A new expert consensus aims to advance evidence-based orthodontic care for adults, offering recommendations for treating alveolar bone defects and protrusive facial deformities, according to a July 24 announcement. The guidance addresses the growing complexity faced by clinicians as more adults seek orthodontic treatment, balancing aesthetics, skeletal relationships, periodontal health, and digital technologies.
Dr. Li Xu, one of the lead authors, said, "The growing demand for adult orthodontic treatment has highlighted critical challenges." To address these issues, international experts developed three complementary consensus articles published in the International Journal of Oral Science. These articles provide an evidence-based framework for diagnosing and delivering adult orthodontic care through systematic reviews and multidisciplinary input.
The consensus emphasizes that correcting protrusive facial deformities involves more than straightening teeth. Adult patients often present with complex skeletal and soft tissue characteristics that complicate diagnosis and planning. Dr. Chenchen Zhou said, "The diagnosis of protrusive facial deformities should follow the principle of total-element diagnosis," encouraging clinicians to evaluate patients holistically before determining treatment plans.
Recommendations include considering multiple dimensions—such as sagittal, vertical, and transverse relationships—and growth potential when diagnosing underlying causes of deformity and setting realistic goals. Multidimensional analysis is recommended as part of this comprehensive evaluation process.
The guidelines highlight the importance of integrating facial, skeletal, and dental assessments with functional and periodontal considerations to establish clear objectives before selecting a treatment approach. Dr. Wenli Lai said, "The precise initial position of the teeth requires complete and accurate patients' data," noting that photographs, radiographic exams including CBCT scans, and digital models are essential in developing an accurate strategy.
CBCT imaging is strongly recommended when extensive tooth movement is planned to assess alveolar bone conditions thoroughly. Where additional support is needed or risks are identified early on—such as reduced bone support or pre-existing defects—the consensus outlines strategies like orthodontic-associated alveolar ridge augmentation to reduce complications.
Authors note that these recommendations will evolve with future research advances: "As our understanding deepens... it will undoubtedly lead to more optimized treatment outcomes and improved long-term patient stability," concludes Dr. Chenchen Zhou.
