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Pietzka S, Fink J, Winter K, Wilde F, Schramm A, Ebeling M, Kasper R, Sakkas A. Dental Root Injuries Caused by Osteosynthesis Screws in Orthognathic Surgery-Comparison of Conventional Osteosynthesis and Osteosynthesis by CAD/CAM Drill Guides and Patient-Specific Implants. J Pers Med 2023; 13:jpm13050706. [PMID: 37240877 DOI: 10.3390/jpm13050706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND/AIM The primary aim was to evaluate the prevalence and localisation of dental injuries caused by osteosynthesis screws during orthognathic surgery, comparing two different CAD/CAM planning/surgical approaches through retrospective evaluation of post-operative computed tomography. MATERIAL AND METHODS This study considered all patients who underwent orthognathic surgery from 2010-2019. The examination for dental root injuries between conventional osteosynthesis (Maxilla conventional cohort) and osteosynthesis with patient-specific implant (Maxilla PSI cohort) was performed by evaluating the post-operative CT scans. RESULTS A total of 126 patients were included in the study. Among the 61 patients of the Maxilla conventional cohort, 10 dental root injuries in 8 patients (13.1%) were detected in the post-operative CT scan, representing 1.5% (n = 10/651) of the osteosynthesis screws inserted in proximity of the alveolar crest. No dental injury occurred following osteosynthesis in the 65 patients of the Maxillary PSI cohort (n = 0/773 screws) (p < 0.001). During a mean follow-up period of 13 months after primary surgery, none of the injured teeth showed evidence of periapical alterations and no endodontic treatments were necessary. CONCLUSIONS Maxillary positioning using CAD/CAM-fabricated drill/osteotomy guide and osteosynthesis with PSI can significantly reduce the risk for dental injury compared to the conventional procedure. However, the clinical significance of the detected dental injuries was rather minor.
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Affiliation(s)
- Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Juliana Fink
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
| | - Karsten Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, 04109 Leipzig, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Marcel Ebeling
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Robin Kasper
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
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Inchingolo AM, Malcangi G, Costa S, Fatone MC, Avantario P, Campanelli M, Piras F, Patano A, Ferrara I, Di Pede C, Netti A, de Ruvo E, Palmieri G, Settanni V, Carpentiere V, Tartaglia GM, Bordea IR, Lorusso F, Sauro S, Di Venere D, Inchingolo F, Inchingolo AD, Dipalma G. Tooth Complications after Orthodontic Miniscrews Insertion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1562. [PMID: 36674316 PMCID: PMC9867269 DOI: 10.3390/ijerph20021562] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 05/13/2023]
Abstract
Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords "orthodontic mini-screw" and "dental damage", resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin-pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.
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Affiliation(s)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Stefania Costa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Pasquale Avantario
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Merigrazia Campanelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Netti
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Elisabetta de Ruvo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Salvatore Sauro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, University CEU Cardenal Herrera, CEU Universities, C/Santiago Ramón y Cajal, s/n., Alfara del Patriarca, 46115 Valencia, Spain
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Baumgartner D, Schramel JP, Kau S, Unger E, Oberoi G, Peham C, Eberspächer-Schweda M. 3D printed plates based on generative design biomechanically outperform manual digital fitting and conventional systems printed in photopolymers in bridging mandibular bone defects of critical size in dogs. Front Vet Sci 2023; 10:1165689. [PMID: 37065217 PMCID: PMC10098091 DOI: 10.3389/fvets.2023.1165689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Conventional plate osteosynthesis of critical-sized bone defects in canine mandibles can fail to restore former functionality and stability due to adaption limits. Three-dimensional (3D) printed patient-specific implants are becoming increasingly popular as these can be customized to avoid critical structures, achieve perfect alignment to individual bone contours, and may provide better stability. Using a 3D surface model for the mandible, four plate designs were created and evaluated for their properties to stabilize a defined 30 mm critical-size bone defect. Design-1 was manually designed, and further shape optimized using Autodesk ® Fusion 360 (ADF360) and finite element analysis (FE) to generate Design-2. Design-4 was created with the generative design (GD) function from ADF360 using preplaced screw terminals and loading conditions as boundaries. A 12-hole reconstruction titanium locking plate (LP) (2.4/3.0 mm) was also tested, which was scanned, converted to a STL file and 3D printed (Design-3). Each design was 3D printed from a photopolymer resin (VPW) and a photopolymer resin in combination with a thermoplastic elastomer (VPWT) and loaded in cantilever bending using a customized servo-hydraulic mechanical testing system; n = 5 repetitions each. No material defects pre- or post-failure testing were found in the printed mandibles and screws. Plate fractures were most often observed in similar locations, depending on the design. Design-4 has 2.8-3.6 times ultimate strength compared to other plates, even though only 40% more volume was used. Maximum load capacities did not differ significantly from those of the other three designs. All plate types, except D3, were 35% stronger when made of VPW, compared to VPWT. VPWT D3 plates were only 6% stronger. Generative design is faster and easier to handle than optimizing manually designed plates using FE to create customized implants with maximum load-bearing capacity and minimum material requirements. Although guidelines for selecting appropriate outcomes and subsequent refinements to the optimized design are still needed, this may represent a straightforward approach to implementing additive manufacturing in individualized surgical care. The aim of this work is to analyze different design techniques, which can later be used for the development of implants made of biocompatible materials.
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Affiliation(s)
- Doris Baumgartner
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
- *Correspondence: Doris Baumgartner
| | - Johannes Peter Schramel
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Silvio Kau
- Department of Pathobiology, Institute of Morphology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Christian Peham
- Movement Science Group, University Equine Hospital, Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Matthias Eberspächer-Schweda
- Small Animals Surgery Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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Revisiting the Complications of Orthodontic Miniscrew. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8720412. [PMID: 35958810 PMCID: PMC9359838 DOI: 10.1155/2022/8720412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Miniscrew has been used widely as an effective orthodontic anchorage with reliable stationary quality, ease of insertion and removal techniques, immediate or early loading, flexibility in site insertion, less trauma, minimal patient cooperation, and lower price. Nonetheless, it is not free of complications, and they could impact not only the miniscrew success rate but also patients’ oral health. In this article, literature was searched and reviewed electronically as well as manually to evaluate the complications of orthodontic miniscrew. The selected articles are analyzed and subcategorized into complications during and after insertion, under loading, and during and after removal along with treatment if needed according to the time. In addition, the noteworthy associated factors such as the insertion and removal procedures, characteristics of both regional and local anatomic structures, and features of the miniscrew itself that play a significant role in the performance of miniscrews are also discussed based on literature evidence. Clinicians should notice these complications and their related factors to make a proper treatment plan with better outcomes.
