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.

Evaluation of surface roughness of orthodontic wires by means of atomic force microscopy.

OBJECTIVE: To compare the surface roughness of different orthodontic archwires. MATERIALS AND METHODS: Four nickel-titanium wires (Sentalloy(®), Sentalloy(®) High Aesthetic, Titanium Memory ThermaTi Lite(®), and Titanium Memory Esthetic(®)), three ß-titanium wires (TMA(®), Colored TMA(®), and Beta Titanium(®)), and one stainless-steel wire (Stainless Steel(®)) were considered for this study. Three samples for each wire were analyzed by atomic force microscopy (AFM). Three-dimensional images were processed using Gwiddion software, and the roughness average (Ra), the root mean square (Rms), and the maximum height (Mh) values of the scanned surface profile were recorded. Statistical analysis was performed by one-way analysis of variance (ANOVA) followed by Tukey's post hoc test (P < .05). RESULTS: The Ra, Rms, and Mh values were expressed as the mean ± standard deviation. Among as-received archwires, the Stainless Steel (Ra  =  36.6 ± 5.8; Rms  =  48 ± 7.7; Mh  =  328.1 ± 64) archwire was less rough than the others (ANOVA, P < .05). The Sentalloy High Aesthetic was the roughest (Ra  =  133.5 ± 10.8; Rms  =  165.8 ± 9.8; Mh  =  949.6 ± 192.1) of the archwires. CONCLUSIONS: The surface quality of the wires investigated differed significantly. Ion implantation effectively reduced the roughness of TMA. Moreover, Teflon(®)-coated Titanium Memory Esthetic was less rough than was ion-implanted Sentalloy High Aesthetic.

Effects of orthopedic maxillary expansion on nasal cavity size in growing subjects: a low dose computer tomography clinical trial.

OBJECTIVE: The aim of this retrospective clinical trial was to evaluate the effects of rapid maxillary expansion on skeletal nasal cavity size in growing subjects by use of low dose computer tomography. METHODS: Eight Caucasian children (three male; five female) with a mean age of 9.7 years (SD±1.41) were the final sample of this research that underwent palatal expansion as a first phase of orthodontic treatment. The maxillary expander was banded to the upper first molars and was activated according a rapid maxillary expansion protocol. Low-dose computer tomography examinations of maxilla and of the low portion of nasal cavity were performed before inserting the maxillary expander (T0) and at the end of retention (T1), 7 months later. A low-dose computer tomography protocol was applied during the exams. Image processing was achieved in 3 steps: reslicing; dental and skeletal measurements; skeletal nasal volume computing. A set of reproducible skeletal and dental landmarks were located in the coronal passing through the first upper right molar furcation. Using the landmarks, a set of transverse linear measurements were identified to estimate maximum nasal width and nasal floor width. To compute the nasal volume the lower portion of the nasal cavity was set as region of interest. Nasal volume was calculated using a set of coronal slices. In each coronal slice, the cortical bone of the nasal cavity was identified and selected with a segmentation technique. Dependent t-tests were used to evaluate changes due to expansion. For all tests, a significance level of P<0.05 was used. RESULTS: Rapid maxillary expansion produced significant increases of linear transverse skeletal measurements, these increments were bigger in the lower portion of the nasal cavities: nasal floor width (+3.15 mm; SD ± 0.99), maximum nasal width (+2.47 mm; SD ± 0.99). Rapid maxillary expansion produced significant increment of the total nasal volume (+1.27 cm(3) ± SD 0.65). The anterior volume increase was 0.58 cm(3) while the posterior one was 0.69 cm(3). CONCLUSION: In growing subjects RME is able to significantly enlarge the dimension of nasal cavity. The increment is bigger in the lower part of the nose and equally distributed between the anterior e the posterior part of the nasal cavity.

Dental occlusion and posture: an overview.

OBJECTIVES: In recent decades, it has been suggested that disorders of the masticatory system such as malocclusions, can influence whole body posture. A growing number of patients are seeking concomitant treatment for dental malocclusions and postural disorders. The aim of this overview is to critically analyze the relationship between dental occlusion and posture. MATERIALS AND METHODS: A literature overview was carried out to analyze the association between "malocclusion" versus "head posture", "spine curvature", and "body sway". RESULTS: The studies showed that even if some associations have been found between occlusal factors and postural alterations, there is not enough scientific evidence to support a cause-effect relations. Most studies suffer from major flaws such as lack of control groups, failure to take into account for the possible confounders, inappropriate study design, and lack of sufficient reliability and validity of used diagnostic tests. CONCLUSIONS: On the basis of this overview, it is not advisable to perform occlusal and/or orthodontic treatment, especially if irreversible and expensive, to treat or prevent postural imbalances or alteration of spine curvatures.