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Chawshli OF, Hasan HS, Yalda FA, Al-Talabani SZ. The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail. Orthod Craniofac Res 2024; 27:118-125. [PMID: 37496467 DOI: 10.1111/ocr.12700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND OBJECTIVES The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region. MATERIALS AND METHODS Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side. RESULTS The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months. CONCLUSION This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.
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Affiliation(s)
- Omar Fawzi Chawshli
- The Department of Pedodontics, Orthodontics and Preventive Dentistry, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Hasan Sabah Hasan
- Orthodontic Department, Azadi Dental Center, General Directorate of Hawler, Ministry of Health, Erbil, Iraq
- Orthodontic Department, Privet Specialized Dental Clinic, Erbil, Iraq
| | - Fedil Andraws Yalda
- The Department of Oral Diagnosis, College of Dentistry, Hawler Medical University, Erbil, Iraq
| | - Shaho Z Al-Talabani
- P.O.P Department, College of Dentistry, Hawler Medical University, Erbil, Iraq
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Singh S, Sahoo N, Jena S, Mohanty P, Dash BP, Meher J. Effect of Surface Topography on the Primary Stability of Miniscrew Implants in Orthodontics-A Systematic Review and Meta-Analysis. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S78-S82. [PMID: 38595562 PMCID: PMC11000993 DOI: 10.4103/jpbs.jpbs_906_23] [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: 09/15/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 04/11/2024] Open
Abstract
This present study has the purpose of determining how surface topography of implants affects the initial stability of miniscrew implants (MSIs). Electronic databases like PubMed Central, Scopus, Web of Science, Embase, and Cochrane Library, as well as reference lists, were thoroughly searched up until September 2022. Clinical trials involving individuals who got anchorage through mini-implants, along with information on categories of mini-implants dimension, shape, thread design, and insertion site, were required as part of the eligibility criteria. Primary and secondary stability were also assessed. We carried out selection process for the study, extraction of data, quality assessment, and a meta-analysis. The qualitative synthesis included 10 papers: three randomized, four prospective, and four retrospective clinical investigations. The results of this meta-analysis demonstrate that the clinical state of MIs is controlled by their geometrical surface qualities, which are also influenced by their shape and thread design. According to the evidence this meta-analysis produced, this circumstance exists. The duration of the follow-up period and MI success rates did not correlate with one another.
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Affiliation(s)
- Shivani Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Nivedita Sahoo
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Sanghamitra Jena
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Pritam Mohanty
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Bhagabati P. Dash
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Jasbir Meher
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
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Zago H, Navarro RDL, Laranjeira V, Fernandes TMF, Conti ACDCF, Oltramari PVP. 3-D Evaluation of temporary skeletal anchorage sites in the maxilla. J Clin Exp Dent 2021; 13:e1131-e1139. [PMID: 34824700 PMCID: PMC8601705 DOI: 10.4317/jced.57574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/10/2020] [Indexed: 11/18/2022] Open
Abstract
Background The selection of temporary anchorage device (TAD) site can be a challenging task since one should not only consider the 2-D distances between roots, but also the entire 3-D space. Thus, the aim of this study was to evaluate the posterior maxillary region areas available for the insertion of temporary anchorage devices in reconstructed images from cone beam computed tomography (CBCT).
Material and Methods Sample consisted of 72 patients with indication for orthodontic treatment, grouped into three distinct age groups: 11 to 14 years (age group 1), 15 to 19 years (age group 2) and aged 20 years or older (age group 3), which were further subdivided as to the type of malocclusion (Angle Class I, II and III). Orthopantomographic reconstructions and cross sections were obtained with the Dolphin Imaging software. The distance between the roots of maxillary teeth (canines, premolars and first molars) was determined at 5 mm of the cementoenamel junction, as well as the depth of bone availability at different insertion angles (90°, 75°, 60°, 45°). The influence of different angulations, age, and malocclusion on bone availability was evaluated by ANOVA, followed by the Bonferroni post-test. For the evaluation of the interaction of these factors, 2-way ANOVA was used.
