The interceptive treatment of Class II malocclusion using clear aligners is still debatable. This retrospective study analyzes the short-term occlusal and cephalometric effects in 40 growing patients with Class II malocclusion. The sample was divided into 2 groups: Following the dentoalveolar expansion protocol, the first group was treated with clear aligners (GI). The second group was untreated (GN). Dental arches were scanned before and 1 year after the therapy. Similarly, linear measurements on digital casts and cephalometric ones on lateral X-rays were compared. Maxillary (Lmax), mandibular intermolar length (Lmand), and posterior transverse intermolar discrepancy (DIT) were evaluated. The distance between the mesiobuccal cusp of the upper first molar and the buccal groove of the first lower molar was considered at both sides (Cdx and Csx). The statistical descriptive analysis of T0 and T1 values was performed using a paired t-test, setting a p value < 0.05. A greater improvement in molar and skeletal Class II parameters in the GI group compared to the GN group was detected. Specifically, in GI, Lmax improved by 3.3 mm, Lmand by 1.1 mm, and DIT improved from − 2.1 mm to 0.1 mm, while Cdx and Csx decreased by 1.28 mm and 1.13 mm, respectively. In contrast, the GN group showed smaller improvements, with Lmax increasing by 1 mm, Lmand by 0.8 mm, DIT improving from − 2 mm to -1.8 mm, and both Cdx and Csx exhibiting slight increases of 0.04 mm and 0.09 mm, respectively. No statistically significant differences were observed regarding divergence or the correlation between skeletal and dental measurements. Dentoalveolar expansion using Invisalign First appears effective and predictable with better outcomes than the control group. An improvement of skeletal Class II is detected in the treated group with dental improvements on maxillary arch.

Background: Orthodontically driven osteogenesis (ODO) is a surgical tunnel modification of periodontally accelerated osteogenic orthodontics (PAOO), combining selective corticotomy with bone grafting in sequential and/or segmental fashion. This is a minimally invasive approach that enhances periodontal health and allows orthodontic tooth movement beyond the original alveolar envelope. Considering the lack of long-term three-dimensional data on orthodontically driven osteogenesis (ODO), this study aims to quantitatively assess the long-term stability of alveolar bone and buccal cortical thickness following ODO, using CBCT imaging. The null hypothesis is that ODO does not result in significant changes in alveolar bone volume or cortical thickness over a seven-year follow-up period. Methods: Twenty patients (13 females, 7 males; mean age 27.4 ± 5.3 years) who had undergone orthodontically driven osteogenesis (ODO) using a minimally invasive tunnel approach and segmental corticotomy protocol followed by clear aligner therapy were retrospectively evaluated. The mean follow-up period after treatment was 7 years (range: 5–15 years). Cone beam computed tomography (CBCT) scans were obtained at one year postoperatively (T1) and again at the long-term follow-up visit (T2). Buccal bone thickness measurements were taken at standardized levels (3 mm, 5 mm, and 7 mm apical to the cementoenamel junction) and compared between T1 and T2 to evaluate bone stability over time. In addition, histologic evaluation of the previously grafted area was performed in two patients: one sample was collected during an alveolar ridge augmentation procedure six months after ODO, and the other during orthognathic surgery eight months after ODO. The samples were analyzed to assess new bone formation and integration of graft material. Results: Radiographic analysis showed long term stability of the new bone support. Histologic examination showed newly formed lamellar and reticular bone. Bone marrow showed no inflammatory infiltration, and bone particles were still detectable but incorporated in the newly created bone. Conclusions: Based on these findings, ODO appears to be a promising technique that could induce stable bone osteogenesis. A larger cohort study can enhance the evidence of these promising results to popularize this technique.

