{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T02:16:47Z","timestamp":1762049807108,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Aligners represent a common treatment for orthodontic patients thanks to their countless advantages including aesthetics, comfort, and oral hygiene maintenance; at the same time, they are associated with a reduced number of visits and a low incidence of complications. Although aligners have undergone considerable improvements over time, to date they have limitations in resolving the most serious malocclusions related to transverse maxillary deficiency. The aim of the present study was to retrospectively evaluate an orthodontic protocol (the Nuvola\u00ae OP System) which associates a morpho-functional corrector (to be used for 30 min\/day) with the aligner, allowing for the treatment of cases that would be difficult or unpredictable with aligners alone. Methods: Linear measurements were taken on STL files of 100 patients. In 77 patients between 18 and 55 years (mean 28.6 \u00b1 16.2 (standard deviation) years), 3D superimpositions of the maxilla obtained from intraoral scans before and after treatment were performed in order to evaluate the degree of maxillary expansion. The normality of the data distribution was tested. The pre- and post-treatment data were compared using a paired t-test with a 5% significance level. After treatment, a questionnaire was proposed to assess patients\u2019 degree of satisfaction and compliance. Results: A statistically significant difference (p &lt; 0.05) for each distance evaluated was found. The maximum expansion was obtained at the first molar level (2.35 \u00b1 1.64 mm). Of the subjects who completed the questionnaire, 96% were satisfied and 90% were able to perform the protocol without difficulty for the required duration. Conclusions: A significant expansion of the maxillary arch as well as a high degree of patient satisfaction and compliance were observed with the Nuvola\u00ae OP System. Further studies are needed in order to clinically evaluate the relative contribution of the aligners and morpho-functional device to the obtained expansion.<\/jats:p>","DOI":"10.3390\/ijerph19095751","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T21:23:27Z","timestamp":1652131407000},"page":"5751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Use of Aligners Associated with Nuvola\u00ae OP System for Transverse Maxillary Deficiency: A Retrospective Study on 100 Patients"],"prefix":"10.3390","volume":"19","author":[{"given":"Giovanna","family":"Perrotti","sequence":"first","affiliation":[{"name":"Lake Como Institute, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Carrafiello","sequence":"additional","affiliation":[{"name":"Private Practice, 42122 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ornella","family":"Rossi","sequence":"additional","affiliation":[{"name":"Lake Como Institute, 22100 Como, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorena","family":"Karanxha","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Baccaglione","sequence":"additional","affiliation":[{"name":"Private Practice, 20154 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-0984","authenticated-orcid":false,"given":"Massimo","family":"Del Fabbro","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"},{"name":"IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1179\/14653121141362","article-title":"Northcroft Lecture: How has the spectrum of orthodontics changed over the past decades?","volume":"38","author":"Melsen","year":"2011","journal-title":"J. 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