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Deglow ER, O Connor Esteban M, Zubizarreta-Macho Á, Hernández Montero S, Tzironi G, Abella Sans F, Albaladejo Martínez A. Novel digital technique to analyze the accuracy and intraoperative complications of orthodontic self-tapping and self-drilling microscrews placement techniques: An in vitro study. Am J Orthod Dentofacial Orthop 2022; 162:201-207. [PMID: 35337702 DOI: 10.1016/j.ajodo.2021.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The objectives of this study were to analyze and compare the accuracy and intraoperative complications of orthodontic self-tapping and orthodontic self-drilling microscrew placement techniques. METHODS A total of 60 orthodontic microscrews were randomly distributed into 2 study groups: (1) group A, orthodontic self-drilling microscrew placement technique (n = 30); and (2) group B, orthodontic self-tapping microscrew placement technique (n = 30). Cone-beam computed tomography and intraoral scans were performed before and after the orthodontic microscrew placement techniques and uploaded in 3-dimensional implant planning software to analyze the deviation angle and the horizontal deviation measured at the coronal entry point and apical endpoint between orthodontic microscrews planned and performed, using the Student t test. In addition, intraoperative complications, such as root perforations after the orthodontic microscrews placement and the fracture of the orthodontic self-tapping microscrews during their placement, were also analyzed. RESULTS The paired t test revealed statistically significant differences at the apical endpoint (P <0.001) between planned and performed orthodontic self-tapping and self-drilling microscrew placement techniques. However, the paired t test revealed no statistically significant differences at the coronal entry point (P = 0.1047) and angular deviations (P = 0.3251) between planned and performed orthodontic self-tapping and self-drilling microscrews placement techniques. Furthermore, 4 root perforations were observed at the orthodontic self-tapping microscrews placement technique, and 1 orthodontic self-tapping microscrew was fractured during the placement procedure. CONCLUSIONS The results show that the orthodontic self-drilling microscrew technique increases the accuracy of orthodontic microscrews placement, resulting in fewer intraoperative complications.
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Affiliation(s)
- Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain
| | - Miriam O Connor Esteban
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain; Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Salamanca, Spain.
| | - Sofĺa Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain
| | - Georgia Tzironi
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, Salamanca, Spain
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
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Long term clinical result of implant induced injury on the adjacent tooth. Sci Rep 2021; 11:7913. [PMID: 33846470 PMCID: PMC8041840 DOI: 10.1038/s41598-021-87062-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/23/2021] [Indexed: 11/08/2022] Open
Abstract
The purpose of the retrospective study was to investigate the long-term result of implant-induced injury on the adjacent tooth. The subjects of this retrospective study were patients who had received implants and had tooth injury; direct invasion of root (group I), root surface contact (group II), or < 1 mm distance of the implant from the root (group III). Clinical and pathological changes were periodically examined using radiographs and intra-oral examinations. Paired t-tests and chi-square tests were used to evaluate the implant stability quotient (ISQ) of implant and tooth complications, respectively (α = 0.05). A total of 32 implants and teeth in 28 patients were observed for average 122.7 (± 31.7, minimum 86) months. Seven teeth, three of which were subsequently extracted, needed root canal treatment. Finally, 90.6% of the injured teeth remained functional. Complications were significant and varied according to the group, with group I showing higher events than the others. The ISQs increased significantly. One implant in group I resulted in osseointegration failure. The implant survival rate was 96.9%. In conclusion, it was found even when a tooth is injured by an implant, immediate extraction is unnecessary, and the osseointegration of the invading implant is also predictable.
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Geshay D, Campbell P, Tadlock L, Schneiderman E, Kyung HM, Buschang P. Stability of immediately loaded 3 mm long miniscrew implants: a feasibility study. Dental Press J Orthod 2021; 26:e2119155. [PMID: 33759962 PMCID: PMC8018754 DOI: 10.1590/2177-6709.26.1.e2119155.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/21/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.
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Affiliation(s)
| | - Phillip Campbell
- Texas A&M University, College of Dentistry, Department of Orthodontics (Dallas/TX, USA)
| | - Larry Tadlock
- Texas A&M University, College of Dentistry, Department of Orthodontics (Dallas/TX, USA)
| | - Emet Schneiderman
- Texas A&M University, College of Dentistry, Department of Biomedical Sciences (Dallas/TX, USA)
| | - Hee-Moon Kyung
- Kyungpook National University, Department of Orthodontics (Daegu, Korea)
| | - Peter Buschang
- Texas A&M University, College of Dentistry, Department of Orthodontics (Dallas/TX, USA)
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Burgaz İ, Zengin M, Uckan S. Radiographic assessment of the response of teeth following trauma during screw placement for maxillo-mandibular fixation. Dent Traumatol 2021; 37:474-478. [PMID: 33501703 DOI: 10.1111/edt.12654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND/AIM Maxillo-mandibular fixation (MMF) screws have gained popularity in recent years for inter-maxillary fixation. MMF screw application involves the risk of dental injury. However, knowledge about the healing responses after root damage in humans is limited, thereby warranting the need to classify the radiographic assessment of healing to enable better prediction of the healing response and effective management of the potential complications. The aim of this study was to assess and classify the radiographic assessment of the responses after root damage to evaluate the long-term outcomes. MATERIAL AND METHODS The dental records of patients who underwent orthognathic surgery or trauma management during 2014-2016 at an Oral and Maxillofacial Surgery Department were retrospectively analyzed. The data regarding dental injuries resulting from MMF screw application were evaluated. In total, 16 patients with 34 roots damaged from MMF screw application were enrolled. Post-operative orthopantomographs were analyzed by visual inspection of the affected areas to clarify the extent of root healing. The inter- and intra-rater reliability assessments were subsequently performed. RESULTS The results indicated substantial inter- and intra-rater reliability of the responses. Most cases of root damage that were not radiographically related to the pulp (Schulte-Geers Class III defects) had complete or partial healing responses. In addition, 20% of the defects related to the pulp had additional resorption of the bone/dental tissues during the follow-up period. CONCLUSIONS Three different radiographic responses of root damage following MMF screw trauma were identified. Understanding these different responses is important to guide the management of the potential complications. This proposed radiographic assessment can be used to present root healing data in a more standardized and reliable manner.
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Affiliation(s)
- İlker Burgaz
- Department of Oral and Maxillofacial Surgery, Medipol University, İstanbul, Turkey
| | - Mustafa Zengin
- Department of Oral and Maxillofacial Surgery, Medipol University, İstanbul, Turkey
| | - Sina Uckan
- Department of Oral and Maxillofacial Surgery, Medipol University, İstanbul, Turkey
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Cornelis MA, Tepedino M, Cattaneo PM, Nyssen-Behets C. Root repair after damage due to screw insertion for orthodontic miniplate placement. J Clin Exp Dent 2019; 11:e1133-e1138. [PMID: 31824593 PMCID: PMC6894909 DOI: 10.4317/jced.56472] [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: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 11/05/2022] Open
Abstract
Background The aim of this investigation was to describe the healing reactions following root damage caused by placement of a miniplate anchorage system. Material and Methods In 4 beagle dogs, 4 titanium miniplates (2 self-tapping screws per miniplate) were placed in each maxilla, after drilling of pilot-holes. Six fixation screws were unintentionally inserted damaging the root of maxillary canines. Two weeks later, half of the miniplates were loaded with a coil spring. Two dogs were euthanized 7 weeks after placement of the miniplates, while the remaining two after 29 weeks. Histological sections were prepared, microradiographed, observed under U.V. light, then stained and analysed under ordinary light. Results Four screws caused direct root damage; one was damaged during the drilling process; one caused damage to the periodontal ligament only. Among these 6 screws, 2 were mobile and 4 were stable at sacrifice. Limited root damage showed some repair after 29 weeks, consisting in a thick layer of mineralized cementum including anchoring periodontal fibres. Tissue repair was not related to screw stability or loading status. Conclusions Limited root damage has shown potential to heal, while extensive root damage has not. Precise position of insertion of the miniplates is thus of utmost importance. Key words:Temporary anchorage devices, animal studies, root resorption.
