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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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Fu S, Zhang Y, Wang R, Zou X, Ai F, Wang J, Ma X, Xia H, Lei W. Calcium phosphate cement promotes the stability of osteoporotic lumbar pedicle screw by enhancer-injecters with different number of holes. BMC Surg 2023; 23:354. [PMID: 37980464 PMCID: PMC10657603 DOI: 10.1186/s12893-023-02235-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/16/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUNDS This study aimed to compare whether Calcium phosphate cement (CPC) promotes the stability of osteoporotic lumbar pedicle screw by enhancer-injecters with different number of holes. METHODS Through a self-designed bone cement injection device, the pedicle screw canal was strengthened with calcium phosphate bone cement, and divided into 4-hole group, 6-hole group, 8-hole group, straight pore group and the control group. The screw was inserted into the mechanical test module, the Maximum insertion torque and Maximum axial pull-out strength were recorded, and the distribution of calcium phosphate bone cement was analyzed by CT and X-ray. The data results were analyzed using SPSS19.0 statistical software package. RESULTS The distribution of bone cement in different reinforcement groups was different and showed regularity. The bone cement in the 4-hole group was roughly located in the head 1/3 of the screw, the 6-hole group was located in the middle 1/3 of the screw, and the 8-hole group was located in the caudal 1/3 of the screw. Compared with the control group, the maximum axial pull-out force of screws in the lateral hole and full screw tunnel reinforcement group was significantly increased. There was no significant difference between the 4-hole, 6-hole and straight pore groups. There was no difference in the screw-in torque between the reinforcement groups, and they all increased significantly compared with the control group, and the difference was statistically significant. After the screw was pulled out, the interface between the bone cement and the polyurethane material was fractured, and a tight package was formed with the screw. CONCLUSIONS Enhancer syringes with different hole numbers combined with CPC bone cement injection can significantly increase the maximum screw pull-out force. The 8-hole group has a smaller pull-out force and is relatively prone to leakage of reinforcing material, which lacks safety in use. The local reinforcement of 4-hole and 6-hole sheath can play a similar role to that of total nail tunnel reinforcement.
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Affiliation(s)
- Suochao Fu
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China.
| | - Yu Zhang
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China
| | - Renkai Wang
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China
| | - Xiaobao Zou
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China
| | - Fuzhi Ai
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510020, People's Republic of China
| | - Jianhua Wang
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China
| | - Xiangyang Ma
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China.
| | - Hong Xia
- Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China
| | - Wei Lei
- Fourth Department of Orthopedics, Xijing Hospital, Air Force Military Medical University, Xi'an, 733399, People's Republic of China.
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Gezer P, Yilanci H. Comparison of mechanical stability of mini-screws with resorbable blasting media and micro-arc oxidation surface treatments under orthodontic forces: An in vitro biomechanical study. Int Orthod 2023; 21:100775. [PMID: 37263049 DOI: 10.1016/j.ortho.2023.100775] [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: 01/01/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The aim of this study was to compare the primary stability of mini-screws with different surface treatments such as resorbable blasting media (RBM) and micro-arc oxidation (MAO) under in vitro orthodontic forces. MATERIAL AND METHODS Thirty-six self-drilling TiAl6V4-ELI grade 23 titanium alloy 1.6×8mm mini-screws were inserted into polyurethane foam blocks and divided into three groups according to surface properties: machine surface (MS), RBM-treated, and MAO-treated. An orthodontic force of 150g was applied to the mini-screws using NiTi coils. Maximum insertion torque (MIT) and maximum removal torque (MRT) were measured with a digital torque screwdriver during insertion and removal. For each mini-screw, stability measurements were made with the Periotest M device at day 0 and weeks 1, 2, 4, 8, and 12. RESULTS Significant differences in MIT were observed between all groups in pairwise comparisons (P<0.001) with the highest value in the MAO-treated group and the lowest in the MS group. The mean MRT values differed in all three groups (P=0.001). In pairwise comparisons of MRT, only the difference between MS group and RBM-treated group was significant. The highest value was observed in the RBM-treated group, while the lowest value was observed in the MS group. Periotest values were significantly higher in the MAO-treated group than the RBM-treated group at weeks 8 and 12. A positive significant correlation was found between MIT and MRT in all groups. No significant correlation was found between MIT, MRT and Periotest values in all groups. CONCLUSION RBM-treated group was significantly higher than the MS group in MIT and MRT values. According to Periotest values, RBM-treated group was found to be significantly more stable than the MAO-treated group at weeks 8 and 12. Therefore, RBM surface treatment was found to be more favourable than other surfaces to increase success rate in clinical applications.
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Affiliation(s)
- Pınar Gezer
- Department of Orthodontics, Faculty of Dentistry, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
| | - Hilal Yilanci
- Department of Orthodontics, Faculty of Dentistry, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Ravi J, Duraisamy S, Rajaram K, Kannan R, Arumugam E. Survival rate and stability of surface-treated and non-surface-treated orthodontic mini-implants: a randomized clinical trial. Dental Press J Orthod 2023; 28:e2321345. [PMID: 37283426 DOI: 10.1590/2177-6709.28.2.e2321345.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 03/28/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES This clinical trial was conducted to evaluate the stability and failure rate of surface-treated orthodontic mini-implants and determine whether they differ from those of non-surface-treated orthodontic mini-implants. TRIAL DESIGN Randomized clinical trial with a split-mouth study design. SETTING Department of Orthodontics, SRM Dental College, Chennai. PARTICIPANTS Patients who required orthodontic mini-implants for anterior retraction in both arches. METHODS Self-drilling, tapered, titanium orthodontic mini-implants with and without surface treatment were placed in each patient following a split-mouth design. The maximum insertion and removal torques were measured for each implant using a digital torque driver. The failure rates were calculated for each type of mini-implant. RESULTS The mean maximum insertion torque was 17.9 ± 5.6 Ncm for surface-treated mini-implants and 16.4 ± 9.0 Ncm for non-surface-treated mini-implants. The mean maximum removal torque was 8.1 ± 2.9 Ncm for surface-treated mini-implants and 3.3 ± 1.9 Ncm for non-surface-treated mini-implants. Among the failed implants, 71.4% were non-surface-treated mini-implants and 28.6% were surface-treated mini-implants. CONCLUSION The insertion torque and failure rate did not differ significantly between the groups, whereas the removal torque was significantly higher in the surface-treated group. Thus, surface treatment using sandblasting and acid etching may improve the secondary stability of self-drilling orthodontic mini-implants. TRIAL REGISTRATION The trial was registered in the Clinical Trials Registry, India (ICMR NIMS). Registration number: CTRI/2019/10/021718.
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Affiliation(s)
- Janani Ravi
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopaedics (Ramapuram, Chennai, Tamil Nadu, India)
| | - Sangeetha Duraisamy
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopaedics (Ramapuram, Chennai, Tamil Nadu, India)
| | - Krishnaraj Rajaram
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopaedics (Ramapuram, Chennai, Tamil Nadu, India)
| | - Ravi Kannan
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopaedics (Ramapuram, Chennai, Tamil Nadu, India)
| | - Edeinton Arumugam
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopaedics (Ramapuram, Chennai, Tamil Nadu, India)
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Yu WP, Yu JH, Wang SH, Hsu JT. The Effects of Diameter, Length and Insertion Method on the Stability of Orthodontic Miniscrew. J Med Biol Eng 2022. [DOI: 10.1007/s40846-022-00737-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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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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Kim HJ, Park HS. Long-term evaluation of factors affecting removal torque of microimplants. Prog Orthod 2021; 22:42. [PMID: 34778924 PMCID: PMC8590991 DOI: 10.1186/s40510-021-00383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background The current study aimed to evaluate factors affecting the long-term stability of microimplants using removal torque and the correlation between removal torque and clinical variables. Materials and methods This research evaluated 703 microimplants placed in 354 patients (mean age: 30.4 ± 12.1 years). The removal torque was evaluated according to various clinical variables including sex, age, placement site, microimplant size, and placement method (self-drilling versus pre-drilling). Pearson correlation and stepwise multiple linear regression analyses were performed to investigate different variables and their association with removal torque. Results The mean removal torque was significantly higher in the mandible (4.46 N cm) than in the maxilla (3.73 N cm). The values in the posterior teeth/retromolar areas were significantly higher than those in the anterior teeth area. There were no significant difference in terms of sex. Teenagers had a lower removal torque than older adults in the mandible, but not in the maxilla. Microimplants with a greater length and diameter, except for those with a greater diameter in the maxilla, was associated with a higher removal torque. Regardless of placement torque, the removal torque convergently reached approximately 4 N cm in both placement methods. The removal torque was significantly correlated with screw length in the self-drilling group and with diameter in the pre-drilling group. Conclusions Removal torque was related with placement site, age, placement method, and length and diameter of microimplants.
