Table 2.

Description and outcomes as observed in the studies selected for the systematic review.

Author and Year of Study	Sample Size	Study Design	Study Description/Characteristics	Study Outcome/Inference
Adel et al. 2021 [20]	87 studies	Systematic review	Robotic dental assistants, robotics in diagnosis and simulation of orthodontic problems, robotics in orthodontic patient education, teaching, and training, wire bending and customized appliances, nanorobots/microrobots for accelerating tooth movement and for remote monitoring, robotics in maxillofacial surgeries and implant placement and automated aligner production robotics were all examined in this review of published orthodontic literature.	According to the review, there had been significant research in the recent ten years on arch wire bending and tailored appliance robots, simulative robots for diagnosis, and surgical robots (32%, 22%, and 16%). The orthodontic literature had extensively reported on nanorobots and rehabilitation robots, which were both highly promising (13%, 9%). However, additional scientific information will need to be acquired in the future about patient robots, automated aligner manufacturing robots, and assistive robots (1%, 1%, and 6%).
Allareddy et al. 2019 [21]	-	Literature review	This report’s objectives were to present various machine learning techniques, give a summary of the big data analytics market in the healthcare industry, and talk about potential consequences for the orthodontics industry. The traditional analytical methods may no longer be useful for analyzing clinical outcomes due to the growing availability of data from numerous sources.	The current state of big data analytics in the healthcare industry, as well as the typical analytical methods used to analyze massive data sets, were found to be extremely advantageous, the authors concluded. There were various ways that big data analytics could be utilized in orthodontics to enhance clinical outcomes.
Cunha et al. 2021 [22]	-	Literature review	This article’s objective was to provide a description of the resources and clinical uses of CAD/CAM technology in orthodontics.	The use of virtual bracket removal and digital indirect bonding may have shortened the length of orthodontic treatment, eliminated clinical and laboratory stages, enhanced patient comfort, and improved accuracy and predictability. However, the use of CAD/CAM technology in orthodontics came at a higher cost and required specialized training.
Elshazly et al. 2021 [23]	7 aligners	In-vitro study	In this in vitro work, the use of shape memory polymers (SMPs) as the materials for aligners was studied as a novel strategy to get around the rate-limiting staging of traditional aligners. The goal of the study’s design was to move an upper central incisor 1.9 mm in the right direction with just one aligner after several steps/activations. A moving upper central incisor aligned typodont model that was specifically designed for scanning was used. Resin models were produced using orthodontic software and a 3D printer.	The results revealed that the SMPs’ aligner’s overall correction efficiency was around 93%. (1.76 mm). Following the reforming stage, the corrective movement was 0.94 0.04 mm, followed by 0.66 0.07 mm and 0.15 0.10 mm after the first and second activation steps, respectively. It was determined that the use of SMP-based aligners for orthodontic aesthetic treatment has a bright future.
Gandedkar et al. 2019 [24]	-	Literature review	Recent advancements in orthodontic 3D applications, such as 3D printing, diagnosis, and management, recent advancements in orthodontic biomaterials, nanotechnology, biomimetics, battery-driven devices, recent advancements in orthodontic patient education, orthodontic training, and orthodontics practice management, and recent advancements in orthodontics were all examined in this scoping review of published orthodontic literature for the past 10 years (2009–2019). A total of 1245 records were looked up, and 65 potentially pertinent items were fully located. Following screening, 42 studies were included in the scoping review because they satisfied the selection criteria.	The review discovered that studies relating to morphological features or surface characteristics with regard to 3D applications (49% representation)—3D printing, diagnosis, and management—were the most common. The past ten years have seen significant reports on biomaterials, nanotechnology, biomimetics, and battery-driven devices, as well as orthodontic marketing and the influence of social media (27%) and biomaterials. According to the authors, more scientific information was required in the fields of patient education, e-health, tele-orthodontics, and patient confidentiality protection.
Hassan et al. 2021 [25]	-	Literature review	This study intended to analyze recent advancements in BPA-free monomers used in the production of adhesives and resin dental composites. Due to their relevance to potential orthodontic applications, the most promising polymeric smart materials were also highlighted.	According to the authors, recent advancements in polymeric orthodontic materials had the ability to address the shortcomings of earlier materials through increased mechanical characteristics and, most crucially, BPA-free constructions. Additionally, the effectiveness and durability of orthodontic treatments would have been enhanced by the newly discovered family of polymers with intriguing qualities, such as the dual functions of shape-memory polymers, self-healing, self-cleaning, and biomimetic adhesion.
