Accuracy and Completeness of ChatGPT-Generated Information on Interceptive Orthodontics: A Multicenter Collaborative Study.

Background: this study aims to investigate the accuracy and completeness of ChatGPT in answering questions and solving clinical scenarios of interceptive orthodontics. Materials and Methods: ten specialized orthodontists from ten Italian postgraduate orthodontics schools developed 21 clinical open-ended questions encompassing all of the subspecialities of interceptive orthodontics and 7 comprehensive clinical cases. Questions and scenarios were inputted into ChatGPT4, and the resulting answers were evaluated by the researchers using predefined accuracy (range 1-6) and completeness (range 1-3) Likert scales. Results: For the open-ended questions, the overall median score was 4.9/6 for the accuracy and 2.4/3 for completeness. In addition, the reviewers rated the accuracy of open-ended answers as entirely correct (score 6 on Likert scale) in 40.5% of cases and completeness as entirely correct (score 3 n Likert scale) in 50.5% of cases. As for the clinical cases, the overall median score was 4.9/6 for accuracy and 2.5/3 for completeness. Overall, the reviewers rated the accuracy of clinical case answers as entirely correct in 46% of cases and the completeness of clinical case answers as entirely correct in 54.3% of cases. Conclusions: The results showed a high level of accuracy and completeness in AI responses and a great ability to solve difficult clinical cases, but the answers were not 100% accurate and complete. ChatGPT is not yet sophisticated enough to replace the intellectual work of human beings.

"Surgery First" vs "Traditional Sequence" Surgery: A Qualitative Study of Health Experiences in 46 Bimaxillary Orthognathic Patients.

Introduction: Orthognathic patients are advocating an active role in selecting their appropriate ortho-surgical treatment, between the surgery first (SF) and the traditional sequence (TS) approaches. The aim of this study was to evaluate, through qualitative analysis, the subjective perceptions of the outcomes of each protocol. Methods: In-depth interviews were conducted with 46 (10 male and 36 female) orthognathic patients (23 SF and 23 TS) treated with bimaxillary orthognathic surgery by the same surgeon, between 2013 and 2015. Average treatment duration was 6.5 months for SF and 12 months for TS. Inclusion criteria were: the presence of Class III or Class II asymmetries and open bite. Patients were excluded if they refused interviews or stopped attending post-treatment follow-up. Investigated health experiences included overall satisfaction with appearance, self-confidence after surgery, perceived treatment time, functional recovery, and diet restrictions. Results: All SF and TS patients showed overall satisfaction with their appearance (though TS showed more enthusiastic tones) and approved their degree of functional recovery after surgery. Class III SF patients had earlier improvements in self-confidence after surgery. Orthodontics was considered enduring by both SF and TS patients. Conclusions: SF patients expressed a higher degree of satisfaction with the reduction in overall treatment time and with the early psychological benefit deriving therefrom. Both SF and TS patients completely approved of the aesthetic outcomes and the functional recovery from which they benefitted due to the entire procedure.

Association between Polymorphisms in the IL-1ß, TNFRSF11B, CASP1, and IL-6 Genes and Orthodontic-Induced External Apical Root Resorption.

Orthodontic-induced external apical root resorption (EARR) is a severe condition affecting the roots of the teeth, whose genetic causes have been inconclusive to date. The aim of the present study was to assess the influence of selected single nucleotide polymorphisms (SNPs) IL-1ß, TNFRSF11B, CASP1, and IL-6 genes on post-orthodontic EARR. A sample of 101 patients with clearly assessable orthopantomograms and lateral cephalometric radiographs taken before and at the end of the orthodontic treatment was used to evaluate the presence of EARR. The association between genetic polymorphisms and EARR was assessed with the Chi2 test. A binary logistic multi-level model was built to evaluate the ability of patient- and tooth-level variables to predict EARR occurrence. The overall prevalence of EARR resulted to be around 40%. Within the limitations of this study, a significant association was found between EARR presence and the SNP for the IL-1ß gene but not for the TNFRSF11B, CASP1, and the IL-6 genes. The final multi-level model demonstrated that the SNP for the IL-1ß gene increases the odds of developing EARR by around four times. Since there is currently no accurate method to determine which patients will develop EARR prior to orthodontic treatment, further studies are needed to investigate the predictive ability of further genetic variants on EARR development.

