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Abd ElMotaleb MA, El-Beialy AR, El-Sharaby FA, ElDakroury AE, Eid AA. Effectiveness of low frequency vibration on the rate of canine retraction: a randomized controlled clinical trial. Sci Rep 2024; 14:7952. [PMID: 38575623 PMCID: PMC10995157 DOI: 10.1038/s41598-024-58268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
To investigate the effectiveness of AcceleDent Aura vibrating device on the rate of canine retraction. Thirty-two patients requiring extraction of upper first premolars and canine retraction were randomly allocated with a 1:1 ratio into either no-appliance group or the AcceleDent Aura appliance group. Canine retraction was done applying 150gm of retraction force using NiTi coil springs on 16 × 22 stainless steel archwires. The duration of the study was 4 months. Models were collected and digitized directly after extraction of upper first premolars and at monthly intervals during canine retraction for recording the monthly as well as the total distance moved by the canine. Digitized models were superimposed on the initial model and data were statistically analyzed. Anchorage loss, rotation, tipping, torque and root condition were evaluated using cone beam computed tomography imaging. Pain was evaluated by visual analog scale. No patients were dropped-out during this study. There was no statistically significant difference between both groups regarding the total distance travelled by the canine (P = 0.436), as well as the rate of canine retraction per month (P = 0.17). Root condition was the same for the two groups. Regarding the pain level, there was no statistically significant difference between the two groups at day 0 (P = 0.721), after 24 h (P = 0.882), after 72 h (P = 0.378) and after 7 days (P = 0.964). AcceleDent Aura was not able to accelerate orthodontic tooth movement. Pain level couldn't be reduced by vibrational force with an AcceleDent device during orthodontic treatment. Root condition was not affected by the vibrational forces.
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Affiliation(s)
| | - Amr Ragab El-Beialy
- Orthodontic Department, Faculty Dentistry, Cairo University, 11 ElSaraya St. Manial, Cairo, Egypt.
| | - Fouad Aly El-Sharaby
- Orthodontic Department, Faculty Dentistry, Cairo University, 11 ElSaraya St. Manial, Cairo, Egypt
| | - Amr Emad ElDakroury
- Orthodontic Department, Faculty Dentistry, Cairo University, 11 ElSaraya St. Manial, Cairo, Egypt
| | - Ahmed Abdelsalam Eid
- Orthodontic Department, Faculty Dentistry, Cairo University, 11 ElSaraya St. Manial, Cairo, Egypt
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Migliorati M, De Mari A, Annarumma F, Aghazada H, Battista G, Campobasso A, Menini M, Lo Giudice A, Cevidanes LHS, Drago S. Three-dimensional analysis of miniscrew position changes during bone-borne expansion in young and late adolescent patients. Prog Orthod 2023; 24:20. [PMID: 37271798 DOI: 10.1186/s40510-023-00469-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/06/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Maxillary expansion in patients at the end of their growth relies on the possibility to use miniscrew supported expanders to apply expansion forces directly to the midpalatal suture. Although miniscrews provide a stable anchorage unit, several studies have reported that they do not remain in exactly the same position during treatment. The aim of the present study was to analyze miniscrew position changes after the expansion using bone-borne appliances in late adolescent patients. METHODS Nineteen patients (13 females, 6 males), with a mean age of 17.81 (SD = 4.66), were treated with a Bone-Borne Expander Device. The appliance was designed with 4 miniscrews: 2 in the anterior palatal area, at the third rugae level; 2 in the posterior area. A CBCT and an intraoral scan were obtained before treatment (T0), and then, a second CBCT was obtained after the expansion (T1). Data on peri-suture bone thickness were collected at T0, then the CBCTs were superimposed, and changes between mini-screws position on T0 and T1 were evaluated, both by linear and angular displacements. RESULTS Significant longitudinal differences were found in the distance of the head and the tip of miniscrews measured at the occlusal plane, as well as angular changes. Correlations between displacement measurements and peri-suture bone thickness and height measurements were found as well. CONCLUSIONS While acting as bone anchor units, miniscrews do not remain in the same position during bone-borne expansion. The amount of displacement was related to peri-sutural total bone height and cortical thickness, especially in the anterior area of the naso-frontal maxillary complex.
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Affiliation(s)
- Marco Migliorati
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy.
| | - Anna De Mari
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
| | | | - Hussein Aghazada
- Private Practice, Piazzale Ardeatino, 1G, 00154, Rome, RM, Italy
| | | | | | - Maria Menini
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Dental Clinic, Unit of Orthodontics, University of Catania, Catania, Italy
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Harbor, MI, USA
| | - Sara Drago
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
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Fontes J, Martin VZ, Resende M, Colaço B, Gomes PDS, Amarante JM. Effect of Splinting on Orthodontic Mini-Implant Tipping and Bone Histomorphometric Parameters: An In Vivo Animal Model Study. J Funct Biomater 2023; 14:jfb14050239. [PMID: 37233349 DOI: 10.3390/jfb14050239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/22/2023] [Indexed: 05/27/2023] Open
Abstract
This study aimed to address the stability of orthodontic mini-implants submitted to an immediate orthodontic functional load, in splinted or unsplinted conditions, further characterizing the histomorphometric parameters of the neighboring bone tissue, in an in vivo experimental model. Mini-implants (1.4 × 6.0 mm) were placed in the proximal tibia of New Zealand White rabbits and immediately loaded with a 150 g force. Tissue healing was characterized within 8 weeks. Microtomography was used to assess the mini-implants' tipping and bone histomorphometric indexes. Loaded implants were evaluated in splinted and unsplinted conditions, with data being compared to that of unloaded mini-implants with the Kruskal-Wallis nonparametric test, followed by Dunn's multiple comparison tests. The splinting of mini-implants submitted to immediate orthodontic loading significantly reduced the tipping to levels similar to those of unloaded mini-implants. Immediate loading further increased the histomorphometric indexes associated with bone formation at the peri-implant region, in both splinted and unsplinted conditions, with no significant differences between the tension and compression regions. Accordingly, within this experimental setting, splinting was found to lessen tipping and mini-implants' displacement, without affecting the increased bone formation at the peri-implant region, induced by a functional orthodontic load.
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Affiliation(s)
- Joana Fontes
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Victor Zacharias Martin
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal
- LAQV/REQUIMTE-Laboratório Associado para a Química Verde/Rede de Química e Tecnologia, University of Porto, 4100-007 Porto, Portugal
| | - Marta Resende
- Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Bruno Colaço
- LAQV/REQUIMTE-Laboratório Associado para a Química Verde/Rede de Química e Tecnologia, University of Porto, 4100-007 Porto, Portugal
- Department of Zootechnics, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Center for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
| | - Pedro de Sousa Gomes
- BoneLab-Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal
- LAQV/REQUIMTE-Laboratório Associado para a Química Verde/Rede de Química e Tecnologia, University of Porto, 4100-007 Porto, Portugal
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BATISTA ES, FRANCO A, SOARES MQS, NASCIMENTO MDCC, JUNQUEIRA JLC, OENNING AC. Assessment of cone beam computed tomography for determining position and prognosis of interradicular mini-implants. Dental Press J Orthod 2022; 27:e222190. [PMID: 36449961 PMCID: PMC9707856 DOI: 10.1590/2177-6709.27.5.e222190.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/14/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the influence of dynamic visualization of cone beam computed tomography (CBCT) scans on orthodontist's assessment of positioning status and prognosis of interradicular mini-implants (MI). METHODS Three MI positions were virtually simulated in thirty CBCT volumes: (1) MI 1 mm from the lamina dura (LD), (2) MI touching the LD and (3) MI overlapping the LD. Each position was exposed to orthodontists (n = 35) as panoramic reconstruction, sagittal reconstruction and a sequence of axial slices. Each orthodontist evaluated the MI position (relationship with the LD) and scored the prognosis using a four-point scale (the higher the score, the better the prognosis). Kappa, Friedman and Nemenyi statistics were used. RESULTS Statistically significant associations were detected between the prognosis scores and the type of image visualized (p<0.05). The dynamic visualization of the CBCT volume (axial slices) was associated with higher scores for prognosis and more reliable evaluation of MI positioning. Inconsistent outcomes were more frequently associated with panoramic and sagittal reconstructions. CONCLUSION The dynamic visualization of axial slices allowed orthodontists to perform better assessment of MI position and considerably affected prognosis judgment.
