{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:58:22Z","timestamp":1790600302797,"version":"4.1.0"},"reference-count":0,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare soft tissue changes and improvements in facial esthetics between Activator and mandibular advancement (MA) treatment using three-dimensional (3D) facial images and two-dimensional (2D) cephalometric analysis. Second, to assess dentoskeletal effects of Activator and MA through 2D cephalometric evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A total of 70 growing patients with skeletal Class II malocclusion (Activator: n = 37; MA: n = 33) were included. Lateral cephalograms and 3D facial images (3dMD face system, Atlanta, Georgia, USA) were analyzed to assess dentoskeletal and soft tissue changes before and after treatment. Point-to-point registration followed by a precision best-fit approach was applied to superimpose the 3D photographs, focusing on 3D analysis of the whole face and seven soft tissue regions. Cephalometric analysis was conducted to quantify dentoskeletal and soft tissue effects. The multivariate Hotelling\u2019s T\n                      <jats:sup>2<\/jats:sup>\n                      test was applied to compare the composite treatment outcomes between MA and Activator groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All soft tissue regions except the upper lip significantly increased from pre- to post-treatment. MA produced greater correction of soft tissue convexity (2.57\u00b0) and chin with sl-VL increasing 0.97 mm more than the Activator. Skeletal and dental parameters improved over time in both treatments. U1-SN and overjet significantly decreased more in MA (5.57\u00b0 and 3.49 mm) than Activator (3.51\u00b0 and 2.25 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Activator and MA effectively advanced the mandible, retracted upper incisors, reduced overjet, and improved soft tissue profile. MA is more effective in improving upper incisor proclination and facial profile esthetics than the Activator.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/062025-502.1","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:30:44Z","timestamp":1783729844000},"source":"Crossref","is-referenced-by-count":0,"title":["Dentoskeletal and soft tissue effects of clear aligner mandibular advancement appliances versus Activator for skeletal Class II malocclusion: a retrospective clinical study"],"prefix":"10.2319","author":[{"given":"Jiamin","family":"Zhao","sequence":"first","affiliation":[{"name":"PhD Candidate, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, Xi\u2019an Jiaotong University, Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryan","family":"Ateek","sequence":"additional","affiliation":[{"name":"Resident, Department of Orthodontics, College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Lu","sequence":"additional","affiliation":[{"name":"Resident and PhD Candidate, Department of Orthodontics College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mei","sequence":"additional","affiliation":[{"name":"Associate Professor and Associate Dean, Discipline of Orthodontics, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianglin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Resident, Department of Orthodontics, College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongning","family":"Li","sequence":"additional","affiliation":[{"name":"Resident, Department of Orthodontics, College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingxia","family":"Zeng","sequence":"additional","affiliation":[{"name":"Associate Professor, School of Public Health, Xi\u2019an Jiaotong University Health Science Center, Xi\u2019an Jiaotong University, Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menghong","family":"Li","sequence":"additional","affiliation":[{"name":"Research Associate and PhD Candidate, Department of Orthodontics, College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Qi","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Orthodontics, College of Stomatology, Xi\u2019an Jiaotong University,Xi\u2019an, Shaanxi, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/aop\/article-10.2319-062025-502.1\/article-10.2319-062025-502.1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/aop\/article-10.2319-062025-502.1\/article-10.2319-062025-502.1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:03:23Z","timestamp":1790597003000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/aop\/article-10.2319-062025-502.1\/article-10.2319-062025-502.1.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2319\/062025-502.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,10]]}}}