Efficacy of Behaviour Change Techniques to improve oral hygiene control of individuals undergoing orthodontic therapy. A systematic review.

AIM: This study aims to review the available evidence on the efficacy of behaviour change techniques to improve compliance in young orthodontic patients and to compare these with conventional oral hygiene instructions. METHODS: The review was conducted according to the PRISMA statement. PICO method was used to define eligibility criteria. Two independent reviewers performed the research, examined electronic databases (MEDLINE, Scopus and CENTRAL) and manually checked relevant journals. Only RCTs with more than 10 participants and 3 months follow-up were included. Data extraction and their qualitative analysis were performed for included studies. RESULTS: Search strategy identified 320 articles. After screening for titles, abstracts and full texts, 10 articles were then selected for qualitative analysis. High methodological heterogeneity was present among studies and therefore no meta-analysis was performed. Low risk of bias was detected for one study only. The most common intervention was "mobile phone communication," which was investigated in five studies. Motivational interviewing, repeated reinforcements and visual-aided approach were also examined. CONCLUSION: The interest in remote control of patients compliance appears to be fruitful, nonetheless there is no consensus as to a unique treatment protocol. Every other treatment looks beneficial but higher methodological homogeneity should be sought for in future investigations.

Influence of single post, oval, and multi-post restorative techniques and amount of residual tooth substance on fracture strength of endodontically treated maxillary premolars.

PURPOSE: The aim of this study was to compare the influence of the number of coronal walls and post-endodontic restorations on the mechanical strength of 165 recently extracted endodontically treated maxillary premolars. METHODS: The teeth were divided into 3 control (no post) and 3 test groups according to the number of residual walls. Each test group was divided into subgroups according to the type of post-endodontic restoration (single, oval, and multi-post techniques). Samples were prepared conforming to the assigned subgroup. A universal loading machine applied a load parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and the Kruskal Wallis test were used for comparisons (P ≤ 0.05), and Tukey's test for multiple comparisons. RESULTS: For intact teeth, significant differences were found among all 3 subgroups, with single post showing the highest values. For 3 residual walls, oval post resulted in significantly lower values than single and multi-post systems. For 2 residual walls, the multi-post technique showed almost twice the resistance of oval post restorations. CONCLUSION: In oval canals the use of a single or multi-post technique increased post-and-core resistance even in intact teeth, whereas oval fiber posts showed no improvements. Multi-post design improved fracture resistance mostly in maxillary premolars lacking both marginal ridges.

A New Proposal: a Digital Flow for the Construction of a Haas-Inspired Rapid Maxillary Expander (HIRME).

Maxillary expansion is a common orthodontic treatment used for the correction of posterior crossbite resulting from reduced maxillary width. Transverse maxillomandibular discrepancies are a major cause of several malocclusions and may be corrected in different manners; in particular, the rapid maxillary expansion (RME) performed in the early mixed dentition has now become a routine procedure in orthodontic practice. The aim of this study is to propose a procedure that reduces the patient cooperation as well as the lab work required in preparing a customized Haas-inspired rapid maxillary expander (HIRME) that can be anchored to deciduous teeth and can be utilized in mixed dentition with tubes on the molars and hooks and brackets on the canines. This article thus presents an expander that is completely digitally developed, from the first moment of taking the impression with an optical scanner to the final solidification phase by the use of a 3D printer. This digital flow takes place in a CAD environment and it starts with the creation of the appliance on the optical impression; this design is then exported as an stl extension and is sent to the print service to obtain a solid model of the device through a laser sintering process. This "rough" device goes through a post-processing procedure; finally, a commercial expansion screw is laser-welded. This expander has all the advantages of a cast-metal Haas-type RME that rests on deciduous teeth; moreover, it has the characteristic of being developed with a completely digitized and individualized process, for the mouth of the young patient, as well as being made completely of cobalt-chrome, thus ensuring greater adaptability and stability in the patient's mouth.

