Children with asthma may experience functional and developmental oral changes due to altered breathing patterns and systemic effects of the disease. This study aimed to evaluate the relationships among mouth breathing, occlusion, and salivary parameters in school-aged children with asthma. This comparative cross-sectional study included 88 children who were equally divided into two groups. Group I (study group): This group consisted of children with asthma who were sex- and age-matched. Group II (the control group): included healthy children. The ages ranged from 6-12years. An interview-based questionnaire, clinical examination, and salivary biochemical studies were conducted. This study revealed a significantly greater prevalence of mouth breathing in asthmatic children (p < 0.001), especially in patients with uncontrolled asthma. Additionally, they had a greater prevalence of anterior overjet (p = 0.01) and anterior open bite (p = 0.02). Interestingly, none of the children presented a posterior crossbite. Notably, no significant difference in salivary parameters was observed between the two groups. Asthma and its level of control may influence functional and developmental aspects of oral health, particularly in children with mouth breathing. Early and effective asthma management, along with monitoring oral functions, can help mitigate these effects and support better overall oral health in asthmatic children.

Breastfeeding is associated with infant health benefits, such as a reduced risk of infections, obesity, and diabetes, and offers protection against breast and ovarian cancer in mothers. However, its possible relationship with dental caries and malocclusions has recently been suggested. The present umbrella review assessed the relationship between breastfeeding and oral health. This umbrella review evaluated the relationship between breastfeeding and oral health in individuals under 18 years of age by systematically reviewing studies available in databases such as PubMed, Scopus, Web of Science, and others. The Mantel-Haenszel method was used to calculate odds ratios (OR) with 95% confidence intervals. Eighteen reviews on caries, malocclusions, bone mass, muscle function, and cleft lip/palate were analyzed. Breastfeeding was found to be a protective factor against dental caries (OR 0.71), with duration having no significant effect. A lower prevalence of open bite (OR 0.67) and posterior crossbite (OR 0.68) was also observed. Breastfeeding for ≥ 6 months was protective against overjet, dental crowding, and Class II malocclusion. However, it was associated with an increased risk of overbite (OR 1.95). Narrative analysis showed benefits of breastfeeding for muscular and craniofacial development, and it was considered safe in children with post-surgical cleft lip/palate. Breastfeeding has positive effects on multiple aspects of children's oral health, reinforcing its importance for both oral and systemic health, thanks to its nutritional, mechanical and immunological benefits.

To explore the prevalence of discrepancies between estimated and actual orthodontic treatment duration and identify predictors of treatment delays. A total of 96 patients (62.5% female; age = 15.6 ± 6.8 years) who completed an orthodontic treatment with pre-adjusted edgewise fixed appliances between 2015 and 2023 were retrospectively included. Differences between actual and estimated treatment duration >3 months were classified as discrepancies and categorized as "overestimation" or "underestimation." Such discrepancies were compared on demographics, COVID period, and orthodontic parameters using Student's t-tests and chi-square tests, as appropriate. Predictors of underestimated treatment duration were assessed with logistic regression analysis. Actual treatment duration significantly differed from the estimated duration (26.5 ± 9.6 vs. 21.6 ± 3.6 months; P <0.001), with 65.6% cases exhibiting treatment discrepancy (P = 0.003) and 61.5% of them being underestimated (P = 0.032). Cases with underestimated durations more commonly displayed posterior crossbite (30.9% vs. 5.4%; P = 0.004), larger SNA angle (83.7 ± 3.7 vs. 78.8 ± 3.8; P = 0.005), bracket debonding (53.4% vs. 31.4%; P = 0.039; odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.04-6.04), and were most likely conducted during COVID period (33.9% vs. 10.8%; P = 0.011; OR = 4.23, 95% CI = 1.31-13.62) compared to overestimated ones. Posterior crossbite (P = 0.006) and COVID period (P = 0.007) were significant predictors of treatment underestimation. Approximately two-thirds of orthodontic treatments showed discrepancies between estimated and actual duration, with 61.5% being underestimated especially in presence of posterior crossbite and during COVID period.

