{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:26:03Z","timestamp":1793327163552,"version":"4.5.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013094","name":"Science and Technology Planning Social Development Project of Zhenjiang City","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate three-dimensional changes in incisive canal (IC) morphology, root\u2013canal proximity, and root resorption following maxillary incisor (U1) retraction with clear aligners, comparing extraction and non-extraction treatment protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 100 patients (200\u2005U1) treated with clear aligners were retrospectively analyzed using CBCT before and after treatment. The extraction group included 40 patients and the non-extraction group 60. Linear measurements of IC width, root\u2013canal distance, cortical bone width (CBW), IC height, and root length\/width were obtained at three levels above the labial cementoenamel junction (H1\u2013H3: 2, 4, and 6\u2005mm). Volumetric and surface area analyses of the IC and U1 were performed to evaluate morphological and structural remodeling. Group differences and predictive factors for root resorption and canal contact\/invasion were assessed statistically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Extraction-based retraction produced significantly greater reductions in canal width, CBW, and root\u2013canal distance, with increased apical root resorption, most notably in patients who underwent substantial anterior retraction (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). The mean decreases in root\u2013canal distance were 1.08\u2009\u00b1\u20090.92\u2005mm, 1.10\u2009\u00b1\u20090.91\u2005mm, and 1.02\u2009\u00b1\u20090.99\u2005mm at H1, H2, and H3, respectively, in extraction cases, vs. 0.40\u2009\u00b1\u20090.58\u2005mm, 0.47\u2009\u00b1\u20090.78\u2005mm, and 0.30\u2009\u00b1\u20090.98\u2005mm in non-extraction cases. Apical root resorption averaged 0.91\u2009\u00b1\u20090.80\u2005mm in the extraction group and 0.32\u2009\u00b1\u20090.56\u2005mm in the non-extraction group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), correlating with closer root\u2013canal proximity. Volumetric and surface area analyses revealed greater reductions in IC and U1 dimensions in extraction cases, indicating intensified bone remodeling. Treatment duration, incisor movement, IC height, and root\u2013canal distance were significant predictors of canal contact, while root resorption correlated positively with treatment duration, incisor movement, and root length.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extraction-based aligner retraction elicits greater osseous remodeling around the incisive canal and increased root resorption, particularly in cases requiring substantial anterior retraction, reflecting a coupled bone\u2013tooth adaptive response to orthodontic loading. These findings highlight the dynamic nature of craniofacial bone physiology and emphasize the need for biologically guided treatment planning to minimize tissue stress and iatrogenic effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1728205","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:32:11Z","timestamp":1770013931000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Three-dimensional CBCT analysis of bone remodeling, root resorption, and incisive canal morphology during miniscrew-assisted aligner-based incisor retraction with and without extractions"],"prefix":"10.3389","volume":"7","author":[{"given":"Remsh Khaled","family":"Al-Rokhami","sequence":"first","affiliation":[{"name":"The Affiliated Stomatological Hospital of Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]},{"name":"Zhenjiang Stomatological 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Fan","sequence":"additional","affiliation":[{"name":"Zhenjiang Stomatological Hospital","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim Ahmed","family":"Sakran","sequence":"additional","affiliation":[{"name":"Zhenjiang Stomatological Hospital","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/0002-9416(82)90427-4","article-title":"Soft-tissue changes associated with maxillary incisor retraction","volume":"81","author":"Rains","year":"1982","journal-title":"Am J Orthod"},{"key":"B2","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1067\/mod.2001.114301","article-title":"The importance of incisor positioning in the esthetic smile: the smile 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