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Purpose Internal cervical os (ICO) stiffness is related to menstrual pain, a key symptom of endometriosis. The study evaluated whether women with endometriosis have a stiffer ICO than unaffected women. Methods A retrospective cross-sectional analysis was conducted using prospectively collected data from women with and without endometriosis, spanning from June 2020 to September 2022. Endometriosis was diagnosed through clinical and ultrasound evaluations, with histological confirmation in a subset of participants. Strain elastography (SE) was employed to measure tissue elasticity in four cervical regions of interest: the ICO and the anterior, posterior, and middle cervical compartments (ACC, PCC, and MCC, respectively). Tissue elasticity was quantified using a color-based scoring system ranging from 0.1 (blue, indicating less elasticity) to 3.0 (red, indicating greater elasticity). Results Overall, 287 women were included, with 157 diagnosed with endometriosis and 130 controls. On SE, women with endometriosis exhibited a lower color score (mean±standard deviation), indicating lower elasticity, for the ICO (0.56±0.28 vs. 0.70±0.26, P=0.001) and PCC (0.69±0.30 vs. 0.80±0.27, P=0.002). Additionally, they had a lower ICO/MCC ratio (0.45±0.28 vs. 0.60±0.32, P=0.001) and ICO/ACC ratio (0.68±0.42 vs. 0.85±0.39, P=0.001). Multiple logistic regression analysis revealed that endometriosis was associated with the ICO color score (odds ratio, 0.053; 95% confidence interval, 0.014 to 0.202; R2=0.358; P=0.001), even after adjusting for confounding factors like the presence of myomas (P=0.040) and the use of hormonal therapy (P=0.001). The results were corroborated in women with histologically confirmed endometriosis (n=71). Conclusion The findings suggest a potential relationship between a stiffer ICO and endometriosis.

Background: Retention is a critical aspect of orthodontic treatment with aligners as it counteracts vertical displacing forces and ensures greater predictability of tooth movement. The aim of this study is to evaluate and compare the retention effectiveness of 3D-printed aligners and thermoformed aligners, analyzing how margin design and thickness gradients affect retention under different occlusal conditions. Methods: Tensile tests were conducted using a Sauter TVO-A01 machine, recording the force required to displace each aligner from the models. Quantitative data on the retention force of each aligner were collected based on malocclusion type and design specifics. Results: Scalloped thermoformed aligners demonstrated significantly lower retention values (p = 0.029) compared to 3D-printed aligners with high margins with horizontal and vertical gradients. Scalloped margin aligners exhibited significantly lower retention values (p = 0.008) compared to straight margin aligners. Additionally, 3D-printed aligners with uniform thickness gradients had significantly lower retention values (p = 0.040) compared to thermoformed aligners. Conclusions: The 3D printing production process enables customizable designs tailored to the unique characteristics of each patient. High-margin 3d-printed aligners with horizontal and vertical gradients provide superior retention, particularly in complex clinical situations such as dental crowding.

Abstract Background The aim of the study was to compare the accuracy and reproducibility of three different 3D facial scanning systems, relying, respectively, on stereophotogrammetry, structured light and a smartphone app and camera. Methods Thirty subjects have been scanned with three different facial scanning systems, stereophotogrammetry, structured light and a smartphone app and camera. Linear measurements were compared with direct anthropometries measured on the patient's face, while the study of areas (forehead, tip of the nose, chin, right and left cheek) was evaluated by overlapping scans using the Geomagic Control X program. Statistical analyses were conducted using IBM SPSS v28 software. Results The ANOVA test was used to compare linear distances and direct anthropometry measurements, revealing statically significant values for all distances investigated, especially for the Face Hunter scanner, except for the Prn–Pog′ distance (p = 0.092). The three facial scans were superimposed pairwise almost the 100 per cent of the overlapping areas fell within the tolerance limits for all three comparisons analysed. The chin was the most accurately reproduced, with no differences among scanners, while the forehead proved to be the least accurately reproduced by all scanners. Conclusions All three acquisition systems proved to be effective in capturing 3D images of the face, with the exception of the Face Hunter scanner, that produced statistically significant differences in linear measurements for the distances Tr–Na′ and Zyg–Zyg with respect to direct anthropometric measurements.