To identify pretreatment malocclusion traits that may influence treatment duration and to assess the correlation between these factors and overall treatment duration. This retrospective study included 1430 patients who completed orthodontic treatment between July 2013 and March 2022. A comprehensive evaluation of patient records was conducted, and data related to the initial malocclusion and its associated traits were extracted, including 13 parameters such as Angle's classification, overjet, overbite, open bite, and crowding. Severe overjet (>9 mm) and reverse overjet were significantly associated with longer treatment duration. Increased overbite was also associated with longer treatment duration, with deep impinging overbite requiring an additional 6 months compared with an average overbite (P < .001). Bilateral posterior crossbite significantly increased mean treatment duration by 4.76 months (P < .001). Additionally, a midline shift > 3 mm was associated with a 2.3-month increase in mean treatment duration (P = .009). Severe malocclusion traits including increased overjet, reverse overjet, deep overbite, and open bite were strongly linked to longer treatment duration. Similarly, crowding, crossbites, and midline shifts also contributed to extended treatment duration. The presence of missing or impacted teeth, particularly impacted canines and central incisors, led to significant delays in treatment.

Mouth breathing in childhood has gained increasing attention in pediatric dentistry and medicine because of its potential association with craniofacial growth disturbances and pediatric obstructive sleep apnea (P-OSA). Since airway function, facial development, and oral habits are closely interconnected during growth, persistent mouth breathing may reflect or contribute to upper airway dysfunction and abnormal dentofacial development. This review aimed to analyze recent evidence regarding the relationship between mouth breathing, craniofacial development, and pediatric obstructive sleep apnea, with emphasis on the role of dentistry in early detection and interdisciplinary management. A narrative literature review was conducted based on PubMed-indexed studies published between 2021 and 2026. The search strategy included terms related to mouth breathing, pediatric obstructive sleep apnea, craniofacial development, adenotonsillar hypertrophy, orthodontics, and pediatric dentistry. Current evidence suggests that mouth breathing is frequently associated with adenotonsillar hypertrophy, sleep-disordered breathing, altered maxillomandibular growth, posterior crossbite, increased lower facial height, high-arched palate, and malocclusion patterns. Recent findings also highlight the dental and orthodontic setting as a strategic environment for early screening of children at risk for sleep-disordered breathing. Although the relationship is multifactorial and not always causal, available evidence supports the incorporation of airway-oriented assessment into routine pediatric dental examinations. Dentistry plays an important role in the early recognition of craniofacial and functional signs suggestive of pediatric obstructive sleep apnea, contributing to timely referral and multidisciplinary care.

Long-term neuromuscular effects of rapid maxillary expansion (RME) for functional posterior crossbite (FPCB) remain unclear. This prospective longitudinal study evaluated RME effects on masticatory muscle electromyographic (EMG) activity and transverse skeletal/dental dimensions in children with FPCB. Seventeen FPCB patients (mean age 8.8 years) treated with Hyrax expanders and 15 age-matched controls with normal occlusion were evaluated. Surface EMG activity, dental casts, and posteroanterior cephalograms were recorded at baseline (T1) and at the final evaluation (T2), with a mean interval of 10.6 months between assessments, encompassing the active expansion phase followed by 6 months of removable retention. EMG analysis showed significantly increased masseter and temporalis activity after RME, indicating improved neuromuscular function. Cephalometric measurements revealed significant increases in maxillary skeletal width and maxillo-mandibular skeletal ratio without mandibular changes. Skeletal expansion (2.97 mm) represented 51% of the total maxillary intermolar width increase (5.86 mm), demonstrating favorable skeletal contribution. The maxillary-to-mandibular intermolar ratio normalized compared with controls. Small sample size, single-center design, and 10-month follow-up duration may limit generalizability and long-term stability assessment. RME significantly improves maxillary transverse dimensions and masticatory muscle activity in young FPCB patients. Early treatment optimizes skeletal-to-dental expansion ratio and promotes favorable stomatognathic system development.

Dentofacial Malocclusion and Salivary Biomarkers in Asthmatic Patients: A Scoping Review.

