## 4 Discussion  
The present paper shows how new technologies can be integrated with acquired knowledge and skills of orthodontic clinicians in order to enhance the diagnosis and treatment plan of specific malocclusion. We discussed the treatment of a seven-year-old female presenting transverse maxillary deficiency and anterior openbite, and we proposed two distinct methods involving (1) the use of a digital diagnostic workflow for the thorough evaluation of maxillary morphology and (2) the use of photobiomodulation to expedite dental movement. Both methodologies have been described in previous studies [5; 10; 12; 13]. We evaluated the palatal size and morphology of a seven-year-old female affected by unilateral functional crossbite patients by using digital linear assessment of maxillary transversal diameters and by surface-based superimposition of mirrored maxillary models. According to this reverse engineering, each virtual palate can be mirrored at an arbitrary point. This procedure allows for the detection of morphologic differences between the two emi-palatal halves. Moreover, the 3D differences of the registered models are usually translated into color codes that represent the distance between corresponding points [25; 26]. By this method, we can verify that the maxilla was narrowed with a symmetric growth pattern involving both the palatal vault and the dento-alveolar processes (Figure 9). This is in disagreement with previous findings showing asymmetric transverse growth of the dento-alveolar process in presence of functional unilateral-posterior crossbite in children [5; 27; 28; 29; 30; 31]. A possible explanation could be that adaptative asymmetric changes of the shape of the dento-alveolar process have still not occurred in the patient presented here. In a previous study [6], the same reverse engineering methodology was used to detect areas of asymmetry in the maxilla of a patient affected by MTD. Authors concluded that reverse engineering methodology could help clinicians in developing a specific appliance for asymmetric expansion of the maxilla. Here, according to the information provided by deviation analysis, we needed to expand the maxilla symmetrically, confirming that the presented diagnostic digital workflow is helpful in providing a comprehensive assessment of the morphology of the palate. Treatment outcomes were reached in less then 4 months. In particular, the anterior openbite was corrected by the combination of the lingual grid and PBM [27; 28; 29]. While the anterior grid forced the tongue in backward and upward position, anterior teeth were free to erupt since they were not obstructed by tongue interposition [30; 32]. This spontaneous eruption was expedited by the administration of PBM, which is able to provoke an accelerated metabolic activity by increasing cellular turnover [13], increasing vascular activity [14; 33; 34], and the availability of ATP [15; 35; 36]. In this respect, PBM is a free-side effects procedure that has also been validated for several therapeutic applications in children [13; 37; 38]. PBM can create a favorable environment for tooth movement, as two types of host responses occur in the irradiated tissues. First, photobiomodulation increases the production of mitochondrial ATP by upregulating the cytochrome c oxidase [12; 14; 39; 40; 41; 42; 43; 44; 45] and promotes the cellular viability and the  
Figure 12: (**A–C**) Intra-oral examination. In particular, see the absence of crossbite at the right side (**A**) and the coincidence between maxillary and mandibular midlines (**B**). expression of osteoclastin in the tension areas of PDL [12; 13; 14; 15; 39; 40; 41; 42; 43]. This increased metabolic activity accelerates cellular turnover (osteoclast, osteoblast, and fibroblasts) [44; 45; 46; 47; 48; 49; 50; 51; 52; 53] and the production of cytokines involved in the bone remodeling, mainly the IL-1b [46; 54; 55; 56; 57].