The Efficacy of the RME II System Compared with a Herbst Appliance in the Treatment of Class II Skeletal Malocclusion in Growing Patients: A Retrospective Study.

(1) Background: The objective of this study was to evaluate the efficacy of the Rapid Maxillary Expander (RME) II System compared to a Herbst appliance and a control group in the treatment of class II skeletal malocclusions in growing patients. (2) Methods: A total of 30 class II patients treated using the RME II System (group R) were compared with 30 patients treated with a Herbst appliance (group H) and 30 untreated class II children (group C). Cephalograms were compared at the start (T0) and after 24 months (T1). Nine cephalometric parameters were analyzed: SN-MP, SN-PO, ANB, AR-GO-ME, AR-GO-N, N-GO-ME, SN-PP, LFH, CO-GN, 1+SN, IMPA, OVERJET, and OVERBITE. Since the variables failed the normality test, a Wilcoxon test was performed for a pairwise comparison of the cephalometric measurements taken at T0 (pre-treatment) and at T1 (post-treatment). ANOVA with Tukey post hoc correction was used to evaluate the differences among the groups. (3) Results: ANOVA showed a statistically significant difference for all analyzed variables except for AR-GO-ME, AR-GO-N, and N-GO-ME. Post hoc Tukey's HSD test showed the following difference: the SN-PO angle in group H was 3.59° greater than in group R; the LFH in group H was 4.13 mm greater than in group R. The mandibular length (CO-GN) in group H was 3.94 mm greater than in group R; IMPA in group H was 6.4° greater than in group R; and the ANB angle in group H was 1.47° greater than in group R. (4) Conclusions: The RME II System is an effective therapeutic device for class II skeletal malocclusion treatment in growing patients.

Botulinum Toxin Type A and Hyaluronic Acid Dermal Fillers in Dentistry: A Systematic Review of Clinical Application and Indications.

Background: Botulinum toxin type A (BoNT-A) and hyaluronic acid (HA) dermal fillers are increasingly utilized in dentistry for therapeutic and aesthetic purposes. However, a comprehensive synthesis of their clinical applications and indications in dentistry is lacking. This systematic review aimed to analyze the clinical application and indications of BoNT-A and HA dermal fillers in dentistry, providing insights into their efficacy, safety profiles, and limitations. Methods: A systematic search was conducted in PubMed/MEDLINE databases to identify relevant studies published between 2018 and 2024. Medical Subject Headings (MeSH) terms and keywords related to BoNT-A, HA dermal fillers, dentistry, clinical applications, and indications were used. Study selection criteria included randomized controlled trials (RCTs) and non-RCTs involving human participants of any age group. Data extraction and synthesis followed established guidelines, focusing on study characteristics, participant demographics, intervention details, outcome measures, and key findings related to BoNT-A and HA dermal fillers' clinical application in dentistry. Results: Systematic searches across electronic databases and grey literature identified 857 records, with an additional 73 from hand searches. After screening titles and abstracts, 542 records were excluded, leaving 374 full-text publications for evaluation. Ultimately, 12 RCTs and 13 non-RCTs were included. The systematic review encompassed diverse geographic locations: Brazil, Italy, Spain, Syria, India, Egypt, Korea, and the Netherlands, involving samples sizes ranging from 14 to 143 participants. The review synthesized findings on HA's efficacy in various areas, including bone repair, gingivitis management, temporomandibular joint disorders, postoperative swelling reduction, periodontal defect treatment, chin and check projection and lips augmentation. BoNT-A exhibited promising efficacy in managing orofacial pain conditions, gummy smile treatment and neuromodulation of the lower third muscles. Safety profiles varied among studies, with some reporting minimal adverse effects while others noted dose-related concerns. Conclusion: BoNT-A and HA dermal fillers offer a wide array of clinical applications in dentistry, ranging from therapeutic interventions to aesthetic enhancements. Despite promising efficacy, careful consideration and monitoring of safety outcomes are essential when integrating these interventions into clinical practice. Further research addressing methodological limitations and safety concerns is warranted to optimize their utilization and improve patient care in dentistry.