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Affiliation(s)
- Ho-Jin Kim
- Department of Orthodontics, School of Dentistry, Kyungpook National University, 2175, Dalgubeoldae-ro, Jung-Gu, Daegu, 41940, Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, 2175, Dalgubeoldae-ro, Jung-Gu, Daegu, 41940, Korea.
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Effect of Microimplant Neck Design with and without Microthread on Pullout Strength and Destruction Volume. MATERIALS 2021; 14:ma14205991. [PMID: 34683583 PMCID: PMC8541548 DOI: 10.3390/ma14205991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
The microthread neck concept has been applied to dental implants. This study investigated the pullout strength and destruction volume of orthodontic microimplants with and without the microthread neck design. Fifteen microimplants (diameter: 1.5 × 10 mm) of three types (Types A and B: without microimplant neck; Type C: with microimplant neck) were tested. The insertion torque (IT), Periotest value (PTV), horizontal pullout strength (HPS), and horizontal destruction volume (HDV) of each type were measured. Kruskal–Wallis H test and Dunn’s post-hoc comparison test were performed to compare the measured values of the three types of microimplants. The correlations of the measured values were used to perform the Spearman’s correlation coefficient analysis. The ITs of Types B (8.8 Ncm) and C (8.9 Ncm) were significantly higher than those of Type A (5.2 Ncm). Type B yielded the lowest PTV (4.1), and no statistical differences in PTV were observed among the three types. Type A had a significantly lower HPS (158.8 Ncm) than Types B (226.9 Ncm) and C (212.8 Ncm). The three types did not exhibit any significant differences in the HDV. The results of the Spearman’s correlation coefficient test revealed that HDV (ρ = 0.710) and IT (ρ = 0.813) were strongly correlated with HPS, whereas for PTV and HPS, it was not. HPS was strongly and significantly correlated with HDV. The orthodontic microimplant with a microimplant neck design did not perform better than that without a microthread in the mechanical strength test.
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Hung BQ, Yu W, Park HS, Kyung HM, Hong M. Correlation between insertion torque and peri-implant bone strain during placement of orthodontic mini-implants: A finite element study. Am J Orthod Dentofacial Orthop 2021; 161:248-254. [PMID: 34629237 DOI: 10.1016/j.ajodo.2020.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Insertion torque is the amount of torque exerted on the implant to tighten into the bone. We investigated whether insertion torque values could be correlated with the strain level in the peri-implant cortical bone resulting from mini-implant insertion. METHODS The insertion of a standard size mini-implant (φ 1.4 mm × 7 mm) into maxillary alveolar bone was simulated using the finite element method. A total of 3600 calculation steps were employed to numerically reproduce the mini-implant insertion process and analyze the insertion torque and strain distribution in bone. Special attention was given to the relationship between insertion torque values and strain level in the cortical bone at the final tightening. The strain level was quantified using the following 3 strain parameters: (1) average insertion strain, (2) peak insertion strain recorded near the mini-implant thread tips, and (3) the size of the damage zone in the cortical bone. Correlations between the insertion torque values and these 3 parameters were analyzed using linear regression. RESULTS Direct proportionality and strong correlation were found between the insertion torque values and each of the 3 strain parameters: average insertion strain (r2 = 0.91), peak insertion strain (r2 = 0.91), and the size of damage zone (r2 = 0.90) in the peri-implant cortical bone. CONCLUSIONS The results of this finite element method study demonstrated that insertion torque could serve as a reliable indicator of the strain level in the peri-implant cortical bone resulting from mini-implant insertion.
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Affiliation(s)
- Bui Quang Hung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Wonjae Yu
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Mihee Hong
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea.
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Singh J, Singh SK, Gupta AR, Nayak SC, Vatsa R, Priyadarshni P. Comparative Evaluation of Primary Stability of Two Different Types of Orthodontic Mini-Implants. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S128-S131. [PMID: 34447060 PMCID: PMC8375815 DOI: 10.4103/jpbs.jpbs_604_20] [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: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background The mini-implants introduced new possibilities of adequate anchorage in orthodontics. Furthermore, due to its small size, it can even be placed at relatively difficult sites with ease. Removal torque should be high to prevent implant unscrewing. Objective This prospective clinical trial was aimed to evaluate the insertion torque and removal torque of single-threaded and double-threaded cylindrical orthodontic mini-implants. Materials and Methods A total of 36 cases were randomly divided into two groups, with an equal number of patients in each group (n = 18). In Group 1 single-threaded cylindrical mini-implant was placed, and in the other group, cylindrical implants with double-threaded were placed. Maximum insertion torque (MIT) and maximum removal torques (MRTs) were recorded for both groups. Data collected were subjected to statistical analysis. Results MIT was found to be significantly higher than MRT for both the groups and between the groups. Intergroup comparison in the present study showed significantly higher values for MIT than MRT. Intergroup comparison of MIT showed more values for Group 2 as compared to Group 1. Similar statistically significant values were seen in terms with MRT, where double-threaded cylindrical mini-implants had more torque value than the other group. Conclusions Orthodontic mini screws represent effective temporary anchorage devices. Double-threaded cylindrical mini-implants have significantly higher insertion and removal torque than single-threaded mini-implants and hence better stability.
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Affiliation(s)
- Jyotirmay Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Sanjay Kumar Singh
- Department of Orthodontics and Orthopedics, Patna Medical College and Hospital, Patna Bihar, India
| | - Abhinav Raj Gupta
- Consultant Orthodontist, G. S. Memorial Hospital and Trauma Center, Varanasi, Bihar, India
| | - Subhash Chandra Nayak
- Department of Orthodontics and Dentofacial Orthopaedics, Hi-tech Dental College and Hospital, Bhbaneshwar, Odisha, India
| | - Ritesh Vatsa
- Department of Dentistry, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India
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Al-Thomali Y, Basha S, Mohamed RN. Effect of surface treatment on the mechanical stability of orthodontic miniscrews. Angle Orthod 2021; 92:127-136. [PMID: 34338745 DOI: 10.2319/020721-111.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES To provide collective quantitative evidence about the effect of surface treatments on the mechanical stability of orthodontic miniscrews (MSs). MATERIALS AND METHODS The study was registered in PROSPERO (No. CRD42020209652). The research question was defined according to the PICO (population, intervention, control, and outcomes) format. Various research databases were searched for animal and human studies on effects of surface treatment on the mechanical stability of MSs. Both prospective and retrospective in vivo clinical studies published in English were included. The risk of bias was assessed using SYRCLE's risk of bias tool for animal studies. The meta-analysis was conducted using RevMan 5.4. RESULTS A total of 109 articles were identified; 14 were included in the systematic review, and seven studies with sandblasting, acid etching (SLA) methods of surface treatment were included for meta-analysis. The number of study participants ranged from 6 to 24 (total n = 185), with a mean of 13.2. A total of 949 MSs were used with a mean of 67.8. The overall success rate for surface-treated MSs ranged from 47.9% to 100%. Forest plot of removal torque values showed significantly higher values for SLA surface-treated MSs compared with controls with a standard mean difference of 2.61 (95% confidence interval = 1.49-3.72, I2 = 85%). Forest plot of insertion torque showed a standard mean difference of -6.19 (95% confidence interval = -13.63-1.25, I2 = 98%, P = .10). CONCLUSIONS Surface treatment of MSs improved primary and secondary stability with good osseointegration at the bone-implant surface. However, significant heterogeneity across the studies included in the meta-analysis made it difficult to draw conclusions.
