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Bian C, Bai Y, Zhang N. Adult female skeletal anterior open bite treated by customized lingual orthodontic appliance with miniscrews-assisted in vertical control for perfect orthodontic compensation: A case report with 5-year follow-up. Int Orthod 2024; 22:100820. [PMID: 37952500 DOI: 10.1016/j.ortho.2023.100820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
The benefits of lingual orthodontics go beyond appearance. In this case study, a 30-year-old female patient was treated with a custom lingual orthodontic appliance for a Class II high-angle malocclusion, anterior open bite, incisor biprotrusion and crossbite, unilateral second molar scissor bite and dysfunctional tongue thrust. To achieve a counterclockwise rotation of the mandible, implant anchorage was used to control the vertical height. To complete the compensatory therapy, four first premolars were removed. As well as ensuring aesthetics over the 20-month treatment period, the treatment also established a Class I molar relationship, normal overbite and overjet, and improved the facial profile. After a five-year follow-up, the treatment results remained stable.
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Affiliation(s)
- Ce Bian
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Yuxing Bai
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
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Gomes NB, Almeida JVFPD, Neves JG, Correr AB, Correr-Sobrinho L, Costa AR. Evaluation of mechanical properties and morphology of miniscrews Ti6Al4V cold worked versus annealed in artificial bones. Int Orthod 2024; 22:100835. [PMID: 38141559 DOI: 10.1016/j.ortho.2023.100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/25/2023]
Abstract
PURPOSE This study aimed to evaluate the influence of different manufacturing procedures (Eli annealed - hot work versus cold worked - cold work) of the raw material under mechanical properties and morphological characteristics of orthodontic miniscrews (MS). MATERIAL AND METHODS Thirty MS were randomly separated into 3 types (n=10) according to manufacturer and manufacturing process of the raw material: type A - SIN® annealed (control group); type B - Dentfix® annealed; and, type C - Dentfix® cold worked. MI were inserted in artificial bone blocks, through the manufacturer's specific manual key attached to the digital torquemeter stabilized via custom device. Data of fracture's occurrence was performed using Fisher's exact test. Comparisons between the other two types regarding insertion torque and removal torque were performed using the Mann-Whitney test. Data of fracture torque, shear stress, normal stress and torque ratio was submitted to Kruskal Wallis and Dunn tests (α=0.05). Representative images of surface morphology and fractures were selected. RESULTS Type C showed statistically the lowest fracture torque (N.cm) (26.11±0.41) (P=0.0012) and highest torque ratio (%) (98.74±0.85) (P=0.0007). Type C showed statistically higher calculated shear (MPa) (2,432.73±508.41) and normal stress (MPa) (1,403.86±293.39) than type B and type A, showing that they differed in relation to the mechanical strength of the material with which they were made (P=0.0007). CONCLUSION Type A fractured completely inside the most apical bone. Type B and type C fractured closer to the transmucosal profile. Cold worked process should be more prone to fractures than those annealed raw manufactured.
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Affiliation(s)
- Neylla Berg Gomes
- Department of Orthodontics, Hermínio Ometto Foundation - FHO, Araras, SP, Brazil
| | | | - José Guilherme Neves
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Américo Bortolazzo Correr
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil
| | - Ana Rosa Costa
- Department of Orthodontics, Hermínio Ometto Foundation - FHO, Araras, SP, Brazil; Department of Restorative Dentistry, Dental Materials area, Piracicaba Dental School, State University of Campinas, FOP - UNICAMP, Piracicaba, SP, Brazil.
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Bharadwaj A, Ahuja S, Bhambri E, Gupta S, Uppal J. A 3D Finite Element Analysis of biomechanical effects on teeth and bone during true intrusion of posteriors using miniscrews. Int Orthod 2024; 22:100819. [PMID: 37864876 DOI: 10.1016/j.ortho.2023.100819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE The primary objective of this study was to investigate the biomechanical effects and stresses on bone, PDL, cementum and displacement along X-,Y- and Z-axis during true intrusion of molars using mini-implants with finite element analysis; the secondary objective of the study was to find out the best method for posterior intrusion in clinical practice. MATERIAL AND METHODS A 3D finite element method was used to simulate true molar intrusion using sliding mechanics. Two groups were made, with mini-implants placed on buccal side and palatal side with a cap splint for MODEL1, and a single mini-implant placed buccally with transpalatal arch (TPA) for MODEL2. The material characteristics which include the Young's modulus and Poison's ratio were assigned. von Mises stress, principal stress on PDL and alveolar bone, displacements in all the 3 planes were determined. RESULTS Bone stress patterns showed compressive stresses on the buccal aspect and tensile stresses on the palatal aspect for both MODELS. Stresses in the PDL and cementum were mainly concentrated in the apex region, with a more uniform distribution of stresses for MODEL 1. Tooth displacement showed true intrusion for both MODELS, i.e. the Z axis, and a more controlled buccal tipping for MODEL 1. CONCLUSION Of the modalities compared, the best controlled tooth movements for posterior intrusion in the treatment of open bite were obtained with mini-implants placed with a cap splint (MODEL 1).
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Affiliation(s)
- Ankit Bharadwaj
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Sachin Ahuja
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Eenal Bhambri
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Seema Gupta
- A.C.P.M Dental College, Maharashtra University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Dhule, Maharashtra 424002, India
| | - Japjee Uppal
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Prosthodontics and Crown and Bridge, Sri Ganganagar, Rajasthan 335001, India.
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Zheng DH, Hou FC, Zang YJ, Li B. Effects of low-level laser therapy on orthodontic miniscrew stability: a systematic review. Eur J Med Res 2023; 28:50. [PMID: 36707888 PMCID: PMC9881366 DOI: 10.1186/s40001-023-01010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Miniscrews as auxiliary anchorage devices in orthodontic treatment have definite advantages and efficacy. The aim of the present study was to investigate the scientific evidence including randomized controlled trials (RCTs) or controlled clinical trials (CCTs) to support the application of low-level laser therapy to improve miniscrews stability in orthodontic treatment. METHODS An extensive literature research was conducted with the Cochrane Library, PubMed, EMBASE, Web of Science and ScienceDirect without language limitations. All searches were inclusive until June 2020. The Cochrane Risk of Bias Tool was used to assess the risk of bias (RoB) in the included RCTs. RESULTS Through the electronic searches, 428 titles and abstracts were identified. From these, 4 articles were retrieved for review, and 3 of these met the inclusion criteria. Two RCTs reported increased miniscrews stability with low-intensity laser therapy, but the other one reported no difference. Except one study assessed as "high risk of bias" the other two were rated as "low risk of bias". CONCLUSION There is insufficient evidence to support or refute the effectiveness of LLLT for improvement of miniscrew stability. Further studies with a better study design, reliable evaluation method, comprehensive evaluation intervals and appropriate loading protocol are required to provide more reliable evidence for the clinical application of LLLT.