Background: Alzheimer’s disease is a slowly progressing neurodegenerative illness and the most common form of dementia. This pathology leads to an increase in cognitive decline and is responsible, in patients, for several difficulties in performing various activities of daily living, such as oral hygiene. Several experimental studies have shown that oral health in patients with Alzheimer’s disease worsens in direct proportion to the progression of the disease due to the appearance of gingivitis and periodontitis. Methods: This clinical literature review aims to evaluate a possible correlation between periodontal disease and Alzheimer’s disease, trying to understand if the periopathogens can contribute to the onset or the progression of Alzheimer’s disease (AD). The study was conducted on the database PubMed (MEDLINE) of full-text systematic reviews in English on humans and animals that were published in the last five years, from 2018 to 2023. This returned 50 publications, which, once the eligibility criteria were applied, resulted in the 10 publications examined in this review. The selected articles were organized through the construction of tables, analyzed, and compared through Judith Garrard’s Matrix method to arrive at the review results. Results: Infection by periopathogens can increase the risk of developing Alzheimer’s disease, but also the onset of the latter can make it more difficult to maintain proper oral hygiene, favoring the onset of periodontal disease: it is possible to affirm the existence of a correlation between periodontitis and AD. It was found that patients exposed to chronic periodontitis have a greater risk of developing a cognitive decline or AD and that oral pathogens can be responsible for neuropathologies and increasing systemic inflammation. Conclusions: Periodontitis and periodontal pathogens represent a real risk factor for the onset or worsening of AD; however, the pathogenetic mechanism is still not completely clear.

Objective: Compare the bonding survival rate of two distinct bonding materials: Ortho Solo + Gradia LoFlo Resin and single component GC Ortho Connect. Materials and Methods: Indirect bonding fixed appliance treatment was required for 26 consecutive patients, 8 males and 18 females, with a mean age of 22.1 +/- 4.2 years. All patients were treated with SWM (Straight-Wire Mirabella) technique (Sweden and Martina, Due Carrare, Padova, Italy). Each patient's bonding process followed a contralateral pattern. Firstly, a 37 % orthophosphoric acid etching gel was used for 20 s, subsequently the single or two components light-cured adhesives were applied through a split-mouth cross-arch procedure. The patients underwent a 12-month follow-up period and brackets failures were rebounded, but not further included in the study. Statistical analysis was performed to analyse the survival rate of the bonding materials and the influence of the variables, with a significant level of α = 0,05. Results: The GC Connect group was used on 349 teeth, while the Ortho Solo + Gradia group was used on 351 teeth, and the indirect debonding rate was respectively 17.5% and 12.8%. With respect to the total sample, statistically significant values were found for both sex and dental arch. The bracket’s survival rate for incisors, canines, premolars and molars was not significant. However, a higher debonding rate was clinically appreciable in upper and lower molars. Conclusion: In a 12-months observation period, considering all maxillary and mandibular teeth the indirect survival rate for the group GC Ortho Connect and Ortho Solo + Gradia was respectively 82.5% and 87.2%. Although the difference was not significant, a pronounced tendency to debonding for the single component group was appreciable from a clinically point of view.

Objectives To evaluate the efficacy of mandibular advancement devices (MADs) in improving apnea-hypopnea index (AHI) in positional obstructive sleep apnea (POSA), compared with a control group of nonpositional OSA (NPOSA) patients, from mild to very severe degree, in order to to find the main variables characterizing the examined group as potential predictors of treatment success.

The aim was to objectively assess compliance in patients prescribed headgear and evaluate the impact of monitoring awareness, treatment duration, gender, and age on compliance levels. A total of 22 patients with Class II malocclusion wore the headgear integrated with the force and temperature sensitive Smartgear monitoring system (Smartgear, Swissorthodontics AG, Cham, Switzerland). Patients were instructed to wear the headgear for 13 h daily over a 3-month period. Randomly, 11 patients were informed that they monitored and 11 were not informed. Data were organized using Microsoft Excel and analyzed using R for statistical estimates, graphs, and hypothesis testing. Smartgear recorded an average daily compliance of 6.7 h. No statistically significant differences were found in cooperation between study group and control group over the 3 months of treatment, regardless of gender and age. However, there was slight greater cooperation in the first month than in the other months, and patients ≤10 years of age had almost 2 h more cooperation than their older counterparts. Moreover, the informed group exhibited an average of 1.1 more hours of cooperation per day than the uninformed group, which may carry clinical significance. This cooperation primarily occurred at night and was found to be statistically significant. Compliance among young patients typically remained lower than the prescribed level, regardless of their gender and psychological maturity. Although an awareness of monitoring does not seem to improve compliance, implementing such systems could still offer dentists a valuable means of obtaining objective information about their patients’ adherence.

Objectives: The following retrospective study was devised with the aim of evaluating the correlation between OSAS and various anatomical factors. Material and Methods: Thirty-seven patients over the age of 40 were analyzed, of which 19 were classified as OSAS cases and 18 as control cases. For each, 17 anatomical variables were identified and examined using Invivo Dental software on CBCT scans, WebCeph software on laterolateral teleradiographs, and Rhinoceros 6.0 software on dental casts. Results: A generalized linear model of all the anatomical factors identified only two statistically significant variables. Specifically, the total volume of the palate displayed a inverse correlation with OSAS, while the distance between the S point and the Go point (S-Go) exhibited a direct correlation with the disease. Conclusion: The likelihood of an individual having OSAS appears to decrease as the volume of the palate increases but increase as the lingual measure S-Go increases.

