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Kotan S, Koç A, Öner Talmaç AG. The current overview of the devices of temporary anchorage placed on the palatal bone: CBCT study. Odontology 2024:10.1007/s10266-024-00931-3. [PMID: 38564121 DOI: 10.1007/s10266-024-00931-3] [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: 05/31/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
Temporary anchorage devices (TADs) are frequently applied to different anatomic areas with different protocols to increase skeletal effects and anchorage in orthodontic treatment planning. It has been reported in many literatures that primary stability for orthodontic TADs is significant for long-term survival rate. For this reason, different areas of the palatal region, which has many indications, have been widely used in the studies. In this evaluation where bone quality and thickness are important, density, bone thickness, and fractal dimension (FD) on cone beam computed tomography (CBCT) will provide more predictable clinical results. The aim of this study was to evaluate bone thickness, density, and FD in the palatal region of the first, and second premolars, and first molars. There was a remarkable difference (p < 0.05) between the parameters of FD, thickness and density of bone in the identified areas in the palatal region. In terms of thickness and FD, the 1st premolar region had significantly higher values than the other regions (p < 0.05). In terms of density, the values in the right 1st molar and right 1st premolar regions were significantly higher (p < 0.05). The 1st premolar region is an ideal site for placement of palatal TADs. CBCT-assisted preliminary evaluation of FD value, bone density, and thickness may increase clinical success when selecting the location of TADs to be applied to the palatal bone.
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Affiliation(s)
- Seda Kotan
- Department of Orthodontics, Faculty of Dentistry, Iğdır University, Iğdır, 76000, Turkey.
| | - Alaettin Koç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
| | - Ayşe Gül Öner Talmaç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
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Hassan Alzahrani F, Devanna R, Althomali Y, Hassan Felemban N, Manjunath Battepati P, Holenarasipur AV. Impact of digital orthodontics on maxillary protraction with implants in children with skeletal class III: A systematic review and meta-analysis. Saudi Dent J 2024; 36:240-248. [PMID: 38420003 PMCID: PMC10897631 DOI: 10.1016/j.sdentj.2023.11.013] [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: 07/12/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 03/02/2024] Open
Abstract
Objective The objective of this systematic review is to assess the effectiveness of digital orthodontics in utilizing implants for maxillary protraction as a treatment for skeletal class III malocclusion in children. Materials and Methods The study was registered with PROSPERO with the number CRD42023407406 on 23/03/2023. We conducted an extensive comprehensive literature search in nine electronic databases, including PubMed, PubMed Central, Scopus, Cochrane databases, Google Scholar, MEDLINE, EMBASE, LILACS, and the Web of Sciences databases. The studies were evaluated for their methodology, the intervention technology used, the outcomes, and their quality. Publication bias assessment was conducted using the Jadad scale and the ROBINS-I assessment tool. Results We included a total of 17 studies that comprised a total of 376 patients in this analysis. The number of patients and participants fluctuated between 1 and 71, with > 60 % being female. The patients were aged between 1.1 and 19.2 years. We included only nine studies in the meta-analysis, in which we observed a success rate between 71.4 % and 100 % with a 95 % CI of 17.4 ± 2.988 (±17.2 %) [14.412-20.388]. The failure rates, although minimal, ranged from 5.9 % to 28.6 %, with a 95 % CI of 2.3 ± 1.480 (±64.3 %) [0.820-3.780]. Conclusion The evidence suggests that digital orthodontics is a promising approach for treating children with skeletal class III malocclusion using implants for maxillary protraction. However, further high-quality studies are required for validating our current observations and regulating the stability of treatment outcomes on a long-term basis.