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Affiliation(s)
- De-Hua Zheng
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Feng-Chun Hou
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Yan-Jun Zang
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Bing Li
- grid.410645.20000 0001 0455 0905Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, China ,grid.412521.10000 0004 1769 1119Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China ,No. 306, Ningxia Road, Shinan District, Qingdao, 266000 Shandong China
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Yacout YM, El-Harouni NM, Madian AM. Dimensional changes of upper airway after slow vs rapid miniscrew-supported maxillary expansion in adolescents: a cone-beam computed tomography study. BMC Oral Health 2022; 22:529. [PMID: 36424571 PMCID: PMC9686034 DOI: 10.1186/s12903-022-02581-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To date, the effects of different activation rates of miniscrew-supported expanders on the airway have not been compared. Hence, the purpose of this retrospective study was to evaluate and compare the effects of slow and rapid miniscrew-supported maxillary expansion on the upper airway dimensions using cone-beam computed tomography (CBCT). METHODS Data of 20 patients (Age 12 to 16 years old) treated using miniscrew-supported expanders at the Faculty of Dentistry, Alexandria University was collected. The patients were equally divided into two groups according to the activation protocol; slow maxillary expansion (SME): activation once every other day, and rapid maxillary expansion (RME): activation twice daily. CBCT scans obtained pre-expansion and 5 months post-expansion were used to evaluate the changes in the upper airway dimensions. Comparisons between the two time points within each group were done using paired samples t-test. SME and RME groups were compared using independent samples t-test. Significance level was set at p < 0.05. RESULTS Both groups showed a significant increase in anterior, middle, and posterior nasal cavity width. SME resulted in significantly greater increase of the anterior nasal cavity width than RME (Mean difference between the groups, 2.64 mm; 95% CI, 0.83, 4.45; p = 0.007). The dimensions of the retropalatal and retroglossal airways did not change significantly in either group. Both groups resulted in a significant increase of maxillary width, palatal width, and inter-molar width. RME showed a significantly larger increase of inter-molar width than SME (Mean difference between the groups, - 2.44 mm; 95% CI, - 3.88, - 1.00; p = 0.002). CONCLUSIONS The use of either a slow or rapid activation protocol is effective in expanding the nasomaxillary complex, with greater expansion achieved in the anterior section of the nasal cavity using the slow rate. However, the expander design employed in the current study does not affect the dimensions of the retropalatal or retroglossal airways.
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Affiliation(s)
- Yomna M. Yacout
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, P. O. Box: 21521, Alexandria, Egypt
| | - Nadia M. El-Harouni
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, P. O. Box: 21521, Alexandria, Egypt
| | - Ahmed M. Madian
- grid.7155.60000 0001 2260 6941Department of Orthodontics, Faculty of Dentistry, Alexandria University, P. O. Box: 21521, Alexandria, Egypt
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Mitchell B, Liu J, Lee S, Watanabe K, Kim DG, Fields HW, Guo X, Wei-En L, Deguchi T. Quantitative evaluation of training method in placing miniscrews in orthodontic graduate program. Prog Orthod 2022; 23:33. [PMID: 36184724 PMCID: PMC9527266 DOI: 10.1186/s40510-022-00430-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/18/2022] [Indexed: 11/27/2022] Open
Abstract
Background The purpose of this study was to assess the effectiveness of training residents in an orthodontic program in the placement of miniscrews by using cone beam computed tomography (CBCT) images. A total of 90 miniscrews were placed in 15 pig mandibles over a 3-year period by 15 first-year orthodontic residents. Miniscrews were divided into three groups (Control group: no radiographs; 2D group: placement with 2D radiographs; CBCT group: placement with CBCT). Proximity of the miniscrew to the neighboring root was measured. The miniscrew success rate was examined in the graduate clinic from 2015 to 2021. Results The percentage of root contact for each group was: 36.7% (11/30), 20.0% (6/30), 0% (0/30), for the Control, 2D, and CBCT groups, respectively. The CBCT group was significantly different from the Control and 2D groups (p < 0.05). For root proximity, the miniscrews were significantly closer to the roots in the Control (p < 0.001) and 2D (p < 0.001) groups compared with the CBCT group. No significant difference was observed between the Control and 2D groups (p = 0.80). There was no significant difference among the years in the miniscrew success rate. Conclusions Training the residents in an orthodontic graduate program using CBCT may be helpful to avoid root damage and to decrease the miniscrew failure rate.
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Affiliation(s)
- Bobby Mitchell
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Jie Liu
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Sanghee Lee
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Keiichiro Watanabe
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Henry W Fields
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Xiaohan Guo
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Lu Wei-En
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA.
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Maino GB, Cremonini F, Maino G, Paoletto E, De Maio M, Spedicato GA, Palone M, Lombardo L. Long-term skeletal and dentoalveolar effects of hybrid rapid maxillary expansion and facemask treatment in growing skeletal Class III patients: a retrospective follow-up study. Prog Orthod 2022; 23:44. [PMID: 36178519 DOI: 10.1186/s40510-022-00429-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regardless of the treatment protocol, stability in Class III patients always represents a major concern. The aim of this study was to assess the short and long-term skeletal and dentoalveolar modifications in a group of class III patients treated with hybrid rapid maxillary expander (RME) and facemask (FM). Indeed, no long-term studies have been conducted yet with the objective of evaluating the effects of this kind of approach when applied to patients who have already gone thought their peak of growth. MATERIAL AND METHODS 27 patients with skeletal Class III malocclusion were treated using hybrid RME according to alternating rapid maxillary expansion and constriction (ALT-RAMEC) protocol, followed by 4 months of facemask therapy. After the orthopaedic phase, each patient underwent orthodontic treatment with fixed multibracket appliances. A mean follow-up of 7 years, 10 months was performed. Pre-treatment (TO), post-treatment (T1) and follow up (T2) cephalometric tracing were analysed, comparing dental and skeletal measurements. RESULTS Point A advanced by a mean of 3.5 mm with respect to VerT, then relapsed by 0.7 in the post-facemask period, thereby yielding of a mean advancement of 2.7 at T2. The sagittal relationship significantly changed after RME + facemask protraction (3.8° of ANB and 5.189 mm of Wits). Although both Wits and ANB values worsened over time, the improvement from T0 is still appreciable at T2. CONCLUSION Despite the physiological relapse due to mandibular growth, the long-term cephalometric follow-up confirms the maintenance of all positive outcomes of the previous orthopaedic treatment with hybrid RME and facemask.
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Wang Y, Sun J, Shi Y, Li X, Wang Z. Buccal bone thickness of posterior mandible for microscrews implantation in molar distalization. Ann Anat 2022; 244:151993. [PMID: 36041697 DOI: 10.1016/j.aanat.2022.151993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/04/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study explored the inter-radicular space and buccal bone thickness of the posterior mandibular region to provide an appropriate miniscrew insertion site for lower dentition distalization. METHODS The cone-beam computed tomographic (CBCT) records of 63 subjects were collected. Buccal bone thickness (BBT) was measured at four sections: (I) the root of the second premolar(P1); (II) the mesial root of the first molar(P2); (III) the distal root of the first molar(P3); (IV) the mesial root of the second molar(P4). The narrowest inter-radicular space of the four sections was also detected. Both BBT and inter-radicular space were measured at 4 height levels, 2, 4, 6 and 8mm from the alveolar ridge. RESULTS The largest BBT was observed at the mesial root of the second molar at 6 and 8mm, demonstrating a thickness of 6.77±2.50mm and 7.46±1.94mm, respectively. It provided sufficient coverage for mini-implants inserted 10°-30° oblique to the root. Therefore, during distalization of the mandibular dentition, roots have sufficient space to bypass the inclined mini-implants on the lingual side, avoiding miniscrew-root contact. The width between the mesiodistal roots of the first molar was the smallest, showing 1.53±0.69mm and 2.13±0.65mm at 4 and 6mm. Miniscrews implanted in this region had an increased risk of root proximity. CONCLUSIONS The most appropriate insertion site at the mandibular buccal shelf was the mesial point of the second molar at 6-8mm from the alveolar ridge, and an insertion angle of 10°-30° was recommended to avoid miniscrew-root contact. CBCT analysis is recommended before implantation due to individual differences.
