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Tarigan SHP, Sufarnap E, Bahirrah S. The Orthodontic Mini-Implants Failures Based on Patient Outcomes: Systematic Review. Eur J Dent 2024; 18:417-429. [PMID: 37848073 PMCID: PMC11132791 DOI: 10.1055/s-0043-1772249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Anchorage is a challenge and essential issue for an orthodontist in determining the success of orthodontic treatment. Orthodontic anchorage is defined as resistance to unwanted tooth movement. Mini-implant is one of the devices that can be used as an anchor in orthodontic treatment. Many cases have reported successful treatment using mini-implant, but there are cases where mini-implants may fail. Failure of mini-implants can affect orthodontic treatment, and it is known that several factors may lead to mini-implant loss in orthodontic treatment. This systematic review aimed to determine the factors influencing mini-implant failure in orthodontic treatment. Articles were selected from electronic databases (PubMed, Google Scholar, The Cochrane Library, ScienceDirect) from January 2015 until 2023 according to the PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) under the PEOS (Population-Exposure-Outcome-StudyType) framework questions for systematic review. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022337684). All data collected were in English, and filtering was done by eliminating duplicate data, meta-analysis, case reports, case series, mini-reviews, and animal studies. The analysis was further divided into three groups, that is, patient-related, implant-related, and operator-related and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]). Twenty-one articles were identified according to the inclusion criteria in the form of retrospective, prospective, in vivo, and randomized controlled trial studies. Mini-implant failures due to patient-related showed six etiological factors, failures due to implant-related had eight etiological factors, and only one factor was operator-related, which may lead to mini-implant failure. The data was extracted without a computerized system and only in English. Mini-implant failure can be caused by many factors; we could not accuse one major factor as a cause. However, the quality or condition of the bones and oral hygiene are factors that play a significant role in obtaining the stability of implants. Mini-implant failure is highly influenced by poor oral hygiene and peri-implant inflammation. Comprehensive diagnostic prior to mini-implant insertion should be appropriately considered. This systematic review describes several factors that can influence mini-implant failure, divided into three groups: patient-related, implant-related, and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]).
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Affiliation(s)
| | - Erliera Sufarnap
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Siti Bahirrah
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
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De Felice ME, Caruso S, Kueffer M, Gatto R, Wilmes B. Upper Midline Correction Using the Mesial-Distalslider. Bioengineering (Basel) 2024; 11:450. [PMID: 38790317 PMCID: PMC11117984 DOI: 10.3390/bioengineering11050450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
AIM The purpose of the present study is the three-dimensional (3D) analysis of molar and incisor movements that occur during the correction of the upper midline deviation by using the Mesial-Distalslider appliance. MATERIALS AND METHODS A total of 20 consecutive patients (12 women and 8 men; mean age 19.6 ± 11.1 years) were selected from the Orthodontic Department of Heinrich-Heine University of Düsseldorf. To correct the upper midline deviation (>2 mm), the patients were treated with asymmetric mechanics (mesialization on one side and distalization on the contralateral side) with the aid of Mesial-Distalslider. Dental casts were taken for each patient before (T0) and after the treatment (T1). The casts were 3D digitized and the models were superimposed on the palatal anterior region. Three-dimensional molar movements and sagittal incisor movements (proclination and retroclination) were assessed for T0 and T1. RESULTS At the end of the treatment, the total movements of the molars resulted in 4.5 ± 2.2 mm (antero-posterior direction), -0.4 ± 2.4 mm (transverse direction) and 0.3 ± 0.9 mm (vertical direction) on the mesialization side, and -2.4 ± 1.7 mm (antero-posterior direction), -0.5 ± 1.5 mm (transverse direction) and 0.2 ± 1.4 mm (vertical direction) on the distalization side. Incisor displacement was 0.9 mm ± 1.7 (mesialization side) and 0.6 mm ± 0.7 (distalization side). CONCLUSION The Mesial-Distalslider appliance could be considered a valuable tool in orthodontic treatment for upper midline correction. Within the limits of a retrospective study, asymmetric molar movements appeared possible without clinically relevant anchorage loss.
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Affiliation(s)
- Maria Elena De Felice
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Italy; (S.C.); (R.G.)
| | - Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Italy; (S.C.); (R.G.)
| | - Maximilian Kueffer
- Department of Orthodontics, University of Düsseldorf Heinrich Heine, Moorenstraße 5, 40225 Düsseldorf, Germany; (M.K.); (B.W.)
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Italy; (S.C.); (R.G.)
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf Heinrich Heine, Moorenstraße 5, 40225 Düsseldorf, Germany; (M.K.); (B.W.)
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van den Braak MCT, Hoekstra JWM, Bronkhorst EM, Schols JGJH, Ongkosuwito EM, Meijer GJ, van den Beucken JJJP. The effect of surface roughening on the success of orthodontic mini-implants: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2024; 165:262-271.e3. [PMID: 38069923 DOI: 10.1016/j.ajodo.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Orthodontic mini-implants are a widely accepted treatment modality in orthodontics; however, the failure rate is moderately high. Surface roughening is the golden standard in conventional oral implantology, and this may prove beneficial for orthodontic mini-implants as well. The objective of this systematic review is to assess the effect of surface roughening on the success rate of orthodontic mini-implants in both adolescent and adult patients undergoing orthodontic treatment. METHODS Randomized studies comparing the success of surface-roughened and smooth, machined-surface orthodontic mini-implants were included. A literature search was conducted for 6 electronic databases (Pubmed/Medline, Embase, Cochrane, CINAHL, Web of Science, and Scopus), Clinical trial registry (https://www. CLINICALTRIALS gov), and grey literature (Google Scholar). A manual search of the reference lists of included studies was performed. Two authors independently performed the screening, data extraction, risk of bias, and quality assessments. The risk of bias was assessed with the Cochrane risk-of-bias 2.0 Tool. Data were synthesized using a random effect model meta-analysis presented as a forest plot. The certainty in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS A total of 4226 unique records were screened, and 6 of these were included in the quantitative analysis. Four additional articles were selected for a secondary outcome. A total of 364 orthodontic mini-implants were included in the primary outcome analysis. There was no statistically significant effect of surface roughening on the success of orthodontic mini-implants (odds ratio = 0.63 favoring roughened orthodontic mini-implants; 95% confidence interval, 0.35-1.14). The secondary outcome (ie, the overall failure rate of roughened orthodontic mini-implants) was 6% based on studies with high heterogeneity. Limitations of this study were the risk of bias, study imprecision, and possible publication bias, leading to a very low certainty in the body of evidence. CONCLUSIONS There is very low-quality evidence that there is no statistically significant effect of surface roughening on the success of orthodontic mini-implants in humans. The overall failure rate of surface-roughened orthodontic mini-implants was 6%. FUNDING No funding was received for this review. REGISTRATION This study was preregistered in the Prospective Register of Systematic Reviews (CRD42022371830).
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Affiliation(s)
- Matheus C T van den Braak
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jan Willem M Hoekstra
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jan G J H Schols
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Edwin M Ongkosuwito
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gert J Meijer
- Department of Oral Maxillofacial Surgery, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jeroen J J P van den Beucken
- Section of Regenerative Biomaterials, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Merati M, Ghaffari H, Javid F, Ahrari F. Success rates of single-thread and double-thread orthodontic miniscrews in the maxillary arch. BMC Oral Health 2024; 24:191. [PMID: 38317101 PMCID: PMC10845463 DOI: 10.1186/s12903-024-03866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
AIM There is limited research on the clinical performance of double-thread orthodontic miniscrews. This study aimed to compare the stability of double-thread and single-thread orthodontic miniscrews and identify the potential associations between patient-related and location-related factors with miniscrew stability. METHODS This retrospective cohort study involved 90 orthodontic miniscrews (45 single-thread, 45 double-thread) with identical dimensions (8 mm length, 1.6 mm diameter). The screws were inserted in various locations within the upper jaw of 83 patients (54 females, 29 males; mean age = 15.1 ± 2.4 years). Failure was defined as excessive mobility or loss of miniscrew after placement. The data recorded were patient age, gender, insertion site, side of insertion (buccal or lingual), duration of force application, and failure occurrence. RESULTS The overall success rate within the sample was 92.2%. Double-thread miniscrews exhibited a significantly higher success rate than single-thread miniscrews (P = 0.049), with 97.8% and 86.7% success rates, respectively. Gender, age, insertion location, and side of insertion did not show significant associations with failure (P > 0.05). Log-rank analysis revealed a significant difference between the two groups (P = 0.046), indicating a higher probability of survival for the double-thread design. CONCLUSIONS The overall success rate of orthodontic miniscrews was high in the present sample. Double-thread miniscrews placed in various locations within the maxillary arch demonstrated superior stability and survival rates compared to their single-thread counterparts. Therefore, double-thread miniscrews may be preferred when bone quality is inadequate, such as in young patients.
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Affiliation(s)
- Mohsen Merati
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
| | - Hassanali Ghaffari
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
| | - Fatemeh Javid
- School of Dentistry, Shahed University of Medical Sciences, Tehran, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran.