Evaluation of occlusal force in Class II subdivision malocclusion.

BACKGROUND: Class II subdivision is a malocclusion characterized by dental and functional asymmetry that is difficult to manage. Impaired muscle function can result in asymmetrical growth, leading to occlusal instability. OBJECTIVE(S): The study aimed to assess occlusal force in patients with Class II subdivision malocclusion using Innobyte. Additionally, the discrepancies of force generated at the position of maximum intercuspidation between the left and right sides of the arches were evaluated. METHODS: The occlusal force of 66 patients with Class II subdivision malocclusion (group S) was measured and compared with that of 66 patients with Class I (group I) and 66 patients with Class II malocclusion (group II). The S group patients had a Class I molar on the right side and a Class II molar on the left side. ANOVA test, followed by the Games-Howell post hoc test, was performed to compare the mean of the total force among the groups. To assess the difference in force between the right and left arches, one-way ANOVA test followed by Tukey's post hoc comparison was performed. Finally, a boxplot was created to show the trend of occlusal force recorded in the three groups of patients. RESULTS: The occlusal force differed significantly among the groups (p < .001). Post hoc Games-Howell analysis showed significant differences as follows: the total force in group S was 165.24 N greater than in group II and in group I was 218.06 N greater than in group II. The difference (right-left) in total force between the groups was statistically significant (p < .001). Tukey's post hoc test showed following significant correlation: in group S was 53.51 N greater than in group II and 63.12 N greater than in group I. CONCLUSIONS: Among the analysed groups, patients with Class II malocclusion exhibited the lowest value of occlusal force. In patients with Class II subdivision malocclusion, force asymmetry, characterised by a higher value on the Class I side and a lower value on the Class II side was observed.

Skeletal and dental effects of function-generating bite appliance compared to rapid palatal expander and untreated controls.

INTRODUCTION: Maxillary expansion is a fundamental interceptive orthodontic treatment, which can be achieved through either a rapid expansion protocol or functional devices. However, no data exist about the efficacy of functional devices in achieving skeletal expansion. Therefore, the aim of this study was to compare the effects of the rapid palatal expander (RPE) and the function-generating bite type M (FGB-M) on the transversal dimension of the maxilla, and on the maxillary and mandibular dental arch width. METHODS: One hundred eighty-one skeletal Class I patients, aged between 6 and 12 years and with a cervical vertebral maturation stage II or III, with maxillary transversal deficiency were retrospectively enrolled; among these 55 were treated with FGB-M, 73 were treated with RPE and 51 were untreated subjects retrieved from historical databases. The pre-treatment (T0) and post-treatment (T1) frontal cephalograms were retrieved, and the maxillary and mandibular widths, and the distance between upper and lower first molars were measured. T1-T0 interval was of 17.3 months (RPE), 24.6 months (FGB-M) and 18.2 months (controls). RESULTS: The statistical analysis showed that there were no statistically significant differences between the RPE and FGB-M groups regarding skeletal and dental expansion, while the untreated control group differed significantly from the other two groups. CONCLUSION: The comparison between patients treated with RPE and FGB-M showed that there were no statistically significant differences between the RPE and FGB-M groups regarding the amount of skeletal expansion and dental arch width, suggesting that both appliances can be used to achieve similar results.

Treatment of Mandibular Impacted Canine in a Patient with Class II Division 1 Malocclusion with "Reverse Pin": A Case Report.

This case report presents an orthodontic treatment conducted on a 13-year-old girl with bilateral Class II malocclusion and a mandibular impacted canine. The presence of an impacted tooth necessitates careful consideration of the timing of orthodontic treatment, the appropriate surgical procedure to expose the tooth, the specific orthodontic mechanics involved, and the potential problems that may arise, all of which depend on the type and location of the canine impaction in the jaw. The treatment plan included a surgical procedure to expose the impacted tooth and orthodontic traction to guide it into position. Correction of the Class II Division 1 malocclusion utilized a specialized technique called the "reverse pin", reducing vertical side effects. The revised version maintains clarity and key information about the case report and treatment.

