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Liu F, Wang X, He Y, Han R, Wang T, Guo Y. Jaw osteoporosis: Challenges to oral health and emerging perspectives of treatment. Biomed Pharmacother 2024; 177:116995. [PMID: 38917761 DOI: 10.1016/j.biopha.2024.116995] [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: 04/19/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
Osteoporosis is a prevalent bone metabolic disease that poses a significant challenge to global human health. Jaw osteoporosis, characterized by microstructural damage of the jaw resulting from various factors, is one of the common manifestations of this condition. Recent studies have demonstrated that jaw osteoporosis has multifaceted effects on oral health and can negatively impact conditions such as periodontitis, oral implantation, orthodontic treatment, and wound healing. However, there are still some limitations in the conventional treatment of osteoporosis. For instance, while bisphosphonates can enhance bone quality, they may also lead to osteonecrosis of the jaw, which poses a potential safety hazard in oral diagnosis and treatment. In recent years, considerable attention has been focused on improving the pathological condition of jaw osteoporosis. Treatment strategies such as gut microbial regulation, extracellular vesicles, molecular targeted therapy, herbal medicine, mechanical stimulation are expected to enhance efficacy and minimize adverse reactions. Therefore, understanding these effects and exploring novel treatments for jaw osteoporosis may provide new insights for oral health maintenance and disease treatment. This article reviews the impact of jaw osteoporosis on oral health and describes the limitations associated with current methods. It also discusses emerging perspectives on treatment, offering a comprehensive overview of the challenges and future directions in managing jaw osteoporosis.
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Affiliation(s)
- Fushuang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuan Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yikai He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruiying Han
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Tianyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yongwen Guo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
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Liu JN, He YX, Jia XT, Huang R, Zeng N, Fan XC, Huang XF. Feasibility of mini-implant insertion between mesial and distal buccal roots of a maxillary first molar: A cone-beam computed tomography imaging study. Am J Orthod Dentofacial Orthop 2023; 164:665-673. [PMID: 37318427 DOI: 10.1016/j.ajodo.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mini-implant insertion in the maxillary posterior region can be influenced by anatomic limitations, thus increasing the failure rate. We explored the feasibility of a new implantation site: the region between the mesial and distal buccal roots of the maxillary first molar. METHODS Cone-beam computed tomography data from 177 patients were collected from a database. The maxillary first molars were morphologically classified by analyzing the angle and morphology of the mesial and distal buccal roots. Next, 77 subjects were randomly selected from the 177 patients to measure and analyze the hard-tissue morphology in the maxillary posterior region. RESULTS We devised the Morphological Classification on the Mesial and Distal Buccal Roots of Maxillary First Molar (MCBRMM), divided into 3 types: MCBRMM-I, II, and III. In all subjects, MCBRMM-I, II, and III accounted for 43%, 25%, and 32%, respectively. At 8 mm from the mesial cementoenamel junction of maxillary first molars, the interradicular distance between the maxillary first molar's mesiodistal buccal roots of MCBRMM-I was 2.6 mm, showing an upward trend from the cementoenamel junction to the apex. The distance from the buccal bone cortex to the palatal root was >9 mm. The buccal cortical thickness was >1 mm. CONCLUSIONS This study provided a potential site for mini-implant insertion in the maxillary posterior region: the alveolar bone of maxillary first molars in MCBRMM-I.
