Orthodontic repositioning of a lingually positioned transmigrated mandibular canine.

This case report presents the successful orthodontic repositioning of a transmigrated and lingually positioned mandibular canine with conventional mechanics. Treatment began with the aim of creating space for the four permanent canines that had not yet erupted. Cervical headgear, mesial slice, and extraction of the deciduous teeth were executed, but only the right canines erupted; moreover, the mandibular left canine had become lingually transmigrated. Multibracket therapy was performed with the orthodontic repositioning of both left canines in 2 steps. They were repositioned, and good alignment was obtained. To our knowledge, this is the first case report describing the orthodontic repositioning of a lingually transmigrated canine with conventional double-arch mechanics. This treatment was successful and without significant complications, even though this approach can be challenging and time-consuming.

The knowledge of orthodontic and craniofacial growth amongst Italian Pediatric Medical Residents for early diagnosis in growing patients: a cross-sectional study.

Paediatric residents usually visit children since the first years of life and can potentially diagnose craniofacial anomalies and malocclusions. Therefore, the aim of this study was to assess the ability of paediatric medical residents to diagnose malocclusions in growing subjects at an early stage. Eighty-three paediatric medical residents from the University of Pavia, Italy, who were enrolled in the Paediatric Residency program, participated in an online questionnaire. The questionnaire covered demographic variables, oral examination practices, dental and orthodontic knowledge, and sources of information. Following this, the residents were presented with a photographic analysis and asked to determine the treatment priority for 10 patients with malocclusions using the Index of Orthodontic Treatment Need (IOTN). On average, it was recommended that the first orthodontic visit should occur at around 4.92 years of age. The results showed that 75.9% of the residents always performed oral examinations on their patients, and 48.1% assigned a priority score of 8 or higher. The scores obtained by the paediatric residents did not significantly differ based on the year of study, frequency of oral examinations, or sources of information reported. Notably, there was a particular underestimation of treatment priority for malocclusions characterized by a significant increase in overjet. The findings suggest a potential lack of improvement in orthodontic knowledge during the medical residency program. It is recommended to increase the availability of orthodontic information sources for paediatric residents to enhance their understanding in this area.

Effect of different enamel pretreating agents on bonding efficacy and survival rates of orthodontic brackets: In vitro study and split-mouth randomized clinical trial.

INTRODUCTION: This double in vitro study and randomized clinical trial aimed to investigate the bonding failure rates of orthodontic brackets after enamel pretreatment with agents showing different particle sizes. METHODS: For the in vitro study, 80 bovine teeth were randomly divided into 4 groups according to the pretreating method used and their particle sizes: erythritol (14 µm), glycine (18-22 µm), sodium bicarbonate (70 µm), and no pretreatment. Scanning electron microscopy microphotographs were performed after pretreatment. Then, brackets were bonded, and shear bond strength was calculated. For the clinical study, agents with low (erythritol) and high (sodium bicarbonate) particle sizes were chosen. Twenty consecutive patients willing to start fixed orthodontic treatment with vestibular stainless steel brackets were enrolled. Patients were randomly divided into 2 groups following a split-mouth design. Group A underwent a 5-second enamel pretreatment procedure with erythritol for teeth belonging to maxillary left and mandibular right quadrants, whereas the remaining quadrants were pretreated for 5 seconds with sodium bicarbonate powder. In group B, quadrants were inverted. Then, brackets were bonded on the vestibular surfaces of teeth, and patients were visited monthly for 12 months to assess bond failures. Periodontal evaluation of probing pocket depth, bleeding on probing, plaque index, and papilla bleeding index was conducted before bonding and after 1, 3, 6, and 12 months. RESULTS: The in vitro study showed that erythritol and control presented significantly higher shear bond strength values for other agents. Bicarbonate showed the lowest values. In the clinical study, 20 patients (aged 16.4 ± 3.9 years) were enrolled, and all completed the study. Erythritol showed a significantly lower failure rate (3%) than sodium bicarbonate (7.5%). Kaplan-Meier survival plots showed statistically significant differences in risk of failure between the 2 groups during the 12-month follow-up. CONCLUSIONS: Enamel pretreatment with erythritol can be a viable technique to reduce failure rates of orthodontic brackets. REGISTRATION: The trial was not registered. PROTOCOL: The protocol was not published before trial commencement. FUNDING: No funding or grant was received for this research.