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Choi JY, Kim MJ, Kim SH, Chung KR, Nelson G. Effect of Different Head Hole Position on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study. SENSORS 2021; 21:s21113798. [PMID: 34070904 PMCID: PMC8198358 DOI: 10.3390/s21113798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
Abstract
The orthodontic miniscrew is driven into bone in a clockwise direction. Counter-clockwise rotational force applied to the implanted miniscrew can degrade the stability. The purpose of this three-dimensional finite element study was to figure out the effect of shifting the miniscrew head hole position from the long axis. Two miniscrew models were developed, one with the head hole at the long axis and the other with an eccentric hole position. One degree of counter-clockwise rotation was applied to both groups, and the maximum Von-Mises stress and moment was measured under various wire insertion angles from −60° to +60°. All Von-Mises stress and moments increased with an increase in rotational angle or wire insertion angle. The increasing slope of moment in the eccentric hole group was significantly higher than that in the centric hole group. Although the maximum Von-Mises stress was higher in the eccentric hole group, the distribution of stress was not very different from the centric hole group. As the positive wire insertion angles generated a higher moment under a counter-clockwise rotational force, it is recommended to place the head hole considering the implanting direction of the miniscrew. Clinically, multidirectional and higher forces can be applied to the miniscrew with an eccentric head hole position.
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Affiliation(s)
- Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul 02447, Korea;
| | - Min-Jung Kim
- Department of Convergence Medicine, Asan Medical Center, Asan Medical Institute of Convergence Science and 8 Technology, Seoul 02447, Korea;
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
- Correspondence:
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California, San Francisco, CA 94143, USA;
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Nenen F, Garnica N, Rojas V, Oyonarte R. Comparison of the primary stability of orthodontic miniscrews after repeated insertion cycles. Angle Orthod 2021; 91:336-342. [PMID: 33378455 DOI: 10.2319/050120-375.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To compare the primary stability of miniscrews after repeated cycles of insertion through insertion torque (IT) measurements and resonance frequency analysis (RFA). MATERIALS AND METHODS Sixty titanium miniscrews were divided into two groups according to the insertion protocol: one with predrilled sites and the other self-drilled into porcine iliac crest bone specimens. Each group had three cycles of reinsertion. After each insertion, the IT and RFA were measured. The IT was measured by using a torque meter, and the RFA was measured using the Osstell ISQ device. A total of five miniscrews of each group were selected for sequential assessment of the morphology of their tip and threads using scanning electron microscopy after each insertion cycle. RESULTS No statistically significant differences were found in the IT values of miniscrews reinserted up to three times in the group with predrilled surgical sites. The IT value increased significantly with the number of reinsertions in the self-drilled group. The RFA value decreased as the number of insertions increased in both groups. CONCLUSIONS Under the conditions of this in vitro study, reinserting miniscrews deteriorates the integrity of their tip and thread. Reinsertion should be discouraged particularly when insertion sites are not predrilled.
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Mistry D, Dalci O, Papageorgiou SN, Darendeliler MA, Papadopoulou AK. Authors' response. Am J Orthod Dentofacial Orthop 2021; 159:404-406. [PMID: 33795079 DOI: 10.1016/j.ajodo.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Dipika Mistry
- Sydney, New South Wales, Australia, and Zurich, Switzerland
| | - Oyku Dalci
- Sydney, New South Wales, Australia, and Zurich, Switzerland
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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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Drilling Capability of Orthodontic Miniscrews: In Vitro Study. Dent J (Basel) 2020; 8:dj8040138. [PMID: 33371233 PMCID: PMC7766744 DOI: 10.3390/dj8040138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 11/17/2022] Open
Abstract
The aims of this study were to assess the values and mechanical properties of insertion torque (IT) of steel miniscrews inserted in artificial bone blocks (Sawbones, Pacific Research Laboratories, Vashon, WA, USA) with different bone densities and to detect any scratches on the surface of the miniscrews after insertion. Forty self-drilling miniscrews (Leone S.p.A. ø 1.75 mm, L 8 mm) have been inserted into bone blocks that mimic different stability conditions (density: 20 PCF-pounds per cubic foot, 40 PCF, and 30 + 50 PCF with 2 mm and 4 mm of cortical bone). Before insertion and after removal, all miniscrews were inspected with a stereomicroscope 5x and a SEM to detect potential microscopic cracks. Using an electronic surgical motor (W&H Dentalwerk Bürmoos GmbH, Werner Bader Str. 1, 5111 Bürmoos, Austria), the maximum insertion torque value was registered. Stereomicroscope and SEM examination did not indicate any morphological and surface structural changes to the miniscrews, irrespective of the bone density they were inserted into. The findings showed that IT increased significantly with increasing bone density. In each artificial bone block, morphostructural analysis demonstrated the adequate mechanical properties of the self-drilling miniscrews. IT measurements indicated torque values between 6 and 10 Ncm for blocks with a density of 30 + 50 PCF, whereas the suggested values are between 5 and 10 Ncm.
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Staderini E, Patini R, Tepedino M, Gasparini G, Zimbalatti MA, Marradi F, Gallenzi P. Radiographic Assessment of Pediatric Condylar Fractures after Conservative Treatment with Functional Appliances-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249204. [PMID: 33317118 PMCID: PMC7763300 DOI: 10.3390/ijerph17249204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/28/2022]
Abstract
Background: To evaluate the effectiveness of conservative treatment with functional appliances for condylar fractures in pediatric age. Methods: Four electronic databases (PubMed, EBSCO, Scopus, and Web of Science) were consulted with no restriction of publication status or year, up to 31 August 2020. Selection criteria: based on the PICOS criteria, the selection criteria were set for observational human studies, with at least 10 patients and six months of follow-up. The study population included pediatric patients (aged 5–16 years), with unilateral or bilateral condylar fracture, treated with functional appliances. Condylar remodeling and mandibular growth were analyzed through sequential radiographic examinations. Data collection and analysis: Two independent reviewers carried out title-abstract screening, and a senior investigator was involved to solve any disagreement. The quality of the evidence was assessed through the Canada Institute of Health Economics (IHE) quality appraisal checklist, and the National Institutes of Health (NIH) quality assessment tool. Results: A total of 971 articles were retrieved from the electronic search; among them, three studies met the eligibility criteria. A moderate risk of bias was detected in all the studies, due to common limitations (absence of multicenter studies, prospective design, blindness of the investigators, patients’ drop-out). At follow-up examinations (between 6 months and 4.9 years), the difference of condylar neck length between the “injured” and “healthy” side was approximately 2 mm, while the anteroposterior condylar width discrepancy was recorded up to 1 mm. Conclusions: Short- and long-term data revealed that conservative treatment with functional appliances led to partial or full radiological recovery of the joint morphology, along with good to excellent functional results. Patients’ age has a crucial role on the treatment choice, and the type of fracture (presence of condylar displacement, or dislocation) is also a major prognostic indicator of the radiologic outcome. Limitation: To confirm the effectiveness of functional appliances, more prospective clinical long-term follow-up studies with homogeneous samples of condylar fractures are deemed necessary. Registration: The study protocol was registered on PROSPERO (CRD42020205650).
