{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T04:25:05Z","timestamp":1794025505300,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Clinical Technology Innovation Project of Beijing Hospitals management center","award":["XMLX202132"],"award-info":[{"award-number":["XMLX202132"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze the relevant risk factors causing the reduction of periodontal ligament area (PDLA) of the maxillary central incisor by measuring the PDLA before and after orthodontic treatment using a previously validated cone-beam computed tomography-periodontal ligament (CBCT-PDL) deep learning segmentation network, providing a theoretical basis for orthodontic clinical treatment design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on 63 patients who completed comprehensive orthodontic treatment in the Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, between May 2021 and December 2022. Pre- and post-treatment CBCT images and clinical data were extracted from the hospital\u2019s dedicated imaging database. Using the CBCT-PDL segmentation network and orthodontic measurement and analysis software, PDLA and root length (RL) of 126 maxillary central incisors, were quantified before and after orthodontic treatment. Absolute and percentage changes in PDLA (\u0394PDLA and \u0394PDLA%, respectively) and RL (\u0394RL and \u0394RL%, respectively) were calculated. Statistical analyses were conducted, including Mann-Whitney U tests, Spearman correlation analysis, Generalized Linear Mixed Model and multiple linear regression, to identify the associated predictors of reduced PDLA in maxillary incisors from risk factors including gender, age, U1-NA angle, Angle\u2019s classification, sagittal skeletal pattern (ANB angle), vertical skeletal pattern, history of chronic periodontitis, tooth extraction status, and treatment duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At the end of active orthodontic treatment, \u0394PDLA and \u0394PDLA% were significantly higher in the following subgroups compared with the reference group: patients with ANB angle\u2009&gt;\u20093\u00b0 [Maxillary right central incisor (T11) \u0394PDLA: 9.49(13.37) mm, Maxillary left central incisor (T21) \u0394PDLA: 11.02(14.45) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05; \u0394PDLA%: T11 6.73(8.20) %, T21 7.05(8.66) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05], tooth extraction treatment group [T11 \u0394PDLA: 11.83(14.14) mm, T21 \u0394PDLA: 11.82(16.67) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05; \u0394PDLA%: T11 7.54 (10.13) %, T21 8.23(10.32) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.058], and treatment duration\u2009&gt;\u20092 years [T11 \u0394PDLA: 9.34(14.83) mm, T21 \u0394PDLA: 11.94(15.56) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.059; \u0394PDLA%: T11 7.00 (10.87) %, T21 8.37(8.73) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05]. Additionally, the U1-NA angle\u2009&gt;\u200928.5\u00b0 subgroup showed marginally significantly higher \u0394PDLA [11.46(25.13) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.082], and patients with skeletal Class II malocclusion exhibited a marginally significantly higher \u0394PDLA% [T11 7.53 (12.03) %, T21 6.91(9.24) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.059] relative to controls. Significant predictors of root resorption included adult age [T11 \u0394RL: 0.63(1.30) mm, T21 \u0394RL: 0.98(1.33) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05; T11 \u0394RL%: 5.41(11.20) %, T21 \u0394RL%: 8.16(10.20) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05], and tooth extraction treatment [T11 \u0394RL: 0.73(1.42) mm, T21 \u0394RL: 1.12(1.41) mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01; T11 \u0394RL%: 6.33(12.03) %, T21 \u0394RL%: 8.20(11.84) %,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05]. Multiple linear regression revealed that \u0394RL%, as a post-orthodontic outcome variable, was independently positively associated with \u0394PDLA% (\u03b2\u2009=\u20090.536,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among patient-related and treatment-related factors, the pre-treatment U1-NA angle significantly positively affected \u0394PDLA% (\u03b2\u2009=\u20090.257,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Pre-treatment \u2220ANB (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.055) and treatment duration (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.082) demonstrated marginal statistical significance, while age and tooth extraction status exerted no significant effects (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Subgroup analyses identified adulthood, pre\u2011treatment \u2220ANB\u2009&gt;\u20093\u00b0, pre\u2011treatment U1\u2011NA angle\u2009&gt;\u200928.5\u00b0, tooth extraction, and treatment duration\u2009&gt;\u20092 years as associated risk factors for supporting tissue loss around the teeth. Multiple linear regression further confirmed the independent effects of pre\u2011treatment U1\u2011NA angle, \u2220ANB, and treatment duration on periodontal ligament area reduction. A comprehensive pre\u2011treatment evaluation of combined skeletal\u2011dental features is critical for individualized orthodontic risk stratification and clinical decision\u2011making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-09294-3","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:44:28Z","timestamp":1784090668000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk factors for periodontal ligament area reduction in maxillary central incisors following orthodontic treatment: a retrospective analysis using a deep learning-based CBCT-PDL segmentation network"],"prefix":"10.1186","volume":"26","author":[{"given":"Ruiqi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochuan","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2082-5742","authenticated-orcid":false,"given":"Xiaofeng","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"1","key":"9294_CR1","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1590\/2176-9451.20.1.052-058","volume":"20","author":"CP Mau\u00e9s","year":"2015","unstructured":"Mau\u00e9s CP, do Nascimento RR, Vilella Ode V. 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Verbal informed consent was obtained from all contactable participants via telephone prior to their inclusion in the study, and an exemption from informed consent was granted by the Bioethics Committee of Beijing Friendship Hospital, Capital Medical University for those who were unreachable. This clinical trial was registered at the Chinese Clinical Trial Registry (ChiCTR, Identifier: ChiCTR2600116097, registered on January 5, 2026).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not Applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1960"}}