Effect of Long-Term Brushing on Deflection, Maximum Load, and Wear of Stainless Steel Wires and Conventional and Spot Bonded Fiber-Reinforced Composites.

Fiber-reinforced composite (FRC) retainers are an aesthetic alternative to conventional Stainless Steel splints. They are generally used with a full bonded technique, but some studies demonstrated that they could be managed with a spot bonding technique to significantly decrease their rigidity. In order to propose this FRC spot bonding technique for clinical use, the aim of this study was to evaluate mechanical properties and surface wear of fibers left uncovered. Tests were made by simulating tooth brushing, comparing FRC spot bonding technique splints with stainless steel and FRC traditional technique splints. Specimens were tested both at 0.1 mm of deflection and at maximum load, showing higher values of rigidity for the FRC full bonded technique. After tooth brushing, no significant reduction in values at 0.1 mm deflection was reported, while we found a similar reduction in these values for the Stainless Steel and FRC spot bonding technique at maximum load, and no significant variation for the FRC full bonded technique. SEM images after tooth brushing showed wear for FRC fibers left uncovered, while no relevant wear signs in metal and conventional FRC fibers were noticed. Results showed that FRC spot bonding technique has advantages in mechanical properties when compared to the FRC traditional full bonding technique, also after tooth brushing. However, the surface wear after tooth brushing in the FRC spot bonding technique is considerable and other tests must be performed before promoting this technique for routine clinical use.

Spot-Bonding and Full-Bonding Techniques for Fiber Reinforced Composite (FRC) and Metallic Retainers.

Fiber reinforced Composite (FRC) retainers have been introduced as an aesthetic alternative to conventional metallic splints, but present high rigidity. The purpose of the present investigation was to evaluate bending and fracture loads of FRC splints bonded with conventional full-coverage of the FRC with a composite compared with an experimental bonding technique with a partial (spot-) resin composite cover. Stainless steel rectangular flat, stainless steel round, and FRC retainers were tested at 0.2 and 0.3 mm deflections and at a maximum load. Both at 0.2 and 0.3 mm deflections, the lowest load required to bend the retainer was recorded for spot-bonded stainless steel flat and round wires and for spot-bonded FRCs, and no significant differences were identified among them. Higher force levels were reported for full-bonded metallic flat and round splints and the highest loads were recorded for full-bonded FRCs. At the maximum load, no significant differences were reported among spot- and full-bonded metallic splints and spot-bonded FRCs. The highest loads were reported for full bonded FRCs. The significant decrease in the rigidity of spot-bonded FRC splints if compared with full-bonded retainers suggests further tests in order to propose this technique for clinical use, as they allow physiologic tooth movement, thus presumably reducing the risk of ankylosis.

Sella turcica bridging and dental anomalies: is there an association?

BACKGROUND: Sella turcica bridging (STB), or calcification of the interclinoid ligament of sella turcica, has been reported to be associated with some dental anomalies (palatal canine impaction and transposition). HYPOTHESIS OR AIM: The aim of the study was to find any association between canine impaction, hyperdontia or hypodontia and sellar dimensions or bridging. DESIGN: Lateral cephalometric radiographs from 78 patients with impacted canines, 68 with dental agenesis and 17 with hyperdontia were collected. Linear dimensions of sella turcica were calculated and compared to those of a control group (47 individuals). A standardize scoring scale was used to quantify the extent of STB from each radiographs. RESULTS: The frequency of partial and complete calcifications of sella in patients with dental anomalies is increased when compared to controls. STB can influence the interclinoid distance but does not affect other linear dimensions of sella. No statistically significant difference has been found in sellar dimensions and STB expression when evaluating radiographs at different ages. CONCLUSIONS: STB is frequently found in patients with dental abnormalities.

