Effects of Removable Functional Appliances on the Dentoalveolar Unit in Growing Patients.

Background and Objectives: The objective of this retrospective controlled study is to compare class II growing patients who underwent treatment with two different functional appliances: the Fraenkel regulator (FR-2), utilized as the control group, and the elastodontic device "Cranium Occluded Postural Multifunctional Harmonizers" (AMCOP), utilized as the test group. Materials and Methods: The study sample consisted of 52 patients with class II division I malocclusion (30 males, 22 females, mean age 8.6 ± 1.4 years) who were treated with the two different types of appliances: Group 1 (n = 27, mean age 8 [7.00, 9.00] years, 12 females, 15 males) received treatment with AMCOP, while Group 2 (n = 25, mean age 9.2 years [8.20, 10.00], 10 females, 15 males) received treatment with FR-2. The mean treatment duration for Group 1 was 28.00 [21.50, 38.00] months, while for Group 2 it was 23.70 [17.80, 27.40] months. Cephalometric analyses were performed on lateral cephalograms taken before treatment (T1) and after treatment (T2). Results: Significant intragroup differences were observed over time in Group 1 for 1^/PP. Similarly, significant intragroup differences were observed over time in Group 2 for SNB, ANB, and IMPA. Conclusions: Both treatment modalities resulted in the correction of class II malocclusion with dentoalveolar compensation, although the treatment duration with AMCOP tended to be longer on average.

Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report.

The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient's needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.

Effects of Elastodontic Appliance on the Pharyngeal Airway Space in Class II Malocclusion.

BACKGROUND: The present study analyzed the changes obtained on the upper airway and hyoid bone dimensions in a group of patients with skeletal Class II malocclusion treated with functional elastodontic devices compared to an untreated control group. METHODS: A group of 33 patients (19 females and 14 males) with Class II malocclusion treated with AMCOP® SC elastodontic device was compared with a control group of 35 subjects (17 females and 18 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start (T0) and end of treatment/period of observation (T1). Cephalometric analysis was performed and linear measurements to evaluate airway space and hyoid bone position were also obtained. A multivariate analysis of variance for repeated measures (MANOVA) was performed to determine the effects of interactions for the groups for time. RESULTS: Statistically significant differences were found in the study group from T0 and T1 with an improvement of superior upper airway (SPAS p < 0.0001), while in the control group it did not change in a statistically significant way from T0 to T1. The MANOVA test showed statistically significant differences between the two groups for the changes of SPAS (p = 0.003), IAS (p = 0.049), and H-C3 vertical (p = 0.038) values. CONCLUSIONS: Functional elastodontic therapy produced significant favorable airway changes in skeletal class II subjects.

Elastodontic treatment with oral bio-activators in young children.

BACKGROUND: Elastodontic therapy can correct bad oral habits and malocclusions in young patients by guiding jaw growth, eliminating functional disorders, and improving tooth position. The aim of this study was to assess the effects of bio-activator therapy on the presence of atypical swallowing with tongue thrust in growing patients. METHODS: A retrospective study was conducted. Data regarding the early orthodontic treatment of 40 consecutive patients with atypical swallowing and tongue thrust (23 males and 17 females) were assembled from January 2019 to January 2020. All patients (≥7 and ≤15 years of age) were monitored for 1 year in a private practice in Isernia, Italy. RESULTS: The mean age at commencement of orthodontic treatment was 8.5 years (range=7.1-14.9 years), and the mean total duration of therapy was 1 year (range=11 months-1 year). Final lateral radiographs demonstrated a mean of improvement of 8° for upper and lower incisor proclination (I/SN) and 3.5° for incisor mandibular plane angle (IMPA) in 36 patients, and 5° of I/SN and 2° of IMPA in the remaining 4 children after 1 year of treatment. CONCLUSIONS: Bad oral habits in younger patients must not be ignored. The duration of treatment can differ depending on the severity of the open bite and the patient's cooperation. This study demonstrates the short-term efficacy of these myofunctional appliances in the treatment of atypical swallowing. In order to quickly eliminate factors which endanger healthy development of dento-skeletal structure, it is important to closely monitor patients during their development phase.

Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report.

Aim: In the literature, many studies and articles are investigating new devices and approaches to achieve rapid palate expansion through the opening of the palatal suture, and evaluating the skeletal, dental, and soft tissue effects. The purpose of this review was to assess how palatal expansion is performed in adolescent patients with permanent dentition. Furthermore, it was reported as an example of successful orthodontic treatment of an 11-year-old female patient affected by maxillary skeletal transverse deficiency, in permanent dentition. Methods: A search of the literature was conducted on PubMed, Cochrane, Scopus, Embase, and Web of Science databases. Inclusion criteria were the year of publication between 2017 and 2022, patients aged 10 to 16 years in permanent dentition, with transversal discrepancy, treated with tooth-borne, bone-borne, hybrid palatal expanders. Results: A total of 619 articles were identified by the electronic search, and finally, a total of 16 papers were included in the qualitative analysis. Conclusions: From this study, it was assessed that MARPE is more predictable, and it determines a more significant expansion of the suture than the Hyrax expander, with fewer side effects.

Innovative Application of Diathermy in Orthodontics: A Case Report.

INTRODUCTION: Several strategies have been proposed in the literature to accelerate tooth movement, many of which are invasive and have numerous side effects, such as surgical techniques (corticotomy and piezocision technique). This research investigates to what extent diathermy can accelerate the orthodontic alignment phase. MATERIALS AND METHODS: A patient with lower teeth crowding index of the same magnitude was selected. The orthodontic treatment with Nickel-Titanium (NiTi) thermal arc 0.015 in the lower arch was performed, associated with a weekly application of diathermy using the intraoral handpiece. The total duration of treatment was three weeks. During each session, an intraoral transducer was employed to stimulate the hard and soft tissues of the left dental hemiarch, which was also orthodontically aligned like the right one. RESULTS: Comparing the tooth movements of four elements of the two hemiarchies, it was found that, overall, the two teeth examined on the treated side underwent a more significant number of changes than on the untreated side, although not by a significant amount. CONCLUSIONS: The use of diathermy, according to the authors, is a non-invasive approach that may speed up the orthodontic alignment phase and reduce treatment duration, resulting in a lower risk of caries, gingival recessions, root resorptions, and patient compliance improvement, without side effects. Further studies and an adequate sample size will be needed to confirm the findings.

Experimental Analysis of the Use of Cranial Electromyography in Athletes and Clinical Implications.

BACKGROUND: Cranial surface electromyography is assumed to analyze the correlation between the stomatognathic apparatus and the muscular system and its implications on the physical status of professional athletes. The purpose of this paper is to evaluate surface cranial electromyography as an aid in the diagnosis and treatment of occlusal and muscular disorders in professional athletes. METHODS: A sample of 25 athletes (mean age 23 years, 20 men and 5 women) underwent electromyographic recording; among them, 13 had a sports injury condition (symptomatic athletes), while 12 were in perfect physical condition (asymptomatic athletes). At odontostomatological examination, 6 showed cranio-mandibular disorders (dysfunctional athletes), while 19 showed no disorders (functional athletes). The treatment plan to resolve the symptoms of the dysfunctional athletes was chosen based on the electromyographic data. One month after the start of therapy with an occlusal splint, a follow-up was performed, and the results were compared with the initial data. RESULTS: Statistical analysis showed that the chosen therapy following the use of electromyography was effective in 72% of cases, while 28% of patients did not respond to therapy (p = 0.028). CONCLUSIONS: The use of cranial electromyography in competitive athletes is a valuable tool in therapeutic choice aimed at balancing occlusal loads and improving the patient's global tonic postural attitude, resulting in positive feedback in the qualitative assessment of sports performance.

The Efficacy of a New AMCOP® Elastodontic Protocol for Orthodontic Interceptive Treatment: A Case Series and Literature Overview.

