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Magdi S, Abdelsayed FA, Aboulfotouh MH, Fahim FH. Friction versus frictionless mechanics during maxillary en-masse retraction in adult patients with Class I bimaxillary dentoalveolar protrusion: a randomized clinical trial. Eur J Orthod 2024; 46:cjae034. [PMID: 39011819 DOI: 10.1093/ejo/cjae034] [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] [Indexed: 07/17/2024]
Abstract
BACKGROUND Extraction space closure is a challenging phase during orthodontic treatment that affects not only the total treatment duration but also the whole treatment outcome. OBJECTIVE To compare the efficiency of friction and frictionless mechanics during en-masse retraction of maxillary anterior teeth in adult patients with bimaxillary dentoalveolar protrusion. TRIAL DESIGN Two-arm parallel group, single-center randomized clinical trial. MATERIALS AND METHODS Thirty-two adult patients with bimaxillary protrusion were recruited and randomly allocated to two different retraction mechanics. A friction group, using NiTi coil springs and a frictionless group using closing T-loops for en-masse retraction. Randomization in a 1:1 ratio was generated by Microsoft Excel. The randomization numbers were secured in opaque sealed envelopes for allocation concealment. Retraction started in all patients following first premolars extraction using miniscrews as a source of indirect anchorage. Activation was done on a monthly basis until complete retraction of anterior segment. The rate of retraction, amount of anchorage loss, the dental, and soft tissue changes were analyzed on digital models and lateral cephalograms taken before retraction and after space closure. BLINDING The outcome assessor was blinded through data concealment during assessment. RESULTS Two patients were lost to follow up, so 30 patients completed the trial. The rate of anterior segment retraction was 0.88 ± 0.66 mm/month in the frictionless group compared to 0.72 ± 0.36 mm/month in the friction group which was statistically significant. Anchorage loss of 1.18 ± 0.72 mm in the friction group compared to 1.29 ± 0.55 mm in the frictionless group with no significant difference. Comparable dental and soft tissue changes following en-masse retraction were reported in both groups, with no statistically significant difference. HARM one patient complained of soft tissue swelling following miniscrew insertion, but the swelling disappeared after one week of using mouth wash. LIMITATION The study focused only on the maxillary arch. CONCLUSION Both mechanics have successfully achieved the required treatment objectives in patients with bimaxillary dentoalveolar protrusion. Frictionless group showed a faster rate of retraction than the friction group, which was statistically but not clinically significant. TRIAL REGISTRATION Clinicaltrials.gov with the identifier NCT03261024.
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Affiliation(s)
- Sally Magdi
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Fatma A Abdelsayed
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mai H Aboulfotouh
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Fady H Fahim
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Tang Y, Lu W, Zhang Y, Wu W, Sun Q, Zhang Y, Liu X, Liang W, Chen S, Han B. Variations in the alveolar bone morphology in maxillary molar area: a retrospective CBCT study. BMC Oral Health 2024; 24:872. [PMID: 39090625 PMCID: PMC11295338 DOI: 10.1186/s12903-024-04588-w] [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: 01/27/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND This study quantitatively analyzed the anatomic structure of the alveolar bone in the maxillary molar region at three potential locations for Temporary Anchorage Device (TAD) placement. Additionally, the study compared the variability in this region across different age groups, sagittal skeletal patterns, vertical facial types, and sexes. METHODS In this retrospective cone-beam computed tomography study, the buccal alveolar bone was analyzed in the posterior molar area of 200 patients, the measurement items include buccal alveolar bone height, alveolar bone thickness, interradicular distance, and maxillary retromolar space. RESULTS Buccal alveolar height was greatest in the U56 region. The interradicular space was largest in the U56 region and increased from the alveolar crest to the sinus floor. Buccal alveolar bone thickness was highest in the U67 region and generally increased from the alveolar crest to the sinus floor. The maxillary retromolar space gradually increased from the alveolar crest to the root apex. CONCLUSIONS TADs are safest when placed in the buccal area between the maxillary second premolar and the first molar, particularly at the 9 mm plane. The U67 region is the optimal safe zone for TAD placement for maxillary dentition distalization. TADs placement in adolescents can be challenging. Maxillary third molar extraction can be considered for maxillary dentition distalization.
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Affiliation(s)
- Yao Tang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- Stomatology Hospital, School of Stomatology Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Wenhsuan Lu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Yunfan Zhang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Weiqiang Wu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Qiannan Sun
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Yuning Zhang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Xiaomo Liu
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China
| | - Wei Liang
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
| | - Si Chen
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
| | - Bing Han
- Department of Orthodontics, Cranial-Facial Growth and Development Center, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, PR China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, 100081, PR China.
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Abu Arqub S, Greene R, Greene S, Laing K, Kuo CL, Godoy LDC, Uribe F. Retrospective evaluation of the success rate and factors associated with the stability of alveolar ridge orthodontic miniscrews: Pilot study. J World Fed Orthod 2024; 13:181-188. [PMID: 38643033 DOI: 10.1016/j.ejwf.2024.02.001] [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: 12/19/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND An uncommon location for placing miniscrews, used to provide anchorage control in various tooth movements, is the alveolar ridge. This study aimed to provide an evaluation of the success rate of alveolar ridge miniscrews and examine variables that might impact their success. METHODS Charts for 295 patients who had miniscrews were screened. Twenty patients (5 male and 15 female: average age = 38.15 ± 15.10 years) with a total of 50 alveolar ridge miniscrews were analyzed. A customized data form was used to collect patients' and miniscrews' related variables. Kaplan-Meier estimator was used for the survival function, whereas Cox proportional hazards regression models were used to associate collected variables with alveolar ridge miniscrew survival. RESULTS In total, 31 (62.0%) miniscrews were stable and 19 (38.0%) failed. The survival time for those that failed was 6.03 ± 7.08 months. The follow-up period for those that survived was 35.84 ± 19.47 months. Male gender versus female (hazard ratio [HR] 2.46; 95% confidence interval [CI] 1.35-4.48; P = 0.003), and if the miniscrew was a replacement versus non-replacement (HR 0.27; 95% CI 0.07-0.99; P = 0.048) influenced the survival. Additionally, miniscrews that were used for both indirect and direct or indirect anchorage alone plus those with evidence of splinting showed a 100% survival rate, which led to an HR 0 (P < 0.001). When the previously mentioned variables were modeled, none seemed to have a significant effect on failure except for splinting and type of anchorage (P < 0.001), because none of the splinted miniscrews failed. CONCLUSIONS The failure rate of alveolar ridge miniscrews was (38.0%) over 6.03 ± 7.08 months. The survival rate was (62.0%) over 35.84 ± 19.47 months. The evidence of splinting and the type of anchorage had a significant effect on survival probability.
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Affiliation(s)
- Sarah Abu Arqub
- Clinical assistant professor, Department of Orthodontics, University of Florida, Gainesville, Florida.
| | - Renee Greene
- Resident, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
| | - Sara Greene
- Resident, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
| | - Kolbe Laing
- Dental student, UConn School of Dental Medicine, University of Connecticut, Farmington, Connecticut
| | - Chia-Ling Kuo
- Associate Professor, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut
| | - Lucas Da Cunha Godoy
- Associate Professor, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut
| | - Flavio Uribe
- Professor Ravi Nanda Endowed Professor Program Director and Chair, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
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Xiao T, Su JY, Lei J, Zhang X, Yu J, Nie XP, Ying QH, Hou JX, Guo J. Effectiveness of different intrusion modes of maxillary anterior teeth with mini-implants in clear aligner treatment: a three-dimensional finite element analysis. BMC Oral Health 2024; 24:758. [PMID: 38956625 PMCID: PMC11218253 DOI: 10.1186/s12903-024-04537-7] [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: 01/18/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The intrusion of maxillary anterior teeth is often required and there are various intrusion modes with mini-implants in clear aligner treatment. The objective of this study was to evaluate the effectiveness of maxillary anterior teeth intrusion with different intrusion modes, aiming to provide references for precise and safe intrusion movements in clinical practice. METHODS Cone-beam computed tomography and intraoral optical scanning data of a patient were collected. Finite element models of the maxilla, maxillary dentition, periodontal ligaments (PDLs), clear aligner (CA), attachments, and mini-implants were established. Different intrusion modes of the maxillary anterior teeth were simulated by changing the mini-implant site (between central incisors, between central and lateral incisor, between lateral incisor and canine), loading site (between central incisors, on central incisor, between central and lateral incisor, between lateral incisor and canine), and loading mode (labial loading and labiolingual loading). Ten conditions were generated and intrusive forces of 100 g were applied totally. Then displacement tendency of the maxillary anterior teeth and CA, and stress of the PDLs were analyzed. RESULTS For the central incisor under condition L14 and for the canine under conditions L11, L13, L23, and L33, the intrusion amount was negative. Under other conditions, the intrusion amount was positive. The labiolingual angulation of maxillary anterior teeth exhibited positive changes under all conditions, with greater changes under linguoincisal loading. The mesiodistal angulation of canine exhibited positive changes under labial loading, while negative changes under linguoincisal loading except for condition L14. CONCLUSIONS The intrusion amount, labiolingual and mesiodistal angulations of the maxillary anterior teeth were affected by the mini-implant site, loading site, and loading mode. Labial and linguoincisal loading may have opposite effects on the intrusion amount of maxillary anterior teeth and the mesiodistal angulation of canine. The labiolingual angulation of the maxillary incisors would increase under all intrusion modes, with greater increases under linguoincisal loading.
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Affiliation(s)
- Tian Xiao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Jing-Yuan Su
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Jie Lei
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Xin Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Jian Yu
- Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Xiu-Ping Nie
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Qiao-Hui Ying
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China
| | - Jun-Xiang Hou
- R&D center, Wuxi EA Medical Instruments Technologies Ltd, Wuxi, 214174, China
| | - Jie Guo
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, No.44-1 Wenhua Road West, Jinan, Shandong, 250012, China.
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Al-Gazzawi AMQ, Knode V, Ludwig B, Othman A, Salamini A, Pandis N, Fleming PS. Midpalatal miniscrew insertion: The accuracy of digital planning and surgical placement. Am J Orthod Dentofacial Orthop 2024; 166:69-75. [PMID: 38647514 DOI: 10.1016/j.ajodo.2024.02.014] [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: 11/01/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION The objective of this study was to investigate the accuracy of palatal miniscrew insertion, evaluating the effect of guide fabrication and surgical placement. METHODS Guided insertion of bilateral paramedian palatal miniscrews was undertaken using Appliance Designer software (3Shape, Copenhagen, Denmark). A resin surgical guide (P Pro Surgical Guide; Straumann AG, Basel, Switzerland) was used. Superimposition of the miniscrew position relative to the digital design was undertaken using bespoke software (Inspect 3D module, OnyxCeph; Image Instruments GmbH, Chemnitz, Germany) to assess surgical inaccuracy. Miniscrew position relative to the surgical guide was also assessed to isolate the effect of planning inaccuracies. Both horizontal and vertical discrepancies were evaluated at both implant locations. RESULTS Twenty-seven patients having bilateral palatal insertions were examined. Mean discrepancies were <0.5 mm, both in the horizontal and vertical planes. The mean overall horizontal and vertical discrepancy between the digital design and final miniscrew position on the left side was 0.32 ± 0.15 mm and 0.34 ± 0.17 mm, respectively. The maximum horizontal discrepancy observed was 0.72 mm. No significant differences were observed in relation to the accuracy of mini-implant positioning on the basis of sidedness, either for horizontal (P = 0.29) or vertical (P = 0.86) discrepancy. CONCLUSIONS High levels of accuracy associated with guided insertion of paramedian palatal implants were recorded with mean discrepancies of less than 0.5 mm both in the horizontal and vertical planes. No difference in accuracy was noted between the left and right sides. Very minor levels of inaccuracy associated both with surgical techniques and surgical guide fabrication were recorded.
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Affiliation(s)
| | | | - Bjorn Ludwig
- Private practice, Traben-Trarbach, Germany; Department of Orthodontics, University of Homburg, Saar, Germany
| | | | | | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Medical Faculty, Dental School, University of Bern, Bern, Switzerland
| | - Padhraig S Fleming
- Division of Public and Child Dental Health, Dublin Dental University Hospital, The University of Dublin, Trinity College Dublin, Dublin, Ireland.