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Affiliation(s)
- Marie A Cornelis
- Associate Professor,Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Faculty of HEALTH, Vennelyst Boulevard 9, 8000 Aarhus, Denmark
| | - Michele Tepedino
- Associate lecturer, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 2, 67100 L'Aquila, Italy
| | - Paolo M Cattaneo
- Associate Professor, Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Faculty of HEALTH, Vennelyst Boulevard 9, 8000 Aarhus, Denmark
| | - Catherine Nyssen-Behets
- Professor, Pôle de Morphologie, Institut de Recherche expérimentale et clinique, Université catholique de Louvain, Avenue Mounier 52 bte B1.52.04, 1200 Brussels, Belgium
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Oh HJ, Cha JY, Yu HS, Hwang CJ. Histomorphometric evaluation of the bone surrounding orthodontic miniscrews according to their adjacent root proximity. Korean J Orthod 2018; 48:283-291. [PMID: 30206527 PMCID: PMC6123080 DOI: 10.4041/kjod.2018.48.5.283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/01/2018] [Accepted: 02/07/2018] [Indexed: 11/14/2022] Open
Abstract
Objective This study was conducted to perform histomorphometric evaluations of the bone surrounding orthodontic miniscrews according to their proximity to the adjacent tooth roots in the posterior mandible of beagle dogs. Methods Four male beagle dogs were used for this study. Six orthodontic miniscrews were placed in the interradicular spaces in the posterior mandible of each dog (n = 24). The implanted miniscrews were classified into no loading, immediate loading, and delayed loading groups according to the loading time. At 6 weeks after screw placement, the animals were sacrificed, and tissue blocks including the miniscrews were harvested for histological examinations. After analysis of the histological sections, the miniscrews were categorized into three additional groups according to the root proximity: high root proximity, low root proximity, and safe distance groups. Differences in the bone–implant contact (BIC, %) among the root proximity groups and loading time groups were determined using statistical analyses. Results No BIC was observed within the bundle bone invaded by the miniscrew threads. Narrowing of the periodontal ligament space was observed in cases where the miniscrew threads touched the bundle bone. BIC (%) was significantly lower in the high root proximity group than in the low root proximity and safe distance groups. However, BIC (%) showed no significant differences among the loading time groups. Conclusions Regardless of the loading time, the stability of an orthodontic miniscrew is decreased if it is in contact with the bundle bone as well as the adjacent tooth root.
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Affiliation(s)
| | - Jung-Yul Cha
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Villela HM, Vedovello Filho M, Valdrighi HC, Santamaria-Jr M, Menezes CCD, Vedovello SAS. Evaluation of miniscrew angulation in the posterior maxilla using cone-beam computed tomographic image. Dental Press J Orthod 2018; 23:46-55. [PMID: 29791691 PMCID: PMC5962247 DOI: 10.1590/2177-6709.23.1.046-053.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 10/01/2017] [Indexed: 11/29/2022] Open
Abstract
Objective: This study aimed at evaluating whether changes in the insertion angle is a determining factor in the positioning of the miniscrews body in a region with larger interradicular space in the posterior maxilla. Methods: Analysis of 60 posterior maxillary quadrants were made using images obtained by means of cone-beam computed tomographic image (CBCT), with 0.076-mm voxel, which presented a real miniscrew inserted in the mesial region of the maxillary first molars, serving as reference point for the placement of the virtual miniscrews. Measurements of the distances between roots were made in three points on the body of the virtual miniscrews (A, B and C), at four different angulations, 70o, 60o, 50o and 40o (T1 to T4), in relation to the long axis of the second premolar. This evaluation was made in four groups, selected in accordance with the disposition of the roots of the second premolars and first molars: Group 1 (all types of roots), Group 2 (convergent roots), Group 3 (divergent roots) and Group 4 (parallel roots). Results: There were no statistically significant differences in the measurements of points A, B and C, at the different angles (70o, 60o, 50o and 40o) and in the different groups (p > 0.05). Conclusions: Changes in the insertion angle is not a determinant factor in the positioning of miniscrews body in regions with larger interradicular space in posterior maxilla.
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Affiliation(s)
- Henrique M Villela
- Programa de Pós-graduação em Ortodontia, Fundação Hermínio Ometto, Uniararas, Araras, SP, Brazil
| | - Mario Vedovello Filho
- Programa de Pós-graduação em Ortodontia, Fundação Hermínio Ometto, Uniararas, Araras, SP, Brazil
| | - Heloísa C Valdrighi
- Programa de Pós-graduação em Ortodontia, Fundação Hermínio Ometto, Uniararas, Araras, SP, Brazil
| | - Milton Santamaria-Jr
- Programa de Pós-graduação em Ortodontia, Fundação Hermínio Ometto, Uniararas, Araras, SP, Brazil
| | | | - Silvia A S Vedovello
- Programa de Pós-graduação em Ortodontia, Fundação Hermínio Ometto, Uniararas, Araras, SP, Brazil
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12
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Greiner CL, Verstraete FJM, Stover SM, Garcia TC, Leale D, Arzi B. Biomechanical evaluation of two plating configurations for fixation of a simple transverse caudal mandibular fracture model in cats. Am J Vet Res 2017; 78:702-711. [PMID: 28541156 DOI: 10.2460/ajvr.78.6.702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate biomechanical properties of intact feline mandibles, compared with those for mandibles with an experimentally created osteotomy that was stabilized with 1 of 2 internal fixation configurations. SAMPLE 20 mandibles from 10 adult feline cadavers. PROCEDURES An incomplete block study design was used to assign the mandibles of each cadaver to 2 of 3 groups (locking plate with locking screws [locking construct], locking plate with nonlocking screws [nonlocking construct], or intact). Within each cadaver, mandibles were randomly assigned to the assigned treatments. For mandibles assigned to the locking and nonlocking constructs, a simple transverse osteotomy was created caudal to the mandibular first molar tooth after plate application. All mandibles were loaded in cantilever bending in a single-load-to-failure test while simultaneously recording load and actuator displacement. Mode of failure (bone or plate failure) was recorded, and radiographic evidence of tooth root and mandibular canal damage was evaluated. Mechanical properties were compared among the 3 groups. RESULTS Stiffness, bending moments, and most post-yield energies for mandibles with the locking and nonlocking constructs were significantly lower than those for intact mandibles. Peak bending moment and stiffness for mandibles with the locking construct were significantly greater than those for mandibles with the nonlocking construct. Mode of failure and frequency of screw damage to tooth roots and the mandibular canal did not differ between the locking and nonlocking constructs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that both fixation constructs were mechanically inferior to intact mandibles. The locking construct was mechanically stronger than the nonlocking construct.