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Affiliation(s)
- Ji-Nan Liu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yin-Xue He
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xue-Ting Jia
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Rui Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; School of Public Health, Peking University, Beijing, China
| | - Xiao-Chuan Fan
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Feng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Stursa L, Wendl B, Jakse N, Pichelmayer M, Weiland F, Antipova V, Kirnbauer B. Accuracy of Palatal Orthodontic Mini-Implants Placed Using Fully Digital Planned Insertion Guides: A Cadaver Study. J Clin Med 2023; 12:6782. [PMID: 37959247 PMCID: PMC10647273 DOI: 10.3390/jcm12216782] [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: 09/21/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Digital workflows have become integral in orthodontic diagnosis and therapy, reducing risk factors and chair time with one-visit protocols. This study assessed the transfer accuracy of fully digital planned insertion guides for orthodontic mini-implants (OMIs) compared with freehanded insertion. Cone-beam computed tomography (CBCT) datasets and intraoral surface scans of 32 cadaver maxillae were used to place 64 miniscrews in the anterior palate. Three groups were formed, two using printed insertion guides (A and B) and one with freehand insertion (C). Group A used commercially available customized surgical templates and Group B in-house planned and fabricated insertion guides. Postoperative CBCT datasets were superimposed with the planning model, and accuracy measurements were performed using orthodontic software. Statistical differences were found for transverse angular deviations (4.81° in A vs. 12.66° in B and 5.02° in C, p = 0.003) and sagittal angular deviations (2.26° in A vs. 2.20° in B and 5.34° in C, p = 0.007). However, accurate insertion depth was not achieved in either guide group; Group A insertion was too shallow (-0.17 mm), whereas Group B insertion was deeper (+0.65 mm) than planned. Outsourcing the planning and fabrication of computer-aided design and computer-aided manufacturing insertion guides may be beneficial for certain indications; particularly, in this study, commercial templates demonstrated superior accuracy than our in-house-fabricated insertion guides.
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Affiliation(s)
- Lea Stursa
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (B.W.); (N.J.); (M.P.); (B.K.)
| | - Brigitte Wendl
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (B.W.); (N.J.); (M.P.); (B.K.)
| | - Norbert Jakse
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (B.W.); (N.J.); (M.P.); (B.K.)
| | - Margit Pichelmayer
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (B.W.); (N.J.); (M.P.); (B.K.)
| | - Frank Weiland
- Private Practice, Untere Schmiedgasse 16, 8530 Deutschlandsberg, Austria;
| | - Veronica Antipova
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, Austria;
| | - Barbara Kirnbauer
- Department of Dental Medicine and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (B.W.); (N.J.); (M.P.); (B.K.)
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Zhao J, Liu S, Zhang Z, Gong K, Zhao J. Understanding the thrust force evolution and primary stability for dental implantation – An in-vitro experimental investigation. Proc Inst Mech Eng H 2022; 236:1732-1743. [DOI: 10.1177/09544119221131880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The dental implant is challenging due to the unstable quality of the surrounding bone. This study aimed to explore the feasibility of using thrust force characteristics to identify different bone types and the influencing mechanisms of spindle speed and feed rate on primary stability of dental implants through in-vitro experiments. 13 groups of osteotomy experiments were performed on mandibles and maxillae of pigs with different bone types (I, II, and III) under different spindle speeds (600 and 800 rpm) and feed rates (20 and 60 mm/min). The thrust force evolution under different conditions was extracted and analysed to elaborate the distribution and thickness of the cortical and trabecular bone layers on different bone types. Dental implant placements were performed, and corresponding primary stabilities were obtained. Furthermore, histologic observation was conducted to reveal the bone/implant contact morphology. From the results, the amplitude and trend of thrust force show a regular variation during drilling different bone types. The highly dynamic information of thrust force can be analysed to characterise the distribution and thickness of the cortical and trabecular bone layers, hence effectively detecting different bone types. Since a lower feed rate and resulting bone temperature elevation lead to more thermal damages, primary stability decreases with the decrease of feed rate. Spindle speed has no significant effect. This study establishes a more in-depth understanding into the thrust force evolution and also provide a clinical option for reducing the complexity of bone type and drilling parameters determination in osteotomy.
