With an increasing understanding of the differences between men and women’s psychological experiences, this study aimed to probe the sex-based differences in anxiety, depressive symptoms, and coping strategies among orthognathic patients. The study hypothesis was that female patients would show higher levels of anxiety and depressive symptoms than males, and that coping mechanisms would differ between male and female sexes. A cross-sectional design was adopted, examining orthognathic patients from the Department of Oral and Maxillo-Facial Surgery at the Emergency Clinical Municipal Hospital in Timisoara, Romania, from 2020 to 2023. Eligible participants (18+ years with no prior orthognathic treatment) completed a comprehensive online questionnaire 6 weeks before scheduled surgery. This was composed of validated self-report instruments comprising the SF-36, GAD-7, and the PHQ-9, and the COPE-60, along with additional sociodemographic data. Of the 127 orthognathic patients analyzed (68 men and 59 women, aged 18 to 65 years, mean age 32), men rated their physical health status slightly better on the SF-36 scale. However, the most notable difference was in mental health, with females scoring higher on both the PHQ-9 (indicative of depression) and the GAD-7 (indicative of anxiety) scales. Specifically, female participants exhibited average PHQ-9 scores 1.8 points higher and GAD-7 scores 1.5 points higher than their male counterparts. Coping mechanisms also varied: 42% of male patients primarily employed “Disengagement” strategies, while 58% of females predominantly used “Engagement” and “Emotion Focused” strategies. Emotion-focused coping was associated with a 1.6-fold increased risk of depressive symptoms. Sex differences play a crucial role in the psychological experiences of orthognathic patients, evident in anxiety and depression levels, perceived health status, and coping strategies. This underlines the importance of sex-tailored psychological support in the preoperative phase for orthognathic surgery patients.

The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial, and antioxidant properties. This systematic review synthesizes evidence from clinical trials to evaluate the efficacy of natural products in reducing inflammation and bacterial presence in orthodontic and orthognathic treatment settings. The database search was conducted across PubMed, Scopus, and Embase up to January 2024. The review focused on randomized controlled trials only. The selected studies centered on the anti-inflammatory, antibacterial, and antioxidant effects of natural products, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for data extraction. Nine studies, totaling 358 participants, were included. Significant findings demonstrated a reduction in gingival inflammation by over 40% with the use of Aloe vera compared to chlorhexidine. Another study noted a decrease in bleeding on probing by 13.6 points in the treatment group over placebo. Additionally, honey showed a rapid modulation of plaque pH and significantly reduced bacterial counts of Streptococcus mutans. Furthermore, the use of resveratrol emulgel was linked to substantial improvements in gingival health, with a reduction in the gingival index and probing pocket depth. The results indicate that natural products can significantly enhance orthodontic treatment outcomes by reducing inflammation and bacterial levels. These products offer effective alternatives to traditional treatments and show potential for integration into routine orthodontic care protocols. Further research is encouraged to standardize application methods and dosages to maximize clinical benefits and patient satisfaction.

Craniofacial asymmetry can have significant psychosocial implications, affecting the quality of life in adolescents and young adults. This study aimed to assess the impact of age and complexity of craniofacial asymmetry on quality of life and psychosocial outcomes in patients undergoing orthodontic and orthognathic correction. A cross-sectional study was conducted on 149 patients aged 13–26 years with moderate or severe craniofacial asymmetry that had a gnathion deviation higher than 2 mm, according to the American Association of Orthodontists. Participants were divided into three groups: teenagers (n = 53), adults (n = 46), and a control group (n = 50) with relative craniofacial asymmetry. Quality of life and psychosocial impacts were evaluated using validated questionnaires that measure health-related quality of life (SF-36), body image satisfaction and self-acceptance (BIQLI), anxiety and depression levels (HADS), and perceived stress (PSS-10). These tools provided an encompassing appraisal of the psychological and social implications associated with craniofacial asymmetry before and six months after orthodontic and orthognathic correction. Before the intervention, adults had higher mental health scores compared to teenagers (p = 0.037). At the 6-month follow-up, no significant differences in mental health scores were observed between the two groups (p = 0.121). BIQLI results showed significant differences in satisfaction with appearance and self-acceptance between teenagers and adults, both before intervention (p = 0.045 and p = 0.051, respectively) and at six months (p = 0.062 and p = 0.031, respectively). HADS results showed significant differences in anxiety levels before intervention (p = 0.039) but not at six months (p = 0.133). PSS-10 results showed no significant differences in perceived stress between the groups. In conclusion, this study demonstrates that craniofacial asymmetry significantly impacts the quality of life and psychosocial well-being of adolescents and young adults. Specifically, teenagers, as compared to young adults, reported lower satisfaction with their appearance and lower self-acceptance before intervention, underscoring the profound psychosocial challenges that adolescents with craniofacial asymmetry may experience. These age-related differences underscore the importance of tailored interventions to address unique psychosocial needs at different developmental stages.

