The aim of this study was to compare the crossbite correction of a group (n = 43; f/m 19/24; mean age 27.6 ± 9.5 years) with surgically assisted rapid palatal expansion (SARPE) versus a non-surgical transversal dentoalveolar compensation (DC) group (n = 38; f/m 25/13; mean age 30.4 ± 12.9 years) with completely customized lingual appliances (CCLA). Arch width was measured on digital models at the canines (C), second premolars (P2), first molars (M1) and second molars (M2). Measurements were obtained before treatment (T₀) and at the end of lingual treatment (T₁) or after orthodontic alignment prior to a second surgical intervention for three-dimensional bite correction. There was no statistically significant difference (p > 0.05) in the amount of total crossbite correction between the SARPE and DC-CCLA group at C, P2, M1 and M2. Maxillary expansion was greater in the SARPE group and mandibular compression was greater in the DC-CCLA group. Crossbite correction in the DC-CCLA group was mainly a combination of maxillary expansion and mandibular compression. Dentoalveolar compensation with CCLAs as a combination of maxillary expansion and mandibular compression seems to be a clinically effective procedure to correct a transverse maxillo-mandibular discrepancy without the need for surgical assistance.

The aim of this study was to investigate buccolingual tooth movements (tipping/translation) in surgical and nonsurgical posterior crossbite correction. A total of 43 patients (f/m 19/24; mean age 27.6 ± 9.5 years) treated with surgically assisted rapid palatal expansion (SARPE) and 38 patients (f/m 25/13; mean age 30.4 ± 12.9 years) treated with dentoalveolar compensation using completely customized lingual appliances (DC-CCLA) were retrospectively included. Inclination was measured on digital models at canines (C), second premolars (P2), first molars (M1), and second molars (M2) before (T₀) and after (T₁) crossbite correction. There was no statistically significant difference (p > 0.05) in absolute buccolingual inclination change between both groups, except for the upper C (p < 0.05), which were more tipped in the surgical group. Translation, i.e., bodily tooth movements that cannot be explained by pure uncontrolled tipping, could be observed with SARPE in the maxilla and with DC-CCLA in both jaws. Dentoalveolar transversal compensation with completely customized lingual appliances does not cause greater buccolingual tipping compared to SARPE.

Background: This prospective study aimed to evaluate the influence of the computer type (tablet or desktop) on accuracy and tracing time of cephalometric analyses. Methods: Dental students used a web-based application specifically developed for this purpose to perform cephalometric analyses on tablet and desktop computers. Landmark locations and timestamps were exported to measure the accuracy, successful detection rate and tracing time. Reference landmarks were established by six experienced orthodontists. Statistical analysis included reliability assessment, descriptive statistics, and linear mixed effect models. Results: Over a period of 8 semesters a total of 277 cephalometric analyses by 161 students were included. The interrater reliability of the orthodontists establishing the reference coordinates was excellent (ICC > 0.9). For the students, the mean landmark deviation was 2.05 mm and the successful detection rate for the clinically acceptable threshold of 2 mm suggested in the literature was 68.6%, with large variations among landmarks. No effect of the computer type on accuracy and tracing time of the cephalometric analyses could be found. Conclusion: The use of tablet computers for cephalometric analyses can be recommended.

The aim of this study was to investigate a possible relation between skeletal phenotypes and virtual mounting data in orthognathic surgery patients. A retrospective cohort study including 323 female (26.1 ± 8.7 years) and 191 male (27.9 ± 8.3 years) orthognathic surgery patients was conducted. A k-means cluster analysis was performed on the mounting parameters: the angle $\alpha$ between the upper occlusal plane (uOP) and the axis orbital plane (AOP); the perpendicular distance (AxV) from the uOP to the hinge axis; and the horizontal length (AxH) of the uOP from upper incisor edge to AxV, with subsequent statistical analysis of related cepalometric values. Three clusters of mounting data were identified, representing three skeletal phenotypes: (1) balanced face with marginal skeletal class II or III and $\alpha =8^{\circ }$, AxV = 36 mm and AxH = 99 mm; (2) vertical face with skeletal class II and $\alpha ={11}^{\circ }$, AxV = 27 mm and AxH = 88 mm; (3) horizontal face with class III and $\alpha =2^{\circ }$, AxV = 36 mm and AxH = 86 mm. The obtained data on the position of the hinge axis can be applied to any digital planning in orthognathic surgery using CBCT or a virtual articulator, provided that the case can be clearly assigned to one of the calculated clusters.

Objective: There is a lack of studies on patient-reported outcomes in orthodontics. The aim of this study was to evaluate the changes in patient-reported chief complaints during orthognathic surgery treatment. Materials and methods: Patients undergoing orthognathic surgery at the University Hospital Münster between 2019 and 2023 were eligible for inclusion in this prospective cohort study. Patient-reported chief complaints were recorded on visual analogue scale (VAS) forms before treatment ( $$\text {T}_{0}$$ ), and reevaluated after presurgical orthodontic treatment ( $$\text {T}_{1}$$ ), and 6–9 months after surgery ( $$\text {T}_{2}$$ ). Chief complaints were grouped into three main categories (pain, function, aesthetics) and ten subcategories, and their intensity was quantified over time. Results: A total of 217 out of 386 recruited patients (56%) completed all study assessments and were included in the final analysis (female/male = 126/91, median age 24.1 years). Dental function, facial aesthetics, and dental aesthetics were the most frequently reported complaints at $$\text {T}_{0}$$ . At $$\text {T}_{1}$$ , there was a statistically significant improvement in dental aesthetics. There was a statistically significant reduction in the intensity of each of the 10 subcategories from $$\text {T}_{0}$$ to $$\text {T}_{2}$$ . Conclusion: Orthognathic surgery patients most frequently report dental function, facial aesthetics, and dental aesthetics as their chief complaints, and these complaints were improved significantly after treatment. Clinical relevance: The improvement in patient-reported chief complaints can be used to inform patients prior to treatment.

Background: The aim of this study was to investigate if there is a significant difference in the incidence of buccal gingival recession after non-surgical transversal dentoalveolar compensation with completely customized lingual appliances (DC-CCLA) versus surgically assisted rapid palatal expansion (SARPE). Methods: This cohort study included 81 adult patients with posterior crossbite. The DC-CCLA group (n = 38; f/m 25/13; mean age 30.3 ± 13.0 years) was treated with dentoalveolar compensation using completely customized lingual appliances. The SARPE-group (n = 43; f/m 19/24; mean age 28.2 ± 9.4 years) was treated with SARPE and buccal straight wire appliances. The number of buccal gingival recessions was recorded on digital models before treatment (T0) and after removal of fixed appliances (T1). Statistical analyses included Fisher’s exact tests, Chi-squared tests, Mann-Whitney U tests and mixed-effects logistic regression to evaluate the influence of various variables on the incidence of gingival recession. Results: In 3976 teeth evaluated, the incidence of developing gingival recessions was 8.1% with DC-CCLA (n = 77) and 5.8% with SARPE (n = 60). This difference was not statistically significant (p > 0.05). Age was a significant factor for the incidence of gingival recession and recessions were more likely to occur in males and in the maxillary posterior region. Conclusions: There was no statistically significant difference in the incidence of gingival recessions between dentoalveolar compensation with CCLAs and SARPE after debonding, with some degree of gingival recession being inevitable with both treatment approaches.