Severe Crowding Associated with Lower Canine Premature Resorption: Interceptive Treatment with Clear Aligners-A Pilot Study.

BACKGROUND: Early mixed dentition represents a critical phase since crowding conditions can occur. The interceptive resolution of dental crowding allows favorable arch and occlusal development. The aim of the present investigation was to evaluate dentoalveolar changes of clear aligner treatment planned to manage lower incisor crowding, loss of arch length, and midline deviation in early mixed dentition. METHODS: A total of 13 patients (7 females, 6 males, 9.4 ± 1.2 age) treated with clear aligners were selected. Arch dimensions and incisor inclinations were evaluated before (T0) and at the end of interceptive treatment (T1). A paired t-test was chosen to compare T1-T0 changes. The level of significance was set at 5%. RESULTS: The greatest significant increase in mandibular width was observed at the level of the first deciduous molars (+2.44 ± 1.4 mm), followed by the second permanent molars (+2.16 ± 1.4 mm). Lower arch length and arch depth showed a statistically relevant increase (2 ± 0.6 mm and 4.5 ± 1.6 mm, respectively). The mean lower dental midline changes were statistically significant (1.42 ± 0.73 mm). CONCLUSIONS: Early treatment with clear aligners, including the combination of transversal arch development, maintenance of leeway space, and guidance of eruption, represents a valid treatment strategy in early mixed dentition to manage arch crowding and occlusion development.

Clinical Efficacy and Tolerability of a New Experimental Mucoadhesive Patch for Topical Anesthesia of Oral Mucosa in Pediatric Dentistry.

Background: The injection of local anesthetics is the procedure that still causes the most fear and anxiety in a dental session; to minimize this problem, we can use topical anesthesia. The aim of this study is to analyze the tolerability and the clinical efficacy in the control of pain, during the subsequent injection of the local anesthetic, of an experimental anesthetic patch with a new formulation, which was previously tested in gel formula. Methods: A total of 150 children, aged 4 to 9 years, were included in the study. Each patient was treated using three different pre-anesthesia methods (placebo gel, experimental gel, and experimental patch), according to a split-mouth procedure, within a week of each other. The injection pain was analyzed using the WBFPRS and FLACC scales. Patients' caregivers' satisfaction was recorded at the end of the procedures. The data were analyzed using one-way ANOVA-RM, Wilcoxon-Mann-Whitney, Mann-Whitney U, and χ2 tests. Results: In this study, significantly higher pain ratings were observed with the topical placebo gel and lower pain ratings were observed with the experimental patch. Conclusion: The use of the patch proved to be very effective in reducing pain both subjectively and objectively, in the absence of both local and systemic side effects, validating its use in the oral mucosa.

Systematic Review of Zinc's Benefits and Biological Effects on Oral Health.

BACKGROUND: This review was based on the following question: "What is the state-of-the-art regarding the effect of zinc exposure in the oral cavity on a population of adults and children, compared to dental products containing materials other than zinc, considering in vivo (clinical trials and observational studies) and in vitro studies?" according to a PICOS strategy format. This study aims to analyze zinc application in dental materials, with different compositions and chemical formulations, considering how mechanical and biological properties may influence its clinical applicability. METHODS: In vivo (clinical trials: controlled clinical trials (CCTs) and randomized controlled trials (RCTs); and observational studies: case control and cohort studies) trials or in vitro studies published in English or Italian during the last 10 years on children and adult patients with zinc exposure were included by three different reviewers using the MEDLINE (via PubMed), Scopus, and Web of Science electronic databases. RESULTS: Titles and abstracts were evaluated following the eligibility criteria. The full texts of eligible studies were then reviewed against the inclusion/exclusion criteria. Scientific and technical information of the 33 included studies were collected into evidence tables, reporting data on in vivo and in vitro studies. A narrative approach was adopted. CONCLUSIONS: Antibacterial activity was found to be the most studied property of zinc, but further investigations are needed to establish adjuvant zinc therapies in patients with oral disease.

An evaluation of the Invisalign® Aligner Technique and consideration of the force system: a systematic review.