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Affiliation(s)
- Eroncy Souto BATISTA
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
| | - Ademir FRANCO
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
| | | | | | | | - Anne Caroline OENNING
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic (Campinas/SP, Brazil)
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Janson G, Rizzo M, Valerio MV, Oyonarte R, Garib D. Stability of first and second premolars extraction space closure. Am J Orthod Dentofacial Orthop 2022; 162:367-373. [DOI: 10.1016/j.ajodo.2021.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 11/15/2022]
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A comparative assessment of the dentoskeletal effects of clear aligners vs miniplate-supported posterior intrusion with fixed appliances in adult patients with anterior open bite. A multicenter, retrospective cohort study. Am J Orthod Dentofacial Orthop 2022; 162:214-228.e4. [PMID: 35339320 DOI: 10.1016/j.ajodo.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to retrospectively evaluate the dentoskeletal effects of clear aligners (Invisalign) vs miniplate-supported posterior intrusion (MSPI) and identify factors associated with posttreatment overbite in adults with anterior open bite. METHODS Twenty-nine patients treated with Invisalign and 24 with MSPI combined with full-fixed orthodontic appliances were included from 5 orthodontic practices. Pretreatment and posttreatment lateral cephalometric measurements were included as outcomes. Comparisons across groups and identification of final overbite predictors were assessed with regression modeling and machine learning techniques. RESULTS MSPI induced significantly greater maxillary molar intrusion (1.5 mm; 95% confidence interval [CI], 0.83-2.17; P <0.001), with subsequent reduction of anterior face height (ANS-Me) (-2.77 mm; 95% CI, -3.64 to -1.91; P <0.001), Mp-SN° (-1.95°; 95% CI, -2.77 to -1.12; P <0.001), and ANB° (-1.69°; 95% CI, -2.44 to -0.94; P <0.001) compared with Invisalign. MSPI resulted in a significantly larger increase in SNB° (0.94°; 95% CI, 0.23-1.65; P = 0.01) and point-Pog projection (2.45 mm; 95% CI, 1.12-3.77; P = 0.001). Compared with MSPI, Invisalign had a significantly greater increase in the distance of maxillary (1.05 mm; 95% CI, 0.38-1.72; P = 0.003) and mandibular (0.9 mm; 95% CI, 0.19-1.60; P = 0.01) incisal edges relative to their apical bases, with borderline greater lingual tipping of only the maxillary incisors (2.82°; 95% CI, -0.44 to 6.09; P = 0.09). Appliance type and initial overbite were significant final overbite predictors across all models. However, this difference was only evident in male patients (males [1.65; 95% CI, 0.99-2.32; P <0.001]; female [-0.04; 95% CI, -0.52 to 0.44; P = 0.87]). CONCLUSIONS Both appliances effectively improve overbite. MSPI applied the correction via molar intrusion and counterclockwise mandibular autorotation, whereas Invisalign via maxillary and mandibular incisor extrusion.
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Zhao J, Du S, Liu Y, Saif BS, Hou Y, Guo YC. Evaluation of the stability of the palatal rugae using the three-dimensional superimposition technique following orthodontic treatment. J Dent 2022; 119:104055. [PMID: 35121138 DOI: 10.1016/j.jdent.2022.104055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To determine the uniqueness and stability of the palatal rugae after orthodontic treatment. METHODS Cast models of untreated subjects (n=50) were obtained twice at intervals of 8-30 months. Cast models of patients who received non-extraction (n=50) and extraction (n=50) orthodontic treatment were obtained before and after treatment at intervals of 11-41 months and 14-49 months, respectively. All 300 cast models were scanned digitally. The palatal rugae were manually extracted and transformed into 3D point clouds using reverse engineering software. An iterative closest point (ICP) registration algorithm based on correntropy was applied, and the minimum point-to-point root mean square (RMS) distances were calculated to analyze the deviation of palatal rugae for scans of the same subject (intrasubject deviation [ISD]) and between different subjects (between-subject deviation [BSD]). Differences in ISD between each group and the deviation between ISD and BSD of all 150 subjects were evaluated. RESULTS Significant differences were found in the 150 ISD and 1225 BSD in each group, as well as the 150 ISD and 11175 BSD across all groups. The mean values of ISD in untreated, non-extraction and extraction group were 0.178, 0.229 and 0.333 mm, respectively. When the first ruga was excluded in the extraction group, the mean ISD decreased to 0.241 mm, which was not significantly different from that in the non-extraction group (p=0.314). CONCLUSIONS Orthodontic treatment can influence the palatal rugae, especially in cases of extraction. Furthermore, variation mainly existed in the first ruga in cases of extraction. However, palatal rugae are still unique and may be used as a supplementary tool for individual identification. CLINICAL SIGNIFICANCE This study indicates that palatal rugae might be applied in the evaluation of orthodontic tooth movement and forensic individual identification. The registration algorithm based on correntropy provides a credible, precise, and convenient method for palatal rugae superimposition.
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Affiliation(s)
- Jiamin Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China
| | - Shaoyi Du
- Institute of Artificial intelligence and robotics, College of Artificial Intelligence, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, Shaanxi, PR China
| | - Yuying Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Institute of Artificial intelligence and robotics, College of Artificial Intelligence, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, Shaanxi, PR China
| | - Badr Sultan Saif
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China
| | - Yuxia Hou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China
| | - Yu-Cheng Guo
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an 710004, Shaanxi, PR China; Institute of Artificial intelligence and robotics, College of Artificial Intelligence, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, Shaanxi, PR China.
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Becker K, Rauch N, Brunello G, Azimi S, Beller M, Hüfner M, Nienkemper M, Schwarz-Herzke B, Drescher D. Bone remodelling patterns around orthodontic mini-implants migrating in bone: an experimental study in rat vertebrae. Eur J Orthod 2021; 43:708-717. [PMID: 34476491 PMCID: PMC8643410 DOI: 10.1093/ejo/cjab065] [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] [Indexed: 11/13/2022]
Abstract
Background Orthodontic implant migration has been clinically observed in presence of continuous loading forces. Recent studies indicate that osteocytes play a crucial role in this phenomenon. Objectives Aim of this study was to investigate local osteocytic gene expression, protein expression, and bone micro-structure in peri-implant regions of pressure and tension. Material and methods The present work reports a complementary analysis to a previous micro-computed tomography study. Two customized mini-implants were placed in one caudal rat vertebra and connected by a nickel–titanium contraction spring generating different forces (i.e. 0, 0.5, 1.0, and 1.5 N). Either at 2 or 8 weeks, the vertebrae were harvested and utilized for 1. osteocytic gene expression using laser capture micro-dissection on frozen sections coupled with qPCR, 2. haematoxylin–eosin staining for qualitative and quantitative analyses, 3. immunofluorescence staining and analysis, and 4. bone-to-implant contact on undecalcified samples. Results At the two time points for all the performed analyses no significant differences were observed with respect to the applied force magnitudes and cell harvesting localization. However, descriptive histological analysis revealed remarkable bone remodelling at 2 weeks of loading. At 8 weeks the implants were osseointegrated and, especially in 1.0 and 1.5 N groups, newly formed bone presented a characteristic load bearing architecture with trabecula oriented in the direction of the loading. Conclusions The present study confirmed that stress-induced bone remodelling is the biological mechanism of orthodontic implant migration. Bone apposition was found at ‘tension’ and ‘pressure’ sites thus limiting implant migration over time.
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Affiliation(s)
- Kathrin Becker
- Department of Orthodontics, University Clinic of Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, University Clinic of Düsseldorf, Germany
| | - Giulia Brunello
- Department of Oral Surgery, University Clinic of Düsseldorf, Germany.,Department of Neurosciences, University of Padua, Italy
| | - Sarah Azimi
- Department of Orthodontics, University Clinic of Düsseldorf, Germany
| | - Mathias Beller
- Institute for Mathematical Modeling of Biological Systems, University of Düsseldorf, Germany.,Systems Biology of Lipid Metabolism, University of Düsseldorf, Germany
| | - Mira Hüfner
- Department of Orthodontics, University Clinic of Düsseldorf, Germany
| | - Manuel Nienkemper
- Department of Orthodontics, University Clinic of Düsseldorf, Germany.,Private Practice, Dusseldorf, Germany
| | | | - Dieter Drescher
- Department of Orthodontics, University Clinic of Düsseldorf, Germany
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Gao J, Nguyen T, Oberoi S, Oh H, Kapila S, Kao RT, Lin GH. The Significance of Utilizing A Corticotomy on Periodontal and Orthodontic Outcomes: A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:biology10080803. [PMID: 34440034 PMCID: PMC8389689 DOI: 10.3390/biology10080803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary The collaboration between periodontics and orthodontics has the potential to allow safer orthodontic tooth movement and improve vulnerable oral conditions especially for patients with very thin bone and soft tissue. By providing this interdisciplinary surgical approach where thin bone and soft tissue are surgically augmented to convert a fragile-thin to a robust-thick tissue phenotype, this permits orthodontic treatment in these previously thin tissue cases to proceed without iatrogenically induced adverse effects. This is an infrequently performed procedure with few clinical recommendations. This review paper provides the rationale and the currently available evidence on the benefits of this novel surgical approach. Abstract Purpose: This systematic review compares the clinical and radiographic outcomes for patients who received only a corticotomy or periodontal accelerated osteogenic orthodontics (PAOO) with those who received a conventional orthodontic treatment. Methods: An electronic search of four databases and a hand search of peer-reviewed journals for relevant articles published in English between January 1980 and June 2021 were performed. Human clinical trials of ≥10 patients treated with a corticotomy or PAOO with radiographic and/or clinical outcomes were included. Meta-analyses were performed to analyze the weighted mean difference (WMD) and confidence interval (CI) for the recorded variables. Results: Twelve articles were included in the quantitative analysis. The meta-analysis revealed a localized corticotomy distal to the canine can significantly increase canine distalization (WMD = 1.15 mm, 95% CI = 0.18–2.12 mm, p = 0.02) compared to a conventional orthodontic treatment. In addition, PAOO also showed a significant gain of buccal bone thickness (WMD = 0.43 mm, 95% CI = 0.09–0.78 mm, p = 0.01) and an improvement of bone density (WMD = 32.86, 95% CI = 11.83–53.89, p = 0.002) compared to the corticotomy group. Conclusion: Based on the findings of the meta-analyses, the localized use of a corticotomy can significantly increase the amount of canine distalization during orthodontic treatment. Additionally, the use of a corticotomy as a part of a PAOO procedure significantly increases the rate of orthodontic tooth movement and it is accompanied by an increased buccal bone thickness and bone density compared to patients undergoing a conventional orthodontic treatment.