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Tadinada A, Marczak A, Yadav S. Diagnostic efficacy of a modified low-dose acquisition protocol for the preoperative evaluation of mini-implant sites. Imaging Sci Dent 2017; 47:141-147. [PMID: 28989896 PMCID: PMC5620458 DOI: 10.5624/isd.2017.47.3.141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 12/01/2022] Open
Abstract
Purpose The objective of this study was to compare the outcomes of surgical mini-implant placement when potential mini-implant sites were scanned using a lower-dose 180° acquisition protocol versus a conventional 360° acquisition protocol. Materials and Methods Ten dentate human skulls were used to provide sites for potential mini-implant placement. The sites were randomly divided into 2 groups: 360° and 180° cone-beam computed tomography (CBCT) acquisition protocols. A small-volume 180° CBCT scan and a 360° CBCT scan of each site were acquired using a Morita Accuitomo-170 CBCT machine and then a mini-implant was placed. A follow-up 360° CBCT scan was done as a gold standard to evaluate the location of the mini-implant and root perforation. Two raters evaluated the scans. Results Ninety-eight percent of the mini-implants placed did not perforate any root structure. Two percent of the sites had an appearance suggestive of perforation. On a Likert scale, both raters agreed that their subjective evaluation of the diagnostic quality of the protocols, ability to make and read measurements of the sites, and preferences for the specified diagnostic task were comparable. The Cohen kappa showed high inter-rater and intra-rater agreement. Conclusion In this ex vivo study, we found that the 180° rotational acquisition was as effective as the conventional 360° rotational acquisition for the preoperative evaluation of potential mini-implant sites.
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Affiliation(s)
- Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Alana Marczak
- School of Dental Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Facial improvement after mandibular midline distraction and surgically assisted rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2017; 152:523-542. [PMID: 28962738 DOI: 10.1016/j.ajodo.2016.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/22/2022]
Abstract
This case report describes the retreatment of a 49-year-old woman with severe crowding in the mandibular incisor region and tapered maxillary and mandibular arches. Treatment consisted of mandibular midline distraction and surgically assisted rapid maxillary expansion to increase arch length. The need for proper presurgical orthodontics is described, and the complications during treatment are discussed. The results of treatment, including the superimposition of 3-dimensional facial scans, are presented. The treatment approach we used is typically indicated for patients with previous extractions of all first premolars who develop significant crowding after treatment. Surgical planning in 3 dimensions and the use of a 3-dimensional designed surgical osteotomy guiding wafer should improve the predictability of this treatment approach.
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Healing of root and surrounding periodontium after root damage with miniscrew implants: a histomorphologic study in dogs. Clin Oral Investig 2017; 22:1103-1111. [PMID: 28861710 DOI: 10.1007/s00784-017-2194-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 08/21/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The main purpose of this study was to investigate the detailed healing process of the roots and surrounding periodontium [cementum, periodontal ligament (PDL), and bone] at different time points after intentional root damage with miniscrew implants (MSIs). MATERIALS AND METHODS After cone-beam computed tomography examination and measurement, a total of 78 premolar and molar roots from five beagle dogs were intentionally damaged by implanting miniscrews in the interradicular region. MSIs were immediately removed, and the histological morphology was observed at days 0 and 3 and at weeks 1, 2, 3, 4, 6, 8, and 12 after root injury using haematoxylin and eosin and fluorescence stainings (fluorescence staining was performed at days 28 and 56). RESULTS An early new attachment of PDL adhering on to the damaged root surface was found at week 2 after root injury. Tissue differentiation of newly formed bone tissue, PDL, and cementum began at week 3. Moreover, the newly formed cementum and bone were constantly forming and mineralising at weeks 4, 6, 8, and 12, and the width of PDL gradually narrowed until close to the normal width at week 12. CONCLUSIONS This study demonstrated the complete healing process of the roots and surrounding periodontium after root damage with MSIs in dogs when the damage was limited to the cementum or dentin. CLINICAL RELEVANCE The findings of this study may help provide a better understanding of the detailed healing process in roots and PDLs damaged by MSIs.
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Ghanbarzadeh M, Heravi F, Abrishamchi R, Shafaee H, Ghazi N, Heravi P, Ghanbarzadeh H. Cementum and dentin repair following root damage caused by the insertion of self-tapping and self-drilling miniscrews. J Orthod Sci 2017; 6:91-96. [PMID: 28717633 PMCID: PMC5508409 DOI: 10.4103/jos.jos_150_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: The aim of this study was to evaluate the histological responses of cementum, root dentin, and pulp following intentional root injuries caused via self-tapping and self-drilling miniscrews. MATERIALS AND METHODS: Fourteen patients (with a mean age of 15.7 years and age range of 14–18 years) who were scheduled for the extraction of all four first premolars as part of their orthodontic treatment plan participated in this study. The roots of the right and the left quadrants' first premolars were designedly injured using self-tapping miniscrews and self-drilling miniscrews, respectively. Teeth were extracted eight weeks after the injury. Cementum repair was assessed through histological examinations. RESULTS: In this study, 40 teeth (75.4%) showed reparative cementum formation and 13 teeth (24.5%) showed no repair. There was no significant difference between the two groups regarding the formation of reparative cementum (P = 0.3). In all examined teeth, the inflammatory response of the pulp to the cold test was within the normal range. CONCLUSION: This study showed that in most cases, the healing of cementum was observed eight weeks after the injury and the two methods of miniscrew insertion showed no significant difference when it comes to the healing process.
