Buccal Alveolar Bone changes and upper first molar displacement after maxillary expansion with RME, Ni-Ti leaf springs expander and Tooth- Bone-borne Expander. A CBCT based analysis.

AIM: To evaluate the buccal alveolar bone changes and the upper first molar displacement in subjects treated with conventional rapid maxillary expansion (RME), Ni-Ti leaf springs expander (Leaf Expander) and Tooth-Bone-borne Expander (Hybrid Expander) using CBCT scans. METHODS: The sample consisted of 52 children treated with RME (n=18), Leaf Expander (n= 17) and Hybrid Expander (n= 17). CBCTs were taken before and after maxillary expansion and the Horos software was used for the analysis. Descriptive statistics and paired t-test were used to assess changes between the pre-treatment and post-treatment measurements. ANOVA test and Tukey's post hoc test with Bonferroni correction was used for between groups comparison. CONCLUSION: The Hybrid Expander during preadolescence showed few advantages over the use of tooth-anchored expanders. An expansion approach with mini-screws is not preferable during early mixed dentition to a conventional approach. The differences in dental tipping values were clinically insignificant and the reduction in cortical bone thickness remained less than 1 mm. When possible, the use of second primary molars as anchorage should be preferred.

Fake academic writing: ethics during chatbot era.

"Professor, have you ever seen anything like this?". Few weeks ago I was asked this question by two young and esteemed specialist in orthodontics of my research group, actually PhD students, who showed me a laptop screen. "No, I have never seen anything so potentially extraordinary. But doubts arise: is this legal? Or rather, is it ethical for us to use it in the field of research?" So I asked the questioners, Dr. Serafin and Dr. Bocchieri, to write a short essay on this new form of artificial intelligence, the chatbots, to give me an idea of what they are, what their potential is, and how they can change the veracity of data when an artificial mind replaces a human one. After "letterally" 5 minutes, they returned to me and let me read the following: The rapid advancement of artificial intelligence (AI) technology has led to a proliferation of AI-powered tools that are having a significant impact in the realm of academic writing to automate various aspects of the editorial process, from research to proofreading and even generating complete high-quality scientific articles. Chatbots are AI-virtual assistants that offer significant benefits but there are also important ethical considerations that must be considered. One concern is related to the accuracy and reliability of AI-generated content, particularly in scientific writing where accuracy is of utmost importance. There are also concerns about the potential for AI to be used to produce plagiarized or fraudulent content, which could undermine the credibility of scientific soundness. To mitigate this risk, it is crucial to establish clear guidelines and regulations for their use. Additionally, academic institutions and publishers should take steps to verify the authenticity of authors and promote transparency and accountability in the publishing process. The use of chatbots in academic writing has the potential to revolutionize the way in which research is conducted and written. However, it is important to ensure that the ethical implications of this technology are carefully considered and addressed. This includes ensuring that AI-generated content is accurate, reliable, and trustworthy and that the use of AI does not result in the displacement of human imagination. To address these ethical considerations, it is recommended that academic institutions and scientific journals work together to establish clear guidelines and regulations for the use of AI in academic writing, ensuring that AI-powered tools are ethical. By taking a responsible approach, we can ensure that the benefits of this technology are realized while minimizing any potential negative consequences. Finally, the most important but missing information is that this editorial is fully written by a chatbot. Therefore, pay attention: the search for health for our patients must go through scientific honesty that produces data and analyzes them "humanly". I share my amazement, but also my concern. As a university professor, as a clinician, as a researcher, but also as a "father" of future orthodontists, I always have doubts about the message we want to leave, and in this editorial I would like to reproduce an excerpt from a conversation with Marco and Salvo, as if we were discussing the legitimacy of cheating in a card game.

Comparison of cephalometric changes in Class II growing patients with increased vertical dimension after high-pull and cervical headgear treatment.

AIM: The aim of the present study was to evaluate the cephalometric changes in growing Class II patients with increased vertical dimension treated with cervical or high-pull headgear, by using an untreated control group with similar skeletal characteristics. MATERIALS: From the initial sample, 56 patients satisfied the inclusion and exclusion criteria; 20 patients were treated with cervical headgear (CHG), 15 with high-pull headgear (HHG), and 21 were not treated (CG). Cephalograms were available for each subject at baseline (T1) and after treatment/observation time (T2) for the three groups. A total of 17 measurements were taken on the lateral head films. Group comparison among CHG, HHG and CG was done using ANOVA test. CONCLUSION: In Class II high-angle growing patients, cervical headgear seems to be preferred in the correction of maxillary protrusion, molar relationship and increased anterior facial height. Extrusion of the upper molar may favour forward repositioning of the mandible and clockwise rotation in Class II patients with increased vertical dimension.