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Affiliation(s)
- Jonathan Gao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Trung Nguyen
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Snehlata Oberoi
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Heesoo Oh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94103, USA;
| | - Sunil Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Richard T. Kao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
- Private Practice, San Jose, CA 95125, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
- Correspondence:
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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: 6] [Impact Index Per Article: 2.0] [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: 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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Bowman SJ. Reprint of: Uno, dos, tres: One concept for three angle classes. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Effect of micro-osteoperforations on rate of space closure by mini-implant supported maxillary anterior en-masse retraction: A randomized clinical trial. J Oral Biol Craniofac Res 2021; 11:185-191. [PMID: 33598396 DOI: 10.1016/j.jobcr.2021.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background Micro-osteoperforations is one of the non-invasive surgical techniques used in attempt to accelerate OTM. Conflicting reports on its effectiveness has been reported in the literature. Objectives The objectives of this trial were to investigate the effect of micro-osteoperforations on the rate of space closure and on molar anchorage loss during mini-implant supported maxillary anterior en-masse retraction. Trial design A single center, parallel arm, randomized controlled trial was conducted. Method Sixty, male and female subjects (age range 16-25 years) having Class I bimaxillary protrusion or Class II div 1 malocclusion, who required fixed mechanotherapy with either upper 1st premolar or all four 1st premolar extractions were allocated into two groups using 1:1 allocation ratio. The allocation was done by block randomization method with a block size of 6. In the experimental group, 5 MOPs per side were performed only once just before the en-masse anterior retraction. Mini-screws were placed in order to obtain maximum anchorage. Impressions were taken every month till 4 months and rate of space closure was measured on 3D study models. Results Data of 27 subjects in control (attrition = 3) and 28 subjects in experimental group (attrition = 2) were analyzed at the end of this trial. There was a statistically significant increase in the rate of en-masse retraction for the 1st month(p = 0.001,95%CI, 0.17, 0.37 mm) but there was no statistically significant difference for the subsequent 2nd (p = 0.450,95%CI,0.13,0.43 mm), 3rd(p = 0.204,95%CI,0.23,0.47 mm) and 4th month (p = 0.680,95%CI,0.21,0.41 mm) between experimental and control groups. There was also no difference (p > 0.05) in molar anchorage loss between both groups at all time intervals. Conclusion Micro-osteoperforations (MOPs) did not accelerate the rate of anterior en-masse retraction over a period of 4 months; however, it temporarily increases the rate of retraction only for first month and no affect on molar anchorage. Trial registration The trial was registered at www.ctri.nic.in with CTRI No- CTRI/2019/03/018140).
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Liu Y, Yang ZJ, Zhou J, Xiong P, Wang Q, Yang Y, Hu Y, Hu JT. Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101401. [PMID: 32473793 DOI: 10.1016/j.jebdp.2020.101401] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the clinical effectiveness of mini-implants (MIs) and conventional anchorage appliances used for orthodontic anchorage reinforcement in patients with class I or II malocclusion with bimaxillary protrusion. MATERIALS AND METHODS Literature search was conducted through PubMed, Embase, and Cochrane from inception to July 2018. The following Medical Subject Heading terms were used for the search string: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Standardized mean difference (SMD) and 95% confidence interval (CI) of horizontal and vertical movements of teeth from baseline were used for comparison. RESULTS A total of 12 studies were included in the final analysis. MI group significantly lowered mesial movement of molars compared to conventional anchorage group (SMD = -1.48, 95% CI = -2.25 to -0.72; P = .0002). There was significantly higher retraction of incisors in the MI group than in the conventional group (SMD = -0.47 mm, 95% CI = -0.87 to -0.07; P = .02). No significant difference was seen in vertical movement of molars (SMD = -0.21 mm, 95% CI = -0.87 to 0.45; P = .52) and incisors (SMD = -0.30, 95% CI = -1.18 to 0.58; P = .5). CONCLUSION MIs seem to be more effective than the conventional anchorage devices in terms of minimizing unintended mesial movement of molars with maximum retraction of anterior teeth.
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Affiliation(s)
- Yan Liu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Zhen-Jin Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jing Zhou
- Department of Stomatology, Kunming Yanan Hospital, Kunming City, China.
| | - Ping Xiong
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Quan Wang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yan Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yu Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jiang-Tian Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
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Shyagali TR, Aghera D. Evaluation of stress generation on the cortical bone and the palatal micro-implant complex during the implant-supported en masse retraction in lingual orthodontic technique using the FEM: Original research. J Dent Res Dent Clin Dent Prospects 2019; 13:192-199. [PMID: 31857865 PMCID: PMC6904918 DOI: 10.15171/joddd.2019.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background. This study aimed to evaluate and analyze the distribution of stresses on the palatal micro-implants and the cortical bone at the micro-implant site with optimal orthodontic retraction force in lingual orthodontics. Methods. ANSYS 12.1 software was used to construct the finite element model of the maxillary bone, teeth and the periodontal ligament along with the lingual bracket set-up with wire and the micro-implant. Six- and 8-mm micro-implants were constructed. The final model consisted of 99190 nodes and 324364 elements. A 200-gram of retraction force was applied from the micro-implant to the anterior retraction hook. The micro-implant was embedded between the second premolar and the first molar. Hyper-view software was used to get the results in X-Y-Z dimensions. Results. The maximum von Mises stresses detected were 52.543 MPa for 6-mm micro-implant and 54.489 MPa for 8-mm micro-implant. Maximum stress was at the neck of the micro-implant. The 8-mm implant model showed 6×10-3 mm of lingual displacement. The least displacement of 1×10-3 mm was noticed for both the implant models in the apico-occlusal direction. The maximum von Mises stresses in the cortical bone at the micro-implant site was 18.875 MPa for 6-mm micro-implant and 21.551 MPa for 8-mm micro-implant. Conclusion. Six-mm micro-implant can be the choice for the implant-supported lingual orthodontic retraction as it produced minimal stresses on the cortical bone, and the initial stress displacements produced on the micro-implant were also minimal.
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Wang X, Cao Y, Liu Z, Wang Z, Chu X, Wang L, Hu X, Zhao H, Diao Z, Peng F, Ye H, Cao Z. Alveolar Bone Density Reduction in Rats Caused by Unilateral Nasal Obstruction. Balkan Med J 2019; 36:311-319. [PMID: 31290639 PMCID: PMC6835169 DOI: 10.4274/balkanmedj.galenos.2019.2018.12.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Oral breathing can cause morphological changes in the oral and maxillofacial regions. Aims To investigate whether oral breathing affected structural changes in bone tissues. Study Design Animal experimentation. Methods A total of 48 8-day-old male Sprague−Dawley rats were divided into two groups: a breathing group and a sham (control) group. All Sprague−Dawley rats were killed at 7 weeks after unilateral nostril obstruction modeling. Then, structural changes in bone tissues were detected by micro-computed tomography, and the expression levels of receptor activator of nuclear factor-κB, osteoprotegerin, and receptor activator of nuclear factor-κB ligand in the signal pathway of bone metabolism within the local alveolar bone and serum of rats were detected by reverse transcription-quantitative polymerase chain reaction and Western blotting. Results The results showed that receptor activator of nuclear factor-κB ligand and receptor activator of nuclear factor-κB levels in bone tissues and serum in the oral breathing group were higher than those in the control group [Maxillary alveolar bone: receptor activator of nuclear factor-κB ligand (pRNA=0.009, pprotein=0.008), receptor activator of nuclear factor-κB (pRNA=0.008, pprotein=0.009); Mandibular alveolar bone: receptor activator of nuclear factor-κB ligand (pRNA=0.047, pprotein=0.042), receptor activator of nuclear factor-κB (pRNA=0.041, pprotein=0.007); Serum: receptor activator of nuclear factor-κB ligand (pRNA<0.001, pprotein<0.001), receptor activator of nuclear factor-κB (pRNA<0.001, pprotein<0.001)], along with decreased osteoprotegerin expression (Maxillary alveolar bone: pRNA=0.038, pprotein=0.048; Mandibular alveolar bone: pRNA<0.001, pprotein<0.001; Serum: pRNA=0.009, pprotein=0.006) and elevated receptor activator of nuclear factor-κB ligand/osteoprotegerin. Micro-computed tomography analysis indicated a significant difference in the level of bone volume fraction, as well as trabecular thickness in maxillary alveolar bone between the experimental and control groups (p=0.049, p=0.047). Meanwhile, trabecular thickness, and cortical thickness levels in mandibular alveolar bone also differed significantly between the experimental and control groups (p=0.043, p=0.024). Conclusion Structural changes of the respiratory system affect the alveolar bone structure and unilateral nasal obstruction may lead to a change in regional specific bone density.