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Patel SD, Ghosh A, Parashar P, Shenavi L, Agarwal SK, Rawat S, Makkad RS. Effectiveness of Miniscrew-Supported Molar Intrusion: A Clinical Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S707-S710. [PMID: 38595451 PMCID: PMC11000891 DOI: 10.4103/jpbs.jpbs_957_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/01/2023] [Accepted: 10/05/2023] [Indexed: 04/11/2024] Open
Abstract
Mini-screws, also known as temporary anchorage devices (TADs), offer enhanced control and versatility in orthodontic treatment by providing stable anchorage points. This clinical study aims to evaluate the effectiveness of mini-screw-supported molar intrusion in orthodontic practice. For this clinical study, a cohort of 40 orthodontic patients with various malocclusions requiring molar intrusion as part of their treatment plan was recruited. The age range of the participants spanned from 14 to 35 years, representing a diverse patient population. The intervention involved the implementation of mini-screw-supported molar intrusion on one side of the maxillary arch in each patient. To achieve this, temporary mini-screws were strategically placed, and a combination of orthodontic forces and mini-screw anchorage was employed to intrude the molars. The primary outcome measure for this study was the amount of molar intrusion achieved, which was quantified in millimeters from the initial evaluation to the final visit. Additionally, the duration of treatment required to achieve the desired molar intrusion was recorded in months. The results of this clinical study demonstrated that mini-screw-supported molar intrusion was an effective and safe orthodontic technique. On average, a significant mean molar intrusion amount of 4.8 mm (standard deviation [SD] ± 0.6) was achieved with the mini-screw-supported approach. Furthermore, the treatment duration required to attain the desired molar intrusion was relatively short, with a mean of 6.2 months (SD ± 1.1). In conclusion, this clinical study provides evidence that mini-screw-supported molar intrusion is an effective and safe approach in orthodontic practice. It offers orthodontists the advantage of enhanced control and predictability in molar intrusion procedures.
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Affiliation(s)
- Sejal D. Patel
- Department of Orthodontics and Dentofacial Orthopaedics, Government Dental College and Hospital, Jamnagar, Gujarat, India
| | - Anirban Ghosh
- Department of Orthodontics and Dentofacial Orthopedics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
| | - Pranav Parashar
- Department of Dentistry, N.S.C.B Medical College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Lina Shenavi
- Department of Orthodontics and Dentofacial Orthopedics, College of Dental Sciences and Hospital, Bhavnagar, Amargadh, Gujarat, India
| | - Satendra Kumar Agarwal
- Department of Orthodontics and Dentofacial Orthopaedics, KGF College of Dental Sciences and Hospital, Karnataka, India
| | - Siddharth Rawat
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Ramanpal Singh Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, Chhattisgarh, India
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Ghozy EA, Albelasy NF, Shamaa MS, El-Bialy AA. Cephalometric and digital model analysis of dentoskeletal effects of infrazygomatic miniscrew vs. Essix- anchored Carriere Motion appliance for distalization of maxillary buccal segment: a randomized clinical trial. BMC Oral Health 2024; 24:152. [PMID: 38297285 PMCID: PMC10832169 DOI: 10.1186/s12903-024-03925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024] Open
Abstract
TRIAL DESIGN Parallel. OBJECTIVE To compare skeletally anchored Carriere Motion appliance (CMA) for distalization of the maxillary buccal segment vs. Essix anchored CMA. METHODS Thirty-two class II malocclusion patients were randomly allocated into two equal groups. One group was treated with infrazygomatic (IZC) miniscrew- anchored CMA (IZCG) and the other group treated with Essix retainer- anchored CMA (EXG). Two lateral cephalograms and two digital models for upper and lower arches were taken for each patient: immediately before intervention and after distalization had been completed. RESULTS Distalization period was not significantly different between the two groups. In contrast to EXG, IZCG showed insignificant difference in ANB, lower incisor proclination, and mesial movement of the lower first molar. There was significant rotation with distal movement of maxillary canine and first molar in both groups. CONCLUSION IZC anchored CMA could eliminate the side effects of class II elastics regarding lower incisor proclination, mesial movement lower molars with a more significant amount of distalization of the maxillary buccal segment but with significant molar rotation. TRIAL REGISTRATION The ClinicalTrials.gov Protocol Registration and Results System (PRS) has this RCT registered as (NCT05499221) on 12/08/2022.
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Affiliation(s)
- Eglal Ahmed Ghozy
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35116, Egypt.
| | - Nehal Fouad Albelasy
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35116, Egypt
| | - Marwa Sameh Shamaa
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35116, Egypt
| | - Ahmed A El-Bialy
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35116, Egypt
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Fang X, Ding H, Fan C, Pang L, Xu T, Liu J, Jiang C. Comparison of mandibular buccal shelf morphology between adolescents and adults with different vertical patterns using CBCT. Oral Radiol 2024; 40:58-68. [PMID: 37773481 DOI: 10.1007/s11282-023-00710-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE This retrospective study aimed to analyze the anatomical structure of the mandibular buccal shelf (MBS) in adolescents and adults with different vertical patterns to determine the optimal location for miniscrew insertion in orthodontic treatment. METHODS Cone-beam computed tomography (CBCT) scans of 230 patients were utilized for measurements. The morphology and thickness of alveolar bone at the MBS were measured. Two-way ANOVA and regression analysis were conducted to analyze the influencing factors on alveolar bone and cortical bone thickness. RESULTS Age had a significant effect on alveolar bone thickness (level I: F = 62.449, level II: F = 18.86, p < 0.001), cortical bone thickness (level II: F = 18.86, p < 0.001), alveolar bone tilt (F = 6.267, p = 0.013), and second molar tilt (F = 6.693, p = 0.01). Different vertical patterns also influenced alveolar bone thickness (level I: F = 20.950, level II: F = 28.470, p < 0.001), cortical bone thickness (level I: F = 23.911, level II: F = 23.370, p < 0.001), and alveolar bone tilt (F = 27.046, p < 0.001). As age increased, the alveolar bone thickness at level I decreased by 0.096 mm and at level II decreased by 0.073 mm. Conversely, the thickness of alveolar bone at level I and level II increased by 0.06 mm and 0.075 mm, respectively. The cortical bone thickness at level I and level II increased by 0.024 mm and 0.29 mm, respectively. However, the alveolar bone thickness decreased by 0.931 mm and 1.545 mm at level I and level II, and the cortical bone thickness decreased by 0.542 mm and 0.640 mm at level I and level II, respectively. CONCLUSION Age, different vertical patterns, alveolar bone inclination, and different shapes of MBS significantly affected the thickness of alveolar bone and cortical bone in the MBS area. Notably, only alveolar bone thickness and cortical bone thickness at level II were affected by age and different vertical patterns simultaneously. These findings can provide valuable insights for orthodontic practitioners in selecting the most suitable location for miniscrew insertion during treatment planning.
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Affiliation(s)
- Xiaoxu Fang
- Qingdao Stomatological Hospital Affiliated to Qingdao University, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Hong Ding
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Cunhui Fan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
| | - Lei Pang
- The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Tao Xu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Jialin Liu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Chunmiao Jiang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, 266003, China.
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de Paiva TT, Barros DMC, Bittencourt RC, Savelli MBB, Lorenzoni DC, de Alcantara Cury-Saramago A, Mattos CT. Pain perception and expectation related to interradicular mini-implants insertion: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:7029-7043. [PMID: 37864604 DOI: 10.1007/s00784-023-05311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants. MATERIALS AND METHODS Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I. RESULTS A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I2 statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94). CONCLUSION Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively. CLINICAL RELEVANCE This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.
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Affiliation(s)
- Thais Teixeira de Paiva
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | | | | | | | - Diego Coelho Lorenzoni
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | | | - Claudia Trindade Mattos
- Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
- Faculdade de Odontologia, Disciplina de Ortodontia, Rua Mário Santos Braga, 30, 2° andar, sala 214, Centro, Niterói, CEP 24020-140, Brazil.
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Gill G, Shashidhar K, Kuttappa M, Kushalappa P B D, Sivamurthy G, Mallick S. Failure rates and factors associated with infrazygomatic crestal orthodontic implants - A prospective study. J Oral Biol Craniofac Res 2023; 13:283-289. [PMID: 36880016 PMCID: PMC9984842 DOI: 10.1016/j.jobcr.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 01/29/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
Objective Infrazygomatic crestal (IZC) implants have gained increased popularity over the past few years. Hardly any studies have been done to assess the rate and reasons for failure of IZCs. This prospective study was planned and designed with the primary objective of assessing the rate of failure of bone-screws (BS) placed in the infrazygomatic crest. In continuation, the secondary objective was to assess the factors that were associated with the failure. Materials and methods The study was carried out by taking a detailed case history, (age, gender, vertical skeletal pattern, medical history), photographic records, radiographs, and clinical examination of a total of 32 randomly selected. patients of south indian origin who required infrazygomatic implants bilaterally as the choice of anchorage conservation to retract their incisors. All selected subjects were required to take a PA Cephalogram after the implant placement. The age of the patients ranged from 18 to 33 with an average age of 25 years. The patient log was maintained which included the treatment mechanics, status of oral hygiene, stability of implants, time of loading of the implant, presence of inflammation and time of failure of implant. The angulation of implant was measured on a digital PA cephalogram using Nemoceph software. These parameters were examined to evaluate independent and dependent variables using the Chi-Square test and Fischer's exact test. Result A failure rate 28.1% for IZC placed in the infrazygomatic crest region was observed. Patients with a high mandibular plane angle, poor oral hygiene, immediately loaded implant, peri-implantitis, and severe clinical mobility showed higher failure rates. Variables such as age, gender, sagittal skeletal pattern, length of the implant, type of movement, occluso-gingival position, method of force application, and angle of placement were not significantly associated with implant failure. Conclusion Oral hygiene and peri-screw inflammation must be controlled to minimize the failure of bone screws placed in the infrazygomatic crest region. Loading of the implant should be done after a latent period of two weeks. A higher failure rate was observed in patients with vertical growth pattern.