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Affiliation(s)
- Edoardo Staderini
- Postgraduate School of Orthodontics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (E.S.); (M.A.Z.); (F.M.); (P.G.)
| | - Romeo Patini
- Postgraduate School of Orthodontics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (E.S.); (M.A.Z.); (F.M.); (P.G.)
- Correspondence: (R.P.); (M.T.); Tel.: +39-06-3015-4286 (R.P.)
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Viale S.Salvatore, Edificio Delta 6, 67100 L’Aquila, Italy
- Correspondence: (R.P.); (M.T.); Tel.: +39-06-3015-4286 (R.P.)
| | - Giulio Gasparini
- Maxillofacial Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCSS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Maria Antonietta Zimbalatti
- Postgraduate School of Orthodontics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (E.S.); (M.A.Z.); (F.M.); (P.G.)
| | - Francesca Marradi
- Postgraduate School of Orthodontics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (E.S.); (M.A.Z.); (F.M.); (P.G.)
| | - Patrizia Gallenzi
- Postgraduate School of Orthodontics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy; (E.S.); (M.A.Z.); (F.M.); (P.G.)
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18
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Migliorati M, Drago S, Amorfini L, Nucera R, Silvestrini-Biavati A. Maximum insertion torque loss after miniscrew placement in orthodontic patients: A randomized controlled trial. Orthod Craniofac Res 2020; 24:386-395. [PMID: 33274528 DOI: 10.1111/ocr.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare torque recordings of immediately loaded orthodontic miniscrews between insertion time and different post-placement timepoints (2 weeks, 4 weeks and removal time, respectively). SETTING AND SAMPLE POPULATION Parallel trial with an allocation ratio of 1:1. Eligibility criteria were needs of fixed orthodontic treatment, no systemic disease and absence of using drugs altering bone metabolism. MATERIAL AND METHODS Patients received miniscrews, 2.0 mm diameter and 10 mm length. All miniscrews underwent inter-radicular placement, and they were placed in the maxilla or in the mandible, palatally or buccally. No pre-drilling was performed. Miniscrews were loaded immediately after the insertion and were used for distalization, intrusion, extrusion, mesialization or indirect anchorage. Patients were randomly divided into three groups. For each patient, Maximum Insertion Torque (MIT) was evaluated at baseline. MIT was measured again after 2 weeks and after 4 weeks by tightening the screw a quarter of turn in Groups 1 and 2, respectively. At the end of the treatment, maximal removal torque was evaluated in Group 3. Torque variation with respect to insertion time was considered as the primary outcome. Baseline and longitudinal differences were tested using the linear mixed-effects (LME) model. RESULTS Forty seven patients and 74 miniscrews were followed up. An association existed between maximum insertion torque and the observation time. A torque decrease of 26.9% and 30% after 2 weeks was observed for mandibular and maxillary miniscrews, respectively. After 1 month, torque values were similar to the baseline records. The overall success rate was 79.7%. No serious harm was observed. CONCLUSIONS Maximum insertion torque undergoes a loss during the first 2 weeks, and its values may depend on the insertion site and the anchorage purpose. Removal torque value is almost the same as the initial torque after 1 month.
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Affiliation(s)
- Marco Migliorati
- Orthodontics Department, School of Dentistry, University of Genova, Genova, Italy
| | - Sara Drago
- Orthodontics Department, School of Dentistry, University of Genova, Genova, Italy
| | | | - Riccardo Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Chang CH, Lin LY, Roberts WE. Orthodontic bone screws: A quick update and its promising future. Orthod Craniofac Res 2020; 24 Suppl 1:75-82. [PMID: 33225592 DOI: 10.1111/ocr.12429] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
Orthodontic bone screws (OBSs) provide intraoral anchorage by penetrating oral mucosa and seating firmly in basilar bone (BB). Retromolar (prosthetic-type) implants introduced the extra-alveolar (E-A) concept for BB anchorage to move teeth throughout the alveolar process, but the clinical procedures were complex and expensive. Titanium alloy (Ti) miniscrews placed in inter-radicular (I-R) alveolar bone are more convenient and provide some tooth movement potential, but multiple screws are usually required and the devices often interfere with the path of tooth movement. The advantages of BB anchorage and the convenience of miniscrew are combined into the E-A OBS system. These miniscrews are relatively large in diameter (2 mm), and strong (stainless steel), which are placed intraorally in the BB of the infra-zygomatic crest (IZC) and mandibular buccal shelf (MBS). E-A OBSs provide osseous anchorage to retract the dentition and/or rotate either arch. Recovery of impactions is effectively managed with lever arm springs anchored with IZC or MBS bone screws. An emerging frontier is BB anchorage for correcting severe malocclusions with clear aligners. Since the osseous-anchored mechanics are complementary, fixed appliances and clear aligners can be used individually or in tandem to resolve a broad variety of malocclusions. This report summarizes current concepts for conservatively managing complex malocclusions such as severe crowding, skeletal discrepancies, asymmetries and impactions with the OBS system.
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Affiliation(s)
| | - Lexie Y Lin
- Beethoven Orthodontic Center, HsinChu, Taiwan
| | - Wilbur Eugene Roberts
- Department of Orthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USA.,Department of Mechanical Engineering, IUPUI, Indianapolis, IN, USA.,Department of Orthodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
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20
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Influence of Orthodontic Anchor Screw Anchorage Method on the Stability of Artificial Bone: An In Vitro Study. MATERIALS 2020; 13:ma13143205. [PMID: 32708469 PMCID: PMC7411596 DOI: 10.3390/ma13143205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 11/17/2022]
Abstract
This study aims to compare the torque values for various lengths of the titanium-based orthodontic anchor screw (OAS), different anchorage methods and varying artificial bone densities after predrilling. Furthermore, the effects of these parameters on bone stability are evaluated. A total of 144 OASs were prepared with a diameter of 1.6 mm and heights of 6, 8 and 10 mm. Artificial bones were selected according to their density, corresponding to Grades 50, 40 and 30. Torque values for the automatic device and manual anchorage methods exhibited a statistically significant difference for the same-sized OAS, according to the bone density of the artificial bones (p < 0.05). However, when insertion torque was at the maximum rotations, there was no significant difference in the torque values for the Grade 30 artificial bone (p > 0.05). When the torque values of both anchorage methods were statistically compared with the mean difference for each group, the results of the manual anchorage method were significantly higher than those of the automatic device anchorage method (p < 0.05). A statistically significant difference was observed in the bone stability resulting from different OAS anchorage methods and artificial bone lengths. These findings suggest that the automatic anchorage method should be used when fixing the OAS.
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Ting CC, Hsu KJ, Hsiao SY, Chen CM. The correlation among gripping volume, insertion torque, and pullout strength of micro-implant. J Dent Sci 2020; 15:500-504. [PMID: 33505623 PMCID: PMC7816014 DOI: 10.1016/j.jds.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background/purpose The fixation stability is the key factor for orthodontic micro-implant to succeed. This study evaluated the mechanical properties of three types of micro-implants by analyzing their structural configurations. Materials and methods Thirty micro-implants of three types (diameter 1.5 mm, Types A, B, C) were assessed. All micro-implants were manually driven into artificial bones at an 8-mm depth. The insertion torque (IT), pullout strength (PS), and gripping volume (GV) of each type were measured. The indexes of mechanical properties denoted as the PS/IT, GV/IT and PS/GV ratios. Intergroup comparisons and intragroup correlation were examined using statistical analysis. Results Type B had the greatest inner–outer diameter ratio (0.67), and Type A had the smallest (0.53). The IT of Type A (5.26 Ncm) was significantly (p = 0.038) lower than that of Type C (8.8 Ncm). There was no significant difference in the pullout strength. The GV of Type A (9.7 mm3) was significantly greater than Type C (8.4 mm3). Type C was significantly greater than Type B (7.2 mm3). The ratios of mechanical properties (PS/IT, PS/GV, and GV/IT) were found significant in intergroup comparison. The PS/GV ratio was in order: Type B (26.5) > Type A (23.0) > Type C (20.2). Spearman's rho rank correlation test showed that PS of Type B was correlated significantly with GV. Conclusion The design of thread and gripping volume were the important factors that contributes to the mechanical strengths of micro-implant.
