Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans ; Consensus ; Orthodontic Appliance Design ; Orthodontic Appliances, Removable ; Tooth Movement Techniques/methods* ; Malocclusion/therapy* ; Orthodontics, Corrective/instrumentation*

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

OBJECTIVES: This study aims to compare the effects of two orthodontic treatment modalities for skeletal class Ⅲ malocclusion on specific changes in airway volume, morphology, palatal angle, mandibular rotation, and bone displacement. Results provide scientific evidence for the selection of orthodontic treatment plans and reduce the risk of developing obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Thirty-six patients diagnosed with skeletal class Ⅲ malocclusion at the Department of Orthodontics, the Affiliated Stomatological Hospital of Nanjing Medical University from September 2018 to December 2023 were divided into two groups: orthodontic-orthognathic treatment group (18 patients) and camouflage orthodontic treatment group (18 patients). Changes in airway volume, cross-sectional area, palatal angle, mandibular, and tongue positions were observed through pre- and post-operative cone beam computed tomography and 3D cephalometric measurements. RESULTS: In the camouflage orthodontic treatment group, nasopharyngeal volume and oropharyngeal volume statistically increased after treatment (P<0.05). In the orthodontic-orthognathic treatment group, changes in nasopharyngeal volume, nasopharyngeal airway, distance from posterior tongue to pharyngeal wall, palatal angle, mandibular rotation, and hyoid bone displacement were statistically significant after surgery (P<0.05). In the comparison between the two groups after treatment, changes in the distance from posterior tongue to pharyngeal wall, palatal angle, and distance from hyoid bone to sella turcica point were statistically significant (P<0.05). CONCLUSIONS Patients in the orthodontic-orthognathic treatment group showed significantly greater changes in oropharyngeal cross-sectional area, palate angle, and tongue position compared with patients in the camouflage orthodontic treatment group. As individuals susceptible to OSAHS often exhibit mandibular retrusion and decreased minimum airway cross-sectional area, special attention should be paid to airway morphology changes when adopting orthodontic-orthognathic treatment to avoid adverse consequences.
Humans ; Hyoid Bone/diagnostic imaging* ; Malocclusion, Angle Class III/therapy* ; Male ; Female ; Cone-Beam Computed Tomography ; Cephalometry ; Orthodontics, Corrective/methods* ; Adult ; Mandible ; Pharynx/diagnostic imaging* ; Sleep Apnea, Obstructive/etiology* ; Orthognathic Surgical Procedures

Early orthodontic treatment has been a hot spot and focus of development in recent years in the field of orthodontics, pediatric dentistry, and general practice dentistry. However, there are still some misconceptions, such as excessive or premature intervention, strict control of indications, exaggeration of the role of early orthodontic treatment. This article starts from the analysis of the current status of early orthodontic treatment in China and combines the latest literature and reviews at home and abroad to analyze the nine issues that dentists and the public are concerned about one by one, including whether early orthodontic treatment is a new concept, whether it is necessary, the timing of early orthodontic treatment, the indications for early orthodontic treatment, whether it can provide a non-tooth extraction or non-surgical opportunity, whether it can completely change the facial profile such as retrognathia and growth pattern of the mandible, whether it can treat habitual mouth breathing or adenoid face or obstructive sleep apnea, the role of myofunctional therapy with prefabricated appliances in early orthodontic treatment, whether transparent aligners are superior to traditional aligners in early orthodontic treatment, with the aim of promoting the standardization of early orthodontic treatment. Early orthodontic treatment must choose the right indications, master the basic principles and techniques of orthodontics, and choose the most suitable treatment method and timing for the child.
Humans ; Orthodontics, Corrective/methods* ; Malocclusion/therapy* ; Orthodontics ; China ; Child

Periodontally accelerated osteogenic orthodontics (PAOO) is an adjunctive technique in orthodontic treatment, based on the principle of the regional acceleratory phenomenon (RAP). It aims to shorten orthodontic treatment duration by enhancing osteoclast activity. In recent years, the surgical approach of PAOO has been gradually optimized with the development of techniques such as piezosurgical corticotomy and alveolar micro-osteoperforations. The materials used have also improved, including novel grafting materials such as bioactive glass and new barrier membranes like platelet-rich fibrin. Thanks to these clinical innovations, PAOO is evolving toward a trend of minimal pain, low invasiveness, and high efficacy. However, clinical research on PAOO remains limited, large-sample, multicenter randomized controlled trials are still needed to evaluate the clinical effectiveness of different surgical techniques and grafting materials in PAOO.
Humans ; Osteogenesis/physiology* ; Orthodontics/methods* ; Orthodontics, Corrective/methods* ; Piezosurgery/methods*

