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Bioengineering
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Advances in Appliance Design and Techniques in Orthodontics
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Advances in Appliance Design and Techniques in Orthodontics

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 14337

Special Issue Editor

Dr. Madhur Upadhyay

E-Mail Website
Guest Editor
Division of Orthodontics, School of Dental Medicine, University of Connecticut Health, Farmington, CT, USA
Interests: orthodontics; appliances; innovation; technology; treatment techniques

Special Issue Information

Dear Colleagues,

Since Edward Angle first popularized the edgewise appliance at the turn of the century, orthodontics has primarily been driven by advances in appliance design. We have witnessed some rapid innovation in the past two decades with the advent of new techniques, materials, and appliances. Innovation, often outside orthodontics, in basic sciences, material design, imaging techniques, and other technologies such as artificial intelligence hold tremendous promise in advancing efficient tooth movement. These developments will have a huge impact on the current standard of care, especially for adult orthodontics. They will make treatment faster, accurate, and more in line with individual patient needs

This Special Issue will focus on recent innovations of bioengineering sciences in orthodontics.

The journal will be accepting contributions (both original articles and reviews) mainly centered on the following topics:

  1. Skeletal anchorage in orthodontics;
  2. Artificial intelligence in diagnosis and treatment planning;
  3. Esthetic alternatives for orthodontic treatment;
  4. Application of smart mechanics for efficient treatment;
  5. Surgical orthodontics;
  6. Imaging.

Dr. Madhur Upadhyay
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Research