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Affiliation(s)
| | - Raghu Devanna
- Orthodontic Dentistry Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Yousef Althomali
- Orthodontic Dentistry Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Nayef Hassan Felemban
- Orthodontic Dentistry Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Prashant Manjunath Battepati
- Pediatric Dentistry Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Amith V. Holenarasipur
- Community Dentistry Department of Preventive Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
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Zhu F, Ji L, Zhou C, Cao Y, Chen Z, Wu X, Zou J, Gao Y. Accuracy of Microimplant Placement Using a 3D Guide Plate for Orthodontic Anchorage. Appl Bionics Biomech 2023; 2023:9060046. [PMID: 37404956 PMCID: PMC10317578 DOI: 10.1155/2023/9060046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/31/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for orthodontic treatment and investigate the accuracy and feasibility of a 3D guide plate in clinical practice. A total of 30 microimplants were placed in 15 patients in the Department of Stomatology, Affiliated Hospital of Jiangnan University. Before surgery, DICOM data from cone-beam computed tomography (CBCT) scans and STereoLithography data from the 3D model scan were imported to 3Shape Dental System. Data fitting and matching were performed, and 3D guide plates were designed primarily focusing on the thickness of guide plates, amount of concave compensation, and dimensions of the ring. Assist implantation method was used to place the microimplants, and postoperative CBCT images were used to evaluate the position and implantation angle. The feasibility of placing microimplants and precise implantation guided by the 3D guide plate. CBCT data before and after the placement of microimplants were compared. Regarding the secure positioning of microimplants based on CBCT data, 26 implants were categorized as Grade i, four as Grade ii, and none as Grade iii. No loosening of microimplants 1 and 3 months after surgery was reported. The implantation of microimplants is more accurate under the guidance of a 3D guide plate. This technology can achieve accurate implant positioning, thus ensuring safety, stability, and improved success rates after implantation.
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Affiliation(s)
- Fangyong Zhu
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Lian Ji
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Chen Zhou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yannan Cao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Zhifei Chen
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Xiangbing Wu
- Department of Stomatology, Wuxi People's Hospital, 214000 Wuxi, China
| | - Jianming Zou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yufeng Gao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
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Musa M, Zhang Q, Awad R, Wang W, Ahmed MMS, Zhao Y, Almashraqi AA, Chen X, Alhammadi MS. Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders. Clin Oral Investig 2023; 27:2299-2310. [PMID: 37039959 DOI: 10.1007/s00784-023-04963-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/19/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). MATERIALS AND METHODS In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35 years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal-Wallis test, respectively. RESULTS The course of treatment was 6-12 months, with an average of 9.1 months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. CONCLUSION In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. CLINICAL RELEVANCE This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.
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Affiliation(s)
- Mazen Musa
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Al Tagana Dental Teaching Hospital, Faculty of Dentistry, University of Science and Technology Omdurman, Omdurman, 11111, Khartoum, Sudan
| | - Qianqian Zhang
- Department of Stomatology, Shaan'xi Provincial People's Hospital, Xi'an, Shaanxi, People's Republic of China
| | - Riham Awad
- Department of Pediatrics Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China
| | - Wenfang Wang
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Madiha Mohammed Saleh Ahmed
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
- Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Yemen
| | - Yunshan Zhao
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Abeer A Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Kum J, Park KH, Kim HJ, Hong M, Yu W, Park HS. Minimum required length of orthodontic microimplant: a numerical simulation and clinical validation. Am J Orthod Dentofacial Orthop 2023; 163:858-866. [PMID: 36732093 DOI: 10.1016/j.ajodo.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION This study aimed to determine the minimum required length of microimplants (MIs) to prevent excessive micromotion during MI healing that can lead to MI failure. METHODS Hypothesizing that the implantation depth of MI in cancellous bone (IDcancel) is the key to the control of micromotion during MI healing, we numerically investigated the minimum IDcancel required to maintain MI micromotion to below the threshold (30 μm) that would threaten MI survival. Twenty MI and bone models were built using MIs of 4 lengths and bone specimens with 5 different cortical bone thicknesses to create IDcancel in the 0.5-5.5 mm. Then, applying a horizontal force of 1.5 N on the MI head, we calculated the micromotion (peak and average MI micromotions) and determined the minimum IDcancel. A clinical test was performed to verify the numerical result by placing 160 MIs in the posterior maxilla and mandible. RESULTS A strong correlation (r2= 0.694) was found to exist between IDcancel and MI micromotion. A minimum of 2.5 mm of IDcancel was needed to maintain the level of MI micromotion (peak micromotion) <30 μm threshold. The 6-month survival rate of MI was strongly correlated with IDcancel (r2= 0.744) and decreased sharply when IDcancel was ≤2 mm. CONCLUSIONS The minimum lengths of MIs to provide the minimum IDcancel of 2.5 mm required to promote successful MI healing in the posterior maxilla and mandible are 5.2 and 6.5 mm, respectively.
