Robert Willer Farinazzo Vitral

Bibliometric analyses have become essential for understanding scientific production and innovation dynamics; however, large-scale applications remain limited by challenges related to data extraction, preprocessing, citation network reconstruction, and reproducibility, particularly when using PubMed-indexed records. This study presents a fully automated and reproducible computational workflow for large-scale bibliometric analyses based on the Disruption Index (DI). The pipeline enables systematic retrieval of PubMed data, standardized metadata processing, construction of citation networks, and calculation of DI values within a fixed post-publication citation window. Implemented in Python, the workflow integrates automated querying, XML parsing, data consolidation, and network-based citation classification, allowing scalable and transparent analyses that are infeasible through manual approaches. In a demonstrative application focused on orthodontic literature, the pipeline processed more than 67,000 articles and reconstructed over 300,000 citation relationships, resulting in a final analytical sample of 3,234 articles with indexed references and citations. The automated framework ensures methodological transparency, facilitates replication, and substantially reduces the time and technical barriers associated with advanced bibliometric studies. By providing an open and extensible solution for calculating the Disruption Index at scale, this workflow supports robust assessments of scientific innovation and consolidation and can be readily adapted to other biomedical research domains indexed in PubMed.

Introduction: Lower incisor inclinations can be orthodontically performed for better aesthetic results or to camouflage a skeletal problem. However, when buccolingual tooth movement occurs beyond the adaptive limits of the bone, it is associated with the onset of periodontal problems after treatment. Objective: This study aimed to evaluate the effects of natural and orthodontically induced buccolingual inclination of the lower incisors on the interproximal bone crest (IBC) at the end of orthodontic treatment. Material and Methods: A retrospective analysis of cephalometric and periapical radiographs obtained from the initial (T0) and final (T1) orthodontic documentation of 60 orthodontically treated individuals was performed. The lower incisor inclination in relation to the mandibular plane (IMPA), the thickness of the alveolar process and mandibular symphysis and the height of the IBC were measured. Results: There was no significant change in IMPA during treatment in the evaluated sample. Men had significantly thicker mandibular symphysis than women. A significant reduction was observed in alveolar process thickness and IBC height throughout the sample. Age showed a significant positive correlation with change in IBC height. Although IMPA was not directly correlated with IBC change during treatment, it was indirectly correlated when evaluated in conjunction with other variables. Conclusion: IMPA was not directly related to IBC height change. IMPA, alveolar process thickness and mandibular symphysis together were related to IBC height change.

Introduction: In Brazil, the population’s easy access to the judicial system exposes healthcare professionals, including orthodontists, to the risk of becoming involved in legal disputes for which they are often inadequately prepared. Objective: In this context, the aim of this study was to assess the legal vulnerability of professionals involved in orthodontic practice and to identify factors associated with professional practice. Material and Methods: This cross-sectional observational study was conducted using a previously validated questionnaire administered to 247 professionals engaged in orthodontic practice. Participants were classified into low, moderate, and high levels of legal vulnerability. Data were analyzed using descriptive and inferential statistics, including Pearson’s chi-square and Fisher’s exact tests. Results: The results indicated greater vulnerability among non-specialists, professionals with fewer years since graduation and shorter clinical experience, as well as among those who graduated from private institutions (p < 0.001). In addition, 72.8% of participants believed that patients’ economic status may influence the occurrence of legal claims, and 53.5% reported lacking legal guidance for drafting contracts in their professional practice. Conclusion: The findings suggest the presence of vulnerabilities related to legal knowledge and professional practices, particularly among less experienced professionals and non-specialists in Orthodontics.

Introduction: The presence of orthodontic brackets can compromise the efficiency of oral hygiene, leading to changes in oral microbiota, increasing the risk of gingival changes after removal of the fixed orthodontic appliance. Objective: The objective of this study was to evaluate changes in gingival volume in the lower anterior teeth after removal of the fixed orthodontic appliance. Methods: The sample consisted of 84 lower anterior teeth of 14 adult individuals in the final phase of fixed orthodontic treatment and had the gingival condition of their lower incisors recorded through photographs. The evaluation times were from T0 to T4. At T0, the individuals underwent removal of dental calculus and prophylaxis with a sodium bicarbonate jet, installation of a fixed retainer, digital periapical radiography of the anteroinferior teeth and extraoral frontal photograph to record the gingival condition. At T1, the appliance was removed and the gingival biotype was determined. Other photographic exams were performed at times T2, T3 and T4. Results: Clinical incisor crown values showed a significant increase 21 days after orthodontic appliance removal. The height of the papilla between the incisors showed a significant reduction on the 14th day after removal of the appliance, while the papilla between the canine and the lateral incisor showed significance only in the last evaluation. Conclusions: The sample showed a predominance of thin gingival biotype, the radiographic variables showed no significant correlation. There were gingival changes in the anteroinferior region, with spontaneous and progressive reduction of all analyzed papillae.

