José Antonio Alarcón

Background: Sequential distalization of the upper arch with clear aligners is widely used to correct Class II malocclusion, but its predictability across molars, canines, and incisors is unclear. This study compared virtual planning with intraoral outcomes and identified the associated side effects. Methods: A retrospective study analyzed 80 maxillary quadrants from 40 patients with dental Class II malocclusion treated with Invisalign^® (Smart Track^® material) using a sequential V-pattern distalization protocol with Class II elastics and vertical rectangular/optimized attachments. Predicted movements were extracted from ClinCheck Pro^®. Scans at baseline and after the first approved aligner stage were superimposed on the palatal rugae using Geomagic Control X^®. Extrusion/intrusion, buccolingual movement, mesiodistal translation, rotation, angulation, and torque were measured for molars, canines, and incisors. Results: Molar distalization reached 1.80 of the 2.60 mm planned (69.2%), and canines 1.12 of 2.45 mm (45.7%) and incisor intrusion reached only 0.03 of the 1.45 mm planned (2.1%). Buccolingual molar movement was most predictable (97.4%), and molar rotation showed moderate-to-good predictability (88.4%); incisor rotation, angulation and torque accuracy were 62.2%, 53.8% and 23.2%, respectively. Molar angulation and torque were markedly overexpressed, with unplanned intrusion of 0.80 mm; canine angulation/torque were similarly overexpressed. Incisor intrusion/torque movements were least predictable. Conclusions: Predictability of sequential upper-arch distalization varied widely across tooth groups and movement types. Linear distalization was moderately to poorly predictable and rotational movements were well reproduced, but angulation/torque control were the least predictable, especially for molars and canines, with unintended molar intrusion and buccal torque. Incisor torque, intrusion, and retrusion were most underexpressed. Vertical rectangular attachments improved molar tipping control, while absent attachments and Power Ridges worsened incisor torque/translation. Clinicians should anticipate overcorrection and refinement stages to avoid false expectations based on the initial ClinCheck outcome.

The European Middle Pleistocene represents a critical spatiotemporal interval in human evolution, marked by increasing morphological variability and ongoing debate regarding the evolutionary processes leading to the emergence of Neandertals. In particular, it remains unclear whether this variability reflects the coexistence of multiple evolutionary lineages within Europe or structured variation within a single, evolving lineage. Within this context, the site of Bilzingsleben (Thuringia, Germany) provides a key contribution to discussions of European Middle Pleistocene population structure. This study presents a detailed morphological assessment of the Bilzingsleben E7 mandibular fragment, integrating qualitative anatomical observations with quantitative analyses of discrete characters. The Bilzingsleben mandible was examined directly and evaluated within a broad comparative framework including European Middle Pleistocene hominins, Neandertals, and selected African and Asian specimens. Multivariate analyses, including Principal Coordinates Analysis (PCoA) and neighbor-joining cluster analysis based on Gower distances, were used to explore patterns of morphological affinity. Qualitative analysis indicates that the Bilzingsleben mandible exhibits a mosaic combination of predominantly primitive features—such as multiple mental foramina, marked lateral relief of the corpus, and a weakly developed submandibular fossa—together with a limited number of incipiently derived traits, including posterior extension of the corpus and a downward orientation of the digastric fossae. Quantitative results consistently place Bilzingsleben within the morphological variability of European Middle Pleistocene hominins but outside the compact Neandertal cluster. In the PCoA, Bilzingsleben occupies an intermediate (PCo1) and peripheral position (PCo2), contrasting with more centrally positioned specimens such as Mauer. Taken together, these results support an interpretation of Bilzingsleben as part of a European Middle Pleistocene set of populations exhibiting mosaic morphology, rather than considering Bilzingsleben as evidence for a distinct evolutionary lineage. When integrated with evidence from other anatomical elements from Bilzingsleben, the mandibular morphology supports interpreting this population within the broader evolutionary context of the Neandertal lineage.

