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Willershausen I, Ehrenfried A, Krautkremer F, Ströbel A, Seidel CL, Paulsen F, Kopp M, Uder M, Gölz L, May MS. Impact of different cephalometric skeletal configurations on anatomic midface parameters in adults. Clin Oral Investig 2023; 28:55. [PMID: 38157063 PMCID: PMC10756868 DOI: 10.1007/s00784-023-05472-7] [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: 07/31/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Skull morphology and growth patterns are essential for orthodontic treatment, impacting clinical decision making. We aimed to determine the association of different cephalometric skeletal configurations on midface parameters as measured in 3D CT datasets. MATERIALS AND METHODS After sample size calculation, a total of 240 fully dentulous patients between 20 and 79 years of age (mean age: 42 ± 15), who had received a CT of the skull within the scope of trauma diagnosis or intracranial bleeding, were retrospectively selected. On the basis of cephalometric analysis, using MPR reconstructions, patients were subdivided into three different vertical skull configurations (brachyfacial, mesofacial, dolichofacial) and the respective skeletal Class I, II, and III relationships. Anatomic parameters were measured using a three-dimensional post-processing console: the thickness of the maxillary and palatine bones as well as the alveolar crest, maxillary body and sutural length, width and height of the hard palate, maxillary facial wall thickness, and masseter muscle thickness and length. RESULTS Individuals with brachyfacial configurations had a significantly increased palatal and alveolar ridge thicknesses compared to those with dolichofacial- or mesofacial configurations. Brachyfacial configurations presented a significantly increased length and thickness of the masseter muscle (4.599 cm; 1.526 cm) than mesofacial (4.431 cm; 1.466 cm) and dolichofacial configurations (4.405 cm; 1.397 cm) (p < 0.001). Individuals with a skeletal Class III had a significantly shorter palatal length (5.313 cm) than those with Class I (5.406 cm) and Class II (5.404 cm) (p < 0.01). Sutural length was also significantly shorter in Class III (p < 0.05). CONCLUSIONS Skeletal configurations have an impact on parameters of the bony skull. Also, measurable adaptations of the muscular phenotype could result. CLINICAL RELEVANCE The association between viscerocranial morphology and midface anatomy might be beneficial for tailoring orthodontic appliances to individual anatomy and planning cortically anchored orthodontic appliances.
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Affiliation(s)
- Ines Willershausen
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse 11, 91054, Erlangen, Germany.
| | - Amelie Ehrenfried
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse 11, 91054, Erlangen, Germany
| | - Franziska Krautkremer
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse 11, 91054, Erlangen, Germany
| | - Armin Ströbel
- Center for Clinical Studies (CCS), Medical Faculty, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Corinna Lesley Seidel
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse 11, 91054, Erlangen, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Markus Kopp
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Lina Gölz
- Department of Orthodontics and Orofacial Orthopedics, Friedrich-Alexander-University Erlangen-Nürnberg, Gluecksstrasse 11, 91054, Erlangen, Germany
| | - Matthias Stefan May
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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Cui MX, Qi Y, Xue LF, Xu YX, Yue J, Zhao JZ, Li C, Xiao WL. Comparative study of stress characteristics around the adjacent teeth tissues during insertion of mini-screws with different insertion angles: A three-dimensional finite element study. J Mech Behav Biomed Mater 2023; 142:105879. [PMID: 37141745 DOI: 10.1016/j.jmbbm.2023.105879] [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: 02/09/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/06/2023]
Abstract
With a limited alveolar bone position, there is a high risk that mini-screws (MS) implants could cause damage to the adjacent teeth. To reduce this damage, the position and tilt angle of the MS must be optimized. The aim of this study was to assess the effect of MS implantation angle on the stress exerted on adjacent periodontal membrane and roots. A three-dimensional finite element model containing dentition, periodontal ligament, jaw and MS were established based on the CBCT images and MS scanning data. The MS was first inserted perpendicular to the surface of the bone at specific locations and then tilted at an angle of 10° and 20° to the mesial and distal teeth, respectively. The stress distribution in the periodontal tissue of the adjacent teeth was analyzed after MS implantation at different angles.The stress on the adjacent tooth root and periodontal ligament was most uniformly distributed when the MS was inserted vertically. It changed 9.4-97.7% when the axis of MS was tilted at 10-degree and 20-degree angles from the point of vertical insertion. The stresses experienced by the periodontal ligament and the root are similar. When the horizontal angle of the MS insertion was changed, the MS was closer to the adjacent tooth, resulting in greater stress near the PDL and root. It was recommended to insert the MS vertically into the alveolar bone surface to avoid root damage due to excessive stress.
