To analyze the derotation of maxillary mesio-rotated first permanent molars in subjects with Class II edge-to-edge dental malocclusion in mixed dentition treated with Invisalign Clear Aligners (CA). In total, 36 patients (16 males, 20 females, 9.9 ± 1.9 years) treated with CA are enrolled from the Department of Orthodontics. Inclusion criteria are the following: Caucasian ancestry, mixed dentition, molar Class II edge-to-edge, no tooth/craniofacial anomalies, no caries/periodontal diseases. Pre-treatment (T1) and post-treatment (T2) digital casts, and final ClinCheck representations (T2ClinCheck) are acquired. The Henry’s angle (HA) is used to assess maxillary first molars rotation. The molars with an HA > 11° are taken (53 teeth). Five measurements are performed at T1, T2, and T2ClinCheck: Henry’s angle (HA), mesiobuccal-expansion (MBE), distobuccal-expansion (DBE), mesiobuccal-sagittal (MBS), and distobuccal-sagittal (DBS). A paired t-test was used to compare T2-T1 and T2ClinCheck-T2. The T2-T1 shows a distal-rotation (difference −6.3°) with an expansion of 2.2 mm for MBE and 1.5 mm for DBE. At T2, the mesiobuccal cusps show a distal movement of 1.0 mm and the distobuccal cusps of 0.9 mm. The HA’s T2ClinCheck-T2 difference is −4.2°. In the sagittal plane, the difference is 0.9 mm for the MBS and 0.7 mm for the DBS. The expansion showed the highest predictability (60% HA, 52.6% MBS, and 56.25% DBS). The CA effectively produces an arch expansion and upper molars’ distal rotation. Upper molar derotation provides a 1 mm of gain in arch perimeter and occlusal improvement.

The objective of this study was to examine the distal rotation of mesial rotated maxillary first permanent molars in a sample of Class II dental malocclusion adult patients treated with Invisalign Clear Aligners (CA). Forty patients (20 males, 20 females, 22.4 ± 3.9 years) were included in the study sample (Department of Orthodontics of University of Rome “Tor Vergata”). Inclusion criteria were: Caucasian ancestry, complete permanent dentition with fully erupted upper second molars, Class II molar relationship, absence of tooth or craniofacial anomalies or caries and periodontal diseases. Pre-treatment (T1), post-treatment (T2) digital casts, and final ClinCheck simulation models (T2CC) were analysed. To measure the rotation of maxillary first molars, Henry’s angle (H°) was evaluated. Maxillary first molars with an H° > 11° were considered mesio-rotated (in total 59 teeth). The treatment CA protocol included disto-rotation without distalization movements. At T1, T2 and T2CC five measurements on the collected dental casts were analysed: Henry’s angle (H°); mesial buccal expansion (ME); distal buccal expansion (DE); mesial buccal sagittal (MS); and distal buccal sagittal (DS). A comparison between the results of T2–T1 and T2CC–T2 was performed using a paired t-test. The differences between T2–T1 highlighted a significant distal rotation of the maxillary first molars (−7.4°) and an expansion movement of 2.20 mm for ME and 1.50 mm for DE. In the post-treatment, the mesial buccal cusps shifted of 1.0 mm, while the distal buccal cusps showed a distal movement of 0.9 mm. Analysing the H° comparison between T2CC-T2, the difference was −1.1°. The T2CC-T2 comparison in the sagittal plane showed a difference of 0.9 mm for the MS and 0.7 mm for the DS. The accuracy was 82% for molar derotation movement. In conclusion, CA provides the upper arch expansion associated with the upper first molars’ distal rotation. These movements provide 2 mm of improvement in arch perimeter and molar intercuspation.

Background: To study the covariation between palatal and craniofacial skeletal morphology in Class III growing patients through geometric morphometric analysis (GMM). Methods: In this retrospective study, 54 Class III subjects (24F,30M;7.6 ± 0.8yy) were enrolled following these inclusion criteria: European ancestry, Class III skeletal and dental relationship, early mixed dentition, prepubertal skeletal maturation, familiarity for Class III malocclusion, no pseudo Class III malocclusion. Each patient provided upper digital cast and cephalogram before starting the therapy. Landmarks and semilandmarks were digitized (239 on the casts;121 on the lateral radiographs) and GMM was used. Procrustes analysis and principal component analysis (PCA) were applied to show the principal components of palatal and craniofacial skeletal shape variation. Two-block partial least squares analysis (PLS) was used to assess pattern of covariation between palatal and craniofacial morphology. Results: Regarding palatal shape variation, PC with largest variance (PC1) described morphological changes in the three space dimensions, while, concerning the craniofacial complex components, PC1 revealed morphological differences along the vertical plane. A significant covariation was found between palatal and craniofacial shape. PLS1 accounted for more than 61,7% of the whole covariation, correlating the craniofacial divergence to palatal height and width. Conclusions: In Class III subjects increments of angle divergence are related to a narrow and high palate.

Background To evaluate morphologic differences between class III malocclusion success and failure treatment subjects in order to identify which variables are more predictive for long-term stability in early orthopedic treatment. In this retrospective study, 31 patients were enrolled from the Department of Orthodontics (Rome Tor Vergata). Inclusion criteria were as follows: white ancestry, class III malocclusion, mixed dentition, cervical stage (CS) 1-2, no pseudo-class III. Pre-treatment radiographic and cast records were collected. Each patient underwent rapid maxillary expansion/facial mask/bite block (RME/FM/BB) orthopedic treatment until correction. At T1 (permanent dentition, CS4), records were recollected. According to treatment stability, relapse group (RG, 19) and success group (SG, 12) were identified. Sagittal and vertical cephalometric and digital cast measurements were performed. Student’s t tests were used for statistically significant differences inter and intra groups. For discriminant analysis, relapse or success status was added to each patient’s T0 data. Results At T0, RG showed larger upper anterior transversal width (p = 0.0266), while at T1 the upper anterior length was shorter than SG (p = 0.0028). Between T1 and T0, both groups showed larger upper anterior and posterior transversal widths. SG had greater upper anterior (p = 0.0066) and posterior (p = 0.449) sagittal length. RG presented larger lower anterior (p = 0.0012) and posterior (p = 0.0002) transversal widths, while there were no differences in SG lower arch. Discriminant analysis provided two predictive variables with an accuracy of 80.6%: upper anterior length and upper posterior length. Conclusion A shorter and wider maxilla could be a predisposing factor for relapse and failure of the early orthopedic treatment of class III malocclusion patients. The absence of mandibular changes could be predictable for treatment success.

This paper proposes an offline solution for global path provisioning in new-generation optical networks based on the generalized multiprotocol label switching (GMPLS) paradigm. This solution is based on a multilayer approach, which involves both the optical and the electrical layers and optimizes the network configuration and traffic routing. The proposed global provisioning solution can be easily combined with dynamic routing solutions, providing the network with the possibility of reacting promptly to traffic changes. Data flows are assumed to be structured into label switched paths (LSPs), which represent the connection in a GMPLS-based network, at any hierarchical level. The global provisioning issue is a difficult optimization problem. As a solution, we propose a new heuristic algorithm based on the shortest path computation and a mathematical programming approach, which makes use of the optimization solver CPLEX. A large computational study shows the effectiveness of the former, in terms of quality of the solutions. The advantages of the multilayer provisioning strategy are analyzed in a relevant case study by evaluating the network congestion