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Affiliation(s)
- Xue Wang
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yongge Cao
- Haiyuan College, Kunming Medical University, Kunming, Yunnan, China
| | - Zhenhua Liu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zihan Wang
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoying Chu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lei Wang
- School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xuanxuan Hu
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Han Zhao
- School of the Second Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhanqiu Diao
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fengting Peng
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Ye
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhensheng Cao
- School of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Aboalnaga AA, Salah Fayed MM, El-Ashmawi NA, Soliman SA. Effect of micro-osteoperforation on the rate of canine retraction: a split-mouth randomized controlled trial. Prog Orthod 2019; 20:21. [PMID: 31155698 PMCID: PMC6545296 DOI: 10.1186/s40510-019-0274-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/23/2019] [Indexed: 01/05/2023] Open
Abstract
Background Among the recent modalities introduced to accelerate orthodontic tooth movement (OTM) is micro-osteoperforations (MOPs), in other words, bone puncturing. The aim of this split-mouth trial was to investigate the effects of MOPs on the rate of OTM. Methods Eighteen patients requiring bilateral first premolar extraction and upper canine retraction with maximum anchorage were enrolled in this study. Immediately before canine retraction, three MOPs were randomly allocated to either the right or left sides. MOPs were performed using a mini-screw (1.8 mm diameter, 8 mm length) distal to the canine. Canine retraction continued for 4 months. Data were collected from monthly digital models, in addition to pre- and post-retraction maxillary CBCT images. The primary outcomes were the rate of canine retraction per month and the total distance moved by the canines. The secondary outcomes were the effect of MOPs on anchorage loss, canine root resorption, and pain. Results The mean rate of canine retraction in both sides was 0.99 ± 0.3 mm/month. The total distance moved by the canine cusp tip was greater in the MOP than the control side (mean difference 0.06 ± 0.7 mm), which was statistically insignificant (P > 0.05(. The total distances moved by the canine center and apex were significantly greater in the MOP than the control side (mean difference 0.37 ± 0.63 mm (P < 0.05) and 0.47 ± 0.56 mm (P < 0.01) respectively). Insignificant differences were detected regarding anchorage loss and root resorption between both sides (P > 0.05). Mild to moderate pain was experienced following the MOP procedure, which rapidly faded away within 1 week. Conclusions Micro-osteoperforations were not able to accelerate the rate of canine retraction; however, it seemed to facilitate root movement.
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Affiliation(s)
- Amira A Aboalnaga
- Department of Orthodontics, Faculty of Dentistry, Cairo University, 11 Saraya El-Manial Street, Cairo, Egypt.
| | - Mona M Salah Fayed
- Department of Orthodontics, Faculty of Dentistry, Cairo University, 11 Saraya El-Manial Street, Cairo, Egypt
| | - Noha A El-Ashmawi
- Department of Orthodontics, Faculty of Dentistry, Cairo University, 11 Saraya El-Manial Street, Cairo, Egypt
| | - Sanaa A Soliman
- Department of Orthodontics, Faculty of Dentistry, Cairo University, 11 Saraya El-Manial Street, Cairo, Egypt
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Jang W, Choi YJ, Hwang S, Chung CJ, Kim KH. Anchorage loss assessment of the indirect anchor tooth during adjunctive orthodontic treatment. Am J Orthod Dentofacial Orthop 2019; 155:347-354. [PMID: 30826037 DOI: 10.1016/j.ajodo.2018.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/01/2018] [Accepted: 04/01/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This study quantitatively assessed movement of anchor teeth connected to a miniscrew (indirect anchor tooth) and investigated factors affecting movement during adjunctive orthodontic treatment. METHODS Dental plaster models of 28 patients whose treatment included an indirect anchor tooth on one side were collected before and after treatment. The casts were digitally scanned, and 2 groups were constituted: the indirect anchor teeth (experimental group; n = 52) and the untreated teeth (control group; the first and second premolars opposing the indirect anchor tooth to which no orthodontic force was applied; n = 55). Pretreatment and posttreatment models were superimposed and the amount and direction of indirect anchor tooth movement were evaluated with the use of a univariate linear mixed model. Possible factors affecting movement of the indirect anchor tooth and its significance were also evaluated with the use of a multiple linear mixed model. RESULTS The indirect anchor tooth moved 0.91 ± 0.50 mm and did not exhibit significant differences in the transverse, vertical, or sagittal directions. The location of the indirect anchor tooth affected movement and the tooth moved significantly more in the mandible than in the maxilla. CONCLUSIONS The indirect anchor tooth can move during adjunctive orthodontic treatment and thus requires careful monitoring for occlusal changes.
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Affiliation(s)
- Woowon Jang
- Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Shinchon Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Soonshin Hwang
- Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Dental Hospital, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.
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Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J Orthod 2019; 40:519-530. [PMID: 29315365 DOI: 10.1093/ejo/cjx093] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Miniscrews in orthodontics have been mainly used for anchorage without patient compliance in orthodontic treatment. The literature has reported changing failure rates. Objective The aim of this review was to provide a precise estimation of miniscrew failure rate and the possible risk factors of the mechanically-retained miniscrews. Search method Electronic search in database was undertaken up to July 2017 through the Cochrane Database of Systematic Reviews, MEDLINE, Scopus, and Ovid. Additional searching for on-going and unpublished data, hand search of relevant journals and grey lietraure were also undertaken, authors were contacted, and reference lists screened. Eligibility criteria Randomised controlled trials (RCTs) and prospective cohort studies (PCSs), published in English were obtained, which reported the failure rate of miniscrews, as orthodontic anchorage, with less than 2 mm diameter. Data collection and analysis Blind and induplicate study selection, data extraction, and risk of bias assessment were undertaken in this research. Failure rates and relevant risk factors of miniscrews with the corresponding 95 per cent confidence intervals (CIs) were calculated by using the random-effects model. The heterogeneity across the studies was assessed using the I2 and Chi2 test. The risk of bias was assessed using Cochrane risk of bias and Newcastle-Ottawa Scale. Subgroup and sensitivity analyses were performed in order to test the robustness of the results in meta-analysis. Results The 16 RCTs and 30 PCSs were included in this research. Five studies were not included in the meta-analysis due to a lack of the statistical information needed to compute the effect sizes. About 3250 miniscrews from 41 studies were pooled in a random-effect model. The overall failure rate of miniscrews was 13.5 per cent (95% CI 11.5-15.9). Subgroup analysis showed that miniscrews 'diameter, length and design, patient age, and jaw of insertion had minimal effect on rate of miniscrews failure while the type of the gingivae and smoking had statistically significant effect. Conclusion Miniscrews have an acceptably low failure rate. The findings should be interpreted with caution due to high-level of heterogeneity and unbalanced groups in the included studies. High quality randomized clinical trial with large sample sizes are required to support the findings of this review.