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Affiliation(s)
- Majid Ghanbarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzin Heravi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hooman Shafaee
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Ghazi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Safe zones for miniscrews in maxillary dentition distalization assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2017; 151:500-506. [DOI: 10.1016/j.ajodo.2016.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/21/2022]
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18
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Yang B, Zou Q, Lin L, Li L, Zuo Y, Li Y. Synthesis and characterization of fluorescein-grafted polyurethane for potential application in biomedical tracing. J Biomater Appl 2016; 31:901-910. [PMID: 27932701 DOI: 10.1177/0885328216681893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Redesigned multifunctional biopolymers represent a novel building bridge for interdisciplinary collaborations in biomaterials development. We prepared fluorescein-grafted polyurethane scaffolds (PU-C1, PU-C5, and PU-B1) to meet both clinical needs and biological safety evaluations, using different contents of calcein and different synthesis procedures for potential biomedical tracing. X-ray diffraction, infrared, X-ray photoelectron spectroscopy, nuclear magnetic resonance, scanning electron microscopy, and light microscopy were used to analyze the composition and structure of polyurethanes, as well as to observe their morphology with and without biomarkers. Fluorescence spectrophotometer and fluorescence microscopy were used to detect the fluorescence characteristics. The results showed that the grafting of calcein significantly affected the chemical structure and fluorescence sensitivities of copolymers. When compared to calcein, which was added before synthesis (PU-C1), the marker that was added during the extender process (PU-B1) presented higher fluorescence efficiency. Both PU-C5 and PU-B1 exhibited strong fluorescent response and good cytocompatibility in vitro and in vivo, with no interference from the autofluorescence of tissues after 4 weeks of implantation. The fluorescence-marked material can be used to continuously and noninvasively monitor the dynamic changes in polymers, which provides a way to clearly trace the material or to distinguish between the material and tissue in vivo.
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Affiliation(s)
- Boyuan Yang
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
| | - Qin Zou
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
| | - Lili Lin
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
| | - Limei Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
| | - Yi Zuo
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
| | - Yubao Li
- Research Center for Nano Biomaterials, Analytical & Testing Center, Sichuan University, China
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Camargo I, Van Sickels J, Laureano Filho J, Cunningham L. Root contact with maxillomandibular fixation screws in orthognathic surgery: incidence and consequences. Int J Oral Maxillofac Surg 2016; 45:980-4. [DOI: 10.1016/j.ijom.2016.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 12/05/2015] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
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Are assessments of damping capacity and placement torque useful in estimating root proximity of orthodontic anchor screws? Am J Orthod Dentofacial Orthop 2016; 150:124-9. [PMID: 27364214 DOI: 10.1016/j.ajodo.2015.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 12/01/2015] [Accepted: 12/01/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Placement torque and damping capacity may increase when the orthodontic anchor screws make contact with an adjacent root. If this is the case, root contact can be inferred from the placement torque and damping capacity. The purpose of this study was to verify the detectability of root proximity of the screws by placement torque and damping capacity. For this purpose, we investigated the relationship among placement torque, damping capacity, and screw-root proximity. METHODS The placement torque, damping capacity, and root proximity of 202 screws (diameter, 1.6 mm; length, 8.0 mm) were evaluated in 110 patients (31 male, 79 female; mean age, 21.3 ± 6.9 years). Placement torque was measured using a digital torque tester, damping capacity was measured with a Periotest device (Medizintechnik Gulden, Modautal, Germany), and root contact was judged using cone-beam computed tomography images. RESULTS The rate of root contact was 18.3%. Placement torque and damping capacity were 7.8 N·cm and 3.8, respectively. The placement torque of screws with root contact was greater than that of screws with no root contact (P <0.05; effect size, 0.44; power, <0.8). Damping capacity of screws with root contact was significantly greater than that of screws with no root contact (P <0.01; effect size, >0.5; power, >0.95). CONCLUSIONS It was suggested that the damping capacity is related to root contact.
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21
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Lee JY, Kim PS, Choi C, Kim KB. Root repair and regeneration after miniscrew root damage. J World Fed Orthod 2016. [DOI: 10.1016/j.ejwf.2016.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Arzi B, Stover SM, Garcia TC, Leale DM, Verstraete FJM. Biomechanical evaluation of two plating configurations for critical-sized defects of the mandible in dogs. Am J Vet Res 2016; 77:445-51. [DOI: 10.2460/ajvr.77.5.445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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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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Mer G, Brezulier D, Sorel O. [Bone-based anchorage failure]. Orthod Fr 2016; 87:67-76. [PMID: 27083224 DOI: 10.1051/orthodfr/2015038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this article is to list the circumstances likely to give rise to failure of orthodontic temporary bone-supported anchorage and, hence, to attempt to define criteria for correct miniscrew usage. Our study was based on a review of the literature and analyses of clinical cases. Our findings show that, with a sound knowledge of the indications for screw selection and positioning and of the insertion protocols combined with a clear understanding of orthodontic mechanics, bone-based anchorage can henceforth provide orthodontists with an essential tool to enable formerly unachievable dental movements and to stabilize unwanted movements, thus making treatment both more reliable and more effective.
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Affiliation(s)
- Grégoria Mer
- 1828 avenue Roger Salengro, 92370 Chaville, France
| | - Damien Brezulier
- UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 Place Pasteur, 35000 Rennes, France
| | - Olivier Sorel
- UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 Place Pasteur, 35000 Rennes, France
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Abstract
This study aimed to investigate a causal relationship between the stability of orthodontic anchor screws (screws) and the degree of their proximity to the root (root proximity) using mobility test device (Periotest) and cone-beam computed tomography (CBCT). In total, 165 (diameter 1.6 mm; length 8 mm) screws in 58 patients (average age, 24.4 ± 8.5 years) were evaluated. After screw placement, CBCT was used for diagnostic imaging of the area around the site. Root proximity was evaluated and categorized into three groups: A, no contact; B, single contact; and C, multi-contact. The Periotest value was used to assess screw stability. The screw failure rate according to root proximity significantly differed between categories A and C. In addition, failure rate significantly differed between mandibular screws with and without root contact. Periotest values in categories A and C were significantly higher in the mandible than in the maxilla. Mandibular screws had greater mobility than maxillar screws, even when the screw avoided root contact. The lower stability of mandibular screws with root contact might be related to their greater mobility.
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Affiliation(s)
- Toru Shigeeda
- Department of Orthodontics, Nihon University School of Dentistry
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Bins A, Baart JA, Forouzanfar T, van Loon JJWA. A Comparison of Torque Forces Used to Apply Intermaxillary Fixation Screws. J Oral Maxillofac Surg 2015; 73:2367-74. [PMID: 26428613 DOI: 10.1016/j.joms.2015.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/12/2015] [Accepted: 09/12/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE When establishing intermaxillary fixation (IMF) using bone screws, fracture of a screw is a potential complication. This study was conducted to investigate the forces that arise at bone screw insertion and to determine safety margins between torque for manually tightened insertion and torque until breakage for 3 different IMF screw systems, which could ultimately favor the use of 1 IMF screw system based on decreased risk of complications. MATERIALS AND METHODS IMF screws were placed into porcine mandibles by 3 oral and maxillofacial surgeons. The porcine mandibles were evaluated for cortical thickness and suitable insertion sites by cone-beam computed tomography. Measurements of torque until failure were performed on predrilled aluminum plates by the primary author. A digital torque screwdriver measured 180 data points per second as continuous data and recorded the measurements. RESULTS Measurements indicated clear differences in torsion forces between manually tightened insertions and torque until breakage for all 3 IMF screw systems. No statistical difference in safety margins was found among the IMF screw systems. CONCLUSIONS Because no statistical differences in safety margins were found among the IMF screw systems, this study indicates that IMF screw selection should be based on other clinical factors, such as ease of use or economic factors. Future prospective studies are necessary to fully determine evidence-based criteria for IMF screw selection.
