Reproducible and descriptive Three-dimensional treatment evaluation can enhance future treatment based on realistic results. So, the purpose of this study was to describe a new method for three-dimensional treatment evaluation showing how to use fully-automated craniofacial superimposition of CBCT records combined with reference system to obtain descriptive and comparable results. This new method was named United Reference Method (URM). URM is a combination of automated 3D superimposition on anterior cranial base surface anatomy and measurements based on reference system. It was developed to show how to use fully-automated superimposition to obtain descriptive numerical comparable values. The method is based on: one main reference system for both superimposed CBCT records, semi-automation to increase accuracy, all measurements are projections and auxiliary references to aid in landmarks identification and measurements. The method steps can be described following a four-step approach: (1) Superimposition performed through a fully automated, voxel-wise, rigid registration considering only cranial base as a stable structure; (2) Identification of reference landmarks once on the superimposed records for corrected Frankfort Horizontal plane (C-FH) construction and a new semi-automated constructed Sella point to correct Orbital asymmetry; (3) Head orientation of superimposed CBCT images based on the C-FH; (4) Identification of landmarks affected by treatment with the aid of auxiliary reference planes. Evaluation of linear or angular changes derived by projection of same pre- and post-treatment landmarks on the C-FH. Pre- and post-expansion CBCT scans of 20 unilateral cleft lip and palate patients were used to calculate intra and inter-rater reliability. (X, Y and Z) coordinates, mean, standard deviation (SD) and Intra-class Correlation Coefficient (ICC) were calculated. The proposed coordinates for C-FH construction showed ICC ≥ 0.998 and SD ranging from 0.064 to 0.242 mm. On the other hand, excluded coordinates due to expected natural craniofacial asymmetry had the lowest reliability ICC ≥0.742 and SD dramatically increased up to 1.112 mm. URM showed adequate reliability so it can be used to produce three-dimensional descriptive data of craniofacial structural changes.

Background: Bonded composite bite turbos are an efficient tool in the treatment of deep bite malocclusion. Patient satisfaction with orthodontic appliances has been correlated with treatment success. The aim of this study is to evaluate the level of patient satisfaction associated with bonded composite anterior bite turbos in deep bite treatment. Materials and Methods: This study was a one-arm prospective clinical study. Sixty patients, younger than 25 years old with permanent dentition and increased anterior overbite were treated with composite bite turbos bonded to the maxillary central incisors. A questionnaire form using the Likert scale with five responses (Very Unpleasant, Unpleasant, Acceptable, Pleasant, and Very Pleasant) was used by patients to document their satisfaction and feedback regarding the bite turbos after 1 week and 1 month. Statistical analyses with the chi-squared test was used to analyze the data for statistical significance. Results: Spearman’s correlation coefficient was used to determine the correlation between age and satisfaction score, while the Mann–Whitney U test was used to compare the satisfaction scores between males and females. There was a statistically significant difference between all patient responses after 1 week and 1 month. A significant decline occurred in the unpleasant response from 10% after 1 week to 0% after 1 month; acceptable response from 36.7% after 1 week to 3.3% after 1 month. There was a statistically significant increase in the pleasant and very pleasant responses. Minor speech and eating difficulties were reported during the first week by 46.7% of patients. Conclusions: Anterior bite turbos made from Triad Gel and bonded to palatal surfaces of both maxillary central incisors using a Mini-Mold tip with 5 mm depth tip will most likely lead to an acceptance rate of 90% after 1 week and 100% acceptance rate after 1 month, without any problems in 53.3% of the patients. Short follow-up periods and lack of control group are the main limitations in this study. Trial registration: Registered at ClinicalTrials.gov (NCT07143916).

Background: Traditional methods for palatal expansion using fixed appliances often face limitations in comfort and aesthetics. In comparison, aligner therapy has limitations, particularly regarding maxillary expansion. The aim of this study is to examine the biomechanical properties regarding the wire diameter and bending of different stainless steel wires to evaluate their potential for incorporation into maxillary aligner therapy. Materials and Methods: Three rectangular stainless steel wires (0.016″ × 0.022″, 0.017″ × 0.025″, and 0.019″ × 0.025″) were tested for mechanical expansion forces in the intermolar region, comparing non-tooth-shaped bent wires (A groups) and tooth-shaped bent wires (B groups). Using a Z010 testing machine (ZwickRoell GmbH and Co. KG, Ulm, Germany), expansion forces were measured at 1 mm intervals over a 5 mm distance, with 15 samples analyzed per group. Statistical analyses included the Shapiro–Wilk test for normal distribution, the Mann–Whitney U test, which revealed significant results (U = 225, p < 0.001), and the Kruskal–Wallis test, which indicated significance (H = 39.130; df = 2; p < 0.001). Results: Tooth-shaped bent wires exhibited significantly lower expansion forces than non-tooth-shaped bent wires for all tested wire types. This difference was most notable in wires with larger transverse profiles (0.019″ × 0.025″), where the tooth-shaped bent wires displayed a marked reduction in mechanical load capacity. Specific force measurements for non-tooth-shaped wires ranged from 760.61 ± 79.51 mN at 1 mm of deformation to 2468.46 ± 66.27 mN at 5 mm of deformation, while tooth-shaped wires ranged from 116.80 ± 3.74 mN to 1979.49 ± 23.23 mN. Conclusions: These findings suggest that non-tooth-shaped bent wires offer a more efficient and uniform expansion potential for maxillary movements due to their stable elastic properties. Clinically, integrating non-tooth-shaped stainless steel wires into aligner therapy may provide a viable method for maxillary expansion, supporting both first- and second-order movements in orthodontic treatment. Further research is needed to explore the integration of such wires for effective maxillary expansion in aligner therapy.