Results Bone availability was found to be poor between roots in the molar region. There was a reduction in bone availability with increasing age. With regard to angulations, greater bone availability was found in depth for 45° angulation in the canine and first premolar regions and for angulation of 75° or 90° in the molar region. However, there was no difference between bone availability in the region of the second premolars.
Conclusions According to applied methodology it can be concluded that the region between canines and premolars accepts better vertical angular variations for TADs insertion. Key words:Cone-Beam Computed Tomography, Orthodontic Anchorage Procedures.
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Affiliation(s)
- Humberto Zago
- DDS, MSc. Former Graduate Student, Department of Orthodontics, UNOPAR - University of North Paraná, Brazil
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Effects of Intrabony Length and Cortical Bone Density on the Primary Stability of Orthodontic Miniscrews. MATERIALS 2020; 13:ma13245615. [PMID: 33317089 PMCID: PMC7763864 DOI: 10.3390/ma13245615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
Miniscrews have gained recent popularity as temporary anchorage devices in orthodontic treatments, where failure due to sinus perforations or damage to the neighboring roots have increased. Issues regarding miniscrews in insufficient interradicular space must also be resolved. This study aimed to evaluate the primary stability of miniscrews shorter than 6 mm and their feasibility in artificial bone with densities of 30, 40, and 50 pounds per cubic foot (pcf). The primary stability was evaluated by adjusting the intrabony miniscrew length, based on several physical properties: maximum insertion torque (MIT), maximum removal torque (MRT), removal angular momentum (RAM), horizontal resistance, and micromotion. The MIT and micromotion results demonstrated that the intrabony length of a miniscrew significantly affected its stability in low-density cortical bone, unlike cases with a higher cortical bone density (p < 0.05). The horizontal resistance, MRT, and RAM were affected by the intrabony length, regardless of the bone density (p < 0.05). Thus, the primary stability of miniscrews was affected by both the cortical bone density and intrabony length. The effect of the intrabony length was more significant in low-density cortical bone, where the implantation depth increased as more energy was required to remove the miniscrew. This facilitated higher resistance and a lower risk of falling out.
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Primary Stability of Orthodontic Titanium Miniscrews due to Cortical Bone Density and Re-Insertion. MATERIALS 2020; 13:ma13194433. [PMID: 33028011 PMCID: PMC7579606 DOI: 10.3390/ma13194433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 11/17/2022]
Abstract
The increasing demand for orthodontic treatment over recent years has led to a growing need for the retrieval and reuse of titanium-based miniscrews to reduce the cost of treatment, especially in patients with early treatment failure due to insufficient primary stability. This in vitro study aimed to evaluate differences in the primary stability between initially inserted and re-inserted miniscrews within different cortical bone densities. Artificial bone was used to simulate cortical bone of different densities, namely 20, 30, 40, and 50 pound per cubic foot (pcf), where primary stability was evaluated based on maximum insertion torque (MIT), maximum removal torque (MRT), horizontal resistance, and micromotion. Scanning electron microscopy was used to evaluate morphological changes in the retrieved miniscrews. The MIT, MRT, horizontal resistance, and micromotion was better in samples with higher cortical bone density, thereby indicating better primary stability (P < 0.05). Furthermore, a significant reduction of MIT, MRT, and horizontal resistance was observed during re-insertion compared with the initial insertion, especially in the higher density cortical bone groups. However, there was no significant change in micromotion. While higher cortical bone density led to better primary stability, it also caused more abrasion to the miniscrews, thereby decreasing the primary stability during re-insertion.
