The present survey was performed to determine orthodontic treatment need in a large sample (n = 703) of 12-year-old schoolchildren from the southern part of Italy. The sample comprised 331 males (47 per cent) and 372 females (53 per cent), all orthodontically untreated. Two examiners, who had been previously trained in the use of occlusal indices, screened all the schoolchildren. The prevalence rates for the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) as well as for occlusal features (Angle Class, overjet, overbite, crowding, posterior crossbite) were calculated for the total sample. The IOTN grades were statistically compared in the two genders using the chi-square test. The findings indicated that this southern Italian school population showed a rather low prevalence rate for objective need for treatment (grades 4 and 5; 27.3 per cent of the total sample). This prevalence rate is generally lower than those reported in northern and central European countries (Sweden, Germany, and UK) but slightly greater than those in France. No significant differences in the DHC grades of the IOTN were found between genders. Among the occlusal features diagnosed in the subjects examined, a high prevalence rate was found for crowding (45.9 per cent). Moreover, posterior crossbites and Class III malocclusions, which would presumably have benefited from early orthodontic intervention, were still present in 14.2 and 4.3 per cent of the students, respectively.

Biologically active substances are expressed by cells within the periodontium in response to mechanical stimuli from orthodontic appliances. Several possible biomarkers representing biological modifications during specific phenomena as simile‐inflammatory process, bone resorption and formation, periodontal ligament changes, and vascular and neural responses are proposed. Citations to potentially published trials were conducted by searching PubMed, Cochrane databases, and scientific textbooks. Additionally, hand searching and contact with experts in the area were undertaken to identify potentially relevant published and unpublished studies. Selection criteria were as follows: animal models involving only mice and rats undergoing orthodontic treatment; collection of gingival crevicular fluid (GCF) as a noninvasively procedure for humans; no other simultaneous treatment that could affect experimental orthodontic movement. The data suggest that knowledge of the remodeling process occurring in periodontal tissues during orthodontic and orthopedic therapies may be a clinical usefulness procedure leading to proper choice of mechanical stress to improve and to shorten the period of treatment, avoiding adverse consequences. The relevance for clinicians of evaluating the rate of some substances as valid biomarkers of periodontal effects during orthodontic movement, by means of two models of study, mice and men, is underlined.

To evaluate differences between orthodontists and general dentists in experience with clear aligners (CA), patients’ demand and perception, types of patients, and malocclusion treated with CA and to compare the two groups of clinicians not using CA in their practice. A Web-based survey was developed and sent to the 129 members of the European Aligner Society and randomly to 200 doctors of dental surgery by e-mail. They responded on demographics and to one of two different parts for clinicians using CA or not using CA. Statistical analysis was performed with SAS EGv.6.1. The response rate was 74%. Among the total of respondents, the majority reported utilizing CA in their practice with a greater percentage of orthodontists (P = 0.0040). Overall, orthodontists learned more about CA during academic seminars comparing to general dentists, and they treated more class I with crowding (P = 0.0002) and with open bite (P = 0.0462). The majority of patients treated with CA were female and adults with a full-time employment, and the patients’ knowledge about CA treatment was mainly provided by information from external media advertising. For respondents not using CA, orthodontists were more likely to report that CA limit treatment outcomes, whereas general practitioners were reported not having enough experience to use them. There were some significant differences between orthodontists and general dentists mainly in experience and case selection for clinicians using CA as well as in the reasons provided for not using CA in their practice.

Aim: The aim of the present study was to compare the accuracy of the actual space obtained through interproximal enamel reduction (IPR) compared to the amount of IPR planned through the digital setup during clear aligner treatment (CAT). Materials and methods: A total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with CAT and manual stripping were selected for a total of 40 subjects and 80 dental arches. For each patient, the amount of planned IPR and the amount of actual IPR performed were recorded. Each arch was considered individually. For each arch, the mesio-distal tooth measurements were obtained from second to second premolars. Results: No systematic measurement errors were identified. In 25 cases, stripping was planned and performed in both arches; in 4 cases only in the upper arch and in the remaining 7 cases only in the lower arch. The difference between planned IPR and performed IPR was on average 0.55 mm (SD, 0.67; P = 0.022) in the upper arch and 0.82 mm (SD, 0.84; P = 0.026) in the lower arch. The accuracy of IPR in the upper arch was estimated to be 44.95% for the upper arch and 37.02% for the lower arch. Conclusion: Overall, this study showed that the amount of enamel removed in vivo did not correspond with the amount of IPR planned. In most cases, the performed IPR amount was lower than planned. When considering the actual amount in millimeter, these differences may not be considered clinically relevant.

Background: The use of locally delivered antibacterials containing chlorhexidine (CHX) was proposed to improve the effectiveness of non‐surgical periodontal treatment. The present multicenter randomized study investigated the effects of a xanthan‐based chlorhexidine (Xan‐CHX) gel used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.Methods: Ninety‐eight systemically healthy subjects with moderate to advanced periodontitis were recruited in four centers (59 females and 39 males; aged 24 to 58 years). For each subject, two experimental sites located in two symmetric quadrants were chosen with probing depths (PD) ≥5 mm and positive for bleeding on probing (BOP). These two sites were randomized at the split‐mouth level with one receiving a single SRP treatment and the other receiving a single SRP + Xan‐CHX gel treatment. Supragingival plaque, modified gingival index, PD, clinical attachment level (CAL), and BOP were evaluated at baseline (prior to any treatment) and after 3 and 6 months. At the same times, subgingival microbiologic samples and gingival crevicular fluid (GCF) were collected for the analysis of total bacterial counts (TBCs), including the identification of eight putative periodontopathogens, and alkaline phosphatase (ALP) activity, respectively.Results: The Xan‐CHX treatment group showed greater improvements compared to the SRP group for PD and CAL at 3 and 6 months (P <0.001). The differences in PD reduction between the treatments were 0.87 and 0.83 mm at 3 and 6 months, respectively (P <0.001); for CAL, these were 0.94 and 0.90 mm, respectively (P <0.001). Similar behavior was seen when the subgroup of pockets ≥7 mm was considered. The percentage of sites positive for BOP was similar between the treatments at each time point. For the comparisons between the treatment groups, no differences were seen in the TBCs and GCF ALP activity at baseline and 6 months; in contrast, slightly, but significantly, lower scores were recorded for the Xan‐CHX treatment group at 3 months (P = 0.018 and P = 0.045, respectively). Moreover, greater reductions in the percentages of sites positive for the eight putative periodontopathic bacteria were generally seen for the Xan‐CHX treatment group compared to SRP alone.Conclusions: The adjunctive use of Xan‐CHX gel promoted greater PD reductions and CAL gains compared to SRP alone. These results were concomitant with better microbiologic and biochemical outcomes when Xan‐CHX gel use was added to SRP, particularly up to 3 months after treatment.