Kevin Manzella1, Lorenzo Franchi2, Thikriat Al-Jewair3. 1. In the Private Practice of Orthodontics at Kathryn E. Rand Orthodontics, West Seneca, NY. kevin.manzella@gmail.com. 2. Department of Surgery and Translational Medicine, Orthodontics, Università degli Studi di Firenze, Florence, Italy. 3. Department of Orthodontics, State University of New York at Buffalo, Buffalo, NY.