Background/Objectives: Combining orthognathic surgery with orthodontic therapy is a crucial approach for correcting severe dentofacial deformities that orthodontics alone cannot address. This study aimed to quantify skeletal, dental, and soft tissue alterations following orthognathic surgery and to assess correlations among cephalometric parameters to improve understanding of treatment outcomes. Methods: A prospective observational study was conducted on 25 Romanian patients (44% female and 56% male; median age, 28 years) who underwent orthognathic surgery. Standardized pre- and postoperative lateral cephalometric radiographs were analyzed using WebCeph 2.0.0 software. The evaluated parameters included the SNA angle (sella–nasion–point A, indicating maxillary position), SNB angle (sella–nasion–point B, indicating mandibular position), ANB angle (maxillo-mandibular relationship), Pog-N-Perp (distance from pogonion to the nasion-perpendicular line), U1–NA° (inclination of the upper incisor relative to the maxillary base), L1–NB° (inclination of the lower incisor relative to the mandibular base), nasolabial angle, and facial convexity. Statistical analyses included paired t-tests and correlation analysis. Results: Significant anterior repositioning of the maxilla was observed, with SNA increasing from 83.6° to 86.3° (p = 0.019). The SNB angle remained stable, while ANB increased toward normalized sagittal relationships (0.9° to 3.0°, p = 0.060). Soft tissue analysis revealed a slight increase in the nasolabial angle (102° to 105°) and improved facial convexity. Strong correlations were found between skeletal parameters (SNB and ANB, r = −0.852, p < 0.001) and between skeletal and dental variables (ANB and L1–NB°, r = 0.652, p < 0.001), confirming coordinated skeletal–soft tissue adaptation. Conclusions: Orthognathic surgery significantly enhances skeletal balance and facial harmony, particularly through maxillary advancement. The integration of virtual surgical planning and interdisciplinary collaboration improves accuracy, predictability, and patient-centered outcomes in surgical orthodontics.

Background: Stackable metallic or magnetic multi-template systems translate a prosthetically (facially) driven plan into each surgical phase of full-arch rehabilitation. Our objective was to map and critically describe the clinical applications, accuracy, and short-term outcomes of stackable/sequential guides and to illustrate the operational steps with a standardized magnet-retained case. Methods: Following a prospectively registered protocol (OSF, June 2025), we performed a scoping review in accordance with and PRISMA guidance. PubMed, Scopus and Embase were searched to 26 June 2025 for primary human studies using stackable or sequential static guides to place ≥4 implants per arch with immediate (≤72 h) loading. Duplicate-independent screening and data-charting captured guide design, planning platform, surgical accuracy, implant survival, prosthetic outcomes and patient-reported measures. A single non-analytic clinical vignette was included solely to illustrate the facially driven stackable workflow. Results: Eight studies (five countries, 2021–2025) encompassing 351 implants and one additional clinical case met the inclusion criteria. Mechanical indexing predominated (7/9 protocols); only two papers, including our case, used magnetic retention. Mean coronal and angular deviations, reported in two cohorts, were 0.95 mm/2.8° and 0.87 mm/2.67°, respectively—well within accepted thresholds for full-arch guided surgery. Immediate loading was achieved in 100% of arches; cumulative implant survival was 97.1% after 3–12 months. Patient-reported satisfaction exceeded 90 mm on VAS scales when measured. Our case demonstrated 0.90 mm/2.95° accuracy, 100% implant stability ≥ 35 N cm and uneventful provisionalisation at 12 weeks. Conclusions: Early clinical reports show clinically acceptable accuracy and high short-term survival with streamlined workflow. However, evidence remains heterogeneous and short-term; prospective multi-centre studies with standardized accuracy metrics, ≥3-year follow-up, validated PROMs, and cost-effectiveness analyses are still needed.

Background: Dentofacial deformities (DFDs) comprise heterogeneous sagittal, vertical, transverse, and asymmetry components, yet clinical severity is often summarized using isolated measurements. Objectives: To operationalize a reproducible composite DFD severity score and evaluate its cross-sectional associations with quality of life, function, airway-related screening indicators, and psychosocial burden. Methods: In this single-center cross-sectional study, consecutive adults assessed in an orthognathic surgery pathway underwent a prespecified 0–100 severity scoring framework integrating sagittal discrepancy (|Wits| and |ANB deviation|), vertical pattern (SN-MP angle), and asymmetry/transverse variables (chin deviation, asymmetry index, transverse discrepancy, and absolute overjet). Outcomes included the Oral Health Impact Profile-14 (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), FACE-Q facial appearance satisfaction scale, PHQ-9, GAD-7, STOP-Bang, functional testing, and CBCT-derived upper-airway metrics. Results: Severe DFDs had higher composite severity (62.9 ± 12.8 vs. 25.3 ± 10.9), larger sagittal discrepancy (|Wits| 6.3 ± 2.8 vs. 3.1 ± 1.8), and higher SN-MP angles (39.8 ± 7.4 vs. 34.7 ± 7.2) (all p < 0.001). Severe DFDs also had worse OQLQ (36.2 ± 6.2 vs. 24.1 ± 7.2), OHIP-14 (18.3 ± 4.2 vs. 12.4 ± 4.1), FACE-Q satisfaction (45.7 ± 10.3 vs. 67.6 ± 9.6), masticatory performance (59.4 ± 8.5 vs. 75.1 ± 7.5), and smaller airway area (126.7 ± 29.6 vs. 161.4 ± 27.7) (all p < 0.001). In multivariable logistic regression, |Wits|, SN-MP angle, asymmetry index, and lower airway area independently predicted severe status; PHQ-9 was associated with severity in unadjusted analyses but did not retain independent significance after multivariable adjustment. Model discrimination was high (AUC 0.91). Conclusions: This multidimensional severity framework captures clinically meaningful cross-sectional differences across morphologic, functional, airway-related, and psychosocial domains. Its interpretability remained stable in sensitivity analyses, but external and longitudinal validation is still required before broader implementation.