Background: This case report aimed to quantify dental, alveolar, and skeletal changes, periodontal health, and sleep quality after treatment with a tooth-borne rapid palatal expander (RPE) in a young adult with bilateral posterior crossbite due to transverse maxillary deficiency. Tooth-borne RPE is typically indicated during the prepubertal or pubertal growth phases; however, some post-pubertal or young adult patients may still present with incomplete maturation of the midpalatal suture—the so-called “gray zone.” In clinical practice, treatment decisions should ideally consider multiple skeletal resistance areas (the zygomaticomaxillary buttress, the pterygomaxillary junction, the nasal aperture pillars), although midpalatal suture assessment often remains central to case selection. Methods: A 19-year-old male patient presented with a skeletal Class III tendency, dental crowding, and anterior and bilateral posterior crossbites, accompanied by snoring and breathing difficulties. The patient declined surgical- and miniscrew-assisted RPE. Cone-beam computed tomography (CBCT) scan revealed incomplete midpalatal suture maturation. Based on periodontal evaluation, a conventional tooth-borne RPE was chosen. Pre- and post-expansion CBCT scans were used to evaluate dental, skeletal, and periodontal outcomes. Results: After one year of treatment, bilateral posterior crossbite was successfully corrected. Buccal bone thickness showed a slight reduction only on the upper left first molar (from 1.2 mm to 0.9 mm), without evidence of dehiscence or fenestration. A 2° increase in the dental tipping angle (DTA) was observed on both molars, and the palatal alveolar angle (PAA) increased by 3°. Sutural separation expanded from 0.32 mm to 7.82 mm. The Midpalatal Opening Related to Expander Opening (MORE) factor was 0.54, indicating a predominantly skeletal response. Periodontal health remained stable, and CBCT analysis confirmed increases in intermolar width (from 36.08 mm to 50.02 mm) and palatal maxillary width (from 28.04 mm to 34.5 mm). A reduction in the Pittsburgh Sleep Quality Index (PSQI) from 7 to 3 was observed, though this finding should be interpreted cautiously due to its subjective nature and the absence of objective airway measurements. Conclusions: The present case report suggests that tooth-borne RPE may represent a viable and minimally invasive option for correcting posterior crossbite in carefully selected young adults with incomplete midpalatal suture maturation. However, the findings are limited to a single case with short follow-up and should be regarded as hypothesis-generating rather than conclusive.

Pycnodysostosis (PDS) is an autosomal recessive form of osteosclerotic skeletal dysplasia characterized by craniofacial anomalies, a high-arched palate, and a narrowed pharyngeal space due to mandibular and maxillary deficiencies. These structural anomalies in the upper airway predispose PDS patients to obstructive sleep apnea (OSA). OSA can be managed in PDS patients using either a conservative (non-surgical and multidisciplinary) approach or surgical interventions. Given the craniofacial anomalies associated with PDS, orthodontic treatment aims to address the maxillary transverse deficit and retrognathia. Currently, there is no evidence regarding the impact of orthodontic therapy on OSA levels among PDS patients. This study reports the long-term morphological and functional changes in the upper airway of a PDS patient following adenotonsillectomy and uvulopalatoplasty at an early age (3.6 years) and orthodontic camouflage in late mixed dentition (10 years). Polysomnographies (PSGs), nuclear magnetic resonance (NMR), and lateral cephalograms taken before and after ENT surgery and orthodontic treatment were analyzed. Lateral X-rays were evaluated for changes in the posterior airway space (PAS), while polysomnographies provided the apnea–hypopnea index (AHI). The NMR scans were segmented to measure the perimeter and radius of the upper airway. The findings of this study indicate that improvements following uvulopalatoplasty (UPP) were partial and temporary. Nonetheless, orthodontic therapy and the use of elastics did not appear to influence the PAS or AHI. Future studies with larger cohorts are needed to evaluate the long-term effectiveness of the UPP procedure. This study was conducted in accordance with the CARE guidelines.

Digital integration has also extended to orthognathic surgery, allowing clinicians to overcome previous limitations related to periodontal architecture. This case report illustrates a fully digital approach to preparing for a dentoskeletal class III malocclusion for bimaxillary surgery. The patients underwent orthodontic treatment using Invisalign Clear Aligners to reverse the dental compensation associated with this malocclusion and enable the surgical repositioning of the maxillary and mandibular bones through maxillofacial surgery. Moreover, to ensure safe dental movement, periodontal support was provided through ODO (Orthodontically Driven Osteogenesis), a surgical technique combining selective corticotomy, particulate bone grafting, and orthodontic movement. “The patient underwent a Le Fort I osteotomy of the maxilla and a bilateral sagittal split osteotomy of the mandible. Fixation was achieved using custom-made titanium plates and screws to ensure stability. A refinement stage with aligners followed to accomplish a bilateral Class I molar and canine relationship(alignment?).”

Background/Objectives: Resin 3D printing is widely used to fabricate orthodontic diagnostic models, but the practical performance of commercial desktop workflows compared to dental-certified workflows is still debated. This study compared the dimensional accuracy and 7-day stability of maxillary orthodontic models printed from the same master STL file using a dental-certified workflow versus two commercial desktop workflows. Methods: An ISO 20896-1:2019-based reference cast with four 6 mm calibration spheres was used to generate a master STL file. Fifteen models were printed (n = 5 per workflow) using Primeprint™ (dental-certified workflow) and two commercial desktop printers (Anycubic Photon Mono M5s; Phrozen Sonic Mighty 14K REVO). The models were digitized at baseline (T0, ≤48 h) and after 7 days (T7) using a laboratory scanner. Surface superimposition in CloudCompare^® calculated the RMS (root mean square) surface deviation and mean signed deviation, and two calibrated operators performed independent extractions. Results: The mean RMS deviations were 0.05), and the inter-operator agreement was excellent (ICC 0.991–0.999). Conclusions: Under the tested workflows, dental-certified and commercial desktop resin printing produced orthodontic models with a comparable global surface accuracy and short-term dimensional stability.