The efficacy of a modified mandibular advancement device for OSA treatment in a group of adult patients.

OBJECTIVE: The Mandibular Advancement Device (MAD) is actually recommended for the treatment of Obstructive Sleep Apnea (OSA) with mild or moderate severity. The present study evaluated the effects of a fully customizable MAD-type device (It Makes You Sleep, IMYS), in patients with moderate-to-severe OSA. METHODS: Twenty-nine patients (15 men and 14 women; mean age 62, SD ±10 years) were retrospectively enrolled. Home Sleep Apnea Testing ;(HSAT) was performed for all patients at baseline (T0) and after three months (T1) of IMYS therapy. The analyzed respiratory parameters were: Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), Minimum Oxygen Saturation (minSO2) and Medium Oxygen Saturation (medSO2). RESULTS: From T0 to T1, a significant reduction of AHI and ODI was reported, as well as a significant increase of minSO2 and medSO2. CONCLUSION: The IMYS device could be an effective MAD appliance for treating moderate-to-severe OSA.

Correlation between dental arch form and OSA severity in adult patients: an observational study.

BACKGROUND: The role of interdental widths and palatal morphology on the development of obstructive sleep apnea (OSA) has not been well investigated in adult patients yet. The aim of this paper was to assess the morphology of maxilla and mandibular dental arches on three-dimensional (3D) casts and to correlate these measurements with the severity of OSA. METHODS: Sixty-four patients (8 women and 56 men, mean age 52.4) with a diagnosis of mild-to-moderate OSA were retrospectively enrolled. On each patient, home sleep apnea test and 3D dental models were collected. Apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were recorded, as well as the dental measurements including inter-molar distance, anterior and posterior widths of maxillary and mandibular arches, upper and lower arch lengths, palatal height, and palatal surface area. The respiratory and dental variables were then correlated. RESULT: A statistically inverse correlation was found between ODI and anterior width of lower arch, maxillary arch length, palatal height, and palatal area. AHI showed a significant inverse correlation with anterior width of mandibular arch and maxillary length. CONCLUSION: A significant inverse correlation between maxillary and mandibular morphology and respiratory parameters was shown in the present paper.

Twenty eight months marginal bone level follow-up of an immediate post-extractive implant with immediate definitive loading.

OBJECTIVE: The aim of this case report was to show the marginal bone level (MBL) variation, after 28 months, around an aesthetic post-extraction implant immediate loading positioned in a 46-years-old woman. MATERIAL AND METHODS: After a careful evaluation of the X-rays and CBCT images, a 4×13 conical implant was placed in seat 21 after the atraumatic extraction of the fractured element and the management of the infected area. Correct primary stability (torque 70 Ncm) was obtained by inserting the implant in a palatal position with respect to the alveolus. To complete the surgery, regeneration procedures were carried out using a granular bone substitute (Geistlich Bio-Oss®) covered with a connective tissue graft taken from the palate. Just three days later, a straight titanium abutment Curvomax™ with gold tite (UNIHG) was screwed (35 Ncm) and a lithium disilicate glass ceramic crown was cemented. RESULTS: The radiographic analysis of the MBL at 28 months of follow-up shows a significant stability of the peri-implant bone confirmed by an excellent aesthetic integration of the soft tissues around the prosthetic crown. CONCLUSIONS: A careful and dedicated surgical planning accompanied by the use of appropriate materials and an accurate surgical protocol, seems to allow the rehabilitation of frontal areas that is difficult to manage, obtaining excellent aesthetic, functional and predictable results over time. We believe that the goal, in this case, is also linked to the immediate delivery of the final crown which has significantly reduced operating times and improved aesthetic parameters, translating into better patient satisfaction.

Single ultra-short implant rehabilitation of posterior atrophic maxillae with 5 years follow-up.

Rehabilitation of edentulous ridges, in some cases, can represent a challange for both the oral surgeon and the patient. After teeth loss, posterior sectors of the maxilla can shrink because of both the crestal resorption and sinus pneumatization. The implant placement in such cases requires invasive procedures of sinus lift and bone augmentation. In cases where these steps are not possible, short implant placement should be considered to offer a fixed rehabilitation. We report a case of rehabilitation with a short 5mm length implant in the posterior maxillae atrophic area. A documented follow-up of 5 years is reported, showing a good biologic and functional performance.

