A Knowledge-Based Algorithm for Automatic Monitoring of Orthodontic Treatment: The Dental Monitoring System. Two Cases.

BACKGROUND: In the dental field, digital technology has created new opportunities for orthodontists to integrate their clinical practice, and for patients to collect information about orthodontics and their treatment, which is called "teledentistry." Dental monitoring (DM) is a recently introduced orthodontic application that combines safe teledentistry with artificial intelligence (AI) using a knowledge-based algorithm, allowing an accurate semi-automatic monitoring of the treatment. Dental Monitoring is the world's first SaaS (Software as a Service) application designed for remote monitoring of dental treatment, developed in Paris, France, with Philippe Salah as the Co-founder and CEO. CASES PRESENTATION: This report describes two cases in which DM system was essential to achieve the control of certain movements: it was possible to follow the movement, even if complex, such as the anterior cross of an adult patient and a lack of space in the canine of the growing patient. The software analyzed the fit and retention of the aligner, thus ensuring correct biomechanics. They were treated during the COVID-19 pandemic lockdown with aligners. The first case is a growing patient who was monitored during an interceptive orthodontic treatment to manage a retained upper canine. The second case is an adult patient forced to finalize his treatment of upper lateral incisor crossbite. The software analyzed the fit and retention of the aligner, thus ensuring correct biomechanics. CONCLUSIONS: DM system appears to be a promising method, useful for improving the interaction between doctor and patient, generally acceptable and useful to patients, even in critical clinical situations, at least in cases with optimal compliance and ability to use the tool properly.

Clinical Management of Hypodontia of Two Mandibular Incisors.

This article presents the clinical management of a patient with bilateral congenitally missing mandibular incisors. This condition is relatively rare and always needs a careful diagnosis and treatment planning. The chosen treatment strategy for this patient included space closure by protraction of the mandibular posterior teeth and canine substitution of missing incisors. Furthermore, the problems arising from this treatment plan, such as premolar-protected occlusion and tooth size discrepancy, are discussed. From the case presented in this study, we can conclude that space closure may be considered an efficient treatment approach for achieving satisfactory functional and aesthetic results.

Early Treatment of Anterior Crossbite with Eruption Guidance Appliance: A Case Report.

The purpose of this investigation was to show how to manage an anterior crossbite in early mixed dentition with an eruption guidance appliance (EGA). The analyzed clinical case reported an anterior crossbite, a bimaxillary retrusion tendency, and a horizontal growth pattern. The anterior crossbite was an unfavorable occlusal condition that could lead to a class III malocclusion growth pattern. An early treatment approach was suggested to reach a correct sagittal jaw relationship. Hence, the selected approach acted on the dentoalveolar sector, aiming to have effects on the posterior vertical dimension and to improve the sagittal jaw's relation. An EGA was selected to treat the patient in early mixed dentition. After 7 months of therapy with night-time use, the dental malocclusion was completely resolved. The patient continued to be treated with the same device, used as active retention. With the EGA treatment, the erupting forces, rather than the active forces, were used to resolve the dental malocclusion. This approach allowed a low compliance requirement and had a minimum psychosocial and psychological impact on the patient. The early treatment was essential to give a functional occlusion and a good balance of the soft perioral tissues and muscles.

Myofunctional Treatment of Anterior Crossbite in a Growing Patient.

The purpose of this case report is to add another means of treatment for the anterior crossbite malocclusion in early mixed dentition. The selected functional device is an eruption guidance appliance (EGA). The analysed patient had a functional anterior crossbite, a mandibular protrusion tendency, and a normodivergent growth pattern. The early treatment was suggested to correct the malocclusion and avoid unfavourable occlusal conditions that could end in a class III malocclusion growth pattern. After 18 months of treatment, with night-time use, the malocclusion was completely resolved. This therapy strategy allowed the correction of the sagittal jaws' relationship and maximum control of the vertical dimension. After 2 years of follow-up, the results were preserved. The peculiarity of this kind of intraoral orthodontic tools is the use of the erupting forces rather than the active forces. This early treatment of anterior crossbites with EGA may be considered an effective treatment approach for achieving good functional and aesthetic results.