OBJECTIVE: Since its introduction 25 years ago, the Invisalign® system has undergone multiple digital and biomechanical evolutions and its effectiveness is often compared to traditional systems without considering the many differences which characterize them. The main aim of this systematic review is to look at the literature dealing with studies on teeth movements using the Invisalign® system and the management of these movements through digital planning and artificial intelligence. MATERIALS AND METHODS: The following electronic databases were searched: MEDLINE, Embase, the Cochrane Oral Health Group's Trials Register, and CENTRAL. Unpublished studies were searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. RESULTS: Twenty-four studies (15 retrospective, 5 prospective, 2 pilot, and 2 case-control) were included. The results of the analysis carried out on the available literature show that the Invisalign® system is recognized to be a valid alternative to conventional orthodontic treatment in no-extraction cases. The results are influenced by the methods for assessing the effectiveness of this technique and by the comparison bias of the traditional system with the innovative digital system. CONCLUSIONS: Since the introduction of SmartForce and SmartTrack material, the efficacy of the treatment has improved. There is still a shortage of high-quality evidence concerning the treatment modality. In order to make the treatment with the aligners more efficient, a correct management of the ClinCheck® software and a proper use of the biomechanics are necessary. The aligned force-driven system should be taken into account when developing the digital planning.

Bioactive Peptides Derived from Edible Insects: Effects on Human Health and Possible Applications in Dentistry.

Novel foods, including edible insects, are emerging because of their nutritional characteristics and low environmental impacts and could represent a valid alternative source of food in a more sustainable way. Edible insects have been shown to have beneficial effects on human health. Insect-derived bioactive peptides exert antihypertensive, antioxidant, anti-inflammatory, and antimicrobial properties and have protective effects against common metabolic conditions. In this review, the roles of edible insects in human health are reported, and the possible applications of these peptides in clinical practice are discussed. A special mention is given to the role of antimicrobial peptides and their potential applications in controlling infections in orthodontic procedures. In this context, insects' antimicrobial peptides might represent a potential tool to face the onset of infective endocarditis, with a low chance to develop resistances, and could be manipulated and optimized to replace common antibiotics used in clinical practice so far. Although some safety concerns must be taken into consideration, and the isolation and production of insect-derived proteins are far from easy, edible insects represent an interesting source of peptides, with beneficial effects that may be, in the future, integrated into clinical and orthodontic practice.

Effects of Rapid Maxillary Expander and Delaire Mask Treatment on Airway Sagittal Dimensions in Pediatric Patients Affected by Class III Malocclusion and Obstructive Sleep Apnea Syndrome.

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder that is very common in pediatric patients. In the literature, there are very few studies concerning the association between OSAS and class III malocclusion in children. The use of a rapid maxillary expander (RME) in association with the Delaire mask is a common treatment protocol for class III malocclusion. The aim of this work was to evaluate the cephalometric variations of upper airway dimensions and OSA-related clinical conditions after orthodontic treatment with an RME and the Delaire mask, as recorded in pediatric patients with a class III malocclusion who were affected by OSAS. In this preliminary study, 14 pediatric patients with mixed dentition, aged between 6 and 10 years, were selected. All patients were treated with an RME and the Delaire mask. Pre- and post-treatment cephalometric radiographs were traced, analyzed, and compared. The results demonstrated a significant increase in the upper airway linear measurements and the nasopharyngeal and oropharyngeal dimensions (p ≤ 0.05). This increase creates an improvement in airway patency and in OSAS-related clinical conditions. The use of the RME in association with the Delaire mask can be effective in the treatment of pediatric patients with a class III malocclusion who are affected by OSAS.

Effectiveness and Tolerability of a New Formulation of a Topical Anesthetic in Reduction of Pain and Parents' Satisfaction in Pediatric Dentistry.

The aim of the present study was to test a new topical anesthetic gel with a different formulation (10% lidocaine, 10% prilocaine) to analyze its effectiveness in pain control, during the subsequent injection of local anesthetic, and the presence of any side effects. METHODS: The study's research design was a randomized controlled clinical trial on 300 children, aged 5-8 years, divided into two groups, each of 150 patients, according to pre-injection procedures (presence or absence of topical anesthesia). The injection pain was analyzed using the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability Scale (FLACC). At the end of the procedures, patients' parents' satisfaction was recorded. The data were analyzed using the Student's T test, Mann-Whitney U test and Chi-square test. RESULTS: There were statistically significant differences between the two groups both in the PRS and FLACC ratings. Both in subjective and objective pain evaluations, significantly higher pain ratings were observed in the group without topical anesthesia. There was also a statistically significant difference in terms of patients' parents' judgment, as in the group with the use of topical anesthetic the level of parental satisfaction is statistically higher. CONCLUSION: The experimental anesthetic has proved very effective in its use as a topical gel in both pain measurement scales, thus validating its use on the oral mucosa, for its pharmacological and psychological effect, in the total absence of local and systemic side effects.