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Affiliation(s)
- Chun-Chan Ting
- School of Dentistry, Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kun-Jung Hsu
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Yu Hsiao
- Department of Dentistry for Child and Special Needs, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Ramírez-Ossa DM, Escobar-Correa N, Ramírez-Bustamante MA, Agudelo-Suárez AA. An Umbrella Review of the Effectiveness of Temporary Anchorage Devices and the Factors That Contribute to Their Success or Failure. J Evid Based Dent Pract 2020; 20:101402. [PMID: 32473811 DOI: 10.1016/j.jebdp.2020.101402] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/16/2019] [Accepted: 11/13/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES New methodological approaches, such as the umbrella review, constitute an important pathway for synthesizing the scientific evidence provided from studies with a high level of evidence. This study aims to summarize the results on the effectiveness of temporary anchorage devices (TADs) and the factors that contribute to their success or failure during orthodontic treatment in patients of different age groups and to identify the gaps in knowledge based on analysis of the scientific literature. METHODS An umbrella review of systematic reviews and meta-analyses was performed. A quality evaluation and a descriptive analysis of the included studies were conducted. The study protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018094463). RESULTS Seventeen systematic reviews and meta-analyses were considered (10 descriptive and 7 with meta-analysis; 12 of high quality and 5 of moderate quality). Variability was observed in the type of intervention and the type of system (TADs). Most of the studies reported high success rates (≥90%), and just one systematic review indicated a low rate of success (≤56%) for the mini-screws. All the studies discussed several factors related to the success of the TADs. These factors were classified as device-related factors, patient-related factors, procedure-related factors, and orthodontic treatment-related factors. Conceptual and methodological gaps were observed when considering the data analysis, the terminology used, and the orthodontic protocols. CONCLUSIONS The results should be analysed cautiously because of several research gaps related to the methodological quality and the high heterogeneity of the original studies and because of the necessity to add several clinical and sociodemographic variables to enrich the data analysis.
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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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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Haddad R, Saadeh M. Distance to alveolar crestal bone: a critical factor in the success of orthodontic mini-implants. Prog Orthod 2019; 20:19. [PMID: 31081528 PMCID: PMC6512897 DOI: 10.1186/s40510-019-0273-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/12/2019] [Indexed: 11/22/2022] Open
Abstract
Background To evaluate the success rate of orthodontic mini-implant (MI) in relation to implant characteristics, mainly implant distance to alveolar crestal bone (AC) and root proximity (RP) to adjacent teeth. Methods Two hundred sixty MIs (209 in maxilla, 51 in mandible) were categorized into success (n = 229) and failure (n = 31) groups. Distances from MI to the most adjacent tooth (DT) and to AC level (DC) were measured on periapical radiographs taken with the orthoradial projection technique. Appropriate statistical tests (chi-square, t test, logistic regression) were applied. Results DC measurements were statistically significantly greater in the success group (7.46 ± 1.7 mm) compared to 3.43 ± 0.81 mm in the failure group. Root proximity was not associated with miniscrew failure. Patient age, mini-implant site, and DC were significant predictors of mini-implant failure (p < 0.001), which decreased significantly with increasing age (Coef = − 0.345; p = 0.013) and when the mini-implant was placed between premolars (p = 0.028) or between premolar and first molar (p = 0.045). The probability of failure also decreased with increasing DC distance (Coef = − 3.595; p < 0.001). Conclusion The distance to alveolar crest was strongly associated with long-term stability. More apical placement of the MI from the crest would be compatible with a denser and thicker bucco-lingual/palatal bone level.
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Affiliation(s)
- Ramzi Haddad
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Maria Saadeh
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Orthodontics, Lebanese University Faculty of Dental Medicine, Beirut, Lebanon.,Department of Forensic Odontology, Anthropology and Human Identification, Lebanese University Faculty of Dental Medicine, Beirut, Lebanon
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TSAI MINGTZU, YU WANPING, HUANG HENGLI, HSU JUITING. EFFECT OF BONE QUALITY ON INITIAL STABILITY OF ORTHODONTIC MINISCREWS. J MECH MED BIOL 2019. [DOI: 10.1142/s021951941940013x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: This study investigated the effects of the contact percentage (BMC%) of three-dimensional (3D) bone-to-miniscrew specimens in relation to host bone quality on initial miniscrew stability. Furthermore, their correlations were evaluated.Methods: Orthodontic miniscrews (1.6[Formula: see text]mm in diameter and 11[Formula: see text]mm in length) were inserted into four types of artificial bones to measure the maximum insertion torque value (ITV). The miniscrew and artificial foam bone specimens were also scanned using microcomputed tomography, and the obtained images were imported into Mimics software to reconstruct the 3D models and calculate the BMC%. The Kruskal–Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were applied for statistical and correlation analyses.Results and Conclusions: Inserting the orthodontic miniscrew into artificial foam bone exhibiting higher bone quality resulted in higher maximum ITV and BMC%. The initial implant stability, quantified using ITV, was strongly positively ([Formula: see text]) and correlated with BMC%, as measured from microcomputed tomography images.
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Affiliation(s)
- MING-TZU TSAI
- Department of Biomedical Engineering, Hungkuang University, Taichung 433, Taiwan
| | - WAN-PING YU
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404, Taiwan
| | - HENG-LI HUANG
- School of Dentistry, College of Dentistry, China Medical University, Taichung 404, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
| | - JUI-TING HSU
- School of Dentistry, College of Dentistry, China Medical University, Taichung 404, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
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Correlation of cone beam CT-derived bone density parameters with primary implant stability assessed by peak insertion torque and periotest in the maxilla. J Craniomaxillofac Surg 2019; 47:461-467. [DOI: 10.1016/j.jcms.2019.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/06/2018] [Accepted: 01/04/2019] [Indexed: 01/24/2023] Open
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Park HJ, Choi SH, Choi YJ, Park YB, Kim KM, Yu HS. A prospective, split-mouth, clinical study of orthodontic titanium miniscrews with machined and acid-etched surfaces. Angle Orthod 2018; 89:411-417. [PMID: 30516419 DOI: 10.2319/031618-211.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To determine whether the success rate and primary stability of surface-treated miniscrews differ from those of nontreated miniscrews. MATERIALS AND METHODS Patients who required one or more miniscrews for the same reason in each quadrant were recruited into a single-blinded, split-mouth, randomized, controlled trial with a 1:1 allocation ratio. Self-drilling miniscrews with two surface types were used: those with no surface treatment, and those with an acid-etched surface treatment. The cumulative success rate and primary stability of each type of miniscrew were examined, and factors potentially affecting the success and failure of miniscrews were investigated. RESULTS Forty patients were included in the study, with a total of 98 orthodontic miniscrews. The overall success rate was 88.8%, and the respective success rates for acid-etched and machined surface miniscrews were 91.8% and 85.7%. The respective mean insertion torques were 13.62 ± 5.95 N·cm and 13.38 ± 4 N·cm, and periotest values measured immediately after insertion were -0.50 ± 2.77 for acid-etched miniscrews and -0.28 ± 3.36 for machined surface miniscrews. There was no significant difference in the mean insertion torques and periotest values according to surface treatment and jaw. CONCLUSIONS Neither the success rate nor the primary stability of acid-etched surface miniscrews and machined surface miniscrews differed significantly. There is a high possibility that miniscrews will fall out in patients who have an open bite or those who require total distalization.