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Affiliation(s)
- Fahad Alharbi
- Department of Orthodontics, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Mohammed Almuzian
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - David Bearn
- Department of Orthodontics, University of Dundee, Scotland, UK
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Becker K, Pliska A, Busch C, Wilmes B, Wolf M, Drescher D. Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis. Int J Implant Dent 2018; 4:35. [PMID: 30357551 PMCID: PMC6200826 DOI: 10.1186/s40729-018-0144-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/27/2018] [Indexed: 11/12/2022] Open
Abstract
Background/aim Retraction of the upper incisors/canines requires maximum anchorage. The aim of the present study was to analyze the efficacy of mini implants in comparison to conventional devices in patients with need for en masse retraction of the front teeth in the upper jaw. Material and methods An electronic search of PubMed, Web of Science, and EMBASE and hand searching were performed. Relevant articles were assessed, and data were extracted for statistical analysis. A random effects model, weighted mean differences (WMD), and 95% confidence intervals (CI) were computed for horizontal and vertical anchorage loss at the first molars in the analyzed patient treatments. Results A total of seven RCTs employing direct anchorage through implants in the alveolar ridge were finally considered for qualitative and quantitative analysis, and further five publications were considered for the qualitative analysis only (three studies: indirect anchorage through implant in the mid-palate, two studies: direct/indirect anchorage in the alveolar ridge). In the control groups, anchorage was achieved through transpalatal arches, headgear, Nance buttons, intrusion arches, and differential moments. WMD [95% CI, p] in anchorage loss between test and control groups amounted to − 2.79 mm [− 3.56 to − 2.03 mm, p < 0.001] in the horizontal and − 1.76 mm [− 2.56 to − 0.97, p < 0.001] favoring skeletal anchorage over control measures. The qualitative analysis revealed that minor anchorage loss can be associated with indirect anchorage, whereas anchorage gain was commonly associated with direct anchorage. Implant failures were comparable for both anchorage modalities (direct 9.9%, indirect 8.6%). Conclusion Within its limitations, the meta-analysis revealed that maximum anchorage en masse retraction can be achieved by orthodontic mini implants and direct anchorage; however, the ideal implant location (palate versus alveolar ridge) and the beneficial effect of direct over indirect anchorage needs to be further evaluated. Electronic supplementary material The online version of this article (10.1186/s40729-018-0144-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany.
| | - Annika Pliska
- Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
| | - Caroline Busch
- Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
| | - Benedict Wilmes
- Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
| | - Michael Wolf
- Department of Orthodontics, Universitätsklinikum RWTH Aachen, Aachen, Germany
| | - Dieter Drescher
- Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
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Mohammed H, Wafaie K, Rizk MZ, Almuzian M, Sosly R, Bearn DR. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis. Prog Orthod 2018; 19:36. [PMID: 30246217 PMCID: PMC6151309 DOI: 10.1186/s40510-018-0225-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/21/2018] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this review was to systematically evaluate the failure rates of miniscrews related to their specific insertion site and explore the insertion site dependent risk factors contributing to their failure. Search methods An electronic search was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Knowledge, Scopus, MEDLINE and PubMed up to October 2017. A comprehensive manual search was also performed. Eligibility criteria Randomised clinical trials and prospective non-randomised studies, reporting a minimum of 20 inserted miniscrews in a specific insertion site and reporting the miniscrews’ failure rate in that insertion site, were included. Data collection and analysis Study selection, data extraction and quality assessment were performed independently by two reviewers. Studies were sub-grouped according to the insertion site, and the failure rates for every individual insertion site were analysed using a random-effects model with corresponding 95% confidence interval. Sensitivity analyses were performed in order to test the robustness of the reported results. Results Overall, 61 studies were included in the quantitative synthesis. Palatal sites had failure rates of 1.3% (95% CI 0.3–6), 4.8% (95% CI 1.6–13.4) and 5.5% (95% CI 2.8–10.7) for the midpalatal, paramedian and parapalatal insertion sites, respectively. The failure rates for the maxillary buccal sites were 9.2% (95% CI 7.4–11.4), 9.7% (95% CI 5.1–17.6) and 16.4% (95% CI 4.9–42.5) for the interradicular miniscrews inserted between maxillary first molars and second premolars and between maxillary canines and lateral incisors, and those inserted in the zygomatic buttress respectively. The failure rates for the mandibular buccal insertion sites were 13.5% (95% CI 7.3–23.6) and 9.9% (95% CI 4.9–19.1) for the interradicular miniscrews inserted between mandibular first molars and second premolars and between mandibular canines and first premolars, respectively. The risk of failure increased when the miniscrews contacted the roots, with a risk ratio of 8.7 (95% CI 5.1–14.7). Conclusions Orthodontic miniscrew implants provide acceptable success rates that vary among the explored insertion sites. Very low to low quality of evidence suggests that miniscrews inserted in midpalatal locations have a failure rate of 1.3% and those inserted in the zygomatic buttress have a failure rate of 16.4%. Moderate quality of evidence indicates that root contact significantly contributes to the failure of interradicular miniscrews placed between the first molars and second premolars. Results should be interpreted with caution due to methodological drawbacks in some of the included studies. Electronic supplementary material The online version of this article (10.1186/s40510-018-0225-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Khaled Wafaie
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mumen Z Rizk
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mohammed Almuzian
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Rami Sosly
- School of Dentistry, University of Dundee, Dundee, UK
| | - David R Bearn
- School of Dentistry, University of Dundee, Dundee, UK
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Oba MK, Marañón-Vásquez GA, Romano FL, Oliveira-Santos C. Additional intraoral radiographs may change the judgment regarding the final position of orthodontic mini-implants. Dental Press J Orthod 2018; 23:54-61. [PMID: 29898158 PMCID: PMC6018447 DOI: 10.1590/2177-6709.23.2.054-061.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 12/13/2017] [Indexed: 11/24/2022] Open
Abstract
Objective: This study aimed to assess if additional vertical bitewing (VBW) and/or occlusal (OC) radiographs may change initial judgment based only on periapical radiograph (PAR) about the final position of orthodontic mini-implants (OMI). Methods: Subjective and objective analyses were performed. Radiographic images of 26 OMI were divided into four groups: PAR, PAR+VBW, PAR+OC and ALL (PAR+VBW+OC). For subjective analysis, five observers were asked to assess if the position of OMI was favorable to its success, using questionnaires with a four-point scale for responses: 1= definitely not favorable, 2= probably not favorable, 3= probably favorable, or 4= definitely favorable. Each group containing sets of images was presented to them in four different viewing sessions. Objective evaluation compared horizontal distances between OMI tip and the root nearest to the device in PAR and VBW. Results: Most of observers (3 out of 5) changed their initial judgment based on PAR about OMI position when additional radiographs were analyzed. Differences between groups (i.e. PAR vs. PAR+VBW; PAR vs. PAR+OC; and, PARvs.ALL) were statistically significant for these observers. For those that changed their judgment about OMI position, confidence level could significantly increase, decrease or even be maintained, not indicating a pattern. There was no agreement for distances between OMI tip and the root nearest to the device in PAR and VBW. Conclusion: Considering the limitations of the study, it is concluded that additional radiographic images may change the judgement about OMI final position without necessarily increasing the degree of certainty of such judgment.
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Affiliation(s)
- Marina K Oba
- Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Residência em Atenção Multiprofissional ao Câncer (Ribeirão Preto/SP, Brazil)
| | - Guido A Marañón-Vásquez
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ortodontia (Ribeirão Preto/SP, Brazil)
| | - Fábio L Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ortodontia (Ribeirão Preto/SP, Brazil)
| | - Christiano Oliveira-Santos
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Radiologia (Ribeirão Preto/SP, Brazil)
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Monga N, Kharbanda OP, Samrit V. Quantitative and qualitative assessment of anchorage loss during en-masse retraction with indirectly loaded miniscrews in patients with bimaxillary protrusion. Am J Orthod Dentofacial Orthop 2016; 150:274-82. [PMID: 27476360 DOI: 10.1016/j.ajodo.2016.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study provides vital insight in assessing anchorage loss when miniscrews are indirectly loaded. METHODS The study sample comprised 18 patients with bimaxillary protrusion (14 girls, 4 boys; mean age, 17.3 ± 4.6 years) selected from a database of 89 patients treated with miniscrews. All subjects who were selected required extraction of all first premolars and maximum anchorage. After initial leveling and aligning, miniscrews were placed between the first molar and the second premolar in all 4 quadrants and loaded by the indirect method at 3 weeks after placement with 200-g nickel-titanium alloy closed-coil springs for en-masse retraction. Mean treatment duration was 29.7 ± 6.8 months. Pretreatment and posttreatment lateral cephalograms were analyzed to measure the amount of anchorage loss, incisor retraction, and the incisors' angular change in reference to the pterygoid vertical reference line and were evaluated by the structural superimposition method. RESULTS The ratio of incisor retraction to molar protraction was 4.2 in the maxilla and 4.7 in the mandible. The first molars showed mean extrusion of 0.20 mm in the maxilla and 0.57 mm in the mandible; these were statistically insignificant. The mean angular change of the first molars was -2.43° in the maxilla and -0.03° in the mandible. The mean anchorage loss in reference to the pterygoid vertical was 1.3 mm in the maxilla and 1.1 mm in the mandible; these were statistically significant. Structural superimpositions showed mean change in molar position of 0.83 mm in the maxilla and 0.87 mm in the mandible, and 5.77 mm in the maxillary incisor and 5.43 mm in the mandibular incisor. These results were compared with the direct anchorage method reported in the literature. CONCLUSIONS Indirect miniscrew anchorage can be a viable alternative to direct anchorage.