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Samie S, Alavi S, Asadi F, Raji SH. Effect of steam and dry heat sterilization on the insertion and fracture torque of orthodontic miniscrews. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.284729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Liao W, Jiang X. Mini-implant anchorage: Much is still unknown. Am J Orthod Dentofacial Orthop 2019; 156:709. [PMID: 31783999 DOI: 10.1016/j.ajodo.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 08/22/2019] [Accepted: 09/12/2019] [Indexed: 11/18/2022]
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Author response. Am J Orthod Dentofacial Orthop 2019; 156:709-710. [DOI: 10.1016/j.ajodo.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/13/2019] [Accepted: 09/14/2019] [Indexed: 11/21/2022]
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Effects of size and insertion angle of orthodontic mini-implants on skeletal anchorage. Am J Orthod Dentofacial Orthop 2019; 156:220-228. [PMID: 31375232 DOI: 10.1016/j.ajodo.2018.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The primary aim of this in vitro study was to compare the insertion torque (IT) and anchorage force (AF) values of 4 different sizes of orthodontic mini-implants with 2 different angles. The second aim was to evaluate the relationship between IT and AF values under different diameter, length, and insertion angle variables. METHODS A total of 160 mini-implants, including 20 implants in each group, with 4 different sizes (1.6 × 8 mm, 1.6 × 10 mm, 2.0 × 8 mm, and 2.0 × 10 mm) at 2 different angles (70° and 90°), were inserted into bovine iliac bone segments. The IT and AF values leading to 1.5 mm deflection were compared. The correlations between IT and AF values under different variables were also analyzed. RESULTS The mini-implants with greater diameter and length showed greater IT and AF values (P <0.05). The IT and AF values of mini-implants inserted at 70° angle were significantly greater than those of mini-implants inserted at 90° angle (P <0.001). Significant correlations were found between IT and AF values in all variables. CONCLUSIONS The diameter, length, and insertion angle of orthodontic mini-implants have significant effects on IT and AF values. Insertion angle and diameter of mini-implants are more effective than implant length on skeletal anchorage. Significant correlations are present between IT and AF values of mini-implants regardless of their diameters, lengths, and insertion angles.
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Bakopoulou A, Hoang P, Fathi A, Foley M, Dunstan C, Dalci O, Papadopoulou AK, Darendeliler MA. A comparative histomorphological and micro computed tomography study of the primary stability and the osseointegration of The Sydney Mini Screw; a qualitative pilot animal study in New Zealand rabbits. Eur J Orthod 2018; 41:360-369. [DOI: 10.1093/ejo/cjy059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
SummaryObjectiveThe aim of this study was to assess the potential of improving orthodontic miniscrews’ (MSs) primary stability in vivo by evaluating the dispersion capacity of an injectable bone graft substitute (iBGS) through a newly designed hollow MS [The Sydney Mini Screw (SMS)] and its integration with the cortical and trabecular bone by using the femur and tibia in a New Zealand rabbit animal model.MethodsIn total, 24 MSs were randomly placed in each proximal tibia and femur of 6 New Zealand rabbits with an open surgery process. Aarhus MSs were used as controls and the effect of injection of iBGS was studied by implanting SMSs with and without iBGS injection. The dispersion of iBGS and the integration of the SMS were studied by using micro Computed Tomography (μCT) and histochemical analysis at two time points, 0 day and 8 weeks post-implantation.ResultsiBGS was successfully injected through the SMS and hardened in situ. After 8 weeks, μCT results revealed that the iBGS particles were resorbed and bone tissue was formed around the SMS and within its lateral exit holes.ConclusionsThis pilot animal study showed the high potential of the combined use of iBGS and SMS as a newly developed technique to promote the primary stability of MSs.
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Affiliation(s)
- Anastasia Bakopoulou
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Peter Hoang
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Ali Fathi
- School of Chemical and Biomolecular Engineering, Faculty of Engineering and Information Technologies, The University of Sydney, Sydney, Australia
| | - Matthew Foley
- Australian Centre for Microscopy & Microanalysis, Department of Archaeology, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Colin Dunstan
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Information Technologies, The University of Sydney, Sydney, Australia
| | - Oyku Dalci
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Alexandra K Papadopoulou
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - M Ali Darendeliler
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
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On the stability efficiency of anchorage self-tapping screws: Ex vivo experiments on miniscrew implants used in orthodontics. J Mech Behav Biomed Mater 2018; 81:46-51. [PMID: 29482179 DOI: 10.1016/j.jmbbm.2018.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The clinical success of orthodontic miniscrews is strictly related to primary stability, which depends on bone viscoelastic properties too. In this study, we evaluated the short time mechanical response of native bone to miniscrews, by a laboratory test based on dynamic loading. METHODS Thirty-six segments of porcine ribs were first scanned by cone-beam computerized tomography to obtain insertion-site cortical thickness, cortical and marrow bone density. Twelve different types of miniscrews were implanted in the bone samples to evaluate the elastic compliance of the implants in response to a point force applied at the screw head normally to the screw axis. The compliance was measured dynamically in a Dynamic Mechanical Analysis apparatus as the Fourier Response Function between the signals of displacement and force. The measurements were repeated in five days successive to the insertion of the miniscrew. FINDINGS The elastic compliance was positively related to observation timepoints, but it was not related neither to the screw type nor to the value of the insertion torque. INTERPRETATION Stability behavior is significantly related to the short time response of native bone rather than to the screw design or the insertion torque values.