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Affiliation(s)
- Gauri Gill
- Gills Multispecialty Dental Solutions, Chandigarh, India
| | - Keerthan Shashidhar
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - M.N. Kuttappa
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Dhyan Kushalappa P B
- Department of Dentistry, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India
| | | | - Soham Mallick
- Dr Soham's Dental Clinic, Mumbai, Maharashtra, India
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Bungău TC, Vaida LL, Moca AE, Ciavoi G, Iurcov R, Romanul IM, Buhaș CL. Mini-Implant Rejection Rate in Teenage Patients Depending on Insertion Site: A Retrospective Study. J Clin Med 2022; 11:jcm11185331. [PMID: 36142978 PMCID: PMC9502099 DOI: 10.3390/jcm11185331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/04/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mini-implants have undeniable advantages in Orthodontics. However, the use of mini-implants shows some limitations and disadvantages related to patient age, the quality of the bone tissue, the characteristics of the oral mucosa, implant site, the state of health of the organism and the quality of oral hygiene. The aim of this paper was to analyze the rejection rate of mini-implants in teenage patients, depending on their insertion site, and examine their stability up to three months after insertion. This retrospective study was conducted on dental charts belonging to patients aged between 12 and 17 years, from Oradea, Romania. The mini-implants were placed for various therapeutic reasons and were inserted in the following sites: buccal maxillary area, the infrazygomatic region, palatal area, buccal mandibular area and lingual area; they had a diameter of 1.6 mm (inter-radicular spaces) and of 2 mm (nonbearing tooth areas), and a length of 6–8 mm (mandible) or 8–10 mm (maxilla). The rejection rate was checked in the first month, second month, third month and after the third month from insertion. A total of 432 patients were included in the study, and they had a total of 573 mini-implants. Most implants were placed in the buccal region of the maxilla (27.7%), and most patients had one mini-implant placed (65.7%). The highest rejection rate was obtained in the first month (15.2%). The rejection rate between genders was similar. The mini-implants from the buccal mandibular region had a significantly higher rate of rejection in the first month (M1) in comparison to the mini-implants from the palatal region (24.4% vs. 8.3%). The mini-implants from the lingual region of the mandible had a significantly higher rate of rejection in the second month (M2) in comparison to the mini-implants from the infrazygomatic or the palatal region (10.5% vs. 0%/0%). Mini-implants are very useful for carrying out various orthodontic treatments, but their stability should be enhanced.
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Affiliation(s)
- Teodora Consuela Bungău
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
- Correspondence: (L.L.V.); (A.E.M.)
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
- Correspondence: (L.L.V.); (A.E.M.)
| | - Gabriela Ciavoi
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Raluca Iurcov
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Ioana Mihaela Romanul
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Camelia Liana Buhaș
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
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Xin Y, Wu Y, Chen C, Wang C, Zhao L. Miniscrews for orthodontic anchorage: analysis of risk factors correlated with the progressive susceptibility to failure. Am J Orthod Dentofacial Orthop 2022; 162:e192-e202. [PMID: 35987884 DOI: 10.1016/j.ajodo.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The phenomenon of orthodontic anchorage miniscrews loosening after being implanted several times happens in daily clinical practice, and the reasons need to be traced. This study aimed to investigate the underlying risk factors influencing the progressive susceptibility of orthodontic miniscrews to failure. METHODS Overall, 889 miniscrews were successively inserted into 347 patients because some loosened or fell off once, twice, or more before achieving their purposes. The number of miniscrew failures (ie, once, twice, or more) was defined as progressive susceptibility to failure. The clinical indicators were assessed via univariate analysis, multicollinearity diagnosis, and Poisson log-linear regression model with stepwise calculation to screen out. RESULTS The progressive susceptibility of miniscrews to failure was proved to be affected by the age of patients, the onset of force application, site of placement, and appliance type. Age and onset of force application presented a negative relationship with susceptibility. Miniscrews inserted in the palatal region appeared to be more stable than the forepart of the arch. In contrast, the retromaxillary and retromandibular areas obtained the lowest stability. The patients with fixed appliances were more unlikely to suffer progressive failure than removable appliances. In addition, the larger number of screws inserted in each patient, the greater probability of failure. CONCLUSIONS Younger people with removable appliances that miniscrews inserted in the retromaxillary or retromandibular regions and earlier onsets of loading had a higher progressive susceptibility to loosening. Meanwhile, the failure rate was elevated with the increasing number of screws per patient received.
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Affiliation(s)
- Yilin Xin
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yeke Wu
- Department of Stomatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenjou Chen
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chen Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lixing Zhao
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Pozzan L, Migliorati M, Dinelli L, Riatti R, Torelli L, Di Lenarda R, Contardo L. Accuracy of the digital workflow for guided insertion of orthodontic palatal TADs: a step-by-step 3D analysis. Prog Orthod 2022; 23:27. [PMID: 35965264 PMCID: PMC9376185 DOI: 10.1186/s40510-022-00423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background The introduction in the orthodontic field of the digital workflow for guided insertion of palatal TADs and the development of the 1-visit protocol led to the reduction of chair time and the possibility of complete customization of designs and materials. Conversely, the reduction of operative steps implicates a lower tolerance of deviations between the planned and the actual position of the miniscrews, particularly when the orthodontic device is fixed on 4 palatal TADs or has a rigid structure. This study aims to analyze the influence of each step of the digital workflow on the deviation of the miniscrews’ axis of insertion in a bicortical sample. The null hypothesis is that there are no significant differences in the deviations among the operative steps.
Methods 33 subjects were selected for insertion of bicortical palatal miniscrews with a 1-visit protocol. Digital files were collected at the three stages of the workflow (i.e., digital planning, laboratory prototype, post-insertion impression). A 3D software analysis was performed on a total of 64 miniscrews. After automatic shape recognition of the guiding holes of the digital plan and the scanbodies of the laboratory prototype and post-insertion impression as geometric cylinders, their three-dimensional longitudinal axis was traced and the deviation among them was calculated. Friedman test with Bonferroni correction was performed to assess the significance of the deviations among the three steps, with significance set at p < 0.05.
Results The laboratory step has a significantly lower degree of deviations (2.12° ± 1.62) than both the clinical step (6.23° ± 3.75) and the total deviations (5.70° ± 3.42). No significant differences were found between miniscrews inserted on the left or the right side. Conclusions This study suggests that laboratory procedures such as surgical guide production or rapid prototyping don’t play a significant role in the degree of deviations between the planned and the positioned palatal TADs. Conversely, the clinical steps have a bigger influence and need to be carefully evaluated. Despite this difference, there is a cumulative effect of deviations that can lead to the failure of the 1-visit protocol.
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Crawford D, Lau TC, Frost MC, Hatch NE. Control of Orthodontic Tooth Movement by Nitric Oxide Releasing Nanoparticles in Sprague-Dawley Rats. FRONTIERS IN DENTAL MEDICINE 2022; 9:811251. [PMID: 36081866 PMCID: PMC9451041 DOI: 10.3389/fmats.2022.811251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
UNLABELLED Orthodontic treatment commonly requires the need to prevent movement of some teeth while maximizing movement of other teeth. This study aimed to investigate the influence of locally injected nitric oxide (NO) releasing nanoparticles on orthodontic tooth movement in rats. MATERIALS AND METHODS Experimental tooth movement was achieved with nickel-titanium alloy springs ligated between the maxillary first molar and ipsilateral incisor. 2.2 mg/kg of silica nanoparticles containing S-nitrosothiol groups were injected into the mucosa just mesial to 1st molar teeth immediately prior to orthodontic appliance activation. NO release from nanoparticles was measured in vitro by chemiluminescence. Tooth movement was measured using polyvinyl siloxane impressions. Bones were analyzed by microcomputed tomography. Local tissue was assessed by histomorphometry. RESULTS Nanoparticles released a burst of NO within the first hours at approximately 10 ppb/mg particles that diminished by 10 × to approximately 1 ppb/mg particles over the next 1-4 days, and then diminished again by tenfold from day 4 to day 7, at which point it was no longer measurable. Molar but not incisor tooth movement was inhibited over 50% by injection of the NO releasing nanoparticles. Inhibition of molar tooth movement occurred only during active NO release from nanoparticles, which lasted for approximately 1 week. Molar tooth movement returned to control levels of tooth movement after end of NO release. Alveolar and long bones were not impacted by injection of the NO releasing nanoparticles, and serum cyclic guanosine monophosphate (cGMP) levels were not increased in animals that received the NO releasing nanoparticles. Root resorption was decreased and periodontal blood vessel numbers were increased in animals with appliances that were injected with the NO releasing nanoparticles as compared to animals with appliances that did not receive injections with the nanoparticles. CONCLUSION Nitric oxide (NO) release from S-nitrosothiol containing nanoparticles inhibits movement of teeth adjacent to the site of nanoparticle injection for 1 week. Additional studies are needed to establish biologic mechanisms, optimize efficacy and increase longevity of this orthodontic anchorage effect.