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Woolley J, Wright N, Meade MJ. Usage of temporary anchorage devices: A cross-cultural and cross-sectional survey of orthodontists in Australia and the UK. Int Orthod 2024; 22:100843. [PMID: 38244360 DOI: 10.1016/j.ortho.2023.100843] [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: 11/21/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/22/2024]
Abstract
INTRODUCTION Detailed insight regarding the use of temporary anchorage devices (TAD) in Australia and the United Kingdom (UK) is lacking. The primary aim of the present cross-sectional survey was to investigate TAD usage among UK-based and Australian-based orthodontists. The secondary objectives were to compare TAD-related preferences and protocols between orthodontists in the two countries. METHODS A pilot-tested electronic questionnaire was distributed to members of the British Orthodontic Society and the Australian Society of Orthodontists. Questions pertained to their demographic details, and current use of TADs including protocols, treatment objectives and factors influencing their use. RESULTS A total of 192 responses were recorded (Australia: 122; UK: 70). One hundred and forty-two respondents (74.0%) reported using TADs as part of their orthodontic treatment, 77.0% in Australia (n=94) and 68.6% in the UK (n=48). Molar protraction was the most common procedure for which TADs were reportedly used (Australia: n=118; 87.2%, UK: n=36; 75.0%). "Loosening" was the most prevalent reported complication overall (n=124; 90.1%). "Confidence", "insufficient postgraduate education" and "availability of equipment" were the factors that most influenced the decision not to provide TADs. CONCLUSIONS Most orthodontists in both countries provided TADs. TAD protocols of orthodontists in both countries were reported. Similarities and differences regarding TAD-related clinical practices and procedures, complications and factors influencing the use of TADs and reasons for not using TADs were explored. Information from the present study can provide baseline data for future related studies in each country and for comparison of TAD usage in other countries.
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Affiliation(s)
- Julian Woolley
- Orthodontic Department, Cambridge University Hospital, Cambridge CB2 0QQ, United Kingdom; King's College London Dental Institute, London, United Kingdom.
| | - Natasha Wright
- Orthodontic Department, Cambridge University Hospital, Cambridge CB2 0QQ, United Kingdom
| | - Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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Mehta S, Arqub SA, Vishwanath M, Upadhyay M, Yadav S. Biomechanics of conventional and miniscrew-assisted rapid palatal expansion. J World Fed Orthod 2024; 13:105-112. [PMID: 38697910 DOI: 10.1016/j.ejwf.2024.03.002] [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: 11/19/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 05/05/2024]
Abstract
Posterior Crossbite is a common condition resulting because of transverse maxillary deficiency. The growth of the craniofacial complex finishes first in the transverse dimension, followed by sagittal and vertical dimensions. Conventional rapid palatal expansion (RPE) appliances are commonly used to correct transverse maxillary deficiency. Although RPE is efficient in correcting posterior crossbite, it results in dental side effects such as buccal tipping of maxillary molars, root resorption, bone dehiscence, and relapse. Mini-implant-assisted RPE has been introduced to increase the skeletal effects of expansion especially in patients with increased maturation and greater interdigitation of midpalatal suture. This article will review the biomechanics of RPE and mini-implant-assisted RPE. Additionally, the different designs of MARPE and the long-term clinical effects of expansion appliances will also be discussed in detail.
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Affiliation(s)
- Shivam Mehta
- Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, Texas
| | - Sarah Abu Arqub
- Division of Orthodontics, University of Florida Health, Gainesville, Florida
| | - Meenakshi Vishwanath
- Program Director, Orthodontic Section, Department of Growth and Development, UNMC College of Dentistry, Lincoln, Nebraska
| | - Madhur Upadhyay
- Division of Orthodontics, Program Director, Orthodontic Fellowship Program, University of Connecticut Health, Farmington, Connecticut
| | - Sumit Yadav
- Henry and Anne Cech Professor of Orthodontics, UNMC College of Dentistry and Children's Hospital and Medical Center, Lincoln, Nebraska.
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Di Carlo G, Biondi G, Gazzola I, Saccucci M. Biomechanical Multipurpose Miniscrew Strategy for Simultaneous Distalization in Class II Patients-The BiGa System. Biomimetics (Basel) 2024; 9:305. [PMID: 38786515 PMCID: PMC11117739 DOI: 10.3390/biomimetics9050305] [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: 04/08/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
An efficient treatment plan using a temporary anchorage device should be built following the principle of reducing the number of tads to obtain a multiple biomechanical advantage. The following case report concerns the Biga system, a strategy that supports orthodontists during class II corrections and vertical control through treatment. A 12-year-old girl with a high angle of skeletal class II was selected. A novel biomechanical strategy was effectively applied using two tads on the upper arch to obtain sequential distalization of the upper teeth and to correct the lower arch spee curve using third-class elastics. Eventually, on the same tads, a double cantilever was applied to control the overbite and intrusion during incisors' retraction. The Biga system is an easy biomechanical strategy that ensures the three-dimensional control of treatment mechanics in class II patients.
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Affiliation(s)
- Gabriele Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161 Rome, Italy;
| | | | - Ivan Gazzola
- Private Practice, 31033 Castelfranco Veneto, Italy;
| | - Matteo Saccucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Viale Regina Elena 287a, 00161 Rome, Italy;
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Patel B, De Rose J, Nash J, Sekula M, Gioia C, Deguchi T, Gudhimella S, Gandhi V. Variability associated with maxillary infrazygomatic crest and palatal bone width, height, and angulation in subjects with different vertical facial growth types: a retrospective cone-beam computed tomography study. Angle Orthod 2024; 94:313-319. [PMID: 38195059 PMCID: PMC11050457 DOI: 10.2319/062023-430.1] [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: 06/01/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES To assess the infrazygomatic crest (IZC) and palatal bone width, height, and angulation in patients with different vertical facial growth types as potential miniscrew insertion sites. MATERIALS AND METHODS In this retrospective cone-beam computed tomography study, 162 subjects (81 males and 81 females, mean age 16.05 ± 0.65 years) were included. They were divided into three groups (hypodivergent, normodivergent, and hyperdivergent) based on the Frankfort mandibular plane angle. Ten buccal bone measurements were made at two different coronal sections: maxillary first molar mesiobuccal and distobuccal roots (bilaterally). Six palatal bone measurements were made on a sagittal section at the maxillary central incisors (bilaterally). A total of 32 measurements per subject were considered in the study. RESULTS No significant difference was observed for the IZC (width and angle) at the maxillary first molar mesiobuccal root. A comparison of normodivergent and hyperdivergent groups for buccal width at the distobuccal root of the first molar showed significant differences. Palatal bone thickness at the level of 2 mm distal to the apex of the central incisor was significantly higher for the hyperdivergent group (10.43 mm) compared with the normodivergent (7.58 mm) and hypodivergent groups (7.83 mm). CONCLUSIONS Hyperdivergent subjects tend to present a longer and deeper IZC and increased palatal bone thickness compared with other groups. The recommended insertion angle for the IZC mini-implant at 3 mm from the alveolar crest should be between 75.5° and 77°.
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Manni A, Migliorati M, Boggio A, Drago S, Paggi E, Calzolari C, Gastaldi G, Cozzani M. Evaluation of the Co-Go-Me angle as a predictor in Class II patients treated with Herbst appliance and skeletal anchorage: a retrospective cohort study. FRONTIERS IN ORAL HEALTH 2024; 5:1389628. [PMID: 38745852 PMCID: PMC11091312 DOI: 10.3389/froh.2024.1389628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction A condylion-gonion-menton (Co-Go-Me) angle threshold of 125.5° has been introduced as a predictive parameter of cephalometric mandibular response in the orthopedic treatment of growing Class II patients with functional appliances, despite some contradictions in the literature. Considering the lack of studies evaluating the role of skeletal anchorage, this study aims to reassess the threshold of 125.5° in the Co-Go-Me angle as a useful predictor in growing skeletal Class II patients treated with acrylic splint Herbst appliance and two mini-screws in the lower arch (STM2). Methods Thirty-five consecutively treated patients (20 males, 15 females; mean age, 11.37 years) with mandibular retrusion were classified into two groups according to their Co-Go-Me baseline values (Group 1, <125.5°; Group 2, >125.5°). The STM2 protocol involved the use of the MTH Herbst appliance with an acrylic splint in the lower arch and two interradicular mini-screws as anchorage reinforcement. Cephalometric analysis was performed by the same operator for each patient at baseline (T0) and at the end of the Herbst phase (T1). The effects of time and group on the variables were assessed by a repeated-measures analysis of variance. The primary research outcome was the difference between the groups in terms of mandibular responsiveness to treatment referred to as the relative difference (T1-T0) in Co_Gn. Results The mean duration of the treatment was 9.5 months. No statistically significant differences between groups were detected at baseline, except from the expected SN/GoMe° (p < 0.001) and Co-Go mm (p = 0.028). No statistically significant changes between groups, which were caused by the treatment, were found considering the mandibular sagittal and vertical skeletal parameters. Similarly, no statistically significant differences were found in the dental changes between the high-angle and low-angle patients, apart from the upper molar sagittal position (p = 0.013). Discussion and conclusions The 125.5° threshold in the Co-Go-Me value was not a reliable predictive parameter for the mandibular response in growing patients treated with the MTH Herbst appliance and lower skeletal anchorage. Due to its effective control in the sagittal and vertical planes, the STM2 technique might be an appropriate protocol to use in treating skeletal Class II patients, regardless of the growth pattern.
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Affiliation(s)
- Antonio Manni
- Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Istituto Giuseppe Cozzani, La Spezia, Italy
| | - Marco Migliorati
- Department of Integrated Diagnostic and Surgical Sciences, University of Genoa, Genoa, Italy
| | - Andrea Boggio
- Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Istituto Giuseppe Cozzani, La Spezia, Italy
| | - Sara Drago
- Department of Integrated Diagnostic and Surgical Sciences, University of Genoa, Genoa, Italy
| | - Elena Paggi
- Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Istituto Giuseppe Cozzani, La Spezia, Italy
| | - Chiara Calzolari
- Department of Integrated Diagnostic and Surgical Sciences, University of Genoa, Genoa, Italy
| | - Giorgio Gastaldi
- Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
| | - Mauro Cozzani
- Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Istituto Giuseppe Cozzani, La Spezia, Italy
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Schwertner A, de Almeida-Pedrin RR, Poleti TMFF, Oltramari P, de Castro Conti ACF, Cotrim-Ferreira FA, de Almeida G, Flores-Mir C, de Almeida MR. Biomechanical analysis of total arch maxillary distalization using infrazygomatic crest miniscrews: a finite element analysis study. Prog Orthod 2024; 25:10. [PMID: 38462550 PMCID: PMC10925583 DOI: 10.1186/s40510-024-00509-3] [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: 07/17/2023] [Accepted: 12/30/2023] [Indexed: 03/12/2024] Open
Abstract
AIM To evaluate the maxillary incisors and canine's immediate movement tendency using three different power arms (PA) height levels during total arch maxillary distalization supported on infrazygomatic crest (IZC) miniscrews according to finite element analysis (FEA). METHODS Three finite element models of the maxilla were developed based on CBCT imaging of a teenage male patient presenting a Class II Division 1 malocclusion in the early permanent dentition. Maxillary complex, periodontium, orthodontic accessories, IZC miniscrews and an orthodontic wire were digitally created. The PAs were placed between canines and lateral incisors and projected at 4, 7, and 10 mm height distances. After that, distalization forces were simulated between PA and IZC miniscrews. RESULTS The anterior teeth deformation produced in the FEA models was assessed according to a Von Mises equivalent. The stress was measured, revealing tendencies of initial maxillary teeth movement. No differences were found between the right and left sides. However, there was a significant difference among models in the under-stress areas, especially the apical and cervical root areas of the maxillary anterior teeth. More significant extrusion and lingual tipping of incisors were observed with the 4 mm power arm compared to the 7 mm and 10 mm ones. The 10 mm power arm did not show any tendency for extrusion of maxillary central incisors but a tendency for buccal tipping and intrusion of lateral incisors. CONCLUSION The maxillary incisors and canines have different immediate movement tendencies according to the height of the anterior point of the en-masse distalization force application. Based on the PA height increase, a change from lingual to buccal tipping and less extrusion tendency was observed for the incisors, while the lingual tipping and extrusion trend for canines increased.