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Nguyen MV, Codrington J, Fletcher L, Dreyer CW, Sampson WJ. The influence of miniscrew insertion torque. Eur J Orthod 2017; 40:37-44. [DOI: 10.1093/ejo/cjx026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Araghbidikashani M, Golshah A, Nikkerdar N, Rezaei M. In-vitro impact of insertion angle on primary stability of miniscrews. Am J Orthod Dentofacial Orthop 2016; 150:436-43. [DOI: 10.1016/j.ajodo.2016.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 11/16/2022]
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Influence of Screw Length and Bone Thickness on the Stability of Temporary Implants. MATERIALS 2015; 8:6558-6569. [PMID: 28793582 PMCID: PMC5512929 DOI: 10.3390/ma8095322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/16/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this work was to study the influence of screw length and bone thickness on the stability of temporary implants. A total of 96 self-drilling temporary screws with two different lengths were inserted into polyurethane blocks (n = 66), bovine femurs (n = 18) and rabbit tibia (n = 12) with different cortical thicknesses (1 to 8 mm). Screws insertion in polyurethane blocks was assisted by a universal testing machine, torque peaks were collected by a digital torquemeter and bone thickness was monitored by micro-CT. The results showed that the insertion torque was significantly increased with the thickness of cortical bone from polyurethane (p < 0.0001), bovine (p = 0.0035) and rabbit (p < 0.05) sources. Cancellous bone improved significantly the mechanical implant stability. Insertion torque and insertion strength was successfully moduled by equations, based on the cortical/cancellous bone behavior. Based on the results, insertion torque and bone strength can be estimate in order to prevent failure of the cortical layer during temporary screw placement. The stability provided by a cortical thickness of 2 or 1 mm coupled to cancellous bone was deemed sufficient for temporary implants stability.
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Insertion Torque and Pull-Out Strength of Orthodontic Mini-implants Comparing Manual and Motor Insertion Methods. J Craniofac Surg 2015; 26:993-6. [DOI: 10.1097/scs.0000000000001582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Falkensammer F, Rausch-Fan X, Arnhart C, Krall C, Schaden W, Freudenthaler J. Impact of extracorporeal shock-wave therapy on the stability of temporary anchorage devices in adults: A single-center, randomized, placebo-controlled clinical trial. Am J Orthod Dentofacial Orthop 2014; 146:413-22. [PMID: 25263143 DOI: 10.1016/j.ajodo.2014.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 06/01/2014] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Falkensammer
- Postdoctoral research fellow, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
| | - Xiaohui Rausch-Fan
- Professor, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christoph Arnhart
- Postdoctoral research fellow, Department of Oral Surgery, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christoph Krall
- Senior staff, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Schaden
- Senior staff, Allgemeine Unfallversicherungsanstalt (AUVA) Trauma Center Meidling, Vienna, Austria
| | - Josef Freudenthaler
- Professor, Department of Orthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Ozdemir F, Uyar VO, Ulkur F. Treatment of Class II Maxillary Retrusion Case Using Miniscrew (Nonextraction Treatment of Adolescent Patient). Turk J Orthod 2014. [DOI: 10.13076/tjo-d-14-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Marquezan M, Mattos CT, Sant'Anna EF, de Souza MMG, Maia LC. Does cortical thickness influence the primary stability of miniscrews?: A systematic review and meta-analysis. Angle Orthod 2014; 84:1093-103. [PMID: 24694015 DOI: 10.2319/093013-716.1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate whether there is evidence to support the association between cortical thickness (CtTh) and the primary stability of mini-implants (MI). MATERIALS AND METHODS A search was performed including articles published until September 2013. The inclusion criteria comprised observational clinical studies conducted in patients who received monocortical MI for orthodontic anchorage and in vivo or ex vivo experimental studies performed to evaluate the primary stability of MI, studies that evaluated the association between CtTh and MI primary stability, CtTh measurement performed numerically, and MI primary stability evaluated by implant stability quotient value, Periotest value , pull-out strength, or insertion torque. Studies conducted exclusively in artificial bone or finite elements were excluded. RESULTS Abstract and title reading identified 15 possible articles to be included. After reading the complete text, three were excluded. One article was found by hand searching and another excluded for an overlapping sample. Finally, 12 articles were selected. A positive correlation was found between primary stability and CtTh when studies that evaluated primary stability through PS were grouped (r = .409) and when studies that evaluated stability in humans were grouped (r = .338). CONCLUSIONS There is a positive association between MI primary stability and CtTh of the receptor site. However, there is still a lack of well-designed clinical trials.