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Affiliation(s)
- Derrick Crawford
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Tommy C. Lau
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Megan C. Frost
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Nan E. Hatch
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
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Vicioni-Marques F, Pimentel DJB, Matsumoto MAN, Stuani MBS, Romano FL. Orthodontic mini-implants: clinical and peri-implant evaluation. J World Fed Orthod 2021; 11:22-28. [PMID: 34906435 DOI: 10.1016/j.ejwf.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022]
Abstract
The study evaluated the clinical changes of orthodontic mini-implants (MI) inserted for the purpose of anchoring during orthodontic treatment. The null hypotheses were: 1-that there is no correlation between proximity of the MI to the root and peri-implantitis or mobility; 2-that peri-implantitis does not interfere with mobility; 3-that the pain is not related to mobility or peri-implantitis. Forty (40) patients were selected and the MI were evaluated for each patient. MI in the upper and lower arch were evaluated for a period of approximately 6 months with relationship to the distance MI - root, peri-implantitis, mobility, biological damage and pain through the analysis of periapical radiography and clinical/periodontal evaluation. The evaluations were performed out by means of scores and a correlation was made between the variables. No statistically significant differences were found between the upper and lower arch in the variables evaluated, except for the mobility that was more present in the lower arch (p = 0.0336). There was a correlation between peri-implantitis and mobility (p = 0.0003) and between pain and mobility (p = 0.0443). However, there was no correlation between a greater degree of peri-implantitis and greater mobility (p = 0.7054). In addition, the MI placed too close to the root showed peri-implantitis (p = 0.0142). The null hypotheses were rejected because there was a positive correlation between the analyzes. The placement of MI close to the root led to greater peri-implantitis. Patients who reported pain had greater mobility of the MI and peri-implantitis led to greater mobility.
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Affiliation(s)
- Fernanda Vicioni-Marques
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Diego Jesus Brandariz Pimentel
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Palone M, Darsiè A, Maino GB, Siciliani G, Spedicato GA, Lombardo L. Analysis of biological and structural factors implicated in the clinical success of orthodontic miniscrews at posterior maxillary interradicular sites. Clin Oral Investig 2021; 26:3523-3532. [PMID: 34837567 DOI: 10.1007/s00784-021-04321-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aims to evaluate success factors implicated in clinical orthodontic miniscrew stability after their interradicular placement in maxilla. MATERIALS AND METHODS Six hundred seventy-six miniscrews were inserted in maxillary interradicular sites in a sample of 276 patients (109 males and 167 females; mean age 19 ± 1.7 years) and immediately loaded. Percentage failure rate was recorded, and the influence of the following factors was investigated: structural (miniscrew length, diameter and body shape), operative (side of insertion site, pilot hole drilling or not) and biological (maximal insertion torque [MIT] and type of gingiva). A chi-square test with Monte Carlo correction was performed to detect the influence of these variables on the failure rate of orthodontic miniscrews. Then both multivariate logistic regression and post hoc analysis were performed, followed by classification and regression tree (CART) analysis. RESULTS The average success rate was 88%. The principal factors implicated in the failure rate were miniscrew length, MIT values and type of gingiva. Specifically, 8 mm miniscrew length, alveolar mucosa and 5-10 Ncm MIT values were linked to higher failure rates. According to CART, the main variable influencing failure is miniscrew length (≤ 8 mm for higher failure rates). For others, MIT values of 5-10 Ncm are linked to higher failure rates (p < 0.05). CONCLUSION Orthodontic miniscrews inserted in the maxilla display good success rates. However, clinicians should be discouraged from using miniscrews of length ≤ 8 mm and MIT values < 10 Ncm, even with longer miniscrews. CLINICAL RELEVANCE Information about factors related to failure rate of miniscrews placed at posterior maxillary interradicular sites is given.
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Affiliation(s)
- M Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy.
| | - A Darsiè
- Private Practice, Treviso, Italy
| | - G B Maino
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
| | - G Siciliani
- School of Dentistry, University of Ferrara, Via Luigi Borsari 46, 44121, FerraraFerrara, Italy
| | - G A Spedicato
- Faculty of Banking and Finance, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123, Milano, Italy
| | - L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
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Risk factors associated with the stability of mini-implants and mini-plates: systematic review and meta-analysis. Clin Oral Investig 2021; 26:65-82. [PMID: 34676428 DOI: 10.1007/s00784-021-04212-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this systematic review is to assess the risk factors associated with the stability of mini-implants and mini-plates in patients undergoing orthodontic treatment using temporary anchorage devices. MATERIAL AND METHODS Search strategies were developed for each electronic database (PubMed/Medline, LILACS, Scopus, Web of Science, Embase, and Cochrane Library) and gray literature (Google Scholar, Proquest, and Open Grey). The risk of bias was assessed using the Cochrane Collaboration tool for assessing the risk of bias and Meta-Analysis of Statistics Assessment and Review Instrument. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses and meta-regressions of random effects were performed for the outcomes of interest. RESULTS A total of 1517 articles were found, of which seven were selected for quantitative synthesis. When comparing the risk of failure between mini-implants and mini-plates, the risk values approached the threshold of statistical significance (p = 0.07) (RR = 1.83; 95% CI = 0.96-3.50; I2 = 69%), showing significance after sensitivity analysis (p < 0.05) and a greater risk for mini-implants. Mandible installation presented a higher risk of failure (RR = 1.85; 95% CI = 1.17-2.91). CONCLUSIONS The evidence found indicates that failure in the stability is related to the type of device and that there is a greater risk by using isolated mini-implants, especially when positioned in the mandible. CLINICAL RELEVANCE These findings help the orthodontist and/or the surgeon to stipulate risks, learn about the predictability of techniques, and communicate with the patient in an easier way.
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Patni VJ, Kolge NE, Pednekar MJ. ‘N-Angle’: Clinical Indicator for Predictable Insertion of Ramal Bone Screws. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/0301574221991947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: The primary concern in the placement of ramal bone screws is the blind nature of the procedure, as there is a thick, mobile layer of soft tissue over the bone; also, the ramus is not a uniplanar structure but is swerving like a propeller blade. The purpose of this study was to evaluate the possibility of establishing clinical guidelines based on visible dental and soft-tissue landmarks for safe, reliable, and accurate insertion of ramal bone screws. Aims and Objectives: Our primary objective was to evaluate the angle formed between the appropriate direction of ramal-implant placement and the line tangential to the buccal surfaces of the first and second permanent molars. Our secondary objective was to evaluate the average distance of the neurovascular bundle from the tip of the bone screw. Materials and Methods: We obtained 80 cone beam computed tomography (CBCT) samples, marked reference lines and points on selected axial and coronal sections, and evaluated the following parameters using the software’s linear- and angular-measurement device: the angle between the appropriate direction of ramal bone screw placement and the line tangential to the buccal surfaces of the first and second permanent molars; and the proximity of the bone screw to the neurovascular bundle. Results: The angle between the constructed line of insertion and the occlusal line, as evaluated from our study, was 19.04 (SD ± 6.89) degrees. The proximity of the neurovascular bundle from the screw is 7.1773 (SD ± 1.73988) mm. Conclusion: We can conclude that ramal bone screws can be placed with a comfortable margin of safety.
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Affiliation(s)
- Vivek J Patni
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Neeraj E Kolge
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Madhura J Pednekar
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
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Jeong DM, Oh SH, Choo H, Choi YS, Kim SH, Lee JS, Hwang EH. Root proximity of the anchoring miniscrews of orthodontic miniplates in the mandibular incisal area: Cone-beam computed tomographic analysis. Korean J Orthod 2021; 51:231-240. [PMID: 34275879 PMCID: PMC8290084 DOI: 10.4041/kjod.2021.51.4.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/02/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022] Open
Abstract
Objective This outcome analysis study evaluated the actual positions of the orthodontic miniplate and miniplate anchoring screws (MPASs) and the risk factors affecting adjacent anatomic structures after miniplate placement in the mandibular incisal area. Methods Cone-beam computed tomographic images of 97 orthodontic miniplates and their 194 MPASs (diameter, 1.5 mm; length, 4 mm) in patients whose miniplates provided sufficient clinical stability for orthodontic treatment were retrospectively reviewed. For evaluating the actual positions of the miniplates and analyzing the risk factors, including the effects on adjacent roots, MPAS placement height (PH), placement depth (PD), plate angle (PA), mental fossa angle (MA), and root proximity were assessed using the paired t-test, analysis of variance, and generalized linear model and regression analyses. Results The mean PDs of MPASs at positions 1 (P1) and 2 (P2) were 2.01 mm and 2.23 mm, respectively. PA was significantly higher in the Class III malocclusion group than in the other groups. PH was positively correlated with MA and PD at P1. Of the 97 MPASs at P1, 49 were in the no-root area and 48 in the dentulous area; moreover, 19 showed a degree of root contact (19.6%) without root perforation. All MPASs at P2 were in the no-root area. Conclusions Positioning the miniplate head approximately 1 mm lower than the mucogingival junction is highly likely to provide sufficient PH for the P1-MPASs to be placed in the no-root area.
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Affiliation(s)
- Do-Min Jeong
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - HyeRan Choo
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Craniofacial and Airway Orthodontic Clinic, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Yong-Suk Choi
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Suk Lee
- Department of Dental Education, Graduate School, Kyung Hee University, Seoul, Korea
| | - Eui-Hwan Hwang
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
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Lee Y, Choi SH, Yu HS, Erenebat T, Liu J, Cha JY. Stability and success rate of dual-thread miniscrews. Angle Orthod 2021; 91:509-514. [PMID: 34181723 DOI: 10.2319/083020-756.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To date, the clinical stability of dual-thread orthodontic miniscrews has not been studied. This study aimed to compare the primary stability and long-term clinical success rate of dual-thread and cylindrical orthodontic miniscrews and to examine the association between various clinical factors and the success rate of miniscrews. MATERIALS AND METHODS A total of 145 cylindrical and 135 dual-thread miniscrews were inserted in the maxillary and mandibular buccal alveolar areas of 142 patients. The torque and Periotest (Siemens, Bensheim, Germany) values were recorded during insertion and removal. The effect of clinical variables such as sex, age, screw design, jaw, side of placement, root proximity, and site of placement on the success rate was examined using logistic regression analysis. RESULTS There was no statistically significant difference (P = .595) in the overall clinical success rate between the two designs, with an overall success rate of 82.1% and 84.4% for the cylindrical and dual-thread miniscrews, respectively. Age and screw-root proximity were significantly associated with failure (P < .05). CONCLUSIONS The dual-thread miniscrews did not show superior long-term stability and clinical success rate as compared with the cylindrical miniscrews. The results of this study suggest that patient age and screw-root proximity influence the clinical success rate of miniscrews.