Effects of Rapid Palatal Expansion on the Upper Airway Space in Children with Obstructive Sleep Apnea (OSA): A Case-Control Study.

Obstructive Sleep Apnea (OSA) in children needs a multidisciplinary approach. Even if the first-line treatment of pediatric OSA is adenotonsillectomy, nowadays rapid palatal expansion (RPE) is considered a valid additional treatment. The aim of this study is to evaluate cephalometric changes in upper airways dimensions after rapid palatal expansion (RPE) in children suffering from Obstructive Sleep Apnea (OSA). A total of 37 children (range age 4-10 years) with diagnosis of OSA referred to Dentistry Unit of Bambino Gesù Children's Research Hospital IRCCS (Rome, Italy) were included in this pre-post study and underwent lateral radiographs at the start (T0) and at the end (T1) of a RPE treatment. Inclusion criteria were: diagnosis of OSA confirmed by cardiorespiratory polygraphy (AHI > 1) or pulse oximetry (McGill = >2), skeletal maxillary contraction evaluated by presence of posterior crossbite. A control group of 39 untreated patients (range age 4-11 years), in good general health, was set up. A paired T-test was used to investigate the statistical differences between T0 and T1 values in both groups. The results showed a statistically significant increase of nasopharyngeal width in the treated group after RPE treatment. Moreover, the angle that identifies mandibular divergence compared to palatal plane (PP-MP°) was significantly reduced. In the control group, no statistically significant differences were observed. The present study showed that RPE treatment determines a significant sagittal space increase in the upper airways space and a counterclockwise mandibular growth in children with OSA compared to a control group. These results suggest that a widening of the nasal cavities induced by RPE may support a return to physiological nasal breathing and promote a counterclockwise mandibular growth in children. This evidence confirms the crucial role of the orthodontist in the management of OSA in pediatric patients.

Experience and Prevalence of Dental Caries in Migrant and Nonmigrant Low-SES Families' Children Aged 3 to 5 Years in Italy.

Dental caries is a public health problem in children and is more prevalent in low-socioeconomic-status groups. The aim of this study is to assess the association between migrant families and the prevalence of caries among young children in Italy. This is a cross-sectional study. In the age range of 3 to 5 years, a total of 266 migrant children and 301 nonmigrant children were examined in three Italian charity dental centers. All children had families with low SES. The dmft was determined by intraoral examination performed by six pediatric dentist specialists to assess their dental health. In this study, the prevalence of caries (71%) and the mean dmft (3.68; SD: 1.52) of migrant children were statistically significantly higher than the percentage (52%) and the mean dmft of the nonmigrant control group (3.10; SD: 1.65) with no differences between genders. For the migrant children, the mean (0.49; SD: 0.32) of restorations (filled teeth) was statistically significantly lower than that of nonmigrant children (1.20; SD: 0.48). This study highlights that dmft values and the prevalence of caries are higher in migrant children than in nonmigrant children. In addition, the control group shows a higher level of dental caries than the national mean.

What Do Mothers (or Caregivers) Know about Their Children's Oral Hygiene? An Update of the Current Evidence.

Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents' incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children's oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman's care should increase parents' knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.

Intercepting of Class III Malocclusion with a Novel Mechanism Built on the Orthopaedic Appliance: A Case Report.