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Affiliation(s)
- Yaqi Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Jing Sun
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Yanli Shi
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Xin Li
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China; Department of Orthodontics,Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, Shandong, China.
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Fouda AS, Afify AK, Aboulfotouh MH, Attia KH, Abouelezz AM, Elkordy SA. Dental arch changes after anterior open bite treatment in the mixed dentition produced by miniscrew-supported palatal crib vs conventional fixed palatal crib. Angle Orthod 2022; 92:487-496. [PMID: 35130348 DOI: 10.2319/082321-659.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the dental arch changes produced by the miniscrew-supported palatal crib (MSPC) and the conventional fixed palatal crib (CFPC) after the treatment of patients with anterior open bite (AOB) attributed to the tongue-thrusting habit in the mixed dentition stage. MATERIALS AND METHODS A total of 26 children aged 8 to 11 years with an AOB were randomly distributed into two equal groups; the MSPC group was treated using a palatal crib supported by two miniscrews inserted paramedially, whereas the CFPC group was treated using a conventional fixed palatal crib soldered to bands. Digital models were obtained pretreatment and after a follow-up duration of 9 months. RESULTS The MSPC group included 12 participants (9 girls and 3 boys; mean age, 9.4 ± 0.75 years), and the CFPC group included 12 participants (10 girls and 2 boys; mean age, 9.0 ± 0.73 years). The amount of AOB closure was similar in both groups: 3.97 ± 1.44 mm in the MSPC group and 3.97 ± 0.89 mm in the CFPC group. There was significant mesial movement of the maxillary first molar in the CFPC (-1.42 ± 0.99 mm) compared with the MSPC group (-0.53 ± 0.32 mm). CONCLUSIONS Both appliances resulted in similar improvement in the amount of AOB closure. There was significantly more mesial movement of the maxillary first molars in the CFPC group compared with the MSPC group.
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Pujol P. [Traction of impacted teeth using bone anchorage and cantilever springs: a case report]. Orthod Fr 2021; 92:431-41. [PMID: 34933851 DOI: 10.1684/orthodfr.2021.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Egression and orthodontic traction can lead to parasitic movements on the anchoring elements. It is often necessary to use a device including several dental elements sometimes associated with traction auxiliaries. The author, through clinical cases, will develop his therapeutic approach, to limit these parasitic movements as much as possible. The use of a bone anchorage associated with a cantilever arch improves the management of this frequent orthodontic problem.
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Hiriyanna NM, Degala S, Shetty SK. Comparative Evaluation of Drill-Free and Self-Tapping Titanium Miniscrews for Semi-Rigid Internal Fixation in Maxillofacial Trauma. J Maxillofac Oral Surg 2021; 21:129-135. [PMID: 34421236 PMCID: PMC8371421 DOI: 10.1007/s12663-021-01632-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/05/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Conventional semi-rigid fixation systems in maxillofacial trauma use self-tapping titanium miniscrews (STS) that require preliminary drilling of a pilot hole. Although drill-free miniscrews (DFS) accompany these systems, they have not dominated practice despite their allure of improved screw-bone contact and holding power. The COVID-19 pandemic has brought these DFS to light as they avoid aerosol production. The present study has compared DFS to STS in patients being treated with miniplate fixation for maxillofacial trauma to understand their feasibility for maxillofacial fracture fixation. Methodology This prospective case–control study sampled 16 patients each with zygomaticomaxillary buttress fracture and parasymphysis fracture of the mandible and grouped alternating patients as case (DFS) and control (STS). Intraoperatively duration of fixation, incidence of screw failures and fragment stability; postoperatively occlusion, neurosensory deficits, teeth vitality and infection and removal rates were evaluated at postoperative week 1, 3, 6, 12 and 24 using Cramer's V test. A P value < 0.05 was considered significant. Results In the 32 patients evaluated, DFS reduced internal fixation time at zygomaticomaxillary buttress (P = 0.001) but not at parasymphysis (P = 0.206). No significant difference in screw failures or fragment stability was observed. Stable occlusion was maintained in all groups with vital teeth and intact neurosensory function, but the summative incidence of infection was significant at week 24 when STS was used at parasymphysis (P = 0.019). Discussion While DFS may facilitate ease of insertion with a single instrument pick-and-screw-in approach, avoiding thermal osteonecrosis and aerosol production, they fail to confer any other clinical advantage.
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Affiliation(s)
- Namitha M Hiriyanna
- Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Saikrishna Degala
- Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Sujeeth Kumar Shetty
- Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysuru, 570015 India
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Fouda AS, Attia KH, Abouelezz AM, El-Ghafour MA, Aboulfotouh MH. Anchorage control using miniscrews in comparison to Essix appliance in treatment of postpubertal patients with Class II malocclusion using Carrière Motion Appliance. Angle Orthod 2021; 92:45-54. [PMID: 34338733 DOI: 10.2319/021421-126.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate anchorage control using miniscrews vs an Essix appliance in treatment of Class II malocclusion by distalization using the Carrière Motion Appliance (CMA). MATERIALS AND METHODS Twenty-four postpubertal female patients with Class II, division 1 malocclusion were randomly distributed into two equal groups. CMA was bonded in both groups, and one group was treated with miniscrews as anchorage (12 patients, mean age = 18.0 years) while the other group was treated with an Essix appliance as anchorage (12 patients, mean age = 17.8 years). For each patient, two cone-beam computed tomographic scans were obtained: one preoperatively and another after completion of distalization. RESULTS In the Essix appliance group, there was a statistically significant anterior movement (2.2 ± 1.43 mm) as well as proclination of the lower incisor (5.3° ± 4.0°), compared to a nonsignificant anterior movement (0.06 ± 1.45 mm) and proclination (0.86° ± 2.22°) in the miniscrew group. The amount of maxillary molar distalization was higher in the miniscrew group (2.57 ± 1.52 mm) than in the Essix appliance group (1.53 ± 1.11 mm); however, the difference was not statistically significant. CONCLUSIONS Miniscrews led to a decrease in the amount of anchorage loss in the mandibular incisors, both in terms of anterior movement and proclination.