The following prospective study has the aim of evaluating the efficiency of the F22 MAD (mandibular advancement device), a new oral device for the treatment of OSAS (Obstructive Sleep Apnea Syndrome) and snoring. Methods: AHI (apnea-hypopnea index), ODI (Oxygen Desaturation Index), snoring percentage, time spent in the supine position, and Epworth Sleepiness Scale score were evaluated in 19 patients with snoring, mild to moderate OSAS, or severe OSAS who declined CPAP (Continuous Positive Air Pressure) treatment, before and after the application of the F22 MAD. Results: The median value of AHI varied from 15.6 ± 10.7 to 5.7 ± 5.7; the median value of ODI varied from 13.4 ± 8.8 to 6.2 ± 5.2; the median value of the percentage of snoring varied from 30.7 ± 7 to 7.5 ± 10.8, except for the patient who has severe OSAS who increased their value. The value obtained by the self-completion of the ESS questionnaire (Epworth Sleepiness Scale) underwent a statistically significant variation, while clinically significant for 13\19 patients who obtained a reduction of the value >/= of 2 points. Conclusions: It is possible to conclude that the F22 MAD is effective in the treatment of patients with mild and moderate OSAS or simple snoring, reducing the polysomnographic outcomes with statistically and clinically significant results in terms of reduction of AHI, ODI and percentage of snoring.

This retrospective study aims to further investigate the effects of rapid maxillary expansion (RME) treatment on respiratory function in growing patients with contracted upper airways, by assessing nasal resistance using active anterior rhinomanometry (AAR). Methods: At T0 (pre-RME), 122 orthodontic patients aged 5 to 12 years, exhibiting oral breathing and/or snoring along with maxillary contraction, underwent AAR with a mask using the ATMOS Rhino 31 rhinomanometer. Additionally, the SRDB or PSQ-SRDB Questionnaire was utilized to validate the orthodontic history of obstructive sleep apnea syndrome (OSAS). If AAR results at T0 were clinically significant, they were repeated at T1, corresponding to a period of three months after screw fixation, to evaluate changes in nasal resistance values between pre- and post-treatment. Results: The study group comprised 42 oral respiratory patients with a mean age of 7.71 years, suspected of pediatric OSAS. Although the questionnaires did not yield statistically significant results, the therapy induced an overall reduction in airflow resistance values from both nostrils (−24.63% in the right nostril; −26.65% in the left nostril). Conclusions: This study demonstrates the beneficial effects of orthodontic treatment with RME on nasal function in terms of airflow resistance in cases of maxillary contraction.

Abstract Background Regardless of the treatment protocol, stability in Class III patients always represents a major concern. The aim of this study was to assess the short and long-term skeletal and dentoalveolar modifications in a group of class III patients treated with hybrid rapid maxillary expander (RME) and facemask (FM). Indeed, no long-term studies have been conducted yet with the objective of evaluating the effects of this kind of approach when applied to patients who have already gone thought their peak of growth. Material and methods 27 patients with skeletal Class III malocclusion were treated using hybrid RME according to alternating rapid maxillary expansion and constriction (ALT-RAMEC) protocol, followed by 4 months of facemask therapy. After the orthopaedic phase, each patient underwent orthodontic treatment with fixed multibracket appliances. A mean follow-up of 7 years, 10 months was performed. Pre-treatment (TO), post-treatment (T1) and follow up (T2) cephalometric tracing were analysed, comparing dental and skeletal measurements. Results Point A advanced by a mean of 3.5 mm with respect to VerT, then relapsed by 0.7 in the post-facemask period, thereby yielding of a mean advancement of 2.7 at T2. The sagittal relationship significantly changed after RME + facemask protraction (3.8° of ANB and 5.189 mm of Wits). Although both Wits and ANB values worsened over time, the improvement from T0 is still appreciable at T2. Conclusion Despite the physiological relapse due to mandibular growth, the long-term cephalometric follow-up confirms the maintenance of all positive outcomes of the previous orthopaedic treatment with hybrid RME and facemask.

