Background/Objectives: Temporomandibular disorders (TMDs) are a group of multifactorial conditions affecting the temporomandibular joints (TMJs), masticatory muscles, and associated structures. TMDs are identified as the main cause of non-dental orofacial pain in children and adolescents. This scoping review aims to explore recent evidence on prevalence, clinical presentation, associated factors, and treatment approaches of TMDs in children and adolescents. Methods: A systematic search was conducted across PubMed, Scopus and Embase for studies published between 2015 and 2025, following PRISMA-ScR guidelines. Results: Thirty-eight studies were included. TMD prevalence in children and adolescents ranged from 16.9% to 40% through clinical examination, with painful TMD rates ranging from 16.2% to 25.5%, while symptom-based surveys reported prevalences of 9–35.3%. The most frequent diagnoses were myofascial pain, myalgia, arthralgia and disc displacement with reduction. Female sex and increasing age were consistent risk factors. Psychosocial variables, such as anxiety and depression, showed strong associations with pain-related TMDs. Structural and systemic conditions such as musculoskeletal alterations, joint hypermobility, respiratory conditions and headaches/migraines were also frequently reported. Evidence on treatment appears to be limited. In juvenile idiopathic arthritis (JIA), TMJ involvement is prevalent (32.6–64%), particularly in the persistent oligoarticular subtype. Conclusions: TMDs in children and adolescents are prevalent and multifactorial conditions, mainly of muscular origin, presenting more frequently in adolescents and females. Psychosocial factors, functional habits, clenching, mouth breathing and systemic conditions may be associated with TMD presence or severity. Substantial heterogeneity persists in diagnostic criteria, assessment tools and outcome measures. Research on therapeutic interventions is scarce and often limited to small samples. Standardized diagnostic protocols, improvements in research consistency, longitudinal cohorts and RCTs are needed to clarify etiological pathways, validate diagnostic criteria and establish effective, evidence-based strategies for the management of TMDs in children and adolescents.

Interceptive orthodontics plays a key role in the early management of dento-skeletal discrepancies in growing patients, particularly transverse maxillary deficiency. This retrospective clinical study evaluated the dento-skeletal effects of a digitally manufactured, patient-specific Transversal Sagittal Maxillary Expander (TSME). A sample of 45 pediatric patients (mean age 8.5 years) with transverse and sagittal maxillary deficiency was analyzed. All subjects were treated using a customized titanium TSME designed through a multimodal digital workflow combining intraoral scanning, CBCT imaging, and three-dimensional facial acquisition for diagnostic planning and appliance customization. Quantitative treatment outcome assessment was based on standardized lateral cephalometric analysis between pre-treatment (T0) and post-treatment (T1). Statistically significant changes were observed in sagittal and vertical skeletal parameters, including SNA, SNB, ANB, SN–ANS-PNS, SN–GoGn, N–Me, and APDI. The integration of digital technologies and titanium additive manufacturing may support improved appliance customization and workflow standardization. Within the limitations of this retrospective study, digitally manufactured TSME represents a promising approach for patient-specific appliance customization in interceptive orthodontics.

Background: During clinical service, removable orthodontic appliances are continuously exposed to environmental challenges that may compromise material stability and contribute to potentially increasing the risk of local inflammatory responses and hypersensitivity reactions. Method: A literature search was conducted using PubMed/MEDLINE, Scopus, and Web of Science databases. Studies investigating bio-inspired and surface-engineering approaches applicable to orthodontic polymers, acrylic resins, aligner materials, and related dental biomaterials were considered. Evidence from orthodontic adhesives and non-bio-inspired barrier coatings was included when relevant as comparative or translational support. Particular attention was given to polydopamine coatings, polyphenol- and tannic acid-based coatings, chitosan systems, peptide-functionalized surfaces, titanium and titanium oxide-based modifications, nanoparticle-enriched coatings, biomimetic hydrogel-like barriers, and conventional barrier coatings used as comparators. Results: Available evidence suggests that surface modifications reduce monomer diffusion, bacterial adhesion, biofilm formation, and improve cellular responses. Bio-inspired and titanium-based coatings show particular promise by enhancing biocompatibility while providing antimicrobial, antioxidant, anti-inflammatory, and protective barrier properties. Conclusions Bio-inspired surface engineering is a promising approach to improve the biological safety of removable orthodontic appliances. However, further standardized in vitro, in situ, and clinical studies are needed to confirm their long-term stability, durability, and clinical effectiveness in reducing hypersensitivity and other adverse biological effects.