Flexural strengths of conventional and nanofilled fiber-reinforced composites: a three-point bending test.

OBJECTIVES: The purpose of this study was to evaluate the effect of the introduction of nanofillers on the mechanical properties of fiber-reinforced composites (FRCs) for stabilization and conservative treatment of multiple traumatized anterior teeth. In particular, the aim of the research was to point out the force levels of two sizes (diameters 0.6 and 0.9 mm) of both conventional and nanofilled FRCs. METHODS: Eighty FRCs samples were divided into eight groups, each consisting of 10 specimens. Conventional (groups 1, 2, 3, and 4) and nanofilled (groups 5, 6, 7, and 8) FRC samples were evaluated. Each FRC was tested in two diameters (0.6 and 0.9 mm) and under two deflections (1 and 2 mm). Each sample was polymerized with the same halogen curing unit and then evaluated with a 3-point bending test on a universal testing machine after 48 h of dry storage. RESULTS: Nanofilled FRCs showed significantly higher load values than conventional FRCs. Moreover, 0.9-mm-diameter FRCs showed significantly higher load value than 0.6-mm-diameter FRCs. Specimens tested at 2-mm deflection showed significantly higher load values than those tested at 1-mm deflection. CONCLUSIONS: Nanofilled FRCs showed significantly higher load values than conventional FRCs. Higher flexural strength values were recorded with 1-mm deflection for both FRC tested.

Upper Airway Dimensions among Different Skeletal Malocclusions: A Retrospective Observational Study by Cephalometric Analysis.

The aim of the present work was to investigate the upper airway dimensions in adult non-orthodontic patients, equally divided according to their skeletal class. METHODS: In this retrospective cross-sectional study, lateral cephalometric radiographs of adult patients referred for orthodontic consultation were collected. Cephalometric tracing was performed with dedicated software. For each measure, descriptive statistics were calculated. Cephalometric measurements between the different skeletal classes were compared. Linear regressions were performed between upper airway diameters and cephalometric measurements, sex and age. Significance was predetermined for p < 0.05. RESULTS: Lateral cephalometric radiographs of 120 patients were reviewed. Nasopharynx length (NL) and depth (PD) measurements were significantly shorter in skeletal class III patients (p < 0.05). The superior pharyngeal airway space (SPAS) was found to be significantly shorter in class III patients as compared to class II patients (p < 0.05), and the mean airway space (MAS) of class I patients was found to be significantly shorter compared to class II patients (p < 0.05). Palate length (PL) values were found to be significantly longer in class I (p < 0.05). Linear regressions showed that the sella-nasion-A point angle (SNA) and Riedel's angle between point A, the nasion and point B (ANB) significantly influenced NL and PD (p < 0.05). CONCLUSIONS: Class III patients show significantly shorter nasopharynx measurements; clinicians should consider that this sagittal discrepancy could be related to an altered anatomy of the upper respiratory tract.

Effects of Froggy Mouth Appliance in Pediatric Patients with Atypical Swallowing: A Prospective Study.

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student's t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results.

Metallic vs Ceramic Bracket Failures After 12 Months of Treatment: A Prospective Clinical Trial.

INTRODUCTION: Orthodontic treatment with fixed vestibular appliances is still widely used worldwide. When choosing the aesthetic alternative of ceramic brackets, the possibility of failure and cracking of braces should be considered. Therefore, the aim of the present study was to compare the failure rates of ceramic and metal brackets in a 12-month clinical study. METHODS: Eighty patients undergoing fixed orthodontic treatment with vestibular appliances were enrolled and divided into 2 equal groups: MET for metal brackets and CER for ceramic brackets. After bonding, bracket failures were recorded for 12 months, along with the archwire placed at the time of failure. Angle's dental class, skeletal class, Wits appraisal, Little's irregularity index, overjet, overbite, age, and gender of the patients were recorded from pretreatment cephalometric tracings and study casts. The data were statistically analysed (P < .05). RESULTS: Significantly higher failure rates were found for ceramic brackets in the overall analysis, in the mandibular arch, and in the posterior region. Regression analysis revealed a significant influence of round nickel-titanium archwires on higher failure rates, whilst a significant influence of rectangular archwires was found on lower failure rates. CONCLUSIONS: Ceramic brackets showed higher failure rates. Patients should be aware that orthodontic treatment with ceramic brackets may involve delays and inconvenience due to the higher failure rate compared to metal brackets.