Upper canine response to rapid maxillary expander anchored to deciduous vs. permanent molars.

PURPOSE: To understand whether two different designs of Haas-type rapid maxillary expander (H­RME) might have a different influence on canine eruption. PATIENTS AND METHODS: In all, 108 subjects seeking orthodontic treatment were selected and divided into two groups-H­RME with bands on the upper second deciduous molars (GrE), H­RME with bands on the upper first permanent molars (Gr6)-and were also compared to an historical untreated control group (CG) of 29 subjects. Panoramic x­rays (OPG) were performed before and after RME (T0-T1: 16 ± 7 months) and the upper canine angulation to the midline ("α" angle) was measured on both pre- and posttreatment OPG. RESULTS: A significant improvement of the canine position (decrease of the α angle) following RME in subjects with mixed dentition was reported in both treated groups, although the different design of the RME did not significantly affect canine angulation. Canine angulation in untreated subjects with transversal discrepancy did not improve significantly. CONCLUSION: Using RME in the early mixed dentition appears to be an effective procedure to increase the rate of eruption of maxillary canines, but the position of the bands on the upper second deciduous molars or on the upper first permanent molars and the significant different expansion of the upper dental arch at the canine level does not significantly influence the canine angulation following early treatment therapy.

Different Post Placement Strategies for the Restoration of Endodontically Treated Maxillary Premolars with Two Roots: Single Post vs Double Post.

AIM AND OBJECTIVE: The present study compared the fracture strength and failure pattern of endodontically treated, bi-rooted, maxillary premolars with different number of coronal walls and postendodontic restoration (one vs double post). MATERIALS AND METHODS: 105 premolars were divided into 3 groups according to the number of residual walls: control group (intact teeth; n = 15), group 1 (3 residual walls; n = 45), group 2 (2 residual walls; n = 45). Each test group was then divided into 3 subgroups (n = 15 each) according to postendodontic restoration: no post (A), 1 post (B) or 2 posts (C). A load was applied parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and Tukey's tests were used to detect fracture strength differences among groups, while Chi-square test was used to check differences in fracture pattern. RESULTS: No significant differences were observed between control group (intact teeth) and groups A1 (p = 0.999), B1 (p = 0.997) and C1 (p = 1.000); statistically significant differences were detected between control group and groups A2 (p < 0.001), B2 (p < 0.001) and C2 (p < 0.05). Different post placement techniques were non-significantly associated with fracture pattern in both groups 1 (p = 0.666) and 2 (p = 0.143) while, irrespective of the number of posts, the presence of the post was significantly associated with the fracture pattern in teeth with two residual walls. The double-post technique did not further improve the fracture resistance of hardly damaged endodontically treated maxillary bi-rooted premolars compared to single-post technique. Therefore, the insertion of a single post in the palatal canal could be a safer and more conservative choice. CLINICAL SIGNIFICANCE: The double-post technique did not further improve the fracture resistance of severely structurally compromised endodontically treated maxillary premolars with two roots compared to the single-post technique. Therefore, the safer and less invasive treatment is the placement of a single post in the palatal canal.

Zirconia Translucency and Cement Systems as Factors Influencing the Zirconia-Titanium and Zirconia-Zirconia Shear Bond Strength.

