Andrea Volpato

Orthodontic treatment can be safely performed during pregnancy when tailored to the patient’s hormonal, physiological, psychological, and oral health changes. The study aims to establish a safe, trimester-specific orthodontic practical framework that minimizes maternal–foetal risks while ensuring effective treatment. A modular search on MEDLINE/PubMed (National Library of Medicine, Bethesda, MD, USA) was conducted using combined keywords and subtopic-specific queries to identify relevant literature on orthodontics during pregnancy. Most studies were literature reviews, followed by various observational, survey-based, clinical, and case report designs. Orthodontic care during pregnancy must be adapted to trimester-related risks, with minimal interventions in the first trimester, elective procedures in the second, comfort-focused management in the third, and treatment of complex care postpartum. This protocol requires individual adaptation, highlighting the need for personalized medicine and coordinated input from multiple specialists to address orthodontic, obstetric, and psychological factors during pregnancy.

Orthodontic treatment can be safely performed during pregnancy when tailored to the patient’s hormonal, physiological, psychological, and oral health changes. The study aims to establish a safe, trimester – specific orthodontic protocol that minimizes maternal – foetal risks while ensuring effective treatment. A systematic PubMed search using combined keywords and subtopic – specific queries was performed to identify relevant literature on orthodontics during pregnancy. Most studies were literature reviews, followed by various observational, survey – based, clinical, and case report designs. Orthodontic care during pregnancy must be adapted to trimester – related risks, with minimal interventions in the first trimester, elective procedures in the second, comfort focused management in the third, and treatment of complex care postpartum. This protocol requires individual adaptation, highlighting the need for personalized medicine and coordinated input from multiple specialists to address orthodontic, obstetric, and psychological factors during pregnancy.

Background: The widespread adoption of clear aligners in orthodontic practice has driven the development of biomechanical devices to improve treatment efficiency. The mechanical properties of these materials play a critical role in determining their clinical performance and efficacy. This study investigates the Young’s modulus of Clear-Blokker^® (Scheu Dental), a photopolymerisable resin used for the attachment of clear aligner, and evaluates its mechanical behaviour under different curing times (5 s and 10 s) and environmental conditions (dry storage and immersion in artificial saliva at 37 °C). Methods: Forty-eight cylindrical specimens were prepared and subjected to quasistatic compression tests after 14 days. A multi-factorial analysis of variance (ANOVA) at a significance level of 5% was performed to compare the variances. Results: The results showed that samples immersed in artificial saliva had significantly reduced Young’s moduli compared to samples stored in dry conditions (p = 0.0213), while no significant difference was observed between curing times. Conclusions: The results suggest that Clear-Blokker^® has mechanical properties comparable to those of clear aligner materials, making it suitable as a biomechanical aid for orthodontic treatment. However, further clinical studies are required to confirm its long-term efficacy in the oral environment.

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion.

Background: Allergic rhinitis is a frequent cause of nasal obstruction in the pediatric population. The effect of prolonged mouth breathing on craniofacial growth continues to be a controversial topic in the orthodontic literature. This study investigates both the role of allergic rhinitis/asthma in the etiology of posterior crossbite and ogival palate and the influence of allergic rhinitis/asthma on the long-term stability produced by transverse expansion treatment. Methods: A retrospective analysis of the clinical records of 319 subjects between 5 and 12 years, presenting for an orthodontic evaluation was performed. The sample was divided into study and control groups depending on the presence/absence of posterior crossbite and/or ogival palate. Data regarding the subjects’ breathing patterns and allergic respiratory diseases were collected. The relapse rate of transverse expansion treatment was evaluated. Results: An association (p = 0.05) was found between posterior crossbite/ogival palate and the presence of allergies. Multivariate analyses uncovered that both allergic rhinitis and younger ages were associated with posterior crossbite/ogival palate (p = 0.029890; p = 0.000283, respectively). No association was found between allergies and/or asthma and relapse following orthodontic treatment. Conclusions: Although data analysis suggests that allergies can induce transverse maxillary contraction in children, their presence did not seem to affect the outcome of orthodontic expansion treatment.

Introduction: Although the superiority of clear aligners over multi-bracket appliances in keeping gingiva healthy has been suggested, the possible benefits of one aligner design over another have not yet been investigated, especially with regard to the vestibular edge. Objective: The aim of this study was to measure several periodontal indexes in adolescents undergoing orthodontic treatment with aligners, comparing two different types of rim. Methods: The study involved 43 patients aged between 14 and 18 years. The periodontal health was assessed using plaque index (PI), gingival index (GI), and gingival bleeding index (GBI), at the start of the treatment with aligners (T0), with a vestibular rim (VR) reaching up to 3 mm beyond the gingival margin. Three months later (T1), aligners were set to obtain a juxtagingival rim (JR) on the second quadrant and VR on the first quadrant. The periodontal indexes were measured again, both at T1 and then three months later (T2). Results: Intra-quadrant comparisons revealed a statistically significant worsening of the periodontal indexes only for the second quadrant (p<0.05), at T1 (GI), and especially at T2 (PI, GI, GBI), while no statistically significant changes were found for the first quadrant. Conclusions: More severe mechanical irritation, especially during insertion and removal of the aligner, can explain the worsening inflammatory indexes with the JR. In addition, the pressure exerted by the JR on the gingival sulcus seemed to facilitate plaque deposition, whereas the VR had a protective effect, reducing the risk of mechanical trauma.