Objectives: Here, we present the findings of an incipient caries lesion on a permanent upper left second molar attributed to an adult male Neandertal individual from El Sidrón Cave. This study presents new data regarding the antiquity of human caries lesions, their development, and the possibility of the para‐masticatory behavior component as a contributory factor in their origin, at least in Homo neanderthalensis.Materials and Methods: The tooth was examined using a μCT scan to confirm the lesion and to evaluate its extent. Element chemical analysis was performed to check the decalcification on both the lesion edges and pristine surfaces (as carious lesions often involve demineraization of the tissues) using an environmental scanning electron microscope.Results: The lesion was located on the occlusal surface on the protocone cusp, a small furrow filled with sediment, 2.6 mm in length and 0.78 mm in width, and mineral loss on the white surrounding area compared to the apparently intact adjacent enamel.Discussion: This pit lesion resembles the appearance of other Neandertal carious lesions, all from temperate environments. Calcium and phosphorus loss has been documented as has been characterized on dental caries. Regarding the etiology, we propose that an intense masticatory and para‐masticatory activity combined with evidence for a mixed diet with a high carbohydrate component, the molar tooth may have developed a crack lesion, which was then colonized by a bacterial biofilm that deepened into the dentine and developed this small channel‐shaped caries.

Scientific contributions (lectures and posters) to the American Association of Orthodontists (AAO) annual sessions from 2013 to 2023 were investigated with the aims of analysing the contributions of each country and their efficiency, presentation trends, and gender differences during these years as well as the most frequent topics and their evolution. Official data were requested from and provided by the AAO secretary. The year and type of presentation; the name, country and gender of the first author; and the full title of the presentation were considered. In addition, six national indicators that could determine the quantity and quality of scientific production were obtained from the Our World in Data website with regard to the countries that made the greatest contributions to the AAO annual sessions. The USA featured the largest number of lecturers (69.44%), while the presentations of posters were more balanced among the 4 countries that exhibited the highest levels of production (i.e., Brazil, the USA, Mexico and South Korea). Brazil was the main country to perform above expectations. The COVID-19 pandemic resulted in a significant reduction in the number of poster presentations. The male/female ratio was close to 3:1 in terms of lectures and close to 1:1 in terms of posters. In 2023, women presented more posters than did men. The terms clear/aligners and digital were strongly present, and the terms maxillary, adults, and expansion were used increasingly frequently, while the use of the terms brackets or cephalometry decreased. American lecturers included terms that differentiated them from lecturers in other countries. The nationalities of lecturers are not closely related to those of posters, particularly with regard to the USA, Brazil, Canada, Mexico and Turkey. Research spending and economic level are the most significant factors with respect to the type and number of a country’s contributions. Concerning gender, a clear imbalance in favour of men persists among lecturers. Increased distance from the USA makes it more difficult for women to serve as lecturers. An emergent paradigm shift in current topics towards a focus on the terms clear/aligners and digital in lectures is evident.

The emergence of Neandertal morphology (Homo neanderthalensis) is associated with the appearance of mosaic phenotypes in Middle Pleistocene ancestral populations. Using this case as a reference, we analyze the concept of "mosaic evolution". Mosaic evolution suggests that different traits can evolve independently, at different times, resulting in various combinations of primitive and derived traits (mosaics) in descendant species. Often, the seemingly random nature of these trait combinations is interpreted within the conceptual framework of population genetics, where the different states of anatomical traits are seen as direct expressions of allelic variants. In this paper, we propose that the appearance of these mosaics of traits in Middle Pleistocene hominins of Europe occurred within a complex network of morphogenetic interactions involving two factors that affect the organism as a whole. First, during the early part of the Middle Pleistocene, there is an increase in body size, and consequently, an increase in metabolism, which may have affected facial anatomy through the expansion of the respiratory tract. Second, the hominin lineage from which Neandertals, Denisovans, and modern humans descend experiences an increase in the size of certain brain areas, leading to changes in the anatomy of the cranial vault and the integration of anatomical systems related to the base of the skull. In this context, changes in the overall orientation of the basicranium and in the topological relationships between the midline of the skull base and the lateral portions of the skull (temporal fossae) can be explained from an organismic perspective.