The prevalence of malocclusion, a common dental condition characterized by misaligned teeth and jaws, has significant implications for oral health, aesthetics, and overall quality of life. This study investigated the prevalence of malocclusion in Rivers State, Nigeria, a region with diverse demographic and socio-economic characteristics. Using a cross-sectional design, a sample of participants- 310 (148 males and 162 females) from various communities was assessed clinically for malocclusion patterns, including spacing, crowding, crossbite. open bite, and overbite. Data were analyzed to identify the distribution of malocclusion and associated factors such as age, gender, and habits: like thumb-sucking or mouth breathing. Majority of the subjects were found to have Angle's Class 1 molar relationships (80.3%). There was a significantly larger proportion of females (52.2%) as compared with their male counterparts (47.8%). Majority of the children had normal overjet (69.2%) and overbite (55.5%). However significant gender differences were found More females were found to have normal overjet and overbites than their male counterparts, whilst males were found to have a larger proportion of reduced overjet's and overbites. A normal dentoalveolar relationship was a predominant finding. However, crowding of the arches was found in 14.4% whilst 59.5% had spaced arches. Anterior and posterior crossbite was found in 17.1% of the population, whilst open bite was seen in a smaller proportion of 7.1 % Findings revealed that malocclusion is prevalent among both children and adults in Rivers State, residents (children), with specific patterns correlating with socio-demographic variables and oral habits. The results emphasize the need for targeted orthodontic interventions and public health initiatives to address the burden of malocclusion in the region. This study contributes valuable data to the limited research on malocclusion in Nigeria, serving as a foundation for policy formulation and further investigations.

Background: Digit sucking, tongue thrust swallowing, and mouth breathing are potential risk factors for development of malocclusion. The purpose of this study was to verify the prevalence of different occlusal traits among 5–7-year old children and assess their relationship with oral habits. Material/Methods: The study included 503 pre-school children (260 boys and 243 girls) with a mean age of 5.95 years. Different occlusal traits were verified by intraoral examination. Oral habits were diagnosed using data gathered from clinical examination of occlusion and extra-oral assessment of the face, combined with a questionnaire for parents. Results: The study demonstrated that 71.4% of the children presented with 1 or more attributes of malocclusion and 16.9% had oral habits. The vertical and sagittal misrelation of incisors, as well as spacing, were the predominant features. This study showed that digit suckers have higher incidence of anterior open bite (P=0.013) and posterior cross- bite (P=0.005). The infantile type of swallowing demonstrated strong association (P=0.001) with anterior open bite. Conclusions: Non-Nutritive Sucking Habits and Tongue Thrust Swallowing Are Significant Risk Factors for the Development of Anterior Open Bite and Posterior Crossbite in Pre-School Children.

To assess the facial soft tissue modifications following rapid maxillary expansion (RME) with Hybrid Hyrax (HH) and MARPE during late adolescence through 3D stereophotogrammetry. Twenty-two patients with maxillary constrictions and posterior crossbites were randomly allocated into two groups. The HH group (n = 11; mean age 16.7 ± 1.85 years) received an expander anchored with two palatal miniscrews, while the MARPE group (n = 11; mean age 16.2 ± 1.39 years) received an expander with four miniscrews. The expander screws were activated one-quarter turn twice a day for 14 days. 3D facial images were captured at baseline (T1), immediately after the active phase of the expansion (T2) and 6 months post-retention (T3). 3D images were processed using the Quantificare LifeViz Mini App software (Quantificare S.A, France) to achieve 3D measurements. Data analysis was performed blindly, on an intention-to-treat approach. Changes were analysed using two-way ANOVA with repeated measures (p < 0.05). Both groups showed similar patterns of soft tissue changes. Nasal base width increased significantly from T1 to T2 in both groups (HH: 1.5 mm; MARPE: 1.9 mm), followed by a slight decrease at T3. Inter-commissural distance increased (HH: 1.6 mm; MARPE: 2.4 mm) and partially relapsed after expansion. A significant increase in inter-canthal distance was observed in the MARPE group (1.0 mm). Bizygomatic width remained stable after expansion in both groups. Upper and lower facial heights showed increases after expansion (HH: 0.5 mm, MARPE: 1.4 mm; HH: 0.3 mm, MARPE: 0.9 mm, respectively), with no difference between groups. RME anchored on two and four palatal miniscrews in late adolescents produced similar increases in the facial soft tissue immediately after expansion. ReBEC UTN code: U1111-1296-4040.

