Elastodonzia customizzata in età evolutiva: studio pilota (Customized elastodontic therapy during childhood: a pilot study)

OBJECTIVES The introduction of new biocom patible, elastic and resistant inorganic materials in the field of dentistry, has contributed to the birth of a large number of preformed devices, which constitute a specific sector of orthodontics, synthetically defined as elastodontic therapy. The most promising evolution consists in the customization of the devices which, thanks to sophisticated digital set-up technique, introduces the possibility of a three-dimensional orthodontic control of the teeth while maintaining the orthopedic-functional effect. The purpose of the present paper is to verify the therapeutic efficacy and predictability of the results obtained with the use of the new customized elastomer which, thanks to an advanced digital procedure (DDSU: dental digital set up), allows the clinician to pro gram individualized therapies. MATERIALS AND METHODS The research was carried out evaluating a sample of 10 patients, in mixed dentition, aged between 8 and 12 years, all patients were treated at the Department of Biomedical, Surgical and Dental Sciences, Unit of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Milan. All patients included in the study, previously treated with maxillary expansion due to a previous mono or bilateral crossbite, had dental class II sagittal discrepancy and significant increase in overbite and overjet parameters. All subjects underwent scans of the arches and lateral-lateral teleradiography at the beginning (T0) and at the end of the treatment (T1). Vertical and sagittal parameters, both dento-alveolar and skel etal, were measured. Overlaps of 3D models and cephalometric traces were also performed. RESULTS Statistically significant changes have been found comparing the pre-and post-treatment values with customized elastodontic device. Overjet decreased significantly due to the combined effect of a slight mandibular growth and dento-alveolar changes affecting the maxillary and mandibular incisors. Overjet showed a statistically significant decrease between T0 and T1 with an average decrease of approximately 2.69 mm. It should be noted that in patients with a higher degree of overjet (about 7 mm), an improvement of up to 5 mm was obtained. In all cases, complete correction of the sagittal class II discrepancy, both skeletal and dento-alveolar, occurred. CONCLUSIONS The customized elastodontic de vice appears to be effective in correcting increased overjet and overbite, class II malocclusion, in early mixed dentition. Follow-up data are needed to evaluate the long-term effects of this treatment. CLINICAL SIGNIFICANCE Therapy with a customized elastodontic device can be a valid alternative compared to preformed devices, simplifying clinical procedures, making the appliance patient-specific. These characteristics are expressed in an increase in the predictability of the results.

L’introduzione di nuovi materiali inorganici biocompatibili, elastici e resistenti nell’ambiente orale ha contribuito alla nascita di un gran numero di dispositivi preformati che, nel loro complesso, costitui- scono oggi uno specifico settore dell’ortodonzia definito sintetica- mente come elastodonzia. L’evoluzione più promettente con- siste nella customizzazione dei di- spositivi che, grazie a una sofisti- cata tecnica di set-up digitale, in- troduce la possibilità di un control- lo ortodontico tridimensionale del- la dentatura mantenendo inaltera- ta l’azione ortopedica-funzionale. Scopo del lavoro è quello di verifi- care l’efficacia terapeutica e la predicibilità dei risultati ottenibili con l’impiego di un nuovo elasto- mero customizzato che, grazie a un’avanzata procedura digitale (DDSU: dental digital set-up) per- mette al clinico la programmazio- ne di terapie individualizzate