Disinclusion of unerupted teeth by mean of self-ligating brackets: effect of blood contamination on shear bond strength.

OBJECTIVES: The aim of this study was to assess the effect of blood contamination on the shear bond strength and failure site of three different orthodontic self-ligating brackets. STUDY DESIGN: 240 bovine permanent mandibular incisors were randomly divided into 12 groups of 20 specimens each. Orthodontic self-ligating brackets were tested under four different enamel surface conditions: a) dry, b) blood contamination before priming, c) blood contamination after priming, d) blood contamination before and after priming. Brackets were bonded to the teeth and subsequently tested using a Instron universal testing machine. Shear bond strength values and adhesive failure rate were recorded. Statistical analysis was performed using ANOVA and Tukey tests (strength values), and Chi squared test (ARI Scores). RESULTS: Non-contaminated enamel surfaces showed highest bond strengths for all self ligating brackets. Under blood-contamination shear bond strengths lowered for all brackets tested. Groups contaminated before and after primer application showed the lowest shear bond strength. Significant differences in debond locations were found among the groups under the various enamel surface conditions. CONCLUSIONS: Blood contamination of enamel during the bonding procedure lowers bond strength values of self ligating brackets, expecially when contamination occur in different times of the bonding procedure.

Effect of Magnetic Resonance Imaging at 1.5 T and 3 T on Temperature and Bond Strength of Orthodontic Bands with Welded Tubes: An In Vitro Study.

Magnetic resonance imaging (MRI) is a widely used diagnostic technique. Patients wearing orthodontic devices are often requested to remove their appliances before an MRI exam, even when the exam involves anatomical areas far from the head, in order to prevent the heating and detachment of the appliances. The present report aims to evaluate changes in temperature and adhesive forces of molar bands after MRI at two different strength outputs. Sixty stainless steel molar bands were bonded on permanent human upper molars using two different cements: Unitek Multi-Cure Glass Ionomer Band Cement (3M Unitek, Monrovia, CA, USA) and Transbond Plus Light Cure Band Adhesive (3M Unitek). Appliances were subjected to MRI with two different strengths (1.5 Tesla and 3 Tesla). Tubes and band temperature was measured before and after MRI. Subsequently, the shear bond strength (SBS) test was calculated. Data underwent statistical analysis (p < 0.05). After MRI, molar bands exhibited significant heating, even though not clinically relevant, with a temperature increase ranging between 0.48 °C and 1.25 °C (p < 0.05). SBS did not show significant differences (p > 0.05). The present study suggests that, under MRI, the molar bands tested are safe; therefore, their removal could be not recommended for non-head and neck MRI exams. Removal would be necessary just in artifact risk areas.

Orthodontic Fixed Retainer and Unwanted Movements of Lower Anterior Teeth: A Case Report.

The use of fixed retainers at the end of an orthodontic treatment has become a standard practice. Nonetheless, orthodontic relapse can still occur, requiring retreatment in the most severe cases. This case report describes a patient with a mandibular canine to canine fixed retainer presenting uncontrolled torque on all lower anterior teeth, probably due to tongue thrust and/or activation of the wire. Multibracket orthodontic treatment was performed, and an orthodontic lingual sectional was used to control (reposition) the root movement of the lower right cuspid. This case highlights the need for clinicians and patients to be aware of the potential problems associated with bonded retainers. In addition, patients with an orthodontic fixed retainer need regular short-term observation by an orthodontist in order to detect any adverse movements and long-term control by a general dentist.