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Tepedino M, Iancu-Potrubacz M, Grippaudo C, Chimenti C, Laganà G. Does muscular activity related to vertical facial divergence influence the time needed for orthodontic extrusion of palatally impacted maxillary canines? A retrospective study. J Clin Exp Dent 2018; 10:e869-e875. [PMID: 30386519 PMCID: PMC6203914 DOI: 10.4317/jced.55149] [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: 07/17/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present study was to evaluate if the different muscular activity correlated to different degrees of facial divergence has an effect on the time needed to extrude a palatally impacted maxillary canine. Material and Methods Twenty-six patients were retrospectively selected, all treated with a specific cantilever appliance that allows extrusion of the impacted canine applying a physiologic amount of force below 0.6 N in a predictable way. For all the patients, pre-treatment cephalometric tracings were used to evaluate facial divergence through the FMA angle, the angle between the maxillary and mandibular plane, and the angles between the occlusal plane and either the maxillary and mandibular plane. Linear bivariate regression was calculated to evaluate if facial divergence can predict the time needed for canine extrusion. Results The linear regression model was not able to predict extrusion time from variables explaining the facial divergence. Conclusions Palatally impacted maxillary canines can be treated with the application of physiologic extrusion force regardless of patients’ facial divergence and muscular activity. Key words:Impacted canines, cantilever, facial divergence, muscular activity.
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Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maciej Iancu-Potrubacz
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Cristina Grippaudo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore. Istituto di Clinica Odontoiatrica e Chirurgia Maxillo-facciale, Rome, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giuseppina Laganà
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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Gomez JP, Giraldo L, Montoya D, Urrea M. Cortical Piezo-Puncture as a Minimally Invasive Method for Reducing MiniScrew Implant Insertion Torque: A Preliminary in vitro Study. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_53_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective
The objective of this study was to determine the effect of cortical piezo-puncture (CPP) on maximum insertion torque (MIT), maximum removal torque (MRT), and maximum axial load (MAL) during the insertion of self-drilling miniscrew implants (MSI), in an experimental model with proximal epiphysis of bovine tibia.
Materials and Methods
A comparative study was conducted using two groups of 20 self-drilling MSI inserted in intact bone (control group) and in bone with previous CPP (experimental group). MIT, MRT, and MAL of the 20 mini implants of each group were measured. Using SPSS software, Student’s t-test was applied to compare MIT and MRT and the U-test Mann–Whitney test was applied to compare MAL in both groups as well as Pearson and Spearman correlation.
Results
In the experimental group, average values of 12.85 (±4,32) Newton x centimeters (Ncm), 13.7 (±4,54) Ncm, and 22,474 (±895,95) gF for MIT, MRT, and MAL were found, respectively. In the control group, average values found for MIT, MRT, and MAL were 20.2 (±4,7) Ncm, 22.3 (±5,17) Ncm, and 4688,7 (±320,18) gF, respectively. Statistically significant differences were observed in MIT, MRT, and MAL between control and experimental groups (P < 0,001).
Conclusions
CPP before insertion of orthodontic MSI in bovine tibia significantly reduces MIT, MRT, and MAL.
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Affiliation(s)
| | | | | | - Miguel Urrea
- Private Practice, Implantology Pereira, Colombia
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Gurdan Z, Szalma J. Evaluation of the success and complication rates of self-drilling orthodontic mini-implants. Niger J Clin Pract 2018; 21:546-552. [PMID: 29735852 DOI: 10.4103/njcp.njcp_105_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims Orthodontic mini-implants are important devices for successful anchorage management in orthodontics; however, the survival of these devices depends on several clinical factors. The aim of our study was to calculate the success and complication rates of orthodontic mini-implants. Materials and Methods In this retrospective study, patients of our orthodontic department were enrolled, getting overall 59 orthodontic mini-implants during their orthodontic treatment in a 2-year period. Every patient had one or more of the 1.6 mm × 8 mm in size self-drilling mini-implants (Jeil Dual Top Anchor System, Jeil Medical Corp., Seoul, Korea). Screw loading was performed immediately after insertions, keeping tension forces under 150 g. Soft tissue and bone infections, implant mobility and screw loss, implant fracture, and neighboring tooth injury were registered. Relationships between variables were tested using the Chi-square test for statistical significance. Results The success rate of the orthodontic mini-implants was 89.8% in this study while the average loading period was 8.1 months. Soft-tissue infections varied between 6.3% and 33.3% of the cases while screw mobility varied between 3.1% and 20.8% of the cases regarding the anatomic localization. Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034). Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034) and screw mobility was found more frequently in case of intrusions than by extrusions (P = 0.036). Conclusions The overall success rate of mini-implants was found acceptable in this study, however, screw mobility in the buccal fold showed a high incidence, suggesting the thorough consideration of the immediate loading by buccal mini-implants.
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Affiliation(s)
- Z Gurdan
- Department of Paediatric and Adolescent Dentistry, University of Pécs, H-7621 Pécs, Hungary
| | - J Szalma
- Department of Paediatric and Adolescent Dentistry, University of Pécs, H-7621 Pécs, Hungary
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Andrucioli MCD, Matsumoto MAN, Saraiva MCP, Feres M, Figueiredo LCD, Sorgi CA, Faccioli LH, Silva RABD, Silva LABD, Nelson-Filho P. Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin. J Appl Oral Sci 2018; 26:e20170631. [PMID: 29995147 PMCID: PMC6025887 DOI: 10.1590/1678-7757-2017-0631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/23/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. Material and Methods The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). Results All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p>0.05). Conclusion Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implants.
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Affiliation(s)
- Marcela Cristina Damião Andrucioli
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Mírian Aiko Nakane Matsumoto
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Maria Conceição Pereira Saraiva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Magda Feres
- Universidade de Guarulhos, Divisão de Pesquisa Odontológica, Departamento de Periodontia, Guarulhos, São Paulo, Brasil
| | | | - Carlos Artério Sorgi
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, São Paulo, Brasil
| | - Lucia Helena Faccioli
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, São Paulo, Brasil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Lea Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Paulo Nelson-Filho
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
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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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Insertion torque values and success rates for paramedian insertion of orthodontic mini-implants. J Orofac Orthop 2018; 79:109-115. [DOI: 10.1007/s00056-018-0120-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022]
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Pepelassi E, Ntolou P, Tagkli A. Factors related to the clinical application of orthodontic mini-implants. J Int Oral Health 2018. [DOI: 10.4103/jioh.jioh_28_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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36
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How do geometry-related parameters influence the clinical performance of orthodontic mini-implants? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46:1539-1551. [DOI: 10.1016/j.ijom.2017.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/14/2017] [Indexed: 01/27/2023]
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Effects of gripping volume in the mechanical strengths of orthodontic mini-implant. Kaohsiung J Med Sci 2017; 33:578-583. [DOI: 10.1016/j.kjms.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/16/2017] [Accepted: 03/24/2017] [Indexed: 11/17/2022] Open
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Maya RR, Pinzan-Vercelino CRM, Gurgel JDA. Effect of vertical placement angle on the insertion torque of mini-implants in human alveolar bone. Dental Press J Orthod 2017; 21:47-52. [PMID: 27901228 PMCID: PMC5125170 DOI: 10.1590/2177-6709.21.5.047-052.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/20/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of the present ex-vivo study was to evaluate the effect of the vertical placement angle of mini-implants on primary stability by analyzing maximum insertion torque (MIT). Methods: Mini-implants were placed in 30 human cadavers, inserted at either a 90° or 60° angle to the buccal surface of the maxillary first molar. Out of 60 self-drilling mini-implants used, half were of the cylindrical type and half were of the conical type. Primary stability was assessed by means of measuring the MIT. Data were subjected to analysis of variance (ANOVA) and Newman-Keuls tests. A significance level of 5% was adopted. Results: The MIT was higher for both mini-implant types when they were placed at a 90° angle (17.27 and 14.40 Ncm) compared with those placed at a 60° angle (14.13 and 11.40 Ncm). Conclusions: MIT values were differed according to the vertical mini-implant placement angle in the maxillary posterior area. Regardless of the type of mini-implant used, placement at a 90° angle resulted in a higher MIT.