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Affiliation(s)
- Jing Zhao
- Department of Stomatology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China
| | - Sinan Liu
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Zhijun Zhang
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Kun Gong
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
| | - Jian Zhao
- School of Control and Mechanical Engineering, Tianjin Chengjian University, Tianjin, China
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Zhang S, Wei X, Wang L, Wu Z, Liu L, Yan X, Lai W, Long H. Evaluation of Optimal Sites for the Insertion of Orthodontic Mini Implants at Mandibular Symphysis Region through Cone-Beam Computed Tomography. Diagnostics (Basel) 2022; 12:diagnostics12020285. [PMID: 35204375 PMCID: PMC8871083 DOI: 10.3390/diagnostics12020285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023] Open
Abstract
This study aims to evaluate the overall bone thickness (OBT) and cortical bone thickness (CBT) of mandibular symphysis and to determine the optimal sites for the insertion of orthodontic mini implants. Cone-beam computed tomography (CBCT) images of 32 patients were included in this study. The sample was further categorized into three facial types: low-, average-, and high-angle. OBT and CBT were measured at the mandibular symphysis region. All measurements were performed at six different heights from the cementoenamel junction [CEJ] and at seven different angles to the occlusal plane. Analysis of variance (ANOVA) was used for statistical comparison and a p value less than 0.05 was considered statistically significant. Our results revealed that neither OBT nor CBT was influenced by age or sex, except for the observation that CBT was significantly greater in adults than in adolescents. OBT and CBT were significantly greater in low-angle cases than in average- and high-angle cases. Both OBT and CBT were significantly influenced by insertion locations, heights and angles, and their interactions. CBT and OBT were greatest at the location between two lower central incisors, and became greater with increases in insertion height and angle. Both recommended and optimal insertion sites were mapped. The mandibular symphysis region was suitable for the placement of orthodontic mini implants. The optimal insertion site was 6–10 mm apical to the CEJ between two lower central incisors, with an insertion angle being 0–60 degrees to the occlusal plane.
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Affiliation(s)
- Shizhen Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xiaoyu Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lufei Wang
- Department of Oral and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, NC 27599, USA;
| | - Zhouqiang Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lu Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xinyu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Wenli Lai
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
| | - Hu Long
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
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Budsabong C, Trachoo V, Pittayapat P, Chantarawaratit PO. The association between thread pitch and cortical bone thickness influences the primary stability of orthodontic miniscrew implants: a study in human cadaver palates. J World Fed Orthod 2022; 11:68-73. [PMID: 35000882 DOI: 10.1016/j.ejwf.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/27/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to mathematically evaluate the influence of variations in thread pitch and cortical bone thickness on the maximum insertion torque (MIT) and implant stability (IS) of miniscrew implants (MIs). METHODS Sixty custom made MIs with a 0.4-, 0.6-, 0.8-, 1.0-, or 1.2-mm thread pitch,12 for each pitch, were randomly placed into the palates of 10 embalmed human maxillae. The MIT was measured with a hand-operated digital torque reader screwdriver with a holding guide, and the IS test was performed using Anycheck. Conebeam computerized tomography was used to measure the cortical bone thickness(CBT) at each MI site. One-way ANOVA, Tukey post hoc test, Pearson's correlation,and multiple linear regression models were performed using the SPSS program. RESULTS The MIT and IS tests demonstrated a pitch-dependent decrease. The pitch had a strong negative correlation with MIT and IS, while the CBT had a strong positive correlation with those outcomes. The association between pitch and CBT significantly influenced MI primary stability. Moreover, a strong correlation was found between MIT and IS. CONCLUSIONS The MI primary stability, MIT, and IS are strongly influenced by theassociation between MI thread pitch and CBT.
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Affiliation(s)
- Chalermporn Budsabong
- Post-graduate student in rescidency program, Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Vorapat Trachoo
- Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pisha Pittayapat
- Assistant Professor, Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pintu-On Chantarawaratit
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Uchida Y, Namura Y, Inaba M, Osada A, Charleston-Coad T, Nakamura Y, Motoyoshi M. Influence of pre-drilling diameter on the stability of orthodontic anchoring screws in the mid-palatal area. J Oral Sci 2021; 63:270-274. [PMID: 34193778 DOI: 10.2334/josnusd.21-0012] [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] [Indexed: 11/01/2022]
Abstract
PURPOSE The aim of this study was to investigate the stability of orthodontic anchor screws (OASs) in the mid-palatal area according to pre-drilling diameter. METHODS The success rate of 161 OASs (83 patients, φ2.0 mm, 6.0 mm in length) placed in a corresponding area to the mesial and distal borders of the first molar (mesial zone and distal zone) was assessed according to placement location and pre-drilling diameter (1.2 and 1.5 mm). Placement torque values from 73 OASs with a pre-drilling diameter of 1.2 mm were compared between success and failure groups. RESULTS The success rates of OASs pre-drilled with φ1.2 and 1.5 mm were 94.5% and 83.0%, respectively (P < 0.05); corresponding rates in the mesial zone were 100.0% and 77.3% (P < 0.005), and those in the distal zone were 89.2% and 88.6%, respectively. Placement torques of OASs predrilled with φ1.2 mm in the success and failure groups were 25.9 and 19.2 N·cm, respectively (P < 0.05). CONCLUSION A smaller pre-drilling diameter was associated with a higher success rate of OASs in the mid-palatal area, especially in the mesial zone. When pre-drilling diameter of 1.2 mm was used for φ2.0 mm OAS, greater placement torque was indicative of greater OAS stability.