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Affiliation(s)
- Jaemin Kum
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | | | - Ho-Jin Kim
- 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.
| | - 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
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Rutili V, Nieri M, Franceschi D, Pierleoni F, Giuntini V, Franchi L. Effects produced by the facemask with and without skeletal anchorage for the orthopaedic treatment of Class III malocclusion in growing patients: a systematic review and meta-analysis of RCTs. Eur J Orthod 2022; 45:157-168. [PMID: 36074492 DOI: 10.1093/ejo/cjac048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Skeletally anchored facemask has been proposed to maximize skeletal effects and minimize dental effects in the treatment of Class III malocclusion in growing patients. OBJECTIVE To compare the dento-skeletal effects produced by the facemask with or without skeletal anchorage for the treatment of Class III malocclusion in growing patients. MATERIALS AND METHODS PubMed, Cochrane Library, Scopus, Embase, Web of Science, and OpenGrey were used for the electronic search without language, publication status, and year restrictions. Only RCTs were included. Inclusion criteria were: growing patients (age under 18 years) with Class III malocclusion, with indications for treatment with the facemask. Data were extracted by two independent reviewers. GRADE statement was executed. The mean of differences (MD) and the risk ratio (RR) were used. RESULTS Three articles with a total of 123 patients were included. One article was at low risk of bias while two were at high risk of bias. There were no significant differences between the two groups in ANB angle, Wits appraisal, SNB angle, and SN-MP angle. SNA angle was significantly increased in the skeletally anchored facemask (pooled MD = 0.80 favouring skeletal anchorage, 95% CI from 0.29 to 1.31, P = 0.002, I2 = 12 per cent, three studies, GRADE moderate). The U1-SN angle was significantly reduced in the skeletally anchored facemask (pooled MD = -5.91 favouring skeletal anchorage, 95% CI from -7.64 to -4.27, P < 0.00001, I2 = 0 per cent, two studies, GRADE moderate). There were significantly less complications in tooth-anchored facemask (pooled RR = 7.98 favouring dental anchorage, 95 per cent CI from 1.04 to 61.27, P = 0.05, I2 = 0 per cent, two studies, GRADE low). LIMITATIONS Few RCTs (three) were included, and two studies were at high risk of bias. There were no long-term RCTs comparing skeletally anchored facemask with dental-anchored facemask. Only Asiatic patients were included in this systematic review. CONCLUSIONS Skeletally anchored facemask was associated to a greater increase of SNA angle at the end of treatment though clinically not significant. Facemask with skeletal anchorage determined a reduced inclination of maxillary incisors compared to dental-anchored facemask with greater risks of complications. REGISTRATION PROSPERO register (CRD42020221982).
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Affiliation(s)
- Valentina Rutili
- Postgraduate Program in Orthodontics, The University of Florence, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Debora Franceschi
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Felicita Pierleoni
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Veronica Giuntini
- Department of Experimental and Clinical Medicine, The University of Florence, Italy
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, The University of Florence, Italy.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, USA
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Jaramillo-Bedoya D, Villegas-Giraldo G, Agudelo-Suárez AA, Ramírez-Ossa DM. A Scoping Review about the Characteristics and Success-Failure Rates of Temporary Anchorage Devices in Orthodontics. Dent J (Basel) 2022; 10:78. [PMID: 35621531 PMCID: PMC9139455 DOI: 10.3390/dj10050078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/08/2022] [Accepted: 04/21/2022] [Indexed: 02/05/2023] Open
Abstract
This study synthesized the scientific evidence concerning the main characteristics of the Temporary Anchorage Devices (TADs) used in orthodontics and reported the success-failure rates during treatment. For that means, this scoping review collected articles from previous research. A complementary search was carried out in the databases PubMed-MEDLINE, Scopus, LILACS, and EMBASE, focusing on original studies published from 2010 to 2020. We analyzed the main characteristics of the publications. As a result, 103 articles were included. Most of the research was conducted among different groups, who needed TADs principally in the maxilla and an interradicular location between the second premolar and first molar. AbsoAnchor, Dentos Inc., Daegu, Korea, was the most used brand of TADs. The most common characteristics of the devices and biomechanics were a diameter and length of 1.6 mm and 8 mm, a self-drilled system, a closed technique for placement, immediate loading, and forces that ranged between 40 and 800 g. Of the studies, 47.6% showed success rates ≥90%. In conclusion, high success rates were found for TADs, and differences were found according to sociodemographic and clinical variables. The studies showed variability in methodological design, and scientific publications were concentrated in certain countries. We recommend further scientific research on TADs using more standardized designs.