AIM: The following case report aims to show a novel orthopaedic appliance to reduce the side effects of the orthopaedic Class III treatment through the use of two acrylic splints combined with a PowerScope device. MATERIALS AND METHODS: This case report describes the treatment of a 6-year-old patient with a skeletal Class III relationship with a maxillary deficiency and a severe hyperdivergency. The patient underwent a sagittal orthopaedic treatment with a PowerScope device for 12 months. The retention period lasted 4 months. RESULTS: The response of the craniofacial complex to the active orthopaedic treatment of the Class III malocclusion with the PowerScope™ device splints consisted of significant changes in maxillary growth and position. Both angular and linear sagittal measurements of the maxilla showed improvements during active treatment, respectively, of 0.6° and 1.2 mm (SNA from 75.8° to 76.4°; maxillary length from 38.8 mm to 40 mm). These effects allowed for a highly significant improvement in the maxillomandibular skeletal relationships. ANB improved by 1.6° and Wits appraisal by 4 mm. Using this appliance in a hyperdivergent patient, we obtained a vertical control of the mandible with a SN/Go-Gn stable value at 40° and a significant improvement of the ANS-PNS/GoGn angle from 30° to 28°. CONCLUSION: The Class III orthopaedic treatment with the PowerScope™ telescopic and NiTi spring device mounted on the upper and lower resin splints in a Class III correction offered good vertical control during the early orthopaedic treatment by improving the skeletal discrepancy and controlling the hyperdivergency, which is one of the most difficult factors to control in Class III malocclusions.

Hand-Carried Ultrasonography Instrumentation in the Diagnosis of Temporomandibular Joint Dysfunction.

Internal derangement (ID) in the temporomandibular joint (TMJ) is defined as a mechanical problem of the joint that interferes with its function. It is attributed to an abnormal interaction among the articular disc, condyle, and joint eminence. The aim of this study is to evaluate diagnostic efficacy of non-invasive hand-carried ultrasonography instrumentation (US) to provide high-level images for a correct diagnosis of ID. Twenty-eight ID patients, 15 female and 13 males, were examined both clinically and by MRI images in order to achieve a diagnosis of ID (using Helkimo index). Then, they were submitted to US examination with a 12 MHz transducer by using hand-carried instrumentation by a clinician that was blind to their diagnosis and clinical data. TMJ US examination was performed with the mouth closed and mouth open, with proper technique. Each position was then evaluated with two different orientations of the transducer. US showed acceptable results in identifying bone structures. Lower values of diagnostic efficacy were obtained for disc position during joint movements with respect to MRI images. MRI still represents the gold standard for the identification of joint structures. If not corroborated by clinical and anamnestic data, the diagnostic efficacy of US in identifying the position of the disc during opening and closing jaw movements appears limited than compared to MRI.

Prevalence of Early Childhood Caries (ECC) in a paediatric italian population: An epidemiological study.

AIM: The present work aims to evaluate, through an epidemiological study, the prevalence of Early Childhood Caries in an Italian paediatric population, aged up to 71 months, evaluating some determinants that will be illustrated in this study in order to adopt preventive care and intervene as early as possible to limit the development of this disease. METHODS: The sample consisted of 76 children aged up to 71 months who were examined at the PAediatric Dentistry Clinic of the University of l'Aquila. Parents were informed of the research that was taking place. All read the information sheet explaining the study and signed the informed consent where it was emphasised that the data collected would be treated and stored in a strictly confidential manner, pursuant to the Legislative Decree 196/2003 in force in Italy since June 30, 2003, regarding the protection of individuals with regard to the processing of personal data. At the end of this study, a standardised questionnaire administered. The questionnaire, divided into two parts, made it possible to acquire information regarding the characteristics of the population. First part: General data of the child and the medical history of the mother and father; Second part: The age and gender of the child, the type and duration of breastfeeding, the use of sugary pacifiers, oral hygiene and frequency of consumption of sugars drinks and food, identifying the starting age. RESULTS: Evaluating the dmft of each child, 40.79% of our sample population is affected by ECC; 57.89% of the children used the pacifier and 13,16% of them have or have used it with honey with a p value of 0.001, therefore this parameter was statistically significant, together with the intake of candies, chocolates and sugar drinks. The data was collected for a period of about 12 months, consequently a descriptive statistical analysis was conducted in which the characteristics of the population under consideration were outlined. Discrete and nominal variables have been described with frequencies and percentages. The percentage differences were evaluated using the chi-square test and the Fisher test. Quantitative variables were expressed in terms of mean and standard deviation and significance was assessed by the Mann-Whitney test. The level of significance was established as p <0.05. A Logistic Regression was conducted to evaluate the risk factors associated with a dmft>0 setting, dmft=0/dmft>0 as the dependent variable and the variables investigated as explanatory variables. The evaluation of the association was reported as the Odds Ratio with the 95% confidence interval. The statistical analysis was carried out using the Stata 12/1C statistical package. CONCLUSION: ECC is a multifactorial disease in which eating habits play a very important role. A diet that from childhood is characterised by a high consumption of sugar-rich food and drinks is highly associated with the incidence of ECC in later years.