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Affiliation(s)
- Nitika Monga
- Senior resident, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Om Prakash Kharbanda
- Chief, Centre for Dental Education and Research; professor and head, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Vilas Samrit
- Assistant professor, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Lee MY, Park JH, Kim SC, Kang KH, Cho JH, Cho JW, Chang NY, Chae JM. Bone density effects on the success rate of orthodontic microimplants evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2016; 149:217-24. [PMID: 26827978 DOI: 10.1016/j.ajodo.2015.07.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/01/2015] [Accepted: 07/01/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the effect of bone densities on the success rate of orthodontic microimplants with cone-beam computed tomography images. METHODS We examined 127 orthodontic microimplants implanted into the maxillary buccal alveolar bone of 71 patients (53 female, 18 male; mean age, 19.2 years) with malocclusion. The cortical, cancellous, and total bone densities were measured with Simplant Pro 2011 software (version 13; Materialise, Leuven, Belgium), and the correlations between these measurements and the orthodontic microimplant success rates were evaluated with cone-beam computed tomography. RESULTS The overall success rate was 85.0% (108 of 127). Sex, age, and side of placement were not significant factors for success in the results (P >0.05). The density of the cortical bone increased apically (3, 5, and 7 mm) from the alveolar crest, but in the cancellous bone it decreased. Whereas the orthodontic microimplant success rates significantly increased as cancellous bone density and total bone density increased (P <0.01), cortical bone density did not have a significant effect on the success rate (P >0.05). CONCLUSIONS The success rate of orthodontic microimplants significantly increased with higher cancellous and total bone densities, whereas cortical bone density did not have a significant effect.
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Affiliation(s)
- Mi-Young Lee
- Graduate student, Department of Orthodontics, School of Dentistry, Wonkwang University, Iksan, Korea
| | - Jae Hyun Park
- Professor and chair, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz; adjunct professor, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Sang-Cheol Kim
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Kyung-Hwa Kang
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jin-Hyoung Cho
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jin-Woo Cho
- Clinical associate professor, Department of Orthodontics, School of Dentistry, Wonkwang University, Daejeon Dental Hospital, Daejeon, Korea
| | - Na-Young Chang
- Assistant professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
| | - Jong-Moon Chae
- Professor, Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea; visiting scholar, Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A. T. Still University, Mesa, Ariz; instructor, The Charles H. Tweed International Foundation, Tucson, Ariz.
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Meursinge Reynders R, Ladu L, Ronchi L, Di Girolamo N, de Lange J, Roberts N, Plüddemann A. Insertion torque recordings for the diagnosis of contact between orthodontic mini-implants and dental roots: a systematic review. Syst Rev 2016; 5:50. [PMID: 27036120 PMCID: PMC4818448 DOI: 10.1186/s13643-016-0227-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 03/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most orthodontic mini-implants (OMIs) are inserted between dental roots. The prevalence of contacting these structures is high. Such contacts can cause permanent root damage and implant instability. Increased torque levels during implant insertion (the index test) could be a more accurate and immediate measure for diagnosing implant-root contact (the target condition) than radiographs (the reference standard) and could ultimately lead to a reduction or elimination of X-ray exposure. To address this issue, we asked three questions: (1) whether OMIs with root contact had higher insertion torque values than those without, (2) what is the accuracy of the index test compared with the reference standard to diagnose the target condition and what are the adverse effects of the index test, and (3) whether intermediate torque values have clinical diagnostic utility. METHODS Methods were conducted according to our published protocol, which was based on the PRISMA-P 2015 statement. We applied broad spectrum eligibility criteria that included randomized and non-randomized studies on clinical, animal, and cadaver models. Not including such models would be unethical because it could slow down knowledge creation on the adverse effects of implant insertion. We conducted searches in more than 40 electronic databases including MEDLINE and 10 journals were hand-searched. Grey literature and reference lists were also searched. All research procedures were conducted independently by three reviewers. Authors of selected studies were contacted to obtain additional information. Outcomes on the three different research models were analysed separately. Systematic error was assessed with the Cochrane 'Risk of bias tool' for non-randomized studies. RESULTS One clinical, two animal, and two cadaver studies fulfilled the eligibility criteria of the first research question. All studies and subgroups demonstrated higher insertion torque values for OMIs with the target condition than those without. Mean differences (MD) between these effect estimates were statistically significant in one beagle model (MD, 4.64; 95 % CI, 3.50 to 5.79) and three subgroups of cadaver studies (MD, 2.70; 95 % CI, 1.42 to 3.98) (MD, 3.97; 95 % CI, 2.17 to 5.78) (MD, 0.93; 95 % CI, 0.67 to 1.20). Highest mean differences were identified in most self-drilling compared with pre-drilling groups. Clinical heterogeneity between studies was high, and many items were underreported. All studies except one cadaver study scored at least one domain as 'serious risk' of bias. No studies addressed the second research question. One cadaver study addressed the third question which showed the importance of recording torque levels during the entire implant insertion process. Responses of contacted authors were helpful, but often difficult to obtain. Implants fractured in one animal and in one cadaver model. CONCLUSIONS All eligible studies scored higher insertion torque values for implants with root contact than those without, but none of these studies assessed the diagnostic accuracy of the index test. The inclusion of non-randomized and animal and cadaver models in this systematic review provided key findings that otherwise would have been wasted. Such studies are important in the context of the wide applicability of this test, the high prevalence of the target condition, and the underreporting of adverse effects of interventions. A protocol for a potential new diagnostic pathway was presented, and the importance of contacting authors was addressed. The applicability of the findings should be interpreted in the context of underreporting and the many limitations of the included studies.
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Affiliation(s)
- Reint Meursinge Reynders
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,, Via Matteo Bandello 15, 20123, Milan, Italy.
| | - Luisa Ladu
- , Via Matteo Bandello 15, 20123, Milan, Italy
| | | | - Nicola Di Girolamo
- Department of Veterinary Sciences, University of Bologna, Via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, BO, Italy
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Center and Academisch Centrum Tandheelkunde Amsterdam (ACTA), University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Cairns Library Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Annette Plüddemann
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, 2nd floor, Jericho, Oxford, OX2 6NW, UK
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Finite Element Analysis of Bone Stress for Miniscrew Implant Proximal to Root Under Occlusal Force and Implant Loading. J Craniofac Surg 2015. [PMID: 26207429 DOI: 10.1097/scs.0000000000001969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Because of the narrow interradicular spaces and varying oral anatomies of individual patients, there is a very high risk of root proximity during the mini implants inserting. The authors hypothesized that normal occlusal loading and implant loading affected the stability of miniscrew implants placed in proximity or contact with the adjacent root. The authors implemented finite element analysis (FEA) to examine the effectiveness of root proximity and root contact. Stress distribution in the bone was assessed at different degrees of root proximity by generating 4 finite element models: the implant touches the root surface, the implant was embedded in the periodontal membrane, the implant touches the periodontal surface, and the implant touches nothing. Finite element analysis was then carried out with simulations of 2 loading conditions for each model: condition A, involving only tooth loading and condition B, involving both tooth and implant loading. Under loading condition A, the maximum stress on the bone for the implant touching the root was the distinctly higher than that for the other models. For loading condition B, peak stress areas for the implant touching the root were the area around the neck of the mini implant and the point of the mini implant touches the root. The results of this study suggest that normal occlusal loading and implant loading contribute to the instability of the mini implant when the mini implant touches the root.
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Huja SS. Bone anchors--can you hitch up your wagon? Orthod Craniofac Res 2015; 18 Suppl 1:109-16. [PMID: 25865539 DOI: 10.1111/ocr.12082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2015] [Indexed: 11/28/2022]
Abstract
The purpose of this review was to address and understand the current status of mini-screw implants (MSI) that are used in orthodontics. Understanding the biologic adaptation of MSI to its adjacent bone is one of the critical factors to their success. The review explores factors that are associated with failure of MSI, with special focus on an understanding of osseointegration as it relates to MSI. The rationale and importance of measuring bone contact and dynamic bone remodeling in animal studies are outlined. The utility of microcomputed tomography (μCT) as a substitute for conventional histomorphometry is debated. Finally, alveolar physiology and rigidity of implants are explored to understand potential reasons for the high failure rate of MSI when compared to endosseous implants.