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Affiliation(s)
- Alessandro Schwertner
- Post-Doctorate Student, Department of Orthodontics, University of North Paraná, UNOPAR, Londrina, PR, Brazil
| | | | | | - Paula Oltramari
- Department of Orthodontics, University of North Parana, UNOPAR, Londrina, PR, Brazil
| | | | | | - Guilherme de Almeida
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, University of Alberta, Edmonton, AB, Canada
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van den Braak MCT, Hoekstra JWM, Bronkhorst EM, Schols JGJH, Ongkosuwito EM, Meijer GJ, van den Beucken JJJP. The effect of surface roughening on the success of orthodontic mini-implants: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2024; 165:262-271.e3. [PMID: 38069923 DOI: 10.1016/j.ajodo.2023.11.005] [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: 05/01/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Orthodontic mini-implants are a widely accepted treatment modality in orthodontics; however, the failure rate is moderately high. Surface roughening is the golden standard in conventional oral implantology, and this may prove beneficial for orthodontic mini-implants as well. The objective of this systematic review is to assess the effect of surface roughening on the success rate of orthodontic mini-implants in both adolescent and adult patients undergoing orthodontic treatment. METHODS Randomized studies comparing the success of surface-roughened and smooth, machined-surface orthodontic mini-implants were included. A literature search was conducted for 6 electronic databases (Pubmed/Medline, Embase, Cochrane, CINAHL, Web of Science, and Scopus), Clinical trial registry (https://www. CLINICALTRIALS gov), and grey literature (Google Scholar). A manual search of the reference lists of included studies was performed. Two authors independently performed the screening, data extraction, risk of bias, and quality assessments. The risk of bias was assessed with the Cochrane risk-of-bias 2.0 Tool. Data were synthesized using a random effect model meta-analysis presented as a forest plot. The certainty in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS A total of 4226 unique records were screened, and 6 of these were included in the quantitative analysis. Four additional articles were selected for a secondary outcome. A total of 364 orthodontic mini-implants were included in the primary outcome analysis. There was no statistically significant effect of surface roughening on the success of orthodontic mini-implants (odds ratio = 0.63 favoring roughened orthodontic mini-implants; 95% confidence interval, 0.35-1.14). The secondary outcome (ie, the overall failure rate of roughened orthodontic mini-implants) was 6% based on studies with high heterogeneity. Limitations of this study were the risk of bias, study imprecision, and possible publication bias, leading to a very low certainty in the body of evidence. CONCLUSIONS There is very low-quality evidence that there is no statistically significant effect of surface roughening on the success of orthodontic mini-implants in humans. The overall failure rate of surface-roughened orthodontic mini-implants was 6%. FUNDING No funding was received for this review. REGISTRATION This study was preregistered in the Prospective Register of Systematic Reviews (CRD42022371830).
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Affiliation(s)
- Matheus C T van den Braak
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jan Willem M Hoekstra
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jan G J H Schols
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Edwin M Ongkosuwito
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gert J Meijer
- Department of Oral Maxillofacial Surgery, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jeroen J J P van den Beucken
- Section of Regenerative Biomaterials, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Shetty S, Ramesh A, Maniyankod SB, Parveen K, Selvakumar SG, Mubeen M, Amin V. Comparing the Efficiency of Infrazygomatic Crest (IZC) Screws and Conventional Method for Anterior Retraction in Patients Undergoing Fixed Orthodontic Treatment for Class 2 Malocclusion: A Prospective Clinical Study. Cureus 2024; 16:e54599. [PMID: 38524017 PMCID: PMC10959471 DOI: 10.7759/cureus.54599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction In orthodontic treatment for class 2 malocclusion, conventional approaches involve extracting the upper first premolars and using methods like en masse retraction and extra-oral or intra-oral distalization. However, these often result in unintended forces and adverse effects. Contemporary techniques, such as maxillary arch distalization with mini-implants like infrazygomatic crest (IZC) implants, offer superior outcomes. IZC implants provide a safe, flexible, and effective site for implant placement, achieving a remarkable 93.7% success rate. Power arms enable precise control, allowing orthodontists to apply controlled forces for optimal tooth movement. This study aims to compare cephalometric parameters pre and post treatment using IZC/buccal shelf (BS) screws and conventional retraction, assessing the efficiency of IZC screws in maintaining arch length during teeth retraction. Methods In a split-mouth study at Yenepoya Dental College, 40 orthodontic patients aged 18-35 were divided into control (premolar extraction, anterior retraction) and study (third molar removal, IZC screw distalization) groups. The control group used a nitinol spring/E chain for retraction, while the study group employed IZC screw-assisted en masse distalization. Regular reviews and adjustments occurred, with radiographs and study models assessed after six months for cephalometric parameters and arch length. Results A significant difference was found in U1-SN (degree), L1-Apog (in mm), L1-NB (degree), and L1-NB (in mm) of pretreatment records, whereas all other measurements showed statistically similar values between conventional and IZC groups. Improvement was higher with the conventional group when compared with IZC groups in these measurements due to the extraction of the first premolars rather than third molar extraction and distalization. However, the IZC group also showed statistically significant improvement in cephalometric parameters such as U1-SN (degree), L1-Apog (in mm), L1-NB (degree), and L1-NB (in mm). Conclusion The statistical analysis of radiographic and cast measurements in both the maxilla and mandible demonstrated a significant efficiency of IZC screws in teeth retraction while preserving arch length compared to conventional methods. Nevertheless, to strengthen the findings of our study, additional clinical investigations on IZC screws are warranted.
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Affiliation(s)
- Sandeep Shetty
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Abirami Ramesh
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Salwa B Maniyankod
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Katheesa Parveen
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Stanly G Selvakumar
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Minaz Mubeen
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
| | - Vivek Amin
- Orthodontics and Dentofacial Orthopaedics, Yenepoya Dental College, Mangalore, IND
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Zhao N, Zhang Q, Guo Y, Cui S, Tian Y, Zhou Y, Wang X. Analysis of oral microbiome on temporary anchorage devices under different periodontal conditions. Prog Orthod 2023; 24:42. [PMID: 37899378 PMCID: PMC10613604 DOI: 10.1186/s40510-023-00488-x] [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: 12/27/2022] [Accepted: 08/15/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Temporary anchorage devices (TADs) are maximum anchorages that have been widely used in orthodontic treatment. The aim of the study was to uncover whether a history of periodontitis would influence microbiome colonization on the TAD surface. RESULTS Patients were grouped by periodontal evaluations before the orthodontic treatment. Patients with healthy periodontal conditions were classified as the healthy group, and patients diagnosed with periodontitis stage II or even worse were classified as the periodontitis group. Scanning electron microscopy (SEM) was used to analyze the existence of biofilm on the surface of 4 TADs from the healthy group and 4 TADs from the periodontitis group. Fifteen TADs from the healthy group and 12 TADs from the periodontitis group were collected. The microorganisms on the surface of TADs were harvested and analyzed by 16S rRNA gene sequencing. α-diversity indices and β-diversity indices were calculated. Wilcoxon's test was used to determine differences between genera, species as well as KEGG functions. SEM analysis revealed bacteria colonization on the surface of TADs from both groups. Principal coordinate analysis (PCoA) based on β diversity revealed differential sample clusters depending on periodontal conditions (P < 0.01). When comparing specific genera, Fusobacterium, Porphyromonas, Saccharibacteria_(TM7)_[G-1], Dialister, Parvimonas, Fretibacterium, Treponema were more enriched in TADs in the periodontitis group. In the KEGG analysis, TADs in the periodontitis group demonstrated enriched microbial activities involved with translation, genetic information processing, metabolism, and cell motility. CONCLUSIONS This analysis elucidated the difference in total composition and function of TADs oral microorganisms between patients periodontally healthy and with periodontitis.
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Affiliation(s)
- Ningrui Zhao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
| | - Qian Zhang
- Central Laboratory, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - Yanning Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
| | - Shengjie Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
| | - Yajing Tian
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China
| | - Yanheng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China.
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China.
| | - Xuedong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing, 100081, China.
- National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China.
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Mishra G, Kharbanda OP, Chaudhry R, Duggal R. A pattern of microbiological colonization of orthodontic miniscrew implants. Am J Orthod Dentofacial Orthop 2023; 164:554-566. [PMID: 37204351 DOI: 10.1016/j.ajodo.2023.02.023] [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: 07/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Current orthodontic literature reveals a lack of studies on bacterial colonization of orthodontic miniscrew implants (MSI) and their role in the stability of MSI. This study aimed to determine the pattern of microbiological colonization of miniscrew implants in 2 major age groups, to compare it with the microbial flora of gingival sulci in the same group of patients and to compare microbial flora in successful and failed miniscrews. METHODS The study involved 102 MSI placed in 32 orthodontic subjects in 2 age groups: (1) aged ≤14 years and (2) aged >14 years. Gingival and peri-mini implant crevicular fluid samples were collected using sterile paper points (International Organization for Standardization no. 35) >3 months and processed by conventional microbiologic culture and biochemical techniques. A microbiologist characterized and identified the bacteria, and the results were subjected to statistical analysis. RESULTS Initial colonization was reported within 24 hours, with Streptococci being the dominant colonizer. The relative proportion of anaerobic bacteria over aerobic bacteria increased over time in peri-mini implant crevicular fluid. Group 1 had greater Citrobacter (P = 0.036) and Parvimonas micra (P = 0.016) colonizing MSI than group 2. Failed MSI showed a significantly higher presence of Parvimonas micra (P = 0.008) in group 1 and Staphylococci (P = 0.008), Enterococci (P = 0.011), and Parvimonas micra (P <0.001) in group 2. CONCLUSIONS Microbial colonization around MSI is established within 24 hours. Compared to gingival crevicular fluid, peri-mini implant crevicular fluid is colonized by a higher proportion of Staphylococci, facultative enteric commensals and anaerobic cocci. The failed miniscrews showed a higher proportion of Staphylococci, Enterobacter, and Parvimonas micra, suggesting their possible role in the stability of MSI. The bacterial profile of MSI varies with age.
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Affiliation(s)
- Gyanda Mishra
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Om Prakash Kharbanda
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Methawit P, Uezono M, Ogasawara T, Techalertpaisarn P, Moriyama K. Cortical bone microdamage affects primary stability of orthodontic miniscrew. J World Fed Orthod 2023; 12:229-236. [PMID: 37423833 DOI: 10.1016/j.ejwf.2023.06.002] [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: 04/30/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The aim of this study was to investigate the effects of orthodontic miniscrew pitch and thread shape on microdamage in cortical bone. The relationship between the microdamage and primary stability was also examined. METHODS Ti6Al4V orthodontic miniscrews and 1.0-mm-thick cortical bone pieces from fresh porcine tibia were prepared. The orthodontic miniscrews had custom-made thread height (H) and pitch (P) size geometries, and were classified into three groups: control geometry; HCPC (HC; thread height = 0.12 mm, PC; pitch size = 0.60 mm), geometry with a narrower pitch; HCPN (HC; thread height = 0.12 mm, PN; pitch size = 0.30 mm), and geometry with a taller thread height; HTPC (HT; thread height = 0.36 mm, PC; pitch size = 0.60 mm). The orthodontic miniscrews were inserted into a pilot hole in the cortical bone, and maximum insertion torque and Periotest value were measured. After insertion, the samples were stained with basic fuchsin. Histological thin sections were obtained and the bone microdamage parameters, i.e., total crack length and total damage area, and insertion state parameters, i.e., orthodontic miniscrew surface length and bone compression area were calculated. RESULTS The orthodontic miniscrews with the taller thread height resulted in lower primary stability with minimal bone compression and microdamage; however, the narrower thread pitch led to maximum bone compression and extensive bone microdamage. CONCLUSIONS A wider thread pitch reduced microdamage, and decreased thread height resulted in increased bone compression, ultimately resulting in increased primary stability.