Introduction: The ANB angle and the Wits appraisal are common cephalometric tools for assessing anteroposterior jaw discrepancies. Assessment of a patient’s anatomy in the anteroposterior disharmony of the maxillary and mandibular should not be limited to hard-tissue relationships, but should also consider soft tissue involvement, such as the soft tissue facial profile angle. Objective: To evaluate the correlations between sagittal skeletal relationships established through ANB angle and Wits appraisal and to evaluate the soft-tissue facial profile angle, assessed by the G-Sn-Pog’ angle. Material and methods: The sample consisted of 300 individuals (129 male and 171 female). The ANB angle, the Wits appraisal, and by the G-Sn-Pog’ angle were obtained through lateral cephalograms. The facial profile was categorized into three groups. The correlation coefficients between ANB angle and Wits appraisal and between the soft-tissue facial profile angle and skeletal pattern were evaluated. Results: A significant correlation (p <.001) was observed between ANB angle and Wits appraisal (r= .738), between G-Sn-Pog’ and ANB angle (r= -.708), and between G-Sn-Pog’ and Wits appraisal (r= -.586). When assessed separately according to different groups of soft-tissue facial profiles, there was a weak correlation between ANB and Wits assessment in the low soft-tissue facial profile angle subjects (Group II), and a moderate correlation in the high soft-tissue facial profile angle subjects (Group III). Conclusion: The correlation between ANB angle and Wits was moderate to high, except in Group II soft-tissue facial profile subjects.

Introduction: The use of arch models is essential in diagnosis and planning in orthodontics. The demand for digital and printed models has increased among professionals. Objective: The aim of the study was to assess the agreement of horizontal and vertical linear measurements obtained from digital models, printed models, and direct measurements. Materials and Methods: Intraoral scans of 30 individuals were obtained. Digital measurements were performed using the STL files. From printed models, the measurements were done using a digital caliper, and the real measurements were done directly to the mouth of respective patients. Results: The one-sample t test showed no discrepancy between the paired sets of measurements, with the value of 0 (p>0.05). The evaluation of the measurements was done using Bland-Altman analysis in pairs. The three methods showed agreement in horizontal and vertical measurements. Linear regression analyses showed no proportional bias in the data (p>0.05). Conclusion: The horizontal and vertical measurements evaluated showed agreement when measured on digital models, printed models and directly in the individuals’ mouths.

Introduction: The removal of residual resins is a routine procedure in orthodontic clinics and of great importance to the final result of the treatment. Objective: To evaluate the main methods of residual resin removal used by orthodontists, and the main reasons for choosing these methods. Methods: A questionnaire consisting of 21 questions: 6 relating to demographic data and the other 15 relating to two methods used to remove residual resins (drills or pliers) was sent by e-mail to orthodontists registered with the Regional Councils of Dentistry of São Paulo and Rio de Janeiro (Brazil) within April and June, 2023. Questionnaires were sent back by 153 professionals. Results: Residual resin removal is always carried out with high speed drill for 44.7% of the sample, and with low speed drill for 28.7%; 61.3% use irrigation. The multi-laminate carbide bur is used by 82.5% of orthodontists. Pliers are always used by 12.4%. Resin-removing pliers with Widia are used in 39% of cases. The use of high speed was justified by the shorter working time, and the choice of pliers was justified by the smaller damage to the tooth enamel. Conclusion: The most used residual resin removal method was the multi-laminate carbide bur at high speed with irrigation, justified the by shorter working time.

Introduction: The use of clear aligners as an alternative to fixed orthodontic appliances has become popular due to the aesthetic demands of adult patients seeking orthodontic treatment. However, orthodontists’ lack of knowledge about the legal consequences of their activities, and the lack of solid scientific evidence raise concerns regarding civil liability in this type of treatment. Marketing campaigns of manufacturing companies often exaggerate promises of results, and ignore the lack of scientific evidence. Patients, as consumers, are protected by the Consumer Protection Code, whereas orthodontists are considered treatment providers. Therefore, they can be held liable for damage caused to patients, whether by subjective or objective fault. Objective: This article aims to identify the civil responsibilities of orthodontists and aligner manufacturing companies, by means of a literature review, providing basic legal guidance to help professionals protect themselves from possible lawsuits related to treatment with orthodontic aligners. Conclusions: The study highlights the importance of knowledge of legal notions in treatments with orthodontic aligners by orthodontists, who should legally safeguard themselves through individual written contracts, avoiding obligation of results. In addition, in cases of legal claims, it is possible that the manufacturing companies are jointly and severally liable for possible damages claimed by the patient.