Aim: Rapid maxillary expansion (RME) is a widely used interceptive orthodontic procedure in pediatric patients that is often associated with discomfort and pain, particularly during the initial phase of treatment. The present study aims to analyze the intensity and temporal trend of pain perceived by pediatric patients undergoing rapid palatal expansion (RME) by evaluating the influence of factors such as age, sex, type of maxillary transverse deficit, palatal expander, and dental anchorage. Materials and Methods: A prospective observational study was conducted on 134 pediatric patients (mean age 8 years; range 6-14 years) diagnosed with transverse maxillary contraction. Patients were treated with tooth-borne Haas or Hyrax expanders. Pain perception was monitored daily using a specific questionnaire with answers based on the Wong-Baker FACES scale. Collected data were analyzed by using the ANOVA test (p < 0.05). Results: Pain was a common symptom, with greater intensity in the first days of treatment. The Hyrax expander was associated with significantly greater initial pain than the Haas one (p < 0.001). Tooth-borne expanders on the first permanent molars resulted in greater initial pain than anchorage on the second primary molars (p < 0.001). Patients with unilateral posterior crossbite and anterior crossbite reported higher average pain levels (p < 0.001). Age emerged as a significant modulator of pain (p < 0.001), while no significant differences were found based on sex (p = 0.287). Conclusions: Expander type, tooth-anchorage type, maxillary transverse contraction type, and patient age significantly influenced pain perception during pediatric RME. These results provided useful indications for the clinical management of the patient, for the choice of expander and anchorage type and for the timing of intervention.

Breastfeeding is universally recognised as the nutritional gold standard for the neonate, with well-established benefits on immunological, metabolic, and relational levels. However, in light of the evidence accumulated over recent years, limiting its value to the nutritional dimension alone is reductive. Breastfeeding also represents a powerful functional modulator of craniofacial growth and, consequently, an early potential determinant of orthodontic health. Suckling at the breast activates a complex neuromuscular pattern involving the tongue, lips, mandible, and perioral musculature in a coordinated and physiological manner. This functional pattern, which is more demanding and dynamic than artificial feeding, generates mechanical stimuli that are essential for the modelling of the hard palate, transverse expansion of the maxilla, and the correct maxillo-mandibular balance. In accordance with the functional matrix principle, bone growth is not an autonomous process but responds to the functional stimuli of the soft tissues: breastfeeding constitutes, during the first months of life, one of the principal biological inputs capable of directing such development. Epidemiological evidence reinforces this biological rationale. The meta-analysis by Peres et al. [2015] documented a significant reduction in the risk of malocclusion in breastfed children compared to those fed formula. Likewise, Boronat-Catalá et al. [2017] identified a dose-response association between duration of breastfeeding and lower prevalence of occlusal anomalies in the primary and mixed dentitions. Subsequent observational studies confirmed a reduced risk of anterior open bite and posterior crossbite in subjects breastfed for longer periods. The data pertaining to duration are particularly noteworthy: the protective effect appears to be more pronounced the longer breastfeeding is maintained. This suggests that the window of the first months of life represents a critical period of craniofacial plasticity, during which functional stimuli may exert a lasting influence on morphological development. Major health institutions have progressively incorporated these findings into their recommendations. The American Academy of Pediatrics, in the 2022 policy statement [Meek and Noble], highlights the contribution of breastfeeding to oro-facial functional development. Similarly, the Ministry of Health recommends exclusive breastfeeding for the first six months and its continuation until two years of age or beyond, acknowledging its impact on harmonious child development. Within the dental and orthodontic fields, these data warrant reflection: breastfeeding can no longer be regarded as an "external" factor with respect to dentofacial prevention. On the contrary, it represents the first natural functional orthodontic intervention, capable of reducing the incidence of malocclusions and oro-facial dysfunctions through the early modulation of muscular and respiratory stimuli. Methodological limitations remain in the available literature, however: diagnostic heterogeneity, variability in the definition of breastfeeding duration, and the presence of confounding factors such as dummy/pacifier use, non-nutritive sucking habits, and genetic predisposition. Controlled longitudinal studies are required that integrate standardised clinical assessments and objective functional analyses, in order to clarify causal mechanisms and more precisely quantify the magnitude of the protective effect. Notwithstanding these limitations, the clinical message is already sufficiently robust: promoting breastfeeding means investing not only in the child's systemic health but also in early orthodontic prevention. In an era in which the interception of malocclusions is occurring at increasingly early ages, it would be paradoxical to overlook the most physiological and primary of all functional stimuli. Orthodontic prevention begins at birth. And it begins, above all, with breastfeeding.