Craniofacial morphology in Obstructive Sleep Apnea patients.

Background: To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs. Material and Methods: One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p< 0.05. Results: A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p<0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p<0,01) and ODI (rho= -0,2443; p<0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p<0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p<0,05) and ODI (rho=0,1970; p<0,05). Conclusions: The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words:OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway.

A full-field DIC analysis of the mechanical-deformation behavior of polyethylene terephthalate glycol (PET-G) aligners.

OBJECTIVES: The aim was to investigate the full-field mechanical-deformation behavior of clear aligners made by polyethylene terephthalate glycol (PET-G) subjected to cyclic compression tests. METHODS: Digital Image Correlation (DIC) (Chu et al., 1985; Schreier et al., 2009), a contactless full-field measurement technique, and Optical Microscope (OM) analysis were applied to study two PET-G aligners thermoformed from discs of a thickness of 0.75 mm and 0.88 mm. The clear aligners were placed on dental shape resin casts and were subjected to cyclic compression up to 13000 load cycles from 0 to 50 N at room temperature. The chosen number of load cycles simulates the average load history to which an aligner is subjected for one week. Local displacements and strains were measured for each test at 2, 6, 10, 20, 1000, 5000 and 13000 loading cycles. RESULTS: Both aligners showed greater displacements in the early stages of loading, more pronounced for the 0.88 mm one. Local displacement and strain maps are derived both along the load direction and to the transverse one (never done from other researchers). Load-displacement cyclic curves allowed to evaluate the evolution of the stored energy and the stiffness during the test. The OM analyses showed significant morphological variations on the aligners' surface, such as wear and tear, high depressions and cracks, especially for the 0.75 mm specimen. SIGNIFICANCE: Full-field analysis allowed to understand the mechanical behavior of device with complex geometry and complex load distribution, like invisible aligners. The knowledge of the stiffness and the direction of the total displacement helps the orthodontist to implement the best strategy to improve the patient's comfort and the treatment time.

Craniofacial morphology in patients with obstructive sleep apnea: cephalometric evaluation / Morfologia craniofacial em pacientes com apneia obstrutiva do sono: avaliação cefalométrica

Abstract Introduction: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. Objective: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. Methods: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. Results: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. Conclusion: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.

Resumo Introdução: A apneia obstrutiva do sono é caracterizada por um fluxo de ar reduzido nas vias aéreas superiores durante o sono. Duas formas de apneia são descritas: a forma central e a forma obstrutiva. A forma obstrutiva tem sido relacionada a vários fatores, como a morfologia craniofacial. Objetivo: Avaliar a correlação entre a morfologia da base do crânio, da mandíbula e da maxila e a gravidade da apneia obstrutiva do sono. Método: Foram incluídos no presente estudo 84 pacientes com apneia obstrutiva do sono, com média de 50,4 anos; 73 homens e 11 mulheres. Pacientes com alto índice de massa corpórea e comorbidades foram excluídos. Foram coletados cefalogramas laterais e polissonografia para cada paciente para avaliar a correlação entre a morfologia craniofacial e a gravidade da apneia. Foi computado o coeficiente de correlação de postos de Spearman (rho) entre medidas cefalométricas e índices de apneia obstrutiva do sono. A significância estatística foi estabelecida em p < 0,05. Resultados: Pacientes com apneia obstrutiva do sono grave apresentaram redução do crescimento sagital do comprimento mandibular efetivo e do comprimento crânio-basal. O comprimento mandibular foi a única variável que apresentou correlação estatística com o índice de apneia-hipopneia. A dimensão vertical mostrou uma fraca correlação com a gravidade da apneia. Não foi demonstrada correlação com a dimensão maxilar sagital. Conclusão: A gravidade da apneia obstrutiva do sono pode estar correlacionada ao crescimento da base mandibular e craniana. A dimensão facial vertical não apresentou correlação com a gravidade da apneia.