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Du B, Zhu J, Li L, Fan T, Tan J, Li J. Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment. Am J Orthod Dentofacial Orthop 2021; 160:113-123. [PMID: 34092464 DOI: 10.1016/j.ajodo.2020.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This research aimed to measure the bone depth and thickness of different insertion paths for safe placement of infrazygomatic crest miniscrews between the first (U6) and second maxillary molars (U7) by 3-dimensional (3D) reconstruction and to explore their clinical significance. METHODS Cone-beam computed tomography data from 36 adult orthodontic patients were obtained to generate 3D models (n = 72) of the infrazygomatic crest region. For each model, the bone depth and thickness of 27 different insertion paths were measured in the region between U6 and U7. The relationship between bone depth and thickness was statistically analyzed. The clinical risk for each insertion path was assessed according to the impacts of bone depth and thickness on insertion failure. RESULTS Maximum bone depth (median, 7.41 mm; mean, 8.42 mm) was present at 13 mm insertion sites with a gingival tipping angle of 50° and a distal tipping angle of 30°. Maximum bone thickness (median, 3.73 mm; mean, 4.00 mm) was present at 17 mm insertion site with a gingival tipping angle of 70° and a distal tipping angle of 30°. There was a significant negative correlation between bone depth and bone thickness (rs = -0.569, P <0.001). Failure rates were significantly different among different insertion paths (P <0.001). CONCLUSIONS Because the bone depth and thickness may affect the safe insertion of infrazygomatic crest miniscrews in the region between U6 and U7 and they are negatively related, a safe insertion protocol design for distal tooth movement should take both into consideration.
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Affiliation(s)
- Bingran Du
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jiuyu Zhu
- Department of Stomatology, the Third Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Lutao Li
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Tiancheng Fan
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jinchuan Tan
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jianyi Li
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, and Nanhai Hospital, Southern Medical University, Guangdong, China.
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Aleluia RB, Duplat CB, Crusoé‐Rebello I, Neves FS. Assessment of the mandibular buccal shelf for orthodontic anchorage: Influence of side, gender and skeletal patterns. Orthod Craniofac Res 2021; 24 Suppl 1:83-91. [DOI: 10.1111/ocr.12463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 12/01/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Roberta Basañez Aleluia
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Candice Belchior Duplat
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Iêda Crusoé‐Rebello
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
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Ten years of miniscrew use in a U.S. orthodontic residency program. Am J Orthod Dentofacial Orthop 2020; 158:834-839. [DOI: 10.1016/j.ajodo.2019.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/01/2019] [Accepted: 11/01/2019] [Indexed: 11/22/2022]
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23
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Gera S, Cattaneo PM, Hartig LE, Cornelis MA. Computer-aided design and manufacturing of bone- and tooth-borne maxillary protraction with miniscrews and Class III elastics: Can we contemporize Class III treatments in growing patients? Am J Orthod Dentofacial Orthop 2020; 159:125-132. [PMID: 33223373 DOI: 10.1016/j.ajodo.2020.06.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this clinical report is to illustrate an innovative treatment plan for a patient with Class III malocclusion. The plan combined the versatility of computer-aided design and manufacturing technology with miniscrews. Maxillary and mandibular fully customized metal framework anchored to 4 miniscrews was digitally designed and constructed for a growing patient with midface hypoplasia and a skeletal Class III malocclusion. The patient wore Class III elastics between hooks on the maxillary and mandibular frameworks full time for 10 months. Overcorrection was obtained with limited dental side effects, and a significant improvement of the profile was achieved. With the advantages of computer-aided design and manufacturing technology and less invasive insertion procedure compared with miniplate surgery, this patient-specific treatment approach was simple and effective.
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Affiliation(s)
- Shadi Gera
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lill Egekvist Hartig
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
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Al Amri MS, Sabban HM, Alsaggaf DH, Alsulaimani FF, Al-Turki GA, Al-Zahrani MS, Zawawi KH. Anatomical consideration for optimal position of orthodontic miniscrews in the maxilla: a CBCT appraisal. Ann Saudi Med 2020; 40:330-337. [PMID: 32757983 PMCID: PMC7410228 DOI: 10.5144/0256-4947.2020.330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Orthodontic miniscrews are commonly used as temporary anchorage devices. Bone thickness and bone depth are important factors when placing miniscrews. There are no studies to assess the maxillary bone thickness for optimum miniscrew placement in a Saudi population. OBJECTIVE Assess the proximity of the maxillary sinus and nasal cavity in areas where miniscrews are usually inserted using cone beam computed tomography (CBCT). DESIGN Retrospective, cross-sectional. SETTING Department of maxillofacial radiology in a Saudi dental school. PATIENTS AND METHODS Using CBCT images, we measured the distance between the maxillary sinus and nasal cavity to the palatal bone, buccal intra-radicular and infrazygomatic crest areas. Mean values (SD) were compared at various locations, including by gender, and correlation with age was calculated. MAIN OUTCOME MEASURE Mean bone thickness at commonly used sites for orthodontic miniscrew placements in the maxilla. Secondary outcome was the insertion angle in the infrazygomatic crest area. SAMPLE SIZE CBCT images of 100 patients (50 males and 50 females). RESULTS The mean (standard deviation) age for the sample was 25.4 (6.5) years with no significant difference between males and females. In the palate, the distance to the nasal cavity and maxillary sinus was greater anteriorly and decreased significantly posteriorly (P<.001). Buccally, the interdental bone depth was significantly greater between the second premolar and first molar (11.96 mm) compared to between the central and lateral incisors (7.53 mm, P<.001). The mean bone thickness of the infrazygomatic crest area at a 45° insertion angle was 4.94 mm compared to 3.90 at a 70° insertion angle (P<.001). No correlation was found between age and bone thickness. CONCLUSION The distance to the nasal cavity and maxillary sinus was greater in the anterior than posterior areas. There is minimal risk of injuring the maxillary sinus or nasal cavity using the buccal approach. Caution is needed when placing miniscrews in the infrazygomatic crest area. LIMITATIONS Cross-sectional study from one center; hence, findings cannot be generalized to other populations. CONFLICT OF INTEREST None.
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Affiliation(s)
- Maha S Al Amri
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanadi M Sabban
- From the Department of Oral Diagnostic Sciences Faculty of Dentistry King Abdulaziz University
| | - Doaa H Alsaggaf
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad F Alsulaimani
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghassan A Al-Turki
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad S Al-Zahrani
- From the Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Casaña-Ruiz MD, Bellot-Arcís C, Paredes-Gallardo V, García-Sanz V, Almerich-Silla JM, Montiel-Company JM. Risk factors for orthodontic mini-implants in skeletal anchorage biological stability: a systematic literature review and meta-analysis. Sci Rep 2020; 10:5848. [PMID: 32246125 PMCID: PMC7125198 DOI: 10.1038/s41598-020-62838-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/18/2020] [Indexed: 11/09/2022] Open
Abstract
The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.
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26
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Ramírez-Ossa DM, Escobar-Correa N, Ramírez-Bustamante MA, Agudelo-Suárez AA. An Umbrella Review of the Effectiveness of Temporary Anchorage Devices and the Factors That Contribute to Their Success or Failure. J Evid Based Dent Pract 2020; 20:101402. [PMID: 32473811 DOI: 10.1016/j.jebdp.2020.101402] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/16/2019] [Accepted: 11/13/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES New methodological approaches, such as the umbrella review, constitute an important pathway for synthesizing the scientific evidence provided from studies with a high level of evidence. This study aims to summarize the results on the effectiveness of temporary anchorage devices (TADs) and the factors that contribute to their success or failure during orthodontic treatment in patients of different age groups and to identify the gaps in knowledge based on analysis of the scientific literature. METHODS An umbrella review of systematic reviews and meta-analyses was performed. A quality evaluation and a descriptive analysis of the included studies were conducted. The study protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018094463). RESULTS Seventeen systematic reviews and meta-analyses were considered (10 descriptive and 7 with meta-analysis; 12 of high quality and 5 of moderate quality). Variability was observed in the type of intervention and the type of system (TADs). Most of the studies reported high success rates (≥90%), and just one systematic review indicated a low rate of success (≤56%) for the mini-screws. All the studies discussed several factors related to the success of the TADs. These factors were classified as device-related factors, patient-related factors, procedure-related factors, and orthodontic treatment-related factors. Conceptual and methodological gaps were observed when considering the data analysis, the terminology used, and the orthodontic protocols. CONCLUSIONS The results should be analysed cautiously because of several research gaps related to the methodological quality and the high heterogeneity of the original studies and because of the necessity to add several clinical and sociodemographic variables to enrich the data analysis.