Effectiveness and Safety of Intravenous Sedation with Propofol in Non-Operating Room Anesthesia (NORA) for Dental Treatment in Uncooperative Paediatric Patients.

BACKGROUND: Uncooperative children require sedative approach for dental treatment. The aim was to assess the effectiveness of Propofol in "Non-Operating Room Anesthesia" (NORA) for paediatric dental treatment; intraoperative side effects; postoperative side effects; post-discharge effects. METHODS: a prospective study, involving 109 uncooperative children undergoing sedation in NORA using Propofol for dental treatment, was performed. Working sessions, success/failure, intraoperative and postoperative side effects, number of treatment; type of procedure were assessed. Parents completed a post-discharge questionnaire on: pain; crying; fever; vomiting; headache; drowsiness; excitability; irritability; ability to eat; drugs and medical care needing. RESULTS: Success: 96.7%. Intraoperative side effects: 33.3%. Postoperative side effects: 6.4%. Statistically significant association between: intraoperative side effects and age (p = 0.001), health status (p = 0.0007), weight (p = 0.038), respectively; intraoperative side effects and number/ type of dental treatment (p = 0.0055) and scaling (p = 0.0001), respectively. For post-discharge questionnaires, statistically significant association between: age and crying (p = 0.0001) and headache (p = 0.002), respectively; health status and crying (p = 0.015) and drugs needing (p = 0.04), respectively; weight and crying (p = 0.0004); extraction and pain (p = 0.0001) and crying (p= 0.0073), respectively; scaling and crying (p = 0.04), excitability and irritability (p = 0.03), respectively. CONCLUSION: Propofol in NORA was effective with minimal side effects.

A Knowledge-Based Algorithm for Automatic Monitoring of Orthodontic Treatment: The Dental Monitoring System. Two Cases.

BACKGROUND: In the dental field, digital technology has created new opportunities for orthodontists to integrate their clinical practice, and for patients to collect information about orthodontics and their treatment, which is called "teledentistry." Dental monitoring (DM) is a recently introduced orthodontic application that combines safe teledentistry with artificial intelligence (AI) using a knowledge-based algorithm, allowing an accurate semi-automatic monitoring of the treatment. Dental Monitoring is the world's first SaaS (Software as a Service) application designed for remote monitoring of dental treatment, developed in Paris, France, with Philippe Salah as the Co-founder and CEO. CASES PRESENTATION: This report describes two cases in which DM system was essential to achieve the control of certain movements: it was possible to follow the movement, even if complex, such as the anterior cross of an adult patient and a lack of space in the canine of the growing patient. The software analyzed the fit and retention of the aligner, thus ensuring correct biomechanics. They were treated during the COVID-19 pandemic lockdown with aligners. The first case is a growing patient who was monitored during an interceptive orthodontic treatment to manage a retained upper canine. The second case is an adult patient forced to finalize his treatment of upper lateral incisor crossbite. The software analyzed the fit and retention of the aligner, thus ensuring correct biomechanics. CONCLUSIONS: DM system appears to be a promising method, useful for improving the interaction between doctor and patient, generally acceptable and useful to patients, even in critical clinical situations, at least in cases with optimal compliance and ability to use the tool properly.

Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles.