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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] [What about the content of this article? (0)] [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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Al-Melh MA, Badr H, Andersson L. Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study. J Contemp Dent Pract 2021; 22:637-643. [PMID: 34393120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIMS AND OBJECTIVES The aims of this study were to compare the anesthetic effect of a lidocaine/prilocaine (L/P) topical anesthetic with placebo on pain from needle sticks and to compare the anesthetic effect of the L/P topical anesthetic with an infiltrative anesthetic on pain from orthodontic miniscrew placement. MATERIALS AND METHODS Pain elimination was analyzed from two interventions: (a) needle stick and (b) miniscrew insertion. When assessing pain from needle stick, one side of the mandible received 2.5% lidocaine/2.5% prilocaine topical anesthetic, and the other side received placebo. When evaluating pain from miniscrew placement, one side of the mandible received L/P topical anesthetic and the other side received infiltrative anesthetic. The findings were recorded on a Visual Analogue Scale after needle stick and after miniscrew placement. Subjective assessment was analyzed by a questionnaire. RESULTS The L/P topical anesthetic significantly eliminated the pain from needle stick (Mann-Whitney test of medians, 29.0 vs 0.0, respectively, p<0.001). However, the injection anesthetic eliminated the pain from the miniscrew placement better than the L/P topical anesthetic (Mann-Whitney test of medians, 0.0 vs 5.5, respectively, p<0.001). Eighty percent of the subjects felt more comfortable with L/P topical anesthetic than injection anesthetic. Pain from needle stick pain was reported to be the most uncomfortable part of the study. CONCLUSION The L/P topical anesthetic efficiently eliminated pain from needle stick. The L/P topical anesthetic did not completely eliminate pain from miniscrew placement as the injection anesthesia, but it did reduce pain to tolerable levels. CLINICAL SIGNIFICANCE L/P topical anesthetics can significantly eliminate pain from needle stick injections, and L/P topical anesthetics can reduce pain from orthodontic miniscrew placement to tolerable levels.
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Affiliation(s)
- Manal A Al-Melh
- Department of Developmental and Preventive Sciences, Kuwait University, Faculty of Dentistry, Kuwait, Phone:+96567722222, e-mail:
| | - Hanan Badr
- Department of Community Medicine, Kuwait University, Faculty of Medicine, Kuwait
| | - Lars Andersson
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Sweden
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Sampson A, Figueiredo DSF, Jeremiah HG, Oliveira DD, Freitas LRP, Chahoud M, Soares RV, Cobourne MT. The effect of social media on patient acceptance of temporary anchorage devices. Angle Orthod 2021; 91:363-370. [PMID: 33461218 DOI: 10.2319/071020-618.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate the relationship between the use of social networking sites (SNSs) on patient perceptions, acceptance, and expectations of treatment using temporary anchorage devices (TADs) and to compare differences between patients from the United Kingdom and Brazil. MATERIALS AND METHODS Cross-sectional questionnaires were administered to 39 participants at orthodontic practices in the United Kingdom and Brazil about patients' use of SNSs, exposure to TADs on SNSs, and thoughts on extractions, jaw surgery, or TADs as treatment options. RESULTS UK patients prefer for clinicians to have SNS profiles (P = .022). Most UK and Brazilian patients want to see their clinician's work online (76.7%) and use SNSs to get information about treatment options (76.6%). There was a statistically significant difference in Brazilian patients' acceptance of TADs as a treatment option compared with UK patients, particularly if it meant avoiding extractions (P = .002), avoiding jaw surgery (P = .004), or reducing treatment time (P = .010). Knowledge of TADs was greater in Brazilian patients (P < .001). CONCLUSIONS Patients use SNSs to obtain information about treatments and prefer clinicians to have social media accounts. Patients exposed to TADs on SNSs are more likely to accept them as an orthodontic treatment option. UK patients have less knowledge of TADs and are therefore less sure to consider TADs as an option. Brazilian patients are more confident in considering the use of TADs. Clinicians should consider increasing their social media presence to accommodate patients' expectations and acceptance of TADs.
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Nenen F, Garnica N, Rojas V, Oyonarte R. Comparison of the primary stability of orthodontic miniscrews after repeated insertion cycles. Angle Orthod 2021; 91:336-342. [PMID: 33378455 DOI: 10.2319/050120-375.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To compare the primary stability of miniscrews after repeated cycles of insertion through insertion torque (IT) measurements and resonance frequency analysis (RFA). MATERIALS AND METHODS Sixty titanium miniscrews were divided into two groups according to the insertion protocol: one with predrilled sites and the other self-drilled into porcine iliac crest bone specimens. Each group had three cycles of reinsertion. After each insertion, the IT and RFA were measured. The IT was measured by using a torque meter, and the RFA was measured using the Osstell ISQ device. A total of five miniscrews of each group were selected for sequential assessment of the morphology of their tip and threads using scanning electron microscopy after each insertion cycle. RESULTS No statistically significant differences were found in the IT values of miniscrews reinserted up to three times in the group with predrilled surgical sites. The IT value increased significantly with the number of reinsertions in the self-drilled group. The RFA value decreased as the number of insertions increased in both groups. CONCLUSIONS Under the conditions of this in vitro study, reinserting miniscrews deteriorates the integrity of their tip and thread. Reinsertion should be discouraged particularly when insertion sites are not predrilled.
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Lorente T, Lorente P, Perez-Vela M, Lorente C. Orthodontic management of severe iatrogenic biprotrusion and resorptions with miniscrews and corticotomies. Int Orthod 2021; 19:319-28. [PMID: 33820728 DOI: 10.1016/j.ortho.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND This case report describes a patient with severe iatrogenic dental biprotrusion who visited for a second assessment. The patient presented first premolar maxillary extractions, resorbed maxillary incisors and dehiscences in the anterior buccal and palatal cortical bone diagnosed with cone-beam computed tomography (CBCT). MATERIAL AND METHODS At the beginning of treatment, fixed appliances were bonded on all teeth except on the upper incisors to prevent further root resorption. Mandibular first premolar extractions, miniscrews and corticotomies were scheduled for gaining distalization of the teeth in the four quadrants. When this was achieved, an occlusal splint was placed to extrude the posterior teeth with interarch elastics for increasing the vertical dimension. Next, brackets were placed on the maxillary incisors and a comprehensive orthodontic treatment was performed. RESULTS After treatment, changes in incisor positioning were evident, varying the interincisal angle by 57.6 degrees. Nevertheless, slight root resorption of the upper incisors was observed. CONCLUSIONS Correct diagnosis is necessary to design an adequate treatment plan and make orthodontists aware of possible severe unwanted tooth movements before they occur. In dental biprotrusion without overjet, the first objective should be to distalize mandibular teeth prior to maxillary teeth retraction.
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Sánchez-Riofrío D, Viñas MJ, Ustrell-Torrent JM. CBCT and CAD-CAM technology to design a minimally invasive maxillary expander. BMC Oral Health 2020; 20:303. [PMID: 33148234 PMCID: PMC7641819 DOI: 10.1186/s12903-020-01292-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
Background A large number of articles in recent years studying the effects of non-surgically assisted tooth- versus bone-borne maxillary expanders in growing patients have found no significant differences in mid-palatal suture disjunction or even dentoalveolar changes. This suggests the need for new criteria and better use of current technology to make more effective devices and enhance the benefits of conventional treatments. This article describes a titanium grade V computer-aided design/computer-aided manufacturing (CAD/CAM) maxillary expander supported by two miniscrews, along with a 3D printed surgical guide. Methods The first step was to obtain a digitized model of the patient’s upper maxilla. To simplify the process and ensure the placement of the device in a high-quality bone area, the patients’ digital dental cast was superimposed with a cone beam computed tomography (CBCT) scan. Improved resistance to expansion forces was secured through the use of 2 mm-wide miniscrews, long enough for bicortical anchorage. Placement site and direction were assessed individually in order to achieve primary stability. We chose a site between the second premolars and first molars, while the inclination followed the natural contour of the palate vault. A 3D-printed, polyamide surgical guide was designed to ensure the correct placement of the device with a manual straight driver.
