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Despite the growing demand for improving smile aesthetics and occlusal functionality, a significant percentage of patients still refuse or discontinue orthodontic treatment because of pain and discomfort related to this therapy. As consequence, controlling the pain experienced by patients during the same therapy represents a primary concern for both patients and clinicians. Recent pieces of evidence have suggested that photobiomodulation can reduce pain experienced by patients during the decrowding stage or during specific protocols, for example, rapid maxillary expansion. PBM can be performed with lasers and also with a light-emitting diode (LED) device. Nonetheless, few studies on the latter are still present in the literature. The aim of this research is to evaluate the efficacy of photobiomodulation (PBM) with Laser devices in pain management in fixed orthodontic treatment. Only 14 of all articles met the inclusion and exclusion criteria and were therefore used to conduct the research. The different studies compared, in most cases, patients whose mouths were divided into a part treated with PBM and a placebo part. Most of their results show a statistically significant difference in perceived pain between the irradiated arch and the nonirradiated arch. Three authors did not find statistically significant results in favor of PBM, but they used different laser parameters. To obtain generally valid studies, with consistent and reproducible results, it is necessary to standardize the different laser parameters used. LED is less operator-dependent than laser and PBM using this technology seems to have a biological basis similar to that with lasers. In some studies, its clinical efficacy in pain reduction in some orthodontic therapies has been verified. Finally, this article aims to consider LED technology as a future prospect of research on PBM use in orthodontics.

The purpose of this study is to analyze the microbiota of patients undergoing orthodontic treatment with multibrackets and transparent aligners. The second goal is to evaluate the effectiveness of the oral irrigator on the oral hygiene and periodontal health of orthodontic patients. Fifty patients (27 F, 23 M; mean age 21.5 years) were recruited for the study, then divided into two groups. Group A underwent fixed orthodontic therapy with multibracket, and a home protocol that included manual orthodontic toothbrush, interdental brushes, and one-tuft brushes. Group B used transparent aligners for 22 h a day and a home protocol that included a manual brush with soft bristles and dental floss. After 3 months, all patients of the two groups, A and B, underwent plaque evaluation with a phase-contrast microscope. If the test result showed non-pathogenic bacterial flora, the subject continued with the traditional home oral-hygiene protocol. If the test detected pathogenic flora, the subject changed the home protocol, with a sonic toothbrush and oral irrigator, while the microbiological analysis continued to be performed after 3 months. After 3 months, 10 out of 25 patients treated with multibrackets (group A) and only 3 out of 25 patients with aligners (group B) passed from non-pathogenic flora to pathogenic flora. After 6 months, using the oral irrigator and a sonic toothbrush for 3 months, all subjects returned to non-pathogenic flora. This study confirms that in patients treated with multibrackets, the risk of developing unfavorable microbiota increases compared to those treated with clear aligners. The use of an oral irrigator combined with the sonic toothbrush seems to be able to restore good oral hygiene in subjects with pathogenic flora and therefore to be effective at reducing the risk of caries and gingivitis in orthodontic patients.

In the past, complex rehabilitations, such as the rehabilitation of an entire arch with a prosthesis on implants, were reserved for the few patients who presented an optimal state of health as the interventions were long and traumatic. Nowadays, the use of devices such as the Magnetic Mallet and the laser allows us to perform the same interventions in less time and in a minimally invasive way. The case report we present shows how a fragile patient, subjected to the insertion of eight implants on the same day, had a positive response, thanks to the use of a Magnetic Mallet to prepare the implant sites, the application of the photodynamic therapy without dye (diode laser + hydrogen peroxide) to decontaminate the post-extraction alveoli and the use of an erbium laser to induce more bone bleeding and promote healing. The implants were then loaded in 48 h with a Toronto-type temporary total prosthesis. The patient had a pain-free and complication-free outcome. It is interesting to note how technological development, aimed at reducing the morbidity of surgery, makes it possible to perform almost all surgical therapies, even the most advanced, on any patient, regardless of general health conditions.

Background: Epidemiological investigations define the prevalence and distribution of the various types of malocclusions, and can help to identify etiological factors and set the most correct orthodontic therapy. Aim: The goal of this study was to verify the prevalence and distribution of various types of malocclusions in the pediatric population. Methods: The study was performed on a sample of 350 patients (ages 5–9) being treated at the ASST Grande Ospedale Metropolitano Niguarda in Milan. A comparison was presented with one similar epidemiological investigation conducted 22 years earlier by the same researchers. The values of the malocclusion indices were reported from the cephalometric analyzes of the patients and were differentiated on the basis of gender and ethnicity. Results: The predominant traits of malocclusion in the general population of the analyzed sample were: skeletal class II (47.43%), hyper-divergence (40.86%), maxillary retrusion (46%), mandibular retrusion (66%), maxillary hypoplasia (50%), mandibular hypoplasia (49.14%), Wits index > 2 mm (22.57%); overjet > 4 mm (31.1%) and overbite > 4 mm (24.86%). Substantial differences were found between Italian patients and patients belonging to different ethnic groups in almost all parameters, and between the male and female genders in some of them. Patients in the 2000 study had a higher prevalence of Class II and hyper-divergence. Conclusions: This epidemiological investigation can suggest different approaches in setting the orthodontic treatment plan based on the ethnic group of the patient taken in charge and encourage more specific and large-scale analytical studies on the subject.