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Introduction The clinical validity of self-ligating brackets’ advertised claims, such as those for the Damon® appliance system, has been explored, but public awareness remains underexamined. This study assessed Saudi public perceptions of these claims. Materials and methods A web-based survey distributed via social media evaluated perceptions of Damon system claims, including treatment efficiency, patient discomfort, oral hygiene maintenance, and treatment esthetic results. Participants were also asked to outline their perception of Damon’s appliance cost. Responses were ranked on a Likert scale and analyzed using the Chi-square test with Bonferroni corrections. Results Of 918 adults, 11% were familiar with the Damon system. Among Damon appliance-aware respondents, 64.4% believed it was superior to traditional braces. Around 56.4% thought it required fewer visits, and 49.5% believed treatment time was shorter, though many were neutral or uncertain. Regarding tooth extraction needs, 43.6% agreed it required lower needs, while 48.5% believed it causes less discomfort. About 46.5% agreed it was easier to maintain oral hygiene, and 54.5% thought it provided better esthetic results. Notably, 52.5% mistakenly believed it was cheaper than traditional braces. However, no major association was found between socio-demographics and Damon appliance knowledge, but females were more likely to perceive it as superior ( P = .012). Conclusions This study highlighted the dissimilarities between public perception and scientific evidence regarding the Damon system. These mixed findings suggest a need for guidelines in orthodontic advertising to prevent potential misinformation. Providing the public with reliable, evidence-based information is crucial for supporting informed decision-making in orthodontic care.

ABSTRACT Introduction: The number of published orthodontic studies has increased considerably over the past ten years. Objective: To analyze the bibliometric data of international orthodontic studies included in orthodontic journals encompassed by the Scopus database between 2011 and 2020, as well as to undertake data comparison between the period 2010-2015 and the period 2016-2020. Materials and methods: A retrospective search was conducted on 14 orthodontic journals included in the Scopus database from 2011 to 2020. Studies of both primary and secondary types were targeted by the search. The yearly number of studies published in the 14 journals, and the first 20 countries, institutions and their type (public/private), and authors, respectively, regarding publication volume, were presented. Results: Over the past ten years, the number of publications in the chosen journals reached 9200, where the American Journal of Orthodontics and Dentofacial Orthopedics and Angle Orthodontist topped the journal list, with 22% and 12% of the publications, respectively. Furthermore, the orthodontic publication volume showed a declining trend by the end of the decade (-9%), where academic/public institutions produced most of the orthodontic studies, and the US (20%), Brazil (17%), and South Korea (8%) topped the countries with the most orthodontic studies. A comparison of the two halves of the decade revealed that orthodontic research exhibited an increasing trend in developing nations, especially Egypt (104%), Saudi Arabia (88%), and Iran (83%). Conclusion: The orthodontic studies published in the chosen journals over the past ten years showed a dynamic change in yearly publication and ranking of countries, institutions, and authors. RESUMO Introdução: O número de estudos publicados na área da Ortodontia aumentou consideravelmente nos últimos dez anos. Objetivos: Analisar os dados bibliométricos dos estudos ortodônticos internacionais publicados entre 2011 e 2020 em periódicos ortodônticos da base de dados Scopus, bem como realizar a comparação entre os dados dos períodos 2010-2015 e 2016-2020. Material e Métodos: Uma pesquisa retrospectiva foi realizada em 14 periódicos ortodônticos incluídos na base de dados Scopus de 2011 a 2020. Estudos dos tipos primários e secundários foram incluídos na pesquisa. Foram apresentados o número anual de estudos publicados em 14 revistas e os 20 primeiros países, instituições e seu tipo (público/privado) e autores, respectivamente, em relação ao volume de publicações. Resultados: Nos últimos dez anos, o número de publicações nos periódicos escolhidos chegou a 9.200, e o American Journal of Orthodontics and Dentofacial Orthopedics e o Angle Orthodontist lideraram a lista de periódicos, com 22% e 12% das publicações, respectivamente. Além disso, o volume de publicações ortodônticas apresentou uma tendência de queda no final da década (-9%), sendo que as instituições acadêmicas/públicas produziram a maior parte dos estudos ortodônticos, e os EUA (20%), Brasil (17%) e a Coreia do Sul (8%) lideraram os países com mais estudos ortodônticos. Uma comparação das duas metades da década revelou que a pesquisa ortodôntica exibiu uma tendência crescente nos países em desenvolvimento, especialmente Egito (104%), Arábia Saudita (88%) e Irã (83%). Conclusão: Os estudos ortodônticos publicados nos últimos dez anos nos periódicos escolhidos mostraram uma mudança dinâmica na publicação anual e no ranking de países, instituições e autores.

