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Chawshli OF, Hasan HS, Yalda FA, Al-Talabani SZ. The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail. Orthod Craniofac Res 2024; 27:118-125. [PMID: 37496467 DOI: 10.1111/ocr.12700] [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: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND OBJECTIVES The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. MATERIALS AND METHODS Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. RESULTS The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. CONCLUSION This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.
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Affiliation(s)
- Omar Fawzi Chawshli
- The Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Hasan Sabah Hasan
- Orthodontic Department, Azadi Dental Center, General Directorate of Hawler, Ministry of Health, Erbil, Iraq
- Orthodontic Department, Privet Specialized Dental Clinic, Erbil, Iraq
| | - Fedil Andraws Yalda
- The Department of Oral Diagnosis, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Shaho Z Al-Talabani
- P.O.P Department, College of Dentistry, Hawler Medical University, Erbil, Iraq
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Jahanbin A, Eslami N, Salari Sedigh H, Ghazi N, Hosseini Zarch SH, Hoseinzadeh M, Moayedi S. The impact of immediate versus delayed mini-screw placement on alveolar bone preservation and bone density following tooth extraction: evidence from a canine model. BMC Oral Health 2023; 23:972. [PMID: 38057827 PMCID: PMC10701927 DOI: 10.1186/s12903-023-03703-7] [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: 06/07/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this study was to evaluate the impact of mini-screw placement on the alveolar ridge using a split-mouth design. Twelve beagles underwent bilateral extraction of their lateral teeth. In the immediate group, a mini-screw was unilaterally placed approximately 3-4 mm below the alveolar crest of the extraction site on the experimental side. The delayed group received mini-screws six weeks after tooth extraction. On average, the dogs were sacrificed after 11 weeks, and the maxillary bones were excised and scanned using cone-beam computed tomography (CBCT). Histopathological examinations were conducted to assess inflammation and bone formation scores. The results showed that in the immediate group, bone height was significantly greater on the intervention side compared to the control side (p < 0.05), whereas there was no significant difference in the delayed group. In both groups, there was a significant increase in bone density around the mini-screws compared to the control sides (p < 0.05). Mini-screw insertion led to a significant enhancement of bone growth in both groups (p < 0.05), with no notable differences between the two groups. The mini-screws did not have any impact on bone inflammation or width. Overall, both immediate and delayed mini-screw placement in the extraction socket positively influenced bone dimensions, density, and histological properties. However, immediate insertion was more effective than delayed placement in preserving vertical bone height, despite delayed insertion resulting in higher bone density.
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Affiliation(s)
- Arezoo Jahanbin
- Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Eslami
- Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Salari Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Narges Ghazi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Hossein Hosseini Zarch
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hoseinzadeh
- Dentist, Research Assistant, Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sedigheh Moayedi
- Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Tatas Z, Koutsiouroumpa O, Seehra J, Mavridis D, Pandis N. Do pooled estimates from orthodontic meta-analyses change depending on the meta-analysis approach? A meta-epidemiological study. Eur J Orthod 2023; 45:722-730. [PMID: 37435902 DOI: 10.1093/ejo/cjad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND In meta-analyses involving a few trials, appropriate measures should be employed to assess between-study heterogeneity. When the number of studies is less than five and heterogeneity is evident, the Hartung and Knapp (HK) correction should be used. The aim of this study was to compare the reported estimates of published orthodontic meta-analyses with the pooled effect size estimates and prediction intervals (PI) calculated using eight heterogeneity estimators and corrected using the HK correction. MATERIAL AND METHODS Systematic reviews (SRs) published between 2017 and 2022 in four orthodontic journals and the Cochrane Database of Systematic Reviews with a meta-analysis of at least three studies were sourced. Study characteristics were extracted at the SR and the outcome/meta-analysis levels. All selected meta-analyses were re-analysed by fitting a random-effects model using eight different heterogeneity estimators, both with and without the HK correction. For each meta-analysis, the overall estimate, along with its standard error, the P-value, and the corresponding 95% confidence interval (CI), the between-study variance (tau2), the I2 statistic, and the PI were calculated. RESULTS One-hundred-six SRs were analysed. The most prevalent type of SR was non-Cochrane (95.3%), and the most used meta-analyses synthesis model was the random effect (83.0%). The median number of primary studies was 6 (interquartile range: 5, range: 3-45). The between-study variance was reported in most of the eligible meta-analyses (91.5%), but the type of heterogeneity estimator was reported in only one of them (0.9%). In 5 of 106 meta-analyses (4.7%), the HK correction was applied to adjust the CI of the pooled estimate. The percentage of statistically significant results, which became statistically non-significant, ranged from 16.7% to 25%, depending on the heterogeneity estimator. As the number of studies in a meta-analysis increased, the difference between corrected and uncorrected CIs reduced. Based on the PIs, more than half of the meta-analyses having statistically significant results are likely to change in the future, suggesting the result of the meta-analysis is not conclusive. CONCLUSIONS The statistical significance of pooled estimates from meta-analyses with at least three studies is sensitive to the HK correction, the heterogeneity variance estimator, and PIs. Clinicians should be aware of the clinical implications of not appropriately assessing the effect of the small number of studies and the between-study heterogeneity when interpreting results from meta-analyses.
