Introduction: This study aimed to investigate the relationship between bone density and quantity at the insertion sites of palatal miniscrews and skeletal maturation-evaluated with the middle phalanx maturation method-in growing patients. Methods: Sixty patients were analyzed as having a staged third finger middle phalanx radiograph and a cone-beam computed tomography of the maxilla. On the cone-beam computed tomography, a grid was designed to parallel the midpalatal suture (MPS) and posterior to the nasopalatine foramen, both on the palatal and lower nasal cortical bones. Bone density and thickness were measured at the intersections, and medullary bone density was also calculated. Results: Of patients in MPS stages 1-3, 67.6% showed a mean palatal cortical thickness of < 1 mm, whereas in 78.3% of the patients in stages 4 and 5, it was > 1 mm. The nasal cortical thickness showed a similar trend (MPS stages 1-3: 62.16% < 1 mm; MPS stages 4 and 5: 65.2% > 1 mm). There was a significant difference in the density of the palatal cortical bone between MPS stages 1-3 (1272.05 +/- 191.13) and stages 4 and 5 (1572.33 +/- 274.89) and in nasal cortical density between MPS stages 1-3 (1428.09 +/- 198.97) and stages 4 and 5 (1597.97 +/- 267.75) (P < 0.001). Conclusions: This study revealed a correlation between skeletal maturity and maxillary bone quality. MPS stages 1-3 have lower palatal cortical bone density and thickness but high nasal cortical bone density values. MPS stage 4 and, even more, stage 5 show increasing palatal cortical bone thickness and palatal and nasal cortical bone density values. (Am J Orthod Dentofacial Orthop 2023;164:406-15)

Objective: The aim of the present paper is to describe a systematic and detailed protocol for rapid orthodontic extrusion, and to summarize the main results of this protocol in terms of migration of dental, hard and soft tissues, for 10 cases.Clinical considerations: The working design was to apply a protocol lasting 4 weeks of active phase with intense forces (greater than 300 g), perform weekly the circumferential supra‐crestal fiberotomy procedure associated with root‐planning, follow up with a passive stabilization phase of another 4 weeks and evaluate the results.Conclusions: We believe that despite the partial migration of periodontal tissue, the defined protocol we used is, for simplicity of application, brevity of treatment and results, a viable alternative to the surgical technique of clinical crown lengthening in those cases where it is necessary to have more dental tissue exposed for restorative and prosthetic purposes.

Malocclusions and temporomandibular disorders (TMDs) are oral health problems that are spread worldwide. To date, few studies focused on their prevalence and associated risk factors are available. This study aims to define the prevalence and distribution of odontostomatological traits and evaluate specific risk factors in isolated villages in north-eastern Italy, taking advantage of their environmental homogeneity. Nine hundred and forty-four participants aged six to eighty-nine years were enrolled. Thirty-one odontostomatological phenotypes, classified into five domains (airways, bad habits, extraoral and intraoral parameters, TMDs, and teeth), were evaluated. A descriptive statistical analysis was performed; mixed logistic models were used to test the relationships among the traits. According to the study’s findings, Angle’s class I was prevalent (65.3%) followed by class II malocclusion (24.3%); class III and reversed overjet were the least frequent malocclusions (10.4% and 1.8%, respectively). Temporomandibular joint (TMJ) click/noise was prevalent among TMDs (34.7%). The statistically significant (p-value < 0.05) risk factors were ankyloglossia for phonetic issues (OR 1.90) and bruxism for TMJ click/noise (OR 1.70) and pain (OR 2.20). Overall, this work provides a picture of the prevalence of malocclusions and TMDs in a large Italian sample and reveals risk factors to take into account in the development of preventive strategies and treatments.

This study aims to identify the presence, timing, and magnitude of a prepubertal mandibular growth spurt in a Class I and Class II population. From the Burlington and Iowa Growth study of the AAOF Craniofacial Growth Legacy Collection, 83 Class I subjects (37 females and 46 males) and 32 Class II subjects (18 males and 14 females) were identified, as having at least seven consecutive annual lateral cephalograms taken from 5 to 11 years of age. Only subjects with a normodivergent facial pattern were considered. A customized cephalometric analysis was performed, and total mandibular length, defined as the distance between Condylion (Co) and Gnathion (Gn), was calculated. Overall, a significant early peak of mandibular growth was present in all the subjects analysed both in Class I (4.69 mm for males and 4.18 mm for females; P < .05) and in Class II (5.85 mm for males and 4.05 mm for females; P < .05). No differences between males and females were found for the timing of this peak (7 years for Class I and Class II females and 7 years for Class I and 6.5 years for Class II males). In males, a significantly larger peak was observed in Class II than Class I subjects (P = .007). The main limitations of this study were the impossibility of using a suitable growth indicator to identify the timing of the early mandibular growth peak and the limited Class II records retrievable. This investigation suggests that a prepubertal mandibular growth peak is consistently present in both Class I and Class II males and females of clinically significant magnitude. Despite that, chronological age confirms to be unsuitable to identify this peak.