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Affiliation(s)
- Ming-Xue Cui
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Yan Qi
- Department of Stomatology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250014, China
| | - Ling-Fa Xue
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Yao-Xiang Xu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Jin Yue
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Jin-Ze Zhao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Cong Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Wen-Lin Xiao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China.
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Cone-beam computed tomography and digital model analysis of maxillary buccal alveolar bone thickness for vertical temporary skeletal anchorage device placement. Am J Orthod Dentofacial Orthop 2022; 161:e429-e438. [DOI: 10.1016/j.ajodo.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/19/2022]
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Giacobbo LC, Perin MAA, Pereira TM, Garmendia MO, Reichow A, Melo AC, Castilhos BB, Trevilatto PC. RANK
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RANKL
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OPG
gene polymorphisms and loss of orthodontic mini‐implants. Orthod Craniofac Res 2020; 23:210-222. [DOI: 10.1111/ocr.12360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 01/20/2023]
Affiliation(s)
| | | | - Thaís Munhoz Pereira
- School of Life Sciences Pontifícia Universidade Católica do Paraná Curitiba Brazil
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Effects of size and insertion angle of orthodontic mini-implants on skeletal anchorage. Am J Orthod Dentofacial Orthop 2019; 156:220-228. [PMID: 31375232 DOI: 10.1016/j.ajodo.2018.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The primary aim of this in vitro study was to compare the insertion torque (IT) and anchorage force (AF) values of 4 different sizes of orthodontic mini-implants with 2 different angles. The second aim was to evaluate the relationship between IT and AF values under different diameter, length, and insertion angle variables. METHODS A total of 160 mini-implants, including 20 implants in each group, with 4 different sizes (1.6 × 8 mm, 1.6 × 10 mm, 2.0 × 8 mm, and 2.0 × 10 mm) at 2 different angles (70° and 90°), were inserted into bovine iliac bone segments. The IT and AF values leading to 1.5 mm deflection were compared. The correlations between IT and AF values under different variables were also analyzed. RESULTS The mini-implants with greater diameter and length showed greater IT and AF values (P <0.05). The IT and AF values of mini-implants inserted at 70° angle were significantly greater than those of mini-implants inserted at 90° angle (P <0.001). Significant correlations were found between IT and AF values in all variables. CONCLUSIONS The diameter, length, and insertion angle of orthodontic mini-implants have significant effects on IT and AF values. Insertion angle and diameter of mini-implants are more effective than implant length on skeletal anchorage. Significant correlations are present between IT and AF values of mini-implants regardless of their diameters, lengths, and insertion angles.