A new design of mandibular advancement device (IMYS) in the treatment of obstructive sleep apnea.

OBJECTIVE: The mandibular advancement device (MAD) is currently suggested in patients with mild to moderate obstructive sleep apnea (OSA). This study investigated the effects of a new fully customizable MAD-type device called, "It Makes You Sleep" (IMYS), in patients with mild to moderate OSA. METHODS: Sixteen patients (14 men and 2 women; mean age 62; SD ± 11 years) were retrospectively enrolled. Each patient received home sleep apnea testing (HSAT) at baseline (T0) and after three months (T1) of IMYS treatment. The Apnea-Hypopnea Index (AHI), the Oxygen Desaturation Index (ODI), the Minimum Oxygen Saturation (minSO2) and the Medium Oxygen Saturation (medSO2) were analyzed. RESULTS: From T0 to T1, the IMYS treatment showed a significant reduction of AHI and ODI and a significant increase of minSO2 and medSO2. CONCLUSION: The IMYS appliance is an effective device for treating mild or moderate OSA.

Maxillary Transverse Deficit: A Retrospective Study of Two Biologically Oriented Devices through a Digital Workflow.

The aim of this retrospective study was to compare the efficiency of two biologically oriented devices in achieving maxillary expansion: Rapid Palatal Expander (RPE) and Nitanium Palatal Expander-2 (NPE-2). Thirty-six subjects, divided in two equal groups, were included in this study. Maxillary dental arches were scanned using Trios 3 shape®, in order to perform a digital analysis of 3D models. The models were analyzed using Autodesk Fusion 360® and Meshmixer®. All data obtained from analysis of pre-treatment and post-treatment models were processed using Prism® software. The anterior arch width, the posterior arch width, the palate height, and palatal surface were measured to evaluate differences between the devices. A D'Agostino-Pearson normality test was done to check the data. A non-parametric t-test was used to compare the anterior and posterior arch width between the two groups, while a parametric t-test was used to compare the palatal height measurements between the two groups. The p-value was calculated. The limit value fixed was 0.05. Palatal width and surface showed a significant increase in both groups, but no significant changes in palatal height were found. The data processed showed that there were no significant differences between the devices (ΔREP-ΔNPE) in variation of anterior arch width, there were no significant differences in variation of posterior arch width and there were no significant differences in variation of palatal height. The comparison between the two groups showed that both methods were equally effective in correcting transverse defect.

Craniofacial morphology in patients with obstructive sleep apnea: cephalometric evaluation.

INTRODUCTION: Obstructive sleep apnea is characterized by a reduced airflow through the upper airways during sleep. Two forms of obstructive sleep apnea are described: the central form and the obstructive form. The obstructive form is related to many factors, such as the craniofacial morphology. OBJECTIVE: To evaluate the correlation between the morphology of the cranial base, of the mandible and the maxilla, and obstructive sleep apnea severity. METHODS: Eighty-four patients, mean age of 50.4 years old; 73 males and 11 females with obstructive sleep apnea were enrolled in the present study. Patients with high body mass index and comorbidities were excluded. Lateral cephalograms and polysomnography were collected for each patient to evaluate the correlation between craniofacial morphology and obstructive sleep apnea severity. A Spearman's rho correlation test between cephalometric measurements and obstructive sleep apnea indexes was computed. Statistical significance was set at p < 0.05. RESULTS: Patients with a severe obstructive sleep apnea presented a reduction of sagittal growth of both effective mandibular length and cranio-basal length. The mandibular length was the only variable with a statistical correlation with apnea-hypopnea index. Vertical dimension showed a weak correlation with the severity of obstructive sleep apnea. No correlation with maxillary sagittal dimension was shown. CONCLUSION: Obstructive sleep apnea severity may be correlated to mandibular and cranial base growth. Facial vertical dimension had no correlation with obstructive sleep apnea severity.

Occlusal Plane Modification in Clear Aligners Treatment: Three Dimensional Retrospective Longitudinal Study.

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient's 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence.