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Degradation and Biocompatibility of AZ31 Magnesium Alloy Implants In Vitro and In Vivo: A Micro-Computed Tomography Study in Rats. MATERIALS 2020; 13:ma13020473. [PMID: 31963840 PMCID: PMC7013406 DOI: 10.3390/ma13020473] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 11/22/2022]
Abstract
In current orthodontic practice, miniscrew implants (MSIs) for anchorage and bone fixation plates (BFPs) for surgical orthodontic treatment are commonly used. MSIs and BFPs that are made of bioabsorbable material would avoid the need for removal surgery. We investigated the mechanical, degradation and osseointegration properties and the bone-implant interface strength of the AZ31 bioabsorbable magnesium alloy to assess its suitability for MSIs and BFPs. The mechanical properties of a Ti alloy (TiA), AZ31 Mg alloy (MgA), pure Mg and poly-L-lactic acid (PLA) were investigated using a nanoindentation test. Also, pH changes in the solution and degradation rates were determined using immersion tests. Three-dimensional, high-resolution, micro-computed tomography (CT) of implants in the rat femur was performed. Biomechanical push-out testing was conducted to calculate the maximum shear strength of the bone-implant interface. Scanning electron microscopy (SEM), histological analysis and an evaluation of systemic inflammation were performed. MgA has mechanical properties similar to those of bone, and is suitable for implants. The degradation rate of MgA was significantly lower than that of Mg. MgA achieved a significantly higher bone-implant bond strength than TiA. Micro-CT revealed no significant differences in bone density or bone-implant contact between TiA and MgA. In conclusion, the AZ31 Mg alloy is suitable for both MSIs and BFPs.
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Tseng YC, Tsai CC, Cheng JH, Chou ST, Pan CY, Chen PH, Chen CM. Recognizing the peak bone mass (age 30) as a cutoff point to achieve the success of orthodontic implants. Odontology 2019; 108:503-510. [PMID: 31802301 DOI: 10.1007/s10266-019-00476-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
Abstract
The aim of present study was to investigate the critical risk factor (age 30: peak bone mass) to evaluate the success of orthodontic implants. A total of 426 orthodontic implants were placed in 270 patients as orthodontic anchorages. Data were analyzed according to patient's characteristics, location of placement, implant categories, and orthodontic force. The young patients were the age ≤ 30 years and the older patients were the age > 30 years. Statistical analysis was performed and a p value < 0.05 was considered to indicate statistical significance. The Chi-square or Fisher exact test was used depending on sample sizes. The null hypothesis was no statistically significant correlation between age ≤ 30 years and age > 30 years. The overall success rate (with and without predrill) was 89.2%. The success rate of orthodontic implants was significantly larger in younger patients (89.9%) than in older patients (76.1%). Recognizing age-related factor in the success rates, older patient (> 30 years) were significant lower than young patients (≤ 30 years) in the gender (female and male), malocclusion (Class II), facial pattern (ortho and hyperdivergent), location (infrazygomatic crest), jaw (maxilla), side (right), material (titanium and stainless), length (9 mm and 10 mm), diameter (2 mm), load (< 3 weeks), and force (intrusion). Therefore, the null hypothesis was rejected. Age 30 is a cutoff point to achieve the success of orthodontic implants. The success rates of older patients (age > 30 years) were significant lower than young patients (age ≤ 30 years), especially in female.
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Affiliation(s)
- Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Chun Tsai
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jung-Hsuan Cheng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Szu-Ting Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chin-Yun Pan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
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29
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Questionnaire survey on pain and discomfort after insertion of orthodontic buccal miniscrews, palatal miniscrews and, orthodontic miniplates. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.odw.2013.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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30
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Baxter SJ, Sydorak I, Ma PX, Hatch NE. Impact of pharmacologic inhibition of tooth movement on periodontal and tooth root tissues during orthodontic force application. Orthod Craniofac Res 2019; 23:35-43. [PMID: 31593373 DOI: 10.1111/ocr.12350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/17/2019] [Accepted: 10/03/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The goal of this study was to investigate potential negative sequelae of orthodontic force application ±delivery of an osteoclast inhibitor, recombinant osteoprotegerin protein (OPG-Fc), on periodontal tissues. SETTING AND SAMPLE POPULATION Sprague Dawley rats from a commercial supplier were investigated in a laboratory setting. MATERIALS AND METHODS Rats were randomly divided into four groups (n = 7 each): one group with no orthodontic appliances and injected once prior to the experimental period with empty polymer microspheres, one group with orthodontic appliances and injected once with empty microspheres, one group with orthodontic appliances and injected once with polymer microspheres containing 1 mg/kg of OPG-Fc, and one group with orthodontic appliances and injected with non-encapsulated 5 mg/kg of OPG-Fc every 3 days during the experimental period. The animals were euthanized after 28 days of tooth movement for histomorphometric analyses. RESULTS Root resorption, PDL area and widths were similar in animals without appliances and animals with appliances plus high-dose OPG-Fc. PDL blood vessels were compressed and decreased in number in all animals that received orthodontic appliances, regardless of OPG-Fc. Hyalinization was significantly increased only in animals with orthodontic appliances plus multiple injections of 5 mg/kg non-encapsulated OPG-Fc when compared to animals without appliances. CONCLUSIONS Results of this study indicate that while pharmacological modulation of tooth movement through osteoclast inhibition is feasible when delivered in a locally controlled low-dose manner, high-dose levels that completely prevent tooth movement through bone may decrease local blood flow and increase the incidence of hyalinization.
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Affiliation(s)
- Sarah J Baxter
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Inna Sydorak
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Peter X Ma
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nan E Hatch
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Sadr Haghighi AH, Pouyafar V, Navid A, Eskandarinezhad M, Abdollahzadeh Baghaei T. Investigation of the optimal design of orthodontic mini-implants based on the primary stability: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2019; 13:85-89. [PMID: 31592304 PMCID: PMC6773917 DOI: 10.15171/joddd.2019.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 07/02/2019] [Indexed: 12/01/2022] Open
Abstract
Background. The design of an orthodontic mini-implant is a significant factor in determining its primary stability and its clinical success. The aim of this study was to measure the relative effect of mini-implant design factors on primary stability of orthodontic mini-implants.
Methods. Thirty-two 3-dimensional assemblies of mini-implant models with their surrounding bone were generated using finite element analysis software. The maximum displacement of each mini-implant model was measured as they were loaded with a 2-N horizontal force. Employing Taguchi’s design of experiments as a statistical method, the contribution of each design factor to primary stability was calculated. As a result of the great effect of the upper diameter and length, to better detect the impact of the remaining design factors, another set of 25 models with a fixed amount of length and diameter was generated and evaluated.
Results. The diameter and length showed a great impact on the primary stability in the first set of experiments (P<0.05). According to the second set of experiments, increased taper angle in the threaded and non-threaded area decreased the primary stability. There was also an optimum amount of 2.5 mm for threaded taper length beyond which the primary stability decreased.
Conclusion. It is advisable to increase the diameter and length if primary stability is at risk. In the second place, a minimum amount of taper angle, both in the threaded and non-threaded area with an approximate proportion of 20% of threaded taper length to MI length, would be desirable for MIs with a moderate size.
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Affiliation(s)
- Amir Hooman Sadr Haghighi
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Pouyafar
- Department of Mechanical Engineering, Tabriz University, Tabriz, Iran
| | - Ali Navid
- Department of Mechanical Engineering, Tabriz University, Tabriz, Iran
| | - Mahsa Eskandarinezhad
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Bindayel NA, Alwadei A, Almosa N, Aasser W, Qazali A, Samran A, Alqerban A. Evaluation of bracket failure in relation to different factors in patients experiencing comprehensive orthodontic treatment: A Retrospective Cohort Study. JOURNAL OF ORAL RESEARCH 2019. [DOI: 10.17126/joralres.2019.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The aim of this study was to investigate loose brackets in relation to various related factors in orthodontic patients who had completed orthodontic treatment. Material and Methods: In this retrospective study, 738 medical records of patients who had undergone comprehensive orthodontic treatment and matched specific inclusion criteria were selected. Paired t-tests and ANOVA, along with the Mann-Whitney test and Kruskal–Wallis analyses were performed to compare the means of variables between selected subgroups. Results: Loose brackets were found most frequently on premolars, followed by incisors and then canines (p<0.01). Male and young patients were found to have a higher incidence of loose brackets compared to female and adult patients (p=0.044 and p<0.01, respectively). The highest correlation coefficient value was found between treatment duration and total number of loose brackets (0.393), which was statistically significant. Conclusions: The frequency of total number of loose brackets increased with younger age group. Premolar teeth were found to be the most commonly affected teeth, followed by incisors and canines. Mandibular teeth presented more loose brackets than maxillary.
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Sydorak I, Dang M, Baxter SJ, Halcomb M, Ma P, Kapila S, Hatch N. Microsphere controlled drug delivery for local control of tooth movement. Eur J Orthod 2019; 41:1-8. [PMID: 29608684 PMCID: PMC6343727 DOI: 10.1093/ejo/cjy017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Because orthodontic tooth movement is dependent upon osteoclast-mediated resorption of alveolar bone adjacent to the pressure side of tooth roots, biologic mediators that regulate osteoclasts can be utilized to control tooth movement. Objectives To develop a novel method to locally enhance orthodontic anchorage. Methods We encapsulated osteoprotegerin (OPG) in polymer microspheres and tested the effectiveness of microsphere encapsulated versus non-encapsulated OPG for enhancing orthodontic anchorage in a rodent model of tooth movement. A single injection of 1 mg/kg non-encapsulated or microsphere encapsulated OPG was delivered into the palatal mucosa mesial to the first maxillary molar 1 day prior to tooth movement. A positive control group received injections of 5 mg/kg non-encapsulated OPG every 3 days during tooth movement. After 28 days of tooth movement, hemi-maxillae and femurs were dissected. Molar mesial and incisor distal tooth movement was measured using stone casts that were scanned and magnified. Local alveolar, distant femur bone, and tooth root volumes were analyzed by micro computed tomography. Serum OPG levels were measured by ELISA. Osteoclast numbers were quantified by histomorphometry. Results The single injection of microsphere encapsulated OPG significantly enhanced orthodontic anchorage, while the single injection of non-encapsulated OPG did not. Injection of encapsulated OPG inhibited molar mesial movement but did not inhibit incisor tooth movement, and did not alter alveolar or femur bone volume fraction, density, or mineral content. Multiple injections of 5 mg/kg non-encapsulated OPG enhanced orthodontic anchorage, but also inhibited incisor retraction and altered alveolar and femur bone quality parameters. Increased OPG levels were found only in animals receiving multiple injections of non-encapsulated 5 mg/kg OPG. Osteoclast numbers were higher upon tooth movement in animals that did not receive OPG. Osteoclast numbers in OPG injected animals were variable within groups. Conclusions Microsphere encapsulation of OPG allows for controlled drug release, and enhances site-specific orthodontic anchorage without systemic side effects. With additional refinements, this drug delivery system could be applicable to a broad array of potential biologic orthodontic therapeutics.