Paediatric Orthodontics Part 2: Periodontal effects of maxillary expansion.

AIM: Both rapid and slow maxillary expansion protocols may produce different effects on the palatal suture, on the periodontium, and on alveolar anatomy such as lateral flexion of the alveolar processes, root resorption, bone fenestration and the anchorage teeth can show different degrees of inclination and dislocation. In order to reduce these side effects, maxillary expansion devices anchored to deciduous teeth or miniscrew-supported appliances should beconsidered.

3D facial soft tissue changes after rapid maxillary expansion on primary teeth: A randomized clinical trial.

OBJECTIVES: The aim of the present randomized controlled trial (RCT) was therefore the tridimensional evaluation of soft tissue changes after rapid maxillary expansion in growing patients. SETTING AND SAMPLE POPULATION: Treated group comprised 17 patients (10 males and 7 females) with a mean age of 9.8 ± 1.2 years, and control group comprised 17 patients (13 males and 4 females) with a mean age of 9.1 ± 2.1 years. MATERIAL & METHODS: All patients of the treated group underwent maxillary expansion with Haas-type expander while patients of the control group underwent no treatment. 3D facial scans were acquired at T1, at the beginning of treatment or observation period, and at T2, 18 months apart. The mean interval between the timepoints was 18.2 ± 0.4 months. RESULTS: The main differences between groups were reported in the nasal area. Nasal width (Alr-All) significantly increased in the treated group compared with the control. The increase in intereye and mouth width in the study group did not show differences with the control group. No significant differences were reported for lips' protrusion, angular measurements and facial heights between groups. The total nose volume difference was significantly higher in the treated group compared with control, and this result was related mainly to the significant increase in the nasal dorsum volume. CONCLUSION: Maxillary expansion produced significant increase in the nasal base and nasal volumes, but its clinical relevance is still questionable.

Cephalometric changes after headgear anchored to the deciduous second molars in the early mixed dentition.

AIM: The present study aimed to evaluate the cephalometric effects of a headgear anchored to the deciduous second molars in the early mixed dentition. MATERIALS AND METHODS: Study design: The study followed a retrospective longitudinal design and enrolled 31 consecutive patients (17 females and 14 males) treated with high pull (HP) headgear anchored to the deciduous second molars, average age 8y 5m± 5m at pre-treatment time (T0) and 9y 8m± 6m at post-treatment time (T1). All the patients wore the headgear for approximately 8-10 hours at night, with a force of 250 g per side. The active phase of treatment ended once patients obtained a distal step on permanent molars of at least 2 mm. Lateral cephalograms at T0 and T1 were taken; 10 angular measurements were chosen as variables of the study. The paired sample t-test was employed to assess the significance of the differences of each variable between T0 and T1. RESULTS AND CONCLUSION: In this group of Class II patients, HP headgear anchored to the deciduous second molars in the early mixed dentition produced: significant reduction of SNA angle, significant increase of SN/NL angle with no significant change in SN/ML angle, significant labial flaring of upper incisors. As clinically evaluated, the correction of the Class II occlusal relationship and the anterior crowding of maxillary arch were also accomplished.

Effects of rapid vs slow maxillary expansion on nasal cavity dimensions in growing subjects: a methodological and reproducibility study.