Jedlinski et al. 2021 [26]	16 studies	Systematic review	The goal of this study was to thoroughly examine and synthesize the available controlled studies that looked into the precision and effectiveness of intraoral scanners for orthodontic purposes and that gave clinically valuable information and guided subsequent research in this area. MedLine (PubMed), Scopus, Web of Science, and Embase were used to conduct a literature search utilizing free text and MeSH phrases. Studies on the use of intraoral scanners in orthodontics were found using search engines (from 1950 to 30 September 2020). 16 of the 67 full-text articles that had been assessed for inclusion criteria after duplicates had been removed were ultimately chosen and included in the qualitative synthesis.	There was a great deal of information accessible about the usefulness and accuracy of various scanners. The accuracy of scanners from various manufacturers that belonged to the same generation was nearly identical. Due to this, comparable study would not significantly advance orthodontics in the future. The authors stated that finding further uses for digital impressions in orthodontic treatment will be a challenge in the upcoming years.
Monill et al. 2021 [27]	17 studies	Systematic review	The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) criteria were followed for conducting this review. The MEDLINE/PubMed, Scopus, Web of Science, Cochrane, and IEEE Xplore databases were used for the electronic literature search, which had an 11-year time limit from January 2010 to March 2021. There were no extra manual searches carried out. The initial 311 records from the electronic literature search were reduced to 115 when duplicate references were removed. Finally, the qualitative synthesis review included 17 papers that qualified when the inclusion criteria were applied.	The studies that were analyzed showed that anatomical reference points on radiological images could be automatically detected using convolution neural networks. The Cervical Vertebral Maturation stage could be identified using a model of an artificial neural network in the field of growth and development, and the results were identical to those of skilled human observers. Additionally, AI technology may enhance the diagnostic efficacy of orthodontic treatments, aiding the orthodontist in performing their work more precisely and effectively.
Panayi et al. 2021 [28]	-	In-vitro study	A 25-year-old healthy male’s complete records, including a 3D intraoral scan, were obtained. The UBrackets® program imported the scan, and digital setup was completed. DTC® virtual lingual brackets were continuously and automatically placed (Hangzhou DTC, China). The brackets were placed in the ideal location using a variety of manipulators (mesiodistal, labiolingual, rotating). The bases of the brackets were almost extruded toward the surface of the teeth. The extrusion reflected the precise quantity of composite that would be affixed to the bases of the brackets to produce the unique brackets. The IDB tray, the archwire, and the models were finally exported. To bend each next archwire, the exporting wire served as a prototype.	The customized bases were made by inserting DTC lingual brackets into the IDB tray and then covering the bracket bases with composite. A custom-bent, 0.012” NiTi archwire was introduced while accurate bonding was being carried out. For the first time, an orthodontist was able to build a virtual bracket base (labial or lingual) in-house using CAD software called Deltaface Ubrackets® (Coruo, Limoges, France), and then transfer the personalized brackets to the patient using a 3D printed indirect bonding (IDB) tray.
Park et al. 2021 [29]	-	Literature review	This article explored several teledentistry system types for orthodontic practices, implementation tips, and significant regulatory considerations regarding the use of teledentistry for orthodontic applications. Prior to committing to a service, a thorough assessment of the software’s intended use was required, the researchers stated. Additionally, the popularity of teledentistry in orthodontics as a way to confer with and monitor a patient without an in-office visit was accelerated by technological improvements, rising patient demand, and the requirement for social isolation due to Coronavirus Disease 2019.	It was necessary to ensure that the assigned clinic computer met the system’s criteria and install all security measures. Teledentistry patients must be located within the clinician’s statutory license boundary, and appointments must be recorded in the same way as in-office visits. Teledentistry required to be mentioned on informed consent forms. Additionally, it was mentioned that while malpractice insurance covered everything typical and customary allowed by the provider’s license, teledentistry enhanced the requirement for cyber liability insurance.
Saccomanno et al. 2020 [30]	30 patients (16 females)	Observational study	The study included 30 individuals who had received various orthodontic treatments conventionally and who the physician was still monitoring via tele-orthodontics. A comparison with patients who underwent no follow-up or solely in-office follow-ups was not possible due to the clear limitations of tele-practice. Videocalls, specialized applications, intraoral and extraoral pictures taken by the patients, instant messaging, and dedicated programs were the communication methods employed in this study and suggested in their concept of tele-orthodontics.	Tele-orthodontics made it possible to complete some orthodontic follow-up procedures with less chairside time, up to a 45-min reduction in patient waiting time, a lower risk of infection, fewer or no missed appointments, targeted problem-solving, and more follow-ups with patients who are odontophobic. Overall, the benefits of tele-orthodontics outweighed the drawbacks of in-person visits and fewer personal interactions.