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Affiliation(s)
- Zacharias Tatas
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland
| | | | - Jadbinder Seehra
- Centre for Craniofacial Development & Regeneration, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Hospital, Guy's and St Thomas NHS Foundation Trust, UK
| | | | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Switzerland
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Ronsivalle V, Venezia P, Bennici O, D'Antò V, Leonardi R, Giudice AL. Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols. BMC Oral Health 2023; 23:494. [PMID: 37460998 DOI: 10.1186/s12903-023-03113-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND This study aimed to assess the accuracy of digital workflow for guided insertion of miniscrews in the anterior palate using restorative implant dentistry software and licensed software for orthodontic applications. METHODS Twenty subjects (8 males, 12 females, mean age = 16.7 ± 2.1 years) were prospectively selected to receive guided insertion of bicortical palatal miniscrews. Virtual planning was performed using restorative implant dentistry software (Blue Sky Plan*, version 4.7) (group 1 = 10 subjects) and licensed orthodontic software (Dolphin Imaging Software, version 11.0) (group 2 = 10 subjects). A specific 3D Imaging technology was applied to permit the registration of the planned and achieved position of the miniscrews based on the superimposition of maxillary models. The angular deviation (accuracy error) between the planned and the achieved positions of the miniscrews were recorded. Independent Student's test was used with statistical significance set at p value < 0.05. RESULTS The mean accuracy error recorded in group 1 was 7.15° ± 1.09 (right side) and 6.19 ± 0.80 (left side) while the mean error in group 2 was 6.74° ± 1.23 (right side) and 5.79 ± 0.95 (left side). No significant differences were recorded between the two groups (p > 0.05); instead, miniscrews placed on the right side were almost one degree higher than the left side (p < 0.05) in both groups. CONCLUSIONS The clinical accuracy error was similar when using generic and licensed orthodontic software for guided systems.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Via Santa Sofia 78, University of Catania, Catania, Italy
| | - Pietro Venezia
- Department of General Surgery and Medical-Surgical Specialties, Via Santa Sofia 78, University of Catania, Catania, Italy
| | - Orazio Bennici
- Department of General Surgery and Medical-Surgical Specialties, Via Santa Sofia 78, University of Catania, Catania, Italy
| | - Vincenzo D'Antò
- Orthodontic Graduate Program, University of Federico II, Naples, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Via Santa Sofia 78, University of Catania, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Via Santa Sofia 78, University of Catania, Catania, Italy.
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Analysis for Predictors of Failure of Orthodontic Mini-implant Using Patient-Specific Finite Element Models. Ann Biomed Eng 2023; 51:594-603. [PMID: 36167866 DOI: 10.1007/s10439-022-03067-z] [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: 04/21/2022] [Accepted: 08/27/2022] [Indexed: 11/01/2022]
Abstract
In this study, we analyzed the clinical factors and mechanical parameters for predicting orthodontic mini-implant (OMI) failure in the mandible, which has different properties from the maxilla. A patient-specific finite element analysis was applied to 32 OMIs (6 failures and 26 successes) implanted between the mandibular second premolars and first molars used for anchorage. The peak stress and strain parameters were calculated for each sample. A logistic regression of the failure (vs. success) of OMIs on the mechanical parameters in the models was conducted. In addition, the influence of clinical factors on the mechanical parameters considered to be related to OMI failure was examined by a regression analysis. The mechanical parameter which best predicts OMI failure in the mandible was found to be a minimum principal strain of between 0.5 to 1.0 mm from the OMI surface (R2 = 0.8033). The results indicate the patient's bone density, distance between the OMIs and adjacent root, and vertical implantation angle of the OMIs are potential clinical predictors of OMI failure in the mandible.