Objective To investigate the effects of food hardness on chewing behavior in children compared with adults. Materials and methods Healthy children (3–17 years) were equally divided into five groups based on their dental eruption stages. Each participant ate soft and hard viscoelastic test food models (3 each), while the three-dimensional jaw movements and electromyographic (EMG) activity of the bilateral masseter muscles were recorded. The data from the children were compared with a control group of healthy adults (18–35 years). The data were analyzed with nonparametric tests. Results There was no significant difference in the number of chewing cycles and the duration of the chewing sequence between children groups and adults. Children with primary dentition (3–5 years) showed shorter lateral jaw movement and higher muscle activity at the end of the chewing sequence, compared with adults. Further, children’s age-groups (3–14 years) failed to adapt their jaw muscle activity to food hardness. However, at the late-permanent dentition stage (15–17 years), children were capable of performing adult-like chewing behavior. Conclusions Overall, it seems that children as young as 3-year-old are quite competent in performing basic chewing function similar to adults. Yet, there are differences in the anticipation or adaption of jaw muscle activity and jaw kinematics to food hardness. Clinical relevance The study may have clinical implication in the diagnosis and management of children with chewing impairment associated with dental malocclusions and other orofacial dysfunctions.

ObjectiveTo investigate the effects of dental/skeletal malocclusion and orthodontic treatment on four main objective parameters of chewing and jaw function (maximum occlusal bite force [MOBF], masticatory muscle electromyography [EMG], jaw kinematics, and chewing efficiency/performance) in healthy children.Materials and methodsSystematic searches were conducted in MEDLINE (OVID), Embase, and the Web of Science Core Collection. Studies that examined the four parameters in healthy children with malocclusions were included. The quality of studies and overall evidence were assessed using the Joanna Briggs Institute and GRADE tools, respectively.ResultsThe searches identified 8192 studies; 57 were finally included. The quality of included studies was high in nine studies, moderate in twenty-three studies, and low in twenty-five studies. During the primary dentition, children with malocclusions showed similar MOBF and lower chewing efficiency compared to control subjects. During mixed/permanent dentition, children with malocclusion showed lower MOBF and EMG activity and chewing efficiency compared to control subjects. The jaw kinematics of children with unilateral posterior crossbite showed a larger jaw opening angle and a higher frequency of reverse chewing cycles compared to crossbite-free children. There was a low to moderate level of evidence on the effects of orthodontic treatment in restoring normal jaw function.ConclusionsBased on the limitations of the studies included, it is not entirely possible to either support or deny the influence of dental/skeletal malocclusion traits on MOBF, EMG, jaw kinematics, and masticatory performance in healthy children. Furthermore, well-designed longitudinal studies may be needed to determine whether orthodontic treatments can improve chewing function in general.Clinical relevanceComprehensive orthodontic treatment, which includes evaluation and restoration of function, may or may not mitigate the effects of malocclusion and restore normal chewing function.