PURPOSE: To evaluate the bonding ability of self-adhesive and dual-cure resin cement systems applied to zirconia materials of different translucency in combination with each other and with titanium. MATERIALS AND METHODS: Computer-aided design/computer-assisted manufacture (CAD/CAM) disks of three different zirconia materials (Zenostar MO 0 [medium opacity], MT 0 [medium translucency], and T 1 [translucent], Wieland Dental) were milled and hard sintered in order to obtain cylindrical samples of either 12 mm high × 12 mm diameter (used as a substrate) or 12 mm high × 8 mm diameter (to be bonded to the substrate). CAD/CAM disks of titanium (Starbond Ti4 Disc, S&S Scheftner) were milled in order to obtain a cylinder shape (12 mm high × 8 mm diameter to be bonded to the zirconia substrate). The bonding surfaces were sandblasted with alumina particles (70 µm/2 ATM). Two resin cement systems were tested in this study: a self-adhesive resin cement (SpeedCEM Plus, Ivoclar Vivadent) and a dual-cure resin cement (Variolink Esthetic DC, Ivoclar Vivadent) in combination with a primer (Monobond Plus, Ivoclar Vivadent). The smaller cylinders were bonded to the substrate following the manufacturer's instructions. After 24 hours at 37°C storage, each specimen was subjected to shear bond strength testing in a universal testing machine. The substrate was fixed to the machine, and shear force was applied to the small cylinder close to the bonding interface. Shear bond strength data were statistically analyzed by a three-way analysis of variance (ANOVA) followed by the Tukey test for post hoc comparison (P < .05). RESULTS: No significant differences were found between substrates in the shear bond strength test (P = .078). Variolink Esthetic DC showed a statistically significantly higher bond strength compared with the SpeedCEM Plus (P = .001) with the exception of Zenostar MT substrate (P = .014). CONCLUSION: The resin cement systems showed high shear bond strength values when zirconia was resin bonded to either titanium or the corresponding zirconia substrate. Different zirconia translucencies did not affect the bond strength. The use of MDP primer and a dual-cure cement showed statistically significantly higher strength compared with the self-adhesive resin cement system with the only exception being the bonding of the translucent zirconia Zenostar MT.

Rhinofibroscopic and Rhinomanometric Evaluation of Patients with Maxillary Contraction Treated with Rapid Maxillary Expansion. A Prospective Pilot Study.

OBJECTIVE: The aim of this study was to evaluate through nasal fiber optic endoscopy and rhinomanometry the patency of upper nasal airways in patients treated with rapid palatal expansion Study design: 30 patients (12 males and 18 females) aged 7-11 years with transverse maxillary constriction underwent rhinomanometric and fiberoptic examination before (T0) and after rapid palatal expansion (T1).The amount of nasopharynx obstruction was quantified with reference to the full choanal surface. Nasal resistance was recorded separately for right and left sides, and combined for both sides. The differences in nasopharynx obstruction and in nasal resistance between T0 and T1 were statistically evaluated. RESULTS: The amount of nasopharynx obstruction significantly decreased after palatal expansion (p<0.001). Total nasal inspiration and expiration resistance significantly decreased at T1 (p<0.001). The reduction ranged between 0. 23 and 0. 66 Pa/cm3/s for inspiration and between 0. 20 and 0,.58 Pa/cm3/s for expiration. A statistically significant positive correlation existed between the T1-T0 differences in the amount of nasopharynx obstruction and the T1-T0 differences in expiration nasal airway resistance (Spearman's correlation coefficient rho = 0.38; p = 0.03). CONCLUSIONS: Rapid maxillary expansion has an influence on nasal resistance and improves the patency of upper airways in patients with minor or moderate breathing problems.

Cephalometric and dental arch changes to Haas-type rapid maxillary expander anchored to deciduous vs permanent molars: a multicenter, randomized controlled trial.