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Affiliation(s)
- Rafael Ribeiro Maya
- MSc in Orthodontics, Universidade Ceuma (UNICEUMA), São Luís, Maranhão, Brazil
| | | | - Julio de Araujo Gurgel
- Professor, Universidade Ceuma (UNICEUMA), Masters Program in Dentistry, São Luis, Maranhão, Brazil
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Choi HW, Park YS, Chung SH, Jung MH, Moon W, Rhee SH. Comparison of mechanical and biological properties of zirconia and titanium alloy orthodontic micro-implants. Korean J Orthod 2017; 47:229-237. [PMID: 28670564 PMCID: PMC5466905 DOI: 10.4041/kjod.2017.47.4.229] [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] [Received: 07/28/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the initial stability as insertion and removal torque and the clinical applicability of novel orthodontic zirconia micro-implants made using a powder injection molding (PIM) technique with those parameters in conventional titanium micro-implants. METHODS Sixty zirconia and 60 titanium micro-implants of similar design (diameter, 1.6 mm; length, 8.0 mm) were inserted perpendicularly in solid polyurethane foam with varying densities of 20 pounds per cubic foot (pcf), 30 pcf, and 40 pcf. Primary stability was measured as maximum insertion torque (MIT) and maximum removal torque (MRT). To investigate clinical applicability, compressive and tensile forces were recorded at 0.01, 0.02, and 0.03 mm displacement of the implants at angles of 0°, 10°, 20°, 30°, and 40°. The biocompatibility of zirconia micro-implants was assessed via an experimental animal study. RESULTS There were no statistically significant differences between zirconia micro-implants and titanium alloy implants with regard to MIT, MRT, or the amount of movement in the angulated lateral displacement test. As angulation increased, the mean compressive and tensile forces required to displace both types of micro-implants increased substantially at all distances. The average bone-to-implant contact ratio of prototype zirconia micro-implants was 56.88 ± 6.72%. CONCLUSIONS Zirconia micro-implants showed initial stability and clinical applicability for diverse orthodontic treatments comparable to that of titanium micro-implants under compressive and tensile forces.
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Affiliation(s)
- Hae Won Choi
- Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Seok Park
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Shin Hye Chung
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Min Ho Jung
- Department of Orthodontics, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
| | - Won Moon
- Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, USA
| | - Sang Hoon Rhee
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
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Tepedino M, Masedu F, Chimenti C. Comparative evaluation of insertion torque and mechanical stability for self-tapping and self-drilling orthodontic miniscrews - an in vitro study. Head Face Med 2017; 13:10. [PMID: 28558821 PMCID: PMC5450203 DOI: 10.1186/s13005-017-0143-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 05/23/2017] [Indexed: 12/02/2022] Open
Abstract
Background The aim of the present study was to evaluate the relationship between insertion torque and stability of miniscrews in terms of resistance against dislocation, then comparing a self-tapping screw with a self-drilling one. Methods Insertion torque was measured during placement of 30 self-drilling and 31 self-tapping stainless steel miniscrews (Leone SpA, Sesto Fiorentino, Italy) in synthetic bone blocks. Then, an increasing pulling force was applied at an angle of 90° and 45°, and the displacement of the miniscrews was recorded. Results The statistical analysis showed a statistically significant difference between the mean Maximum Insertion Torque (MIT) observed in the two groups and showed that force angulation and MIT have a statistically significant effect on miniscrews stability. For both the miniscrews, an angle of 90° between miniscrew and loading force is preferable in terms of stability. Conclusions The tested self-drilling orthodontic miniscrews showed higher MIT and greater resistance against dislocation than the self-tapping ones. Electronic supplementary material The online version of this article (doi:10.1186/s13005-017-0143-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Viale S.Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy.
| | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Viale S.Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Viale S.Salvatore, Edificio Delta 6, 67100, L'Aquila, Italy
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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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Hosein YK, Dixon SJ, Rizkalla AS, Tassi A. A Comparison of the Mechanical Measures Used for Assessing Orthodontic Mini-Implant Stability. IMPLANT DENT 2016; 26:225-231. [PMID: 27918313 DOI: 10.1097/id.0000000000000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Mechanical loosening remains a common complication associated with mini-implant failure. The purpose of this study was to compare common mechanical measures of mini-implant stability to determine their association and reliability. MATERIALS AND METHODS Ninety self-drilling orthodontic mini-implants from 6 manufacturers were inserted into artificial bone blocks. Insertion torques (ITs) and Periotest values (PVs) were measured. Subsequently, mini-implants underwent pull-out testing for measures of pull-out load (POL) and screw displacement (ScrD). Stability measurements were compared using one-way ANOVA, associations among them were assessed using correlation analyses, and reliability was evaluated using coefficients of variation (COVs). RESULTS Variations in stability of mini-implants were found, specific to the mechanical measure used for assessment (P < 0.05). The strongest correlations were found between IT and PV (r = -0.68) and between IT and POL (r = 0.66). Overall, PV showed the greatest variability (COV: 11%-100%) compared with IT (≤11%), POL (≤4%), and ScrD (≤19%). CONCLUSIONS IT, PV, and POLs only agreed moderately in their assessment of mini-implant stability, and Periotest showed the least reliability in predicting mini-implant stability. As such, independent and interchangeable use of these stability measures should be avoided.
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Affiliation(s)
- Yara K Hosein
- *Postdoctoral Fellow, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry; Bone and Joint Institute; Western University, London, Ontario, Canada. †Distinguished University Professor, Division of Graduate Orthodontics, Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry; Bone and Joint Institute; Western University, London, Ontario, Canada. ‡Professor, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry; Department of Chemical and Biochemical Engineering, Faculty of Engineering; Bone and Joint Institute; Western University, London, Ontario, Canada. §Assistant Professor, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Meursinge Reynders R, Ronchi L, Ladu L, Di Girolamo N, de Lange J, Roberts N, Mickan S. Barriers and facilitators to the implementation of orthodontic mini implants in clinical practice: a systematic review. Syst Rev 2016; 5:163. [PMID: 27662827 PMCID: PMC5034676 DOI: 10.1186/s13643-016-0336-z] [Citation(s) in RCA: 6] [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: 03/13/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous surveys have shown that orthodontic mini implants (OMIs) are underused in clinical practice. To investigate this implementation issue, we conducted a systematic review to (1) identify barriers and facilitators to the implementation of OMIs for all potential stakeholders and (2) quantify these implementation constructs, i.e., record their prevalence. We also recorded the prevalence of clinicians in the eligible studies that do not use OMIs. METHODS Methods were based on our published protocol. Broad-spectrum eligibility criteria were defined. A barrier was defined as any variable that impedes or obstructs the use of OMIs and a facilitator as any variable that eases and promotes their use. Over 30 databases including gray literature were searched until 15 January 2016. The Joanna Briggs Institute tool for studies reporting prevalence and incidence data was used to critically appraise the included studies. Outcomes were qualitatively synthesized, and meta-analyses were only conducted when pre-set criteria were fulfilled. Three reviewers conducted all research procedures independently. We also contacted authors of eligible studies to obtain additional information. RESULTS Three surveys fulfilled the eligibility criteria. Seventeen implementation constructs were identified in these studies and were extracted from a total of 165 patients and 1391 clinicians. Eight of the 17 constructs were scored by more than 50 % of the pertinent stakeholders. Three of these constructs overlapped between studies. Contacting of authors clarified various uncertainties but was not always successful. Limitations of the eligible studies included (1) the small number of studies; (2) not defining the research questions, i.e., the primary outcomes; (3) the research design (surveys) of the studies and the exclusive use of closed-ended questions; (4) not consulting standards for identifying implementation constructs; (5) the lack of pilot testing; (6) high heterogeneity; (7) the risk of reporting bias; and (8) additional shortcomings. Meta-analyses were not possible because of these limitations. Two eligible studies found that respectively 56.3 % (952/1691) and 40.16 % (439/1093) of clinicians do not use OMIs. CONCLUSIONS Notwithstanding the limitations of the eligible studies, their findings were important because (1) 17 implementation constructs were identified of which 8 were scored by more than 50 % of the stakeholders; (2) the various shortcomings showed how to improve on future implementation studies; and (3) the underuse of OMIs in the selected studies and in the literature demonstrated the need to identify, quantify, and address implementation constructs. Prioritizing of future research questions on OMIs with all pertinent stakeholders is an important first step and could redirect research studies on OMIs towards implementation issues. Patients, clinicians, researchers, policymakers, insurance companies, implant companies, and research sponsors will all be beneficiaries.