This study's objectives are to ascertain the frequency of congenital tooth missing and evaluate the relationship between gender and side characteristics. This retrospective study involved participants who attended private dental clinics as well as a dental college in Hail, Saudi Arabia. Out of the 1,150 patients examined, 494 (220 males and 274 females) fulfilled the inclusion criteria. Different types of tooth agenesis were evaluated and classified into the following categories: mild (one or two teeth missing), moderate (three to five teeth missing), and severe (six or more teeth missing). The analysis did not include third molars. The existence of retained primary teeth was noted, along with any dental abnormalities accompanying tooth agenesis. Statistical analysis was conducted utilizing the chi-square test and Fisher's exact test to explore possible relationships between variables. A significance level of 5% (alpha = 0.05) was utilized. Out of the 1150 panoramic radiographs that were examined, 494 individuals (220 (44.5%) males and 274 (55.5%) females) met the criteria for inclusion. The prevalence of congenitally missing permanent teeth was 65 (13.2%) in the study sample. The prevalence of congenitally missing teeth were more incidence in maxilla 36 (56.3%) than mandible 28 (43.8%). There is statistically significant association between the occurrence of congenitally missing teeth and gender or arch (p < 0.05). The prevalence of dental anomalies was similar in both sides. There are not a statistically significant association (p > 0.05) between the occurrence of congenitally missing teeth and side. The second premolar was the most commonly missing (7.3%). The retained deciduous teeth was shown to be the most common dental anomaly, with a prevalence of 15 (23.4%). The prevalence of congenitally missing teeth fell within the range reported in previous studies. Second premolars were the most frequently congenitally missing teeth, with maxillary teeth more commonly affected than mandibular ones.

Background To investigate the regenerative ability of concentrated growth factor (CGF) during endodontic treatment compared with other regenerative procedures. Methods The PubMed, Web of Science Core Collection, Scopus, and Ovid MEDLINE databases were systematically searched to identify studies that examined the use of regenerative endodontic therapy (RET) utilizing CGF for patients, animals, or extracted human teeth. The risk of bias was assessed using the JBI tool for clinical studies, QUIN tool for in vitro studies, and SYRCLE tool for animal studies. The study results were qualitatively synthesized. Results A total of 311 studies were initially retrieved from the databases. Ultimately, nine studies were included (three randomized clinical trials, two retrospective studies, three in vitro studies, and one in vivo animal study). The risk of bias was low in two studies and moderate in seven studies. Compared with other types of regenerative procedures, CGF has a similar influence on root dentinal thickness and apical foramen width. The clinical success rate was also comparable among the investigated regenerative procedures. The influence of CGF on human pulpal/apical papilla stem cells was similar to that of other types of regenerative procedures. However, the effect of CGF was enhanced when it was combined with transforming growth factor beta 1. The use of CGF in animals also exerted radiographic, histological, and immunohistochemical effects similar to those of exerted by other regenerative procedures. Conclusions Compared with other regenerative procedures, CGF resulted in similar radiographic changes after the RET of necrotic permanent teeth. Similarly, CGF-conditioned medium enhanced stem cell viability, proliferation, and differentiation, with no apparent differences from other endodontic regenerative procedures. However, the interpretation of these findings is limited by the heterogeneity of included studies, variations in RET protocols, and the lack of long-term clinical outcome data.

Background: The relationship between orthodontics and endodontics during the treatment planning phase is scarcely investigated, especially when orthodontic treatment is considered for endodontically treated teeth with apical periodontitis. This systematic review aimed to investigate the effect of orthodontic movement on the periapical healing of teeth that have undergone endodontic root canal treatment/retreatment. Materials and methods: On 15 March 2025, a systematic search was conducted in PubMed, Web of Science Core Collection, EBSCO host and complemented with a manual search of Google Scholar and the gray literature. The quality and the risk of bias of the included studies were assessed using the Joanna Briggs Critical Appraisal tools for human studies and the Systematic Review Centre for Laboratory Animal Experimentation for animal studies. The data about the influence of orthodontic movement on the periapical healing of endodontically treated teeth were extracted and pooled. Results: Out of 4614 identified titles, 6 studies were finally included (two animal and four clinical studies). The risk of bias was high in one study, moderate in three, and low in two. The included animal studies demonstrated a significant delay in the healing process of periapical lesions when orthodontic forces were applied shortly after root canal treatment. However, clinical studies showed no significant impact of orthodontic movement on periapical radiolucency except when the quality of obturation was compromised. Conclusions: Current clinical studies indicate that orthodontic tooth movement does not impair the periapical healing of endodontically treated teeth when the root canal obturation is of adequate quality.