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Can the Bone Density Estimated by CBCT Predict the Primary Stability of Dental Implants? A New Measurement Protocol. J Craniofac Surg 2021; 32:e171-e174. [PMID: 33705063 DOI: 10.1097/scs.0000000000006991] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The use of dental implants to restore edentulous parts of the jaws is a common and well-documented treatment method. Effective dental implant treatment is known to be affected by both the quality and the quantity of bone required for implant placement, bone quality is a critical factor to consider when predicting stability of implants. Thus, stability of the initial implant and the possibility of early loading could be predicated using cone-beam computed tomography (CBCT) scans and primary stability parameters before implant placement. OBJECTIVES The aim of this study was to objectively assess bone density obtained by CBCT and the correlations with primary stability of dental implants using implant stability meter IST device. METHODS A total of 40 implants were placed in 16 patients (9 males and 7 females with a range of 22 to 61 years (mean age 40.44 ± 12.3 years). The bone densities of implant recipient sites were preoperatively recorded using CBCT. The maximum insertion torque value of each implant was measured by engine during implant placement and compared to the primary stability for every implant using implant stability meter device (IST). RESULTS A statistically significant correlation was found between bone density value from CBCT with the primary implant stability and insertion torque. CONCLUSION Although the small samples size, the study shown bone density assessment using CBCT is an efficient method and significantly correlated with primary stability using implant stability meter device IST and insertion torque.
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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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Comparison of Trabecular Bone Mineral Density Measurement Using Hounsfield Unit and Trabecular Microstructure in Orthodontic Patients Using Cone-Beam Computed Tomography. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11031028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to measure the bone mineral density of specific regions of maxilla, mandible, and first cervical vertebra using the Hounsfield unit and trabecular microstructure pattern analysis and to compare the two methods. In this study, cone-beam computed tomography (CBCT) images were obtained from 58 patients. Trabecular thickness, trabecular number, trabecular separation, and bone volume fraction were measured in 484 regions for trabecular microstructure parameters and Hounsfield unit was measured for the grayscale value. There was no difference in bone mineral density between the right and left side in every site and between males and females. Trabecular thickness and trabecular number were high in the order of anterior base of the maxilla, mandibular body, first cervical vertebra, and mandibular condyle. Bone volume fraction and Hounsfield unit were high in the order of anterior base of the maxilla, mandibular body, mandibular condyle, and first cervical vertebra (p < 0.05). Trabecular thickness, trabecular number, and bone volume fraction was positively correlated to the Hounsfield unit, and trabecular separation was negatively correlated to the Hounsfield unit (p < 0.005). This study suggests that it is possible to compare the bone mineral density of trabecular bone in various sites using the Hounsfield unit and trabecular microstructure pattern analysis.
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Lee DW, Park JH, Bay RC, Choi SK, Chae JM. Cortical bone thickness and bone density effects on miniscrew success rates: A systematic review and meta-analysis. Orthod Craniofac Res 2020; 24 Suppl 1:92-102. [PMID: 33277824 DOI: 10.1111/ocr.12453] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To systematically review the effects of cortical bone thickness (CBT) and bone mass density (BMD) on miniscrew success rates. METHODS MEDLINE, the Cochrane Library and Scopus were searched up to June 2020. Of a total of 5734 articles, seven studies were finally selected for the review. RESULTS The overall mean success rate weighted by the number of miniscrews was 87.21% (89.87% in the maxilla and 79.24% in the mandible). There was a significantly higher success rate for miniscrews placed in the maxilla compared with those in the mandible (P < .05). CBT showed small positive effect on the success rate of the miniscrews although it failed to reach a statistical significance. The cortical BMD had a minimal effect on the success of the miniscrews. The cancellous BMD demonstrated a very strong effect on the success of the miniscrews in the maxilla, whereas it showed a moderately negative effect in the mandible. LIMITATIONS Because of the small number and clinical heterogeneity of the included studies, the results should be interpreted with caution. Further randomized clinical studies with a large sample size are recommended.