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Affiliation(s)
- Yasuki Uchida
- Department of Orthodontics, and Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Yasuhiro Namura
- Department of Orthodontics, and Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Mizuki Inaba
- Department of Orthodontics, and Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Ayaka Osada
- Department of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Tasku Charleston-Coad
- Department of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Yoshiki Nakamura
- Department of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Mitsuru Motoyoshi
- Department of Orthodontics, and Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
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Determination of sex dimorphisms of the thickness of the hard palate in adolescence using computed tomography: Pilot study. Ann Anat 2021; 238:151764. [PMID: 34004269 DOI: 10.1016/j.aanat.2021.151764] [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: 09/14/2020] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND In addition to traditional craniometric techniques, computer craniometry has been used in recent decades, including stereometric methods, which make it possible to determine the microanatomical spatial relationships and dimensional features of various structures of the skull, in particular the thickness of the inert palate of the maxilla. AIM Determination of the gender-specific variability of the thickness of the bony palate at the age of 18-20 years using CT. MATERIAL AND METHODS The material of the pilot study were 40 computed tomograms of young males and females aged 18-20 years. The method of computer craniometry was used to measure the thickness of the bony palate in sagittal projection taking into account the gender. A graphic raster map was created to identify the palatal areas, then analyze their thickness and determine the safe zones for the mini dental implants. RESULTS In young males and females (18-20 years) the thickness of the bony palate decreases at different levels from front to back and from the median suture to the alveolar process. The greatest thickness of the bony palate corresponds to its anterior third and reliably predominates in young males at all levels compared to young females. In the middle and posterior third palate, the averages do not show gender differences and their variation is insignificant. CONCLUSIONS The greatest thickness of the bony palate can be used as the most favorable zone for the fixation of orthodontic mini dental implants. The variability in the thickness of the bony palate should be considered when selecting the most optimal zones and depth of mini-implant placement.
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Palatal bone thickness at the implantation area of maxillary skeletal expander in adult patients with skeletal Class III malocclusion: a cone-beam computed tomography study. BMC Oral Health 2021; 21:144. [PMID: 33752663 PMCID: PMC7986252 DOI: 10.1186/s12903-021-01489-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Maxillary skeletal expanders (MSE) is effective for the treatment of maxillary transverse deformity. The purpose of the study was to analyse the palatal bone thickness in the of MSE implantation in patients with skeletal class III malocclusion.
Methods A total of 80 adult patients (40 males, 40 females) with an average angle before treatment were divided into two groups, the skeletal class III malocclusion group and the skeletal I malocclusion group, based on sagittal facial type. Each group consisted of 40 patients, with a male to female ratio of 1:1. A cone-beam computed tomography scanner was employed to obtain DICOM data for all patients. The palatal bone thickness was measured at 45 sites with MIMICS 21.0 software, and SPSS 22.0 software was employed for statistical analysis. The bone thickness at different regions of the palate in the same group was analysed with one-way repeated measures ANOVA. Fisher’s least significant difference-t method was used for the comparison of pairs, and independent sample t test was employed to determine the significance of differences in the bone thickness at the same sites between the two groups. Results Palatal bone thickness was greater in the middle region of the midline area (P < 0.01), while the thickness in the middle and lateral areas in both groups was generally lower (P < 0.001). The bone in the anterior, middle, and posterior regions of the two groups became increasingly thin from the middle area toward the parapalatine region. The palatal bone was significantly thinner in the area 9.0 mm before the transverse palatine suture in the midline area, 9.0 mm before and after the transverse palatine suture in the middle area, and 9.0 mm after the transverse palatine suture in the lateral area. Conclusion The palatal bone was thinner in patients with class III malocclusion than in patients with class I malocclusion, with significant differences in some areas. The differences in bone thickness should be considered when MSE miniscrews are implanted. The anterior and middle palatal areas are safer for the implantation of miniscrews, while the thinness of the posterior palatal bone increases the risk of the miniscrews falling off and perforating.