Results Favorable clinical results were presented with 3D images. We confirmed a mid-palatal suture parallel separation of 3.63 mm, along with a higher palatal volume, as well as increased intercanine and intermolar distance. Segmentation of the facial soft tissue showed an expansion of nasal airways and changes in nasal morphology. Conclusions Digital models, CBCT and CAD/CAM technology, are essential to accomplish the goals proposed in this article. Further studies are necessary to establish safer miniscrew placement sites and insertion angles so as to achieve greater in-treatment stability. Both the clinician and the patient can benefit from the use of current technology, creating new devices and updating traditional orthodontic procedures.
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Affiliation(s)
- Diego Sánchez-Riofrío
- Universitat de Barcelona, Feixa Llarga s/n. Pavelló de Govern 2ª pl. Office 2.7, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. .,Universidad Espíritu Santo, Samborondón Campus, Km. 2.5 vía La Puntilla, Samborondón, Ecuador.
| | - María J Viñas
- Faculty of Dentistry, Universidad Complutense de Madrid, Ciudad Universitaria, Plaza Ramón y Cajal S/N, Madrid, Spain
| | - Josep M Ustrell-Torrent
- Director Master of Orthodontics, Dental School, Universitat de Barcelona, Feixa Llarga s/n. Pavelló de Govern 2ª pl. Office 2.7, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
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Colonna A, Drudi M, Spedicato GA, Mollica F, Mazzanti V, Paoletto E, Maino G, Siciliani G, Lombardo L. Assessment of stiffness and load deflection of orthodontic miniscrews used for palatal anchorage: An in vitro biomechanical study. Int Orthod 2020; 18:809-19. [PMID: 33004287 DOI: 10.1016/j.ortho.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the biomechanical properties of miniscrews of 5 different lengths, 2 different diameters, and different combinations of insertion used for palatal skeletal anchorage. MATERIALS AND METHODS Twenty-four different combinations of a total of 120 miniscrews of two different diameters (2.0mm and 2.3mm) and five different lengths (9mm, 11mm, 13mm and 15mm) were tested at different angles of insertion (90° and 45°) and distances from a synthetic bone block (3mm, 5mm, 7mm). Samples were fixed in an Instron Universal Testing Machine and a load was applied in single cantilever mode to the neck of each miniscrew. The stiffness and maximum load before permanent deformation were recorded. Model-based recursive partitioning testing (CART) was used to evaluate differences between groups. RESULTS Significantly higher forces were necessary to deform miniscrews of diameter 2.3mm than those of 2.0mm, those inserted at an angle of 45° with respect to 90°, and at smaller distances between the miniscrew neck and block; in addition, the maximum load and stiffness increased with increasing screw length. CONCLUSION This in vitro experimental study showed strong correlations between deformation load and miniscrew geometry, insertion angle and distance from the synthetic block, results that should be considered when planning miniscrew insertion in order to reduce the risk of unwanted fracture.
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Vela-Hernández A, Gutiérrez-Zubeldia L, López-García R, García-Sanz V, Paredes-Gallardo V, Gandía-Franco JL, Lasagabaster-Latorre F. One versus two anterior miniscrews for correcting upper incisor overbite and angulation: a retrospective comparative study. Prog Orthod 2020; 21:34. [PMID: 32893322 PMCID: PMC7475152 DOI: 10.1186/s40510-020-00336-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/18/2020] [Indexed: 01/29/2023] Open
Abstract
Background Miniscrews are effective devices for performing upper incisor intrusion. Different mechanics can be applied depending on the treatment objectives. This study aimed to evaluate the efficacy of one or two anterior miniscrews for upper incisor correction in cases of overbite and angulation in adult patients. Methods Forty-four adults with deep overbite were divided into two groups: group 1 was treated with one miniscrew between upper central incisors and group 2 with two miniscrews between upper lateral incisors and canines. Incisor intrusion and length were measured from lateral cephalograms before treatment, after treatment and at least 12 months into retention (T0, T1 and T2). Forces were applied (90 g) from the miniscrews to the archwire using elastomeric chains. ANOVA analysis was used to determine whether differences between evaluation times were statistically significant. Results Mean root resorption was 2.15 ± 0.85 mm, which ceased after active treatment. Overbite mean correction was − 3.23 ± 1.73 mm with no statistically significant relapse. Overbite correction and incisor intrusion were significantly greater in group 2 (− 3.80 ± 1.43 versus − 2.75 ± 1.63 for OB and 8.19 ± 3.66 versus 5.69 ± 2.66 for intrusion). Resorption and overbite correction were positively related. No counterclockwise rotation of the mandibular plane was observed. Conclusions Overbite correction can be performed by means of upper incisor intrusion without rotation of the mandibular plane. Correction of upper incisor intrusion and overbite is greater in patients treated with two miniscrews. The increase in upper incisor buccal angulation is greater with one miniscrew. Root resorption is positively related to the extent of intrusion. Stability is satisfactory regardless of whether one or two miniscrews are used.
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Affiliation(s)
- Arturo Vela-Hernández
- Orthodontics Teaching Unit, Department of Stomatology, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | | | | | - Verónica García-Sanz
- Orthodontics Teaching Unit, Department of Stomatology, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
| | - Vanessa Paredes-Gallardo
- Orthodontics Teaching Unit, Department of Stomatology, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain.
| | - José Luis Gandía-Franco
- Orthodontics Teaching Unit, Department of Stomatology, University of Valencia, Gascó Oliag 1, 46010, Valencia, Spain
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21
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Sosly R, Mohammed H, Rizk MZ, Jamous E, Qaisi AG, Bearn DR. Effectiveness of miniscrew-supported maxillary incisor intrusion in deep-bite correction: A systematic review and meta-analysis. Angle Orthod 2019; 90:291-304. [PMID: 31816252 DOI: 10.2319/061119-400.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate systematically the effectiveness of miniscrew-supported maxillary incisor intrusion compared with other nonsurgical intrusive mechanics for deep-bite correction. MATERIALS AND METHODS Unrestricted electronic searches in Embase, Web of Science, MEDLINE, LILACS, and Cochrane's CENTRAL as well as manual searches were conducted up to August 2019. Only randomized clinical trials (RCTs) were included. Study selection, data extraction, and bias assessment were done by two independent reviewers. The Cochrane risk-of-bias tool was used, and the quality of evidence was graded using the GRADE approach. A random-effects meta-analysis of continuous data, with its 95% confidence intervals (CIs), was used. RESULTS Seven RCTs were included in the quantitative synthesis, and the overall quality of evidence was very low to low. When compared with intrusion arches, miniscrews resulted in a more efficient deep-bite reduction with a standardized mean difference (SMD) of -0.48 (95% CI, -0.89 to -0.07). When miniscrews were used, a statistically significant difference was observed favoring less maxillary molar extrusion (SMD, -0.86; 95% CI, -1.46 to -0.27) and more incisor intrusion as measured from centroid to palatal plane (SMD, -0.95; 95% CI, -1.41 to -0.49). Results also showed a statistically nonsignificant difference regarding the amount of resultant root resorption between miniscrews and intrusion arches. CONCLUSIONS There is weak evidence indicating efficient deep-bite correction using miniscrews. Root resorption seems to be an associated adverse effect that occurs regardless of the intrusive mechanics used. These conclusions should be viewed with great caution as further well-designed long-term research is recommended.
