Rosa Valletta

Background: The aim of this prospective longitudinal study was to evaluate three-dimensional facial soft tissue changes following treatment with the Sander Bite Jumping Appliance (BJA) in growing patients with skeletal class II malocclusion. Methods: Seventeen consecutive growing patients (14 males and 3 females; mean age of 11.7 ± 1.1 years) with skeletal class II malocclusion due to mandibular retrusion were treated with the Sander BJA. Three-dimensional facial scans were acquired before treatment (T0) and after completion of active treatment (T1) using a 3dMD stereophotogrammetric system. Twelve angular soft tissue variables were measured after image superimposition using stable facial reference regions. Changes between T0 and T1 were analysed using paired Student’s t-tests (p < 0.05). Results: The facial convexity angle increased significantly from 155.49 ± 4.12° at T0 to 157.21 ± 3.84° at T1, corresponding to a mean change of 1.72° (95% CI: 0.06–3.39; p = 0.044) and a moderate effect size (Cohen’s dz = 0.53). Among the secondary outcomes, significant changes were observed for the SS-N-SL angle (mean change: −1.29°; p = 0.002; dz = −0.89), upper lip position (−1.09°; p = 0.006; dz = −0.77), LS-N-LI angle (−0.69°; p = 0.042; dz = −0.54), and submental angle (+13.86°; p < 0.001; dz = 1.10). No significant changes were observed for the remaining angular measurements. Conclusions: Treatment with the Sander BJA was associated with measurable three-dimensional soft tissue changes predominantly involving the lower facial region. The observed modifications included mainly profile straightening and changes in lip position. Because of the absence of an untreated control group, these findings should be interpreted as treatment-associated soft tissue changes in growing patients.

Background and Objectives: Burning Mouth Syndrome (BMS) remains a challenging condition to manage, as current treatments show variable efficacy and are often limited by tolerability, particularly in older and medically complex patients. This has prompted interest in topical neuromodulatory strategies targeting peripheral mechanisms while minimizing systemic exposure, with topical pregabalin emerging as a potential option. Materials and Methods: In this prospective longitudinal real-world study, 100 patients with BMS treated at a tertiary referral center received topical pregabalin as an off-label intraoral swish-and-spit solution. Patients were assessed at baseline and after 3 months using validated measures of pain intensity (VAS), qualitative pain perception (SF-MPQ), anxiety (HAM-A), depression (HAM-D), sleep quality (PSQI, ESS), and global clinical severity (CGI-S). Results: After 3 months, median VAS decreased from 8 (IQR 7–9) to 5 (IQR 4–6) and SF-MPQ from 10 (IQR 7–17) to 6.5 (IQR 4–10) (both p < 0.001), with concurrent improvements in anxiety, depressive symptoms, and clinical severity. Overall, 46% of patients achieved ≥30% pain reduction, while 73% and 16% reached ≥20% and ≥50% reductions, respectively. Higher baseline pain predicted greater improvement. No serious adverse events were reported. Conclusions: These findings suggest that topical pregabalin may represent a safe and potentially effective option for BMS, although controlled studies are required to confirm its efficacy.

Background/Objectives: The achievement of stable and functional occlusal contacts represents a key objective of orthodontic treatment, particularly in growing patients. Evidence comparing the effectiveness of these two modalities in establishing adequate occlusal contacts in growing patients remains limited. This study aimed to evaluate and compare occlusal contact characteristics following clear aligner therapy (CAT) and fixed orthodontic therapy (FAT). Methods: Twenty-four growing patients (p < 0.05). Statistical difference was also observed in the antero-posterior ratio, with FAT presenting fewer anterior contacts in OCS, NOCS, half-mm, and one-mm measurements (p < 0.05). No significant differences were found between groups in terms of left–right asymmetry or post-treatment single-tooth contacts, except for the second premolar, which exhibited higher contacts in the FAT group (p < 0.05). Conclusions: Fixed orthodontic treatment is more effective than aligners in achieving adequate occlusal contacts, with differences limited to tight contacts and antero-posterior occlusal distribution.