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Chang CJ, Lin WC, Chen MY, Chang HC. Evaluation of total bone and cortical bone thickness of the palate for temporary anchorage device insertion. J Dent Sci 2021; 16:636-642. [PMID: 33854713 PMCID: PMC8025190 DOI: 10.1016/j.jds.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/25/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/PURPOSE The palate has become a popular site for the placement of temporary anchorage devices (TADs) owing to its bone quantity and quality. This study aimed to investigate total and cortical bone thicknesses in the whole palate as well as palatal width using a standard grid system and cone-bean computed tomography (CBCT) images. MATERIALS AND METHODS The CBCT images of 43 samples were selected. The total bone and cortical bone thicknesses of the palate were surveyed on 64 points per patient. The palatal width was measured. The difference between the age and sex groups was analyzed. RESULTS The total palatal bone thickness in the adult group ranged from 9.85 ± 2.04 to 1.87 ± 0.79 mm. In the adolescent group, we found one-third of the incisor roots in the area 3 mm distal to the incisive foramen and 8 mm lateral to the mid-palatal suture. The cortical bone thickness in adults was significantly thicker in the posterior paramedian area than that in adolescents. CONCLUSION The thickest vertical bone is located in the zone 3 mm distal to the incisive foramen and 4-8 mm lateral to the midpalate. The zone 6 mm posterior to the incisive foramen and 2-8 mm lateral to the midpalate exhibited optimal thickness and was away from the incisor roots. This region could be a safe zone for adolescent patients to place TADs. When TADs are to be inserted at the posterior palate, the 2-mm paramedian area should be the first region of choice.
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Affiliation(s)
- Chen-Jung Chang
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Cheng Lin
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Yen Chen
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Chih Chang
- Medical Device Innovation Center, Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
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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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Ahn HW, Kang YG, Jeong HJ, Park YG. Palatal temporary skeletal anchorage devices (TSADs): What to know and how to do? Orthod Craniofac Res 2020; 24 Suppl 1:66-74. [PMID: 33278057 DOI: 10.1111/ocr.12451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/09/2020] [Accepted: 11/29/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Since palatal temporary skeletal anchorage devices (TSADs) have become important tools for orthodontic treatment, this narrative review was aimed to provide an updated and integrated guidelines for the clinical application of palatal TSADs. SETTING AND SAMPLE POPULATION A narrative review article including researches on palatal TSADs in orthodontics related to anatomy, success rate and clinical application. MATERIALS AND METHODS The anatomical characteristics, success rate and its consideration factors and clinical application of palatal TSADs based on the direction of tooth movement were evaluated. RESULTS To improve the stability of TSADs, hard tissue factors such as bone depth, cortical bone thickness, bone density and soft tissue thickness were evaluated. Anatomically risky structures, including the nasopalatine foramen, canal and the greater palatine foramen, nerve, vessel need to be identified before placement. The success rate of palatal TSADs was greater than that of the buccal inter-radicular space. Palatal TSADs have been used for various purposes because they can control tooth movement in all directions and, three-dimensionally; their applications include the retraction of anterior teeth, protraction of posterior teeth, distalization, intrusion, expansion and constriction. They can be applied directly or indirectly to the lingual arch or transpalatal arch. Design modifications using splinted 2 miniscrews have been suggested. CONCLUSION Palatal TSADs allow clinicians to perform minimally invasive and easy placement with good stability by understanding the anatomical characteristics of the palatal region, and they show good control over 3-dimensional tooth movements in various clinical cases.