Background and objectives: The aim of this study is to evaluate mandibular elevator muscles activity and pain on palpation in the early stages of orthodontic treatment with clear aligners using surface electromyography (sEMG). Materials and methods: Surface electromyography (sEMG) activity and pain level on muscle palpation of masseter and anterior temporalis muscles were recorded in a sample of 16 adult subjects (aged 18-32 years; mean 22.5 +/- 3.5 SD) undergoing orthodontic treatment with clear aligners before the treatment (T0), after 1 month of treatment (two clear aligners) (T1), and after 3 months of treatment (T2) (six clear aligners). A chi-square test for nominal data, a Friedman test, and a Wilcoxon-signed rank test as post hoc analysis were applied. Results: No statistically significant differences in muscular pain were observed. At T1, the sEMG activity of masseter muscles at mandibular rest position showed a statistically significant reduction, but after 3 months (T2), the data appeared similar to T0 (p = 0.03 and p = 0.02). Conclusions: During the treatment with clear aligners, subjects could experience an initial reduction in the masseter basal activity after 1 month of treatment. This effect tends to decrease to baseline levels after 3 months of therapy.

Obstructive sleep apnea severity and dental arches dimensions in children with late primary dentition: An observational study.

Objective: The aim of this study was to compare the dimensions of the upper and lower arches in children affected by OSAS with different levels of severity of obstruction.Methods: Twenty-seven Caucasian children (14 males, 13 females; mean age 6, range 5.2-6.1 years) with a diagnosis of OSAS determined by polysomnography were enrolled in this study. The dimensions of both dental arches were measured, and the data were compared among children affected by severe, moderate, and mild OSAS.Results: Statistically significant differences among the three groups revealed that children with severe OSAS had the highest values of upper intercanine and intermolar distances in the sample.Discussion: A severe OSAS grade (AHI > 10) is associated with statistically significantly higher upper intercanine and intermolar distances compared with mild and moderate grades. An early approach to OSAS in children with late primary dentition is auspicated in order to prevent an influence on dental arches growth.

The Effect of Dental Treatment under General Anesthesia on Quality of Life and Growth and Blood Chemistry Parameters in Uncooperative Pediatric Patients with Compromised Oral Health: A Pilot Study.

BACKGROUND: The effect of untreated dental caries and their treatment under general anesthesia (GA) on the quality of life, growth, and blood chemistry parameters in uncooperative pediatric patients has not been extensively elucidated. The aims are to evaluate the impact of dental treatment under GA on oral health-related quality of life (OHRQoL) in uncooperative pediatric patients with severe dental caries and to assess the effect of dental treatment under GA on children's weight (Wt), height (Ht), Body Mass Index (BMI), and blood chemistry parameters. METHODS: Forty-three uncooperative children aged 3-14 years were selected. OHRQoL, through ECOHIS (Early Childhood Oral Health Impact Scale) and COHRQoL (Child Oral Health-Related Quality of Life) questionnaires, Wt, Ht, BMI, and blood chemistry parameters were measured at baseline and eight months after dental treatment under GA. RESULTS: At follow up, the reductions in the ECHOIS and the COHRQoL components were statistically significant (p < 0.0001), there was significant improvement in the anthropometric measures: 76.5% of children increased the percentile curves for weight, 68.6% for height, and 51.4% for BMI; for the blood chemistry parameters: ferritin improved in 68.6% of the samples, PCR in 65.7%, ESR in 68.6%, Vitamin D in 68.6%, and IGF-1 in 65.7%. CONCLUSIONS: Oral health status significantly influences OHRQoL, growth, and blood chemistry parameters in uncooperative pediatric patients.

Early Treatment of Anterior Crossbite with Eruption Guidance Appliance: A Case Report.

The purpose of this investigation was to show how to manage an anterior crossbite in early mixed dentition with an eruption guidance appliance (EGA). The analyzed clinical case reported an anterior crossbite, a bimaxillary retrusion tendency, and a horizontal growth pattern. The anterior crossbite was an unfavorable occlusal condition that could lead to a class III malocclusion growth pattern. An early treatment approach was suggested to reach a correct sagittal jaw relationship. Hence, the selected approach acted on the dentoalveolar sector, aiming to have effects on the posterior vertical dimension and to improve the sagittal jaw's relation. An EGA was selected to treat the patient in early mixed dentition. After 7 months of therapy with night-time use, the dental malocclusion was completely resolved. The patient continued to be treated with the same device, used as active retention. With the EGA treatment, the erupting forces, rather than the active forces, were used to resolve the dental malocclusion. This approach allowed a low compliance requirement and had a minimum psychosocial and psychological impact on the patient. The early treatment was essential to give a functional occlusion and a good balance of the soft perioral tissues and muscles.