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Affiliation(s)
- S S Huja
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY, USA
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Meursinge Reynders R, Ladu L, Ronchi L, Di Girolamo N, de Lange J, Roberts N, Plüddemann A. Insertion torque recordings for the diagnosis of contact between orthodontic mini-implants and dental roots: protocol for a systematic review. Syst Rev 2015; 4:39. [PMID: 25875916 PMCID: PMC4407834 DOI: 10.1186/s13643-015-0014-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/23/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Hitting a dental root during the insertion of orthodontic mini-implants (OMIs) is a common adverse effect of this intervention. This condition can permanently damage these structures and can cause implant instability. Increased torque levels (index test) recorded during the insertion of OMIs may provide a more accurate and immediate diagnosis of implant-root contact (target condition) than radiographic imaging (reference standard). An accurate index test could reduce or eliminate X-ray exposure. These issues, the common use of OMIs, the high prevalence of the target condition, and because most OMIs are placed between roots warrant a systematic review. We will assess 1) the diagnostic accuracy and the adverse effects of the index test, 2) whether OMIs with root contact have higher insertion torque values than those without, and 3) whether intermediate torque values have clinical diagnostic utility. METHODS The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 statement was used as a the guideline for reporting this protocol. Inserting implants deliberately into dental roots of human participants would not be approved by ethical review boards and adverse effects of interventions are generally underreported. We will therefore apply broad spectrum eligibility criteria, which will include clinical, animal and cadaver models. Not including these models could slow down knowledge translation. Both randomized and non-randomized research studies will be included. Comparisons of interest and subgroups are pre-specified. We will conduct searches in MEDLINE and more than 40 other electronic databases. We will search the grey literature and reference lists and hand-search ten journals. All methodological procedures will be conducted by three reviewers. Study selection, data extraction and analyses, and protocols for contacting authors and resolving conflicts between reviewers are described. Designed specific risk of bias tools will be tailored to the research question. Different research models will be analysed separately. Parameters for exploring statistical heterogeneity and conducting meta-analyses are pre-specified. The quality of evidence for outcomes will be assessed through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION The findings of this systematic review will be useful for patients, clinicians, researchers, guideline developers, policymakers, and surgical companies.
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Affiliation(s)
- Reint Meursinge Reynders
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105, AZ Amsterdam, The Netherlands.
| | - Luisa Ladu
- Private practice of orthodontics, Via Matteo Bandello 15, 20123, Milan, Italy.
| | - Laura Ronchi
- Private practice of orthodontics, Via Matteo Bandello 15, 20123, Milan, Italy.
| | - Nicola Di Girolamo
- Department of Veterinary Sciences, University of Bologna, Via Tolara di Sopra 50, Ozzano dell'Emilia (BO), 40064, Italy.
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Center and Academisch Centrum Tandheelkunde Amsterdam (ACTA), University of Amsterdam, Meibergdreef 9, Amsterdam, AZ 1105, The Netherlands.
| | - Nia Roberts
- Bodleian Health Care libraries, University of Oxford, Cairns Library Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
| | - Annette Plüddemann
- Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, New Radcliffe House, 2nd floor, Jericho, Oxford, OX2 6NW, UK.
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Chen G, Chen S, Zhang XY, Jiang RP, Liu Y, Shi FH, Xu TM. A new method to evaluate the positional stability of a self-drilling miniscrew. Orthod Craniofac Res 2015; 18:125-33. [PMID: 25704236 DOI: 10.1111/ocr.12065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the positional stability of miniscrews during orthodontic treatment change in cone-beam computed tomography (CBCT). SETTING AND SAMPLE POPULATION Twenty adult volunteers were enrolled. METHODS In all participants, at least two maxillary first premolars were extracted because of protrusion. Each volunteer received six miniscrews in the maxilla, including two loaded miniscrews to retract anterior teeth and four unloaded miniscrews. CBCT scans were obtained at the beginning of space closure (T1) and approximately 11.8 months later (T2). Three-dimensional miniscrew models were constructed at T1 and T2, and the central axes were calculated using a principal component analysis (PCA) technique. Finally, we measured and compared the angle change of all the miniscrews from T1 to T2. RESULTS The angle change values of the unloaded and loaded miniscrews were 1.64 ± 1.25° and 1.67 ± 1.15°, respectively. No significant differences in the angle change were observed. CONCLUSION Cone-beam computed tomography images revealed both the unloaded and loaded miniscrews to be positionally stable during en-masse retraction in this study.
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Affiliation(s)
- G Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - S Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - X Y Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - R P Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Y Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - F H Shi
- Key Lab of Machine Perception, MOE, Peking University, Beijing, China
| | - T M Xu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
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Falkensammer F, Rausch-Fan X, Arnhart C, Krall C, Schaden W, Freudenthaler J. Impact of extracorporeal shock-wave therapy on the stability of temporary anchorage devices in adults: A single-center, randomized, placebo-controlled clinical trial. Am J Orthod Dentofacial Orthop 2014; 146:413-22. [PMID: 25263143 DOI: 10.1016/j.ajodo.2014.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 06/01/2014] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Falkensammer
- Postdoctoral research fellow, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
| | - Xiaohui Rausch-Fan
- Professor, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christoph Arnhart
- Postdoctoral research fellow, Department of Oral Surgery, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christoph Krall
- Senior staff, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Schaden
- Senior staff, Allgemeine Unfallversicherungsanstalt (AUVA) Trauma Center Meidling, Vienna, Austria
| | - Josef Freudenthaler
- Professor, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Systematic review of mini-implant displacement under orthodontic loading. Int J Oral Sci 2013; 6:1-6. [PMID: 24357855 PMCID: PMC3967307 DOI: 10.1038/ijos.2013.92] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 10/22/2013] [Indexed: 11/17/2022] Open
Abstract
A growing number of studies have reported that mini-implants do not remain in exactly the same position during treatment, although they remain stable. The aim of this review was to collect data regarding primary displacement immediately straight after loading and secondary displacement over time. A systematic review was performed to investigate primary and secondary displacement. The amount and type of displacement were recorded. A total of 27 studies were included. Sixteen in vitro studies or studies using finite element analysis addressed primary displacement, and nine clinical studies and two animal studies addressed secondary displacement. Significant primary displacement was detected (6.4–24.4 µm) for relevant orthodontic forces (0.5–2.5 N). The mean secondary displacement ranged from 0 to 2.7 mm for entire mini-implants. The maximum values for each clinical study ranged from 1.0 to 4.1 mm for the head, 1.0 to 1.5 for the body and 1.0 to 1.92 mm for the tail part. The most frequent type of movement was controlled tipping or bodily movement. Primary displacement did not reach a clinically significant level. However, clinicians can expect relevant secondary displacement in the direction of force. Consequently, decentralized insertion within the inter-radicular space, away from force direction, might be favourable. More evidence is needed to provide quantitative recommendations.
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Papadopoulos MA, Papageorgiou SN. Current evidence on clinical performance of miniscrew implants in orthodontic treatment. Semin Orthod 2013. [DOI: 10.1053/j.sodo.2013.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Enhos S, Veli I, Cakmak O, Ucar FI, Alkan A, Uysal T. OPG and RANKL levels around miniscrew implants during orthodontic tooth movement. Am J Orthod Dentofacial Orthop 2013; 144:203-9. [PMID: 23910201 DOI: 10.1016/j.ajodo.2013.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to determine the peri-miniscrew implant crevicular fluid receptor activator of nuclear factor-кB ligand (RANKL) and osteoprotegerin (OPG) levels around loaded and unloaded miniscrew implants at different time intervals. METHODS Twenty loaded and 16 unloaded miniscrew implants were included in this study. All miniscrew implants were placed bilaterally between the maxillary second premolars and first molars as anchorage units for canine distalization. Peri-miniscrew implant crevicular fluid was taken from the mesiobuccal aspects of the loaded and unloaded miniscrew implants before loading; at 24, 48, and 168 hours; and on day 30 after force application. Enzyme-linked immunosorbent assay kits were used to determine RANKL and OPG levels in the peri-miniscrew implant crevicular fluid samples. Wilcoxon, Mann-Whitney U, and Spearman correlation tests were used for statistical evaluations at the P <0.05 level. RESULTS Although the total amount of OPG was not different between the groups, the total amount of RANKL was significantly elevated in the loaded miniscrew implant group (P <0.05) at all time periods. Peri-miniscrew implant crevicular fluid volume was the highest at 48 hours in the loaded group. Also, the OPG/RANKL ratio in the peri-miniscrew implant crevicular fluid was significantly decreased in the loaded miniscrew implant group. CONCLUSIONS The OPG and RANKL levels vary around loaded and unloaded miniscrew implants as a result of force application.