Background Instagram is a key source of health information, particularly for promoting clear aligners therapy but raising concerns about misinformation. Despite over 400 million Arabic speakers across 22 countries, their representation in health information quality research is limited. Thus, this prospective cross-sectional study aimed to qualitatively and quantitatively analyses Arabic Instagram posts about clear aligner therapy. Methods On 21 April 2025, Arabic posts were collected using 14 popular hashtags following a stratified random sampling approach, with the top 20 posts per hashtag included. Posts were classified by format, poster role, content type, thematic focus and type. Claim accuracy was assessed using established misinformation frameworks and orthodontic guidelines. Inter-rater reliability was ensured with a multi-coder protocol. Statistical analyses included Mann–Whitney U, Chi-square and Kruskal–Wallis tests with Bonferroni corrections (α = 0.05). Results Of 1,058,700 initial posts, 264 were included. Most were promotional (63%), photo-based (75%) and originated from Saudi Arabia (56%). Video and sharing experience posts had higher likes and engagement than photo and marketing posts (p < 0.05). Clinical and educational posts contained more balanced facts (p < 0.001), while 36% of claims were non-factual, particularly in promotional, marketing and practice advertisement posts (p < 0.001, p < 0.05 and p = 0.011, respectively). Conclusion Arabic Instagram content on clear aligners is mainly promotional with substantial misinformation. Educational posts, though more accurate, are less common. Given Instagram's impact on treatment decisions, improving the quality of Arabic orthodontic content is crucial for informed consent and public awareness.

Background The presence of dental anomalies alongside malocclusion or disruption of facial symmetry can lead to issues with tooth alignment and performance. The aim of this study was to assess how common dental abnormalities in relation to malocclusion and facial patterns in residents of the Hail province in Saudi Arabia. Methods A Cross section analytical Observational study design employed cephalometric radiographs and orthodontic records sourced from a private practice in Hail City, Saudi Arabia, as well as the College of Dentistry. Patients who were older than nine were included. A variety of developmental abnormalities were evaluated, and the cephalometric radiograph was utilised to determine the facial pattern and measure the ANB angle in order to categorize the type of malocclusion. Fisher’s exact tests were employed together with chi-square analysis to determine the association between the research variables. Nominal regression was used to assess associations between gender, dental anomalies, malocclusion types, and facial pattern. A significance threshold of 0.05 was chosen. Results A combined total of 541 individuals (233 males and 308 females) satisfied the eligibility requirements. A total of 367 individuals exhibited dental anomalies, accounting for 67.8%. Ectopic eruption was observed in 343 cases, making up 49.0% of tooth anomalies; impaction was seen in 191 cases (27.3%), agenesis in 59 cases (8.4%), and short root in 34 cases (4.9%). In terms of malocclusion, class I was the most common at 41.0% of cases, followed by class II div I at 30.7%, class II div II at 14.2%, and class III at 14.0%. There was no statistically significant correlation between gender and the occurrence of dental anomalies ( p  > 0.05). Patients with dental anomalies had the highest incidence of Class I, Class II, and Class III malocclusions. A significant correlation ( p  < 0.05) was found between the occurrence of dental anomalies and either the types of malocclusions or the various facial patterns. Gender was not significantly associated with dental anomalies or most malocclusion types, except for a borderline lower odds of Class II division 1 in males. The absence of dental anomalies was strongly associated with higher odds of Class II division 2 and borderline higher odds of Class II division 1 compared with Class III. No significant associations were found for facial pattern. Conclusions Dental anomalies were found to be quite common. Dental anomalies were most common in class I, then in class II, then in class III. We found relationships between malocclusions, dental anomalies, and facial patterns. It is critical to use the data to develop appropriate orthodontic treatment and preventive measures for the relevant population.

Background Restoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations. Methods The search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute’s critical appraisal tool and Newcastle–Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool. Results A total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low. Conclusions Although the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth. Database registration PROSPERO (CRD42020218378).