Objective This study compares the accuracy and reliability of WebCeph (web-based program for cephalometric analysis) with the AutoCAD computer software. Materials and methods A sample of pretreatment digital lateral cephalograms of 50 orthodontic patients was analysed with WebCeph and AutoCAD software (as a standard measure). On each cephalogram, 17 landmarks and 11 measurements were marked and performed as skeletal, dental, and soft–tissue parameters. We used six angular and five linear measurements. A paired t-test was used to assess the systematic bias. The intraclass correlation coefficient (ICC) and Bland–Altman plot with linear regression analysis were used to assess the agreement between the two methods. Results There was adequate reproducibility for the measurements with both WebCeph and AutoCAD. The paired t-test showed statistically significant differences for five angular and two linear measurements (P < 0.05). The ICC test between WebCeph and AutoCAD revealed very good to excellent agreement for all measurements, except for the lower incisor to mandibular plane angle. The Bland–Altman plot visually showed a relatively acceptable limit of agreement for three angular and two linear measurements only, and the linear regression analysis revealed a significant proportional bias between the two methods for four angles and the upper lip-Esthetic line (U Lip-E Line). The systematic bias and level of agreement improved with the use of the semi-automatic WebCeph. Conclusions Different problems, such as poor landmark identification/soft tissue tracing and inconsistency of measurements, are inherent to the automatic WebCeph. The semi-automatic WebCeph can overcome some limitations of the automatic WebCeph; however, it should be used for cephalometric analysis with a great deal of caution.

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Summary Objectives To compare the heat-activated nickel titanium (HANT) with superelastic nickel-titanium (SENT) archwires in terms of their effectiveness of aligning teeth, possibility of inducing root resorption, and perception of pain. Subjects and methods Orthodontic patients aged 12 years or over with mandibular anterior crowding of 3–6 mm, who required treatment without extractions were randomly allocated (a simple non-stratified randomization) to the HANT and SENT archwires groups with a 1:1 allocation ratio. The archwire sequence in both groups was 0.014-inch and 0.016-inch, respectively. Each archwire was placed for 4 weeks. The outcome measures included the amount of crowding assessed blindly using Little’s irregularity index (LII), apical root resorption, and pain perception. The effectiveness of alignment was tested using 2 × 2 mixed factorial analysis of variance (ANOVA) model, while root resorption and pain perception were tested by the Mann–Whitney U-test and Wilcoxon signed-rank test (P &lt; 0.05). Results Thirty-four patients were randomized and recruited from four centres, of those 31 were analysed (15 participants for the HANT and 16 for the SENT groups) with an overall mean age of 19.13 ± 5.73 years. The total reduction in the LII was 2.69 mm and 2.74 mm for the HANT and SENT groups, respectively. This did not reach the level of statistical (P = 0.809) or clinical significance. Similarly, root resorption and pain perception showed non-significant difference between groups. However, there was a slight increase in root resorption with the SENT group. Limitations A long-term evaluation of root resorption is required. Conclusions Both HANT and SENT archwires were equally effective in the aligning stage of orthodontic treatment. Root resorption with SENT wires should be monitored throughout treatment. Registration The trial was registered with ClinicalTrials.gov on 18 September 2019, registration number: NCT04090931.

Objective To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.