Objective: To analyze the transversal and anterior-posterior changes obtained in patients treated only with the Damon system. Material and Methods: 51 patients with either class I or class II division 1 sagittal relationship treated with the Damon system and the same archwire sequence were retrospectively selected. Dental casts of each patient before (T0) and after treatment (T1) were scanned and analyzed using NEMOCAST 3D software. Inter-molar, inter first-premolar, inter-second premolar and inter-canine distances were measured in both upper and lower arches. Initial and final lateral cephalograms were traced using the OrisCeph program. Pre and post-treatment measurements were compared using the t-test for repeated measurements. The Pearson Correlation Index and Linear Regression Analysis were used to determine the dependence between continuous variables. The significance level was set at 0.05. Results: Transversal diameters in the upper arch increase statistically significantly, especially in the bicuspid area. Initial intra-arch diameter was the only statistically significant variable correlated with the final expansion obtained. A linear negative correlation between the initial latero-posterior torque and the final expansion was observed in both arches. Conclusion: Using identical arches in patients with very different initial characteristics, the changes in bicuspids’ diameters remain the most predominant. Patients with initial more negative torque in the posterior region had a higher expansion amount.

ABSTRACT Introduction: Class III malocclusion should be intercepted and treated at early age, to prevent the necessity of future complex and expensive procedures. The orthopedic facemask therapy has the goal to achieve skeletal changes, minimizing side effects on dentition. The use of skeletal anchorage, combined with Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol, may be effective in treating a greater number of growing Class III patients. Objective: To summarize the existing evidence-based literature on Class III malocclusion treatment in young adult patients, and to illustrate its application and effectiveness, by presenting an emblematic case report. Conclusion: The resolution of the present case, its long-term follow up, along with the studies conducted on a larger sample, demonstrate the effectiveness of the strategic combination of orthopedic and orthodontic treatments by using an hybrid rapid palatal expander and Alt-RAMEC protocol for treating Class III malocclusions in adult patients.

Abstract Objective The stability of the transverse expansion in passive self-ligating bracket treatments is a debated topic in orthodontics. However, to date, only 3 reports are available in the literature, with the maximum follow-up of 3 years after the end of therapy. The present study aims to evaluate the stability of orthodontic treatment with self-ligating brackets in a 6-year follow-up period of time. Materials and methods A sample of 56 non-extractive cases (of whom 33 females, mean age 16.9, SD = 9.0 years) consecutively treated with Damon® system was retrospectively selected. All patients received fixed retainers from canine to canine in both arches at the end of treatment, and no removable retainers were provided. The mean values of the transverse intercusp, transverse centroid and transverse lingual distances were evaluated for all teeth from canines to second molars in both arches. Each measure was calculated at four timepoints: before treatment (T0), at the end of treatment (T1), one year after treatment (T2) and six years after treatment (T3). Transverse diameters were measured for all teeth, starting from the canines to the second molars, for a total of 1680 observations, and subsequently compared in order to evaluate intra-treatment and post-treatment modifications. Results There were increases in all transverse dental measurements during active treatment. A statistically significant (p

Background: To investigate the accuracy of an F22 Aligner system, considering the amount of prescribed movement, tooth type, grip points, sex and age. Methods: Digital models of 120 patients (64 females and 56 males; mean age 35.2 years ± 7.4) affected by mild-to-moderate Class I malocclusion and treated via F22 Aligners, retrospectively selected from the University of Ferrara Orthodontics Clinic’s electronic database; post-treatment models were generated, and three angular values per tooth and four linear intra-arch measurements per arch were acquired. For angular measurements, planned (T1) and achieved (T2) values were obtained thorough digital model superimpositions. Linear measurements were acquired from pre-treatment, reference and post-treatment models. Statistical comparisons were performed to assess accuracy among tooth types and prescribed movements, tooth type, grip points, sex and age were investigated via chi-squared automatic interaction detection regression trees. Results: Mean accuracy for inclination and angulation were 86.76% and 88.01%, respectively, whereas rotation was less accurate (61.59%), especially for rounded teeth. All variables investigated influenced accuracy, with the exception of inclination, which was only influenced by age. Regarding linear measurements, good expansive capacity was shown, except for the distance between mandibular second premolars. Conclusions: F22 aligners are a viable solution for the treatment of Class I malocclusion of mild-to-moderate complexity, although clinicians should bear in mind the lower predictability of rotation, as well as the influence of the variables investigated.

Endometriosis is a common inflammatory disease affecting women of reproductive age, characterized by the growth of endometrial tissue beyond the uterus. In addition to gynecological manifestations, many endometriosis patients experience gastrointestinal symptoms, indicating a potential association between gut health and the disease. Recent studies have revealed alterations in the gut microbiota of individuals with endometriosis, including reduced diversity, microbial composition imbalances, and pathogenic bacteria. These changes can disrupt immune function, increase inflammation, and contribute to the chronic inflammatory state observed in endometriosis. Moreover, dysregulation of intestinal permeability may further exacerbate gastrointestinal symptoms in affected individuals. Understanding the role of the gut microbiota and intestinal permeability in endometriosis can provide valuable insights into disease pathogenesis, aid in non-invasive diagnostic approaches, and open new avenues for therapeutic interventions. Probiotics, in particular, have shown promise in improving endometriosis-associated pain symptoms and reducing endometriotic lesions in animal models. This review suggests that additional research and well-designed clinical trials are necessary to validate the potential diagnostic and therapeutic benefits of manipulating the gut microbiota in managing endometriosis and its gastrointestinal symptoms, thereby improving the quality of life for those affected.