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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, Cairns Library Level 3, John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
| | - Sharon Mickan
- Department of Allied Health, Gold Coast Health and Griffith University, Queensland, QLD, 4222, Australia
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Tseng YC, Ting CC, Du JK, Chen CM, Wu JH, Chen HS. Insertion torque, resonance frequency, and removal torque analysis of microimplants. Kaohsiung J Med Sci 2016; 32:469-74. [PMID: 27638407 DOI: 10.1016/j.kjms.2016.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 01/24/2023] Open
Abstract
This study aimed to compare the insertion torque (IT), resonance frequency (RF), and removal torque (RT) among three microimplant brands. Thirty microimplants of the three brands were used as follows: Type A (titanium alloy, 1.5-mm × 8-mm), Type B (stainless steel, 1.5-mm × 8-mm), and Type C (titanium alloy, 1.5-mm × 9-mm). A synthetic bone with a 2-mm cortical bone and bone marrow was used. Each microimplant was inserted into the synthetic bone, without predrilling, to a 7 mm depth. The IT, RF, and RT were measured in both vertical and horizontal directions. One-way analysis of variance and Spearman's rank correlation coefficient tests were used for intergroup and intragroup comparisons, respectively. In the vertical test, the ITs of Type C (7.8 Ncm) and Type B (7.5 Ncm) were significantly higher than that of Type A (4.4 Ncm). The RFs of Type C (11.5 kHz) and Type A (10.2 kHz) were significantly higher than that of Type B (7.5 kHz). Type C (7.4 Ncm) and Type B (7.3 Ncm) had significantly higher RTs than did Type A (4.1 Ncm). In the horizontal test, both the ITs and RTs were significantly higher for Type C, compared with Type A. No significant differences were found among the groups, and the study hypothesis was accepted. Type A had the lowest inner/outer diameter ratio and widest apical facing angle, engendering the lowest IT and highest RF values. However, no significant correlations in the IT, RF, and RT were observed among the three groups.
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Affiliation(s)
- Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Chan Ting
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Je-Kang Du
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, Dental Clinics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ju-Hui Wu
- Faculty of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hong-Sen Chen
- Faculty of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Torque ratio as a predictable factor on primary stability of orthodontic miniscrew implants. IMPLANT DENT 2016; 23:576-81. [PMID: 25192157 DOI: 10.1097/id.0000000000000138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the torque ratio (TR) as a predictable factor on primary stability of orthodontic miniscrews. DESIGN Fifty-eight orthodontic patients (17 men, 41 women; mean age, 21.9 years) with a total of 112 titanium miniscrews of 3 different diameters were subjected. Maximum insertion torque (MIT) and maximum removal torque (MRT) were measured by a digital torque checker at the screw placement. Four weeks after the placement, the stable screw was recorded as a success. Multiple logistic regression analysis was performed to estimate the influence of each clinical variable on success. RESULTS Success rates were 82.1% to 89.5%, and there were no significant differences in the 3 types of miniscrews. MIT and MRT showed a positive correlation but did not affect the success rates of miniscrews directly. On the contrary, TR was significantly higher in the success group than in the failure group. In multiple regression analysis, age, TR, and screw proximity had a significant influence on the miniscrew success. CONCLUSIONS TR might be related with the miniscrew success rates, and it can be used as a predictable factor on primary stability of orthodontic miniscrew implants. Miniscrew implants should be replaced if MRT is significantly lower than MIT at placement surgery.
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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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Experimental investigation of the fracture torque of orthodontic anchorage screws. J Orofac Orthop 2016; 77:272-80. [DOI: 10.1007/s00056-016-0032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/12/2016] [Indexed: 10/21/2022]
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Abstract
DATA SOURCES Medline, Embase, LILACS, Cochrane Library, Google Scholar, Web of Science, African Journals Online, Digital Dissertations. STUDY SELECTION Randomised controlled trials (RCTs), prospective controlled clinical trials(CCTs) and prospective cohort studies were included. Studies on implants with a diameter greater than 2 mm were excluded. DATA EXTRACTION AND SYNTHESIS Data were extracted independently by two authors. Bias in RCTs was assessed using the Cochrane risk of bias tool, with non-randomised studies being assessed using the Newcastle-Ottawa Scale. Failures of mini-screw implants were expressed as event rates with 95% confidence intervals. Risk factors were assessed using random effects model and sub-group and meta-regression analyses were also conducted. RESULTS Fifty-two studies; five RCTs, eight CCTs, twenty-seven prospective cohort studies and twelve studies with unclear designs that were assessed to be prospective cohort studies were included. A funnel plot suggested there may be publication bias. Analysis of 4987 miniscrew implants used in 2281 patients indicated an overall failure rate of 13.5% (95% confidence interval, 11.5%-15.8%). Failures were not associated with patient sex or age and mini-screw implant insertion side, whereas they were significantly associated with jaw of insertion. Some trends were identified through exploratory analysis but no definite conclusions could be drawn. CONCLUSIONS Orthodontic miniscrew implants have a modest small mean failure rate, indicating their usefulness in clinical practice. Although many factors seem to affect their failure rates, the majority of them still need additional evidence to support any possible associations.
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Migliorati M, Drago S, Barberis F, Schiavetti I, Dalessandri D, Benedicenti S, Biavati AS. Torque Loss After Miniscrew Placement: An In-Vitro Study Followed by a Clinical Trial. Open Dent J 2016; 10:251-60. [PMID: 27386011 PMCID: PMC4911753 DOI: 10.2174/1874210601610010251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 12/18/2022] Open
Abstract
To evaluate torque loss a week after insertion, both in an in vivo and an in vitro experimental setup were designed. In the in vivo setup a total of 29 miniscrews were placed in 20 patients who underwent orthodontic treatment. Maximum insertion torque (MIT) was evaluated at insertion time (T1). A week later, insertion torque was measured again by applying a quarter turn (T2); no load was applied on the screw during the first week. In the in vitro setup a total of 20 miniscrews were placed in pig rib bone samples. MIT was evaluated at insertion time (T1). Bone samples were kept in saline solution and controlled environment for a week during which the solution was refreshed every day. Afterwards, torque was measured again by applying a quarter turn (T2). The comparison of MIT over time was done calculating the percentage difference of the torque values between pre- and post-treatment and using the parametric two independent samples t-test or the non-parametric Mann–Whitney test. After a week unloaded miniscrews showed a mean loss of rotational torque of 36.3% and 40.9% in in vitro and in in vivo conditions, respectively. No statistical differences were found between the two different setups. Torque loss was observed after the first week in both study models; in vitro experimental setup provided a reliable study model for studying torque variation during the first week after insertion.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Sara Drago
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering (DICCA), University of Genova, Via Montallegro 1, 16145 Genova, Italy
| | - Irene Schiavetti
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genova, Italy
| | - Domenico Dalessandri
- Department of Orthodontics, School of Dentistry, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Integrated Sciences, University of Genova, Largo Benzi 8, 16132 Genova, Italy
| | - Armando Silvestrini Biavati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
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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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