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Affiliation(s)
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - R Curtis Bay
- Biostatistics, Department of Interdisciplinary Health Sciences, A. T. Still University, Mesa, AZ, USA
| | - Sung-Kwon Choi
- Department of Orthodontics, School of Dentistry, University of Wonkwang, Iksan, Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, University of Wonkwang, Iksan, Korea
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Rai S, Misra D, Misra A. Cone-beam computed tomography assessment of bone using grayscale values in patients with diabetes mellitus. A case-control observational study. J Indian Soc Periodontol 2020; 24:560-566. [PMID: 33424174 PMCID: PMC7781243 DOI: 10.4103/jisp.jisp_719_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/06/2019] [Accepted: 06/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background: The density of cortical and cancellous bone is a key reason for implant anchorage which might be severely affected during diabetes. Aim: The aim of the study was to establish the role of cone-beam computed tomography (CBCT) using grayscale values in determining bone density in different jaw sites and in comparing the values in healthy with diabetic patients. Materials and Methods: Bone densities in 322 possible implant sites in healthy and diabetic patients were evaluated using NewTomGiano CBCT machine. Cross-sections obtained were assessed for bone densities in terms of Hounsfield Unit on different sites using New Net Technologies software version 6.1. Statistical Analysis: Data were statistically analyzed using SPSS software (version 19.0). Results: Age-wise cortical and cancellous bone densities were compared and no statistical significance was obtained. Gender-wise bone density was compared and significant results were found in males. Jaw-wise bone density was compared and was found to be significantly high in the mandible. The mean cortical bone density in control group was 1608.572 (±380.36), whereas in diabetic group was 1395.368 (±296.97), and the mean cancellous bone density in control was 906.918 (±185.40) and in diabetic was 559.868 (±128.16). Teeth wise in cortical bone significant values were found at premolar region (P = 0.046) and in cancellous bone significant values were found at canine and premolar region (P = 0.012) and highly significant values were found at molar region (P = 0.001). Conclusion: CBCT unveils a distinct pattern of cortical and cancellous bone density. A high degree of concordance between different regions of the mouth in cortical and cancellous bones was obtained in different study groups. CBCT could be used for bone density analysis.
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Affiliation(s)
- Shalu Rai
- Department of Oral Medicine and Radiology and, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Deepankar Misra
- Department of Oral Medicine and Radiology and, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Akansha Misra
- Department of Oral Pathology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
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Gousman J, Park JH, Chae JM. Evaluating mandibular symphysis bone density according to various skeletal patterns with CBCT. Orthod Craniofac Res 2020; 24:70-77. [PMID: 32599658 DOI: 10.1111/ocr.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/17/2020] [Accepted: 06/22/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this retrospective study was to evaluate the bone density (BD) at the mandibular symphysis according to horizontal and vertical patterns using cone-beam computed tomography (CBCT). SETTING AND SAMPLING Three hundred nineteen untreated adults with a mean age of 24 years. MATERIALS AND METHODS CBCT images were converted into the lateral cephalometric images, and tracings were performed for categorizing the patients based on skeletal features. Cortical BDs at B point, pogonion (Pog), genion (Ge) and menton (Me), and cancellous BDs of the mandibular symphysis were measured using CBCT images. Statistical analyses were performed to evaluate the effects of horizontal and vertical skeletal patterns on BDs. RESULTS Females exhibited higher BD than males at the Me, Pog, Ge (P < .001). Hyperdivergent skeletal pattern showed significantly higher cortical BD than normovergent and hypodivergent skeletal patterns at Me (P < .001). Normovergent skeletal pattern showed significantly higher cortical BD than hypodivergent skeletal patterns at Me (P = .001). Class II skeletal pattern showed significantly higher cortical BD than Class I and III skeletal patterns at Me (P < .001) and Ge (P < .05). Class I skeletal pattern showed significantly higher mean cortical BD than Class III skeletal pattern at B point (P = .025). Cancellous BD was higher in Class III and hypodivergent skeletal patterns than others but showed no statistical significance. CONCLUSIONS Significant differences were identified across various skeletal patterns. Several mandibular symphyseal landmarks showed statistically significant differences in BD at Me, B point and Ge, with Me having the most statistically significant findings.