OBJECTIVE: To assess radiographic changes and dental arch changes with Haas-type rapid maxillary expansion (H-RME) anchored to deciduous versus permanent molars in children with unilateral posterior crossbite. METHODS: In all, 70 patients with unilateral posterior crossbite were randomly allocated to group GrE (H-RME on second deciduous molars) or Gr6 (H-RME on first permanent molars) and compared between T0 (before treatment) and T1 (at the RME removal; i.e., 10 months after the end of the activation of the screw). At T0 and T1, cephalometric head films were digitally traced, dental casts were scanned, and rotations of the upper first molars, of the upper central, and of the upper lateral incisors on the models were measured. RESULTS: Between T0 and T1, the cephalometric analysis showed a significant decrease of the angulation of the upper central incisors to the SN line and to the palatal plane in GrE together with a significant increase of the lower incisors to the mandibular plane (IMPA). The digital dental cast analysis showed that the central and lateral incisors mesiorotated significantly more in GrE than in Gr6. Patients in GrE also showed a statistically significant distorotation of the upper first permanent molars after RME. CONCLUSIONS: GrE showed a significant and spontaneous retraction and alignment of the upper central and lateral incisors compared to Gr6. This is probably due to a more pronounced expansion in the anterior area and more accentuated pressure of the upper lip in GrE. IMPA increased significantly in GrE vs Gr6. GrE also showed a more significant distorotation of the upper first permanent molars compared to Gr6. This is probably due to the design of the H-RME in GrE, where the screw is more anteriorly positioned and the bands are absent on the upper first permanent molars which are, therefore, free to adapt to the best occlusal situation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02798822.

Rapid palatal expansion effects on mandibular transverse dimensions in unilateral posterior crossbite patients: a three-dimensional digital imaging study.

BACKGROUND: The purpose of this controlled study was to investigate indirect effects on mandibular arch dimensions, 1 year after rapid palatal expansion (RPE) therapy. METHODS: Thirty-three patients in mixed dentition (mean age 8.8 years) showing unilateral posterior crossbite and maxillary deficiency were treated with a RPE (Haas type) cemented on the first permanent molars. Treatment protocol consisted of two turns per day until slight overcorrection of the molar transverse relationship occurred. The Haas expander was kept on the teeth as a passive retainer for an average of 6 months. Study models were taken prior (T1) and 15 months on average (T2) after expansion. A control group of 15 untreated subjects with maxillary deficiency (mean age 8.3 years) was also recorded with a 12-month interval. Stone casts were digitized with a 3D scanner (3Shape, DK). RESULTS: In the treated group, both mandibular intermolar distance (+1.9 mm) and mandibular molar angulation (+9°) increased. Mandibular incisor angulation showed an increase of 1.9°. There was little effect on intercanine distance and canine angulation. Controls showed a reduction in transverse arch dimension and a decrease in molar and canine angulation values. CONCLUSIONS: RPE protocol has indirect widening effects on the mandibular incisors and first molars.

Dental arch response to Haas-type rapid maxillary expansion anchored to deciduous vs permanent molars: A multicentric randomized controlled trial.

OBJECTIVE: To assess maxilla and mandibular arch widths' response to Haas-type rapid maxillary expansion (RME) anchored to deciduous vs permanent molars on children with unilateral posterior crossbite. MATERIALS AND METHODS: Seventy patients with unilateral posterior crossbite recruited at the Universities of Genova, Siena, and Insubria (Varese) were randomly located into GrE (RME on second deciduous molars) or Gr6 (RME on first permanent molars) and compared. RESULTS: Upper intermolar distance and permanent molar angulation increased significantly in Gr6 vs GrE at T1. Upper intercanine distance increased significantly in GrE vs Gr6 at T1 and T2. GrE showed significant increases for upper intermolar and upper intercanine widths. Gr6 showed statistically significant increases for upper intermolar widths, for upper and lower intercanine widths, and for increases of angulation of upper and lower permanent molars. CONCLUSIONS: GrE showed reduced molar angulation increases at T1 and reduced molar angulation decreases at T2 when compared with Gr6. At T2, the net increase of the upper intercanine distance in GrE was still significant compared with Gr6, indicating a more stable expansion in the anterior area.

Apical Dimension of Root Canal Clinically Assessed with and without Periapical Lesions.