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Inchingolo AM, Malcangi G, Costa S, Fatone MC, Avantario P, Campanelli M, Piras F, Patano A, Ferrara I, Di Pede C, Netti A, de Ruvo E, Palmieri G, Settanni V, Carpentiere V, Tartaglia GM, Bordea IR, Lorusso F, Sauro S, Di Venere D, Inchingolo F, Inchingolo AD, Dipalma G. Tooth Complications after Orthodontic Miniscrews Insertion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1562. [PMID: 36674316 PMCID: PMC9867269 DOI: 10.3390/ijerph20021562] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 05/13/2023]
Abstract
Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords "orthodontic mini-screw" and "dental damage", resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin-pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.
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Affiliation(s)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Stefania Costa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Pasquale Avantario
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, University CEU Cardenal Herrera, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Migliorati M, Drago S, Pozzan L, Contardo L. Does the planned minsicrew position reflect the achieved one? A clinical study on the reliability of guided minsicrew insertion using lateral cephalogram and maxillary stereolithography file for planning. Am J Orthod Dentofacial Orthop 2022; 162:e312-e318. [PMID: 36192323 DOI: 10.1016/j.ajodo.2022.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The anterior area of the palate is widely used as an insertion site for orthodontic miniscrews. These temporary anchorage devices can be placed either directly or using an insertion guide, and various kinds of digital planning and guides are currently available. This study aimed to verify if the guided procedure can guarantee the correct position of the miniscrews on the patient compared with the digital project. METHODS Twenty-five consecutively treated patients were included in the study. Angular and linear displacements of the miniscrews were evaluated among 3 groups: the planned position, the model position, and the achieved position. RESULTS The median achieved angle between 2 digitally planned screws was 6.22° (interquartile range: 4.35°, 9.08°) and the difference between the angles in the planning and the achievement groups was significant (P <0.001). Lateral and vertical differences were also found among the 3 groups. CONCLUSIONS Results show that the examined workflow is clinically efficient. Differences between the digitally planned position of the orthodontic miniscrews, the control position, and the achieved position were detected both for angular and linear measurements but were not clinically significant.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, University of Genova, Genova, Italy.
| | - Sara Drago
- Department of Orthodontics, School of Dentistry, University of Genova, Genova, Italy
| | - Lucia Pozzan
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luca Contardo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Vasil'ev Y, Enina Y, Dydykin S, Aleshkina O, Suetenkov D, Kulikova N, Chemidronov S, Velichko E, Antonov O, Diachkova E, Kolsanov A. X-ray and anatomical features of the lower jaw alveolar cortical layer in children. Ann Anat 2022; 245:152005. [PMID: 36183932 DOI: 10.1016/j.aanat.2022.152005] [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: 04/25/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION the world studies showed the interest in measurement of the buccal or anterior cortical plate thickness. Data indicate a significant superiority of the spongy substance over the compact one in the distal part of the jaw, which makes it possible to think about a higher effectiveness of transcortical injections. The empirical "rule of 10" provides for the choice of a method of anesthesia in children for primary teeth but demonstrates difficulties with high-quality anesthesia accompanied for permanent teeth. Therefore, the importance of clinical examination and anatomical investigation of the jaw cortical plate in children for competent planning of transcortical interventions has been determined. AIM To study the features of the clinical and X-ray anatomy of the cortical layer in distal alveolar part of the mandible in children. MATERIAL AND METHODS The assessment of the X-ray anatomical characteristics of the mandible was carried out according to 150 anonymized cone-beam computed tomograms of patients aged 6-12 years, performed for the treatment of major diseases. Qualitative assessment and examination of the cortical plate of the distal alveolar part of the mandible were carried out on the skeletonized certified preparations of aged 6-12 in the amount of 50. RESULTS The age characteristics of the cortical plate in the area of the chewing group of teeth in the mandible were determined according to macro anatomical studies, which confirms with the X-ray results. Therefore, the obtained images serve as actual confirmation of X-ray studies, which are ranked by age. The thickness of the cortical plate in the second primary molar of the mandible in subgroups 6, 7 and 8 years has a proportional increase from the cervical region to the apical projection. The average thickness of the cortical plate is 1.57mm at 6 years, 1.52mm at 7 years, 1.6mm at 8 years and 1.84 at 9 years. The cortical plate thickness in the first primary molar of the mandible in subgroups 6 and 7 years has a proportional decrease from the cervical region to the apical projection as well as an inverse proportion to age. The average thickness of the cortical plate is 1.33mm. In the first molar of the mandible at the age limit of 6-12 years the attention is drawn to the linear increase in tissue volume from the cervical region to the apical projection up to 8 years. At 6-8 years the average thickness of the cortical plate in this age group is 1.74±0.2mm, at 9 years - 2.03mm, at 10 - average value in the cervical region it is 1.53 ± 0.23mm, in the root middle it is 2.19± 0.13mm and in the apical projection it is 1.98± 0.16mm, at 11 - 2.22mm and at 12 - 2.35mm. For the second primary molar the average thickness of the buccal cortical plate of the second primary molar is 1.4mm in cervical part, 1.68mm in the root middle and 1.81mm in the apical projection. Finally, thickness of the buccal cortical plate in the cervical region of the first permanent molar is 2mm in groups. CONCLUSION The study makes it possible to determinate with noninvasive way the age limit for the least pronounced zone of the buccal cortical plate.