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Affiliation(s)
- Arjan Bins
- PhD Student, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacques A Baart
- Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Professor and Department Head, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.
| | - Jack J W A van Loon
- Research Associate, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
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Ahmed VKS, Krishnaswamy NR, Thavarajah R. Miniscrew implant fracture and effects of such retained tip on dentin-pulp complex: a histological report. Dent Traumatol 2015; 32:161-5. [PMID: 26382020 DOI: 10.1111/edt.12225] [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: 08/13/2015] [Indexed: 01/21/2023]
Abstract
Miniscrew implants provide an excellent orthodontic anchorage. Besides the clinical benefits, miniscrew implants cause minor discomforts and in certain instances poses problematic complications. Damage to the adjacent tooth structure is the most feared complication of miniscrew implant placement, while fracture of miniscrew implants is the rarest. Miniscrew fracture could occur either during its placement or during its removal. An unusual case report is presented of a miniscrew implant tip fracture following root contact while attempting to remove it. This report highlights the effect of such miniscrew implant fracture on the dentin-pulp complex. The present case is probably the first to give direct histological evidence in humans that a miniscrew fracture or a retained miniscrew implant tip along the dentin/cementum without obvious miniscrew implant penetration could elicit pulp changes. Therefore this case report emphasizes the fact that prior to placing miniscrew implant, clinicians should have acquired proper training and adequate skills in terms of MSI placement and management of fractured MSI.
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Affiliation(s)
- Valai Kasim Shakeel Ahmed
- Department of Orthodontics and Dentofacial Orthopedics, Ragas Dental College and Hospital, Uthandi, Chennai, India
| | | | - Rooban Thavarajah
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Uthandi, Chennai, India
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Bernard-Granger C, Gebeile-Chauty S. [Vitality loss: influence of orthodontic process]. Orthod Fr 2015; 86:161-7. [PMID: 26337093 DOI: 10.1051/orthodfr/2014024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 09/13/2014] [Indexed: 11/15/2022]
Abstract
Vitality loss is an unusual event that can occur before, during or after an orthodontic treatment. It can lead to loss of sensitivity, color change or necrosis of the pulp tissue. Before starting the orthodontic treatment, we have to identify the tooth's risk (injured tooth, included occlusal trauma...). Knowing that, if an endodontic treatment has to be done, it is better to do it before starting orthodontic forces. Lamps do not provide problems except high intensity halogen ones. RPE on children, Le Fort I and mandibular osteotomies, corticotomies, genioplasties are responsible of a transitory ischemia without reaching a pathogen level. Mini-screws or mini-plates may be iatrogenic, if they impact the root. The repair options depend on the delay before removing the miniscrew and the nature of injured tissue.
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Bins A, Oomens MAE, Boffano P, Forouzanfar T. Is There Enough Evidence to Regularly Apply Bone Screws for Intermaxillary Fixation in Mandibular Fractures? J Oral Maxillofac Surg 2015; 73:1963-9. [PMID: 25930955 DOI: 10.1016/j.joms.2015.03.072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/24/2015] [Accepted: 03/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Intermaxillary fixation (IMF) is traditionally achieved with arch bars; however, this method has several well-known disadvantages and other techniques, such as bone screws, are available. This study evaluated current evidence regarding these IMF screws (IMFSs) for mandibular trauma and to assess whether this allows a change of treatment protocol for IMF. MATERIALS AND METHODS A systematic electronic literature search was conducted in the PubMed, Embase, and Cochrane databases. Titles and abstracts retrieved from the search were screened and evaluated for inclusion and exclusion criteria. The full text of all relevant articles was read and citation lists were checked for any missing references. All randomized controlled trials (RCTs) were subjected to a quality assessment. Included articles were checked for outcome measurements concerning occlusion, operative time, oral hygiene, root trauma, wire-stick injuries, and mucosa overgrowth. RESULTS Twenty-two articles (17 case series, 4 RCTs, and 1 cohort study) were included. None of the RCTs scored high methodologic results in the quality assessment. The results suggest IMFSs have similar malocclusion rates as arch bars, fewer wire-stick injuries, improved oral hygiene, and shorter operative time. Root damage is less likely to occur with self-drilling screws and seldom requires treatment. CONCLUSIONS Although the methodologic quality of the included studies is poor, self-drilling IMFSs are recommended for temporary per-operative IMF of noncomminuted mandibular fractures. More high-quality studies are required to allow an evidence-based change of protocol.
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Affiliation(s)
- Arjan Bins
- Ph.D. Student, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Marjolijn A E Oomens
- Resident, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
| | - Paolo Boffano
- Research Associate, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
| | - Tymour Forouzanfar
- Head, Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), The Netherlands
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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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Holmes PB, Wolf BJ, Zhou J. A CBCT atlas of buccal cortical bone thickness in interradicular spaces. Angle Orthod 2015; 85:911-9. [PMID: 25760885 DOI: 10.2319/082214-593.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To provide a road map of buccal cortical bone thickness in interradicular locations where miniscrew implants are commonly placed. MATERIALS AND METHODS Cone-beam computed tomography images from 100 study quadrants (50 maxillary and 50 mandibular) were studied. Cortical bone thickness was measured at the most mesial point, the midpoint, and the most distal point in interradicular areas from the canine to the first molar in both arches at 4 mm and 6 mm from the alveolar ridge. Indicator variables of whether the cortical bone thickness was thinner than 1 mm and thicker than 1.5 mm were constructed and analyzed in a general linear mixed model. RESULTS Buccal cortical bone was significantly thinner at a point bisecting two teeth than the bone adjacent to the teeth (P < .0001). The site with the greatest percentage of measurements <1 mm (20%) was at the midpoint bisecting the mandibular canine and the first premolar. The site with the highest percentage of measurements >1.5 mm (50%) was in the mandible adjacent to the first molar (distal to the midpoint of the second premolar and first molar) at 6 mm from the alveolar crest. CONCLUSION Cortical bone thickness is significantly thinner centrally between two teeth than in the areas adjacent to the roots.
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Affiliation(s)
| | - Bethany J Wolf
- b Assistant Professor, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Jing Zhou
- c Assistant Professor and Interim Director, Orthodontics Postgraduate Program, Department of Pediatric Dentistry and Orthodontics, College of Dental Medicine, Medical University of South Carolina, Charleston, SC
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Abstract
Placement of dental implants in the maxillofacial region is routine and considered safe. However, as with any surgical procedure, complications occur. Many issues that arise at surgery can be traced to the preoperative evaluation of the patient and assessment of the underlying anatomy. In this article, the authors review some common and uncommon complications that can occur during and shortly after implant placement. The emphasis of each section is on the management and prevention of complications that may occur during implant placement.