The aim of this paper is to perform an observational descriptive study of the Obstructive Sleep Apnea Syndrome (OSAS) in a population of children by evaluating the prevalence and role of sex and age variables. The 22-item Pediatric Sleep Questionnaire (PSQ) was administered to parents of children aged 3 to 12 years. The questionnaire is a very simple tool since it allows for the indication of patients with possible OSAS diagnosis through a cut-off of 0.33. The anonymous diagnostic questionnaire, available in digital format, was administered to the population under study by a link or QR code. Only the questionnaires completed in all their parts were recorded and analyzed. Eight hundred and thirty-two questionnaires were collected. One hundred and fifty-four subjects obtained a PSQ score > 0.33 and the prevalence of OSAS was 18.51%. The Chi-square test showed a statistically significant association between the PSQ score > 0.33 and male sex. The higher prevalence of subjects with a value of PSQ > 0.33 (n = 277) are aged 3–4–5 years, followed by the 6–7–8 range in the group with PSQ score > 0.33, p < 0.05. The prevalence of OSAS was 18.51% in children aged 3 to 12 years. The variables male biological sex and the age group 3–8 year were statistically significant for subjects with OSAS diagnosis. This study underlines the use of the 22-item Pediatric Sleep Questionnaire as a first screening tool to identify children at risk of OSAS.

Objective: To analyse and compare the frictional properties of 4 lingual systems combined with two types of stainless steel archwire (0.016x0.022, 0.018x0.025) and a 0.018x0.025 TMA archwire by simulating different misalignment situations in vitro. Material and Methods: Five randomly chosen brackets from each system (e-Brace, Harmony, Incognito, and STb) were used for the measurements and to simulate an upper first premolar extraction case. The friction tests were performed using a material testing machine in combination with a specialized test rig. Results: The lowest absolute friction values were found with the 0.016x0.022 SS wire in a passive configuration. STb provided the lowest mean friction, while Harmony brackets displayed the highest friction. The TMA Beta Titanium wire showed the highest friction values, but maintained proportions similar to those of the other wires as tip and torsion increased. Conclusion: The type of bracket has a significant impact on friction, and there is a positive correlation between mesiodistal bracket width and resistance to sliding. The archwire sections and materials and the vertical displacement, also significantly affect the friction generated by the system.

Objective: To evaluate how the lower arch spontaneously change after upper rapid palatal expansion in a group of patients with transversal skeletal deficit. Material and Methods: Twenty-four patients treated by the same orthodontist with a rapid palatal expander (RPE) bounded on a deciduous molar have been selected. The sample was divided into two groups: no treatment was provided for group one, while group two was treated using a lip bumper or Schwarz appliance. For each patient, dental casts were collected when the RPE was bounded (T0) and at the end of treatment, 9 months ± 3 months later (T1). Each outcome was analyzed, providing descriptive statistics, main effects significance tests and post-hoc analyses with the objective to evaluate the variations between pre-treatment (TO) and post-treatment (T1) of each of them. Results: If the linear measurements are considered, a significant beneficial effect on both arches is observed. However, the upper arch always shows a major increase of all values at T1 with respect to the lower arch. Even though the post-hoc tables indicate that time differences are all statistically significant across considered partitions, the lower arch's increase is more pronounced in group two, where patients were treated in both arches. If the angular measurements are concerned, the increase of lingual crown inclination was found in all patients, independently from the type of treatment in lower arch. Conclusion: All patients show normalization of upper diameters, regardless of whether the lower arch was treated or not.

Objective: To investigate the effectiveness of Suresmile® lingual therapy on torque, tip, and rotations measures through digital evaluation of planning and post-treatment digital models. Material and Methods: A sample of 12 Caucasian adult patients (4 men; mean age 30.6 years ± 3.9 and 8 women; mean age 31.4 years ± 4.5) treated with the Suresmile® lingual orthodontic technique was retrospectively selected, regardless of the type of malocclusion. Digital planning was performed with Suresmile® software, while lingual therapy was accomplished with interactive self-ligating lingual brackets and customized Suresmile® arches. First, digital models of planning and post-treatment digital models were compared using VAM software (and the discrepancies were analyzed through MANOVA and four multivariate. Then, Tukey and Bonferroni's post-hoc tests are performed. Results: The accuracy average values are 60.11 ± 27.67% for torque, 53.52 ± 27.37% for tip and 59.19 ± 26.42% for rotation, while for inaccuracy values are 2.72° ± 2.23° for torque, 2.98° ± 2.16° for tip and 3.58° ± 3.29° for rotation. No significant differences have been recorded evaluating different sectors of both arches. Conclusion: This retrospective preliminary study highlight how overcorrections, especially in the Suresmile lingual technique, should be performed during orthodontic planning. Moreover, the study gets bases for further, more structured future studies that should involve larger and more homogeneous samples.