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Affiliation(s)
- Inna Sydorak
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, USA
| | - Ming Dang
- Macromolecular Science and Engineering Center, University of Michigan, Ann Arbor, USA.,Department of Biologic and Materials Sciences, University of Michigan, Ann Arbor, USA
| | - Sarah J Baxter
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, USA
| | - Michael Halcomb
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, USA
| | - Peter Ma
- Macromolecular Science and Engineering Center, University of Michigan, Ann Arbor, USA.,Department of Biologic and Materials Sciences, University of Michigan, Ann Arbor, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, USA.,Department of Materials Science and Engineering, University of Michigan, Ann Arbor, USA
| | - Sunil Kapila
- Division of Orthodontics, University of California San Francisco, USA
| | - Nan Hatch
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, USA
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Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J Orthod 2019; 40:519-530. [PMID: 29315365 DOI: 10.1093/ejo/cjx093] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Miniscrews in orthodontics have been mainly used for anchorage without patient compliance in orthodontic treatment. The literature has reported changing failure rates. Objective The aim of this review was to provide a precise estimation of miniscrew failure rate and the possible risk factors of the mechanically-retained miniscrews. Search method Electronic search in database was undertaken up to July 2017 through the Cochrane Database of Systematic Reviews, MEDLINE, Scopus, and Ovid. Additional searching for on-going and unpublished data, hand search of relevant journals and grey lietraure were also undertaken, authors were contacted, and reference lists screened. Eligibility criteria Randomised controlled trials (RCTs) and prospective cohort studies (PCSs), published in English were obtained, which reported the failure rate of miniscrews, as orthodontic anchorage, with less than 2 mm diameter. Data collection and analysis Blind and induplicate study selection, data extraction, and risk of bias assessment were undertaken in this research. Failure rates and relevant risk factors of miniscrews with the corresponding 95 per cent confidence intervals (CIs) were calculated by using the random-effects model. The heterogeneity across the studies was assessed using the I2 and Chi2 test. The risk of bias was assessed using Cochrane risk of bias and Newcastle-Ottawa Scale. Subgroup and sensitivity analyses were performed in order to test the robustness of the results in meta-analysis. Results The 16 RCTs and 30 PCSs were included in this research. Five studies were not included in the meta-analysis due to a lack of the statistical information needed to compute the effect sizes. About 3250 miniscrews from 41 studies were pooled in a random-effect model. The overall failure rate of miniscrews was 13.5 per cent (95% CI 11.5-15.9). Subgroup analysis showed that miniscrews 'diameter, length and design, patient age, and jaw of insertion had minimal effect on rate of miniscrews failure while the type of the gingivae and smoking had statistically significant effect. Conclusion Miniscrews have an acceptably low failure rate. The findings should be interpreted with caution due to high-level of heterogeneity and unbalanced groups in the included studies. High quality randomized clinical trial with large sample sizes are required to support the findings of this review.
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Affiliation(s)
- Fahad Alharbi
- Department of Orthodontics, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Mohammed Almuzian
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - David Bearn
- Department of Orthodontics, University of Dundee, Scotland, UK
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Park HJ, Choi SH, Choi YJ, Park YB, Kim KM, Yu HS. A prospective, split-mouth, clinical study of orthodontic titanium miniscrews with machined and acid-etched surfaces. Angle Orthod 2018; 89:411-417. [PMID: 30516419 DOI: 10.2319/031618-211.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine whether the success rate and primary stability of surface-treated miniscrews differ from those of nontreated miniscrews. MATERIALS AND METHODS Patients who required one or more miniscrews for the same reason in each quadrant were recruited into a single-blinded, split-mouth, randomized, controlled trial with a 1:1 allocation ratio. Self-drilling miniscrews with two surface types were used: those with no surface treatment, and those with an acid-etched surface treatment. The cumulative success rate and primary stability of each type of miniscrew were examined, and factors potentially affecting the success and failure of miniscrews were investigated. RESULTS Forty patients were included in the study, with a total of 98 orthodontic miniscrews. The overall success rate was 88.8%, and the respective success rates for acid-etched and machined surface miniscrews were 91.8% and 85.7%. The respective mean insertion torques were 13.62 ± 5.95 N·cm and 13.38 ± 4 N·cm, and periotest values measured immediately after insertion were -0.50 ± 2.77 for acid-etched miniscrews and -0.28 ± 3.36 for machined surface miniscrews. There was no significant difference in the mean insertion torques and periotest values according to surface treatment and jaw. CONCLUSIONS Neither the success rate nor the primary stability of acid-etched surface miniscrews and machined surface miniscrews differed significantly. There is a high possibility that miniscrews will fall out in patients who have an open bite or those who require total distalization.
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Retrospective comparison of the number of screws used for fixation of skeletal anchorage plates in orthodontics, and their failure rates. Br J Oral Maxillofac Surg 2018; 56:941-945. [PMID: 30415962 DOI: 10.1016/j.bjoms.2018.10.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 10/22/2018] [Indexed: 11/20/2022]
Abstract
The aim of this study was to compare the failure rate of fixation of skeletal orthodontic anchorage plates (SAP) with two screws with that of three screws, and to find out if there is a relation between the number of screws used to fix the plates and the failure rate. We reviewed clinical records of 65 patients from five hospitals with 176 SAP, and took into account other factors that may have affected the failure. The overall failure rate was 15/176 (8.5%), and for with two-screw fixation it was 9/86 compared with 6/90 for those with three-screw fixation. Age, sex, and coexisting medical conditions did not affect the failure rate. There was a higher failure rate for those placed in the mandible (11/105) than for those placed in the maxilla (4/71). SAP provide a stable source of skeletal anchorage for orthodontic treatment. Our results show that those fixed with two screws may be marginally more likely to fail than those fixed with three, but further studies are needed to investigate the association between failure and the number of screws used.
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Santos AR, Castellucci M, Crusoé-Rebello IM, Sobral MC. Assessing bone thickness in the infrazygomatic crest area aiming the orthodontic miniplates positioning: a tomographic study. Dental Press J Orthod 2018; 22:70-76. [PMID: 28902252 PMCID: PMC5573013 DOI: 10.1590/2177-6709.22.4.070-076.oar] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 03/31/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction: Due to the increasing use of miniplates for anchorage purposes in orthodontics, it is very important to know more about infrazigomatic crest anatomy (thickness), in adult patients. Objectives: Evaluate the infrazygomatic crest region thickness, in adult (male and female) patients. Methods: Cone-beam computerized tomography (CBCT) images from 40 patients were used to assess cross-sectional measurements of the infrazygomatic crest region. Measurement 1 considered thickness 2 mm above the distobuccal root of the permanent maxillary first molar, while measurement 2 was taken 2 mm above the first measurement. Results: The mean thickness of the infrazygomatic crest in males was 3.55 mm for measurement 1 and 2.84 mm for measurement 2, while in females these were 2.37 mm and 2.24 mm, respectively. Conclusion: The authors concluded that the overall mean thickness of the infrazygomatic crest was 2.49 mm with respect to measurement 1, and 2.29 mm for measurement 2, with no statistically significant differences between gender.
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Affiliation(s)
- Aline Rode Santos
- Universidade Federal da Bahia, Departamento de Ortodontia (Salvador/BA, Brasil)
| | - Marcelo Castellucci
- Universidade Federal da Bahia, Departamento de Ortodontia (Salvador/BA, Brasil)
| | | | - Márcio Costa Sobral
- Universidade Federal da Bahia, Departamento de Ortodontia (Salvador/BA, Brasil)
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Aly SA, Alyan D, Fayed MS, Alhammadi MS, Mostafa YA. Success rates and factors associated with failure of temporary anchorage devices: A prospective clinical trial. ACTA ACUST UNITED AC 2018; 9:e12331. [PMID: 29512336 DOI: 10.1111/jicd.12331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/19/2018] [Indexed: 01/23/2023]
Abstract
AIM The objective of the present study was to investigate success rates and associated factors affecting temporary anchorage device (TAD) failure in different biomechanical applications. METHODS A total of 180 TADs were used as a part of 82 patients' treatment plan (24 males and 58 females); their mean age was 21.41 years. Three types of TADs were used: 50 (3M ESPE, Neuss, Germany), 56 (Bone screw; Jeil Medical, Seoul, Korea), and 74 (Morelli, Sorocaba, Brazil). Eight maxillary and four mandibular sites were selected for insertion. Three different lengths (6, 8, and 10 mm) and three different diameters (1.5, 1.6, and 1.8 mm) were used. The force levels were set at 50, 100, 150, 200, and 250 g. Patient-, implant-, and operator-dependent factors were evaluated throughout the 266 days of function. Qualitative variables were described by proportions and percentages and analyzed using χ2 test. RESULTS The overall success rate was 82.2%. The higher age group showed a significantly higher success rate. Oral hygiene showed a statistically-significant (P ˂ .05) difference between both success and failure groups. All other patient-related factors showed no significant differences. Regarding force levels used, the highest success rate was in 250 g and the lowest was in 100 g. There were no significant differences between both groups regarding other implant- and operator-related factors. CONCLUSIONS Temporary anchorage devices have a good success rate and are beneficial to be integrated in orthodontic treatment planning. Patient age, oral hygiene, and force level are the most significant factors affecting TAD success.
