Background/Objectives: Accurate quantification of alveolar cleft defects for bone grafting remains difficult due to inconsistent anatomical boundaries. This study established an expert consensus on boundary landmarks for alveolar bone graft (ABG) planning and validated the accuracy and reliability of digital volumetric measurement methods. Methods: Three cleft specialists performed repeated simulated graft procedures in seven patient-specific 3D-printed models, first according to the operator’s clinical judgment, and subsequently according to panel-derived consensus boundaries. Two radiologists independently conducted digital volumetric assessments in 3D X-ray imaging using four measurement approaches (axial tracing, interpolated axial tracing, landmark-based mirroring, and mesh-based mirroring), generating 56 independent digital segmentations to be evaluated against the consensus-based physical reference standard. Volumes of the defects were recorded, intra- and inter-rater reliabilities were calculated using the intraclass correlation coefficient (ICC), and differences among methods were analyzed. Results: Operator-defined plans showed significant inter-operator differences (p < 0.001) with poor-to-excellent reliability (intra-rater ICC 0.060–0.967; inter-rater ICC 0.300–0.635). Consensus established standardized boundaries: tilted plane from base of anterior nasal spine to hard palate, cemento-enamel junctions, incisive canal, and alveolar contour. Consensus-based filling showed non-significant inter-rater differences (p = 0.139) and substantially improved reliability (intra-rater ICC 0.904–0.988; inter-rater ICC 0.622–0.861). Among the four digital methods evaluated, axial tracing demonstrated excellent reliability (intra-rater ICC 0.971–0.99; inter-rater ICC 0.965) and high accuracy (mean difference 0.001–0.026 cm³), with no significant difference (p = 0.999) from the physical reference standard. Conclusions: These proposed consensus-based boundary definitions and validated volumetric measurement methods improved the accuracy and reproducibility of personalized alveolar bone graft planning.

Background/Objective: Orthodontic mini-implants (MI) create new niches that may alter the oral microbiota and modulate host immune responses. While clinical inflammation is not always evident, microbial and molecular changes may precede visible signs of peri-implant infection. This study investigated microbial shifts and inflammatory responses following MI placement, with a focus on Saccharibacteria, nitrate-reducing bacteria (NRB), and periodontopathogens. Methods: Saliva and peri mini-implant crevicular fluid (PMICF) samples were collected from eight orthodontic patients at baseline (T0), one week (T1), and one month (T2) after mini-implant placement. DNA was extracted from each saliva and PMICF sample and pooled across the eight patients for each time point. The pooled DNA were then subjected to 16S rRNA gene sequencing using the Oxford Nanopore MinION platform. Statistical analysis was performed to determine shifts in bacterial abundance, diversity, and co-occurrence patterns across the different sample types (saliva vs. PMICF) and time points. Results: Alpha diversity decreased in PMICF at T2, while it remained stable in saliva samples. Periodontopathogens (Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum) increased in PMICF at T2, while NRB and Saccharibacteria, along with a representative host bacterium (Schaalia odontolytica), remained relatively stable. Co-occurrence analysis showed antagonistic relationships between Saccahribacteria/NRB and periodontopathogens. IL-6 significantly decreased from T1 to T2, while CRP showed a non-significant downward trend. The expression of nitrate reductase genes narG and napA remained stable across time intervals. Conclusions: Despite no clinical inflammation, MI placement led to localized microbial shift and mild inflammatory responses. NRB and Saccharibacteria’s stability and antagonistic relationship to periodontopathogens may indicate that they could be involved in maintaining microbial homeostasis. These findings highlight possible early biomarkers and ecological strategies to support oral health in MI patients.