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Affiliation(s)
- Panida Methawit
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Maxillofacial Orthognathics, Tokyo Medical and Dental University, Tokyo, Japan; Tokyo Medical and Dental University and Chulalongkorn University International Joint Degree Doctor of Philosophy Program in Orthodontics
| | - Masayoshi Uezono
- Department of Maxillofacial Orthognathics, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Takeshi Ogasawara
- Department of Maxillofacial Orthognathics, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Keiji Moriyama
- Department of Maxillofacial Orthognathics, Tokyo Medical and Dental University, Tokyo, Japan
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Zhao Y, Jia T, Wang Z. Comparative analysis of anchorage strength and histomorphometric changes after implantation of miniscrews in adults and adolescents: an experimental study in Beagles. BMC Oral Health 2023; 23:639. [PMID: 37670309 PMCID: PMC10478492 DOI: 10.1186/s12903-023-03318-y] [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: 03/12/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVES This study aimed to explore the differences in anchorage strength and histomorphometric changes in orthodontic miniscrews between adult and adolescent beagles. MATERIAL AND METHOD Six adult beagles and six young beagles were used as experimental subjects, and eight miniscrews were symmetrically placed in the posterior mandible of each dog. Measurement of the displacement (mm) of two adjacent miniscrews after load application was performed to compare the anchorage strength between the adult and adolescent groups. Three intravital bone fluorochromes (oxytetracycline, calcein green, xylenol orange) were administered postoperatively to mark the active bone-forming surface. Subsequently, the mineral apposition rate and bone-implant contact ratio were measured for dynamic and static histomorphometry. Finally, the expression levels of the RANKL/OPG ratio were evaluated by immunohistochemistry. RESULTS The average displacement of miniscrews in the adult group was significantly less than that in the adolescent group after load application. For histomorphometry analysis, the mineral exposure rate in the adolescent group was higher than that in the adult group with or without force application. In addition, more fractures and new bone formation but deceased bone-implant contact ratios were observed in the adolescent group than in the adult group. The ratio of RANKL/OPG expression increased more in the adolescent group than in the adult group. CONCLUSION Miniscrews do not remain in the same position as skeletal anchors, and the amount of displacement was higher in adolescent group than that in adult group, reflecting the weaker anchorage strength of miniscrews in adolescents due to the higher bone turnover rate and active bone remodelling. Therefore, it is feasible to apply orthodontic loading to the miniscrews in adult patients earlier, even immediately, but it is recommended to wait a period for the adolescents.
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Affiliation(s)
- Yi Zhao
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
| | - TingTing Jia
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
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McLaughlin V, Liu J, Kalim S, Nguyen K, Kim DG, Sun Z. Application of metal artifact reduction algorithm for CBCT diagnosis of temporary anchorage device-tooth root contact: inadequate to reduce false-positive rate. Dentomaxillofac Radiol 2023; 52:20220396. [PMID: 37427694 PMCID: PMC10461258 DOI: 10.1259/dmfr.20220396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES It was recently found that when cone beam computed tomography (CBCT) was used to examine temporary anchorage device (TAD)-tooth root contact, it tends to yield high false-positive (FP) diagnoses. This study investigated whether application of a metal artifact reduction (MAR) algorithm or reducing CBCT scan voxel-size can remediate this problem. METHODS 18 fresh pig cadaver mandibles underwent TAD placement bilaterally at first molar lingual furcation regions. CBCT scans were taken under varied MAR (absence, presence) and voxel-size (400 µm, 200 µm) settings. Then, TADs were removed and a micro-CT scan (27 µm voxel-size) of the TAD placement site was performed. Three raters, blinded of CBCT scan setting, independently diagnosed whether TADs were in contact with roots. The reliability and accuracy of CBCT diagnoses using micro-CT as the gold-standard were statistically examined. RESULTS Generally, CBCT diagnoses had intrarater (Cohen's κ: 0.54-1) and interrater (Fleiss' κ: 0.73-0.81) reliability, within the moderate to excellent range, which did not vary with MAR setting or scan voxel-size. For diagnostic accuracy, FP rate among all raters was mostly in the 15-25% range and did not change with MAR or scan voxel-size settings (McNemar tests, p > 0.05) while false-negative rate was relatively minimal and only occurred to one rater (9%). CONCLUSIONS When using CBCT to diagnose possible TAD-root contact, applying a currently available Planmeca MAR algorithm or reducing CBCT scan voxel-size from 400 µm to 200 µm may not decrease FP rate. Further optimization of the MAR algorithm for this purpose may be needed.
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Affiliation(s)
- Victoria McLaughlin
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Jie Liu
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Sonya Kalim
- Division of Oral and Maxillofacial Radiology, College of Dentistry, Ohio State University, Columbus, Ohio, United States
| | - Kristin Nguyen
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Zongyang Sun
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, OH, United States
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Ferrillo M, Nucci L, Gallo V, Bruni A, Montrella R, Fortunato L, Giudice A, Perillo L. Temporary anchorage devices in orthodontics: a bibliometric analysis of the 50 most-cited articles from 2012 to 2022. Angle Orthod 2023; 93:591-602. [PMID: 37200455 PMCID: PMC10575636 DOI: 10.2319/010923-18.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To identify and analyze the 50 most cited articles on temporary anchorage devices (TADs) and investigate the achievement and development of scientific research about the topic through a bibliometric analysis. MATERIALS AND METHODS On August 22, 2022, a computerized database search was performed to detect papers published in the scientific literature about TADs from 2012 to 2022. Metrics data were identified using the Incites Journal Citation Reports (Clarivate Analytics) data set. The Scopus database was used to obtain information on the authors' affiliations, country of origin, and h-index. Key words were automatically harvested from the selected articles to implement the visualized analysis. RESULTS From a total of 1858 papers screened by searching the database, a list of the top 50 most cited articles was created. The total number of citations collected by the 50 most cited articles in TADs was 2380. Among the 50 most cited articles on TADs, 38 were original research papers (76.0%) and 12 were reviews (24.0%). As shown by the key word-network analysis, Orthodontic anchorage procedure was identified as the larger node. CONCLUSIONS Findings of this bibliometric study showed an increasing number of citations for papers on TADs, accompanied by a simultaneous rise in scientific interest in this topic in the past decade. The present work identifies the most influential articles, emphasizing the journals, the authors, and the topics addressed.
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Affiliation(s)
- Martina Ferrillo
- Corresponding author: Dr Martina Ferrillo, Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia,” Viale Europa, 88100 Catanzaro, Italy (e-mail: )
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20
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Moeini N, Sabri H, Galindo‐Fernandez P, Mirmohamadsadeghi H, Valian NK. Periodontal status following orthodontic mini-screw insertion: A prospective clinical split-mouth study. Clin Exp Dent Res 2023; 9:596-605. [PMID: 37340755 PMCID: PMC10441601 DOI: 10.1002/cre2.757] [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: 03/22/2023] [Revised: 05/27/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Anchorage control is one of the most important determinants of orthodontic treatments. Mini-screws are used to achieve the desired anchorage. Despite all their advantages, there is a possibility that treatment will not be successful due to conditions related to their interaction with the periodontal tissue. OBJECTIVE To evaluate the status of the periodontal tissue at the sites adjacent to the orthodontic mini-implants. METHODS A total of 34 teeth (17 case and 17 control) in 17 orthodontic patients requiring a mini-screw in the buccal area to proceed with their treatment were included in the study. Oral health instruction was provided to the patients prior to the intervention. In addition, scaling and root planing of the root surface were done using manual instruments and ultrasonic instruments if needed. For tooth anchorage, a mini-screw with Elastic Chain or Coil Spring was used. The following periodontal indices were examined in the mini-screw receiving tooth and the contralateral tooth: plaque index, pocket probing depth, attached gingiva level (AG), and gingival index. Measurements were made before the placement of the mini-screws and 1, 2, and 3 months following that. RESULTS The results revealed a significant difference only in the amount of AG between the tooth with mini-screw and the control tooth (p = 0.028); for other periodontal indices, there were no significant differences between the two groups. CONCLUSION This study showed that periodontal indices in adjacent teeth of the mini-screws do not change significantly compared to other teeth and mini-screws can be used as a suitable anchorage without posing a threat to the periodontal health. Using mini-screws is a safe intervention for orthodontic treatments.
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Affiliation(s)
- Negar Moeini
- Department of PeriodonticsShahid Beheshti University of Medical Sciences School of DentistryTehranTehranIran
| | - Hamoun Sabri
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION)Ann ArborMichiganUSA
| | - Pablo Galindo‐Fernandez
- Oral Surgery and Implant Dentistry Department, School of DentistryUniversity of GranadaGranadaAndalucíaSpain
| | - Hoorieh Mirmohamadsadeghi
- Department of OrthodonticsShahid Beheshti University of Medical Sciences School of DentistryTehranTehranIran
| | - Nasrin Keshavarz Valian
- Department of PeriodonticsShahid Beheshti University of Medical Sciences School of DentistryTehranTehranIran
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21
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Okawa K, Matsunaga S, Kasahara N, Kasahara M, Tachiki C, Nakano T, Abe S, Nishii Y. Alveolar Bone Microstructure Surrounding Orthodontic Anchor Screws with Plasma Surface Treatment in Rats. J Funct Biomater 2023; 14:356. [PMID: 37504851 PMCID: PMC10381738 DOI: 10.3390/jfb14070356] [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: 06/18/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
A lateral load was applied to anchor screws that had undergone surface treatment, and the structure, cellular dynamics, and quality of the bone surrounding anchor screws were analyzed to investigate the effect of this surface treatment on the peri-implant jawbone. In addition, bone microstructural characteristics were quantitatively evaluated for each site of loading on the bone around the anchor screw. Rats were euthanized after observation on days 3, 5, or 7, and bone quality analyses were performed. Bone-implant contact rate increased more rapidly at an early stage in the treated surface group than in the untreated surface group. Bone lacuna morphometry showed that the measured values adjacent to the screw at the screw neck on the compressed side (A) and at the screw tip on the uncompressed side (D) were significantly lower than those at the screw tip on the compressed side (B) and at the screw neck on the uncompressed side (C). Collagen fiber bundle diameter showed that the measured values adjacent to regions A and D were significantly higher than those at regions B and C. Anchor screw surface activation facilitates initial bone contact of the screw, suggesting that early loading may be possible in clinical practice.
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Affiliation(s)
- Keisuke Okawa
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Norio Kasahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Masaaki Kasahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Chie Tachiki
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita 565-0871, Japan
| | - Shinichi Abe
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Yasushi Nishii
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
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22
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Vivigdha V, Krishnan M, Kumar M P S, Murugan P S, Rajamanickam P. Multidisciplinary Approach to Patient-Specific Implants (PSIs): A Case Report and Review of Literature. Cureus 2023; 15:e41238. [PMID: 37529522 PMCID: PMC10387731 DOI: 10.7759/cureus.41238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
Orthodontic treatment often faces challenges in achieving proper anchorage. While orthodontic mini-implants have gained popularity, no universally accepted design and insertion protocol exists for these implants. However, their relatively modest failure rate indicates their clinical reliability. To address complex geometries in the maxilla and mandible, patient-specific implants (PSIs) have emerged as a solution. PSI is currently employed in various domains of oral and maxillofacial surgery like temporomandibular joint (TMJ), total joint replacement, reconstruction of the facial skeleton, and orthognathic surgery. PSI allows for the creation of customized implant fits, leading to shorter rehabilitation times. This case report presents a multidisciplinary approach involving oral surgery and orthodontics, specifically focusing on the design of PSI, surgical placement of PSI, and use of PSI in maxillary protraction in orthodontics. The report highlights the design process of designing PSI and emphasizes its role in orthodontic treatment. By incorporating PSI as a temporary anchorage device (TAD), enhanced stability, precise control over tooth movement, and accurate repositioning of jaws can be achieved. The collaborative effort between orthodontists and oral surgeons is crucial in integrating PSI into the overall treatment plan. Despite the higher costs associated with PSI, their numerous advantages outweigh these drawbacks. PSI plays a vital role in providing enhanced stability, appropriate treatment plan, and achieving desired treatment in orthodontic and oral surgery procedures.