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13 pages, 943 KiB  
Article
Synergy of Regenerative Periodontal Surgery and Orthodontics Improves Quality of Life of Patients with Stage IV Periodontitis: 24-Month Outcomes of a Multicenter RCT
by Karin Jepsen, Christina Tietmann, Conchita Martin, Eric Kutschera, Andreas Jäger, Peter Wüllenweber, Lorena Gaveglio, Daniele Cardaropoli, Ignacio Sanz-Sánchez, Rolf Fimmers and Søren Jepsen
Bioengineering 2023, 10(6), 695; https://doi.org/10.3390/bioengineering10060695 - 07 Jun 2023
Cited by 2 | Viewed by 1456
Abstract
In stage IV periodontitis patients with pathologic tooth migration (PTM), interdisciplinary treatment includes regenerative periodontal surgery (RPS) with an application of biomaterials and orthodontic therapy (OT) to restore function, esthetics and thereby quality of life (QoL). In a 24-month randomized trial we explored [...] Read more.
In stage IV periodontitis patients with pathologic tooth migration (PTM), interdisciplinary treatment includes regenerative periodontal surgery (RPS) with an application of biomaterials and orthodontic therapy (OT) to restore function, esthetics and thereby quality of life (QoL). In a 24-month randomized trial we explored the synergy between regenerative medicine and biomechanical force application. The following methods were used: Forty-three patients had been randomized to a combined treatment comprising RPS and subsequent OT starting either 4 weeks (early OT) or 6 months (late OT) post-operatively. Clinical periodontal parameters and oral health-related QoL (GOHAI) were recorded up to 24 months. We obtained the following results: Mean clinical attachment gain (∆CAL ± SD) was significantly higher with early OT (5.96 ± 2.1 mm) versus late OT (4.65 ± 1.76 mm) (p = 0.034). Pocket closure (PPD ≤ 4 mm) was obtained in 91% of defects with early OT compared to 90% with late OT. GOHAI-scores decreased significantly from 26.1 ± 7.5 to 9.6 ± 4.7 (early OT) and 25.1 ± 7.1 to 12.7 ± 5.6 (late OT). Inconclusion, teeth severely compromised by intrabony defects and PTM can be treated successfully by RPS followed by early OT with the advantage of an overall reduced treatment time. As a result of the combined periodontal-orthodontic therapy, the oral health-related QoL of patients was significantly improved. Early stimulation of wound healing with orthodontic forces had a favorable impact on the outcomes of regenerative periodontal surgery. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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20 pages, 10381 KiB  
Article
Automation of Measurements for Personalized Medical Appliances by Means of CAD Software—Application in Robin Sequence Orthodontic Appliances
by Maite Aretxabaleta, Ariadne Roehler, Christian F. Poets, Alexander B. Xepapadeas, Bernd Koos and Christina Weise
Bioengineering 2022, 9(12), 773; https://doi.org/10.3390/bioengineering9120773 - 06 Dec 2022
Cited by 4 | Viewed by 1768
Abstract
Measuring the dimensions of personalized devices can provide relevant information for the production of future such devices used in various medical specialties. Difficulties with standardizing such measurement and obtaining high accuracy, alongside cost-intensive measuring methodologies, has dampened interest in this practice. This study [...] Read more.
Measuring the dimensions of personalized devices can provide relevant information for the production of future such devices used in various medical specialties. Difficulties with standardizing such measurement and obtaining high accuracy, alongside cost-intensive measuring methodologies, has dampened interest in this practice. This study presents a methodology for automatized measurements of personalized medical appliances of variable shape, in this case an orthodontic appliance known as Tübingen Palatal Plate (TPP). Parameters such as length, width and angle could help to standardize and improve its future use. A semi-automatic and custom-made program, based on Rhinoceros 7 and Grasshopper, was developed to measure the device (via an extraoral scanner digital file). The program has a user interface that allows the import of the desired part, where the user is able to select the necessary landmarks. From there, the program is able to process the digital file, calculate the necessary dimensions automatically and directly export all measurements into a document for further processing. In this way, a solution for reducing the time for measuring multiple dimensions and parts while reducing human error can be achieved. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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14 pages, 2586 KiB  
Article
Learning Cephalometric Landmarks for Diagnostic Features Using Regression Trees
by Sameera Suhail, Kayla Harris, Gaurav Sinha, Maayan Schmidt, Sujala Durgekar, Shivam Mehta and Madhur Upadhyay
Bioengineering 2022, 9(11), 617; https://doi.org/10.3390/bioengineering9110617 - 27 Oct 2022
Cited by 2 | Viewed by 3157
Abstract
Lateral cephalograms provide important information regarding dental, skeletal, and soft-tissue parameters that are critical for orthodontic diagnosis and treatment planning. Several machine learning methods have previously been used for the automated localization of diagnostically relevant landmarks on lateral cephalograms. In this study, we [...] Read more.
Lateral cephalograms provide important information regarding dental, skeletal, and soft-tissue parameters that are critical for orthodontic diagnosis and treatment planning. Several machine learning methods have previously been used for the automated localization of diagnostically relevant landmarks on lateral cephalograms. In this study, we applied an ensemble of regression trees to solve this problem. We found that despite the limited size of manually labeled images, we can improve the performance of landmark detection by augmenting the training set using a battery of simple image transforms. We further demonstrated the calculation of second-order features encoding the relative locations of landmarks, which are diagnostically more important than individual landmarks. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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11 pages, 2470 KiB  
Article
Reconstruction of Oronasal Fistula with Tongue Flap: A Cleft Palate Report
by Francisco Vale, Flávia Pereira, José Saraiva, Eunice Carrilho, Madalena Prata Ribeiro, Filipa Marques, Raquel Travassos, Catarina Nunes, Anabela Baptista Paula and Inês Francisco
Bioengineering 2022, 9(9), 455; https://doi.org/10.3390/bioengineering9090455 - 08 Sep 2022
Cited by 1 | Viewed by 2230
Abstract
Oronasal fistula can persist after conventional secondary alveolar bone graft surgery, which may lead to functional issues, such as regurgitation of fluids from the oral to the nasal cavity. This manuscript describes a clinical case of a patient with a bilateral cleft lip [...] Read more.