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Affiliation(s)
- Shehab A Aly
- Faculty of Dentistry, Future University, Cairo, Egypt
| | - Doha Alyan
- Faculty of Dentistry, Future University, Cairo, Egypt
| | - Mona S Fayed
- Department of Orthodontics and Dentofacial Orthopedics, Cairo University, Cairo, Egypt
| | - Maged S Alhammadi
- Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Yehya A Mostafa
- Department of Orthodontics and Dentofacial Orthopedics, Cairo University, Cairo, Egypt
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Faber J, Morum T, Jamilian A, Eslami S, Leal S. Infection predictive factors with orthodontic anchorage miniplates. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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How do geometry-related parameters influence the clinical performance of orthodontic mini-implants? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46:1539-1551. [DOI: 10.1016/j.ijom.2017.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/14/2017] [Indexed: 01/27/2023]
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Tsai CC, Chang HP, Pan CY, Chou ST, Tseng YC. A prospective study of factors associated with orthodontic mini-implant survival. J Oral Sci 2017; 58:515-521. [PMID: 28025435 DOI: 10.2334/josnusd.16-0145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The orthodontic mini-implant (MI) is a widely used anchorage device in orthodontic treatment. This prospective study analyzed MI survival and factors associated with MI survival in 139 patients (114 females and 25 males; average age, 25.7 years; age range, 12-56 years) who had received orthodontic treatment with MIs. Survival analysis and Kaplan-Meier curves were used to identify clinical variables associated with MI survival. For the 254 MIs investigated, the overall success rate was 85.8%, and the 1-year cumulative survival rate was 81.6%. MI survival was significantly associated with patient age and MI size. Notably, MI survival was significantly longer in patients aged 20-30 years than in older patients. The Cox proportional-hazards model revealed a 5% increase in failure risk for every 1-year increase in age among participants older than 30 years. Additionally, MI failure risk was inversely associated with MI length. MIs are generally reliable anchorage devices for orthodontic treatment but should be used with caution in older patients, due to the higher rate of failure in that population. Another important factor in MI survival is implant size. Future studies should attempt to clarify associations between MI survival and clinical variables.(J Oral Sci 58, 515-521, 2016).
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Maya RR, Pinzan-Vercelino CRM, Gurgel JDA. Effect of vertical placement angle on the insertion torque of mini-implants in human alveolar bone. Dental Press J Orthod 2017; 21:47-52. [PMID: 27901228 PMCID: PMC5125170 DOI: 10.1590/2177-6709.21.5.047-052.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/20/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of the present ex-vivo study was to evaluate the effect of the vertical placement angle of mini-implants on primary stability by analyzing maximum insertion torque (MIT). Methods: Mini-implants were placed in 30 human cadavers, inserted at either a 90° or 60° angle to the buccal surface of the maxillary first molar. Out of 60 self-drilling mini-implants used, half were of the cylindrical type and half were of the conical type. Primary stability was assessed by means of measuring the MIT. Data were subjected to analysis of variance (ANOVA) and Newman-Keuls tests. A significance level of 5% was adopted. Results: The MIT was higher for both mini-implant types when they were placed at a 90° angle (17.27 and 14.40 Ncm) compared with those placed at a 60° angle (14.13 and 11.40 Ncm). Conclusions: MIT values were differed according to the vertical mini-implant placement angle in the maxillary posterior area. Regardless of the type of mini-implant used, placement at a 90° angle resulted in a higher MIT.
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Affiliation(s)
- Rafael Ribeiro Maya
- MSc in Orthodontics, Universidade Ceuma (UNICEUMA), São Luís, Maranhão, Brazil
| | | | - Julio de Araujo Gurgel
- Professor, Universidade Ceuma (UNICEUMA), Masters Program in Dentistry, São Luis, Maranhão, Brazil
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Cottrell DA, Farrell B, Ferrer-Nuin L, Ratner S. Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2017; 75:e94-e125. [DOI: 10.1016/j.joms.2017.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Hourfar J, Bister D, Kanavakis G, Lisson JA, Ludwig B. Influence of interradicular and palatal placement of orthodontic mini-implants on the success (survival) rate. Head Face Med 2017; 13:14. [PMID: 28615027 PMCID: PMC5471718 DOI: 10.1186/s13005-017-0147-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 05/29/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The purpose of this retrospective cohort study was to investigate the success rates of orthodontic mini-implants (OMIs) placed in different insertion sites and to analyse patient and site- related factors that influence mini-implant survival. METHODS Three hundred eighty-seven OMIs were inserted in 239 patients for orthodontic anchorage and were loaded with a force greater than 2 N. Two different insertion sites were compared: 1. buccal inter-radicular and 2. palatal, at the level of the third palatal ruga. Survival was analysed for location and select patient parameters (age, gender and oral hygiene). The level of statistical significance was set at p < 0.05. RESULTS The overall success rate was 89.1%. There were statistically significant differences between insertion sites; success rate was 98.4% for OMIs placed in the anterior palate and 71% for OMIs inserted buccal between roots (p < 0.001). CONCLUSIONS Success rate of OMIs was primarily affected by the insertion site. The anterior palate was a more successful location compared to buccal alveolar bone.
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, Saarland University, Homburg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust and King's College Dental Institute, London, UK
| | - Georgios Kanavakis
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston, USA
| | | | - Björn Ludwig
- Department of Orthodontics, Saarland University, Homburg, Germany. .,Private Practice, Am Bahnhof 54, 56841, Traben-Trarbach, Germany.
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Tunçer Nİ, Arman-Özçırpıcı A, Oduncuoğlu BF, Göçmen JS, Kantarcı A. Efficiency of piezosurgery technique in miniscrew supported en-masse retraction: a single-centre, randomized controlled trial. Eur J Orthod 2017; 39:586-594. [DOI: 10.1093/ejo/cjx015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Kook YA, Park JH, Bayome M, Kim S, Han E, Kim CH. Distalization of the mandibular dentition with a ramal plate for skeletal Class III malocclusion correction. Am J Orthod Dentofacial Orthop 2017; 150:364-77. [PMID: 27476370 DOI: 10.1016/j.ajodo.2016.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 03/01/2016] [Accepted: 03/01/2016] [Indexed: 11/25/2022]
Abstract
The retromolar fossa is an anatomically suitable skeletal anchorage site. The aim of this report was to introduce a novel appliance for the correction of skeletal Class III malocclusions with mandibular dentition distalization. The placement site and the procedure of the ramal plate are described. The resulting force vectors are parallel to the functional occlusal plane leading to efficient molar distalization. This approach is demonstrated with 2 adult patients who refused a surgical treatment option. This ramal plate may be indicated for total arch distalization for nonextraction and nonsurgical cases.
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Affiliation(s)
- Yoon-Ah Kook
- Professor, Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
| | - Jae Hyun Park
- Professor and chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz; adjunct professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Mohamed Bayome
- Research assistant professor, College of Medicine, Catholic University of Korea, Seoul, Korea; visiting professor, Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Sungkon Kim
- Resident, Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
| | - Eugene Han
- Resident, Department of Orthodontics, University of Southern California, Los Angeles, Calif
| | - Chang Hyen Kim
- Associate professor, Department of Oral and Maxillofacial Surgery, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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de Lima E, Brum F, Mezomo M, Pasquali CE, Farret M. Orthodontic treatment of Class III malocclusion with lower extraction and anchorage with mini implants: Case report. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chillès D, Chillès JG, Riemenschneider-Chillès S, Doustkam AA. [Embedded micro-screws, the universal bone anchorage]. Orthod Fr 2016; 87:443-455. [PMID: 27938656 DOI: 10.1051/orthodfr/2016039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION This article revises how embedded micro-screws are used for orthodontic anchorage and points out advantages. MATERIALS AND METHODS The use of surgical screws, their placement and connections are described in detail. The clinical methodology is explained step by step with illustrations and clinical cases. RESULTS Using micro-screw has no doubt many advantages, at the material, anatomic, surgical and mechanical level, as well as the comfort and reliability it provides. It represents a real universal bone anchorage.
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Torque ratio as a predictable factor on primary stability of orthodontic miniscrew implants. IMPLANT DENT 2016; 23:576-81. [PMID: 25192157 DOI: 10.1097/id.0000000000000138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the torque ratio (TR) as a predictable factor on primary stability of orthodontic miniscrews. DESIGN Fifty-eight orthodontic patients (17 men, 41 women; mean age, 21.9 years) with a total of 112 titanium miniscrews of 3 different diameters were subjected. Maximum insertion torque (MIT) and maximum removal torque (MRT) were measured by a digital torque checker at the screw placement. Four weeks after the placement, the stable screw was recorded as a success. Multiple logistic regression analysis was performed to estimate the influence of each clinical variable on success. RESULTS Success rates were 82.1% to 89.5%, and there were no significant differences in the 3 types of miniscrews. MIT and MRT showed a positive correlation but did not affect the success rates of miniscrews directly. On the contrary, TR was significantly higher in the success group than in the failure group. In multiple regression analysis, age, TR, and screw proximity had a significant influence on the miniscrew success. CONCLUSIONS TR might be related with the miniscrew success rates, and it can be used as a predictable factor on primary stability of orthodontic miniscrew implants. Miniscrew implants should be replaced if MRT is significantly lower than MIT at placement surgery.
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