The polymer structure of thermoplastic materials currently used to make aligners is altered by the oral conditions and this negatively affects their capacity to move teeth. This study aimed to compare different options for storing aligners when not in use by superimposing successive 3D images to identify which storage method least affects material shape and weight. Fifty PET-G aligners, produced using the CA Digital method, were divided into four groups (1A, 1B, 1C, and 2D) and were stored for 18 h a day in artificial saliva at 37 °C. Then, to mimic their storage conditions when not in use, aligners in group 1A were immersed for the remaining 8 hours a day in bicarbonate solution, those in group 1B in chlorhexidine solution, those in group 1C in distilled water, and those in group 2D were stored dry. The samples were scanned at the baseline (before the immersion cycles began) and again two weeks later. The digital scans were superimposed and the median deformation, its variability, and weight differences were recorded for each group. Statistical analysis showed aligner deformation (expansion) in all three groups stored in wet conditions, with a statistically significant difference between groups 1A and 1C. Aligners in group 2D shrank slightly, and to a significantly greater degree with respect to group 1C. Variability in the degree of deformation was similar among the three groups stored in wet conditions, but significantly greater in group 2D. Weight gains were recorded in all four groups, the smallest in group 2D and the largest in group 1A. Storing aligners in dry conditions promoted lower deformation in the material, involving a slight shrinkage, whereas wet storage conditions caused an expansion of the aligner, especially when distilled water is used.

Background: Pregnancy is a unique moment in a woman’s life, accompanied with several physiologic changes that have an impact on oral health. Aim of the study: The purpose of the present study was to conduct a critical review of published literature regarding pregnancy and dentistry, the most frequent oral diseases that are encountered during pregnancy, their correlation to adverse pregnancy events, and safe dental treatments that can be performed during pregnancy. Methods: A Medline/COCHRANE search was carried using specific keywords and MeSH terms, combined with the boolean operators “OR” and “AND”. Results: The search led to 146 publications including guidelines, meta-analyses, systematic and non-systematic reviews, published between 2000 and 2021. Discussion and conclusions: Due to the increased inflammatory and immune body response that characterizes pregnancy, periodontal conditions are often aggravated during pregnancy and periodontal disease encountered frequently in pregnant patients. There are conflicting study results in the literature regarding the association between periodontitis and adverse pregnancy outcomes. Periodontal treatment did not show a significant reduction in the adverse outcomes. Many dentists, often due to lack of information, are reluctant to provide dental treatment to pregnant women. However, preventive and restorative dental treatment is safe during pregnancy. Diagnostic radiographs may be performed after the first trimester if absolutely necessary. Analgesics (such as paracetamol) and anesthetics (such as lidocaine) are also considered safe. In case of infection, antibacterial drugs such as amoxicillin, ampicillin, and some cephalosporines and macrolides can also be prescribed. Organogenesis takes place in the first trimester, the time during which the fetus is susceptible to severe malformations (teratogenesis). The ideal time to perform dental treatment is the second trimester (week 17 to 28). However, acute pain or infections make the intervention of the dentist absolutely necessary and emergency treatment can be performed during the whole pregnancy period.

Objective: The aim of the study was to verify and compare the accuracy of full-arch digital impressions obtained using two intraoral scanners and three scanning methodologies. Methods: A resin model created with dental 3-D printing was scanned by a reference scanner (Zfx Evolution - Zimmer Biomet, Palm Beach Gardens, FL) in order to obtain a 3D reference; the same resin model was then scanned with two different intraoral scanners (Zfx IntraScan and Carestream 3600 - CS 3600®, Carestream, Rochester, NY, USA) using: Technique A (from tooth #27 up to tooth #17); Technique B (from tooth #11 up to tooth #17 and then from tooth #21 up to tooth #27) and Technique C (from tooth #22 up to tooth #17, and then from tooth #12 up to tooth #27 - the MeshLab software v. 1.3.3 was then used to match the two scans). The scans obtained were superimposed over the reference scan by means of a software, and the volumetric discrepancies were calculated. Results: The mean results for the Zfx Intrascan scanner were: Technique A = 302.47 ± 37.42 µm; Technique B = 180.45 ± 29.86 µm; Technique C = 147.34 ± 28.23 µm. The mean results for the Carestream 3600 scanner were: Technique A = 303.59 ± 40.20 µm; Technique B = 181.53 ± 29.61 µm; Technique C = 142.28 ± 35.33 µm. Technique C, used by both scanners, produced less volumetric discrepancies compared to the other techniques. Conclusions: The scanning technique had a statistically significant effect on the quality of the scan (p< 0.0001), whereas the scanner did not present any significant influence (p= 0.91).