Background: The aim of this study was to evaluate oral status, the reasons for tooth extractions and related risk factors in adult patients attending a hospital dental practice. Methods: 120 consecutive patients ranging from 23 to 91 years in age (mean age of 63.3 ± 15.8) having a total of 554 teeth extracted were included. Surveys about general health status were conducted and potential risk factors such as smoking, diabetes and age were investigated. Results: a total of 1795 teeth were missing after extraction procedures and the mean number of remaining teeth after the extraction process was 16.8 ± 9.1 per patient. Caries (52.2%) was the most common reason for extraction along with periodontal disease (35.7%). Males were more prone to extractions, with 394 of the teeth extracted out of the total of 554 (71.1%). Male sex (β = 2.89; 95% CI 1.26, 4.53; p = 0.001) and smoking habit (β = 2.95; 95% CI 1.12, 4.79; p = 0.002) were related to a higher number of teeth extracted. Age (β = −0.24; 95% CI −0.31, −0.16; p < 0.001) and diabetes (β = −4.47; 95% CI −7.61, −1.33; p = 0.006) were related to a higher number of missing teeth at evaluation time. Moreover, periodontal disease was more common as a reason of extraction among diabetic patients than among non-diabetic ones (p = 0.04). Conclusions: caries and periodontal disease were the most common causes of extraction in a relatively old study population: further screening strategies might be required for the early interception of caries and periodontal disease.

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.