Effect of Enamel Pretreatment with Pastes Presenting Different Relative Dentin Abrasivity (RDA) Values on Orthodontic Bracket Bonding Efficacy of Microfilled Composite Resin: In Vitro Investigation and Randomized Clinical Trial.

Bonding failure is a clinical issue frequently encountered in orthodontic practice. The aim of this study was to evaluate enamel pretreatment both in vitro and clinically using agents with different RDA values before brackets' bonding, to assess if RDA can affect the Shear Bond Strength (SBS), Adhesive Remnant Index (ARI) and clinical failure rate of orthodontic brackets. For the in vitro study, 220 bovine teeth were pretreated with agents with different RDA values. Subsequently, brackets were bonded. For the clinical study, 20 patients underwent bonding of 20 brackets each with a split-mouth design. Low and high RDA toothpastes were used for enamel pretreatment. SBS, ARI and failures were recorded. Higher SBS values were found for teeth pretreated with lower RDA agents; conversely, lower SBS values were found for teeth pretreated with higher RDA agents (p < 0.05). For high ARI values, RDA increased too (p > 0.05). In the clinical study, a significantly lower failure rate was reported for teeth pretreated with low RDA toothpaste (2.5% in low RDA group, 7.0% in high RDA group; p < 0.05). No significant differences were assessed comparing the two dental arches and anterior and posterior sites. Enamel pretreatment with low RDA toothpastes could increase brackets' survival rate. Further in vitro and clinical studies would be welcomed to confirm these findings.

Shear bond strength of deciduous and permanent bovine enamel.

PURPOSE: The use of bovine teeth as a substitute for human enamel has been proposed for dental studies. The aim of this study was to determine the shear bond strength and Adhesive Remnant Index (ARI) of deciduous and permanent bovine teeth. MATERIALS AND METHODS: Twenty deciduous and 20 permanent extracted bovine teeth were embedded in resin blocks. Stainless steel conventional orthodontic brackets were bonded to the teeth using an orthodontic adhesive. All samples were tested in shear mode on a testing machine. ARI scores were then recorded. Statistical analysis was performed to determine significant differences in bond strength and ARI scores. RESULTS: The bond strength of permanent bovine teeth was significantly higher (p = 0.0010) than that of the deciduous teeth. ARI scores showed no significant differences (p = 0.74). CONCLUSION: Deciduous teeth show lower shear bond strength than permanent teeth.

Skeletal Divergence and Condylar Asymmetry in Patients with Temporomandibular Disorders (TMD): A Retrospective Study.

INTRODUCTION: This study was aimed at evaluating the association between vertical skeletal patterns, condylar height symmetry, and temporomandibular disorders in adults. METHODS: The study sample consisted of 200 patients (ages 18-30 years old) retrospectively recruited: 100 with temporomandibular disorders (TMD) and 100 without TMD (control), diagnosed by Diagnostic Criteria for the Temporomandibular Disorders (DC/TMD). For each subject, skeletal divergence was assessed on lateral cephalograms, and condylar height symmetry was evaluated by orthopantomography (Habets' method). RESULTS: Subjects with temporomandibular disorders showed a strong association with condylar asymmetry (p < 0.0001) and, for the skeletal pattern variables, hyperdivergence (p < 0.001). A correlation with the female sex was also found (p < 0.04), while there was no difference in terms of age in the 2 groups (p > 0.29). CONCLUSIONS: Although it does not imply a direct cause-and-effect relationship, the present study suggests condylar asymmetry and hyperdivergent skeletal pattern are more likely to be associated with a higher risk of temporomandibular disorder joint diseases in adult patients.

Universal Adhesive for Fixed Retainer Bonding: In Vitro Evaluation and Randomized Clinical Trial.