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Affiliation(s)
- Igor Batista Camargo
- Department of Oral and Maxillofacial Surgery, College of Dentistry of Pernambuco, University of Pernambuco, 1650 General Newton Cavalcalte Avenue, Recife, Pernambuco, Brazil 54753-020; Brazilian Army, Brazil; Military Hospital Area of Recife, 95 General Salgado Road, Office 103 Recife, Pernambuco, Brazil 51130-320; Department of Oral and Maxillofacial Surgery, University of Kentucky, College of Dentistry, D-508, 800 Rose Street, Lexington, KY 40536-0297, USA
| | - Joseph E Van Sickels
- Department of Oral and Maxillofacial Surgery, University of Kentucky, College of Dentistry, D-508, 800 Rose Street, Lexington, KY 40536-0297, USA.
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Landin M, Jadhav A, Yadav S, Tadinada A. A comparative study between currently used methods and Small Volume-Cone Beam Tomography for surgical placement of mini implants. Angle Orthod 2014; 85:446-53. [PMID: 25343688 DOI: 10.2319/042214-298.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the outcome of mini implant placement by four different methods: blind placement, a single periapical radiograph (PA), a single panoramic radiograph, and a small-volume cone-beam computed tomography (SV-CBCT). Our hypothesis was that SV-CBCT, with its high resolution, low radiation dose, and three-dimensional depiction of area of interest would yield superior diagnostic information in assessing the potential anchorage site compared to currently used methods that often result in undesired root perforations. MATERIALS AND METHODS Potential mini implant sites of 20 dentate or partially dentate human skulls were imaged using three different imaging modalities: PA, panoramic radiograph, and SV-CBCT. Mini implants were placed in 10 maxillary and 10 mandibular randomized sites blindly and using each of the three imaging modalities. Large-volume CBCT scans done postoperatively were used to detect root perforation. Two oral radiologists analyzed the images for perforation of root structures at each site. RESULTS There was significantly (P < .05) less root perforation with SV-CBCT when compared with other imaging modalities. Fifty-five percent of mini implants placed blindly, 60% of mini implants placed using PA, and 50% of mini implants placed using a panoramic radiograph perforated a root structure, whereas only 5% of mini implants placed using SV-CBCT perforated a root structure. CONCLUSIONS Preoperative evaluation of potential mini implant insertion sites using SV-CBCT aids in predictable placement and results in the least amount of root perforation.
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Affiliation(s)
- Melissa Landin
- a Dental Student, School of Dental Medicine, University of Connecticut Health Center, Farmington, Conn
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Rossouw E. Translational mini-screw implant research. J Orthod 2014; 41 Suppl 1:S8-14. [PMID: 25138369 DOI: 10.1179/1465313314y.0000000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
It is important to thoroughly test new materials as well as techniques when these innovations are to be utilized in the human clinical situation. Translational research fills this important niche. The purpose of translational research is to establish the continuity of evidence from the laboratory to the clinic and in so-doing, provide evidence that the material is functioning appropriately and that the process in the human will be successful. This concept applies to the mini-screw implant; which, has been very successfully introduced into the orthodontic armamentarium over the last decade for application as a temporary anchorage device. The examples of translational research that will be illustrated in this paper have paved the way to ensure that clinicians have evidence to confidently utilize mini-screw implants in orthodontic practice. Needless to say, more studies are needed to ensure a safe, effective and efficient manner to practice orthodontics.
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Affiliation(s)
- Emile Rossouw
- Department of Orthodontics, University of North Carolina School of Dentistry at Chapel Hill, North Carolina, USA
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Zhang R, Gong H, Zhu D, Gao J, Fang J, Fan Y. Seven day insertion rest in whole body vibration improves multi-level bone quality in tail suspension rats. PLoS One 2014; 9:e92312. [PMID: 24637608 PMCID: PMC3956900 DOI: 10.1371/journal.pone.0092312] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 02/20/2014] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to investigate the effects of low-magnitude, high-frequency vibration with rest days on bone quality at multiple levels. Methods Forty-nine three-month-old male Wistar rats were randomly divided into seven groups, namely, vibrational loading for X day followed by X day rest (VLXR, X = 1, 3, 5, 7), vibrational loading every day (VLNR), tail suspension (SPD), and baseline control (BCL). One week after tail suspension, rats were loaded by vibrational loading (35 Hz, 0.25 g, 15 min/day) except SPD and BCL. Fluorescence markers were used in all rats. Eight weeks later, femora were harvested to investigate macromechanical properties, and micro-computed tomography scanning and fluorescence test were used to evaluate microarchitecture and bone growth rate. Atomic force microscopy analyses and nanoindentation test were used to analyze the nanostructure and mechanical properties of bone material, respectively. Inductively coupled plasma optical emission spectroscopy was used for quantitative chemical analyses. Results Microarchitecture, mineral apposition rate and bone formation rate and macromechanical properties were improved in VL7R. Grain size and roughness were significantly different among all groups. No statistical difference was found for the mechanical properties of the bone material, and the chemical composition of all groups was almost similar. Conclusions Low-magnitude, high-frequency vibration with rest days altered bone microarchitecture and macro-biomechanical properties, and VL7R was more efficacious in improving bone loss caused by mechanical disuse, which provided theoretical basis and explored the mechanisms of vibration for improving bone quality in clinics.
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Affiliation(s)
- Rui Zhang
- Department of Engineering Mechanics, Jilin University, Changchun, Jilin, People’s Republic of China
| | - He Gong
- Department of Engineering Mechanics, Jilin University, Changchun, Jilin, People’s Republic of China
- * E-mail: (HG); (DZ)
| | - Dong Zhu
- Department of Orthopedic Surgery, No. 1 Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
- * E-mail: (HG); (DZ)
| | - Jiazi Gao
- Department of Engineering Mechanics, Jilin University, Changchun, Jilin, People’s Republic of China
| | - Juan Fang
- Department of Engineering Mechanics, Jilin University, Changchun, Jilin, People’s Republic of China
| | - Yubo Fan
- School of Biological Science and Medical Engineering, Beihang University, Beijing, People’s Republic of China
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Chang HP, Tseng YC. Miniscrew implant applications in contemporary orthodontics. Kaohsiung J Med Sci 2013; 30:111-5. [PMID: 24581210 DOI: 10.1016/j.kjms.2013.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/31/2013] [Indexed: 11/15/2022] Open
Abstract
The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality) obtained by preoperative diagnostic computed tomography (CT) or by cone-beam computed tomography (CBCT) prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.