To clinically evaluate the dimension of the more apical extent of the root canal after appropriate preflaring in the case of primary treatment and retreatment with and without the presence of periapical radiolucency, 392 single-rooted teeth with only one canal were evaluated during endodontic therapy. The canals were divided in two groups depending on the presence or absence of periapical radiolucency. After preflaring of the root canal the size of the root canal terminus (apical canal dimension) was gauged with hand-held Light Speed LS1 files inserted at the estimated working length and established with the use of an electronic apex locator. The dimension recorded in the computer database was represented by the largest instrument able to reach the electronically established working length. The differences between the treatment groups were assessed using the Mann-Whitney U test and the significance level was set at P < 0.05. Teeth with lesions had a significantly greater diameter in the apical region than teeth without lesions (P < 0.001). The dimension of the apical portion of the root canal is larger in the case of periapical radiolucency. This involves verifying this parameter in order to use the correct sized instruments and to obtain an efficient cutting action at the apical level.

Evaluation of mechanical properties of three different screws for rapid maxillary expansion.

BACKGROUND: The aim of this in vitro study was the evaluation of the mechanical properties the screws for rapid maxillary expansion (RME). METHODS: Three commercially available screws for RME were tested: Leone A2620; Dentaurum Hyrax; Forestadent Palatal Split Screw. All expansion screws were 10 mm in size. For the evaluation of mechanical properties, the screws for RME were adjusted using the same maxillary dental model. An Instron 3365 testing machine with a load cell of 5 kN recorded the forces released by the screws at different amounts of activation (1, 5, 10, 15 and 20 quarters of a turn). Each type of screw was tested 10 times. Comparisons between the forces released by the different types of screws at different amounts of activation were carried out by means of analysis of Kruskal-Wallis test with post-hoc test di Tukey (P < 0.05). RESULTS: The results of this study showed that all 3 expansion devices were able to develop forces that could produce a separation of the palatine processes. The Hyrax and A2620 expanders developed force values over 20 kg and the Palatal Split screws about 16 kg. Both the A2620 and Hyrax expanders showed significantly greater amounts of forces at all the different amounts of activations with respect to the Palatal Split screw. CONCLUSIONS: All tested devices showed the capability of developing expansion forces (16-20 kg) adequate for RME. The A2620 and Hyrax expanders showed a greater level of rigidity than the Palatal Split screw.

Expansion of maxillary arches with crossbite: a systematic review of RCTs in the last 12 years.

The aim of this study was to review recent randomized clinical trials (RCTs) dealing with the effectiveness of various modalities of orthopaedic/orthodontic expansion of maxillary arches with crossbite and the associated 6 month post retention stability. The study selection criteria included RCTs involving subjects with maxillary deficiency with crossbite, with no limits of age. The authors searched the following electronic databases from 1999 to January 2011: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, LILACS, and WEB of SCIENCE. The search strategy resulted in 12 articles meeting the inclusion criteria. Most of the studies did not meet major methodological requirements; some studies were not relevant because of small sample size, possible bias and unaccounted for confounding variables, lack of blinding in measurements, and deficient statistical methods. Treatment outcomes were different depending on the appliance used, tooth tissue-borne/tooth-borne expanders, bonded semi-rapid maxillary expansion (SRME), or rapid maxillary expansion (RME); in any case, methodological flaws prevent any sound conclusion. Stable results have been measured at the 6 month follow-up after removal of the retention plate in the treated groups in the maxillary intermolar and intercanine distances. Long-term stability results should be assessed. The Consolidated Standards of Reporting Trials (CONSORT) Statement could be helpful in improving the reporting of RCTs.

Failure evaluation after a 6-year retention period: a comparison between glass fiber-reinforced (GFR) and multistranded bonded retainers.