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Abstract
As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid fixation, allowing for more focused movements of teeth and for orthopedic growth modification. These types of treatments using rigid fixation have allowed for greater interaction between the orthodontist and the oral and maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontist in today's society.
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Affiliation(s)
- Jason P Jones
- Department of Oral and Maxillofacial Surgery, UT Health San Antonio, 8210 Floyd Curl Drive, MC 8124, San Antonio, TX 78229, USA
| | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, Room 131, M/C 841, Chicago, IL 60612-7211, USA.
| | - Daniel E Perez
- Department of Oral and Maxillofacial Surgery, UT Health San Antonio, 8210 Floyd Curl Drive, MC 8124, San Antonio, TX 78229, USA.
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Almuzian M, Almukhtar A, Ulhaq A, Alharbi F, Darendeliler MA. 3D effects of a bone-anchored intra-oral protraction in treating class III growing patient: a pilot study. Prog Orthod 2019; 20:37. [PMID: 31531735 PMCID: PMC6749004 DOI: 10.1186/s40510-019-0290-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this prospective case series study is to assess the three-dimensional (3D) skeletal and soft tissue effects of the alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol in conjunction with a miniscrew-supported class III elastic wear in class III growing patients. MATERIALS AND METHODS Fourteen consecutive participants (mean age 12.05 ± 1.09 years), who displayed class III malocclusions with retrognathic maxillae, were recruited. A cone beam computed tomography (CBCT) scan was acquired before commencing treatment (T1). All participants were treated with a tooth-bone-borne rapid maxillary expansion (hybrid MARME) appliance that was activated by the Alt-RAMEC protocol for 9 weeks. This was followed by full-time class III elastics, delivering 400 g/side, to protract the maxilla. When a positive overjet was achieved, protraction was ceased and a post-treatment CBCT scan (T2) was taken. The 3D analysis of pre- and post-treatment CBCT scans was blinded. The scans were registered on the anterior cranial base. The Euclidean distance between the two extracted surface models of the pre- and post-treatment scans was displayed as a color surface map. RESULTS All participants completed the intervention successfully. The majority of the participants showed protraction of the anterior maxillary region (71.4%) and in the zygomatic processes (64.2%). The maxilla significantly protracted (SNA 1.87° ± 1.06°; Vert.T-A 3.29 ± 1.54 mm), while the mandibular base significantly redirected posteriorly (SNB - 2.03° ± 0.85°, Vert.T-B - 3.43 ± 4.47 mm) and that was reflected on the ANB and Wits measurements. No adverse effects were observed. CONCLUSION Class III elastics combined with the Alt-RAMEC activation protocol of the hybrid MARME appliance is an effective treatment method for mild/moderate class III malocclusions. A long-term follow-up and comparisons with other treatment modalities are required.
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Affiliation(s)
- Mohammed Almuzian
- Faculty of Dentistry, University of Sydney, Sydney, Australia.,Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Anas Almukhtar
- College of Dentistry, University of Mosul, Mosul, Iraq.,University of Glasgow, Glasgow, UK
| | - Aman Ulhaq
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Fahad Alharbi
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz, AL-Kharj, 11942, Saudi Arabia.
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Ierardo G, Luzzi V, Sfasciotti GL, Nardacci G, Polimeni A, Vozza I. Using of modified rapid palate expander with miniscrews in a patient affected by ectodermic dysplasia. Clin Ter 2019; 170:e168-e173. [PMID: 31173044 DOI: 10.7417/ct.2019.2127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To show the orthodontic treatment in a 8-year-old patient affected by Ectodermal Dysplasia (hypohidrotic type) and presenting multiple agenesiae, contraction of the maxilla and skeletal Class III malocclusion. STUDY DESIGN Because of both oligodontia of primary and secondary dentition and no good retention and anchoring, a hybrid modified rapid palatal expander (RPE) was used. It presented dental anchoring with two bands on first upper molars and skeletal anchoring with two miniscrews in the anterior palate. The project included the use of a CBTC for the bone examination and precise silicon dental impression for the insertion of miniscrews. RESULTS The procedure was successful and the patient solved the expansion in few days, so RPE has been embedded throughout 6 months in order to develop the bone at the median suture. CONCLUSIONS This case report can be considered as a valid example for approaching patients affected by Ectodermal Dysplasia with multiple agenesiae and palatal contraction because of the difficult retention.
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Affiliation(s)
- G Ierardo
- DDS, PhD RTDB, UOC Odontoiatria Pediatrica, Sapienza Università di Roma
| | - V Luzzi
- DDs, PhD RTDB, UOC Odontoiatria Pediatrica,Sapienza Università di Roma
| | - G L Sfasciotti
- MD, DDS Professore Associato, UOC Odontoiatria Pediatrica,Sapienza Università di Roma
| | - G Nardacci
- DDS Specializzanda Odontoiatria Pediatrica Sapienza Università di Roma
| | - A Polimeni
- MD, DDS Professore Ordinario, Direttore UOC Odontoiatria Pediatrica, Sapienza Università di Roma
| | - I Vozza
- DDS, PhD Professore Associato, UOC Odontoiatria Pediatrica, Sapienza Università di Roma, Italia
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Abstract
This case shows that using a rapid palatal expander (RPE) and then a pendulum appliance anchored to palatal miniscrews is an option for improving treatment management in a noncompliant patient requiring maxillary expansion and molar distalization in the late mixed dentition. First, an RPE was used to expand the maxillary arch. Then, a modified pendulum appliance was used to distalize the maxillary first permanent molars. Optimal positioning of two palatal miniscrews enabled both appliances to be supported by skeletal anchorage. Treatment was finished using multibracket fixed appliances, and after 2 years, skeletal Class I as well as dental Class I canine and molar relationships were achieved.