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Affiliation(s)
- Jay Gousman
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, Arizona, USA.,Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, University of Wonkwang, Iksan, Korea
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Casaña-Ruiz MD, Bellot-Arcís C, Paredes-Gallardo V, García-Sanz V, Almerich-Silla JM, Montiel-Company JM. Risk factors for orthodontic mini-implants in skeletal anchorage biological stability: a systematic literature review and meta-analysis. Sci Rep 2020; 10:5848. [PMID: 32246125 PMCID: PMC7125198 DOI: 10.1038/s41598-020-62838-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/18/2020] [Indexed: 11/09/2022] Open
Abstract
The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.
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de Souza RA, Rino Neto J, de Paiva JB. Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial. Prog Orthod 2019; 20:35. [PMID: 31475309 PMCID: PMC6717741 DOI: 10.1186/s40510-019-0288-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM). Methods In this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) (n = 12), the individuals received orthopedic treatment with RME/FM. In group MI (n = 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05). Results Improvement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences (P ≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference (P > 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI. Conclusions The protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.
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Affiliation(s)
- Ricardo Alves de Souza
- School of Dentistry, University of São Paulo, São Paulo, Brazil. .,Southwest Bahia State University, Jequié, Bahia, Brazil.
| | - José Rino Neto
- School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Orthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Butantã, São Paulo, SP, 05508900, Brazil
| | - João Batista de Paiva
- School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Orthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Butantã, São Paulo, SP, 05508900, Brazil
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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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Mandibular condyle bone density in adolescents with varying skeletal patterns evaluated using cone-beam computed tomography: A potential predictive tool. Am J Orthod Dentofacial Orthop 2018; 154:382-389. [DOI: 10.1016/j.ajodo.2017.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 12/01/2017] [Accepted: 12/20/2017] [Indexed: 11/19/2022]
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18
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Park JH, Chae JM, Bay RC, Kim MJ, Lee KY, Chang NY. Evaluation of factors influencing the success rate of orthodontic microimplants using panoramic radiographs. Korean J Orthod 2018; 48:30-38. [PMID: 29291186 PMCID: PMC5702776 DOI: 10.4041/kjod.2018.48.1.30] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/22/2017] [Accepted: 07/10/2017] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this study was to investigate factors influencing the success rate of orthodontic microimplants (OMIs) using panoramic radiographs (PRs). Methods We examined 160 OMIs inserted bilaterally in the maxillary buccal alveolar bone between the second premolars and first molars of 80 patients (51 women, 29 men; mean age, 18.0 ± 6.1 years) undergoing treatment for malocclusion. The angulation and position of OMIs, as well as other parameters, were measured on PRs. The correlation between each measurement and the OMI success rate was then evaluated. Results The overall success rate was 85.0% (136/160). Age was found to be a significant predictor of implant success (p < 0.05), while sex, side of placement, extraction, and position of the OMI tip were not significant predictors (p > 0.05). The highest success rate was observed for OMIs with tips positioned on the interradicular midline (IRML; central position). Univariate analyses revealed that the OMI success rate significantly increased with an increase in the OMI length and placement height of OMI (p = 0.001). However, in simultaneous analyses, only length remained significant (p = 0.027). Root proximity, distance between the OMI tip and IRML, interradicular distance, alveolar crest width, distance between the OMI head and IRML, and placement angle were not factors for success. Correlations between the placement angle and all other measurements except root proximity were statistically significant (p < 0.05). Conclusions Our findings suggest that OMIs positioned more apically with a lesser angulation, as observed on PRs, exhibit high success rates.
