This preliminary retrospective study evaluates how effective the OrthoPulse^® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign^® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign^® orthodontic clear aligners in association with an OrthoPulse^®. The OrthoPulse^® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse^® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse^® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse^® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse^® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements.

Introduction: Myobrace^® is an orthodontic device that has the purpose of correcting oral dysfunctions, thus predisposing the physiological growth of the jaws, aligning teeth, and optimizing face development. This device is usually associated with Myobrace^® Activities to reach this target. Considering the lack of studies in the literature about peripheral blood oxygen saturation (SpO₂) and the use of preformed oral devices, the aim of this study is to quantify the change in blood oxygen saturation (SpO₂) in patients treated with the Myobrace^® System in mixed dentition. Materials and Methods: In this study, 23 children (11 females and 12 males) were involved, who were affected by different oral dysfunctions and were treated with a Myobrace^®. Blood oxygen saturation measurements were taken at baseline and after every four months for a year. The SpO₂ measurements were taken in the rest position and with a closed mouth for a total of 12 min—6 min with and 6 min without the Myobrace^® oral device. All data points were anonymized and recorded on an Excel spreadsheet. A statistical analysis was carried out. Results: Therapy with a Myobrace^® in patients with mixed dentition resulted in a statistically significant increase in oxygen saturation. In particular, in patients with a closed mouth, a statistically significant increase in oxygen saturation was observed, bringing it from 97.66% to 99.00%, while in the rest position, the increase was from 98.03% to 99.07%. Conclusions: The use of Myobrace^® devices in patients with mixed dentition could lead to a significant improvement in blood oxygen saturation.

The purpose of this systematic review is to analyze the dentoalveolar changes resulting from the use of clear aligners in the treatment of transverse maxillary deficiency among growing children in the mixed dentition stage. An electronic literature search was carried out using the following databases: PubMed, Scopus, Cochrane Library, Embase, and Web of Science. The review protocol was prospectively registered in the PROSPERO database. Eligible studies included children aged 6 to 12 years in the mixed dentition period, presenting with erupted maxillary first molars and a transverse deficiency of the maxilla, and undergoing treatment with Invisalign^® First aligners. The review encompassed various study types including retrospective and prospective designs, randomized controlled trials, preliminary studies, and case series. Two independent reviewers conducted the data extraction process. The quality of evidence was assessed using the GRADE approach. Except for studies by Bruni et al., the risk of bias in selected articles was visually summarized in a traffic light plot using the robvis tool, following the ROBINS-I methodology. For the studies by Bruni et al., a separate visual representation was created using robvis with the RoB2 evaluation framework, prepared by the authors S.E.I. and C.A. In total, 14 studies were included in the final synthesis, selected from 265 records retrieved through electronic searches and an additional 36 identified via manual screening. Several parameters were considered in order to assess dentoalveolar expansion: intercanine width, intercanine transpalatal width, intercanine dentoalveolar width, first and second interdeciduous molar width, first and second interpremolar width, first and second interdeciduous molar transpalatal width, first intermolar width, first intermolar mesial, distal, and transpalatal width, molar inclination, arch depth, and arch perimeter, and intermolar dentoalveolar width. An improvement was recorded in all parameters. The studies comparing treatment with Invisalign^® First clear aligners and rapid maxillary expander highlighted that these both determined statistically significant differences compared to the natural growth group. Treatment with Invisalign^® First in mixed dentition proved to be very effective for dentoalveolar expansion of the maxillary arch, with good control of the crown angulation of the upper first molar and an increase in the palatal area similar to RME, compared to pre-treatment or to the natural growth group. It could represent an effective and comfortable alternative to the traditional rapid maxillary expander treatment. However, further high-quality studies are required to support our current observations and verifying the stability of treatment outcomes on a long-term basis.

The aim of this study is to retrospectively investigate the predictability of maxillary arch expansion with Invisalign ^® First in mixed dentition. In a sample of 64 treated patients, 3D digital models from the ClinCheck^® software were compared with post-treatment digital models. Predicted maxillary expansion was related to the final outcome of expansion. At the cuspidal level, there was observed a predictability of 59.68% for deciduous canines, 63.77% for first deciduous molars, 66.99% for second deciduous molars, and 55.61% for first permanent molars. At the gingival level, there was observed a predictability of 49.87% for deciduous canines, 53.11% for first deciduous molars, 53.36% for second deciduous molars, and 45.16% for first permanent molars. The difference between the predicted and achieved expansion was statistically significant (p < 0.05). Within the present limitations, our results suggest that, with Invisalign^® First, it is possible to expand the upper arch in mixed dentition in an effective and predictable way. Clear aligners could represent a new and valid alternative for arch expansion in growing patients.

Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is demanded to reach the optimal therapeutical level; hence, aligners can only be removed during meals. Patients’ compliance might increase and the duration of the treatment might decrease if they were allowed to eat with aligners on. The idea of patients keeping the aligners on during meals has been contemplated, not only to favor patients’ compliance but also treatment effectiveness. This study aims to assess the degree of chewing difficulty that aligners cause when eating certain kinds of food and the quantity of residue left. Material and Methods: A questionnaire titled “Questionnaire for the Assessment of Masticatory Function with Aligners” was administered using Google Forms to 240 patients in treatment with clear aligners. The survey was validated through the reliability test using the test–retest method. This method had a higher correlation coefficient of 0.9 across all items (with a cutoff of 0.8) with statistical significance, and an excellent internal correlation coefficient (α > 0.9). The statistical analysis performed consisted of descriptive analysis, frequencies, percentages, Pearson’s correlation test and Friedman’s test. Results: Pearson’s test showed a statistically significant correlation between all items except between meat or clams and yogurt or ice cream and with mozzarella or soft cheese regarding food chewing difficulties. Pearson’s test showed a statistically significant correlation between all items regarding food residues. A total of 69.2% of the cohort reported some movements of aligners during mastication. In total, 88.3% of them affirmed not to have perceived deformations or breakage of aligners during chewing. Furthermore, 79.2% of them declared that they would continue to eat if eating with aligners was proven to speed up treatment. Conclusions: Wearing clear aligners while chewing foods such as yogurt, ice cream, soft cheese, bread, rice, etc., can be possible and can help shorten the duration of orthodontic treatment, benefiting both the patient and the orthodontist. However, further research using qualitative methods is needed to understand the barriers and facilitators to chewing food with aligners.

This study assessed the masticatory function of participants wearing clear aligners in order to determine whether these devices can be worn even when eating and therefore worn to extend treatment time and boost treatment effectiveness. An intercontrol test was conducted on 20 patients who received Invisalign^® treatment. Each participant was instructed to chew two pieces of Hue-Check Gum^® chewing gum (one pink and the other blue) in 5, 10, and 20 cycles both with and without aligners. After being removed from the oral cavity, the gum was dried and pressed using a 1 × 50 × 50 mm model that was 3D printed with a transparent layer in between. After being scanned on both sides with a flatbed scanner at 600 dpi, the samples were saved as jpg files and subjected to an optoelectronic examination using ViewGum software. To validate the procedure, a control group from a different institution (University of Bern) was used. A statistical analysis of the data was carried out. The Shapiro–Wilk test was used to confirm the normality of the samples. A one-way ANOVA test, a homogeneity of variance test, and a t-test did not reveal statistically significant differences between the two control groups, thus validating the methodology employed. In summary, clear aligners do not radically change the masticatory function while they are worn. As a result, clinicians can exploit the aligners for chewing to obtain a better fit of the plastic material to the dental surface and to attachments. Treatment times for patients could also be shorter.