To compare preadolescents’ smile outcomes after two different orthodontic treatments: RME/Schwarz plate (RS) and clear aligners (CAs). A sample of 31 patients (13 M, 18 F, mean age 8.3 ± 1.2 y.m) treated with RS and a sample of 28 patients (12 M, 16 F, mean age 7.9 ± 1.1 y.m) treated with CAS were included. Pre-treatment and post-treatment records were taken before the treatment (T1) and at the end of treatment (T2). Seventeen variables were evaluated. Both therapies were effective in smile width increase (RS = p < 0.02; CAs = p < 0.04) and buccal corridor reduction (RS = p < 0.02; CAs = p < 0.04). The intragroup analysis showed in the RS group an increase of incisor gingival display (p < 0.02), overbite (OVB) (p < 0.04) alongside a reduction of overjet (OVJ) (p < 0.01). Conversely, the CAs group evidenced a reduction in incisor gingival display (p < 0.04) and OVB (p < 0.01) with an increase in C angulation (p < 0.02) and maxillary incisor inclination (p < 0.04). An intergroup comparison evidenced a greater improvement in smile width, smile index and buccal corridor in the RS group with respect to the CAs group (p < 0.02; p < 0.02; p < 0.03). CAs were more effective in the management of gingival display, incisor position, midline correction (incisor gingival display p < 0.01; maxillary incisor position p < 0.04; maxillary dental midline p < 0.02), with a better control of OVJ (p < 0.01) and OVB (p < 0.02). The RS approach resulted in a greater smile width and a reduction in buccal corridor with respect to the CAs. The CAs provided a better management of both gingival display and smile aesthetics.

Background: Severe skeletal Class III malocclusion in adult patients often requires a combined orthodontic–surgical approach to achieve optimal functional and aesthetic outcomes. Methods: a 25-year-old female presented with severe skeletal Class III malocclusion characterized by maxillary retrusion and mandibular prognathism. Treatment included presurgical orthodontic decompensation followed by Le Fort I osteotomy and bilateral sagittal split osteotomy. Results: significant improvements in facial aesthetics, occlusion, and function were achieved. Conclusions: a combined orthodontic–surgical approach proved effective in achieving stable outcomes.

Objectives: The aim of this case report is to demonstrate that the Invisalign® clear aligner system is an effective and optimal therapeutic option for the treatment of Class II Subdi-vision malocclusion in adolescent patients. Methods: Z.E., a 13.3-year-old Caucasian female adolescent, presented with permanent dentition, Class II Subdivision malocclusion characterized by a Class II molar and canine relationship on the right side and a Class I molar and canine relationship on the left side, increased overjet and overbite, improper inclination of the upper incisors with diastemas, diastemas also present in the lower arch, and non-coincident midlines. The Invisalign® Comprehensive package was selected, and three sets of clear aligners were planned. The patient was instructed to wear the aligners full-time and to change every 7 days. At each follow-up appointment, scheduled every 4 weeks, a single operator assessed aligner fit, attachment positioning, and patient com-pliance. The treatment plan included expansion and restoration to achieve optimal upper and lower arch form, sequential distalization at 50% in the upper right quadrant, Class II elastics, and a “frog-staging” pattern for upper anterior retraction to achieve appropriate vestibular inclination (torque) of the upper incisors during the final phase. Results: Functional occlusion with Class I molar and canine relationships was achieved on both sides. Proper inclination of the upper and lower incisors was obtained. Good inter-cuspation and coincident midlines were observed at the end of treatment. Conclusions: In this case of Class II Subdivision malocclusion, effective esthetic and stable results were achieved using the Invisalign® clear aligner system.