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Affiliation(s)
- Hyo-Won Ahn
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Yoon-Goo Kang
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Hyun-Joo Jeong
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Young-Guk Park
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
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Effects of Intrabony Length and Cortical Bone Density on the Primary Stability of Orthodontic Miniscrews. MATERIALS 2020; 13:ma13245615. [PMID: 33317089 PMCID: PMC7763864 DOI: 10.3390/ma13245615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
Miniscrews have gained recent popularity as temporary anchorage devices in orthodontic treatments, where failure due to sinus perforations or damage to the neighboring roots have increased. Issues regarding miniscrews in insufficient interradicular space must also be resolved. This study aimed to evaluate the primary stability of miniscrews shorter than 6 mm and their feasibility in artificial bone with densities of 30, 40, and 50 pounds per cubic foot (pcf). The primary stability was evaluated by adjusting the intrabony miniscrew length, based on several physical properties: maximum insertion torque (MIT), maximum removal torque (MRT), removal angular momentum (RAM), horizontal resistance, and micromotion. The MIT and micromotion results demonstrated that the intrabony length of a miniscrew significantly affected its stability in low-density cortical bone, unlike cases with a higher cortical bone density (p < 0.05). The horizontal resistance, MRT, and RAM were affected by the intrabony length, regardless of the bone density (p < 0.05). Thus, the primary stability of miniscrews was affected by both the cortical bone density and intrabony length. The effect of the intrabony length was more significant in low-density cortical bone, where the implantation depth increased as more energy was required to remove the miniscrew. This facilitated higher resistance and a lower risk of falling out.
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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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Primary Stability of Orthodontic Titanium Miniscrews due to Cortical Bone Density and Re-Insertion. MATERIALS 2020; 13:ma13194433. [PMID: 33028011 PMCID: PMC7579606 DOI: 10.3390/ma13194433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 11/17/2022]
Abstract
The increasing demand for orthodontic treatment over recent years has led to a growing need for the retrieval and reuse of titanium-based miniscrews to reduce the cost of treatment, especially in patients with early treatment failure due to insufficient primary stability. This in vitro study aimed to evaluate differences in the primary stability between initially inserted and re-inserted miniscrews within different cortical bone densities. Artificial bone was used to simulate cortical bone of different densities, namely 20, 30, 40, and 50 pound per cubic foot (pcf), where primary stability was evaluated based on maximum insertion torque (MIT), maximum removal torque (MRT), horizontal resistance, and micromotion. Scanning electron microscopy was used to evaluate morphological changes in the retrieved miniscrews. The MIT, MRT, horizontal resistance, and micromotion was better in samples with higher cortical bone density, thereby indicating better primary stability (P < 0.05). Furthermore, a significant reduction of MIT, MRT, and horizontal resistance was observed during re-insertion compared with the initial insertion, especially in the higher density cortical bone groups. However, there was no significant change in micromotion. While higher cortical bone density led to better primary stability, it also caused more abrasion to the miniscrews, thereby decreasing the primary stability during re-insertion.
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Möhlhenrich SC, Heussen N, Modabber A, Bock A, Hölzle F, Wilmes B, Danesh G, Szalma J. Influence of bone density, screw size and surgical procedure on orthodontic mini-implant placement - part B: implant stability. Int J Oral Maxillofac Surg 2020; 50:565-572. [PMID: 32713778 DOI: 10.1016/j.ijom.2020.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/17/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
This in vitro study aimed to investigate the influence of bone density, implant size, and surgical procedure on the primary stability (PS) of orthodontic mini-implants (OMIs). In total, 640 OMIs of various sizes (2.0 × 7, 2.3 × 7, 2.0 × 11 and 2.3 × 11 mm) were inserted in the artificial bone of different densities (D1-D4). Placement was performed with an insertion angle of 90° or 60° to the bone surface and in 320 cases without predrilling, which resulted in 64 groups. PS was measured on the basis of implant stability quotient (ISQ) and insertion torque (IT). With regard to all possible influencing parameters, the mean PS differed between 39.20 and 60.00 (ISQ), and 10.00 and 39.00 Ncm (IT). The effect of OMI size and surgical procedure was dependent on bone quality. For example, implant size had less effect in high-density bone and was stronger with decreasing density. Overall, implant length had a greater influence than the diameter, and a high correlation was found among both PS measurement techniques. Therefore, a suitable choice of implant size and surgical protocol with regard to bone density can positively influence PS. In principle, ISQ and IT are suitable for measuring OMI stability.
