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ArticleJournal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie2026

Longitudinal analysis of bite force and strength of orofacial tissues during orthodontic aligner treatment.

Sara Gollino, Marcelo Palinkas, Fernanda Cristina Toloi Fiori Rufato, Luiz Gustavo de Sousa, Luís Fernando Fiori Rufato, Fábio Lourenço Romano, Simone Cecilio Hallak Regalo, Selma Siessere

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Article in Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sara GollinoDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Marcelo PalinkasDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil. palinkas@usp.br.
Fernanda Cristina Toloi Fiori RufatoDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Luiz Gustavo de SousaDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Luís Fernando Fiori RufatoDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Fábio Lourenço RomanoDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Simone Cecilio Hallak RegaloDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.
Selma SiessereDepartment of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, Avenida do Café, s/n, Bairro Monte Alegre, CEP, 14040-904, Ribeirão Preto, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOrthodontic aligners have introduced new approaches in orthodontics, but their effects on the stomatognathic system remain debated. This longitudinal study evaluated the maximum molar bite force and strength of orofacial tissues during orthodontic treatment with aligners. MATERIALS AND

methodsTwenty individuals (16 women and 4 men) participated, with an average age of 30.8 ± 10.9 years, all having natural permanent dentition except for the third molars and no temporomandibular dysfunction. All participants were indicated for treatment with aligners and monitored over four timepoints: pretreatment, 1 month, 3 months, and 6 months after the start of treatment. The variables measured included molar bite force (right and left) using a digital dynamometer and strength of orofacial tissues (lips, tongue, and buccinator muscles) using the Iowa Oral Performance Instrument. Statistical analysis was performed using repeated measures (analysis of variance, ANOVA) and Tukey's post hoc test (P < 0.05).

resultsThe maximum molar bite force significantly decreased after the start of treatment, with a trend of continuous reduction over 6 months (p = 0.04), although there were no significant differences between the timepoints and no significant changes in the left maximum molar bite force. The pressure exerted by the tongue and lips increased after the first month of aligner use, stabilizing afterwards, while buccinator muscle pressure progressively increased, showing significantly higher values compared to the pretreatment timepoint (right: 1 month, P = 0.002; 3 months, P = 0.0003; 6 months, P < 0.0001; left: 1 month, P = 0.007; 3 months, P = 0.0001; 6 months, P < 0.0002).

conclusionsOrthodontic aligners significantly alter the function of the stomatognathic system, reducing bite force and increasing buccinator muscle pressure.

Indexed as

Bite ForceFacial MusclesMuscle StrengthOrthodontic Appliances, RemovableTooth Movement TechniquesAdultFemaleHumansLongitudinal StudiesMaleMolarTreatment OutcomeBuccinator muscle pressureMalocclusionMolarsOrofacial pressureStomatognathic system

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.