Changes in vertical skeletal and neuromuscular balance in growing patients treated with AMCOP®: a cephalometric and EMG evaluation.
Gianna Dipalma, Grazia Marinelli, Angela Di Noia, Laura Ferrante, Filippo Cardarelli, Francesco Inchingolo, Andrea Palermo, Daniela Di Venere, Angelo Michele Inchingolo, Alessio Danilo Inchingolo
Abstract
Open AccessAim: To evaluate changes in vertical skeletal dimensions and neuromuscular balance in growing patients treated with AMCOP® elastodontic appliances, by comparing pre- and post-treatment cephalometric values (Deltadent®) and standardized surface EMG indices. Materials and methods: This monocentric retrospective case series included 9 consecutive children in deciduous/early mixed dentition treated with AMCOP® according to a staged protocol (Open phase for vertical control, then class-specific device when indicated). Wear was prescribed 1 h/day plus nocturnal use. Lateral cephalograms were traced in Deltadent® at baseline (T0) and after therapy (T1). Primary outcomes were overbite and vertical divergence (SN-GoGn; PP-MP). Secondary outcomes included ANS-Me, overjet, interincisal angle, U1-PP and L1-MP. Neuromuscular balance was assessed with Teethan® (POC TA/MM, BAR, TORS, IMP, ASIM), recorded per SENIAM recommendations. Reliability was checked with ICC and Dahlberg's error; paired comparisons used standard parametric/non-parametric tests (α = 0.05). Results: Treatment was completed without adverse events (median duration ≈12-16 months). Most patients showed closure or reduction of anterior open bite, decreased or well-controlled vertical divergence, increased interincisal angle, and reduced overjet, with upper incisor uprighting and stable lower incisor inclination. sEMG demonstrated consistent improvement: barycenter (BAR) shifted toward the normative zone, torsion/asymmetry indices decreased, and global efficiency (IMP) increased. Conclusions: In growing patients, AMCOP® therapy was associated with favorable vertical control and measurable neuromuscular rebalancing, documented by objective cephalometric and EMG metrics. Prospective controlled studies are warranted to confirm efficacy and long-term stability.