Class II malocclusion affects aesthetics and function. Traditional anchorage methods have limitations, and microimplant anchorage (MIA) requires thorough comparison. The objective of this study was to compare the efficacy of MIA with traditional anchorage in treating patients with Class II malocclusion through meta-analysis. This study used a systematic review and meta-analysis, searching 5 English-language and 4 Chinese-language databases. The research question was structured using the PICO framework: Population (Class II malocclusion patients), Intervention (MIA), Comparison (traditional anchorage), and Outcome (cephalometric angle changes). A search formula was created using subject terms and Boolean logic. The Cochrane tool assessed bias risk in randomized controlled trials (RCTs), and the Newcastle-Ottawa scale evaluated the quality of nonrandomized studies. Evidence levels were assessed with GRADE. This study focused on indicators with clinical significance such as the sella-nasion (SN)-A point angle (SNA°). RevMan 5.4 software calculated the standardized mean difference (SMD) and odds ratio, with heterogeneity assessed using I2 and publication bias evaluated using funnel plots and Egger test, along with subgroup and sensitivity analyses. A total of 11 studies were included in the systematic review, of which 2 were RCTs and 9 were retrospective or controlled studies. Meta-analysis incorporated the data from all 11 studies, revealing that the MIA group showed a greater change in nasolabial angle than the traditional anchorage group (SMD = 0.58, P < .001) but no significant differences in SNA°, SN-B point angle, upper incisor to SN plane angle, A point-nasion-B point angle or SN plane to mandibular plane angle. The change in nasolabial angle before and after treatment was less minor in the MIA group for patients with Class II malocclusion. This provides evidence-based guidance on selecting treatment methods for patients with Angle's Class II malocclusion in clinical practice. Previous studies have shown that the choice of anchorage affects the orthodontic effect of Class II malocclusion. This meta-analysis found that the microimplant anchorage technique has certain advantages in treating patients with Angle's Class II malocclusion compared with the traditional anchorage approach; however, the degree of maxillary alveolar bone remodeling warrants further discussion.

Presurgical lip, alveolus, and nose approximation (PLANA) is a novel presurgical infant orthopedics approach that has demonstrated early favorable nasolabial outcomes. However, its associated costs have not been evaluated. This study compared treatment costs between PLANA and nasoalveolar molding (NAM). A single-institution retrospective review of patients treated with NAM (2018-2019) and PLANA (2024-2025) was conducted. Patients were grouped by unilateral or bilateral involvement, and the average number of visits per cohort was calculated. Publicly available standardized payment values from the Centers for Medicare & Medicaid Services were used to approximate the costs of physician services and facility resources. Total costs were calculated from the sum of the costs for physician services, facilities, and medical supplies. Seventy-four patients were included, including 40 treated with NAM (unilateral 30 and bilateral 10), and 34 treated with PLANA (unilateral 24 and bilateral 10). For patients with a unilateral cleft, the average cost of NAM was $4362.37 (services: $1893.67, facilities: $2160.50, and supplies: $308.20), whereas the average cost of PLANA was $2791.94 (services: $752.61, facilities: $830.96, and supplies: $1208.37). Across patients with a bilateral cleft, the average cost of NAM was $4980.01 (services: $2178.93, facilities: $2492.88, and supplies: $308.20), whereas the average cost of PLANA was $3100.76 (services: $895.24, facilities: $997.15, and supplies: $1208.37). The cost of NAM is largely driven by physician services and facility expenses, whereas the cost of PLANA is primarily driven by medical supplies, offset by a reduced number of visits. These findings may inform cleft centers in their selection of presurgical orthopedic interventions and guide the development of standardized payment criteria.

Presurgical infant orthopedics (PSIO) is an established component of cleft care aimed at attenuating deformity severity and optimizing nasolabial anatomy before primary repair. Traditionally, PSIO-most commonly nasoalveolar molding-has been implemented within multidisciplinary care pathways and considered separately from intraoperative anatomy and surgical decision-making. This conceptual separation may limit how presurgical modifications are interpreted and applied during surgery. We present a surgeon-led, hypothesis-generating conceptual framework that reframes PSIO as an anatomy-driven extension of surgical planning rather than an isolated preparatory phase. The aim of this framework is to integrate presurgical modification with intraoperative anatomical interpretation, allowing presurgical preparation and surgical correction to function as coordinated stages of a single reconstructive strategy. This framework is particularly applicable to simplified PSIO approaches that integrate nasal and labial molding with progressive maxillary segment mobilization, including lip taping, nasal elevators, and presurgical lip-alveolus-nose approximation. The innovation lies in establishing a structured feedback loop between presurgical modification and intraoperative anatomy. With contemporary surgical techniques allowing improved visualization of septal alignment, lower lateral cartilage configuration, and ligamentous attachments, presurgical effects can be interpreted intraoperatively to refine surgical reasoning in real time. This model does not seek to replace orthodontic expertise or multidisciplinary care; rather, it proposes a complementary framework that enhances continuity between treatment phases and supports more integrated surgical planning.

An 8-year-old spayed female American Shorthair cat was evaluated for refractory perioral nodules and respiratory distress persisting for 9 months. The patient had a history of feline atopy and chronic gingivostomatitis managed with long-term immunosuppressive therapy, including cyclosporine A and prednisolone. Pre-surgical computed tomography (CT) revealed a 2.1 cm nasolabial mass without osteolysis, later diagnosed as a mycobacterial infection. This unusual infection was tentatively attributed to pharmacological suppression of cell-mediated immunity, potentially impairing both granuloma formation and inflammatory bone resorption. Fine-needle aspiration (FNA) and Ziehl-Neelsen (ZN) staining demonstrated a high burden of acid-fast bacilli (AFB). However, conventional cultures, including inoculation on 3% Ogawa medium, failed due to rapid overgrowth of Klebsiella pneumoniae (K. pneumoniae). Post-mortem multi-target real-time PCR and whole genome sequencing (WGS), together with internal transcribed spacer (ITS) sequencing and phenotypic antimicrobial testing, identified a fatal co-infection comprising Mycobacterium tuberculosis complex (MTBC), Mycobacterium kansasii, K. pneumoniae, and multidrug-resistant Pseudomonas aeruginosa. This report describes a rare feline case of a fatal polymicrobial infection involving both MTBC and non-tuberculous mycobacteria (NTM) in conjunction with opportunistic gram-negative pathogens. The findings suggest that chronic iatrogenic immunosuppression may alter or obscure classical diagnostic features of mycobacteriosis and facilitate complex co-infections. This case highlights the importance of high-sensitivity molecular diagnostics and suggests that immunocompromised companion animals may, in rare instances, serve as cautious indicators of possible household mycobacterial exposure within a One Health framework.