BACKGROUND: Elastodontics is a specific interceptive orthodontic treatment that uses removable elastomeric appliances. They are functional appliances that produce neuromuscular, orthopedic and dental effects. Thus, these devices are useful in the developmental age, when skeletal structures are characterized by important plasticity and adaptation capacity, allowing to remove factors responsible for malocclusions. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This work can be useful to update all orthodontists already adopting these appliances or for those who want to approach them for the first time. This study aimed to describe four cases treated with new elastomeric devices called AMCOP Bio-Activators and to provide an overview of elastodontics, its evolution, indications and limits. METHODS: A total of four clinical cases were presented after a treatment period of 16-20 months to evaluate the clinical and radiological effects of the elastodontic therapy. RESULTS: The effectiveness of Bio-Activators on clinical cases was evidenced with a significant improvement in skeletal and dentoalveolar relationship, and malocclusion correction in a limited treatment period (16-20 months). CONCLUSIONS: The Bio-Activators showed clinical effectiveness to achieve therapeutic targets according to a low impact on the patient's compliance.

Oralbiotica/Oralbiotics: The Impact of Oral Microbiota on Dental Health and Demineralization: A Systematic Review of the Literature.

The oral microbiota plays a vital role in the human microbiome and oral health. Imbalances between microbes and their hosts can lead to oral and systemic disorders such as diabetes or cardiovascular disease. The purpose of this review is to investigate the literature evidence of oral microbiota dysbiosis on oral health and discuss current knowledge and emerging mechanisms governing oral polymicrobial synergy and dysbiosis; both have enhanced our understanding of pathogenic mechanisms and aided the design of innovative therapeutic approaches as ORALBIOTICA for oral diseases such as demineralization. PubMed, Web of Science, Google Scholar, Scopus, Cochrane Library, EMBEDDED, Dentistry & Oral Sciences Source via EBSCO, APA PsycINFO, APA PsyArticles, and DRUGS@FDA were searched for publications that matched our topic from January 2017 to 22 April 2022, with an English language constraint using the following Boolean keywords: ("microbio*" and "demineralization*") AND ("oral microbiota" and "demineralization"). Twenty-two studies were included for qualitative analysis. As seen by the studies included in this review, the balance of the microbiota is unstable and influenced by oral hygiene, the presence of orthodontic devices in the oral cavity and poor eating habits that can modify its composition and behavior in both positive and negative ways, increasing the development of demineralization, caries processes, and periodontal disease. Under conditions of dysbiosis, favored by an acidic environment, the reproduction of specific bacterial strains increases, favoring cariogenic ones such as Bifidobacterium dentium, Bifidobacterium longum, and S. mutans, than S. salivarius and A. viscosus, and increasing of Firmicutes strains to the disadvantage of Bacteroidetes. Microbial balance can be restored by using probiotics and prebiotics to manage and treat oral diseases, as evidenced by mouthwashes or dietary modifications that can influence microbiota balance and prevent or slow disease progression.

Multiple traumatic injury to maxillary incisors in an adolescent female: treatment outcome with two years follow-up.

Number, type and severity of dental injuries per patient differ according to the patient's age and the cause of accident. The trauma group resulting from pedestrian-, bicycle-, and car-related injuries is usually dominated by multiple dental injuries, injuries to the supporting bone and soft-tissue injuries. This report describes a case of a 16.2-year-old female who suffered traumatic injuries to her permanent maxillary incisors after a car accident. Concussion of tooth 12, extrusive luxation of tooth 11, avulsion of tooth 21 and subluxation with complicated crown fracture of tooth 22 were observed at the emergency visit 75 minutes after the trauma. Tooth 21 was dry stored for 15 minutes, then in milk for 60 minutes. The treatment plan according to IADT guidelines was performed with the satisfaction of the dentists and the patient. After 1 year follow- up a replacement root resorption of tooth 21 was diagnosed; it was then considered severe at the time of the 2 year control visit. Educational programs are essential to optimize the treatment outcome both at the accident site and also at the dental office.