OBJECTIVES: The aim of this study was to compare bond failure and breakage rates of two types of bonded lingual orthodontic retainers (GFR and .0175" multistranded stainless steel wire [MST]) after a 6-year retention period. SUBJECTS AND METHODS: Eighty-five young adults were randomly divided into two groups: 40 subjects received 48 GFR retainers (14 maxillary and 34 mandibular retainers), and 45 subjects received 50 MST retainers (18 maxillary and 32 mandibular retainers). A Fisher's exact test was performed in order to identify significant differences in the percentage of detachment and breakage of the retainers between the groups. RESULTS: The maxillary detachment rates were 21.42% for the GFR group and 22.22% for the MST group; the mandibular detachment rates were 11.76% for the GFR group and 15.62% for the MST group. The maxillary breakage rates were 7.14% for the GFR group and 16.66% for the MST group; the mandibular breakage rates were 8.82% for the GFR group and 15.62% for the MST group. The differences were not statistically significant. CONCLUSION: GFR and multistranded stainless steel retainers showed similar results in terms of bond failure and breakage after 6 years of retention. The use of GFR retainers as a retention strategy should not be discouraged and could be considered a viable esthetic alternative to stainless steel wire retainers.

A computerized photographic method to evaluate changes in head posture and scapular position following rapid palatal expansion: a pilot study.

OBJECTIVE: To assess the applicability of a computerized method to measure on digital photographs the changes in head and scapular posture following rapid palatal expansion (RPE) treatment. STUDY DESIGN: Randomized controlled trial. Twenty-three children (age 9.2 +/- 70.88 years) diagnosed with maxillary constriction were randomly divided into two groups: 1. Study group (n = 12): patients receiving RPE treatment; 2. Untreated controls (n = 11). Postural measurements were taken on frontal, lateral, and dorsal views of each subject. In the study group measurements were taken at T0 (the day orthodontic records were taken), T1 (end of RPE active phase), and T2 (RPE removal). In controls the same observations were conducted at T0 and T1(98.18 +/- 36.01 days after T0). Measurements were statistically analyzed (Intraclass Correlation Coefficient, t-tests, Signed Rank test, One-Way Repeated Measures Analysis of Variance, Tukey test; p < 0.05). RESULTS: In the study group a significant reduction in forward head posture (FHP) occurred between T0 and T1. Forward shoulder posture (FSP) decreased significantly between T1 and T2. At T1 treated patients exhibited significantly lower values of the measurements indicating FHP and FSP than controls. CONCLUSION: Changes in head and scapular posture following RPE treatment can be documented with computerized measurements on digital photographs.

Multiple bilateral impactions in an adolescent girl.

This article describes a patient whose permanent canines and premolars had not erupted at age 14 years, although their root formation was complete, with closed apices. Surgical and orthodontic treatment was planned to correct the multiple impactions. The orthodontic traction used 5 strategic teeth and allowed for the eruption of all 12 impacted teeth. The surgical-orthodontic treatment of many impacted teeth yielded good esthetic and periodontal results, as shown by the patient's satisfaction and the periodontal probing 2 years after the treatment. Multiple impacted teeth are a rare eruption disturbance that requires early detection: no signs of a genetic syndrome or an endocrine disorder had been found, or failure to move along the eruption path, which is a characteristic of another syndrome, primary failure of eruption.

Morpho-dimensional analysis of the maxillary central incisor clinical crown in cases of congenitally missing upper lateral incisors.

AIM: the purpose of this study was to analyse the crown morphology of maxillary central incisors in cases of agenesis of the upper lateral incisors, in order to establish patterns of associations between reduced mesio-distal dimensions of anterior teeth and tooth abnormalities in number. MATERIALS AND METHODS: the sample consisted of 31 patients with unilateral and bilateral absence of maxillary lateral incisors. Ninety six subjects without any agenesis were included in the control group. Mesio-distal widths of each central incisor crown were measured by means of 2 parameters; at the apical third of the crown and at the contact point. A Student's t test was used to compare the results of each measurement within both group. RESULTS: Significant differences were found in mesio-distal diameters at the contact points but not in the mesio-distal diameter at the apical third of the crown. CONCLUSIONS: It could be suggested that in case of cases of agenesis of the lateral incisors the central incisors show a rectangular shape of the crown instead of the trapezoid shape in subjects without agenesis. These remarks should be considered before the orthodontic-prosthetic treatment is planned.