Safari et al. 2018 [31]	-	Literature review	This study analyzed the most recent and potential uses of stem cells (SCs) in orthodontics and dentofacial orthopaedics because both fields are related to dentofacial orthopaedics, which involves bone regeneration.	It was found that SCs might be applied to repair infrabony alveolar defects and relocate teeth into the restored regions. SCs will likely be used in orthodontics in the future to broaden movement restrictions, regenerate resorbed roots, and speed up tooth movement. However, this assessment found that the evidence for these roles was insufficient, and more research was needed to assess if these theories would be viable.
Siddiqui et al. 2021 [32]	125 patients (83 females)	Prospective cross-sectional study	In this investigation, each participant answered questions about their knowledge of, access to, and use of social media, as well as their readiness to use it to promote orthodontic treatment. There were neither eligibility requirements nor age limits.	The patients had access to social media in 99% of cases. 30% of these patients had used social media in relation to orthodontic therapy, with Instagram (n = 17) and Snapchat (n = 12) being the most common platforms. Of these patients, 64% were aware that social media platforms were accessible to aid in orthodontic treatment. 73% of the patients said they would be open to using social media to promote orthodontic treatment in the future. Social media was found to be interesting, approachable, and adaptable, and it had been shown successful at increasing patients’ knowledge about orthodontic treatment.
Sycinska et al. 2021 [33]	-	Scientometric analysis	This study looked into how orthodontic treatment was affected by the COVID-19 pandemic epidemic. Using Google Trends, the data regarding orthodontic queries was examined in real-time. Search phrases related to the year before the pandemic outbreak and the time of the epidemic were examined. As another example of various orthodontic appliances, the five-year trend for queries “braces” vs. “invisalign” was contrasted.	Due to the many announcements of limits and lockdowns in the spring of 2020, there was a considerable drop in orthodontics keyword searches. During the initial lockdown in 2020, there was less interest in the question “braces pain.” While the number of searches for “braces” remained largely consistent across the analyzed time period, the number of searches for “invisalign” increased considerably over time. It was determined that the COVID-19 pandemic’s progression significantly influenced the search queries for orthodontic-related terms.
Thurzo et al. 2021 [34]	86 subjects (54 females)	Observational study	This study set out to assess the clinical effects of an AI enhancement to existing orthodontic mobile coaching software. The secondary objective was to describe the benefits of telemonitoring systems for clinical effect evaluation and the deployment of AI (decision tree process algorithm).	Except for the male manifestation of clinical non-tracking as determined by artificial intelligence from video scans, all variables significantly improved after the update. According to the authors, updating existing health care applications to include computerized decision processes greatly improved clinical performance and patient compliance. It was discovered that the approach may have established a baseline for further machine learning optimization.
Thurzo et al. 2022 [35]	12 completed treatments	Observational study	The purpose of this study was to compare two different biocompatible photopolymers and evaluate the practicality of using 3D printed distalizers in clinical settings (white and transparent). On the set of 12 full orthodontic treatments, the frequency of distalizers debonding and patients’ perceptions of aesthetics were assessed. A bonded distalizer treatment time averaged 6.4 months in length. All of the cases involved adults with unilateral Class II malocclusions that were treated using a hybrid strategy as part of the all-encompassing Invisalign® program.	The outcomes demonstrated the viability of perspective practice for 3D design and in-office 3D printing of a customized distalizer. Additionally, the findings revealed no clinically relevant variations between the two biopolymers under study. The study came to the conclusion that dental resin additive manufacturing was a practical technique for customizing and in-office 3D printing of orthodontic accessories, notably distalizers. New materials for 3D printing in orthodontics enable greater individualization and more effective treatment.
Zakrzewski et al. 2021 [36]	-	Literature review	This study concentrated on the idea of nanotechnology and its applications in the field of orthodontics, such as, for example, improving the antibacterial properties of orthodontic resins, resulting in a decrease in enamel demineralization, or controlling friction force during orthodontic movement.	This study demonstrated the use of nanoparticles in orthodontics for their mechanical and antibacterial capabilities. To successfully stop enamel demineralization during orthodontic therapy, nanoparticles can be introduced to acrylic resins, cements, or orthodontic adhesives. The need of managing orthodontic therapy under control and in concert was also noted by the researchers.