AIM: To evaluate the methodological feasibility of a RCT comparing skeletal changes of nasal cavity size obtained with RME and SME, assessed via CBCT. MATERIALS AND METHODS: Twenty Caucasian children with a mean age of 10.4 years were recruited and allocated to receive RME (10 subjects, mean age 10.4 years) or SME (10 subjects, mean age 10.5 years). INCLUSION CRITERIA: constricted maxillary arch, upper and lower first molars erupted, unilateral or bilateral posterior crossbite. EXCLUSION CRITERIA: age above 15 years, history of previous orthodontic treatment, periodontal disease, systemic disease affecting craniofacial growth, or craniofacial congenital syndrome. CBCT examinations were performed before treatment (T0) and 7 months after expander removal (T1). Changes of nasal width (NW), palatal width (PW) and total nasal volume (TNV) were assessed; palatal and nasal expansion was also calculated as a percentage of the increase of intermolar width IMW (PW% and NW%). RESULTS: The correlation between the first and the second readings ranged from 0.991 to 0.995 for linear measurements and was of 0.915 for volumetric measurements. The method error, as described by the value of ?, was in general less than 0.3 mm for linear measurements and 0.372 cm³ for volumetric measurements. All linear transverse skeletal and dental measurements and the nasal volume increased with both RME and SME protocols. CONCLUSION: The reported methodology can be reasonably used to investigate the transverse dimension of nasal cavity. The PW% and NW% parameters more accurately described the efficacy of the two expansion protocols as compared to their corresponding absolute measurement (PW and NW).

Evaluation of masseter muscle in different vertical skeletal patterns in growing patients.

AIM: The present study aimed to evaluate the relationship between masseter size, maxillary intermolar width and craniofacial vertical skeletal pattern. STUDY DESIGN: The study followed a prospective longitudinal design and enrolled 61 subjects (30 males and 31 females), 9-14 years of age (mean age 11.5) at 2-3 CVM stage. The participants were divided into three groups based on their vertical skeletal pattern which was estimated using the Frankfurt-mandibular plane angle: low-angle group (L-A), normal-angle group (N-A), high-angle group (H-A). An additional gender-based distinction was made. Maxillary intermolar width was measured on the maxillary cast of each patient by means of an electronic caliper; masseter volume was estimated by using magnetic resonance (MR) and masseter thickness was measured by means of ultrasonography (US). The US registrations were performed during the relaxation state (RS) and the maximum voluntary contraction (MVC) of the muscle. The indipendent samples T- test was used for sex comparisons; the analysis of variance test (ANOVA) was used to evaluate the differences between the three groups in males and females, and the Pearson r correlation coefficient was employed to assess the correlation between maxillary intermolar width and masseter volume. RESULTS AND CONCLUSION: Maxillary intermolar width, masseter volume and thickness showed significant gender differences; all the tested variables decreased significantly according to the facial vertical pattern, with greater values in females, especially in low- and normal-angle subjects; maxillary intermolar width and masseter volume showed significant correlations, higher in females.

Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

AIM: The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. METHODS: A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. RESULTS: Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. CONCLUSIONS: In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

Multimodal airway evaluation in growing patients after rapid maxillary expansion.

AIM: The objective of this study was to evaluate the airway volume of growing patients combining a morphological approach using cone beam computed tomography associated with functional data obtained by polysomnography examination after rapid maxillary expansion treatment. STUDY DESIGN: 22 Caucasian patients (mean age 8.3±0.9 years) undergoing rapid maxillary expansion with Haas type expander banded on second deciduous upper molars were enrolled for this prospective study. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). METHODS: Image processing with airway volume computing and analyses of oxygen saturation and apnoea/hypopnoea index were performed. RESULTS: Airway volume, oxygen saturation and apnea/hypopnea index underwent significant increase over time. However, no significant correlation was seen between their increases. CONCLUSION: The rapid maxillary expansion treatment induced significant increases in the total airway volume and respiratory performance. Functional respiratory parameters should be included in studies evaluating the RME treatment effects on the respiratory performance.

Maxillary molar distalization therapy in adult patients: a multicentre study.

OBJECTIVES: To evaluate dento-skeletal changes following conventional anchorage molar distalization therapy in adult patients. SETTING AND SAMPLE POPULATION: Thirty-three patients (25 women, mean age 23 years 1 months ± 3 months; 8 men, mean age 28 years 3 months ± 7 months) were recruited from 4 Board Certified specialists. All subjects underwent molar distalization therapy using intra-oral distalizing appliances. SUBJECTS AND METHODS: Cephalometric headfilms were available for all subjects before (T1) and at the end of comprehensive treatment (T2). The initial and final measurements and treatment changes were compared by means of a paired t-test. RESULTS: Mean total treatment time was 3 years 2 months ± 6 months. Maxillary first molar distalized 2.9 ± 0.6 mm contributing 64.4% to Class II molar correction, whereas mandibular first molar showed a concomitant mesial movement of 1.6 ± 0.5 mm. Maxillary incisors retroclined an average of 5.8° ± 3.9°, lower incisors proclined 4.1° ± 1.1° and the occlusal plane rotated downwards and backwards 1.8° ± 2.1°. Clockwise rotation of the mandible (1.7° ± 0.5°) and increase in lower facial height (2.5 ± 1.5 mm) were also observed. CONCLUSIONS: Maxillary molar distalization therapy can be successfully performed in adult patients despite a slight increase in vertical facial dimension should be considered.