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Marquezan M, Lima I, Lopes RT, Sant'Anna EF, de Souza MMG. Is trabecular bone related to primary stability of miniscrews? Angle Orthod 2013; 84:500-7. [PMID: 24245816 DOI: 10.2319/052513-39.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the primary stability of miniscrews inserted into bone blocks of different bone mineral densities (BMDs) with and without cortical bone, and investigate whether some trabecular properties could influence primary stability. MATERIALS AND METHODS Fifty-two bone blocks were extracted from fresh bovine pelvic bone. Four groups were created based on bone type (iliac or pubic region) and presence or absence of cortical bone. Specimens were micro-computed tomography imaged to evaluate trabecular thickness, trabecular number, trabecular separation, bone volume density (BV/TV), BMD, and cortical thickness. Miniscrews 1.4 mm in diameter and 6 mm long were inserted into the bone blocks, and primary stability was evaluated by insertion torque (IT), mini-implant mobility (PTV), and pull-out strength (PS). RESULTS Intergroup comparison showed lower levels of primary stability when the BMD of trabecular bone was lower and in the absence of cortical bone (P≤.05). The Pearson correlation test showed correlation between trabecular number, trabecular thickness, BV/TV, trabecular BMD, total BMD, and IT, PTV, and PS. There was correlation between cortical thickness and IT and PS (P≤.05). CONCLUSION Cancellous bone plays an important role in primary stability of mini-implants in the presence or absence of cortical bone.
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Affiliation(s)
- Mariana Marquezan
- a PhD Student, Department of Pedodontics and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Papadopoulos MA, Papageorgiou SN. Current evidence on clinical performance of miniscrew implants in orthodontic treatment. Semin Orthod 2013. [DOI: 10.1053/j.sodo.2013.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Walter A, Winsauer H, Marcé-Nogué J, Mojal S, Puigdollers A. Design characteristics, primary stability and risk of fracture of orthodontic mini-implants: pilot scan electron microscope and mechanical studies. Med Oral Patol Oral Cir Bucal 2013; 18:e804-10. [PMID: 23722125 PMCID: PMC3790656 DOI: 10.4317/medoral.18674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 11/13/2012] [Indexed: 11/09/2022] Open
Abstract
Objectives: Orthodontic mini-implants (OMIs) are increasingly used in orthodontics but can fail for various reasons. This study investigates the effects of OMI design characteristics on the mechanical properties in artificial bone.
Material and Methods: Twelve self-drilling OMIs (2 small, 6 medium, 4 large) from 8 manufacturers were tested for their primary stability in simulated medium-high cancellous bone and the risk to fracture in high-density methacrylate blocks. For the assessments of the maximum insertion torque (IT) and torsional fracture (TF) 5 of each OMI were used and for the pull-out strength (POS) 10. The OMIs were inserted with a torque screwdriver (12 sec/360°) until the bottom at 8 mm depth was reached. OMI designs were analyzed with a scan electron microscope (SEM).