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Affiliation(s)
- Sukru Enhos
- Department of Periodontology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Placement angle effects on the success rate of orthodontic microimplants and other factors with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2013; 143:173-81. [DOI: 10.1016/j.ajodo.2012.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 09/01/2012] [Accepted: 09/01/2012] [Indexed: 11/19/2022]
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Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop 2012; 142:577-595.e7. [PMID: 23116500 DOI: 10.1016/j.ajodo.2012.05.016] [Citation(s) in RCA: 197] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 05/01/2012] [Accepted: 05/01/2012] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Risk factors concerning orthodontic miniscrew implants have not been adequately assessed. In this systematic review, we summarize the knowledge from published clinical trials regarding the failure rates of miniscrew implants used for orthodontic anchorage purposes and identify the factors that possibly affect them. METHODS Nineteen electronic databases and reference lists of included studies were searched up to February 2011, with no restrictions. Only randomized controlled trials, prospective controlled trials, and prospective cohort studies were included. Study selection and data extraction were performed twice. Failure event rates, relative risks, and the corresponding 95% confidence intervals were calculated. The random-effects model was used to assess each factor's impact. Subgroup and meta-regression analyses were also implemented. RESULTS Fifty-two studies were included for the overall miniscrew implant failure rate and 30 studies for the investigation of risk factors. From the 4987 miniscrew implants used in 2281 patients, the overall failure rate was 13.5% (95% confidence interval, 11.5-15.8). Failures of miniscrew implants were not associated with patient sex or age and miniscrew implant insertion side, whereas they were significantly associated with jaw of insertion. Certain trends were identified through exploratory analysis; however, because of the small number of original studies, no definite conclusions could be drawn. CONCLUSIONS Orthodontic miniscrew implants have a modest small mean failure rate, indicating their usefulness in clinical practice. Although many factors seem to affect their failure rates, the majority of them still need additional evidence to support any possible associations.
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Ortega AJ“AJ, Campbell PM, Hinton R, Naidu A, Buschang PH. Local application of zoledronate for maximum anchorage during space closure. Am J Orthod Dentofacial Orthop 2012. [DOI: 10.1016/j.ajodo.2012.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Feng X, Li J, Li Y, Zhao Z, Zhao S, Wang J. Effectiveness of TAD-anchored maxillary protraction in late mixed dentition. Angle Orthod 2012; 82:1107-14. [PMID: 22458766 DOI: 10.2319/111411-705.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Xiaoxia Feng
- PhD student, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Jianhua Li
- PhD student, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Yu Li
- Instructor, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Zhihe Zhao
- Professor and Chair, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Sen Zhao
- PhD student, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
| | - Jue Wang
- PhD student, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Stomatological Hospital, Sichuan University, Sichuan, PR China
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Bone anchor systems for orthodontic application: a systematic review. Int J Oral Maxillofac Surg 2012; 41:1427-38. [DOI: 10.1016/j.ijom.2012.05.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 03/12/2012] [Accepted: 05/14/2012] [Indexed: 11/21/2022]
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Effect of force on alveolar bone surrounding miniscrew implants: a 3-dimensional microcomputed tomography study. Am J Orthod Dentofacial Orthop 2012; 142:32-44. [PMID: 22748988 DOI: 10.1016/j.ajodo.2012.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 01/01/2012] [Accepted: 01/01/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The primary aim of this study was to better understand how bone adapts to forces applied to miniscrew implants. A secondary aim was to determine whether the direction of force applied to miniscrew implants has an effect on bone surrounding the miniscrew implants. METHODS A randomized split-mouth design, applied to 6 skeletally mature male foxhound dogs, was used to compare miniscrew implants loaded for 9 weeks with 200 or 600 g to unloaded control miniscrew implants. By using microcomputed tomography, with an isotropic resolution of 6 μm, bone volume fractions (bone volume/total volume) were calculated for bone around the entire miniscrew implant surface. Bone volume fractions were calculated for bone 6 to 24, 24 to 42, and 42 to 60 μm from the miniscrew implant surface. For each loaded miniscrew implant, the bone volume fraction was also calculated for 2 compression and 2 noncompression zones. RESULTS The 6 to 24-μm layer showed a significantly lower (P <0.05) bone volume fraction than did the 24 to 42-μm and the 42 to 60-μm layers, which were not significantly different. The bone volume fractions of cortical bone surrounding the apical aspects of the unloaded miniscrew implants were significantly greater (P <0.05) than the bone volume fractions of cortical bone surrounding the loaded miniscrew implants. In contrast, the bone volume fractions of noncortical bone surrounding loaded miniscrew implants were significantly greater (P <0.05) than the bone volume fractions of bone surrounding the unloaded miniscrew implants. Miniscrew implants loaded with 200 g showed significantly greater (P <0.05) amounts of noncortical bone volume fractions than did miniscrew implants loaded with 600 g. With both 200 and 600 g, zones under compression had significantly greater bone volume fractions than did the noncompression zones. CONCLUSIONS The application of force, the amount of force applied, and the direction of force all have significant effects on the amounts of bone produced around miniscrew implants.
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Alves M, Baratieri C, Mattos CT, Araujo MTDS, Maia LC. Root repair after contact with mini-implants: systematic review of the literature. Eur J Orthod 2012; 35:491-9. [DOI: 10.1093/ejo/cjs025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Singh S, Mogra S, Shetty VS, Shetty S, Philip P. Three-dimensional finite element analysis of strength, stability, and stress distribution in orthodontic anchorage: A conical, self-drilling miniscrew implant system. Am J Orthod Dentofacial Orthop 2012; 141:327-336. [DOI: 10.1016/j.ajodo.2011.07.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Revised: 07/01/2011] [Accepted: 07/01/2011] [Indexed: 11/30/2022]
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El-Beialy AR, Fayed MS, El-Bialy AM, Mostafa YA. Accuracy and reliability of cone-beam computed tomography measurements: Influence of head orientation. Am J Orthod Dentofacial Orthop 2011; 140:157-65. [PMID: 21803252 DOI: 10.1016/j.ajodo.2010.03.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 03/01/2010] [Accepted: 03/01/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this research is to determine the accuracy and reliability of measurements obtained from 3-dimensional (3D) cone-beam computed tomography (CBCT) for different head orientations. METHODS Stainless steel wires were fixed to a dry skull at different places. The skull was scanned by using CBCT in the centered and 5 other positions. Intraobserver and interobserver reliability tests were performed by using 6 landmarks identified on the virtual 3D skulls by 2 operators. Two methods were used to determine the accuracy of measurements on the virtual 3D skull scanned in different positions. In the first method, 12 linear distances were compared on the physical skull and the 3D virtual skull in the centered and the other scanning positions. In the second method, registration of each of the 5 positions on the centered position was done separately, and coordinates of 11 landmarks were identified in each position and compared with the centered position. Data gathered from the 2 methods were compared statistically. RESULTS Concordance correlation and Pearson correlation coefficients values were almost 0.9999 in all the comparisons denoting: (1) high intraobserver and interobserver reliability; (2) very high concordance between the physical skull and the CBCT centered-position measurements; (3) very high concordance between measurements of the centered position in relation to those obtained from the different skull positions; and (4) registration of the skulls in the different positions showed high concordance, with the highest values between the centered and off-centered positions, and the lowest with the complex position. CONCLUSIONS Accuracy and reliability of CBCT measurements are not affected by changing the skull orientation. Thus, the upper-lip and chin rests should not be considered absolute requirements during CBCT imaging if a stable head position is ensured.
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Affiliation(s)
- Amr Ragab El-Beialy
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Chen G, Chen S, Zhang XY, Jiang RP, Liu Y, Shi FH, Xu TM. Stable region for maxillary dental cast superimposition in adults, studied with the aid of stable miniscrews. Orthod Craniofac Res 2011; 14:70-9. [PMID: 21457456 DOI: 10.1111/j.1601-6343.2011.01510.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify a stable and reproducible reference region to superimpose serial maxillary dental models in adult extraction cases. SETTING AND SAMPLE POPULATION Fifteen adult volunteers were enrolled. METHODS To reduce protrusion, bilateral maxillary first premolars were extracted in all volunteers. Each volunteer received six miniscrews, including two loaded miniscrews used to retract anterior teeth and four unloaded miniscrews. Impressions for maxillary models were taken at T1 (1 week after miniscrew placement) and T2 (17 months later). Dental models were created and then scanned using a laser scanner. Stability of the miniscrews was evaluated, and dental models were registered using stationary miniscrews. The palatal region, where deviation was within 0.5 mm in all subjects, was determined to be the stable region. Reproducibility of the new palatal region for 3D digital model superimposition was evaluated. RESULTS Deviation of the medial 2/3 of the palatal region between the third rugae and the line in contact with the distal surface of the bilateral maxillary first molars was within 0.5 mm. Tooth movement of 15 subjects was measured to evaluate the validity of the new 3D superimposition method. Displacements were 8.18 ± 2.94 mm (central incisor) and 2.25 ± 0.73 mm (first molar) measured by miniscrew superimposition, while values of 7.81 ± 2.53 mm (central incisor) and 2.29 ± 1.03 mm (first molar) were measured using the 3D palatal vault regional superimposition method; no significant difference was observed. CONCLUSION The medial 2/3 of the third rugae and the regional palatal vault dorsal to it is a stable region to register 3D digital models for evaluation of orthodontic tooth movement in adult patients.
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Affiliation(s)
- G Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
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Alves M, Baratieri C, Nojima LI. Assessment of mini-implant displacement using cone beam computed tomography. Clin Oral Implants Res 2011; 22:1151-1156. [DOI: 10.1111/j.1600-0501.2010.02092.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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