Objective: To evaluate the differences in phonetic alterations caused by three different lingual appliances, all bonded in sequence on the same patients. Material and Methods: Lingual brackets (STb, Incognito and Harmony) were bonded from 1.3 to 2.3 with a 0.013 CuNiTi archwire. The text was formulated to evaluate the phonetic variations in a controlled context (logatomi) and more casual sentences. The recording of the text was performed at time t0 (before positioning the brackets), t1 (after positioning the brackets) and t2 (60 minutes after positioning the brackets). An ANOVA-type analysis was performed. Results: A significant correlation was confirmed between the effects of all the linguistic methods used compared to the absence of the same. The most influenced acoustic variables were the center of gravity of the acoustic spectrum of the analyzed sounds (CoG) and the number of zero crossings of the instantaneous amplitude curve of the considered signal. Conclusion: The effects deriving from the positioning of the various brackets were relatively contained: in some cases, for some subjects, for some consonants and in specific contexts, some brackets may occasionally be less invasive than others. However, no lingual system was systematically better than others regarding phonetic alterations.

Objective: To exploit 3D measurement technology to determine any correlation between neonatal palate morphology and occlusal outcomes at five years in patients receiving surgery for unilateral cleft lip and palate (CLP). Material and Methods: Twenty-nine neonatal and 5-year models treated by the same surgeon using the same protocol for CLP correction were scanned using a high-resolution structured-light scanner and stored in stl format. Dedicated software was used to make linear and surface area measurements on the neonatal models, and each digitized 5-year model was assigned a Five-Year-Old (5YO) index score on three separate occasions by the same investigator. Results: Minimum, maximum, mean, standard deviation and standard error were calculated for each variable considered, and the Pearson coefficient was used to identify any correlations between neonatal variables and 5YO scores. Linear regression analysis showed that the only variable to approach significance was the posterior width of the cleft, which showed an R2 equal to 0.111, indicating that it accounts for 11% of the variability of the 5YO index. There was no other appreciable correlation between linear measurements, surface areas, or their inter-relationships. Conclusion: There is no correlation between neonatal morphological characteristics and occlusal outcomes at 5 years in CLP patients treated via the surgical protocol considered.

Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (≤ 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p

Objective: To analyze and compare the stiffness of different lingual appliances with different archwires. Material and Methods: The three-point bending test was used to analyze the stiffness of the lingual archwires for the different lingual systems: eBrace, Harmony, Incognito, and STb. The deflection load curve of each archwire was obtained to evaluate how the section, the material and the manufacturer affect the elasticity and stiffness characteristics of the wires. The comparison of the stiffness between different systems was carried out through a factor variance analysis with three factors (manufacturer, cross-section, and material), followed by the post-hoc Tuckey test. Results: An increase in the system's rigidity was reported as the wire section increases, regardless of the manufacturer. The stainless steel archwires have ever higher stiffness values than NiTi and TMA. The STb wires of CuNiTi material, by virtue of the characteristics of the thermal wires, have flatter and lower load-deflection curves than the NiTi wires of other manufacturers. Conclusion: Archwires section and material showed a significant influence on the stiffness of the lingual systems. Archwires of the same section and material but different manufacturers show different load-deflection curves of stiffness.

Objective: To evaluate the accuracy of Virtual Surgical Planning (VSP) comparing VSPs and post-operative CBCT scans in patients undergoing bimaxillary orthognathic surgery of severe Skeletal Class III malocclusion. Material and Methods: Twenty-three patients (9 males and 14 females, mean age 24.1 ± 7.0 years) were selected and submitted to bimaxillary orthognathic surgery. Pre-operative VSPs and post-operative CBCTs were compared using both linear (taking into account four skeletal and six dental landmarks, each one described by the respective coordinates) and angular measures (seven planes in total). The threshold discrepancies for post-operative clinical acceptable results were set at ≤2 mm for liner and ≤4° for angular discrepancies. The mean difference values and its 95% confidence interval were identified, comparing which planned and which obtained in absolute value. Results: There were significant statistical differences for all absolute linear measures investigated, although only two overcome the linear threshold value of 2mm in both X and Y-linear dimensions. Linear deviations in Z-linear dimension do not reach statistical significance. All 12 angular measures reach the statistical significance, although none overcome the threshold angular value of 4°. Angular deviation for roll register the higher accuracy in contrast to pitch and yaw. Conclusion: Virtual surgical planning is a reliable planning method to be used in orthognathic surgery field; as a matter of fact, although some discrepancies between the planned on the obtained are evident, most of them meet the tolerability range.