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Affiliation(s)
- S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany; Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany.
| | - N Heussen
- Department of Medical Statistics, University Hospital of the RWTH Aachen, Aachen, Germany; Center of Biostatistics and Epidemiology, Medical School, Sigmund Freud University, Vienna, Austria
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - A Bock
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - B Wilmes
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - G Danesh
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - J Szalma
- Department of Oral and Maxillofacial Surgery, University of Pecs, Pecs, Hungary
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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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Al Amri MS, Sabban HM, Alsaggaf DH, Alsulaimani FF, Al-Turki GA, Al-Zahrani MS, Zawawi KH. Anatomical consideration for optimal position of orthodontic miniscrews in the maxilla: a CBCT appraisal. Ann Saudi Med 2020; 40:330-337. [PMID: 32757983 PMCID: PMC7410228 DOI: 10.5144/0256-4947.2020.330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Orthodontic miniscrews are commonly used as temporary anchorage devices. Bone thickness and bone depth are important factors when placing miniscrews. There are no studies to assess the maxillary bone thickness for optimum miniscrew placement in a Saudi population. OBJECTIVE Assess the proximity of the maxillary sinus and nasal cavity in areas where miniscrews are usually inserted using cone beam computed tomography (CBCT). DESIGN Retrospective, cross-sectional. SETTING Department of maxillofacial radiology in a Saudi dental school. PATIENTS AND METHODS Using CBCT images, we measured the distance between the maxillary sinus and nasal cavity to the palatal bone, buccal intra-radicular and infrazygomatic crest areas. Mean values (SD) were compared at various locations, including by gender, and correlation with age was calculated. MAIN OUTCOME MEASURE Mean bone thickness at commonly used sites for orthodontic miniscrew placements in the maxilla. Secondary outcome was the insertion angle in the infrazygomatic crest area. SAMPLE SIZE CBCT images of 100 patients (50 males and 50 females). RESULTS The mean (standard deviation) age for the sample was 25.4 (6.5) years with no significant difference between males and females. In the palate, the distance to the nasal cavity and maxillary sinus was greater anteriorly and decreased significantly posteriorly (P<.001). Buccally, the interdental bone depth was significantly greater between the second premolar and first molar (11.96 mm) compared to between the central and lateral incisors (7.53 mm, P<.001). The mean bone thickness of the infrazygomatic crest area at a 45° insertion angle was 4.94 mm compared to 3.90 at a 70° insertion angle (P<.001). No correlation was found between age and bone thickness. CONCLUSION The distance to the nasal cavity and maxillary sinus was greater in the anterior than posterior areas. There is minimal risk of injuring the maxillary sinus or nasal cavity using the buccal approach. Caution is needed when placing miniscrews in the infrazygomatic crest area. LIMITATIONS Cross-sectional study from one center; hence, findings cannot be generalized to other populations. CONFLICT OF INTEREST None.