Profile changes following lower incisor repositioning: a comparison between patients with different growth pattern.

AIM: Individual growth changes might play a large role in the variability of treatment results for the soft-tissue profile. The aim of this study is to evaluate the real existence of the relationship between the repositioning of lower incisors, evaluated by Frankfort Mandibular Incisor Angle (FMIA), and the enhancement of profile, evaluated by the angle formed by its intersection with Frankfort plane (Z-angle). We finally compared this relationship in patients with different growth pattern. METHODS: A sample of 81 subjects all treated with Merrifield Directional Force System was divided in two group on the basis of INDEX value (ratio between posterior and anterior facial height): Group 1 (INDEX value ≤0.65, non-favorable growth pattern) and Group 2 (INDEX value >0.65, favorable growth pattern). Differences between post-treatment and pre-treatment values of FMIA and Z-angle were calculated for each group and was named respectively ∆ FMIA and ∆ Z-angle. A ratio between ∆ Z-angle and ∆ FMIA was also calculated. RESULTS: The results of this study show a statistically significant correlation between lower incisors uprighting and profile outcome. A statistically significant difference between Group 1 and Group 2 was not found. CONCLUSION: These results underline the difficulty to quantify and separate the effects of growth and orthodontic treatment of growing patients in determining the final facial configuration.

Meta-analysis of the prevalence of tooth wear in primary dentition.

AIM: To conduct a meta-analysis of all the studies published in literature over the past three decades on the prevalence of dental erosion in preschool children. MATERIALS AND METHODS: The Pubmed data base revealed only one systematic review on the prevalence of tooth wear in children up to 5 years old. The search included works published from January 1982 to September 2012, using the following combinations of keywords: 1) "dental erosion" AND "children"; 2) "dental erosion in primary dentition"; 3) "dental" AND "attrition" AND "prevalence". The inclusion criteria for papers on tooth wear were the deciduous dentition observed only on the palatal and buccal sides with the distinction of erosion, attrition and abrasion. We took into consideration only randomized control trials. We excluded articles not written in English, case reports, historical and forensic studies, in vitro and in vivo studies. In case of doubt and/or when an abstract was not available, the full text copy of the article was examined. The first search on Pubmed revealed 29 articles, the same found in the study of Kreulen [2010], however we selected only multicentric studies focused on children of age below 5 years old, in which only the primary dentition (D) and only anterior teeth (incisors) were considered. RESULTS: Both forest plot and scatter plot showed the prevalence of dental erosion in primary dentition, and that older children had a more severe dental erosion. CONCLUSION: Dental erosion should be considered a paediatric dentistry pathological entity as well as dental caries, and it can be related to more severe systemic diseases such as Gastroesophageal reflux disease. In addition, taking care of these little patients is important because they might suffer persentiveness, and also pulpal pathology caused by the typical structure of deciduous teeth, where the pulp cavity is wide and close to the dentine and the enamel.

Bilateral cross-bite treated by repeated rapid maxillary expansions: a 17-year follow-up case.

BACKGROUND: The objective of this paper is to show the clinical results after the repeated application of a Haas expander for rapid maxillary expansion (RME) anchored onto deciduous teeth in a 7-year-old patient that presented bilateral cross-bite, superior crowding and no space for permanent lateral incisors eruption. CASE REPORT: A first Haas expander was applied to the patient. She was told to activate it once a day, each activation was equal to 0.20 mm. After the first RME, the bilateral cross-bite was solved but still there was not enough space for lateral incisor eruption. A second and then a third Haas expander were applied, with the same activation protocol as the first one, in order to gain space in the anterior region and to achieve proper eruption of the lateral incisors. The patient was then treated with fixed appliances. At debonding the patient presented well aligned arch-forms: space for lateral incisor eruption was gained and superior crowding was solved. Bilateral cross-bite was also corrected. She was seen again 10 years and 17 years after expansions: she showed no relapse and presented a good functional occlusion that had remained stable, and an aesthetically pleasant smile, however she exhibited gingival recessions. CONCLUSION: Repeated rapid maxillary expansion, anchored onto deciduous teeth, performed in early mixed dentition represents a safe and successful treatment to correct severe bilateral cross- bites and to create space for maxillary incisor eruption.