Background The treatment of young children can be difficult even for trained professionals. The prevalence of malocclusion in this phase of development can vary widely according to the population studied, and more specifically, to their genetic heritage. However, physical stimuli, such as habits, can also lead to a lack of proportionality in the craniofacial skeleton. Case Report This paper reports the treatment of C. M. R., a 4-year-old female preschooler, who presented with anterior and posterior crossbites, second molars exhibiting mesial terminal steps, and a negative overject. This case was treated using Direct Dental Tracks to correct the malocclusion, and the patient was followed for three years. Final considerations This treatment was successful in restoring her craniofacial growth and development to the normal individual pattern. The patient is ready to begin the follow-up phase of occlusal development using Planas functional orthopedic appliances until final occlusion is established with the second molars in occlusion.

This prospective longitudinal cohort study aimed to investigate the prevalence, risk factors, and craniofacial correlates of sleep-disordered breathing (SDB) in children, and to evaluate the efficacy of targeted interventions in a nested sub-study. A total of 1,589 children (aged 6–9 years) were enrolled and followed for 36 months. Assessments included Portable polysomnography, cone-beam computed tomography, 3D facial imaging, and standardized clinical examinations. A sub-study of 275 children with moderate-to-severe SDB (obstructive apnea–hypopnea index, OAHI ≥ 5) were allocated to ENT intervention (adenotonsillectomy), orthodontic intervention (rapid maxillary expansion), or control groups. The baseline prevalence of SDB was 28.9%, with a significant male predominance. Multivariate analysis identified adenotonsillar hypertrophy (aOR = 3.42), paternal snoring (aOR = 2.38), obesity (aOR = 2.15), and allergic rhinitis (aOR = 1.86) as key independent risk factors. Children with SDB exhibited distinct craniofacial features, including reduced airway volume, mandibular retrusion, and a 38.2% smaller minimum cross-sectional area. Strong associations were found between SDB and specific malocclusions, including Class II malocclusion (48.6% vs. 27.3%), increased overjet, and posterior crossbite. A bidirectional relationship was observed, where SDB persistence worsened occlusal traits, while SDB remission facilitated spontaneous improvement. In the intervention sub-study, both ENT (68.4% resolution) and orthodontic (52.1% resolution) groups showed significant improvement in OAHI and quality of life scores compared to controls (15.7%). Cost-effectiveness analysis favored the ENT intervention while acknowledging the additional occlusal benefits of orthodontic treatment. SDB is highly prevalent and dynamically interacts with craniofacial growth and occlusal development in children. An interdisciplinary approach, incorporating both ENT and orthodontic perspectives, is supported for effective management, leading to improved respiratory, dentofacial, and quality-of-life outcomes.

IntroductIonThe temporomandibular joint (TMJ) is the most intricate articulation, serving as a pivotal link between the mandible and the cranium, facilitating essential functions such as mastication, speech, and respiration. 1Temporomandibular disorders (TMD) encompass musculoskeletal and neuromuscular dysfunctions affecting the TMJ, masticatory muscles, and associated structures. 2,3Clinically, TMD manifests with mandibular pain, joint sounds, chewing difficulties, and restricted movement, often resulting in significant discomfort, functional impairment, and diminished quality of life. [4][5]][6] The etiology of TMD is multifactorial, involving genetic, anatomical, pathophysiological, psychological, and environmental factors. 2 Several occlusal anomalies, including class II or III malocclusions, anterior open bite, excessive overjet, posterior crossbite, and occlusal interferences, have been implicated in its development. 7However, the association between occlusion and TMD remains contentious, with conflicting perspectives on whether orthodontic treatment induces or alleviates TMD symptoms. 8This ambiguity stems from the complexity of TMD and challenges in establishing causality between orthodontic interventions and TMD onset or resolution.