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Affiliation(s)
- Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea, Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, AZ, USA.,Department of Orthodontics and Wonkwang Dental Research Institute, University of Wonkwang School of Dentistry, Iksan, Korea
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, A. T. Still University, Mesa, AZ, USA
| | - Mi-Jung Kim
- Department of Orthodontics, University of Wonkwang School of Dentistry, Iksan, Korea
| | - Keun-Young Lee
- Department of Orthodontics, Wonkwang University Sanbon Dental Hospital, Gunpo, Korea
| | - Na-Young Chang
- Department of Orthodontics and Wonkwang Dental Research Institute, University of Wonkwang School of Dentistry, Iksan, Korea
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Puttaravuttiporn P, Wongsuwanlert M, Charoemratrote C, Lindauer SJ, Leethanakul C. Effect of incisal loading during orthodontic treatment in adults: A randomized control trial. Angle Orthod 2017; 88:35-44. [PMID: 29099236 DOI: 10.2319/071017-456.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To measure the changes in tooth mobility, alveolar bone, and receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) in the gingival crevicular fluid (GCF) during orthodontic treatment to regain incisal function in the presence and absence of biting exercises. MATERIALS AND METHODS Thirty-six females (42.3 ± 6.5 years old) with periodontally compromised upper incisors received orthodontic treatment to obtain ideal incisor relationships. Eighteen subjects in the experimental biting exercise group were instructed to bite a soft plastic roll for 5 min/d; the 18 control subjects were not given plastic rolls. Alveolar bone thickness, height, and density around the upper incisors were assessed at three root levels using cone-beam computed tomography. GCF was collected at the labial and palatal sites of the upper incisors at pretreatment (T0), end of treatment (T1), 1 month after T1 (T2), and 7 months after T1 (T3). RANKL/OPG was determined using enzyme-linked immunosorbent assays. RESULTS Labial and palatal bone thickness significantly increased (>twofold) from T1 to T3 in the experimental group at all three root levels (all P < .05). Bone thickness correlated negatively with RANKL/OPG ratio between T1 and T2 ( P < .05). Tooth mobility, bone height, and density were not significantly different between T1 and T3. CONCLUSIONS Biting exercises significantly increased bone thickness but did not affect tooth mobility, bone height, or density. The RANKL/OPG ratio decreased 1 month after treatment (T2) and correlated with increased bone thickness. ( ClinicalTrials.in.th TCTR20170625001).
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Hourfar J, Bister D, Lux CJ, Al-Tamimi B, Ludwig B. Anatomic landmarks and availability of bone for placement of orthodontic mini-implants for normal and short maxillary body lengths. Am J Orthod Dentofacial Orthop 2017; 151:878-886. [PMID: 28457265 DOI: 10.1016/j.ajodo.2016.09.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Increasing numbers of orthodontic mini-implants are placed in the anterior maxilla. To our knowledge, bone levels and root proximity of patients with cephalometrically short maxillae have not been investigated before. The first, second, and third rugae were used as clinical reference lines, and the aim of this study was to measure bone availability in that area by comparing patients with short and normal maxillary body lengths. METHODS The sample consisted of 21 patients in each group: short maxillary body length and normal maxillary body length. The patients' study models were bisected, and the outline of the palatal contour was marked on the surface. The models were scanned, and the palatal contours were superimposed on the palatal structures of their respective initial cephalometric headfilms, and the vertical and oblique bone levels of the sagittal plane were compared using the Student t test. The level of significance was set at P <0.05. RESULTS Compared with maxillae of normal maxillary body length, less bone was available in maxillae of short maxillary body length. However, the differences did not reach clinical or statistical significance (P >0.05) at the third rugae. CONCLUSIONS Almost equivalent average bone depth at the third rugae in patients with normal and short maxillary body lengths suggests that this site can be used for 8-mm long obliquely inserted orthodontic mini-implants.
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Affiliation(s)
- Jan Hourfar
- Private Practice, Reinheim, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher J Lux
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Bouthayna Al-Tamimi
- Dental and Maxillofacial Surgery Department, Great Ormond Street Hospital, NHS Foundation Trust, London, United Kingdom
| | - Björn Ludwig
- Private Practice, Traben-Trarbach, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany.
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