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Affiliation(s)
- Hong-Po Chang
- Faculty of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dentistry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- Faculty of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Lim G, Kim KD, Park W, Jung BY, Pang NS. Endodontic and Surgical Treatment of Root Damage Caused by Orthodontic Miniscrew Placement. J Endod 2013; 39:1073-7. [DOI: 10.1016/j.joen.2013.04.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 04/18/2013] [Accepted: 04/23/2013] [Indexed: 11/30/2022]
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Shinohara A, Motoyoshi M, Uchida Y, Shimizu N. Root proximity and inclination of orthodontic mini-implants after placement: Cone-beam computed tomography evaluation. Am J Orthod Dentofacial Orthop 2013; 144:50-6. [DOI: 10.1016/j.ajodo.2013.02.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 02/01/2013] [Accepted: 02/01/2013] [Indexed: 11/29/2022]
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Fäh R, Schätzle M. Complications and adverse patient reactions associated with the surgical insertion and removal of palatal implants: a retrospective study. Clin Oral Implants Res 2013; 25:653-8. [DOI: 10.1111/clr.12152] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Reto Fäh
- Department of Orthodontics and Paediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Marc Schätzle
- Department of Orthodontics and Paediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Estelita S, Janson G, Chiqueto K, Ferreira E, Janson M. Selective use of hand and forearm muscles during mini-implant insertion: a natural torquimeter. J Orthod 2012; 39:270-8. [PMID: 23269691 DOI: 10.1179/1465312512z.00000000040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To compare maximum torque produced by different muscular groups and its influence on mini-implant insertion torque and fracture prevention. DESIGN A prospective study involving in vivo and in vitro laboratory experiments. MATERIALS AND METHODS Eighty-seven professionals were evaluated for maximum torque produced using a screwdriver with combined action between thumb and index fingers [maximum digital torque (MDT)] and by forearm supination movement [maximum brachial torque (MBT)]. Ninety mini-implants distributed over nine different diameters and twenty commercially available mini-implants of two different diameters and trademarks were fractured to determine the fracture torque (FT). The fracture resistance index (FRI) was obtained from: FRI_MDT = FT/MDT and FRI_MBT = FT/MBT. The analysis of variance (ANOVA) and t tests were used to compare the groups. RESULTS MDT was smaller than MBT and both were smaller in females. FT increased for each 0·1 mm of diameter increment. FRI_MDT was greater than FRI_MBT for all diameters. FRI_MDT>1 was found when the diameter was greater than or equal to 1·5 mm. FRI_MBT>1 occurred with diameters equal or greater than 1·7 mm for females and 1·8 mm for males. The 1.5 mm and 1.6 mm diameter of commercially available and mini-implants presented FRI_MBT<1 and FRI_MDT>1. CONCLUSIONS Digital torque was 42% smaller than brachial torque, and it was mechanically safer and biologically more compatible, allowing fracture prevention of 1·5 mm or thicker mini-implant diameter due to insertion torque limitation at 15 N/cm.
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Affiliation(s)
- Sérgio Estelita
- Department of Orthodontics, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
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Cho IS, Kim TW, Ahn SJ, Yang IH, Baek SH. Effects of insertion angle and implant thread type on the fracture properties of orthodontic mini-implants during insertion. Angle Orthod 2012; 83:698-704. [DOI: 10.2319/082812-689.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
Objective:
To determine the effects of insertion angle (IA) and thread type on the fracture properties of orthodontic mini-implants (OMIs) during insertion.
Materials and Methods:
A total of 100 OMIs (self-drilling cylindrical; 11 mm in length) were allocated into 10 groups according to thread type (dual or single) and IA (0°, 8°, 13°, 18°, and 23°) (n = 10 per group). The OMIs were placed into artificial materials simulating human tissues: two-layer bone blocks (Sawbones), root (polymethylmethacrylate stick), and periodontal ligament (Imprint-II Garant light-body). Maximum insertion torque (MIT), total insertion energy (TIE), and peak time (PT) were measured and analyzed statistically.
Results:
There were significant differences in MIT, TIE, and PT among the different IAs and threads (all P < .001). When IA increased, MIT increased in both thread groups. However, TIE and PT did not show significant differences among 0°, 8°, and 13° IAs in the dual-thread group or 8°, 13°, and 18° IAs in the single-thread group. The dual-thread groups showed higher MIT at all IAs, higher TIE at 0° and 23° IAs, and longer PT at a 23° IA than the single-thread groups. In the 0°, 8°, and 13° IA groups, none of the OMIs fractured or became deformed. However, in the 18° IA group, all the OMIs were fractured or deformed. Dual-thread OMIs showed more fracturing than deformation compared to single-thread OMIs (P < .01). In the 23° IA group, all OMIs penetrated the artificial root without fracturing and deformation.
Conclusions:
When OMIs contact artificial root at a critical contact angle, the deformation or fracture of OMIs can occur at lower MIT values than those of penetration.
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Affiliation(s)
- Il-Sik Cho
- Graduate Student (PhD), Department of Orthodontics, School of Dentistry, Seoul National University; Clinical Instructor, Department of Dentistry, Korea University Guro Hospital, Seoul, South Korea
| | - Tae-Woo Kim
- Professor, Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Sug-Joon Ahn
- Associate Professor, Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Il-Hyung Yang
- Assistant Professor, Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Seung-Hak Baek
- Professor, Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
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Barros SE, Janson G, Chiqueto K, Ferreira ES, Janson M. RETRACTED: Selective Use of Hand and Forearm Muscles During Bone Screw Insertion: A Natural Torque Meter. J Oral Maxillofac Surg 2012; 70:e598-607. [DOI: 10.1016/j.joms.2012.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
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Schulte-Geers M, Kater W, Seeberger R. Root trauma and tooth loss through the application of pre-drilled transgingival fixation screws. J Craniomaxillofac Surg 2012; 40:e214-7. [DOI: 10.1016/j.jcms.2011.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 10/07/2011] [Accepted: 10/10/2011] [Indexed: 10/15/2022] Open
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Protocole non conventionnel de mise en place d’implants transradiculaires. Esquisse d’un changement de paradigme. ACTA ACUST UNITED AC 2012; 113:335-49. [DOI: 10.1016/j.stomax.2012.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 05/25/2012] [Indexed: 11/19/2022]
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46
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Shah AH, Behrents RG, Kim KB, Kyung HM, Buschang PH. Effects of screw and host factors on insertion torque and pullout strength. Angle Orthod 2012; 82:603-10. [DOI: 10.2319/070111-427.1] [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
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Huang CT, Hsiang-Hua Lai E, Chang HH, Chang BE, Chen YH, Wang YP, Chen YJ, Chang JZC, Yao CCJ. Damage to the root after tooth movement towards a temporary anchorage device: An animal pilot study. J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ahmed V KS, Rooban T, Krishnaswamy NR, Mani K, Kalladka G. Root damage and repair in patients with temporary skeletal anchorage devices. Am J Orthod Dentofacial Orthop 2012; 141:547-55. [DOI: 10.1016/j.ajodo.2011.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 11/01/2011] [Accepted: 11/01/2011] [Indexed: 11/16/2022]
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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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Barros SE, Janson G, Chiqueto K, Garib DG, Janson M. Effect of mini-implant diameter on fracture risk and self-drilling efficacy. Am J Orthod Dentofacial Orthop 2011; 140:e181-92. [DOI: 10.1016/j.ajodo.2011.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/01/2011] [Accepted: 06/01/2011] [Indexed: 10/17/2022]
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