The impact of dentoskeletal malocclusion on the psychosocial status and oral health-related quality of life (OHRQoL), especially in adolescents, has been a subject of considerable debate in the literature. The aim of the study was to explore the relationship between the severity of dental and skeletal malocclusions and adolescents' self-esteem, their perception of dentofacial aesthetics, and the psychosocial impact of dental aesthetics. Adolescent patients (aged 10-18 years) seeking orthodontic treatment in a hospital clinic were recruited for the study. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), the Orofacial Esthetic Scale (OES), the Rosenberg Self-Esteem Scale (RSES), and the Aesthetic Component of the index of orthodontic treatment need (IOTN-AC) were administered during the first consultation. Overbite (OVB), overjet (OVJ) and the Dental Health Component of the IOTN (IOTN-DHC) were measured by a trained operator on digital models. Lateral cephalometric radiographs were used to evaluate skeletal malocclusions in the sagittal and vertical planes. Comparisons between the groups were performed using analysis of variance (ANOVA), the Kruskal-Wallis test or the χ2 test. Correlations between variables were assessed using Pearson's or Spearman's correlation tests. The majority of adolescents classified according to the IOTN-DSC as having a definite need for orthodontic treatment by clinicians perceived their own need for treatment as low or non-existent. No statistically significant differences were found in the PIDAQ, OES and RSES scores among different IOTN-DHC subgroups. Overjet was associated with self-esteem, while OVB was correlated with dental self-confidence and overall assessment of orofacial aesthetics. Skeletal variables were not associated with the studied domains. The PIDAQ was significantly positively correlated with the IOTN-AC and negatively correlated with the RSES. The perception of malocclusion severity differs between patients and clinicians, highlighting the need to consider patients' values when defining orthodontic goals. Overjet and OVB are clinical variables that can influence the psychosocial domain in adolescents.

Background/Objectives: Parents/caregivers’ reports are valuable because they frequently play a crucial role in making decisions concerning a child’s health, and their perspectives can significantly impact treatment choices. Furthermore, negative effects of oral health issues extend beyond just the adolescent patient, having an impact on family life. The aim of this study is to explore the perception of parents/caregivers regarding their children’s oral-health-related quality of life (OHRQoL) and how the OHRQoL of adolescents impacts their family life. Methods: The Parental-Caregiver Perception Questionnaire-16 (P-CPQ-16) and the Family Impact Scale-8 (FIS-8) were administered to 160 parents/caregivers of adolescents aged 10–18 years old at the Dental Clinic of the University of Naples Federico II (Italy). Adolescents’ oral health status was recorded using the Decayed Missing and Filled Teeth (DMFT/dmft) index and Dental Aesthetic Index (DAI). Results: FIS-8 and P-CPQ-16 scores showed no significant differences across DAI and DMFT/dmft subgroups. However, regression analysis found a significant association between social well-being and total P-CPQ-16 scores with the DAI and DMFT index. Spearman’s correlation showed statistical significance only for the social well-being domain of P-CPQ-16 with respect to DAI scores. Conclusions: Parents/caregivers perceived a difference in their children’s OHRQoL according to different severities of malocclusion and dental caries; however, they did not report any impact on the family’s quality of life. Since adolescents often visit dentists due to parental influence, involving parents who perceive a lower quality of life in children with severe malocclusions or compromised oral health is crucial for effective care.

Background/Objectives: Condylectomy is a delicate and intricate procedure commonly employed in the management of temporomandibular joint (TMJ) disorders, osteochondromas, condylar hyperplasia, hemimandibular hyperplasia, and other pathologies affecting the condylar region. The advent of surgical cutting guides has introduced a new dimension to condylectomy procedures as they enable surgeons to plan and execute precise cuts with a heightened level of accuracy. In the literature already exists cases of cutting guide-based condylectomy, but they only depend on the mere mirroring procedure in virtual planning, which has accuracy limitations because it does not consider asymmetry of peri-condylar structures at the level of the ramus, body, and mandibular angle. Methods: CAD-CAM orthodontic preparation through the NEMOFAB Software was performed to correct the canting of the occlusal plane, following the “orthodontic first” technique. The same software was used for VSP of the surgical cutting guide to perform the condylectomy, basing not to the mere mirroring of the opposite side but considering the whole condylar-TMJ-glenoid fossa structure. Results: At 6 months follow-up, the patient showed good occlusion and an almost totally recovered lower third symmetry as median-upper and lower interincisive lines coincide with each other and with the chin median. A good occlusal and masticatory outcome was obtained. The joint structure was preserved with remodeling of the glenoid cavity caused by the presence of the joint disc, which was preserved during surgery. Conclusions: The goal of this study is to propose a method of therapeutic management of condylar hyperplasia that benefits from accurate pre-operative orthodontic treatment (orthodontics first) to maximize the results of proportional condylectomy, reducing post-operative orthodontic care as well as any need for any adjuvant orthognathic surgery. A new virtual surgical planning method is also proposed for creating a cutting guide that not only takes advantage of the mirroring technique to accurately calculate the amount of condyle to be cut but also considers the entire condyle–TMJ complex to perform a condylectomy that is more precise.