Long-term effect on adenoid dimensions and craniocervical angulation after maxillary expansion with fixed or functional appliances.

BACKGROUND: Maxillary expansion is a common orthodontic procedure that could have a positive effect also on airway patency. The aim of the present study was to evaluate the long-term effects of rapid maxillary expansion (RME) on nasopharyngeal area and cranio-cervical angulation in growing patients, compared to controls treated with a function-generating bite appliance (FGB). MATERIAL AND METHODS: Sixty patients aged 6-14 consecutively treated with RME or FGB were selected retrospectively and divided into two groups. Lateral cephalograms taken before and after treatment were retrieved, and the nasopharyngeal area, delimited superiorly by a sella-posterior nasal spine (PNS) line and inferiorly by a basion-PNS line, and the cranio-cervical angulation were measured. RESULTS: The mean observation time was 17.6 ± 8 months. No differences were present between the two groups regarding age and gender. The nasopharyngeal area increased significantly in both groups after treatment, but with no statistically significant difference between them. The cranio-cervical angulation showed no differences within or between groups. CONCLUSIONS: Maxillary deficiency treatment with either RME or FGB was followed by a comparable increase in nasopharyngeal area. Key words:Rapid maxillary expansion, Airway, Nasopharyngeal area, Adenoid.

Morphometric analysis of sella turcica in growing patients: an observational study on shape and dimensions in different sagittal craniofacial patterns.

The aim of this study was to evaluate the differences in sella dimensions and shape between growing patients with Class I, Class II, and Class III skeletal malocclusions, evaluated through morphometric analysis. Seventy-eight subjects aged between 9 and 13 years were selected and assigned to either the Class I, Class II, or Class III groups according to the measured ANB angle (the angle between the Nasion, skeletal A-point and skeletal B-point). Six landmarks were digitised to outline the shape of the sella turcica. Linear measurements of the sella length and depth were also performed. Procrustes superimposition, principal component analysis, and canonical variate analysis were used to evaluate the differences in sella shape between the three groups. A one-way MANOVA and Tukey's or Games-Howell tests were used to evaluate the presence of differences in sella dimensions between the three groups, gender, and age. The canonical variate analysis revealed a statistically significant difference in sella shape between the Class I and the Class II groups, mostly explained by the CV1 axis and related to the posterior clinoidal process and the floor of the sella. No differences were found regarding linear measurements, except between subjects with different age. These differences in sella shape, that are present in the earlier developmental stages, could be used as a predictor of facial growth, but further studies are needed.

Early treatment of pseudo-class III malocclusion with modified swallowing occlusal contact intercept appliance (S.O.C.I.A.).

AIMS: The aim of the present work was to evaluate the dentoskeletal effects of swallowing occlusal contact intercept appliance (SOCIA) III in pseudo Class III malocclusion treatment. MATERIALS AND METHODS: Thirty-six patients (mean age: 9.46 years old) with pseudo-Class III malocclusion and 22 pseudo-Class III untreated controls (mean age: 8.7 years old) were selected and examined. All patients presented with a cervical stage CS2, CS3, or CS4. Patients with CS5 were not enrolled in the study. Cephalometric analysis was performed before phase 1 treatment (T1) and immediately following phase 2 treatment (T2). STATISTICAL ANALYSIS: Paired t-test and independent t-test. RESULTS: SOCIA III had skeletal and dental effects. The main effects of SOCIA III were on the midface with an effective increase of the sagittal growth (cranial base P < 0.001, anterior cranial base (ACB) P < 0.001, and maxilla growth P < 0.001) and vertical growth (anterior facial height P < 0.001). The effects of SOCIA on the mandible were a control of mandibular postrotation (P = 0.82) and the sagittal growth (P < 0.007). At the end of the treatment, a normal overjet was achieved (P < 0.001). CONCLUSIONS: The SOCIA III effects are resumed as follow: (a) an effective maxillary sagittal increase on the sagittal plane; (b) a vertical mandibular control; (c) a resolution of overjet; (d) no increase of overbite; (e) a stimulation of ACB growth.