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Rice AJ, Carrillo R, Campbell PM, Taylor RW, Buschang PH. Do orthopedic corrections of growing retrognathic hyperdivergent patients produce stable results? Angle Orthod 2019; 89:552-558. [PMID: 30741574 DOI: 10.2319/061818-460.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine if posterior dental intrusion produces stable orthodontic and orthopedic corrections in growing retrognathic hyperdivergent patients. MATERIALS AND METHODS The sample included 14 subjects (five males and nine females), who were 13.4 ± 0.7 years pretreatment, treated for 3.5 years, and followed for 3.6 years posttreatment. During the initial orthopedic phase, 150 g NiTi coil springs were attached to two palatal miniscrew implants (MSIs) for maxillary intrusion; two buccal mandibular MSIs were used for posterior vertical control. Full orthodontic therapy was initiated to correct the malocclusions during the orthodontic phase. Patients were recalled a minimum of 1 year posttreatment (mean 3.6 ±1.6 years). Patients were compared to matched untreated controls. RESULTS Relative to the untreated controls, during treatment and retention, maxillary and mandibular molars underwent 2.8 mm and 3.7 mm of relative posterior intrusion, respectively. Maxillary incisors were extruded 1.3 mm and the mandibular incisors underwent 2.9 mm of relative intrusion. Overall orthopedic changes included a reduction in the mandibular plane angle (MPA; 3.3°), an increase in SN-Pg (2.4°), an increase in S-N-B (2.1°), and a 4.3 mm relative reduction in anterior facial height. The maxillary incisors, which showed 0.6 mm of intrusion (relative to controls), was the only dental or skeletal measure to show a statistically significant between-group posttreatment difference. CONCLUSIONS Except for maxillary incisor position, the substantial dental intrusion and associated orthopedic corrections that were produced during treatment remained stable post-treatment.
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Abedini S, Elkenawy I, Kim E, Moon W. Three-dimensional soft tissue analysis of the face following micro-implant-supported maxillary skeletal expansion. Prog Orthod 2018; 19:46. [PMID: 30450504 PMCID: PMC6240556 DOI: 10.1186/s40510-018-0243-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/27/2018] [Indexed: 12/02/2022] Open
Abstract
Background Skeletal maxillary expander (MSE) is one of the more recent expander designs being utilized for skeletal expansion by splitting the midpalatal sutures applying forces through palatal micro-implants. Its effects on the soft tissue remain a question asked by both patients and clinicians. The aim of this study was to analyze and quantify soft tissue facial changes induced by MSE. Methods 3D facial images (3dMD) were used to capture face scans of 25 patients generating 3D soft tissue meshes before expansion (T0), right after expansion (T1), and 1 year in retention (T2). MATLAB was then used, utilizing non-rigid iterative closest point algorithm, to align all samples in vertex correspondence and generate averages. Surface mapping of each average, along with its variance, allows for quantification of changes between the three pools of samples in 3D space. Results The generated 3D p-maps between T0 and T1 demonstrate that statistically significant changes (p < 0.05 and p < 0.01) are localized in the circummaxillary area (paranasal, lips, and both cheeks). Vector map shows a mean displacement of 1.5 mm in the paranasal area. The right cheek showing a mean displacement magnitude of 2.5 mm while the left cheek has a mean of 2.9 mm. Direction of vectors are latero-anterior with more dominant anterior direction. Conclusions There are significant changes in paranasal, upper lip, and at both cheeks following expansion using MSE with greater magnitude at the cheeks area. Those changes do not relapse after 1 year (p < 0.05).
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Affiliation(s)
- Sara Abedini
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Room 63-082 CHS, 10833 Le Conte Avenue, Box 951668, CA, Los Angeles, 90095-1668, USA
| | - Islam Elkenawy
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Room 63-082 CHS, 10833 Le Conte Avenue, Box 951668, CA, Los Angeles, 90095-1668, USA
| | - Eric Kim
- Department of Computer Science, University of California, Los Angeles, 4732 Boelter Hall, Los Angeles, CA, 90095, USA
| | - Won Moon
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Room 63-082 CHS, 10833 Le Conte Avenue, Box 951668, CA, Los Angeles, 90095-1668, USA.
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Finke H, Koos B, Fischer-Brandies H, Es-Souni M. In vitro biocompatibility of orthodontic miniscrews with human gingival fibroblast and SAOS-2 osteoblast cultures. J Orofac Orthop 2018; 79:328-336. [PMID: 30014178 DOI: 10.1007/s00056-018-0143-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 04/29/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Miniscrews are an important choice for orthodontic anchorage. Yet reports on failures do exist, and attempts have been made to elucidate the causes. Clinical outcomes may be compromised not only by the mechanical implications of miniscrew design and the location of anchorage but also by poor biocompatibility. Hence, this study deals with the surface roughness and elemental composition of miniscrews and how these properties may affect the in vitro biocompatibility of four commercially available miniscrews. METHODS Most of the currently available miniscrews are made of TiAl6V4, an alloy widely considered to be biocompatible. The samples tested in this study included four similarly dimensioned TiAl6V4 products from different manufacturers: tomas® by Dentaurum, OrthoEasy® by Forestadent®, Dual Top™ by Jeil Medical/Promedia, and LOMAS by Mondeal®. The surface properties of these products were characterized by scanning electron microscopy (SEM) and energy-dispersive X‑ray spectroscopy (EDX). Cytotoxicity was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and agar overlay assays according to ISO 10993-5. RESULTS The miniscrew products were found to show variations in surface-finish quality pertaining to topography and chemical composition, with the latter departing slightly from the manufacturers' specifications. MTT assays yielded rates of cell culture viability in excess of 90%, and agar overlay assays did not reveal decoloration beyond the specimen outlines in any of the experimental groups tested. CONCLUSIONS The four miniscrew products exhibited some minor, but statistically significant, differences in microtopography, alloy composition, and biological inertness. Cytotoxicity testing revealed that all four products should be considered non-cytotoxic, thus, ruling out poor biocompatibility as a cause of miniscrew failure.
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Affiliation(s)
- Hannah Finke
- Department of Orthodontics, University of Tübingen, Osianderstr. 2-8, 72076, Tübingen, Germany. .,Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany.
| | - Bernd Koos
- Department of Orthodontics, University of Tübingen, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Helge Fischer-Brandies
- Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Martha Es-Souni
- Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany
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Radwan ES, Montasser MA, Maher A. Influence of geometric design characteristics on primary stability of orthodontic miniscrews. J Orofac Orthop 2018; 79:191-203. [PMID: 29637214 DOI: 10.1007/s00056-018-0131-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 02/07/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Aim of the present study was to investigate the influence of geometric design characteristics on primary stability of orthodontic miniscrews. MATERIALS AND METHODS Forty self-drilling miniscrews with different geometric design characteristics were divided into the following groups (n = 10): group I-Tomas® (Dentaurum, Germany), group II-AbsoAnchor® (Dentos, Korea), group III-HUBIT® miniscrew (HUBIT, Korea), group IV-Creative® (China). The four types were conical miniscrews with 1.6 mm diameter and 6.0 mm length. The miniscrews were manually inserted perpendicular to cow ribs until the full thread length was reached with the help of a 1.3 mm predrilled pilot hole. Each miniscrew was evaluated using scanning electron microscope. Linear and angular measurements were taken using Photoshop CS3 software. Miniscrew stability was measured by the Periotest® and pullout test. RESULTS All linear and angular measurements of the geometric characteristics showed significant differences between the four groups (p ≤ 0.001). Results of the pullout test showed significant differences between the four groups (p ≤ 0.001), while the Periotest® values showed no significant differences (p = 0.122). A multiple linear regression analysis revealed the significant predictors for higher pullout: a larger flank, a higher value for the thread angle, lead angle, and apical face angle (p ≤ 0.001). CONCLUSIONS Orthodontic miniscrews' geometric design characteristics significantly affected the primary stability. Larger pitch width, flank, thread angle, apical face angle, and/or lead angle led to higher primary stability. Smaller a thread shape factor (TSF) also improved primary stability. Varying these characteristics may enhance miniscrew design.