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Affiliation(s)
- Vedha Vivigdha
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Santhosh Kumar M P
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Senthil Murugan P
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Preethi Rajamanickam
- Orthodontics and Dentofacial Orthopaedics, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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23
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Mousa MM, Hajeer MY, Sultan K, Almahdi WH, Alhaffar JB. Evaluation of the Patient-Reported Outcome Measures (PROMs) With Temporary Skeletal Anchorage Devices in Fixed Orthodontic Treatment: A Systematic Review. Cureus 2023; 15:e36165. [PMID: 36937120 PMCID: PMC10017226 DOI: 10.7759/cureus.36165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
Analysis of patient-reported outcome measures (PROMs) is essential to ensure that the skeletal and traditional anchoring methods are appropriately and effectively utilized in the context of patient acceptance and satisfaction. This review's objective was to assess the available data on the levels of discomfort, soft-tissue irritation, functional impairment, and other patient-reported outcomes related to the usage of mini-implants in the context of fixed orthodontic treatment for adult patients. A total of seven electronic bibliographic databases were searched between January 1995 and February 2022. Moreover, a manual search was done in the selected orthodontic journals. This systematic review (SR) covered cohort studies, retrospective studies, randomized clinical trials (RCTs), and controlled clinical trials (CCTs) that studied the use of mini-implants, mini-plates, or onplants as anchorage devices on patients receiving orthodontic treatment. The risk of bias was assessed using Cochrane's risk of bias tool (RoB2 tool). Three RCTs and two cohorts were included in this SR with a total of 468 patients. Three of the four included studies were at high risk of bias. The pain level was in the "mild-to-moderate" category on the first day following the insertion of mini-implants, then decreased to a mild level from the fifth day to the seventh day of insertion (mean values are 36.61, 16.36, and 11.33, respectively). The levels of functional impairments were found to be located between the "mild-to-moderate" and "moderate" categories after the placement of mini-plates and intermaxillary fixation screws, while they experienced a mild level with mini-implants. The greatest pain levels were found after the insertion of the temporary anchorage devices (TADs) and then decreased until they became mild or disappeared completely after one month. Speaking, chewing, and cleaning difficulties were more problematic when using TADs compared to conventional anchorage. To obtain good evidence in this area, more high-quality RCTs are needed.
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Affiliation(s)
- Mudar Mohammad Mousa
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Mohammad Y Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Kinda Sultan
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Wael H Almahdi
- Department of Periodontics, University of Damascus Faculty of Dentistry, Damascus, SYR
| | - Jacqueline Bashar Alhaffar
- Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, SYR
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FEM Analysis of Individualized Polymeric 3D Printed Guide for Orthodontic Mini-Implant Insertion as Temporary Crown Support in the Anterior Maxillary Area. Polymers (Basel) 2023; 15:polym15040879. [PMID: 36850161 PMCID: PMC9966125 DOI: 10.3390/polym15040879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Either due to trauma, extraction or congenital factors, the absence of teeth has aesthetic, functional, financial and psychological consequences. The aim of the current study is to assess an individualized polymeric 3D printed digitally planned surgical guide designed to achieve precision and predictability in non-standard mini-implant orthodontic cases. Twenty-seven patient records with missing anterior teeth were selected from the database of a private clinic in Timisoara, Romania. Based on the analysis of the cases included in the research, a surgical guide for the insertion of mini-implants as provisional crown support was designed. An FEM simulation was performed using the Abaqus numerical analysis software. Finite element simulation revealed the maximum displacements and stresses that occur in the surgical guide. Mini-implant supported provisional crowns can be a simple and low-cost method to increase patient self-esteem and compliance with the orthodontic treatment. Computer aided mechanical simulation is a useful tool in analyzing different polymeric surgical guide designs before being used in clinical situations in order to avoid failure.
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25
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Rosa WGN, de Almeida-Pedrin RR, Oltramari PVP, de Castro Conti ACF, Poleti TMFF, Shroff B, de Almeida MR. Total arch maxillary distalization using infrazygomatic crest miniscrews in the treatment of Class II malocclusion: a prospective study. Angle Orthod 2023; 93:41-48. [PMID: 36126679 DOI: 10.2319/050122-326.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate treatment effects in Class II patients using infrazygomatic crest (IZC) miniscrews (MS). MATERIALS AND METHODS A prospective sample of 25 adolescents (14 females and 11 males; mean age: 13.6 ± 1.5 years) who underwent maxillary dentition distalization treatment with IZC MSs were recruited. Lateral cephalograms and digital models at the beginning of treatment (T1) and after Class II molar correction (T2) were obtained. To compare cephalometric and digital model changes, paired t-test and Wilcoxon test were used. A significance level of 5% was used. RESULTS All patients achieved Class II molar correction over a mean period of 7.7 ± 2.5 months. The IZC MS therapy provided 4 mm of distalization; there was 1.2 mm of intrusion of the first molar with 11.2° distal tipping. The maxillary incisors were retracted 4.7 mm and tipped lingually 13.4°. Overjet and overbite showed a reduction of 3.6 mm and 2.4 mm, respectively. The occlusal plane rotated clockwise 2.8°. The upper lip was retracted by 1 mm and the nasolabial angle increased 5.1°. There was an increase in the interpremolar and intermolar distances. CONCLUSIONS Total arch distalization of the maxillary dentition using IZC MS was effective in the treatment of Class II malocclusions.
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Comparison of in vivo failure of precipitation-coated hydroxyapatite temporary anchorage devices with that of uncoated temporary anchorage devices over 18 months. Am J Orthod Dentofacial Orthop 2022; 163:520-525. [PMID: 36503860 DOI: 10.1016/j.ajodo.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The objective was to compare the stability of hydroxyapatite-coated (HA) temporary anchorage devices (TADs) with uncoated TADs. METHODS Maxillary arches of 92 patients with Class II Division 1 malocclusion requiring premolar extractions were randomly distributed to receive both types of Ti-6Al-4V alloy TADs by a single operator. TADs were replicas of each other except for the HA precipitation surface coating of the threaded part. TADs were placed between the roots of the first molar and the second premolar and were immediately loaded by a 300 g of force nickel-titanium spring for retraction of the anterior segment. The main outcome was the loosening of the TAD. RESULTS TADs of each type were placed in 92 patients. The patients were recalled monthly for 18 months; 10 TADs failed in the HA-coated group (11%), whereas 12 TADs (13%) failed in the uncoated group, with a statistically insignificant difference between the survivability of the TADs in the 2 groups (P = 0.67, log-rank). The Kaplan-Meier curve showed better survivability of the HA-coated TADs between the second and fifth months. The TADs placed on the left side (19.6%) failed significantly more than on the right side (4.3%) (P = 0.002) when placed by a right-handed operator in right-handed patients. CONCLUSION The premise that the HA-coated TADs will have a lower failure rate seems incorrect.
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Mitchell B, Liu J, Lee S, Watanabe K, Kim DG, Fields HW, Guo X, Wei-En L, Deguchi T. Quantitative evaluation of training method in placing miniscrews in orthodontic graduate program. Prog Orthod 2022; 23:33. [PMID: 36184724 PMCID: PMC9527266 DOI: 10.1186/s40510-022-00430-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/18/2022] [Indexed: 11/27/2022] Open
Abstract
Background The purpose of this study was to assess the effectiveness of training residents in an orthodontic program in the placement of miniscrews by using cone beam computed tomography (CBCT) images. A total of 90 miniscrews were placed in 15 pig mandibles over a 3-year period by 15 first-year orthodontic residents. Miniscrews were divided into three groups (Control group: no radiographs; 2D group: placement with 2D radiographs; CBCT group: placement with CBCT). Proximity of the miniscrew to the neighboring root was measured. The miniscrew success rate was examined in the graduate clinic from 2015 to 2021. Results The percentage of root contact for each group was: 36.7% (11/30), 20.0% (6/30), 0% (0/30), for the Control, 2D, and CBCT groups, respectively. The CBCT group was significantly different from the Control and 2D groups (p < 0.05). For root proximity, the miniscrews were significantly closer to the roots in the Control (p < 0.001) and 2D (p < 0.001) groups compared with the CBCT group. No significant difference was observed between the Control and 2D groups (p = 0.80). There was no significant difference among the years in the miniscrew success rate. Conclusions Training the residents in an orthodontic graduate program using CBCT may be helpful to avoid root damage and to decrease the miniscrew failure rate.
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Affiliation(s)
- Bobby Mitchell
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Jie Liu
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Sanghee Lee
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Keiichiro Watanabe
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Henry W Fields
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA
| | - Xiaohan Guo
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Lu Wei-En
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, 4088 Postle Hall, 305 W. 12th Ave, Columbus, OH, 43210, USA.
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Gupta H, Gupta A, Verma S, Singh SP. Comparing the Effect of Miniscrew-Supported and Conventional Maxillary Incisor Intrusion on the Inclination of Maxillary Incisors and Molars - A Systematic Review and Meta-Analysis. Contemp Clin Dent 2022; 13:307-314. [PMID: 36686998 PMCID: PMC9855268 DOI: 10.4103/ccd.ccd_385_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The objective of this study was to compare the effect of miniscrew-supported maxillary incisor intrusion and conventional intrusion mechanics on maxillary incisors and molar inclination. Material and Methods Search databases (PubMed, Scopus, Web of Science, Embase, EBSCOhost, and the Cochrane Library) were searched for randomized trials on intrusion of maxillary incisors via miniscrew-supported and conventional mechanics. The revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was used. Five outcomes ([i] inclination change of upper incisors, [ii] inclination change of upper molars, [iii] intrusion of incisors, [iv] vertical change in upper first molars, and [v] overbite correction achieved) were statistically pooled using Review Manager 5.3. Subgroup analysis was conducted to receive sturdiness in meta-analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. Results Out of 1777 studies, 7 were finally subjected to quality assessment, and 6 were included in the meta-analysis. The incisor inclination following maxillary incisor intrusion increased in miniscrew-supported intrusion in comparison to Connecticut intrusion arch (CTA) subgroup with standard mean difference of 0.66 mm (95% confidence interval = 0.16, 1.03, I2 = 0%). All the included studies showed an increase in molar inclination (distal tipping) in the CTA subgroup compared to the micro-implant group. Of all the seven included studies, only one study was identified with some concerns for the risk of bias, and the other six were judged to have an overall high risk of bias. Conclusion The incisal proclination during deep-bite correction by miniscrew-supported incisal intrusion is more than that in the CTA subgroup; however, the difference may not be clinically very relevant. There is a very low quality of evidence in favor of miniscrew-supported intrusion as compared to conventional intrusion, necessitating the need for good-quality trials.
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Affiliation(s)
- Himali Gupta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Arpit Gupta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Sanjeev Verma
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
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Sarul M, Lis J, Park HS, Rumin K. Evidence-based selection of orthodontic miniscrews, increasing their success rate in the mandibular buccal shelf. A randomized, prospective clinical trial. BMC Oral Health 2022; 22:414. [PMID: 36127718 PMCID: PMC9487090 DOI: 10.1186/s12903-022-02460-3] [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: 06/18/2022] [Accepted: 09/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Skeletal anchorage has made it possible to perform complex orthodontic tooth movements that are difficult or even impossible to achieve with conventional orthodontic treatment. Mandibular buccal shelf miniscrews, used for distalization, play a particularly important role in treatment of Class III malocclusion. Unfortunately, stability of the miniscrews placed in the mandible is still considered at higher risk of failure compared to other intraoral locations. The aim of our study was to determine the influence of the miniscrew size on their long-term stability, occurrence of oral mucosa inflammation and pain lasting over 48 h after implantation. Methods 184 Absoanchor® miniscrews (Dentos, South Korea) in two sizes: SH2018-10 (length 10 mm, ø 1.8–2.0 mm) and SH1514-08 (length 8 mm, ø 1.4–1.5 mm) were inserted in the mandibular buccal shelf in 92 Caucasians aged 20–50 years, diagnosed with Class III malocclusion that required en-masse distalization of the mandibular dentition. Data was statistically analyzed with the level of significance set at p = .05. Results 91.3% of the SH2018-10 and 75% of the SH1514-08 miniscrews were stable, and this difference was statistically significant (p < .05). Inflammation of the oral mucosa was noticed around both types of miniscrews and affected 50% of the SH2018-10 and 26.09% of the SH1514-08 group (p < .05). Pain lasting longer than 48 h after implantation was related to 60.87% and 20.65% of the SH2018-10 and the SH1514-08 miniscrews (p < .05), respectively. Inflammation associated with larger SH2018-10 miniscrews did not affect their stability (p > .05), contrary to the SH1514-08 ones (p < .05). When inflammation was present, the overall success rate declined to 64.29%, from 94.74% noted for TADs without inflammation. According to the log-rank test, smaller TADs failed significantly sooner than the larger ones (p = .002). Conclusion Larger SH2018-10 miniscrews are the anchorage of choice for the mandibular buccal shelf, despite triggering inflammation and long-lasting pain significantly more often than the smaller ones. Therefore, this issue should be discussed with every patient prior to miniscrew use. Trial registration ID: ClinicalTrials.gov Identifier: NCT05280678 Date of Registration: 15/03/2022. Retrospectively registered.
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Affiliation(s)
- Michał Sarul
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wroclaw, Poland
| | - Joanna Lis
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wroclaw, Poland
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, 41940, Korea
| | - Kornelia Rumin
- Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wroclaw, Poland.
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Bungău TC, Vaida LL, Moca AE, Ciavoi G, Iurcov R, Romanul IM, Buhaș CL. Mini-Implant Rejection Rate in Teenage Patients Depending on Insertion Site: A Retrospective Study. J Clin Med 2022; 11:jcm11185331. [PMID: 36142978 PMCID: PMC9502099 DOI: 10.3390/jcm11185331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/04/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mini-implants have undeniable advantages in Orthodontics. However, the use of mini-implants shows some limitations and disadvantages related to patient age, the quality of the bone tissue, the characteristics of the oral mucosa, implant site, the state of health of the organism and the quality of oral hygiene. The aim of this paper was to analyze the rejection rate of mini-implants in teenage patients, depending on their insertion site, and examine their stability up to three months after insertion. This retrospective study was conducted on dental charts belonging to patients aged between 12 and 17 years, from Oradea, Romania. The mini-implants were placed for various therapeutic reasons and were inserted in the following sites: buccal maxillary area, the infrazygomatic region, palatal area, buccal mandibular area and lingual area; they had a diameter of 1.6 mm (inter-radicular spaces) and of 2 mm (nonbearing tooth areas), and a length of 6–8 mm (mandible) or 8–10 mm (maxilla). The rejection rate was checked in the first month, second month, third month and after the third month from insertion. A total of 432 patients were included in the study, and they had a total of 573 mini-implants. Most implants were placed in the buccal region of the maxilla (27.7%), and most patients had one mini-implant placed (65.7%). The highest rejection rate was obtained in the first month (15.2%). The rejection rate between genders was similar. The mini-implants from the buccal mandibular region had a significantly higher rate of rejection in the first month (M1) in comparison to the mini-implants from the palatal region (24.4% vs. 8.3%). The mini-implants from the lingual region of the mandible had a significantly higher rate of rejection in the second month (M2) in comparison to the mini-implants from the infrazygomatic or the palatal region (10.5% vs. 0%/0%). Mini-implants are very useful for carrying out various orthodontic treatments, but their stability should be enhanced.
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Affiliation(s)
- Teodora Consuela Bungău
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
- Correspondence: (L.L.V.); (A.E.M.)
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
- Correspondence: (L.L.V.); (A.E.M.)
| | - Gabriela Ciavoi
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Raluca Iurcov
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Ioana Mihaela Romanul
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Camelia Liana Buhaș
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
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Jedliński M, Janiszewska-Olszowska J, Mazur M, Grocholewicz K, Suárez Suquía P, Suárez Quintanilla D. How Does Orthodontic Mini-Implant Thread Minidesign Influence the Stability?—Systematic Review with Meta-Analysis. J Clin Med 2022; 11:jcm11185304. [PMID: 36142951 PMCID: PMC9506209 DOI: 10.3390/jcm11185304] [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: 07/11/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 12/09/2022] Open
Abstract
Background: Clinical guidelines are lacking for the use of orthodontic mini-implants (OMIs) in terms of scientific evidence referring to the choice of proper mini-design. Thus, the present study aimed to investigate to what extent orthodontic mini-implant thread design influences its stability. Methods: Search was conducted in five search engines on 10 May. Quality assessment was performed using study type specific scales. Whenever possible, meta-analysis was performed. Results: The search strategy identified 118 potential articles. Twenty papers were subjected to qualitative analysis and data from 8 papers—to meta-analysis. Studies included were characterized by high or medium quality. Four studies were considered as low quality. No clinical studies considering the number of threads, threads depth, or TSF have been found in the literature. Conclusions: Minidesign of OMIs seems to influence their stability in the bone. Thread pitch seems to be of special importance for OMIs retention—the more dense thread—the better stability. Thread depth seems to be of low importance for OMIs stability. There is no clear scientific evidence for optimal thread shape factor. Studies present in the literature vary greatly in study design and results reporting. Research received no external funding. Study protocol number in PROSPERO database: CRD42022340970.
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Affiliation(s)
- Maciej Jedliński
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence: ; Tel.: +48-91-466-1690
| | | | - Marta Mazur
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Pedro Suárez Suquía
- Department of Surgery and Medical-Surgical Specialities, Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
| | - David Suárez Quintanilla
- Department of Surgery and Medical-Surgical Specialities, Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
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Xin Y, Wu Y, Chen C, Wang C, Zhao L. Miniscrews for orthodontic anchorage: analysis of risk factors correlated with the progressive susceptibility to failure. Am J Orthod Dentofacial Orthop 2022; 162:e192-e202. [PMID: 35987884 DOI: 10.1016/j.ajodo.2022.07.013] [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: 02/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The phenomenon of orthodontic anchorage miniscrews loosening after being implanted several times happens in daily clinical practice, and the reasons need to be traced. This study aimed to investigate the underlying risk factors influencing the progressive susceptibility of orthodontic miniscrews to failure. METHODS Overall, 889 miniscrews were successively inserted into 347 patients because some loosened or fell off once, twice, or more before achieving their purposes. The number of miniscrew failures (ie, once, twice, or more) was defined as progressive susceptibility to failure. The clinical indicators were assessed via univariate analysis, multicollinearity diagnosis, and Poisson log-linear regression model with stepwise calculation to screen out. RESULTS The progressive susceptibility of miniscrews to failure was proved to be affected by the age of patients, the onset of force application, site of placement, and appliance type. Age and onset of force application presented a negative relationship with susceptibility. Miniscrews inserted in the palatal region appeared to be more stable than the forepart of the arch. In contrast, the retromaxillary and retromandibular areas obtained the lowest stability. The patients with fixed appliances were more unlikely to suffer progressive failure than removable appliances. In addition, the larger number of screws inserted in each patient, the greater probability of failure. CONCLUSIONS Younger people with removable appliances that miniscrews inserted in the retromaxillary or retromandibular regions and earlier onsets of loading had a higher progressive susceptibility to loosening. Meanwhile, the failure rate was elevated with the increasing number of screws per patient received.
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Affiliation(s)
- Yilin Xin
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yeke Wu
- Department of Stomatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenjou Chen
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chen Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lixing Zhao
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Venkatesh P, Harish P, Madakkuni A, Reddy S. Orthodontic Management of Severe Dentoalveolar Collapse with Miniscrew-Assisted TMA Cantilever Springs and Bite Blocks. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2022. [DOI: 10.1177/03015742221086348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Management of mutilated cases is challenging, and adult patients often require orthodontic correction of occlusion before prosthetic replacement of missing teeth. Objective: To highlight the novel, simple, hygienic, and efficient miniscrew-supported Beta titanium molybdenum alloy (TMA) cantilever spring for uprighting severe mesially tipped molars for interdisciplinary treatment. Diagnosis and Treatment: A 23-year-old male patient presented with skeletal Class I relation, average growth pattern, Class II Div 1 malocclusion with dentoalveolar collapse, crowding, multiple missing, supraerupted teeth, and severe mesially tipped mandibular third molars. MBT appliance with 0.022˝ slot was used to achieve the objectives. 38 and 48 were uprighted and protracted with miniscrew implant-supported TMA cantilever springs to substitute 37 and 47. Mild intrusion of maxillary posterior teeth was done with acrylic bite blocks and transpalatal arch (TPA), followed by prosthetic replacement of missing teeth. Results: The patient had a consonant smile arc and a pleasing soft tissue profile. Mandibular third molars were uprighted and protracted with good vertical control, and the mesial pockets were eliminated. The supraerupted maxillary molars were intruded, and group function occlusion was established. Class I canine relationship, normal overjet, and overbite were achieved. Conclusion: Miniscrew supported TMA cantilevers are efficient for uprighting of severely tipped third molars without extrusion, unlike the conventional mechanics. The third molars with good root forms can be protracted and substituted as second molars to minimize prosthetic rehabilitation.
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Affiliation(s)
| | - Pooja Harish
- Department of Orthodontics and Dentofacial Orthopedics, Yenepoya Dental College, Yenepoya (Deemed to be) University, Mangaluru, Karnataka, India
| | - Anjuna Madakkuni
- Impact Oasis Apartment, Chikkabanaswadi, Bangaluru, Karnataka, India
| | - Sumitra Reddy
- Department of Orthodontics and Dentofacial Orthopedics, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
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A comparative assessment of the dentoskeletal effects of clear aligners vs miniplate-supported posterior intrusion with fixed appliances in adult patients with anterior open bite. A multicenter, retrospective cohort study. Am J Orthod Dentofacial Orthop 2022; 162:214-228.e4. [PMID: 35339320 DOI: 10.1016/j.ajodo.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to retrospectively evaluate the dentoskeletal effects of clear aligners (Invisalign) vs miniplate-supported posterior intrusion (MSPI) and identify factors associated with posttreatment overbite in adults with anterior open bite. METHODS Twenty-nine patients treated with Invisalign and 24 with MSPI combined with full-fixed orthodontic appliances were included from 5 orthodontic practices. Pretreatment and posttreatment lateral cephalometric measurements were included as outcomes. Comparisons across groups and identification of final overbite predictors were assessed with regression modeling and machine learning techniques. RESULTS MSPI induced significantly greater maxillary molar intrusion (1.5 mm; 95% confidence interval [CI], 0.83-2.17; P <0.001), with subsequent reduction of anterior face height (ANS-Me) (-2.77 mm; 95% CI, -3.64 to -1.91; P <0.001), Mp-SN° (-1.95°; 95% CI, -2.77 to -1.12; P <0.001), and ANB° (-1.69°; 95% CI, -2.44 to -0.94; P <0.001) compared with Invisalign. MSPI resulted in a significantly larger increase in SNB° (0.94°; 95% CI, 0.23-1.65; P = 0.01) and point-Pog projection (2.45 mm; 95% CI, 1.12-3.77; P = 0.001). Compared with MSPI, Invisalign had a significantly greater increase in the distance of maxillary (1.05 mm; 95% CI, 0.38-1.72; P = 0.003) and mandibular (0.9 mm; 95% CI, 0.19-1.60; P = 0.01) incisal edges relative to their apical bases, with borderline greater lingual tipping of only the maxillary incisors (2.82°; 95% CI, -0.44 to 6.09; P = 0.09). Appliance type and initial overbite were significant final overbite predictors across all models. However, this difference was only evident in male patients (males [1.65; 95% CI, 0.99-2.32; P <0.001]; female [-0.04; 95% CI, -0.52 to 0.44; P = 0.87]). CONCLUSIONS Both appliances effectively improve overbite. MSPI applied the correction via molar intrusion and counterclockwise mandibular autorotation, whereas Invisalign via maxillary and mandibular incisor extrusion.
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Aboshady H, Abouelezz AMA, Aboul Fotouh MH, Elkordy SAM. Failure Rate of Orthodontic Mini-screw after Insertion using 3D Printed Guide versus Conventional Free Hand Placement Technique: Split Mouth Randomized Clinical Trial. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study is to assess the failure rate after mini-screw insertion using digital three-dimensional printed guide versus free hand placement technique through a well-designed split-mouth randomized clinical trial.
METHODS: Forty-two patients with mean age (22.56 ± 3.47 years) indicated for upper first premolars’ extraction (Bimaxillary protrusion and Class II division 1) were included in the study. Their maxillary quadrants were randomized to receive mini-screws as means of anchorage. Pre-operative maxillary cone-beam computed tomography scan with ultra-low-dose protocol was imaged and the maxillary arch was scanned using intra-oral scanner to obtain stereo-lithographic format file for the maxillary arch. Using in vivo and Rapidform Geomagic Studio® _Softwares the mini-screws were planned to be inserted in the buccal inter-radicular space between the upper second premolar and first molar in both right and left sides. For the intervention sides; digital three-dimensional guides were designed and printed for mini-screw insertion. Failure of the mini-screws was assessed till 3 months of loading.
RESULTS: There was no statistical significant difference in failure rate of mini-screws in both intervention (7.14%) and control sides (16.6%), with weak and moderate correlation between the root proximity and the mini-screws failure in intervention and control groups respectively.
CONCLUSIONS: Using a digital three-dimensional printed guide for mini-screw insertion had no effect on the failure rate of the inserted mini-screws.
REGISTRATION: ClinicalTrials.gov Identifier: NCT03653078.
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Matsumoto T, Matsunaga S, Kasahara M, Kasahara N, Nakano T, Ishimoto T, Nishii Y. Evaluation of the Microstructural Characteristics of Bone Surrounding Anchor Screws Placed under a Horizontal Load by Exploring the Orientation of Biological Apatite Crystals and Collagen Fiber Anisotropy. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Norio Kasahara
- Department of Histology and Developmental Biology, Tokyo Dental College
| | - Takayoshi Nakano
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
| | - Takuya Ishimoto
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
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Ikenaka R, Koizumi S, Otsuka T, Yamaguchi T. Effects of root contact length on the failure rate of anchor screw. J Oral Sci 2022; 64:232-235. [DOI: 10.2334/josnusd.21-0536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - So Koizumi
- Department of Orthodontics, Kanagawa Dental University
| | - Takero Otsuka
- Department of Orthodontics, Kanagawa Dental University
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Palone M, Darsiè A, Maino GB, Siciliani G, Spedicato GA, Lombardo L. Analysis of biological and structural factors implicated in the clinical success of orthodontic miniscrews at posterior maxillary interradicular sites. Clin Oral Investig 2021; 26:3523-3532. [PMID: 34837567 DOI: 10.1007/s00784-021-04321-9] [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: 03/19/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aims to evaluate success factors implicated in clinical orthodontic miniscrew stability after their interradicular placement in maxilla. MATERIALS AND METHODS Six hundred seventy-six miniscrews were inserted in maxillary interradicular sites in a sample of 276 patients (109 males and 167 females; mean age 19 ± 1.7 years) and immediately loaded. Percentage failure rate was recorded, and the influence of the following factors was investigated: structural (miniscrew length, diameter and body shape), operative (side of insertion site, pilot hole drilling or not) and biological (maximal insertion torque [MIT] and type of gingiva). A chi-square test with Monte Carlo correction was performed to detect the influence of these variables on the failure rate of orthodontic miniscrews. Then both multivariate logistic regression and post hoc analysis were performed, followed by classification and regression tree (CART) analysis. RESULTS The average success rate was 88%. The principal factors implicated in the failure rate were miniscrew length, MIT values and type of gingiva. Specifically, 8 mm miniscrew length, alveolar mucosa and 5-10 Ncm MIT values were linked to higher failure rates. According to CART, the main variable influencing failure is miniscrew length (≤ 8 mm for higher failure rates). For others, MIT values of 5-10 Ncm are linked to higher failure rates (p < 0.05). CONCLUSION Orthodontic miniscrews inserted in the maxilla display good success rates. However, clinicians should be discouraged from using miniscrews of length ≤ 8 mm and MIT values < 10 Ncm, even with longer miniscrews. CLINICAL RELEVANCE Information about factors related to failure rate of miniscrews placed at posterior maxillary interradicular sites is given.
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Affiliation(s)
- M Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy.
| | - A Darsiè
- Private Practice, Treviso, Italy
| | - G B Maino
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
| | - G Siciliani
- School of Dentistry, University of Ferrara, Via Luigi Borsari 46, 44121, FerraraFerrara, Italy
| | - G A Spedicato
- Faculty of Banking and Finance, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123, Milano, Italy
| | - L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
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Hüfner M, Rauch N, Schwarz-Herzke B, Knorr IJ, Sager M, Drescher D, Becker K. Micro-angiogenic patterns around orthodontic implants migrating in bone: A micro-CT study in the rat tail model. J Clin Periodontol 2021; 49:188-197. [PMID: 34818684 DOI: 10.1111/jcpe.13577] [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: 08/31/2021] [Revised: 10/13/2021] [Accepted: 11/05/2021] [Indexed: 11/27/2022]
Abstract
AIM Recent studies revealed that implants can migrate in bone when subjected to continuous loading. Since this process is suspected to be accompanied by bone remodelling, which requires blood vessel formation, the present work aimed at assessing the micro-angiogenic patterns around migrating implants. MATERIALS AND METHODS In 16 rats, two customized implants were placed in a single tail vertebra and connected with contraction springs (forces: 0 N, 0.5 N, 1.0 N, 1.5 N). After 2 or 8 weeks of loading, the animals were scanned by micro-CT before and after vasculature perfusion with a silicone rubber. Vessels were segmented by subtraction of the two micro-CT scans. Vessel thickness (V.Th), vessel volume per total volume (VV/TV), and vascular spacing (V.Sp) were assessed in a peri-implant volume of interest (VOI) around each implant. RESULTS At 2 weeks of loading, force magnitude was significantly associated with VV/TV and V.Th values (χ2 = 10.942, p < .001 and χ2 = 6.028, p = .010, respectively). No significant differences were observed after 8 weeks of loading. CONCLUSIONS Within the limitations of an animal study, peri-implant vessel thickness and density were associated with force magnitude in the early loading phase, whereas effects diminished after 8 weeks of loading.
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Affiliation(s)
- Mira Hüfner
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - Ivonne Jeanette Knorr
- Central Unit for Animal Research and Scientific Animal Welfare Affairs, University of Düsseldorf, Düsseldorf, Germany
| | - Martin Sager
- Central Unit for Animal Research and Scientific Animal Welfare Affairs, University of Düsseldorf, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Arqub SA, Gandhi V, Mehta S, Palo L, Upadhyay M, Yadav S. Survival estimates and risk factors for failure of palatal and buccal mini-implants. Angle Orthod 2021; 91:756-763. [PMID: 34003884 DOI: 10.2319/090720-777.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The primary objective was to compare the success and survival rates of palatal and buccal mini-implants for different locations and treatment requirements. The secondary objective was to evaluate risk factors influencing the survival of mini-implants. MATERIALS AND METHODS In this retrospective cohort, records of 127 orthodontic patients with 257 mini-implants were included after imposing inclusion/exclusion criteria. Along with the implant failure data, factors such as age, sex, transverse location, anteroposterior location, and purpose of mini-implants were recorded. Kaplan-Meier survival analysis was used to draw the curves and a Nathan Mantel-David Cox test to compare variables. RESULTS The failure rate of palatal mini-implants was 8.5%, whereas the failure rate for buccal shelf mini-implants was 68.7% (P < .0001). A significant difference was that the survival rates of palatal mini-implants were dependent on the purpose of the mini-implants and, for the buccal mini-implants, they were dependent on the skeletal malocclusion and location type of mini-implants (P < .05). CONCLUSIONS The overall survival rate of palatal mini-implants was high, at 91.5%. Of the buccal mini-implants, inter-radicular mini-implants had the highest survival rate for 12 (75.5%) and 24 (71.9%) months, while buccal shelf mini-implants had the lowest success and survival rates for 12 (31.3%) and 24 (20.8%) months. Class III malocclusion had the lowest survival rate for the buccal mini-implants (65.3% and 54.2%) for 12 and 24 months.
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Risk factors associated with the stability of mini-implants and mini-plates: systematic review and meta-analysis. Clin Oral Investig 2021; 26:65-82. [PMID: 34676428 DOI: 10.1007/s00784-021-04212-z] [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: 07/21/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this systematic review is to assess the risk factors associated with the stability of mini-implants and mini-plates in patients undergoing orthodontic treatment using temporary anchorage devices. MATERIAL AND METHODS Search strategies were developed for each electronic database (PubMed/Medline, LILACS, Scopus, Web of Science, Embase, and Cochrane Library) and gray literature (Google Scholar, Proquest, and Open Grey). The risk of bias was assessed using the Cochrane Collaboration tool for assessing the risk of bias and Meta-Analysis of Statistics Assessment and Review Instrument. The certainty of the evidence was assessed using the GRADE tool. Meta-analyses and meta-regressions of random effects were performed for the outcomes of interest. RESULTS A total of 1517 articles were found, of which seven were selected for quantitative synthesis. When comparing the risk of failure between mini-implants and mini-plates, the risk values approached the threshold of statistical significance (p = 0.07) (RR = 1.83; 95% CI = 0.96-3.50; I2 = 69%), showing significance after sensitivity analysis (p < 0.05) and a greater risk for mini-implants. Mandible installation presented a higher risk of failure (RR = 1.85; 95% CI = 1.17-2.91). CONCLUSIONS The evidence found indicates that failure in the stability is related to the type of device and that there is a greater risk by using isolated mini-implants, especially when positioned in the mandible. CLINICAL RELEVANCE These findings help the orthodontist and/or the surgeon to stipulate risks, learn about the predictability of techniques, and communicate with the patient in an easier way.
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Abellán R, Gómez C, Palma JC. Effects of Photobiomodulation on the Upper First Molar Intrusion Movement Using Mini-Screws Anchorage: A Randomized Controlled Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:518-527. [PMID: 34328794 DOI: 10.1089/photob.2020.4979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: The aim of this study was to quantify the changes obtained when the molar intrusion movement is complemented by photobiomodulation (PBM). Background: A common problem in adult patients is the super-eruption of maxillary molars caused by the loss of the antagonist tooth. Super-erupted molars impair oral rehabilitation and can cause both occlusal and functional problems. There is increasing research confirming the benefits of adjunctive PBM during orthodontic treatment. Methods: Twenty patients with indication of a maxillary first molar intrusion for oral rehabilitation were selected. Patients were randomized into two groups to receive orthodontic intrusion (control group) or the same treatment complemented by PBM (PBM group) in repeated doses (days 0, 1, 2, 3, 4, and 7 from the start of the intrusion and in each monthly follow-up) by using a low-power red laser diode (670 nm, 150 mW, 12 min around the molar). Plaque index (PI), probing depth (PD), and bleeding of probing (BOP) were assessed at 0, 1, 2, 3, and 6 months. Stereolithography models generated from an intraoral scanner were taken at 0, 3, and 6 months and cone beam computed tomography (CBCT) records were taken at 0 and 6 months. Mean intrusion distance, mean intrusion velocity, and volumetric resorption were calculated. Results: Periodontal clinical assessments (PI, PD, and BOP) and mean intrusion distance or mean intrusion velocity yielded no differences (p > 0.05) between groups. However, PBM group showed lower values of all these scores during the first 3 months. Intraoral scanner and CBCT were equally effective in accurately monitoring the intrusion distance (p > 0.05). CBCT records allowed volumetric evaluation of the root resorption process, being lesser in the PBM group, but not significantly (p > 0.05). Conclusions: During orthodontic intrusion process, the adjunctive application of PBM may provide better periodontal records and lower progression of root resorption at the expense of a little lower intrusion distance and velocity.
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Affiliation(s)
- Rosa Abellán
- Section of Orthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Clara Gómez
- Department of Low Dimensional Systems, Surfaces and Condensed Matter, Institute of Physical Chemistry Rocasolano, Spanish National Research Council, CSIC, Madrid, Spain
| | - Juan Carlos Palma
- Section of Orthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Giudice AL, Rustico L, Longo M, Oteri G, Papadopoulos MA, Nucera R. Complications reported with the use of orthodontic miniscrews: A systematic review. Korean J Orthod 2021; 51:199-216. [PMID: 33984227 PMCID: PMC8133901 DOI: 10.4041/kjod.2021.51.3.199] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022] Open
Abstract
Objective The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario V. Emanuele, Catania, Italy
| | - Lorenzo Rustico
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Policlinico Universitario G. Martino, Messina, Italy
| | - Miriam Longo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Policlinico Universitario G. Martino, Messina, Italy
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Policlinico Universitario G. Martino, Messina, Italy
| | - Moschos A Papadopoulos
- Department of Orthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Riccardo Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Policlinico Universitario G. Martino, Messina, Italy
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Khan J, Goyal M, Kumar M, Kushwah A, Kaur A, Sharma M. Comparative evaluation of displacement and stress distribution pattern during maxillary arch distalization with Infra Zygomatic Screw- A three dimensional finite element study. Int Orthod 2021; 19:291-300. [PMID: 33875363 DOI: 10.1016/j.ortho.2021.03.006] [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: 02/07/2021] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to evaluate and compare the distribution of stress and displacement of teeth during maxillary arch distalization with IZC (Infra zygomatic crest) screw with two maxillary positions and different lever arm heights. SETTINGS AND DESIGN Six three-dimensional finite element models of the maxillary arch were constructed with third molars extracted. Models 1, 2 and 3: IZC 6 (mesial to mesiobuccal root of first molar, 6) with 0mm, 4mm and 8mm lever arm height; Models 4, 5 and 6: IZC 7 (mesial to mesiobuccal root of second molar, 7) with 0mm, 4mm and 8mm, respectively. MATERIAL AND METHODS MBT preadjusted Brackets (slot size 0.022×0.028") were placed over the clinical crown's centre with 0.019×0.025" stainless steel archwire on all six models. Retraction force of 4N was applied with different combinations of IZC screws and lever arm bilaterally using Nickel-Titanium (NiTi) closed coil spring. Then, evaluation of stress distribution, von Mises stress and maxillary teeth displacement were performed using ANSYS 12.1 software. RESULTS In this study, maximum von Mises stress in alveolar bone (cortical bone) was observed in Model 4 (107.79MPa) at the screw fixation site that was within the optimum limit (135MPa). Different extents of displacements like labiolingual tipping of crown, labiolingual tipping of root, extrusion and intrusion were noticed. The models with 0mm and 4mm lever arm height (models1, 2, 4 and 5) showed more controlled crown and root movements in comparison to 8mm long lever arm models (models 3 and 6). In model 5, a maximum distal movement compared to all other five models was observed. CONCLUSIONS IZC 7 position showed the most favourable results (maximum distalization) with the lever arm height of 4mm. Therefore, the nearer the force to the centre of resistance of the tooth, the greater is distalization. Stresses on the IZC screw decreases when lever arm height increases, in all the models.
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Affiliation(s)
- Junaid Khan
- Department of Orthodontics and Dentofacial Orthopaedics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India.
| | - Manish Goyal
- Department of Orthodontics and Dentofacial Orthopaedics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India
| | - Mukesh Kumar
- Department of Orthodontics and Dentofacial Orthopaedics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India
| | - Ashish Kushwah
- Department of Orthodontics and Dentofacial Orthopaedics, Institute of Dental Education & Advanced Studies, Gwalior, Madhya Pradesh, India
| | - Amandeep Kaur
- Department of Orthodontics and Dentofacial Orthopaedics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India
| | - Madhur Sharma
- Department of Orthodontics and Dentofacial Orthopaedics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India
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Joshi R, Shyagali TR, Jha R, Gupta A, Tiwari A, Tiwari T. Evaluation and Comparison of the Effect of Elastomeric Chain and Stainless Steel Ligature Wire on Maxillary Orthodontic Miniscrew Failure. Int J Appl Basic Med Res 2021; 11:100-105. [PMID: 33912430 PMCID: PMC8061618 DOI: 10.4103/ijabmr.ijabmr_191_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 12/17/2020] [Accepted: 01/12/2021] [Indexed: 12/02/2022] Open
Abstract
Context: Orthodontic miniscrews are used for the purpose of conservation of anchorage. Aims: The aim of the study was to evaluate the orthodontic miniscrew failure between the elastomeric chain-supported retraction and stainless steel (SS) ligature-aided retraction. Settings and Design: This was a cross-sectional split mouth randomized controlled trial. Materials and Methods: The sample (30) was divided equally among the control group and the experimental group (15 each). Miniscrews were placed between second premolar and the first molar of maxilla. The experimental group was based on the split mouth technique wherein right or left side of the maxillary arch was treated using either an elastomeric power chain (EPC) engaged to the miniscrews directly (Group 1) or an EPC engaged indirectly to miniscrews with the help of SS ligature wire (Group 2). In control group, implants were placed in maxilla without any retraction force. Clinical signs of inflammation was assessed at the following interval; 7th day, 14th day, 1st month, 2nd month, and at the time of removal of implant. Statistical Analysis Used: Kruskal–Wallis ANOVA test was used. Results: Mean rank of gingival inflammation was 28.33 at the 1st-month interval in Group 1 and inflammation remained high in the this group for all time intervals in comparison to Group 2. Group 2 showed highest mean rank of inflammation of 26.10 at 7th day. In control group, the inflammation remained low at all the time intervals. Moreover, the difference noted was statistically significant. Conclusions: The gingival inflammation around the peri-implant tissue with the application of EPC at various interval remained high in comparison to the EPC with SS group. The gingival inflammation in the control group was very less, and it remained less throughout the different time periods.
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Affiliation(s)
- Rishi Joshi
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Tarulatha Revanappa Shyagali
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Ruchi Jha
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Abhishek Gupta
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Anil Tiwari
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
| | - Tanvee Tiwari
- Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
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Jyothish S, Athanasiou AE, Makrygiannakis MA, Kaklamanos EG. Effect of nicotine exposure on the rate of orthodontic tooth movement: A meta-analysis based on animal studies. PLoS One 2021; 16:e0247011. [PMID: 33596270 PMCID: PMC7888643 DOI: 10.1371/journal.pone.0247011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/01/2021] [Indexed: 12/09/2022] Open
Abstract
Background Nicotine exposure has been reported to modify bone cell function and the osseous metabolism with potential effects on the rate of orthodontic tooth movement. Objectives To systematically investigate and quantitively synthesize the most recent available evidence from animal studies regarding the effect of nicotine exposure on the rate of orthodontic tooth movement. Search methods Unrestricted searches in 7 databases and hand searching were performed until July 2020 (PubMed, Central, Cochrane Database of Systematic Reviews, SCOPUS, Web of Science, Arab World Research Source, ProQuest Dissertations and Theses Global). Selection criteria We searched for controlled studies on healthy animals investigating the effect of nicotine on the rate of orthodontic tooth movement. Data collection and analysis Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE’s Risk of Bias Tool. Exploratory synthesis and meta-regression were carried out using the random effects model. Results From the initially identified records, 5 articles meeting the inclusion criteria were selected and no specific concerns regarding bias were identified. Quantitative data synthesis showed that the rate of orthodontic tooth movement in the nicotine exposed rats was higher than in the control group animals (2 weeks of force application; 0.317 mm more movement in nicotine exposed rats; 95% Confidence Interval: 0.179–0.454; p = 0.000). No effect of the concentration or the duration force application was demonstrated following exploratory meta-regression. Conclusion Rats administered with nicotine showed accelerated rates of orthodontic tooth movement. Although, information from animal studies cannot be fully translated to human clinical scenarios, safe practice would suggest that the orthodontist should be able to identify patients exposed to nicotine and consider the possible implications for everyday clinical practice.
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Affiliation(s)
- Sanjay Jyothish
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Miltiadis A. Makrygiannakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios G. Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- * E-mail: ,
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Jung MH. Factors influencing treatment efficiency. Angle Orthod 2021; 91:1-8. [PMID: 33289803 DOI: 10.2319/050220-379.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/01/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The purpose of this cohort study was to evaluate the effect of self-ligating brackets (SB) and other related factors that influence orthodontic treatment time. MATERIALS AND METHODS This was a two-armed prospective study. Consecutively treated patients who were recruited from a private practice were enrolled and asked to choose between SB and conventional brackets (CB). If the patient did not have a preference, that patient was randomly allocated. An identical archwire sequence was used, and all patients were treated by a single orthodontist. Treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, whether or not to orthodontic mini-implants (OMI) were used, OMI failure, extraction, American Board of Orthodontics Discrepancy Index, and arch length discrepancy were measured and statistically analyzed using t-tests, correlation analysis, and analysis of covariance (ANCOVA). Stepwise regression analysis was conducted to generate an equation to predict treatment duration. RESULTS A total of 134 patients with an average age of 22.73 years were included. The average treatment duration was 28.63 months. ANCOVA showed no significant difference in treatment duration between CB and SB. Stepwise regression analysis could explain 64.6% of the variance in treatment duration using five variables. CONCLUSIONS SB did not exhibit a significant reduction in treatment time as compared with CB. Patient cooperation, extractions, and malocclusion severity had a significant impact on treatment duration.
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Popova NV, Arsenina OI, Lebedenko IY, Rusanov FS, Khvorostenko EA, Glukhova NV. [The experimental study of a Russian orthodontic mini-screw]. STOMATOLOGIIA 2021; 100:7-12. [PMID: 34180618 DOI: 10.17116/stomat20211000317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The aim of this research is the experimental study measuring stability of the orthodontic miniscrews «Turbo» designed in Russia in comparison with its foreign analogues, namely, «Vector Tas» (USA) and «BioRay» (Taiwan). MATERIAL AND METHODS Four self-drilling orthodontic miniscrews of each manufacturer, i.e. «Vector Tas», USA, (10-mm length, 2-mm diameter), «BioRay», Taiwan, (10-mm length, 2-mm diameter), «Turbo», Russia, (9-mm length, 2-mm diameter), a total of 12 items, were inserted into native pig mandible sample. Their stability was estimated by torques using a dynamometer (Zahoransky AG, Germany) and «Periotest» device («Periotest M», Germany). This experiment was conducted in native pig mandible sample immediately after the screws' placement and in 7 days after loading at an angle 70°. RESULTS After application of a load, the decreased torque values and increased Periotest values were registered in all orthodontic miniscrews. CONCLUSION Orthodontic miniscrews «Turbo» designed in Russia are slightly inferior to «VectorTas» miniscrews and superior to «BioRay» miniscrews in primary stability and stability after 7 days under loading.
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Affiliation(s)
- N V Popova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - O I Arsenina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - I Yu Lebedenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - F S Rusanov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - E A Khvorostenko
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N V Glukhova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Lee DW, Park JH, Bay RC, Choi SK, Chae JM. Cortical bone thickness and bone density effects on miniscrew success rates: A systematic review and meta-analysis. Orthod Craniofac Res 2020; 24 Suppl 1:92-102. [PMID: 33277824 DOI: 10.1111/ocr.12453] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To systematically review the effects of cortical bone thickness (CBT) and bone mass density (BMD) on miniscrew success rates. METHODS MEDLINE, the Cochrane Library and Scopus were searched up to June 2020. Of a total of 5734 articles, seven studies were finally selected for the review. RESULTS The overall mean success rate weighted by the number of miniscrews was 87.21% (89.87% in the maxilla and 79.24% in the mandible). There was a significantly higher success rate for miniscrews placed in the maxilla compared with those in the mandible (P < .05). CBT showed small positive effect on the success rate of the miniscrews although it failed to reach a statistical significance. The cortical BMD had a minimal effect on the success of the miniscrews. The cancellous BMD demonstrated a very strong effect on the success of the miniscrews in the maxilla, whereas it showed a moderately negative effect in the mandible. LIMITATIONS Because of the small number and clinical heterogeneity of the included studies, the results should be interpreted with caution. Further randomized clinical studies with a large sample size are recommended.
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Affiliation(s)
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - R Curtis Bay
- Biostatistics, Department of Interdisciplinary Health Sciences, A. T. Still University, Mesa, AZ, USA
| | - Sung-Kwon Choi
- Department of Orthodontics, School of Dentistry, University of Wonkwang, Iksan, Korea
| | - Jong-Moon Chae
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Department of Orthodontics, School of Dentistry, Wonkwang Dental Research Institute, University of Wonkwang, Iksan, Korea
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Evaluation of success rate and biomechanical stability of ultraviolet-photofunctionalized miniscrews with short lengths. Am J Orthod Dentofacial Orthop 2020; 159:158-166. [PMID: 33243706 DOI: 10.1016/j.ajodo.2019.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/01/2019] [Accepted: 12/01/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of this research was to verify that ultraviolet light (UV)-photofunctionalization improves the success rate and biomechanical stability of miniscrews regardless of length, and to evaluate the comparability of biomechanical stability between UV-photofunctionalized miniscrews with short lengths and untreated miniscrews with conventional lengths. METHODS Eight male beagles (age, 12-15 months; weight, 10-13 kg) received a total of 64 miniscrews, including 7-mm and 4-mm untreated and UV-photofunctionalized, acid-etched miniscrews with the use of a random block design. The cumulative success rates were examined in all studied groups. The insertion and removal torques and screw mobility were measured. Microcomputed tomographic scans and histomorphometric analyses were performed at 8 weeks postoperatively. RESULTS The success rates of 7-mm UV-untreated and UV-photofunctionalized miniscrews were 87.5% and 100%, respectively, vs 43.8% for the 4-mm UV-untreated and 4-mm UV-photofunctionalized miniscrews. The rates were significantly different in accordance with the length (P <0.001). There were no differences in the insertion and removal torque and screw mobility between groups according to the length or UV treatment. However, the 4-mm UV-untreated miniscrews yielded a mean bone area ratio of 6.35 ± 7.43%, whereas the 7-mm UV-photofunctionalized miniscrew yielded a mean ratio of 32.17 ± 8.34% (P = 0.037). CONCLUSIONS The UV-photofunctionalization significantly increased the biomechanical stability and led to increased bone and miniscrew contact area in dogs with miniscrews of the same length. However, the most important factor that affected the success rate of the miniscrew was the length.
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