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Affiliation(s)
- Maha S Al Amri
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanadi M Sabban
- From the Department of Oral Diagnostic Sciences Faculty of Dentistry King Abdulaziz University
| | - Doaa H Alsaggaf
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad F Alsulaimani
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghassan A Al-Turki
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad S Al-Zahrani
- From the Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- From the Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Lo Giudice A, Quinzi V, Ronsivalle V, Martina S, Bennici O, Isola G. Description of a Digital Work-Flow for CBCT-Guided Construction of Micro-Implant Supported Maxillary Skeletal Expander. MATERIALS 2020; 13:ma13081815. [PMID: 32290597 PMCID: PMC7215674 DOI: 10.3390/ma13081815] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023]
Abstract
The introduction of miniscrew-assisted rapid palatal expansion (MARPE) has widened the boundaries of orthodontic skeletal correction of maxillary transversal deficiency to late adolescence and adult patients. In this respect, Maxillary Skeletal Expander (MSE) is a particular device characterized by the engagement of four miniscrews in the palatal and nasal cortical bone layers. Thus, the availability of sufficient supporting bone and the perforation of both cortical laminas (bi-corticalism) are two mandatory parameters for mini-screw stability, especially when orthopedic forces are used. Virtual planning and construction of MSE based on cone-beam computed tomography (CBCT)-derived stereolithography (.stl) files have been recently described in the literature. In this manuscript we described: (a) a user-friendly digital workflow which can provide a predictable placement of maxillary skeletal expander (MSE) appliance according to the patient's anatomical characteristics, (b) the construction of a positional template of the MSE that allows lab technician to construct the MSE appliance in a reliable and accurate position, according to the virtual project planned by the orthodontist on the patient CBCT scans. We also described a case report of an adult female patient affected by skeletal transversal maxillary deficiency treated with MSE appliance that was projected according to the described workflow.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (G.I.)
| | - Vincenzo Quinzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 Coppito, L’Aquila, Italy;
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (G.I.)
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, SA, Italy;
| | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (G.I.)
- Correspondence: ; Tel.: +39-0953782453
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Three-Dimensional Analysis of Cortical Bone Thickness in Individuals With Non-Syndromic Unilateral Cleft Lip and Palate. J Craniofac Surg 2019; 30:2094-2098. [PMID: 31503128 DOI: 10.1097/scs.0000000000005988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The aim of this study was to measure the cortical bone thickness of the infrazygomatic crest area in individuals with unilateral cleft lip and palate using cone beam computed tomography for placement of miniplates used for bone anchored maxillary protraction. MATERIALS AND METHODS CBCT scans were obtained from 31 non-syndromic UCLP children diagnosed with maxillary hypoplasia (17 males, 14 females, mean age: 11.9 years). 5 horizontal and 5 vertical reference planes were drawn at the infrazygomatic crest area. The cortical bone thickness at 25 intersection points on the cleft side and the non-cleft side was measured. RESULTS The mean cortical bone thickness of the 25 measured points was 1.19 mm on the cleft side and 1.17 mm on the non-cleft side with no significant difference. The greatest cortical bone thickness was found to be at the most superior, posterior point (H+6, V+0), which was 1.49 mm on the cleft side and 1.47 mm on the non-cleft side. The thinnest mean cortical bone thickness was measured at the most inferior, anterior point (H-2, V-8), which was 0.94 mm on the cleft side and 0.95 mm on the non-cleft side. There was no significant difference between males and females.
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Tirado Núñez AP, Castrejón Jaime S, Silva Zatarain AN, Gutiérrez Rojo JF. Comparación del grosor óseo palatino bilateral para inserción de miniimplantes. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n2.78843] [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
Objetivo: comparar el grosor óseo palatino bilateral e identificar zonas seguras para inserción de miniimplantes. Métodos: se llevó a cabo un estudio transversal que incluyó 100 tomografías de haz cónico (CBCT) pretratamiento de pacientes que asistieron a la Especialidad de Ortodoncia en la Universidad Autónoma de Nayarit (UAN). Las imágenes fueron orientadas utilizando el mismo protocolo. En el corte sagital, las mediciones se realizaron de los 0 a los 24mm, con intervalos de 3mm entre cada una, con la primera medición en el borde posterior del foramen incisivo. Las mediciones del grosor palatino se realizaron en el corte coronal a los 2, 4, 6 y 8mm de la sutura media palatina hacia ambos lados. Resultados: se encontró mayor grosor en la zona anterior en las medidas sagitales de 0 mm y 3 mm, a diferencia del resto del paladar. Se hallaron diferencias estadísticamente significativas al comparar los valores tanto sagitales como transversales. Con la prueba Post Hoc de Tukey no se encontraron diferencias estadísticamente significativas al comparar el lado derecho con el izquierdo en cada una de las medidas transversales. Conclusiones: no se encontraron diferencias significativas entre los dos lados, se determinó como zona segura la región anterior del paladar de 0mm a 6mm y es primordial la CBCT en todos los pacientes con indicación de miniimplantes en paladar.
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