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Design: Prospective cohort study. Cohort selection: The inclusion criteria comprised patients older than 18 years who attended the orthodontic department at the University of L'Aquila L'Aquila, Italy and requested treatment with clear orthodontic appliance.
Only patients with Class I malocclusion with mild mm or moderate mm crowding were included. The exclusion criteria comprised patients who had medical condition that preclude the use of surface EMG sEMG , patients who had anterior or posterior open bite, patients who had cross bite that include more than one tooth, patients who had edentulous ridges and patients with temporomandibular disorder.
Data analysis: Included patients were assessed at three points in time: at the start of treatment T0 , after 3 months T1 , and after 6 months T2. The patients were instructed during the study to wear each set of aligners Nuvola; Gruppo Europeo di Ortodonzia S.
The following two assessments were done for each patient at T0, T1, and T2: surface electromyography sEMG evaluation and a T-Scan digital occlusal analysis evaluation.
Both evaluations were performed in centric occlusion and with aligners worn. The assessments were done by the same operator. The sEMG evaluation aimed to assess the muscular symmetry and balance. The patients were instructed to clench as much as possible and to maintain the same level of contraction during the test.