Rapid maxillary expansion (RME) is a common orthopedic intervention in mixed dentition. Evaluating facial soft tissue changes is important to understand its functional and esthetic implications. To compare facial soft tissue changes following RME using the Expander with Differential Opening (EDO) and the Hyrax-type (HT). This single- center, two-arm parallel randomized clinical involved twenty-two patients aged 6-11 years with posterior crossbites, who were randomly assigned to two treatment groups. In the EDO group, anterior and posterior screws were activated ½ turn twice a day reaching 10.4 and 7.2 mm, respectively. In the HT group, conventional Hyrax was activated ½ turn twice daily until reaching 7.2 mm. Both appliances were maintained for 6 months. The primary outcome was the change in the nasal base width. Secondary outcomes included five additional facial measurements. Stereophotogrammetry was performed at pre-expansion (T1), immediately post-expansion (T2), and 6 months post-expansion (T3) for both treatment groups. Randomization used a computer-generated 1:1 allocation with sealed opaque envelopes. Although double blinding was not possible, image analyses were blinded to timepoints. Intergroup and interphase changes were analyzed using two-way ANOVA with repeated measures. The comparison of RME groups and the control group was performed using ANOVA and Tukey tests (P < 0.05). The EDO group consisted of 11 patients (3 males, 8 females), with a mean age of 9.45 years. The HT group included 11 patients (4 males, 7 females) with a mean age of 9.35 years. Both type of expanders increased the nasal base width, with no significant difference between groups. A partial relapse of nasal width was observed during retention in the EDO group. The EDO group showed an increase in intercanthal width after RME. Both expanders showed a similar increase in labial intercommissural width and facial heights after expansion, with stability in the retention period. Both expanders increased the nasal base width and the labial intercommissural width. The EDO showed a partial relapse of nasal base width during retention. Soft tissues changes after RME in children were negligible with both types of expanders. No harms were observed. This trial protocol was registered by the Brazilian Clinical Trials Registry (ReBEC) under the number: RBR-2pd4s4q.

Background/Objectives: Accurate identification of dental malocclusions from routine clinical photographs can be time-consuming and subject to interobserver variability. A YOLOv11-based deep learning approach is presented and evaluated for automatic malocclusion detection on routine intraoral photographs, testing the hypothesis that training on a structured annotation protocol enables reliable detection of multiple clinically relevant malocclusions. Methods: An anonymized dataset of 5854 intraoral photographs (frontal occlusion; right/left buccal; maxillary/mandibular occlusal) was labeled according to standardized instructions derived from the Index of Orthodontic Treatment Need (IOTN) A total of 17 clinically relevant classes were annotated with bounding boxes. Due to an insufficient number of examples, two malocclusions (transposition and non-occlusion) were excluded from our quantitative analysis. A YOLOv11 model was trained with augmented data and evaluated on a held-out test set using mean average precision at IoU 0.5 (mAP50), macro precision (macro-P), and macro recall (macro-R). Results: Across 15 analyzed classes, the model achieved 87.8% mAP50, 76.9% macro-P, and 86.1% macro-R. The highest per-class AP50 was observed for Deep bite (98.8%), Diastema (97.9%), Angle Class II canine (97.5%), Anterior open bite (92.8%), Midline shift (91.8%), Angle Class II molar (91.1%), Spacing (91%), and Crowding (90.1%). Moderate performance included Anterior crossbite (88.3%), Angle Class III molar (87.4%), Head bite (82.7%), and Posterior open bite (80.2%). Lower values were seen for Angle Class III canine (76%), Posterior crossbite (75.6%), and Big overjet (75.3%). Precision–recall trends indicate earlier precision drop-off for posterior/transverse classes and comparatively more missed detections in Posterior crossbite, whereas Big overjet exhibited more false positives at the chosen threshold. Conclusion: A YOLOv11-based deep learning system can accurately detect several clinically salient malocclusions on routine intraoral photographs, supporting efficient screening and standardized documentation. Performance gaps align with limited examples and visualization constraints in posterior regions. Larger, multi-center datasets, protocol standardization, quantitative metrics, and multimodal inputs may further improve robustness.