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Affiliation(s)
- Eman Saad Radwan
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mona A Montasser
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Ahmed Maher
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Cozzani M, Fontana M, Maino G, Maino G, Palpacelli L, Caprioglio A. Comparison between direct vs indirect anchorage in two miniscrew-supported distalizing devices. Angle Orthod 2016; 86:399-406. [PMID: 26222412 PMCID: PMC8601749 DOI: 10.2319/040715-231.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/01/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare two distalizing devices supported by palatal miniscrews, the MGBM System (MGBM) and the Distal Screw appliance (DS), in dental Class II patients. MATERIALS AND METHODS Pretreatment (T1) and postdistalization (T2) lateral cephalograms of 53 Class II malocclusion subjects were examined. MGBM consisted of 29 patients (16 males, 13 females) with a mean pretreatment age of 12.3 ± 1.5 years; DS consisted of 24 patients (11 males, 13 females) with a mean pretreatment age of 11.3 ± 1.2 years. The mean distalization time was 6 ± 2 months for MGBM and 9 ± 2 months for DS. Initial and final measurements and treatment changes were compared by means of a Student's t-test. RESULTS Maxillary superimpositions showed that the maxillary first molar distalized an average of 5.5 mm in the MGBM and 3.2 mm in the DS between T1 and T2; distal molar tipping was greater in the MGBM (10.3°) than in the DS (3.0°). First premolar showed a mean mesial movement of 1.4 mm, with a mesial tipping of 4.4° in the MGBM; on the contrary, first premolar showed a distal movement of 2.2 mm, with a distal tipping of 6.2°, in the DS. CONCLUSIONS The MGBM system resulted in greater distal molar movement and less treatment time, resulting in more efficient movement than was associated with the DS; DS showed less molar tipping during distalization.
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Affiliation(s)
- Mauro Cozzani
- Professor of Orthodontics, School of Dental Medicine, University of Cagliari, La Spezia, Italy
| | - Mattia Fontana
- Research Fellow in Orthodontics, University of Insubria, Varese, Italy
| | - Giuliano Maino
- Visiting Professor, Post-Graduate Program in Orthodontics, University of Insubria, Varese, Italy
| | - Giovanna Maino
- Graduate in Orthodontics, Private Practice, Basso del Grappa, Italy
| | | | - Alberto Caprioglio
- Chairman, Post-Graduate Program in Orthodontics, School of Dental Medicine, Department of Surgical and Morphological Science, University of Insubria, Varese, Italy
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Poon YC, Chang HP, Tseng YC, Chou ST, Cheng JH, Liu PH, Pan CY. Palatal bone thickness and associated factors in adult miniscrew placements: A cone-beam computed tomography study. Kaohsiung J Med Sci 2015; 31:265-70. [PMID: 25910562 DOI: 10.1016/j.kjms.2015.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/01/2014] [Accepted: 11/03/2014] [Indexed: 11/18/2022] Open
Abstract
Palatal bone thickness measurements obtained by cone-beam computed tomography (CBCT) in 30 men and 28 women were evaluated for associated factors. Palatal bone thickness was measured at 20 locations unilateral to the midpalatal suture and posterior to the incisive foramen. Tongue position, presence of posterior crossbite, and palatal morphology were recorded. Lateral cephalograms acquired from CBCT data were used to calculate Frankfort-mandibular plane angles (FMA). At almost all sites, bone thickness was greater in males than in females, but the difference was statistically significant at only seven sites. Bone thickness showed no associations with tongue position, palatal morphology, or presence of posterior crossbite. In women, FMA significantly correlated with bone thickness at 12 locations. In conclusion, palatal bone thickness is unassociated with tongue position, posterior crossbite, or palatal morphology. In hyperdivergent women, however, available bone may be smaller than normal in the middle and posterior palatal areas; in such cases, a shorter than normal miniscrew may be needed to avoid penetrating the nasal cavity.
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Affiliation(s)
- Yi-Ching Poon
- Faculty of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hong-Po Chang
- Faculty of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dentistry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- Faculty of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Szu-Ting Chou
- Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jung-Hsuan Cheng
- Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pao-Hsin Liu
- Department of Biomedical Engineering, I-Shou University (Yanchao Campus), Kaohsiung, Taiwan
| | - Chin-Yun Pan
- Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Chang C, Liu SSY, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod 2015; 85:905-10. [PMID: 25603272 DOI: 10.2319/092714.695.1] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the initial failure rate (≤4 months) for extra-alveolar mandibular buccal shelf (MBS) miniscrews placed in movable mucosa (MM) or attached gingiva (AG). MATERIALS AND METHODS A total of 1680 consecutive stainless steel (SS) 2 × 12-mm MBS miniscrews were placed in 840 patients (405 males and 435 females; mean age, 16 ± 5 years). All screws were placed lateral to the alveolar process and buccal to the lower first and second molar roots. The screw heads were at least 5 mm superior to the soft tissue. Loads from 8 oz-14 oz (227 g-397 g, 231-405 cN) were used to retract the mandibular buccal segments for at least 4 months. RESULTS Overall, 121 miniscrews out of 1680 (7.2%) failed: 7.31% were in MM and 6.85% were in AG (statistically insignificant difference). Failures were unilateral in 89 patients and bilateral in 16. Left side (9.29%) failures was significantly greater (P < .001) compared with those on the right (5.12%). Average age for failure patients was 14 ± 3 years. CONCLUSION MBS miniscrews were highly successful (approximately 93%), but there was no significant difference between placement in MM or AG. Failures were more common on the patient's left side and in younger adolescent patients. Having 16 patients with bilateral failures suggests that a small fraction of patients (1.9%) are predisposed to failure with this method.
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Affiliation(s)
- Chris Chang
- a Private Practice, Beethoven Orthodontic Center, Hsinchu City, Taiwan
| | - Sean S Y Liu
- b Assistant Professor, Department of Orthodontics and Orofacial Genetics, Indiana University School of Dentistry, Indianapolis, Ind
| | - W Eugene Roberts
- c Professor Emeritus of Orthodontics and Adjunct Professor of Mechanical Engineering, Indiana University and Purdue University, Indianapolis, Ind
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Yáñez-Vico RM, Iglesias-Linares A, Cadenas de Llano-Pérula M, Solano-Reina A, Solano-Reina E. Management of occlusal canting with miniscrews. Angle Orthod 2013; 84:737-47. [PMID: 24364753 DOI: 10.2319/051313-369.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 14-year-old boy with a skeletal Class II malocclusion and open bite whose chief complaint was a posterior crossbite showed a canted occlusal plane with asymmetric gummy smile and mandibular deviation at clinical examination. The treatment with miniscrews focused on the bilateral intrusion of the maxillary posterior teeth and, after resolving the open bite, a new biomechanical technique involving joined miniscrews was applied for an en masse intrusion of the left side. This treatment strategy achieved optimal occlusion with improvements to the sagittal, vertical, and transverse relationships and achieved a harmonious smile.
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Affiliation(s)
- Rosa Maria Yáñez-Vico
- a Associate Professor of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Seville, Seville, Spain
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