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Kang Q, Cha C, Huang D, Zuo S, Yan X. Evaluation of palatal support tissues for placement of orthodontic mini-implants in mouth breathers with high-narrow palates versus nose breathers with normal palates: a retrospective study. Clin Oral Investig 2019; 24:1259-1267. [PMID: 31302770 DOI: 10.1007/s00784-019-03004-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to compare the palatal total support tissues (TSTs) and bone support tissues (BSTs) at 5-mm paramedian section to the midsagittal suture between mouth breathers with high-narrow palates and nose breathers with normal palates and confirm the practicability and limitation on superimposition of lateral cephalograms and plaster models for orthodontic mini-implant (OMI) implantation in these patients. MATERIAL AND METHODS The sample consisted of 27 mouth breathers with high-narrow palates (study group (SG)) and 27 nose breathers with normal palates (control group (CG)). Upper digital dental models were superimposed with corresponding cone beam computed tomography (CBCT) images; then, TSTs and BSTs vertical to the curvature of the palatal mucosa were measured on the 5-mm paramedian section to the midsagittal suture. The measuring sites were the third ruga (R) and the sites anterior and posterior to R at 2-mm interval (A2, A4, A6, and A8; P2, P4, P6, and P8) along the palatal mucosa outline. TSTs and BSTs were also measured on the superimposition of lateral cephalograms and plaster models, and the site with the largest TST value in each patient was recorded. Descriptive statistics, independent-samples t test, and hierarchical clustering heat map were used for statistical analysis. RESULTS The greatest average values of TSTs and BSTs in SG were 12.24 ± 2.63 mm and 9.59 ± 2.36 mm at P2 site, and those in CG were 12.96 ± 2.39 mm and 10.56 ± 2.38 mm at R site, respectively. The average values of both TSTs and BSTs in SG were less than those in CG at all insertion sites. Significant differences (P < 0.05) were found at A4, A6, and R for TSTs and at R and P4 for BSTs. P2 and R were clustered together for both TSTs and BSTs by the cluster analysis on heat map in both SG and CG. In both groups, only one patient from SG was found to have the insertion site with the largest TST value on 2D superimposition located in the blue area on the heat map, where the measurement values of TSTs were less than 8.5 mm and those of BSTs were less than 5 mm. CONCLUSIONS Mouth breathers with high-narrow palates may have less palatal support tissues than nose breathers with normal palates at 5-mm paramedian section to the midsagittal suture of palate. The site a little posterior to R is more suitable for OMI implantation in mouth breathers. Two-dimensional superimposition of lateral cephalograms and plaster models can provide relatively effective assessment for the site choice of OMI implantation in both mouth breathers with high-narrow palates and nose breathers with normal palates. CLINICAL RELEVANCE Three-dimensional superimposition of CBCT data and digital dental model can provide accurate information for palatal OMI implantation. Meanwhile, 2D superimposition of lateral cephalograms and plaster models can be used for assessing the implantation sites at 5-mm paramedian section to the midsagittal suture of palates in mouth breathers under most conditions even those who have less palatal support tissues.
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Affiliation(s)
- Qichao Kang
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Chang Cha
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Desheng Huang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Sihui Zuo
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China
| | - Xiulin Yan
- Department of Orthodontics, School of Stomatology, China Medical University, NO.117, Nanjing North Street, Heping District, Shenyang, 110002, Liaoning, China.
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Silva Zatarain AN, Gutiérrez Rojo JF, Castrejón S. Comparación de distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes. ACTA ODONTOLÓGICA COLOMBIANA 2018. [DOI: 10.15446/aoc.v8n2.73876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción: la colocación de mini implantes interradiculares, como alternativa para el anclaje de aparatología ortodóntica, varía acorde a la clasificación esquelética del paciente Clase I o II. Es necesario realizar la correcta identificación de la ubicación radicular y grosor cortical como parte del análisis estratégico del área a intervenir. Objetivo: comparar tomográficamente las distancias interradiculares y grosor del hueso cortical en dos sectores del maxilar inferior para colocación de mini implantes. Materiales y métodos: estudio transversal que incluyó 120 tomografías computarizadas de haz cónico, pertenecientes a pacientes Clase I (60) y Clase II (60) esquelética. Se identificó tomográficamente la distancia interradicular, el ancho bucolingual y el grosor del hueso cortical bucal, a partir de la cresta alveolar entre el segundo premolar y primer molar inferior derecho y entre el canino y lateral del mismo lado. Un análisis estadístico con prueba t Student al 95% de confianza comparó la ubicación de las estructuras anatómicas para clase I y II esquelética. Resultados: en la distancia interradicular, comparativamente entre clase I y II, se encontró significancia entre canino y lateral derecho (p=< 0.054) a los 8 mm. En este mismo sector, en el ancho bucolingual, se encontró diferencia significativa a 6mm de altura (p=<.04). En el grosor del hueso cortical no se encontraron diferencias estadísticas al comparar los valores para la Clase I y II. Conclusiones: en Clase I y II, el mayor espesor para la colocación de mini implantes se registró en el espacio interradicular a 8 mm de altura y en el ancho bucolingual a 6 mm.
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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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