Stomatognathic apparatus and the postural system interact through biomechanical chains, whose neuromuscular properties influence both gross and fine motor coordination. To evaluate changes in body posture and motor functions in children with malocclusion who are treated with palatal expanders, 8 right-handed children (6-12 years) with unilateral posterior crossbite were enrolled in this non-randomized pragmatic longitudinal study. Fine motor skills tests, handgrip strength, 3D body posture analysis, electromyography, thermography and stabilometry were performed before and after the treatment with a Rapid Palatal Expander (RPE) at T0pre (before using RPE), t0Post (immediately after using RPE), T1 (after 21 days of RPE use) and T3 (after 6 months). The positive effect on malocclusion, as demonstrated by reduced mandibular offset, did not result in changes in motor symmetries across time. Velocity variance of stabilometry was reduced during the treatment. The immediate wearing of device only slightly affected the results. The beneficial results at the occlusal level through RPE were not accompanied by changes at the neuromuscular and postural level. Clinicians and practitioners should consider that orthodontics treatments and devices which are adapted due to neuromuscular and posturometric tests may be task and test-related.

To compare the effects of quad helix (QH) anchored on permanent molars versus rapid maxillary expansion (RME) anchored on deciduous teeth on palatal morphology in early mixed dentition patients. A two-arm randomized controlled trial, together with a non-randomized normal bite data for comparison. Seventy-one patients (mean age: QH=9.3years; RME=9.4years) with unilateral posterior crossbite were analysed. The QH group (n=36) and RME group (n=35) were evaluated at baseline (T0), post-retention (T2), and one-year post-treatment (T3). A third age- and sex-matched control group (n=22; mean age=9.1years) served as a normative reference. Evaluated outcomes were 3D palatal measurements, as well as treatment success rate and total treatment duration. Both treatment groups showed significant increases in palatal surface area, projection plane area, and volume from T0 to T3. The RME group experienced a greater increase in palatal surface area (7.0%) compared to the QH group (4.2%) over the same period (P=0.045). Palatal volume increased notably more in the RME group during active treatment (T0-T2), with an 11.2% gain versus 6.8% in the QH group (P=0.046). By T3, palatal vault dimensions had normalized in both groups compared to the control group. The RME group completed treatment 97days earlier than the QH group. Treatment with either QH or RME resulted in normalized palatal vaults compared to the control group. RME had a significantly shorter treatment time but achieved similar success in correcting posterior crossbite as QH. This trial was registered at ClinicalTrials.gov (ID NCT04458506) and Researchweb.org (project number 260581).

Aim:To use a cohort-based orthodontic analysis to examine the association between early childhood oral habits (such as mouth breathing, tongue thrusting, dummy use, and thumb sucking) and the occurrence, kind, and severity of developing malocclusions in a pediatric population.Methodology:A 2-year cohort study followed 220 children (ages 3–6) with full primary dentition and no orthodontic history. Examinations at baseline, 12, and 24 months assessed malocclusion, while caregiver questionnaires recorded oral habits. Logistic regression, adjusted for age, sex, and socioeconomic status, analyzed the impact of habits persisting over 3 years.Results:Malocclusion prevalence rose from 37.7% to 48.2%. Dummy use past age 3 was linked to posterior crossbite (OR = 3.58), and thumb/finger sucking past age 4 to anterior open bite (OR = 4.21). Tongue thrusting related to anterior open bite and mouth breathing to narrow maxilla and overjet. Duration and frequency predicted severity more than habit type.Conclusion:Prolonged oral habits greatly increase malocclusion risk. Stopping them before age 3 or 4 can prevent dentoalveolar changes and reduce future orthodontic needs.