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This study retrospectively evaluated the influence of prosthetic features on marginal bone level changes around bone-level implants with an external hex connection. A total of 100 patients with 166 implants and cemented crowns were included. Demographic and clinical data were collected. Prosthetic features were radiographically evaluated, including emergence angle (EA), emergence profile (EP), crown-implant ratio (CIR), and abutment height. Marginal bone levels were measured on intraoral radiographs taken at baseline and after at least 1 year. The correlation between prosthetic features and marginal bone loss (MBL) was then investigated. The mean follow-up time was 43.94 months. Implant length varied between 5 and 13 mm. The mean height of the abutments used was 1.55 mm. EA measured an average 30.62 degrees (± 13.20) mesially and 29.45 degrees (± 13.07) distally. The CIR was 0.99 (± 0.26). The mean MBL was 0.19 mm on the mesial side and 0.20 mm on distal side of the implants. Significant positive associations emerged between MBL and implant length (P < .005) and with EA (P < .05). A convex profile of the crown was shown to be associated with a higher distal MBL (P = .025) compared to concave and str aight profiles. [ABSTRACT FROM AUTHOR]

Featured Application: Nail biting is a very common oral disorder whose dental and clinical implication are not well-known. Therefore, this study is a novelty in the field of oral disease since it considers changes on tooth shape caused by nail biting. Nail biting (NB) is a repetitive and uncontrolled parafunctional activity that can affect oral health by altering tooth shape and intraoral position. Nowadays, there is not enough scientific evidence about the impact of NB on teeth; therefore, this study aimed to evaluate the effects of NB on the length, width and inclination of upper central incisors. This retrospective study involved 76 patients, 40 males and 36 females, with a mean age of 10.6 ± 0.3 years. Digital scans of the maxillary arch of each patient were recorded. Next, the length, width and inclination of upper central incisors used and not used for NB were measured. Finally, data were analysed with a paired t-test. Statistical analysis showed statistically significant differences in the length and inclination of upper central incisors used for NB compared with those of upper central incisors not used for NB, while the width did not show a significant difference. There were relevant changes in upper central incisors subjected to NB, demonstrating that NB impairs the shape, morphology and inclination of teeth. Therefore, because of the potentially negative consequences of NB, it is recommended that NB not be underestimated. [ABSTRACT FROM AUTHOR]

Introduction: Maxillary expansion is a fundamental interceptive orthodontic treatment, which can be achieved through either a rapid expansion protocol or functional devices. However, no data exist about the efficacy of functional devices in achieving skeletal expansion. Therefore, the aim of this study was to compare the effects of the rapid palatal expander (RPE) and the function‐generating bite type M (FGB‐M) on the transversal dimension of the maxilla, and on the maxillary and mandibular dental arch width. Methods: One hundred eighty‐one skeletal Class I patients, aged between 6 and 12 years and with a cervical vertebral maturation stage II or III, with maxillary transversal deficiency were retrospectively enrolled; among these 55 were treated with FGB‐M, 73 were treated with RPE and 51 were untreated subjects retrieved from historical databases. The pre‐treatment (T0) and post‐treatment (T1) frontal cephalograms were retrieved, and the maxillary and mandibular widths, and the distance between upper and lower first molars were measured. T1–T0 interval was of 17.3 months (RPE), 24.6 months (FGB‐M) and 18.2 months (controls). Results: The statistical analysis showed that there were no statistically significant differences between the RPE and FGB‐M groups regarding skeletal and dental expansion, while the untreated control group differed significantly from the other two groups. Conclusion: The comparison between patients treated with RPE and FGB‐M showed that there were no statistically significant differences between the RPE and FGB‐M groups regarding the amount of skeletal expansion and dental arch width, suggesting that both appliances can be used to achieve similar results. [ABSTRACT FROM AUTHOR]

Introduction: Implant stability is influenced by bone density, implant design, and site preparation characteristics. Piezoelectric implant site preparation (PISP) has been demonstrated to improve secondary stability compared with conventional drilling techniques. Osseodensification drills (OD) have been recently introduced to enhance both bone density and implant secondary stability. The objective of the present multi‐center prospective randomized controlled trial was to monitor implant stability changes over the first 90 days of healing after implant bed preparation with OD or PISP. Methods: Each patient received two identical, adjacent or contralateral implants in the posterior maxilla. Following randomization, test sites were prepared with OD and control sites with PISP. Resonance frequency analysis was performed immediately after implant placement and after 7, 14, 21, 28, 60, and 90 days. Implants were then restored with single screw‐retained metal‐ceramic crowns and followed for 12 months after loading. Results: Twenty‐seven patients (15 males and 12 females; mean age 63.0 ± 11.8 years) were included in final analysis. Each patient received two identical implants in the posterior maxilla (total = 54 implants). After 1 year of loading, 53 implants were satisfactorily in function (one failure in test group 28 days after placement). Mean peak insertion torque (40.7 ± 12.3 Ncm and 39.5 ± 10.2 Ncm in test and control group, respectively) and mean implant stability quotient (ISQ) value at baseline (71.3 ± 6.9 and 69.3 ± 7.6 in test and control group, respectively) showed no significant differences between the two groups. After an initial slight stability decrease, a shift to increasing ISQ values occurred after 14 days in control group and after 21 days in test group, but with no significant differences in ISQ values between the two groups during the first 90 days of healing. Conclusion: No significant differences in either primary or secondary stability or implant survival rate after 1 year of loading were demonstrated between implants inserted into sites prepared with OD and PISP. [ABSTRACT FROM AUTHOR]