Objective: To obtain reference values for tip, torque and in-out from digital models of Italian and Mozambican subjects in ideal occlusion using a repeatable and validated method and to compare these measurements with previously reported values. Material and Methods: Dental parameters were acquired from digital models of each subject, categorized to one of two groups: Italians (23 males, 27 females; mean age 28.3 years, ±5.7 years) and Mozambicans (14 males, 15 females; mean age, 23.4 years, ±5.9), using VAM software. All subjects had ideal occlusion, permanent dentition and no previous orthodontic treatment, fillings or prostheses. After normality of data was assumed (p

Objective: To compare the dento-alveolar effects between dental and skeletal anchored expansion devices to achieve maxillary expansion in different groups of patients: pure dental anchorage was used in growing patients and skeletal anchorage in adult patients. Linear, angular and volumetric parameters have been analysed. Material and Methods: 22 patients has been selected from the total archive of patients treated in the Orthodontics Department of the University of Ferrara, Italy, divided into 3 groups according to the appliance used to obtain the transversal maxillary correction. Digital files of the upper arch were obtained from scans performed using an intro-oral scanner before treatment (T0) and at the end of expansion (T1). Therefore, linear, angular and volumetric measurements have been performed. Results: There is a highly significant statistic variation of the 3-3, 4-4 and 6-6 diameter as a function of time. There was a statistically significant variation of the palatal vault angle and of the 6-6 distance at the cusp level as a function of time. Moreover, it appears that these parameters are reduced in the group with skeletal anchored expander. No tooth considered have encountered a statistically significant change in tip and torque values, no matter the type of RPE and the treatment time. For all patients, we have recorded the superimposition of the maxillary dental cast before and after treatment. Conclusion: In all patients, we obtained a resolution of the maxillary transverse deficit. Patients treated by pure skeletal anchored devices have recorded a less variations of palatal vault angle and the distance between first molar cusps, as if the expansion was gained more parallel. The expansion obtained showed reduced dental side effects, as tip and torque values haven’t changed in a statistically significant way.

Objective: To verify the existence of a correlation between the mesio-distal size of teeth and the arch width by analyzing the data separately for maxillary and mandibular arch in patients with ideal occlusion. Material and Methods: 58 patients with ideal occlusion were studied, for a total of 276 files analyzed. Dental casts were then scanned using a professional scanner (Epson Perfection v 330) and images were obtained in TIFF format at 600 dpi. All single teeth measurements were carried out for all teeth of both arches using the VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). The repeatability and reproducibility of the measurement method were evaluated using the Gauge R&R method. In case a correlation between tooth size and arch size is found to be significant, a linear regression analysis can be applied through the following statistical relationship: y=a+b*x, where y is the result (inter-molar distance “AvgB66” or inter-canine distance “Cusp 33”), and x the specific tooth. The a and b respectively represent the intercept (point of intersection between the line and the y axis) and the slope of the line that describes the regression ratio. Results: The statistical analysis highlights a significant correlation (p

Objective: To assess the scientific evidence on direct and indirect bonding techniques to analyse the differences related to treatment time, number of appointments and number of bracket detachments. Material and Methods: The MEDLINE and Cochrane Library databases were searched through to March 2021. Reference lists from the retrieved publications were also examined. The following article types that described data on the different types of direct and indirect bonding techniques in orthodontics were included: prospective and retrospective cohort studies, case-control studies and randomized controlled clinical trials (RCCTs). Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: The search strategy initially resulted in 824 articles, and after a careful selection comprising the inclusion criteria, 12 articles were picked for the final review, specifically 2 cohort studies, 4 case-control studies and 6 RCCTs. The methodological quality was low in 4 studies, medium in 2, and high in 6 articles. Conclusion: The evidence currently available suggests that the use of computer-aided bonding is related to a reduction in treatment time and the number of appointments compared to direct and manual indirect bonding. However, the total bonding time for computer-aided bonding technique, including digital bracket placement, was longer than for direct bonding. Further high-quality RCTs on the differences between direct and indirect bonding are necessary to determine more precise data, as well as additional advantages and disadvantages.