Oronasal fistula can persist after conventional secondary alveolar bone graft surgery, which may lead to functional issues, such as regurgitation of fluids from the oral to the nasal cavity. This manuscript describes a clinical case of a patient with a bilateral cleft lip and palate that underwent tongue graft surgery for closure of an oronasal fistula after three failed local mucosa flap surgeries. The multidisciplinary treatment was comprised of orthodontic treatment, mucosa and alveolar grafts for palate closure and aesthetic rehabilitation of the anterior maxillary teeth. Smile aesthetics were noticeably improved, enhancing the patient’s self-perception and confidence. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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11 pages, 1840 KiB  
Article
Stress Relaxation Properties of Five Orthodontic Aligner Materials: A 14-Day In-Vitro Study
by Paolo Albertini, Valentina Mazzanti, Francesco Mollica, Federica Pellitteri, Mario Palone and Luca Lombardo
Bioengineering 2022, 9(8), 349; https://doi.org/10.3390/bioengineering9080349 - 28 Jul 2022
Cited by 5 | Viewed by 2040
Abstract
We aimed to investigate the stress relaxation properties of five different thermoplastic aligner materials subjected to 14 days of constant deflection. Five different thermoplastic aligner materials were selected, whose elastic properties varied: F22 Evoflex, F22 Aligner, Durasoft, Erkoloc-Pro and Duran. The static properties [...] Read more.
We aimed to investigate the stress relaxation properties of five different thermoplastic aligner materials subjected to 14 days of constant deflection. Five different thermoplastic aligner materials were selected, whose elastic properties varied: F22 Evoflex, F22 Aligner, Durasoft, Erkoloc-Pro and Duran. The static properties of these materials—in particular, stiffness, stress–strain curve and yield stress—were measured with a three-point bending test. For all the tests that were performed, a minimum of three samples per material were tested. The yield load, yield strength, deformation and particularly the stiffness of each material were found to be similar in the single-layer samples, while the double-layer samples showed far lower stiffness values and were similar one to another. F22 Evoflex and Erkoloc-Pro maintained the highest percentages of stress, 39.2% and 36.9%, respectively, during the 15-day period. Duran and Durasoft obtained the lowest final stress values, 0.5 MPa and 0.4 MPa, respectively, and the lowest percentage of normalized stress, 4.6% and 3.9%, respectively, during the 15-day period. All the materials that we tested showed a rapidity of stress decay during the first few hours of application, before reaching a plateau phase. The F22 Evoflex material showed the greatest level of final stress, with relatively constant stress release during the entire 15-day period. Further research after in vivo aging is necessary in order to study the real aligners’ behavior during orthodontic treatment. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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10 pages, 2128 KiB  
Article
Elastodontic Devices in Orthodontics: An In-Vitro Study on Mechanical Deformation under Loading
by Vincenzo Quinzi, Gianni Gallusi, Elisabetta Carli, Francesca Pepe, Elena Rastelli and Simona Tecco
Bioengineering 2022, 9(7), 282; https://doi.org/10.3390/bioengineering9070282 - 28 Jun 2022
Cited by 6 | Viewed by 1489
Abstract
The purpose of the present study was to evaluate the mechanical resistance of elastodontic devices (ED): their maximum compression loads and plastic deformation under loading (percentage). An Instron universal machine (Model 3365, Instron, Industrial Product Group, Grove City, PA, USA) was employed with [...] Read more.
The purpose of the present study was to evaluate the mechanical resistance of elastodontic devices (ED): their maximum compression loads and plastic deformation under loading (percentage). An Instron universal machine (Model 3365, Instron, Industrial Product Group, Grove City, PA, USA) was employed with a 100 N load cell and with Bluehill software for loading analyses. Each device was submitted to a five-cycles test. The following ED were evaluated: A.M.C.O.P. (Micerium, Genova, Italy) in red color, in orange color, and in blue color; HealthyStart (Ortho-Tain, Winnetka, IL, USA), and T4K™ phase 1 (Myofunctional Research Co., Helensvale, Australia). During the five-cycles test, the Ortho-Tain device delivered the greatest compression load (7.56 N), with the lowest percentage of deformation (0.95%). For all devices, a slight plastic deformation of the material was registered, ranging from 0.95% to 1.75%. For the T4K device it was not possible to complete the five-cycles test. For all the analyzed ED, a slight plastic deformation under loading was registered, that in all cases can be considered clinically acceptable. Further studies are needed to test the appliances after clinical usage. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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12 pages, 9676 KiB  
Technical Note
Concept for the Treatment of Class III Anomalies with a Skeletally Anchored Appliance Fabricated in the CAD/CAM Process—The MIRA Appliance
by Lutz D. Hodecker, Reinald Kühle, Frederic Weichel, Christoph J. Roser, Christopher J. Lux and Carolien A. J. Bauer
Bioengineering 2023, 10(5), 616; https://doi.org/10.3390/bioengineering10050616 - 19 May 2023
Cited by 1 | Viewed by 1239
Abstract
Objective: Intermaxillary elastics, anchored skeletally, represent a promising concept for treatment in adolescent patients with skeletal Class III anomalies. A challenge in existing concepts is the survival rate of the miniscrews in the mandible or the invasiveness of the bone anchors. A novel [...] Read more.
Objective: Intermaxillary elastics, anchored skeletally, represent a promising concept for treatment in adolescent patients with skeletal Class III anomalies. A challenge in existing concepts is the survival rate of the miniscrews in the mandible or the invasiveness of the bone anchors. A novel concept, the mandibular interradicular anchor (MIRA) appliance, for improving skeletal anchorage in the mandible, will be presented and discussed. Clinical case: In a ten-year-old female patient with a moderate skeletal Class III, the novel MIRA concept, combined with maxillary protraction, was applied. This involved the use of a CAD/CAM-fabricated indirect skeletal anchorage appliance in the mandible, with interradicularly placed miniscrews distal to each canine (MIRA appliance), and a hybrid hyrax in the maxilla with paramedian placed miniscrews. The modified alt-RAMEC protocol involved an intermittent weekly activation for five weeks. Class III elastics were worn for a period of seven months. This was followed by alignment with a multi-bracket appliance. Discussion: The cephalometric analysis before and after therapy shows an improvement of the Wits value (+3.8 mm), SNA (+5°), and ANB (+3°). Dentally, a transversal postdevelopment in the maxilla (+4 mm) and a labial tip of the maxillary (+3.4°) and mandibular anterior teeth (+4.7°) with gap formation is observed. Conclusion: The MIRA appliance represents a less invasive and esthetic alternative to the existing concepts, especially with two miniscrews in the mandible per side. In addition, MIRA can be selected for complex orthodontic tasks, such as molar uprighting and mesialization. Full article
(This article belongs to the Special Issue Advances in Appliance Design and Techniques in Orthodontics)
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