In recent years, the early orthodontic treatment of malocclusion has become a hot issue in the field of orthodontics. Some new phenomena and new problems that have emerged require in-depth analysis and discussion, and need to be given correct guidance and norms. Malocclusion refers to the deformities of teeth, jaws, and craniofacial bones caused by genetic and environmental factors during growth and development. Based on the accurate judgment of the etiology and diagnosis, choosing the right time and suitable indications, with the advantage of growth and development, the most suitable appliance can be selected in the early stage of malocclusion to fix malocclusion, and to effectively prevent and block the formation and development of malocclusion. This article will discuss how to timely and appropriately carry out the early prevention and treatment of malocclusion with six aspects, including methods of performing early orthodontic treatment, the basis and guarantee of early orthodontic treatment, correctly understanding early orthodontic treatment, the issues that should be paid attention to in carrying out early orthodontic treatment, actively advocating multidisciplinary cooperation during early orthodontic treatment and understanding face management in a serious way.
Dental Care ; Humans ; Malocclusion/therapy* ; Malocclusion, Angle Class II/therapy* ; Orthodontic Appliances, Functional ; Orthodontics, Corrective/methods*

In recent years, with the rapid development of digital technology, the application of oral virtual patients in prosthodontics, orthodontics, oral and maxillofacial surgery, and other disciplines has gradually increased. Although the focus on oral virtual patients varies in different disciplines, the application of oral virtual patients in assisting the prediction of treatment effects and the formulation of treatment plans will have good prospects. The construction accuracy and presentation effects of oral virtual patients can be influenced by the source of three-dimensional (3D) image, and methods of registration. Based on the studies and clinical experiences of our team, researches of other teams, the source of 3D images, the construction methods, and the clinical applications of virtual patients in prosthodontics will be presented, so as to provide a reference for normalized application and development of oral virtual patients and to offer a future development direction of oral virtual patients.
Humans ; Prosthodontics/methods* ; Imaging, Three-Dimensional ; Orthodontics ; Surgery, Oral

Objective: To explore the establishment of an efficient and automatic method to determine anatomical landmarks in three-dimensional (3D) facial data, and to evaluate the effectiveness of this method in determining landmarks. Methods: A total of 30 male patients with tooth defect or dentition defect (with good facial symmetry) who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology from June to August 2021 were selected, and these participants' age was between 18-45 years. 3D facial data of patients was collected and the size normalization and overlap alignment were performed based on the Procrustes analysis algorithm. A 3D face average model was built in Geomagic Studio 2013 software, and a 3D face template was built through parametric processing. MeshLab 2020 software was used to determine the serial number information of 32 facial anatomical landmarks (10 midline landmarks and 22 bilateral landmarks). Five male patients with no mandibular deviation and 5 with mild mandibular deviation were selected from the Department of Orthodontics or Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June to August 2021. 3D facial data of patients was collected as test data. Based on the 3D face template and the serial number information of the facial anatomical landmarks, the coordinates of 32 facial anatomical landmarks on the test data were automatically determined with the help of the MeshMonk non-rigid registration algorithm program, as the data for the template method to determine the landmarks. The positions of 32 facial anatomical landmarks on the test data were manually determined by the same attending physician, and the coordinates of the landmarks were recorded as the data for determining landmarks by the expert method. Calculated the distance value of the coordinates of facial anatomical landmarks between the template method and the expert method, as the landmark localization error, and evaluated the effect of the template method in determining the landmarks. Results: For 5 patients with no mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (1.65±1.19) mm, the landmark localization error of the midline facial anatomical landmarks was (1.19±0.45) mm, the landmark localization error of bilateral facial anatomical landmarks was (1.85±1.33) mm. For 5 patients with mild mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (2.55±2.22) mm, the landmark localization error of the midline facial anatomical landmarks was (1.85±1.13) mm, the landmark localization error of bilateral facial anatomical landmarks was (2.87±2.45) mm. Conclusions: The automatic determination method of facial anatomical landmarks proposed in this study has certain feasibility, and the determination effect of midline facial anatomical landmarks is better than that of bilateral facial anatomical landmarks. The effect of determining facial anatomical landmarks in patients without mandibular deviation is better than that in patients with mild mandibular deviation.
Adolescent ; Adult ; Algorithms ; Anatomic Landmarks ; Cephalometry/methods* ; Face/anatomy & histology* ; Female ; Humans ; Imaging, Three-Dimensional/methods* ; Male ; Malocclusion ; Middle Aged ; Orthodontics ; Software ; Young Adult