkey&#xae; platform. The survey was distributed through the French Syndicate of Specialists in Orthodontics (SFSO), the Syndicate of Orthodontists of France (Les ODF), and a professional Facebook group, reaching an estimated 2971 orthodontists. Responses were collected anonymously. Data were analyzed using Python v3.12.7 with univariate and bivariate statistics; associations were assessed using &#x3c7;2 and Spearman correlation tests, with significance set at &#x3b1; = 0.05. Of 201 respondents, 59.7% (n = 120) reported active practice of LO. The most frequently used systems were WIN&#xae; (43.9%) and Incognito&#xae; (36.7%). A majority of practitioners treated 1-10 lingual cases annually, whereas aligner therapy was reported more frequently, with 28.3% indicating 21-50 aligner cases per year. Nearly half (48.4%, n = 46 of 95 respondents) reported offering lingual treatment less often since the rise in aligner use, and 76.8% (n = 73 of 95 respondents) perceived a decrease in patient demand for lingual appliances. Major reported barriers to lingual practice included prolonged chairside time (28.5%), limited clinician training (23.5%), and low patient demand (22.3%). Despite these challenges, 92.3% of respondents reported satisfaction with their clinical outcomes. Following the discontinuation of the Incognito&#xae; system, 28.6% of users planned to discontinue LO, and 80% expressed intent to transition to aligner therapy. Although a majority of the respondents report experience with LO, it represents a minority of their annual caseload. The increasing use of CAs appears to have influenced reported practice patterns. However, these findings reflect practitioner-reported behaviors and perceptions rather than clinical indications or appropriateness. LO is still perceived by clinicians as offering advantages in predictability, efficacy, and esthetic discretion, suggesting it may continue to play a role for select patients in contemporary orthodontic practice.

This study aimed to quantify the minimum perceptible degrees of rotation, buccolingual inclination (torque), and mesiodistal angulation (tip) of anterior teeth. Six digital models were scanned, segmented, and manipulated in ArchForm. Controlled movements were applied to maxillary and mandibular incisors and canines, including buccolingual inclination (3&#xb0;, 6&#xb0;, 10&#xb0;, 13&#xb0;), mesiodistal angulation (5&#xb0;, 10&#xb0;, 15&#xb0;, 20&#xb0;), and rotation (5&#xb0;, 10&#xb0;, 15&#xb0;, 20&#xb0;). Orthodontists evaluated paired original and manipulated images and identified the type of movement perceived. Orthodontists demonstrated high perceptual sensitivity across all simulated movements. Rotational discrepancies of 5&#xb0; were correctly identified by 65%-92% of evaluators, with accuracy increasing progressively. Tip showed consistently strong detection even at 5&#xb0; (75%-88%), reaching over 90% at 20&#xb0;. Torque yielded lower accuracy at 3&#xb0; (57%-74%), but surpassed 70% at 6&#xb0; and exceeded 80%-90% for 10&#xb0; and 13&#xb0;. Detection accuracy varied according to tooth type, with maxillary central incisors exhibiting the highest detection rates and canines showing greater variability at lower magnitudes. Rotational and tip discrepancies were consistently identified at 5&#xb0; or greater, whereas torque showed lower detection at 3&#xb0;. These findings establish quantitative perceptual thresholds for angular deviations in anterior teeth, values relevant to optimal esthetic outcomes.

This study examined the demographics, practice characteristics, service mix, and barriers faced by general and pediatric dentists in the provision of orthodontic care to the pediatric population, including children enrolled in Medicaid programs. A 31-item questionnaire was developed and distributed by email to 567 members of the Academy of Gp Orthodontics and the American Orthodontic Society. Analyses included descriptive and inferential statistical methods: chi-square, Kruskal-Wallis, and Student t tests; analysis of variance; and Spearman correlation. A value of (P < 0.05) was considered statistically significant. Thirty-four practitioners (6.0%), the majority male (58.8%), completed the survey. The mean (SD) age of respondents was 53.3 (11.8) years, and on average they had been practicing 23.3 (12.9) years. Respondents primarily practiced in suburban areas (47.1%), and most identified as general dentists (85.3%). Only 23.5% reported providing orthodontic services to children enrolled in Medicaid. The most common reasons for not participating in the program included low reimbursement rates, difficulty with billing, and patient noncompliance. Although time dedicated to orthodontic services varied, the majority (55.9%) allocated 10% to 25% of their practice time to such treatments. Most respondents (79.4%) referred cases to orthodontists, mainly Class III malocclusions (30.6%) and open bites (23.6%). General and pediatric dentists increase access to orthodontic services by evaluating patients, rendering care, and, when appropriate, referring patients to specialists. Respondents to this survey reported multiple barriers to providing orthodontic care, particularly for the Medicaid population. These findings underscore the need for reforms to address financial and administrative barriers to orthodontic care, particularly for underserved populations.