Background: To evaluate the correlation between cephalometric skeletal parameters and Obstructive Sleep Apnea syndrome (OSAs) severity, in adult patients with OSAs., Material and Methods: One hundred patients (94 males,6 females mean age 59,3) with diagnosis of OSAs were retrospectively enrolled. Each patient received Home Sleep Apnea Testing (HSAT) and latero-lateral radiograph. Eight cephalometric parameters (cranial deflection angle, saddle angle, articular angle, divergence angle, cranial base angle, skull base length, mandibular length, maxilla length) were analyzed and then related to Apnea/Hypopnea Index (AHI) and to the Oxygen Desaturation Index (ODI), recorded by HSAT. A Spearman's rho correlation test between cephalometric measurements and HSAT indices was performed. Statistical significance was set at p < 0.05., Results: A negative statistically significant correlation was found between mandibular length (Condilion-Gnathion distance) and AHI (rho= -0,2022; p <0,05) and between maxilla length (Ans-Pns) and AHI (rho= -0,2984; p <0,01) and ODI (rho= -0,2443; p <0,05). A statistically significant correlation was also observed between the divergence angle (S-N^Go-Me) and AHI (rho=0,2263; p <0,05) and between cranial deflection angle (Fh^NBa) and AHI (rho=0,2212; p <0,05) and ODI (rho=0,1970; p <0,05)., Conclusions: The OSAs severity may be related to certain predisposing features in craniofacial morphology, such as maxillary and mandibular length, divergence and cranial deflection. Key words: OSAs, Home Sleep Apnea Testing, AHI, ODI, Cephalometry, Airway., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright: © 2023 Medicina Oral S.L.)

Objective: The aim of this case report was to show the marginal bone level (MBL) variation, after 28 months, around an aesthetic post-extraction implant immediate loading positioned in a 46-years-old woman., Material and Methods: After a careful evaluation of the X-rays and CBCT images, a 4×13 conical implant was placed in seat 21 after the atraumatic extraction of the fractured element and the management of the infected area. Correct primary stability (torque 70 Ncm) was obtained by inserting the implant in a palatal position with respect to the alveolus. To complete the surgery, regeneration procedures were carried out using a granular bone substitute (Geistlich Bio-Oss®) covered with a connective tissue graft taken from the palate. Just three days later, a straight titanium abutment Curvomax™ with gold tite (UNIHG) was screwed (35 Ncm) and a lithium disilicate glass ceramic crown was cemented., Results: The radiographic analysis of the MBL at 28 months of follow-up shows a significant stability of the peri-implant bone confirmed by an excellent aesthetic integration of the soft tissues around the prosthetic crown., Conclusions: A careful and dedicated surgical planning accompanied by the use of appropriate materials and an accurate surgical protocol, seems to allow the rehabilitation of frontal areas that is difficult to manage, obtaining excellent aesthetic, functional and predictable results over time. We believe that the goal, in this case, is also linked to the immediate delivery of the final crown which has significantly reduced operating times and improved aesthetic parameters, translating into better patient satisfaction.

Background: Maxillary expansion is a common orthodontic procedure that could have a positive effect also on airway patency. The aim of the present study was to evaluate the long-term effects of rapid maxillary expansion (RME) on nasopharyngeal area and cranio-cervical angulation in growing patients, compared to controls treated with a function-generating bite appliance (FGB)., Material and Methods: Sixty patients aged 6-14 consecutively treated with RME or FGB were selected retrospectively and divided into two groups. Lateral cephalograms taken before and after treatment were retrieved, and the nasopharyngeal area, delimited superiorly by a sella-posterior nasal spine (PNS) line and inferiorly by a basion-PNS line, and the cranio-cervical angulation were measured., Results: The mean observation time was 17.6 ± 8 months. No differences were present between the two groups regarding age and gender. The nasopharyngeal area increased significantly in both groups after treatment, but with no statistically significant difference between them. The cranio-cervical angulation showed no differences within or between groups., Conclusions: Maxillary deficiency treatment with either RME or FGB was followed by a comparable increase in nasopharyngeal area. Key words: Rapid maxillary expansion, Airway, Nasopharyngeal area, Adenoid., Competing Interests: Conflicts of interest The authors declare that they have no conflict of interest., (Copyright: © 2021 Medicina Oral S.L.)