Intrusive luxation of primary upper incisors and sequelae on permanent successors: a clinical follow-up study.

AIM: The purpose of this report is to evaluate the epidemiological aspects of intrusion that occur against upper incisors in primary dentition, to determine the statistic correlation of developmental disturbances to permanent teeth in relation to age of children at the time of trauma. MATERIALS AND METHODS: A retrospective study was performed based on radiographic and clinical data of 34 intruded incisors in 30 patients aged between 12 and 60 months. Baseline data were collected in a questionnaire designed following the guidelines of the IADT-Italy. The descriptive statistical analysis between the different variables was performed with the Chi-squared test and the level of significance was set at 5%. The following parameters were considered: gender, age of patient at the time of injury, emergency treatment, clinical signs (vitality, mobility, spontaneous pain, colour change), presence of complications, degree of spontaneous re-eruption and possible developmental disorders to the following tooth. RESULTS: Intrusive luxation is not statistically related to gender. During the first 6-month follow-ups, 20 incisors belonging to 12 subjects aged between 12-24 months at the time of intrusion exhibited pulpal necrosis. The highest rate of total spontaneous re-eruption occurred in incisors intruded at 12-24 months. The likelihood of spontaneous re-eruption decreased with the child's age. A significant correlation between mobility at clinical follow-up and developmental disorders in permanent teeth was found, whereas a statistical correlation between age of patient at the time of trauma and sequelae was not pointed out, even if 17 primary incisors intruded at 12-24 months did not develop an arrest of root formation. CONCLUSION: The most traumatic intrusions in primary dentition occurs between 12 and 24 months of age, the most common cause being fall while walking. Intruded incisors with moderate mobility developed enamel hypoplasia and ectopic eruption. There was no significant correlation between age at the time of intrusion and type of subsequent developmental disturbances.

A long-term retrospective clinical study on MTA pulpotomies in immature permanent incisors with complicated crown fractures.

AIM: The study was undertaken to evaluate mineral trioxide aggregate (MTA) clinically and radiographically as a pulpotomy agent in immature permanent teeth whose pulps were exposed by a complicated crown fracture. MATERIALS AND METHODS: Thirty incisors with exposed pulps in twenty-nine patients were examined for this retrospective study. According to exclusion criteria, only twenty-seven teeth were selected. Each tooth was treated with partial pulpotomy and the wounded pulp was covered with mineral trioxide aggregate. The children were recalled for clinical and radiographic evaluation at 3 months, 6 months, at approximately 12 months and 36 months. RESULTS: Out of 27 cases, 22 were categorized as 'healed' and 1 as 'healing'. The remaining 4 ones highlighted persistent disease and needed further endodontic treatment. CONCLUSION: MTA partial pulpotomy is an effective treatment in maintaining pulpal vitality and allowing physiological root development (apexogenesis).

Efficacy of orthopedic treatment with protraction facemask on skeletal Class III malocclusion: a systematic review and meta-analysis.

The objective of this systematic review was to estimate the efficacy of protraction facemask on the correction of Class III malocclusion in the short term. A systematic review of articles was performed using different electronic databases (PubMed, Ovid, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, and Google Scholar). Search terms comprised 'orthopedic treatment' and 'Class III malocclusion'. The selection criteria were set in order to include in this review only randomized clinical trials (RCTs) performed treating with facemask Class III growing patients. Studies' selection, data extraction, and risk of bias's assessment were executed independently by two authors using pre-defined data forms. All pooled analyses of data were based on random effects models. A pre-specified subgroup analysis was planned to evaluate the effect of preliminary rapid palatal expansion on facemask efficacy. Three RCTs met our inclusion criteria. In total, data from 155 patients (92 treated and 63 controls) were collected. The treated group showed the following significant changes: ANB° +3.66° [95%CI (2.58, 4.74)]; SNA° +2.10 [95%CI (1.14, 3.06)]; SNB° -1.54 [95%CI (-2.13, -0.95)]; SN-palatal plane -0.82° [95%CI (-1.62, -0.02)]; and SN-mandibular plane +1.51 [95%CI (0.61, 2.41)]. Heterogeneity varied from low to moderate (mean I(2) value: 41.4 ± 20.8). Facemask is effective correcting Class III malocclusion in the short term. The skeletal modifications induced by facemask are forward displacement of maxilla, backward displacement of mandible, clockwise rotation of the mandibular plane, and counterclockwise rotation of the maxillary plane.

pH of tooth surface in healthy adolescents at rest and after a glucose rinse: effect of 72 hours of plaque accumulation.