This study evaluated the performance of a multimodal large language model (MLLM), Chat Generative Pretrained Transformer-5.5 (ChatGPT-5.5), in determining orthodontic treatment need based on the Index of Complexity, Outcome, and Need (ICON) using intraoral photographs and digital model images. Agreement at the ICON component level and consistency with the total ICON score were also examined. A total of 104 patients contributed 520 intraoral photographs and 520 rendered digital model images. Two orthodontists independently scored all ICON components (aesthetics, crowding/spacing, crossbite, vertical relationship, and buccal relationship), and cases with complete interrater agreement were used as the reference standard. A standardized ICON prompt for ChatGPT-5.5 was optimized using the Iterative Prompt Calibration (IPC) method. Model outputs were assessed using accuracy, sensitivity, specificity, F1-score, exact agreement rates, Cohen's kappa, and intraclass correlation coefficients (ICC). Confusion matrices and ROC curves were generated for the binary treatment-need decision. The ChatGPT-5.5 achieved overall accuracies of 74.0% for intraoral photographs and 72.1% for model images. Recall was high for treatment-required cases (0.871 and 1.00, respectively) but markedly lower for cases not requiring treatment (0.471 and 0.147). Component-level agreement varied considerably, with significant differences between photographs and models for crowding/spacing and vertical relationships. The anteroposterior relationship showed higher accuracy in model evaluations. ICC values for the total ICON score were 0.463 for photographs (moderate reliability) and 0.154 for models (poor reliability). AUC values were 0.671 and 0.574, indicating limited discriminative performance. Although ChatGPT-5.5, evaluated as a MLLM, demonstrated moderate accuracy in the binary classification of orthodontic treatment need, its inconsistent performance across ICON components and tendency to overestimate treatment need limit its current clinical reliability. Therefore, clinical decision-making should remain guided by expert judgment.

Orthodontic finishing is a preference-sensitive decision point in which patients and clinicians may place different emphasis on satisfaction and clinician-defined finishing standards. This study compared patient and orthodontic clinician perspectives on treatment completion, focusing on how satisfaction is weighted relative to occlusal perfection. A cross-sectional study used two online surveys (adult patients and orthodontic clinicians) with five-point Likert items. Ordinal responses were compared using Mann-Whitney U tests; selected contrasts were dichotomized (agree 4-5 vs. 1-3) and tested using Fisher's exact tests with odds ratios. Within-clinician paired comparisons used Wilcoxon signed-rank tests. Free-text responses were translated and grouped into clinically interpretable categories. In total, 100 patient and 23 clinician questionnaires were analyzed. Patients tended to disagree with stopping treatment when satisfied if bite/alignment remained imperfect (mean 2.37, SD 1.39; 21.6% agree 4-5), whereas clinicians tended to endorse satisfaction having equal weight to occlusal perfection (mean 3.91, SD 0.95; 69.6% agree 4-5), with a significant distributional difference (p = 4.25 &#xd7; 10&#x207b;&#x2076;). Clinicians were more likely than patients to endorse the satisfaction-weighted stance when dichotomized (OR 8.27; p = 2.23 &#xd7; 10&#x207b;&#x2075;). Clinicians also showed a principle-practice tension, endorsing "equal weight" more strongly than comfort ending earlier (paired p = 0.000918). Qualitative responses most often defined success as straightness and improved appearance; burdens centered on time/appointments, with cost a common barrier. Patients and clinicians differed in how satisfaction-guided treatment completion was viewed and applied. Explicit finishing discussions about residual discrepancies, marginal gains, and time/burden trade-offs may support clearer shared decision-making at treatment completion.

Objectives: A comprehensive diagnosis and treatment were carried out in 104 newborns, including 48 children diagnosed with unilateral cleft lip and palate (UCLP) and 56 patients diagnosed with bilateral cleft lip and palate (BCLP). The control group consisted of 116 medical records and diagnostic models of jaws from newborns with UCLP/BCLP, which were analysed before and after orthodontic correction using a removable facebow with headgear attachment. Methods: All newborns (n = 104) underwent orthodontic correction to reposition of the alveolar process fragments in UCLP and intermaxillary bone in BCLP using mini-implants and elastic traction devices/springs, followed by primary cheiloplasty. Cheiloplasty was performed one month after fragment alignment had been achieved. Results: Statistical analysis showed that orthodontic correction using mini-implants and elastic traction was highly effective. In the UCLP group, normalised alignment of alveolar fragments was achieved in 97.9% of cases (p = 0.0000000016); in the BCLP group, normalised positioning of the intermaxillary bone was observed in 96.42% (p = 0.00000000007). A direct comparison between the treatment and control groups revealed consistent significance across all diastasis measurements, supporting the clinical advantage of fixed orthodontic approaches. Conclusions: The clinical data and statistical analysis indicate that the fixed orthodontic appliance combined with mini-implants and elastic traction is effective. This approach normalises alveolar and intermaxillary positioning and provides optimal preoperative conditions for primary cheiloplasty and subsequent uranoplasty. It also shortens rehabilitation duration and leads to stable aesthetic and functional results.