Background: To achieve a successful result, the orthodontist must use a systematic approach to plan the orthodontic treatment. Defining the correct position of the upper and lower incisors and evaluating their relationship with intermaxillary discrepancy and facial divergence have been recognized as the starting point for the diagnostic decision regarding extractions and anchorage requirements. The aim of our study was to analyze the relationship between intermaxillary discrepancy (ANPg^), mandibular inclination (SN^GoGn), lip incompetence, and the positioning of the upper and lower incisors (UIPs and LIPs) in a group of orthodontic patients. This retrospective study included 290 lateral cephalograms in 122 males (42.1%) and 168 females (57.9%) aged 8 to 53 years (median 14; interquartile range IQR 12–17). Data were analyzed by means of one-way Analysis of Variance (ANOVA) and linear regression analysis. Results: This study showed a statistically significant increase in LIP values in patients with lip incompetence (p < 0.001). Moreover, the distribution of LIPs in groups with various SN^GoGn and ANPg^ angles was significantly different (p < 0.001). The regression analysis also showed a positive association between the LIP and SN^GoGn and between the LIP and ANPg^. Conclusion: The LIP presented a statistically significant difference in patients with and without lip incompetence, which varied significantly in subjects with different sagittal malocclusions and vertical face patterns.

Background: Preformed elastodontic appliances (EAs) have been described as safe, cost-effective, and easy-to-use devices for interceptive orthodontic treatment in growing patients. This study aimed to assess the knowledge and the attitude of dentists toward the use of EAs and to compare the behaviors of orthodontists (Os) with those of general dental practitioners (GDPs). Methods: An anonymous survey was distributed among dentists through social media. Twenty-two items were divided as follows: characteristics of respondents; general knowledge about EAs; section for EA-users; and section for EA non-users. Chi-squared tests were used to analyze differences in responses between groups. Results: Participants included 226 Os and 168 GDPs. The majority in both groups reported having adequate knowledge about EAs and utilizing them in their practice. GDPs usually use EAs to treat children during the early phase of growth, while Os also use EAs to address orthodontic problems in different stages of dentition, experiencing a chair time reduction compared with traditional appliances. Regarding EA non-users, GDPs seem not to find an application among their patients, whereas Os reported not having enough patient compliance during treatment. Conclusions: Although treatment with EAs is common among all dentists, differences exist between Os and GDPs in the awareness and application, as well as in the reasons provided for not using EAs.

The aim of the current study was to assess patient and parental satisfaction following treatment during mixed dentition with two removable orthodontic devices: elastodontic appliances (EAs) and clear aligners (CAs). Consecutive patients below the age of 12 years who had completed the active phase of EA or CA therapy were recruited. A dedicated written questionnaire divided into four sections was used to measure parental and patient satisfaction regarding treatment experiences and treatment outcomes. The total sample included 56 subjects: 28 belonged to the EA group (7 girls and 21 boys; mean age 11 years); 28 belonged to the CA group (12 girls and 16 boys; mean age 9 years). Patients and parents of both the EA and CA groups were satisfied with the treatment experiences and outcomes. According to parental reporting, EA treatment was significantly more painful than CA therapy (p = 0.003), but this was not confirmed by the patients (p = 0.100). Both parents and patients reported EAs being significantly more difficult to wear than CAs (p < 0.001 and p = 0.001, respectively). Functional improvements were reported, including a reduction in grinding sounds in the CA group (p = 0.020) and breathing improvements in the EA group (p = 0.023). According to the parents, school life and social life were significantly improved in the CA group, as compared to the EA group (school life p < 0.001, social life p = 0.001). Finally, parents belonging to the CA group found that their child’s treatment was much shorter than expected (p = 0.003).

Arch expansion might be used to correct buccal corridors, improve smile aesthetics, resolve dental cross bite, and gain space to resolve crowding. In clear aligner treatment, the predictability of the expansion is still unclear. The purpose of this study was to evaluate the predictability of dentoalveolar expansion and molar inclination with clear aligners. In the study, 30 adult patients (27 ± 6.1 years old) treated with clear aligners were selected (treatment time: 8.8 ± 2.2 months). The upper and lower arch transverse diameters were measured for canines, first and second premolars, and first molars on two different sides (gingival margins and cusp tips); moreover, molar inclination was measured. A paired t-test and Wilcoxon test were used to compare prescription (planned movement) and achieved movement. In all cases, except for molar inclination, a statistically significant difference was found between achieved movement and prescription (p < 0.05). Our findings showed a total accuracy of 64% for the lower arch, 67% at the cusp level, and 59% at the gingival level, with a total accuracy of 67% for the upper arch, 71% at the cusp level, and 60% at the gingival level. The mean accuracy for molar inclination was 40%. Average expansion was greater at cusps of canines than for premolars, and it was lowest for molars. The expansion achieved with aligners is mainly due to the tipping of the crown rather than bodily movement of the tooth. The virtual plan overestimates the expansion of the teeth; thus, it is reasonable to plan an overcorrection when the arches are highly contracted.