AIM: This study was performed to evaluate the effect of a glucose rinse and of plaque accumulation on pH of tooth surface in healthy adolescents with a device used in gastroenterology and never tested in the oral cavity. MATERIALS AND METHODS: Values of pH were monitored in 12 adolescents using a portable device (pH-day 2® Menfis, bioMedica S.r.l., Bologna, Italy) with a disposable antimonium electrode kept in contact with the interproximal surface of the upper molars for 40 minutes respectively before and after a one-minute rinse with 10 ml of a 10% glucose solution. The same procedure was repeated in the same subjects after 72 hours of plaque accumulation. RESULTS: The device tested resulted difficult to use on the tooth surface because of the size of the active part of the probe. The glucose rinse caused a statistically significant decrease of the mean pH, restrained in basal conditions (d = -0.16, p <0.05), clinically relevant after plaque accumulation (d = -1.24, p <0.05). Time in minutes of pH < 6 grew considerably only in case of combination of plaque accumulation and glucose rinse (d = 20.90, p <0.05). A Stephan's curve of drop and recover of the pH values was not recorded. CONCLUSIONS: The continuous recording of pH of natural plaque present on the tooth could represent an alternative to other techniques found in literature. More studies are necessary to verify the suitability of this new device for the monitoring of pH in the oral cavity.

Spontaneous correction of anterior crossbite by RPE anchored on deciduous teeth in the early mixed dentition.

AIM: The purpose of this study was to evaluate the effectiveness of Haas RPE anchored on deciduous teeth in the early mixed dentition, for inducing the spontaneous correction of permanent incisor's crossbite, without compliance, without post bite-plane and no involvement of the permanent teeth. MATERIALS AND METHODS: The sample group comprised 50 consecutive patients (mean age 8y 5m, SD 2y 1m), 31 males, 19 females. They showed a cross-bite affecting one or more permanent incisors, for a total of 70 teeth. The patients were treated with Haas RPE appliance anchored on second deciduous molars and bonded on deciduous canines. No direct forces were applied on the permanent teeth. RESULTS: Anterior crossbite self-corrected 'spontaneously' in 84% of the cases. Lateral incisors had a higher rate of self-correction than central incisors. All hyper-divergent subjects showed a spontaneous crossbite self-correction. CONCLUSION: The early maxillary expansion by Haas RPE anchored on deciduous teeth is an efficient and effective procedure to induce the anterior crossbite self-correction in the early mixed dentition without the need of a bite-plane, no involvement of the permanent teeth and without compliance.

Condylar morphology in growing patients related to vertical dimension.

AIM: Aim of the study was to evaluate the mandibular morphology, especially the condylar one, in growing patients, according to the different vertical patterns. The objective was to analyze which condylar dimensions significantly vary in low, normal and high angle divergency growing patients with the use of the orthopantomogram (OPG). METHODS: From a database of randomly selected 514 patients, 96 subjects (48 males and 48 females) with skeletal Class I according to lateral cephalograms were selected and divided in three equal groups in relation to their vertical dimension (32 low FMA angle, 32 normal FMA angle and 32 high FMA angle). Each patient was examined with three OPGs at three different stages of dentition. OPGs were taken at the time of initial observation (T0 = first transitional phase of mixed dentition), after an average time of 12±1 months (T1=inter-transitional phase of mixed dentition) and after 36±3 months (T2=second transitional phase of mixed dentition). The radiological technician and the radiologic device were the same for each x-ray. On each OPG, condylar and mandibular ramus morphology of both sides was traced. Eleven linear and angular measurements were reported on each tracing. Data were analyzed by Wilcoxon's signed rank test and the Student's t-test. RESULTS: The study showed different condylar characteristics according to the vertical patterns. Differences were evident between males and females. CONCLUSION: The length of the mandibular ramus resulted longer in short-face patients respect to long-face subjects.