This study aims to assess the efficacy of a universal adhesive (Scotchbond Universal, 3M ESPE) (SB) in total-etch mode, compared to a traditional orthodontic primer (Transbond XT Primer, 3M ESPE) (XT Primer), to perform bonding of orthodontic fixed retainers along with the Transbond XT Light Cure Adhesive Paste (3M ESPE). For the in vitro study, a round section wire (Ortosmail Krugg) was bonded using XT Primer for 20 bovine incisors (Group 1) and SB for other 20 (Group 2). Samples were debonded in a universal testing machine applying a tangential force to specimens (crosshead speed of 1 millimeter per minute). Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. For the in vivo study, 100 patients needing upper and lower canine-to-canine fixed retainers after orthodontic treatment were randomly assigned to two groups of 50 participants each, i.e., group 1 (retainer bonding with XT Primer) and group 2 (retainer bonding with SB). Over two years, examinations were carried out monthly, and detachments were registered by considering the teeth and arches affected. In vitro, no statistically significant differences in SBS and ARI scores were demonstrated between the two groups, both showing a mean bond strength of about 12 MPa and major frequency of ARI "2" (>50% remnant adhesive on the enamel). Conversely, a significantly lower failure rate over 2 years was assessed clinically for group 2 in both arches. Independently of the adhesive and arch, incisors reported a significantly higher failure rate than canines. Scotchbond Universal used in total-etch mode could be a valid alternative to the traditional orthodontic Transbond XT Primer.

Fear of the Relapse: Effect of Composite Type on Adhesion Efficacy of Upper and Lower Orthodontic Fixed Retainers: In Vitro Investigation and Randomized Clinical Trial.

The aim of this laboratory and clinical study is to determine the reliability of the flowable nanocomposite Filtek Supreme XTE (FL) for the adhesion of orthodontic retainers, compared to highly filled orthodontic resin Transbond XT (XT). Portions of a round section multistranded wire (Ortosmail Krugg) were bonded to 40 bovine incisors with Scotchbond Universal in total-etch modality. For group one (XT, 20 samples), the orthodontic resin was used, whereas in group two (FL, 20 samples), the flowable one. Specimens were placed into a universal testing machine which applied a shear force on retainers with a crosshead speed of one/minute. Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. In the clinical trial, 100 patients requiring a canine-to-canine palatal and lingual retainer were randomly divided into two groups, according to the resin used for bonding procedure: the orthodontic in group one (XT, 50 participants) and the flowable in group two (FL, 50 participants). Monthly visits were carried out over a 24-month follow up to assess any detachment occurring on teeth of both arches. All data were submitted to statistical analysis. In vitro, FL reported a significant lower mean SBS, whereas no significant differences in ARI were reported between the two groups which both showed a major frequency of scores "1" and "2". At the end of the 24-month follow up, FL reported significantly higher failure rates in both arches besides a significantly lower survival rate starting from the sixth month after retainers bonding. According to the results assessed in vitro and clinically, XT would be preferable to FL when performing retainers bonding procedure.

Orthodontic debonding and tooth sensitivity of anterior and posterior teeth.

OBJECTIVES: To assess whether orthodontic debonding and onset of tooth sensitivity were related and if anterior and posterior teeth showed different sensitivity. MATERIALS AND METHODS: 40 patients were divided into a trial group (group 1, at the end of the multibracket treatment) and a control group (group 2, not under treatment). After the application of compressed air and cold water to mandibular incisors and first molars, participants were asked to report the pain felt for each tooth using a 100-mm visual analogue scale. In group 1, assessment was performed just before debonding (T0), immediately after completion of debonding (T1) and 7 days after (T2). In group 2, values were assessed at the beginning of a follow-up visit (T0), at the end of the same visit (T1) and 7 days after (T2). RESULTS: Considering overall teeth, statistical analyses showed significantly higher values in the trial group at T1 after both stimuli, especially after cold water, besides a significant difference between T0 and T2 values in the same group. Anterior teeth showed significantly higher VAS scores than posterior after the two thermal stimuli, except after air stimulation in group 1 at T2 and in group 2. CONCLUSIONS: Orthodontic debonding leads to sensitivity to thermal stimuli especially in the anterior teeth, however pain level is restored within 7 days.

Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating).

BACKGROUND: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. METHODS: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. RESULTS: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53-20.95), while the percentage reduction was 94.8% (CI 95% 91.91-97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. CONCLUSIONS: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes.