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Arango-Piloneta EV, Plaza-Ruiz SP, León-Lara DF, Munera M, Bedoya-Henao B, Martínez-Gallego T. Stress distribution for mandibular extra-alveolar anchorage at different angles and force magnitudes: a finite element study. Comput Methods Biomech Biomed Engin 2024; 27:1587-1595. [PMID: 37647253 DOI: 10.1080/10255842.2023.2252549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/16/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
The aim of this study was to evaluate the stress distribution in cortical and cancellous bones and within the screw when a stainless steel extra-alveolar screw (EA-S) is inserted into the retromolar region of the mandible using the finite element method (FEM). The stress values in the EA-S were highest at 60° with horizontal (shear) force and lowest at 90° with axial force. In the bones (cortical and cancellous), the stress value was greatest at 90° with horizontal force. Greater stability of the screw may be achieved by tilting it to the force when horizontal loads are applied.
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Affiliation(s)
- E V Arango-Piloneta
- Orthodontic Department, Fundación Universitaria CIEO-UniCIEO, Bogotá, Colombia
| | - S P Plaza-Ruiz
- Orthodontic Department, Fundación Universitaria CIEO-UniCIEO, Bogotá, Colombia
| | - D F León-Lara
- Engineering Department, Escuela Militar Nueva Granada, Bogotá, Colombia
| | - M Munera
- UWE Bristol - Frenchay Campus, University of West England, Bristol, UK
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Tarigan SHP, Sufarnap E, Bahirrah S. The Orthodontic Mini-Implants Failures Based on Patient Outcomes: Systematic Review. Eur J Dent 2024; 18:417-429. [PMID: 37848073 PMCID: PMC11132791 DOI: 10.1055/s-0043-1772249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Anchorage is a challenge and essential issue for an orthodontist in determining the success of orthodontic treatment. Orthodontic anchorage is defined as resistance to unwanted tooth movement. Mini-implant is one of the devices that can be used as an anchor in orthodontic treatment. Many cases have reported successful treatment using mini-implant, but there are cases where mini-implants may fail. Failure of mini-implants can affect orthodontic treatment, and it is known that several factors may lead to mini-implant loss in orthodontic treatment. This systematic review aimed to determine the factors influencing mini-implant failure in orthodontic treatment. Articles were selected from electronic databases (PubMed, Google Scholar, The Cochrane Library, ScienceDirect) from January 2015 until 2023 according to the PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) under the PEOS (Population-Exposure-Outcome-StudyType) framework questions for systematic review. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022337684). All data collected were in English, and filtering was done by eliminating duplicate data, meta-analysis, case reports, case series, mini-reviews, and animal studies. The analysis was further divided into three groups, that is, patient-related, implant-related, and operator-related and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]). Twenty-one articles were identified according to the inclusion criteria in the form of retrospective, prospective, in vivo, and randomized controlled trial studies. Mini-implant failures due to patient-related showed six etiological factors, failures due to implant-related had eight etiological factors, and only one factor was operator-related, which may lead to mini-implant failure. The data was extracted without a computerized system and only in English. Mini-implant failure can be caused by many factors; we could not accuse one major factor as a cause. However, the quality or condition of the bones and oral hygiene are factors that play a significant role in obtaining the stability of implants. Mini-implant failure is highly influenced by poor oral hygiene and peri-implant inflammation. Comprehensive diagnostic prior to mini-implant insertion should be appropriately considered. This systematic review describes several factors that can influence mini-implant failure, divided into three groups: patient-related, implant-related, and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]).
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Affiliation(s)
| | - Erliera Sufarnap
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Siti Bahirrah
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
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Lin D, Wen S, Ye Z, Yang Y, Yuan X, Lai W, You M, Long H. Evaluation of Optimal Insertion Sites and Angles for Orthodontic Mini-Implants at the Anterior Nasal Spine Region Based on Cone-Beam Computed Tomography. J Clin Med 2024; 13:837. [PMID: 38337531 PMCID: PMC10856276 DOI: 10.3390/jcm13030837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/24/2023] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND To infer the optimal angulation and height level of mini-implant insertion in the anterior nasal spine (ANS) region from alveolar bone depth (BD) and labial cortical bone thickness (CBT) through cone-beam computed tomography (CBCT), the influences of sex, age, and growth pattern on BD, CBT, and the starting point of the ANS were examined. MATERIAL AND METHODS BD and CBT were measured on CBCT median sagittal images at specific angles (0, 15, 30, 45, and 60 degrees) to simulate the angulation of insertion. The height level of the first axial image with obvious bone ridge was recorded as the start of ANS. RESULTS The average height of ANS start was 9.42 mm from the alveolar bone crest between the central incisors. The variations in height level and insertion angle combined, or either of them individually, significantly influenced BD and CBT, demonstrating overall decreasing trends (p < 0.001). BD was not influenced by sex, age, or growth pattern (p > 0.05). However, CBT was found to be correlated with sex and growth pattern, while the height level of ANS start was associated only with growth pattern, particularly in hypodivergent patients (p < 0.05). CONCLUSION The recommended insertion height level is 14-16 mm from the alveolar bone crest and the recommended angulation is 30-45°. An innovative inequity in the relationship between a certain height level and the insertion angulation is proposed.
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Affiliation(s)
- Donger Lin
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
| | - Shangyou Wen
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
| | - Zelin Ye
- Department of Oral Radiology, 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 610041, China; (Z.Y.); (M.Y.)
| | - Yi Yang
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
| | - Xuechun Yuan
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
| | - Wenli Lai
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
| | - Meng You
- Department of Oral Radiology, 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 610041, China; (Z.Y.); (M.Y.)
| | - Hu Long
- Department of Orthodontics, 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 610041, China; (D.L.); (S.W.); (Y.Y.); (X.Y.); (W.L.)
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Duske K, Turan B, Prinz C, Lenz JH, Stahl F, Warkentin M. Functionality testing of an innovative biomechanically optimized and surface-modified orthodontic mini-screw-a comparative study. J Orofac Orthop 2024:10.1007/s00056-023-00508-9. [PMID: 38224419 DOI: 10.1007/s00056-023-00508-9] [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: 04/17/2023] [Accepted: 10/09/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE The failure rate of orthodontic mini-screws depends strongly on primary stability and, thus, on insertion torque. Further improvement regarding the failure rate might be achieved by modifying the surface coating. Therefore, the aim of the study was to investigate the stability of a newly designed and surface-modified orthodontic mini-screw in beagle dogs. METHODS Newly designed mini-screws coated either with DOTIZE® or DOTIZE®-copper (DOT GmbH, Rostock, Germany; each: n = 24) were inserted in the mandibles of eight beagle dogs for a duration of 8 months. Insertion and removal torque were measured. These data were compared to values generated by using the artificial bone material Sawbones® (Sawbones Europe AB, Malmö, Sweden). Experiments with and without torque limitation (each: n = 5) were run. The bone-to-implant contact rate and the amount of bone between the threads were examined. Statistical significance was set at P < 0.05. RESULTS The success rates of the in vivo study reached high levels with 95.3% for the DOTIZE-coated and 90.5% for the DOTIZE-copper-coated screws, whereas the insertion and removal torque did not differ between the coatings. During insertion, a torque limitation of 20 Ncm was necessary to ensure that the recommended limit was not exceeded. The insertion in Sawbones without torque limitation revealed a significantly higher torque compared to torque-limited insertion (18.2 ± 1.3 Ncm, 23.6 ± 1.3 Ncm). Bending occurred (n = 5) in the thread-free part of the mini-screw. CONCLUSIONS Surface coating might be able to improve the performance of orthodontic mini-screws. The study showed high success rates and stable mini-screws until the end of observation. Further investigations are necessary.
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Affiliation(s)
- Kathrin Duske
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany.
| | - Billan Turan
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany
| | | | - Jan Hendrik Lenz
- Department of Oral and Maxillofacial Surgery, Rostock University Medical Center, Rostock, Germany
| | - Franka Stahl
- Department of Orthodontics, University Dental School, Rostock University Medical Center, Strempelstr. 13, 18057, Rostock, Germany
| | - Mareike Warkentin
- Working Group for Implant Materials, Faculty of Mechanical Engineering and Marine Technologies, University of Rostock, Rostock, Germany
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Zhao NR, Guo YN, Cui SJ, Tian YJ, Zhou YH, Wang XD. Microbiological Advances in Orthodontics: An Overview and Detailed Analysis of Temporary Anchorage Devices. Curr Med Sci 2022; 42:1157-1163. [PMID: 36544036 DOI: 10.1007/s11596-022-2653-x] [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: 09/03/2021] [Accepted: 08/08/2022] [Indexed: 12/24/2022]
Abstract
Dental biofilm is the initiating factor of oral diseases, such as periodontitis and caries. Orthodontic treatment could alter the microbiome structure balance, and increase the risk of such diseases. Furthermore, fixed appliances can induce temporary changes in the microbiome community, and the changes that clear aligners bring are smaller by comparison. Temporary anchorage devices (TADs) are skeletal anchorages that are widely used in orthodontic treatment. Microorganisms affect the occurrence and development of inflammation surrounding TADs. At present, existing researches have verified the existence of plaque biofilm on the surface of TADs, but the formation of plaque biofilm and plaque composition under different stable conditions have not been fully understood. The development of high-throughput sequencing, molecular biology experiments, and metabonomics have provided new research ideas to solve this problem. They can become an effective means to explore the microbiome surrounding TADs.
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Affiliation(s)
- Ning-Rui Zhao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yan-Ning Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Sheng-Jie Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Ya-Jing Tian
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yan-Heng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Xue-Dong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
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Roberts WE, Chang CH, Chen J, Brezniak N, Yadav S. Integrating skeletal anchorage into fixed and aligner biomechanics. J World Fed Orthod 2022; 11:95-106. [DOI: 10.1016/j.ejwf.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
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Optimization Analysis of Two-Factor Continuous Variable between Thread Depth and Pitch of Microimplant under Toque Force. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2119534. [PMID: 35770114 PMCID: PMC9236792 DOI: 10.1155/2022/2119534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Microimplant, an anchorage device, is widely applied in clinical orthodontic treatment. Since tooth torque is required to be controlled during orthodontic tooth movement, a novel microimplant needs to be developed to apply better torque force during orthodontic. In this study, the optimal value ranges of thread depth and pitch under toque force were studied for choosing microimplant with relevant value ranges in clinical design from biomechanical perspective. Finite element analysis (FEA) and optimization design technology were used for accessing the optimal value ranges of thread depth and pitch under toque force. Thread depth (D) (0.1 mm to 0.4 mm) and pitch (P) (0.4 mm to 1 mm) were used as continuous variables, with the other parameters as constant, and the optimal value ranges were obtained by analyzing the tangent slope and sensitivity of the response curve. When a torque force of 6 Nmm was applied on the microimplant, the maximum equivalent stress (Max EQV) of cortical bone and maximum displacements (Max DM) of microimplant were analysis indexes. When 0.55 mm ≤ P ≤ 1 mm, the Max EQV of cortical bone was relatively smaller with less variation range. When 0.1 mm ≤ D ≤ 0.35 mm, the Max DM of microimplant was relatively smaller with less variation range. So in conclusion, the initial stability of microimplants with pitch 0.55 mm ≤ P ≤ 1 mm and thread depth 0.1 mm ≤ D ≤ 0.35 mm was better with the torque force applied.
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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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Palone M, Casella S, De Sbrocchi A, Siciliani G, Lombardo L. Space closure by miniscrew-assisted mesialization of an upper third molar and partial vestibular fixed appliance: A case report. Int Orthod 2022; 20:100602. [PMID: 35012896 DOI: 10.1016/j.ortho.2021.100602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
This case report demonstrates how the use of skeletal anchorage and appropriate orthodontic biomechanics can be used to resolve even complex cases, reducing unwanted dental movements and allowing the use of a partial vestibular appliance. It describes the complete mesialization of the left upper third molar and space closure following extraction of tooth UR7, due to vertical fracture one year after previous endodontic therapy for caries. This therapeutic choice was conditioned by the need not to alter the good pre-existing interarch relationships, and above all by the patient's request to be treated conservatively, and therefore not to undergo prosthetic implant rehabilitation. The use of orthodontic miniscrews and the careful application of orthodontic biomechanics, based on both direct and indirect anchorage, enabled the treatment objectives to be achieved in a reasonable period of time with reduced treatment costs.
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Affiliation(s)
- Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
| | - Sofia Casella
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy.
| | | | - Giuseppe Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi-Borsari, 46, 44121 Ferrara, Italy
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Derton N, Palone M, Siciliani G, Albertini P, Cremonini F, Lombardo L. Resolution of lower second molar impaction through miniscrew-supported biomechanics: A proposal for a simplified classification. Int Orthod 2021; 19:697-706. [PMID: 34696999 DOI: 10.1016/j.ortho.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 11/24/2022]
Abstract
Two case reports are presented showing how the strategic use of skeletal anchorage via orthodontic miniscrews manages to solve the complex problems of orthodontic disimpaction of second mandibular molars with excellent anchorage control and reduction of the adverse effects common to the use of conventional methods. The temporary anchorage device (TAD)-mediated biomechanics used can be categorized as both "pulling from the distal side" and "pushing from the mesial side" techniques in which both direct and indirect anchorage mechanics were employed. Each of these mechanics has its advantages and disadvantages, which must be weighed and considered on a case-by-case basis. Based on the force application side and the type of anchorage, a simplified classification of TADs supported biomechanics for the recovery of fully or partially impacted second molars is proposed.
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Affiliation(s)
| | - Mario Palone
- Postgraduated School of Orthodontics, University of Ferrara, Ferrara, Italy.
| | | | - Paolo Albertini
- Postgraduated School of Orthodontics, University of Ferrara, Ferrara, Italy
| | | | - Luca Lombardo
- Postgraduated School of Orthodontics, University of Ferrara, Ferrara, Italy
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