Lombardo, Luca

Einleitung: Dieser Fallbericht zeigt die Behandlung einer Klasse-I-Patientin mit transversaler Unterentwicklung des Oberkiefers unter Verwendung einer hybriden Gaumennahterweiterungsapparatur (GNE-Apparatur). Um unerwünschte dentale Effekte zu vermeiden und eine rein skelettale Expansion insbesondere des vorderen Gaumens zu erreichen, wurde im Verlauf der Behandlung von der hybriden auf eine rein knöcherne Verankerung umgestellt. Kasuistik: Die 13-jährige Angle-Klasse-I-Patientin mit Tendenz zu einem frontoffenen Biss wünschte die Korrektur der Fehlstände ihrer Frontzähne. Die Patientin wies neben einer bilateralen Klasse-IMolarenbeziehung beidseits eine Klasse-II-Eckzahnbeziehung (Höckerspitzen auf gleicher Höhe) auf. Der Oberkiefer war transversal unterentwickelt und der obere Zahnbogen V-förmig, aber es bestanden keine Kreuzbisse. Die ektopen oberen Eckzähne zeigten sich kranial verlagert und die seitlichen Schneidezähne standen zu weit palatinal. Nach einer ersten Expansionsphase mit der hybrid verankerten GNE-Apparatur (21 Aktivierungen) wurde durch Entfernen der beiden Retentionsarme auf eine rein knöcherne Verankerung umgestellt (weitere 14 Aktivierungen). Anschließend wurden zur Stellungskorrektur, Nivellierung und Kieferkoordination in beiden Kiefern Multibracketapparaturen eingesetzt, woraufhin weitere Aktivierungen der knöchern verankerten GNE-Apparatur erfolgten (insgesamt 45 Aktivierungen). Schlussfolgerungen: Hybride GNE-Apparaturen sind eine sinnvolle Option für die Schmalkieferkorrektur bei adoleszenten Patienten mit fortgeschrittener Skelettreife. Eine exakte Planung der Miniimplantatinsertion mit bikortikaler Verankerung erleichtert den Wechsel von der hybriden zu einer rein knöchernen Verankerung, die unerwünschte dentale Effekte vermeidet und die skelettale Wirkung maximiert. Zudem ermöglicht sie eine transversale Expansion des vorderen Gaumens, ohne iatrogene bukkale Nonokklusion zu generieren. Parole chiave: bikortikale Verankerung, Multibracketapparatur, GNE-Apparatur, Oberkiefer, palatinale Miniimplantate, Schmalkiefer, Gaumenexpander, skelettale Verankerung, transversale Unterentwicklung

This case report describes a patient with two missing teeth who underwent one-stage orthodontic treatment using minimally visible appliances. As one space was already closed, the treatment consisted of asymmetrical space closure using skeletal anchorage and a partial vestibular appliance. The goal was to close the extraction space by mesialising the posterior teeth while avoiding side-effects on the other teeth, considering that both the maxilla and mandible were symmetrical to each other, and the dental midlines were perfectly coincident. This case report demonstrates the possibility of achieving space closure using maximum anterior anchorage without adverse effects on the rest of the dentition and the profile. Parole chiave: asymmetrical space closure, maximum anterior anchorage, Miniscrew Assisted Palatal Appliance System

The objective of this clincal article is to describe a new method to assess the accuracy of extra-alveolar miniscrew placement with respect to the digital planning. This is a radiation-free method; thanks to a specially printed abutment, it is possible to obtain two .stl files: one with the digital planning of the miniscrew position and another of the miniscrew placed in the oral cavity. These two files are superimposed with Geomagic Control X Software to assess the discrepancy between the digitally planned and the actual position of the miniscrew. Parole chiave: skeletal anchorage, digital planning, radiation free, miniscrew placement, model superimposition

This case report describes a complex full-step Class-II malocclusion with protrusion of maxillary incisors in an adult patient treated with lingual straight-wire appliance. The two-fold aim was to obtain an ideal occlusal relationship and improvement of smile aesthetics. This report illustrates that an appropriate treatment strategy, including anchorage control by en-masse distalisation and intermaxillary elastics, is needed to achieve the planned results, even with a completely invisible appliance. The placement of miniscrews on the palatal side provided more space for tooth distalisation, thus allowing the correction of a full-step Class-II relationship. An aesthetic buccal sectional was added in the last two months of treatment to correct the maxillary left first premolar, which exhibited a significant torque discrepancy during en-masse retraction. Parole chiave: Class-II, en-masse distalisation, miniscrews, lingual appliance