Objectives: This study aimed to evaluate the effectiveness of a novel hybrid aligner system, Geniova Technologies™ (GT), for arch expansion and to compare the predictability of its virtual setup with a conventional clear aligner system (CA) after the first treatment phase. Materials and Methods: Forty (mean age: 31.3 years for GT, 38.4 years for CA) adult patients with maxillary dentoalveolar compression and anterior crowding >3 mm were enrolled and assigned to GT and CA groups. Transverse changes for canines and premolars were measured at the cusp and cervical levels. Results: No significant baseline differences in transverse dimensions were found between groups. Treatment duration (4.25 months for GT vs. 9.75 months for CA) and the number of aligners (4.25 in GT vs. 28.25 in CA) significantly differed (p < 0.001). At the cusp level, mean transverse expansions for the maxillary first premolars were 2.78 mm (GT) and 2.44 mm (CA). However, effectiveness comparisons revealed no significant differences in expansion outcomes, with both groups showing similar accuracy. Conclusions: The GT group achieved comparable dentoalveolar expansion of canines and premolars in significantly less time and with fewer aligners than the CA group. The predictability of virtual setup measurements was similar for both systems, confirming their comparable performance in achieving planned expansion.

Objectives: This study aimed to evaluate the efficacy of a novel hybrid aligner system, Geniova Technologies™ (GT), for arch expansion and to compare the predictability of its virtual setup measurements with a conventional clear aligner system (CA) after the first treatment phase.Materials and Methods: Adult patients with maxillary dentoalveolar compression and anterior crowding >3 mm were enrolled and assigned to GT and CA groups. Transverse changes for canines and premolars were measured at the cusp and cervical levels after the first set of aligners.Results: No significant baseline differences in transverse dimensions were found between groups. Treatment duration (4.25 months for GT vs. 9.75 months for CA) and the number of aligners (4.25 in GT vs. 28.25 in CA) significantly differed (p<0.001). However, effectiveness comparisons revealed no significant differences in expansion outcomes, with both groups showing similar accuracy.Conclusions: The GT group achieved comparable dentoalveolar expansion of canines and premolars in significantly less time and with fewer aligners than the CA group. The predictability of virtual setup measurements was similar for both systems, confirming their comparable performance in achieving planned expansion.

Background: There is a lack of studies comparing the status of dental specialties worldwide. Therefore, this study aimed to analyze the differences and similarities between the number and types of dental specialties in 31 countries, including every continent, in the world. Materials and methods: Available official documents and webpages from regulatory bodies, official colleges and councils, and dental institutions were collected from 31 countries and analyzed to obtain reliable data on dental specialties. Differences were analyzed using the Lorentz curve and Gini test. Additionally, a cluster analysis was performed to obtain groups of countries with similar patterns in the number and types of dental specialties. Results: A total of 32 different specialties were officially recognized among all the analyzed countries. Orthodontics and oral surgery (100% and 93.1%, respectively) were the two most frequently officially recognized dental specialties worldwide. The total global degree of inequality in the 31 analyzed countries was 42.4%. The Anglo-Saxon countries showed the greatest similarity, approximately 15-fold higher than the European countries. Cluster analysis differentiated six main groups of countries according to the number and types of dental specialties. European countries formed one of the two largest clusters, and the other cluster was of Anglo-Saxon, Asian, African, and several Eastern European countries with a high number of specialties. Conclusions: Officially recognized dental specialties in the different continents and countries show an asymmetric organization. The number, names, and skills of officially recognized dental specialties exhibited significant differences, showing inequalities in their organization. The Anglo-Saxon pattern of dental specialties showed greater equality than the European pattern. Orthodontics was the only constant element among the different patterns.