Results: SEM images revealed a great variation in product refinement. In the whole sample, a cylindrical OMI shape was associated with higher POS (p<0.001) but lower IT (p=0.002) values. The outer and inner OMI diameters were design characteristics well correlated with POS, IT and TF values (ranging from 0.601 to 0.961). Greater thread depth was related to greater POS values (r= 0.628), although OMIs with similar POS values may have different IT values. Thread depth and pitch had some impact on POS. TF depended mainly on the OMI inner (r= 0.961) and outer diameters (r=0.892). A thread depth to outer diameter ratio close to 40% increased TF risk.
Conclusions: Although at the same insertion depth the OMI outer and inner diameters are the most important factors for primary stability, other OMI design characteristics (cylindrical vs. conical, thread design) may significantly affect primary stability and torsional fracture. This needs to be considered when selecting the appropriate OMI for the desired orthodontic procedures.
Key words:Orthodontic mini-implants, primary stability, insertion torque, pullout strength, torsional fracture.
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Affiliation(s)
- André Walter
- Universitat Internacional de Catalunya, Campus Sant Cugat, Josep Trueta s/n, 08195, St. Cugat del Vallès, Barcelona, Spain,
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A report on the use of Er:YAG laser for pilot hole drilling prior to miniscrew insertion. Lasers Med Sci 2013; 30:605-9. [PMID: 23793415 DOI: 10.1007/s10103-013-1374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The aim of the present in vitro study was to investigate the required time period of the Er:YAG laser that is used for drilling through cortical bone when pilot hole drilling is needed before miniscrew insertion. Even though Er:YAG laser is used in various in vivo and in vitro studies, there is no accepted procedure of laser for depth control during drilling through cortical bone. The study sample consisted of 120 cortical bone segments having 1.5 and 2.0 mm of cortical bone thickness. An Er:YAG laser, with a spot size of 1.3 mm and an air-water spray of 40-50 ml/min, was used. The laser was held 2 mm away from and perpendicular to the bone surface with different laser settings. Twelve specimens were prepared for each subgroup. As the cortical bone thickness increased, the time needed to drill through the bone increased. Frequency increase directly caused a decrease in irradiation duration. When three different frequency, three different energy, and four different power values were tested for both the 1.5- and 2-mm cortical bone thicknesses, the shortest duration needed to drill through cortical bone was seen in the 3.6-W (300 mJ-12 Hz) setting. When pilot holes are drilled prior to miniscrew placement in 1.5 to 2 mm of cortical bone using Er:YAG laser, the most appropriate value is found with the 3.6-W (300 mJ-12 Hz) setting.
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Migliorati M, Benedicenti S, Signori A, Drago S, Barberis F, Tournier H, Silvestrini-Biavati A. Miniscrew design and bone characteristics: an experimental study of primary stability. Am J Orthod Dentofacial Orthop 2012; 142:228-34. [PMID: 22858333 DOI: 10.1016/j.ajodo.2012.03.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 03/01/2012] [Accepted: 03/01/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the correlations between bone characteristics, orthodontic miniscrew designs, and primary stability. METHODS Four different miniscrews were placed in pig ribs. The miniscrews were first scanned with a scanning electron microscope to obtain measurable images of their threads. Subsequently, the maximum insertion torque of the screws and the maximum load value in the pullout force tests were measured; furthermore, bone specimen characteristics were analyzed by using cone-beam computed tomography. For each bone sample, the insertion site cortical thickness as well as both cortical and marrow bone density were evaluated. The nonparametric Kendall rank correlation (tau) was used to evaluate the strength of the associations among the characteristics measured. The nonparametric Kruskall-Wallis test was used to evaluate the differences among the groups, and post-hoc comparisons were assessed by using the Nemenyi-Damico-Wolfe-Dunn test. RESULTS A significant dependence was found between pitch and maximum insertion torque (tau, -0.49). Positive correlations were also found between pullout force and maximum insertion torque (tau, 0.64), cortical thickness (tau, 0.36), and marrow bone density (tau, 0.35). CONCLUSIONS In this in-vitro experimental study, strong correlations were observed among miniscrew geometry, bone characteristics, and primary stability.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, Genoa University, Genoa, Italy.
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