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Affiliation(s)
| | | | | | - Olga Aleshkina
- Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Dmitriy Suetenkov
- Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
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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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Revisiting the Complications of Orthodontic Miniscrew. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8720412. [PMID: 35958810 PMCID: PMC9359838 DOI: 10.1155/2022/8720412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Miniscrew has been used widely as an effective orthodontic anchorage with reliable stationary quality, ease of insertion and removal techniques, immediate or early loading, flexibility in site insertion, less trauma, minimal patient cooperation, and lower price. Nonetheless, it is not free of complications, and they could impact not only the miniscrew success rate but also patients’ oral health. In this article, literature was searched and reviewed electronically as well as manually to evaluate the complications of orthodontic miniscrew. The selected articles are analyzed and subcategorized into complications during and after insertion, under loading, and during and after removal along with treatment if needed according to the time. In addition, the noteworthy associated factors such as the insertion and removal procedures, characteristics of both regional and local anatomic structures, and features of the miniscrew itself that play a significant role in the performance of miniscrews are also discussed based on literature evidence. Clinicians should notice these complications and their related factors to make a proper treatment plan with better outcomes.
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Quantitative Assessment of Posterior Maxillary Arch for Orthodontic Miniscrew Insertion Using Cone Beam Computed Tomography: A Cross-Sectional Analysis. Int J Dent 2022; 2022:8257256. [PMID: 35662891 PMCID: PMC9162861 DOI: 10.1155/2022/8257256] [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: 02/11/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Methods and Materials Cone beam computed tomography records of 35 patients (70 quadrants) from maxilla were evaluated. The images were analyzed using the NNT viewer software (version 23). The measurements were made on axial sections at 2, 4, 6, and 8 mm from CEJ. The optimal sites were defined in terms of mesiodistal palatal or buccal interradicular distance, alveolar cortical bone thickness, and palatal or buccal safe depth of the bone for miniscrew insertion. Descriptive statistics, paired t-test, and repeated measure ANOVA were used to analyze the data. Results The mean buccal interradicular distance was the lowest between first and second molar (2.44 mm) and the highest between first and second premolar (3.28 mm). The mean palatal interradicular distance was the lowest between first and second premolar (3.64 mm) and the highest between second premolar and first molar (5.30 mm). The mean buccal safe depth was the lowest between canine and first premolar (1.96 mm) and the highest between first and second molar (2.61 mm). The mean palatal safe depth was the lowest between second premolar and first molar (3.35 mm) and the highest between first and second molar (3.56 mm). The thinnest and thickest buccal cortical thicknesses were detected on canine and first molar (1.04 mm) and on the second premolar and second molar (1.56 mm). Conclusion The quantity and quality of the maxillary alveolar process is an important factor to decide where to insert the orthodontic miniscrews, necessitating careful preoperative evaluation.
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Abstract
The objective of this study was to evaluate the effect of bone–miniscrew contact percentage (BMC%) and bone quality and quantity on orthodontic miniscrew stability and the maximum insertion torque value (ITV). Orthodontic miniscrews of five different dimensions and several bovine iliac bone specimens were used in the evaluation. Miniscrews of each dimension group were inserted into 20 positions in bovine iliac bone specimens. The experiment was divided into three parts: (1) Bone quality and quantity were evaluated using cone-beam computed tomography (CBCT) and microcomputed tomography. (2) The 3D BMC% was calculated. (3) The ITVs during miniscrew insertion were recorded to evaluate the stability of the orthodontic miniscrews. The results indicated that longer and thicker miniscrews enabled higher ITVs. CBCT was used to accurately measure cortical bone thickness (r = 0.939, P < 0.05) and to predict the bone volume fraction of cancellous bone (r = 0.752, P < 0.05). BMC% was significantly influenced by miniscrew length. The contribution of cortical bone thickness to the ITV is greater than that of cancellous bone structure, and the contribution of cortical bone thickness to BMC% is greater than that of cancellous bone structure. Finally, the higher is BMC%, the greater is the ITV. This study concludes that use of CBCT may predict the mechanical stability of orthodontic miniscrews.