Background/Objectives: Class II malocclusion in growing patients may be associated with altered mandibular posture, occlusal instability, and adaptive changes in masticatory muscle function. This prospective, controlled, non-randomized longitudinal study evaluated changes in masseter and anterior temporalis muscle activity during Andresen functional appliance therapy and compared them with untreated Class I and Class II controls. Methods: Seventy children with skeletal and dental Class II malocclusion were treated with a customized Andresen appliance; 50 untreated Class II children and 30 untreated children with physiological Class I occlusion served as comparison groups. All participants were in mixed dentition and at cervical stage CS3 at baseline. Standardized bilateral sEMG recordings were obtained at T0, T1 (6 months), and T2 (12 months). Longitudinal sEMG outcomes were analyzed using mixed-design repeated-measures ANOVA, with time as the within-subject factor and group as the between-subject factor; prespecified T0-to-T2 contrasts were accompanied by Cohen’s d effect sizes. Results: In the treated Class II cohort, IMPACT increased from 108.64 ± 3.40 at T0 to 111.58 ± 3.13 at T1 and 113.82 ± 3.27 at T2 (within-group time effect p < 0.001). ATTIV changed from −0.88 ± 0.42 at T0 to +0.96 ± 0.55 at T1 and +1.65 ± 0.78 at T2 (p < 0.001). In contrast, neither the untreated Class II nor the physiological Class I group showed statistically significant within-group time effects for IMPACT (p = 0.96 and p = 0.58, respectively) or ATTIV (p = 0.78 and p = 0.93, respectively). Significant T0-to-T2 differences between treated and untreated Class II groups were observed for ATTIV (p < 0.001; d = +5.28) and IMPACT (p < 0.001; d = +2.00). Conclusions: Andresen therapy was associated with statistically supported longitudinal differences in masticatory muscle recruitment compared with untreated Class II controls. The observed pattern may reflect treatment-associated neuromuscular adaptation; however, causal attribution remains limited by the non-randomized design, and the sEMG changes should be interpreted as modifications in muscle recruitment rather than as evidence of physiological normalization or clinical improvement.

Background/Objectives: Photoreactive zwitterionic PMBPAz coatings have previously been used to modify dental PMMA, but their integrated performance on clinically polished orthodontic PMMA under a specified composite-aging challenge remains insufficiently characterized. This in vitro study compared untreated, polished, and PMBPAz-MPC-coated PMMA before and after laboratory aging. Materials and Methods: Heat-polymerized PMMA specimens were tested for early Streptococcus mutans adhesion, 24 h biofilm indices, surface chemistry and wettability, protein adsorption, mechanical properties, and human gingival fibroblast responses. A separate four-time-point MPC-PMMA series evaluated artificial saliva immersion alone, while the composite-aged groups also underwent thermocycling and simulated toothbrushing. Results: Compared with polished PMMA, MPC-PMMA showed lower 2 h adhesion by 0.73 log10 CFU/cm² (81%) before aging and 0.62 log10 CFU/cm² (76%) after composite aging; the corresponding decreases in crystal violet biomass were 44.6% and 37.9%. In the saliva-only series, coating-associated XPS phosphorus decreased from 3.8 to 3.3 at.%, and the contact angle increased from 18.6° to 21.7° at T28; following composite aging, the corresponding values were 2.9 at.% and 24.3°. Extract-exposed fibroblasts showed group-dependent changes in LDH and inflammatory mediators. Conclusions: Under the specified in vitro conditions, PMBPAz-MPC treatment of polished orthodontic PMMA was associated with reduced early S. mutans colonization, including after composite aging. The findings do not establish clinical efficacy or long-term biological safety.

Introduction: Active spitting competence is a developmental milestone potentially relevant to fluoride safety and preventive counselling in paediatric dentistry. It is defined as the voluntary ability to understand a simple instruction and consistently expel oral contents without swallowing. Its acquisition reflects neuromuscular and cognitive maturation, together with imitation, supervision, and repeated practice. This clinical perspective explores whether spitting competence may complement age-based fluoride counselling. Methods: Available developmental and clinical evidence concerning oral motor development, spitting acquisition, and fluoride dentifrice ingestion in early childhood was narratively examined and interpreted from a paediatric dental perspective. A conceptual framework was developed to consider the potential role of qualitative chairside observation of spitting ability. This article is not a systematic review and does not aim to establish normative cut-offs or age thresholds. Results: Evidence suggests that active spitting develops within a broad developmental window, commonly between approximately 2 and 5 years, with considerable interindividual variability. Young children may swallow a substantial proportion of toothpaste during brushing, and repeated ingestion of fluoride-containing dentifrice during tooth development may increase fluorosis risk. A brief qualitative observation of spitting competence could complement age-based fluoride guidance by identifying children requiring closer supervision and conservative toothpaste management. However, its predictive validity and clinical utility have not been established. Conclusions: Functional spitting assessment may represent a useful adjunct to individualized fluoride counselling in paediatric dental practice. However, current evidence does not support its use as a standalone criterion or the definition of specific age thresholds. Prospective validation studies are required to determine whether spitting competence can reliably predict dentifrice ingestion and inform future clinical recommendations.