Objective: To perform a morphological evaluation concerning the extent of interproximal enamel reduction (IPR) with different manual instruments in different types of teeth and a qualitative analysis of enamel surface characteristics at the contact point before and after IPR. Material and Methods: 40 freshly extracted, caries-free, and intact human teeth were used for the study (20 bicuspids and 20 incisors) and performed IPR just on the mesial surface. The morphological variation of contact point was evaluated by superimposed the stl file, obtained thanks to an extraoral scanner, at T0 and T1 for each tooth. Two types of strip were used, Intensiv Manual Ortho Strips Coarse/Medium and Steelcarbo Horico Strips. Teeth were then cut lengthwise, removed the most apical root portion and the mesial and distal halves were gilded and observed at different magnifications. Results: The morphological variation following stripping mainly depends on the extent of the stripping, while the diameter, the type of strip and the shape of the tooth itself do not appear to be relevant. The 500X and 1500X magnifications allowed to appreciate better the characteristics of the surface of the stripped enamel and the differences with the intact enamel. All teeth treated, independently from the kind of strip used, shows deep marks and grooves in the direction of stripping. In both cases, the enamel appears significantly damaged at great magnifications . Conclusion: Stripping always and inevitably leads to a change in the shape of the contact point and is directly correlated to the amount of stripping performed. The use of polishing after the removal of enamel interproximal is necessary in all cases.

Objective: To evaluate the accuracy of three different digital bracket positioning systems, comparing vertical, mesiodistal and buccolingual accuracy. Material and Methods: The same case was sent to Orapix, Insignia, and Orthocad systems and the brackets were bonded to the malocclusion models. Damon 3 MX brackets were used with all systems and the brackets were bonded to the models with the same bonding protocol and materials. The comparison of the position of each single bracket was made with digital photography, and ImageJ software was used to find the length in pixels and then convert it to hundredths of a mm for vertical, mesiodistal and buccolingual displacement, compared to the setup. Results: Insignia System reported the average higher vertical displacement (0.28 mm), compared with the other two appliances (0.22-0.23 mm), and showed the lowest average displacement for the mesiodistal and buccolingual positioning (0.14 and 0.07 mm, respectively). However, these slight bracket positioning variations between these bonding systems were not statistically different (p>0.05). Conclusion: The three systems analyzed were shown to be accurate in positioning the brackets, and none of them was statistically better.

(1) Background: the aim of this study was to investigate the transmittance levels of aligners in relation to different thermoforming disks and printers after 14 days of in vitro aging. (2) Methods: the transmittance level of 18 aligners was investigated. Three printers were used to create the aligner: Carbon L1, Prodways LD20 and RapidShape D100+. Each printer produced 6 aligners: three were made of Zendura FLX material and three of Scheu Ca Pro+. Each sample was subjected to spectrophotometry analysis of its transmittance levels, for a total of 54 measurements at T0. Then, all samples were aged in vitro at a constant temperature in artificial saliva supplemented with food coloring for 14 days each. The spectrophotometry protocol was repeated, and the same 54 measurements were collected at T1 (after aging). The resulting data were analyzed and compared by means of ANOVA (p < 0.05). (3) Results: all tested aligners revealed lower transmittance values after aging. Scheu CA Pro+ aligners showed higher transparency at T0, but a significant worsening of its aesthetic at T1. On the other hand, Zendura FLX aligners presented slightly reduced transmittance levels before aging, which, however, remained more stable after 14 days, showing no significant difference. In the specific, aligners produced by Prodways LD20 printers showed better optical properties than the others, both at T0 and T1. (4) Conclusions: Differences in pre-and-post-aging optical properties of aligners are influenced by the manufacturing process. Both the thermoplastic disks and the printers, thanks to new technologies, played a positive role in the final transparency of the product, which improved in all values compared to previous studies.

Objective: The purpose of this retrospective preliminary study was to analyze the skeletal and dentoalveolar effects of a new clear functional appliance in a sample of patients close to growth spurt with class II malocclusion attributable to mandibular retrusion. Materials and methods: A sample of growing patients underwent functional Class II correction using F22® (Sweden and Martina, Due Carrare (PD), Italy) Young, realized combining the aesthetic characteristics of the F22® clear aligner with the structural features of a functional appliance. For each patient, a digital setup was performed by a single operator to plan a mandibular advancement to the therapeutic position. Cephalometric analysis before and after treatment was performed. The purpose of the statistical analysis was to evaluate dental and skeletal changes associated with F22® Young device, and whether there were statistically significant differences in anatomical measurements between the beginning and end of treatment. Results: 15 patients, 7 females and 8 males of average age 10.3, were treated with the F22® Young appliance for an average period of 10 months ± 0.5 (maximum 11.5 months, minimum 10.5 months). The data showed that the SNB angle increase was statistically significant from T0 to T1, leading to a reduction in the ANB angle. Values for the mandible length, both total (Co-Gn) and at the base (Go-Pg), significantly increased. Conclusions: According to this preliminary study, F22® Young appliance is effective in promoting mandibular advancement when used near the pubertal growth peak. The device is comfortable and aesthetic, which certainly promoted patient compliance, a key factor for treatment success.