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Zhang S, Choi Y, Li W, Shi D, Tang P, Yang L, Wang Y, Yang X, Wu J. The effects of cortical bone thickness and miniscrew implant root proximity on the success rate of miniscrew implant: A retrospective study. Orthod Craniofac Res 2021; 25:342-350. [PMID: 34582625 DOI: 10.1111/ocr.12538] [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: 07/16/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effects of cortical bone thickness (CBT), miniscrew implant root proximity (MRP) and other related factors on the success rate of miniscrew implant (MSI). MATERIALS AND METHODS Four hundred and five MSIs placed in 171 patients were analysed in this retrospective study. The primary predictor variables were CBT and MRP at MSI insertion sites. The predictor variables also included patient, location, MSI design and procedure related factors. The outcome variable was the survival of MSI. The differences in measurement data between success group and failed group were evaluated by the analysis of variance and independent samples t tests. Patient, location, MSI design and procedure related factors associated with the MSI prognosis were analysed by survival analysis with Cox proportional hazard regression model. The P value was set at .05. And the survival curves of independent factors were plotted. RESULTS The overall success rate of MSI was 82.7%. The age of MSI host, CBT, interdental root distance (IRD) and MRP at MSI sites showed no significant differences between failed group and success group. CBT and insertion jaws were independent prognosis factors screened out by Cox proportional hazard regression model. Failure risk (hazard ratio) of MSI with CBT <1 mm was 4.72. The failure risk in the mandible was 3.80 times as high as that in the maxilla. CONCLUSION Inadequate CBT (<1 mm) contributed to the failure of MSI. MSI placed in the maxilla showed better prognosis compared to the mandible. MRP had no significant effect on the prognosis.
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Affiliation(s)
- Shuting Zhang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhsin Choi
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wa Li
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Shi
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Tang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li'an Yang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Wang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Yang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyong Wu
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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14
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Iodice G, Nanda R, Drago S, Repetto L, Tonoli G, Silvestrini-Biavati A, Migliorati M. Accuracy of direct insertion of TADs in the anterior palate with respect to a 3D-assisted digital insertion virtual planning. Orthod Craniofac Res 2021; 25:192-198. [PMID: 34344059 DOI: 10.1111/ocr.12525] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Direct and 3D-assisted methods are an available alternative when inserting temporary anchorage devices (TADs) in the anterior palate for orthodontic anchorage. This study aimed to evaluate the differences between a planned insertion versus a direct method on digital models. SETTINGS AND SAMPLE POPULATION Seventy TADs were inserted by the direct insertion method in 35 patients who needed palatal TADs for orthodontic anchorage. For each patient, placement was independently planned by the superimposition of lateral cephalograms and corresponding plaster models. After mini-implant placement, impressions were taken with scanbodies. For the measurement of both linear and angle deviations, virtual planning models and postoperative oral scans were compared using 3D software for automatic surface registration and calculations. RESULTS Comparing TADs positioned by the direct method and the digitally planned method, a mean linear distance was found of 2.54 ± 1.51 mm in the occlusal view and 2.41 ± 1.33 mm in the sagittal view. No significant difference has been found between TADs positioned in the right and left palatal sides. A mean distance of 7.65 ± 2.16 mm was found between the tip of the digitally planned TAD and the central incisors root apex. CONCLUSIONS Both direct and 3D-assisted TAD insertion methods are safe and accurate in the anterior palate. However, the use of insertion guides facilitates TAD insertion, allowing less-experienced clinicians to use palatal implants.