Background: In the present paper, the authors analyze the effect of the "Swallowing Occlusal Contact Intercept Appliance" (SOCIA) in treatment of children with hyperdivergent Class II malocclusion. This functional appliance has no intra-oral anchorage, but induces a continuous periodontal, muscular, and articular stimulation., Methods: Twenty-six patients with hyperdivergent growth and class II malocclusion were selected and treated with SOCIA appliance. Cephalometric analysis was performed before treatment (T1) and immediately after the treatment (T2)., Results: After 24 months treatment authors observed a modification of maxillary growth with a reduction of the divergence with an increase of the posterior facial height, a modification of condylar inclination and forward position of the a hyoid. No modifications was observed about the ANB angle. After treatment the open bite was resolved with a reduction of the inclination of the upper incisors., Conclusions: SOCIA is a reliable functional appliance in growing age patients with a hyperdivergent pattern growth, anterior open bite and class II molar malocclusion.

Background: To evaluate if changes in lower incisor position following orthodontic treatment are correlated with development of gingival recessions., Material and Methods: Pre- and post-treatment digital models and lateral cephalograms of 22 subjects were collected retrospectively. The clinical crown length, gingival scallop, and papilla height of the central lower incisor were measured along with the cephalometric incisor's inclination, the distance from the mandibular plane, and the distance between the Infradentale and Menton points. Statistical correlations between gingival and cephalometric variables were studied. In addition, two groups were defined based on the post-treatment incisor inclination value ('normal' or 'proclined') and compared., Results: The incisor inclination was correlated with the change in gingival scallop and papilla height. Moreover, there was a statistically significant difference in clinical crown height and gingival scallop between the 'normal' group and the 'proclined' group., Conclusions: Changes in lower incisor position, especially an excessive proclination, after orthodontic treatment may play a role in the development of gingival recession. Key words: Orthodontic treatment, Incisor inclination, IMPA, Gingival recession, Alveolar bone., Competing Interests: Conflict of interest statement:The authors state that they have no conflicts of interest.

Background: The aim of this study is to evaluate determinants of maxillary canine impaction taking into account both canine position related variables and the pattern of facial growth., Material and Methods: A retrospective clinical and radiographic analysis was carried out on 109 patients aged between 9 and 10 years at the time of first evaluation. At baseline, SN-GoMe angle, the interincisal angle, the canine angle α and the canine distance d were used to characterize canine location and vertical facial growth. At the end of a two years follow up period the eruption state of each canine of each patient was recorded and accordingly classified as erupted or impacted on a clinical and radiographic basis. Univariate and multivariate statistical analyses were performed, including correlation among the studied variables and principal components analysis; several machine learning methods were also used in order to built a predictive model., Results: At the end of the two years follow up period after the first examination, 54 (24.77%) canines were classified as impacted. Except for Angle α values, there were no statistically significant differences between impacted and erupted canines. The studied variables were not significantly correlated, except for the SN-GoMe Angle and the distance d in the impacted canine group and the angle α and the distance d in erupted canines group. All variables, except for SN-GoMe Angle in erupted canines, have a partial communality with the first two principal components greater than 50%. Among the learning machine methods tested to classify data, the best performance was obtained by the random forest method, with an overall accuracy in predicting canine eruption of 88.3%., Conclusions: The studied determinants are easy to perform measurements on 2D routinely executed radiographic images; they seems independently related to canine impaction and have reliable accuracy in predicting maxillary canine eruption. Key words: Canine impaction, Determinants, Facial growth., Competing Interests: Conflict of interest statement:The authors declare that they have no conflict of interests.

Background: A treatment modality for Class II division 1 malocclusion is discussed. Orthodontic treatment of patients with deep bite and Class II malocclusion is an important challenge in clinical practice. The aim of this work is to compare the efficacy of anterior bite plane functional appliance (ABPFA) by assessing the changes in different times with untreated patients by literature., Material and Methods: The study group comprised 22 subjects with Class II division 1 malocclusion and hypo-divergent. Eligibility criteria for this study were: dental Class II division 1 malocclusion, hypo-divergent skeletal pattern, late mixed or permanent dentition. We analyzed with the use of stable bone structure (ASCB) at two different times: pre-treatment (T0) and post-treatment (T1) after 24 months. Inter-group differences were evaluated with paired samples t-test at the P <0.05 level., Results: No statistical significant differences were found in cephalometric skeletal measurements, whereas dental parameters showed a significant different overjet, which was significantly reduced (6 mm at T0 vs. 5 mm at T1) in our series., Conclusions: In ABPFA group, the treatment effects were reduce mainly Class II malocclusion, overjet and overbite alteration. This appliance seems to suggest a significant beneficial effect in mandible displacement by reducing the counter clockwise rotation of the mandible, which is further confirmed by the almost absence of modifications of ArGoMe and SNGoMe angles. The ABPFA is particularly suitable to reduce the non-desirable dental effects represented by lower incisors pro inclination, and upper incisors retro-inclination. Key words: Orthodontics, Functional orthodontics, Class II malocclusion, Anterior bite plane functional appliance., Competing Interests: Conflict of interest statement:The authors have declared that no conflict of interest exist.