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Aim: The objective of the present study was to evaluate the failure rate of palatal computer-guided miniscrews placed in the paramedian (PM) and parapalatal (PP) regions for orthodontic purposes. An additional aim was to investigate whether a learning curve was required to perform computer-guided miniscrew insertion as well as to evaluate the peri-implant soft tissue response at three follow-up time points., Materials and Methods: A total of 202 palatal computer-guided miniscrews were inserted in 78 subjects for orthodontic purposes. A surgical guide was designed after planning the appropriate insertion sites on 3D images created by the fusion of CBCT scans and digital dental model images. The orthodontic appliances were disassembled monthly to perform a percussion test and evaluate the mobility of each miniscrew. To determine whether a learning curve was required for computer-guided miniscrew insertion, the time point of miniscrew failures and the number of surgeries were evaluated. Bleeding on probing (BOP) and probing pocket depth (PPD) were recorded for each miniscrew at 2- (T0), 6- (T1), and 12-month (T2) follow-up time points., Results: An immediate failure rate of 4.95% was recorded due to lack of primary stability immediately following miniscrew insertion, with a statistically significantly higher failure rate of PP miniscrews (P = 0.00). Failure of the miniscrews occurred at random times, with no learning curve required for their insertion. The measured BOP rates (mean: 3.13%) and PPD values (mean: 1.68 mm) remained stable over time., Conclusions: Computer-guided miniscrew insertion in the palatal vault showed a low failure rate without a determined learning curve required for their insertion to obtain predictable results and with long-term stability of peri-implant soft tissue indices.

Background: The treatment of mandibular second molar (MM2) impaction presents a challenge for orthodontists and requires a surgical-orthodontic approach. This study aims to compare the effectiveness of two techniques for treating impacted MM2: a traditional technique using brass wire and a technique employing skeletal anchorage. Methods: Twelve MM2 with mesio-angular impaction, with an inclination angle between 25° and 40° and an impaction depth between 4 and 10 mm, were selected and randomly divided into two treatment groups. Patients in Group A were treated using the traditional brass wire technique, while those in Group B underwent treatment with a skeletal anchoring technique that utilized a miniscrew positioned in the retromolar region and an elastic sling chain. For both groups, treatment time and the influence of the disimpaction technique on oral health-related quality of life (OHRQoL) were evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results: The results indicated an average treatment time of 168.67 ± 52.32 days for Group A and 76 ± 10.17 days for Group B, with a statistically significant difference ( p -value = 0.0002). Regarding the impact on the patients' OHRQoL, Student's t -test did not reveal a statistically significant difference between the two groups at 3 and 7 days of follow-up. Conclusions: Both techniques are considered effective for the treatment of impacted MM2 (angulation 25-40°, depth 4-10 mm). The use of skeletal anchorage significantly reduces treatment times without negatively affecting OHRQoL. The results of this study should be confirmed by further studies with larger sample sizes.

The use of traditional intra-oral devices in maxillary molar distalization is not without undesirable consequences. The aim of the present study was to compare the miniscrew-supported distal-jet appliance to a traditional distal-jet appliance by evaluating the amount of upper first molar distalization and the dentoalveolar side effects. Data of 600 subjects visited at the orthodontic unit of Sapienza University of Rom were analyzed. Only 46 patients met the inclusion criteria and were selected and treated. Subjects were assigned randomly to receive treatment either with miniscrew-supported distal-jet appliance (Group A) or with a traditional distal-jet appliance (Group B). In Group A, miniscrews were inserted using a computer-guided surgical guide. The amount of upper first molar distalization and the dentoalveolar side effects were assessed both on the digital casts and on the lateral cephalometric radiograph at the end of the distalization phase. A descriptive statistical analysis that included the mean values and the standard deviation was conducted to evaluate the molar distalization and the dentoalveolar effects in two groups. Intergroup differences were determined using the Student's t -test. The significance was set at p ≤ 0.05. In Group A, greater maxillary first molar distalization and a spontaneous distalization of the first premolars and a palatal inclination of central incisors were observed. By contrast, in Group B, the first premolars tipped mesially and a proclination of the maxillary central incisors was observed. In both groups, the transverse widths of the dental arch increased while a greater tendency of first premolar extrusion and of maxillary first molar rotation was observed in Group B. The skeletal anchorage device achieved greater first molar distalization and did not cause dento-alveolar side effects.

We report a clinical case with chronic progressive external ophthalmoplegia, retinal pigmentation and left anterior hemiblock (Kearns-Sayre Syndrome) associated with mitral valve prolapse. The mitral valve prolapse is present in familiar neuromuscular diseases. We think that mitral valve prolapse is expression of diffuse metabolic process of muscular heart in Kearns-Sayre Syndrome.