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Affiliation(s)
- Giorgio Iodice
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Division of Orthodontics, University of Naples "Federico II", Naples, Italy
| | - Ravindra Nanda
- Department of Craniofacial Sciences, Division of Orthodontics, School of Dental Medicine, University of Connecticut, Farmington, CT, USA.,Division of Orthodontics, University of Connecticut Health Center, Farmington, CT, USA
| | - Sara Drago
- Orthodontic Department, Dental School, Genova University, Genova, Italy
| | - Laura Repetto
- Orthodontic Department, Dental School, Genova University, Genova, Italy
| | - Giorgio Tonoli
- Orthodontic Department, Dental School, Genova University, Genova, Italy
| | | | - Marco Migliorati
- Orthodontic Department, Dental School, Genova University, Genova, Italy
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15
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Al-Thomali Y, Basha S, Mohamed RN. Effect of surface treatment on the mechanical stability of orthodontic miniscrews. Angle Orthod 2021; 92:127-136. [PMID: 34338745 DOI: 10.2319/020721-111.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES To provide collective quantitative evidence about the effect of surface treatments on the mechanical stability of orthodontic miniscrews (MSs). MATERIALS AND METHODS The study was registered in PROSPERO (No. CRD42020209652). The research question was defined according to the PICO (population, intervention, control, and outcomes) format. Various research databases were searched for animal and human studies on effects of surface treatment on the mechanical stability of MSs. Both prospective and retrospective in vivo clinical studies published in English were included. The risk of bias was assessed using SYRCLE's risk of bias tool for animal studies. The meta-analysis was conducted using RevMan 5.4. RESULTS A total of 109 articles were identified; 14 were included in the systematic review, and seven studies with sandblasting, acid etching (SLA) methods of surface treatment were included for meta-analysis. The number of study participants ranged from 6 to 24 (total n = 185), with a mean of 13.2. A total of 949 MSs were used with a mean of 67.8. The overall success rate for surface-treated MSs ranged from 47.9% to 100%. Forest plot of removal torque values showed significantly higher values for SLA surface-treated MSs compared with controls with a standard mean difference of 2.61 (95% confidence interval = 1.49-3.72, I2 = 85%). Forest plot of insertion torque showed a standard mean difference of -6.19 (95% confidence interval = -13.63-1.25, I2 = 98%, P = .10). CONCLUSIONS Surface treatment of MSs improved primary and secondary stability with good osseointegration at the bone-implant surface. However, significant heterogeneity across the studies included in the meta-analysis made it difficult to draw conclusions.
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16
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Beyling F, Klang E, Niehoff E, Schwestka-Polly R, Helms HJ, Wiechmann D. Class II correction by maxillary en masse distalization using a completely customized lingual appliance and a novel mini-screw anchorage concept - preliminary results. Head Face Med 2021; 17:23. [PMID: 34187487 PMCID: PMC8240392 DOI: 10.1186/s13005-021-00273-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023] Open
Abstract
Background The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized lingual appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. Methods This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Results Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected. Conclusions The technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.
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Affiliation(s)
- Frauke Beyling
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.
| | - Elisabeth Klang
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany
| | - Eva Niehoff
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
| | | | - Hans-Joachim Helms
- Department of Medical Statistics, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Dirk Wiechmann
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
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17
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Choi JY, Kim MJ, Kim SH, Chung KR, Nelson G. Effect of Different Head Hole Position on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study. SENSORS 2021; 21:s21113798. [PMID: 34070904 PMCID: PMC8198358 DOI: 10.3390/s21113798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
Abstract
The orthodontic miniscrew is driven into bone in a clockwise direction. Counter-clockwise rotational force applied to the implanted miniscrew can degrade the stability. The purpose of this three-dimensional finite element study was to figure out the effect of shifting the miniscrew head hole position from the long axis. Two miniscrew models were developed, one with the head hole at the long axis and the other with an eccentric hole position. One degree of counter-clockwise rotation was applied to both groups, and the maximum Von-Mises stress and moment was measured under various wire insertion angles from −60° to +60°. All Von-Mises stress and moments increased with an increase in rotational angle or wire insertion angle. The increasing slope of moment in the eccentric hole group was significantly higher than that in the centric hole group. Although the maximum Von-Mises stress was higher in the eccentric hole group, the distribution of stress was not very different from the centric hole group. As the positive wire insertion angles generated a higher moment under a counter-clockwise rotational force, it is recommended to place the head hole considering the implanting direction of the miniscrew. Clinically, multidirectional and higher forces can be applied to the miniscrew with an eccentric head hole position.
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Affiliation(s)
- Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul 02447, Korea;
| | - Min-Jung Kim
- Department of Convergence Medicine, Asan Medical Center, Asan Medical Institute of Convergence Science and 8 Technology, Seoul 02447, Korea;
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
- Correspondence:
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California, San Francisco, CA 94143, USA;
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