Aims: To assess the correlation between tooth wear and sleep-time masseter muscle activity (sMMA) in a group of healthy young adults who underwent home electromyographic/electrocardiographic (EMG/ECG) recordings with a portable device. Methods: A total of 41 healthy volunteers (23 women, 18 men; mean age 28.8 years, range 25 to 40) with good natural dentition underwent a 2-night in-home evaluation with a portable device that allowed a simultaneous sleep-time recording of EMG signals from both masseter muscles and heart rate. The number of sleep bruxism (SB) episodes per sleep hour (SB index); the number of phasic, tonic, and mixed sMMA events per hour; and the total number of sMMA events per night were calculated. All individuals also underwent an assessment of tooth wear on digital casts with the adoption of a six-degree rating scale. Correlations between sMMA variables and tooth wear were assessed using the Pearson test. The null hypothesis was that correlation between the two conditions would not be significant. Results: On average, the SB index was 4.5 ± 2.6, while the total number of sleep-time masseter contractions was 97.2 ± 55.2. Of those contractions, almost 60% were phasic. Average tooth wear was 1.5 ± 0.7, with the canines and mandibular incisors showing the highest wear scores. For all pairwise analyses, correlation values were not significant (P values 0.11 to 0.69), with r values ranging from 0.064 to 0.253. Conclusion: The null hypothesis of an absence of correlation between tooth wear and sMMA could not be rejected, implying that tooth wear cannot be used as an indicator of ongoing SB or sMMA. Future studies taking into account the multifaceted nature of tooth wear and the complex natural course of sleep phenomena are encouraged to investigate the issue further, at the individual level. J Oral Facial Pain Headache 2019;33:199–204. doi: 10.11607/ofph.2081 Parole chiave: electromyography, masticatory muscles activity, sleep bruxism, tooth wear

Aims: To assess the correlation between tooth wear and sleep-time masseter muscle activity (sMMA) in a group of healthy young adults who underwent home electromyographic/electrocardiographic (EMG/ECG) recordings with a portable device. Methods: A total of 41 healthy volunteers (23 women, 18 men; mean age 28.8 years, range 25 to 40) with good natural dentition underwent a 2-night in-home evaluation with a portable device that allowed a simultaneous sleep-time recording of EMG signals from both masseter muscles and heart rate. The number of sleep bruxism (SB) episodes per sleep hour (SB index), the number of phasic, tonic, and mixed sMMA events per hour, and the total number of sMMA events per night were calculated. All individuals also underwent an assessment of tooth wear on digital casts with the adoption of a six-degree rating scale. Correlations between sMMA variables and tooth wear were assessed using Pearson test. The null hypothesis was that correlation between the two conditions would not be significant. Results: On average, the SB index was 4.5 ± 2.6, while the total number of sleep-time masseter contractions was 97.2 ± 55.2. Of those contractions, almost 60% were phasic. Average tooth wear was 1.5 ± 0.7, with the canines and mandibular incisors showing the highest wear scores. For all pairwise analyses, correlation values were not significant (P values .11 to .69), with r values ranging from 0.064 to 0.253. Conclusion: The null hypothesis of an absence of correlation between tooth wear and sMMA could not be rejected, implying that tooth wear cannot be used as an indicator of ongoing SB or sMMA. Future studies taking into account the multifaceted nature of tooth wear and the complex natural course of sleep phenomena are encouraged to investigate the issue further, at the individual level. Parole chiave: electromyography, masticatory muscles activity, sleep bruxism, tooth wear

Objective: The aim was to conduct a semi-objective analysis of phonetic alterations in patients during the first 24 h after being fitted with F22 aligners. Our secondary objective was to analyse the patients' perception of any speech impediments caused by the aligners, and the impact of such alterations on their daily lives. Methods: Thirty patients were given the Fanzago articulation test at three different time points defined as T0 (before aligner fitting), T1 (immediately after aligner fitting) and T2 (24 h after aligner fitting), and results were evaluated independently by three speech therapists. Patients were also asked to fill in a questionnaire consisting of six items on their perception of any phonetic alterations provoked by the aligners, and the influence of this on their daily lives. Results: The results of the semi-objective analysis based on the Fanzago articulation test revealed the alteration of only three phonemes of the 28 assessed, specifically "s", "ts" and "ʃ". Furthermore, these alterations were only found in four out of 30 patients at T1, and three out of 30 patients at T2. The questionnaire revealed that 28 out of 30 patients perceived some speech anomalies, but that this had no significant impact on their daily lives. Conclusions: These findings show that F22-aligner therapy has no significant impact on patients' phonetic articulation; the alterations detected were slight and involved only three phonemes, "s", "ts" and "ʃ". Parole chiave: F22 aligner, orthodontic aligners, phonetic alterations

Aims: To determine whether there is a correlation between any psychological features and sleep bruxism (SB). Methods: A total of 36 healthy volunteers underwent an in-home evaluation with a portable device combining electromyographic (EMG) and electrocardiographic (ECG) recordings for the diagnosis of SB. They were administered questionnaires that assessed state and trait anxiety levels and coping strategies. The study hypothesis was that the SB index was significantly correlated with an individual's anxiety and coping. Correlation between SB index and psychological features was assessed and a comparison between SB prevalences in subjects with different psychological scores was carried out. Results: Correlation analysis showed that the SB index was not correlated with any of the psychological scales; however, there were some significant correlations (r values range from 0.393 to 0.458) between the SB index and specific items from the trait anxiety and coping scales. Crosstabulations of subjects with SB and with high (overmedian) or low (undermedian) scores for the various psychological measures revealed significant correlations between the prevalence of SB in higher-scoring subjects for state anxiety scores (Phi coefficient = .456; P = .006), trait anxiety scores (Phi = 0.369; P = .027), and social support coping strategy (Phi = 0.387; P = .020). Conclusion: These findings support the study hypothesis only in part and confirm the absence of a clear-cut relationship between SB and psychological features. Parole chiave: anxiety, bruxism, coping, personality, psychology, sleep bruxism