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Tarigan SHP, Sufarnap E, Bahirrah S. The Orthodontic Mini-Implants Failures Based on Patient Outcomes: Systematic Review. Eur J Dent 2024; 18:417-429. [PMID: 37848073 PMCID: PMC11132791 DOI: 10.1055/s-0043-1772249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Anchorage is a challenge and essential issue for an orthodontist in determining the success of orthodontic treatment. Orthodontic anchorage is defined as resistance to unwanted tooth movement. Mini-implant is one of the devices that can be used as an anchor in orthodontic treatment. Many cases have reported successful treatment using mini-implant, but there are cases where mini-implants may fail. Failure of mini-implants can affect orthodontic treatment, and it is known that several factors may lead to mini-implant loss in orthodontic treatment. This systematic review aimed to determine the factors influencing mini-implant failure in orthodontic treatment. Articles were selected from electronic databases (PubMed, Google Scholar, The Cochrane Library, ScienceDirect) from January 2015 until 2023 according to the PRISMA method (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) under the PEOS (Population-Exposure-Outcome-StudyType) framework questions for systematic review. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022337684). All data collected were in English, and filtering was done by eliminating duplicate data, meta-analysis, case reports, case series, mini-reviews, and animal studies. The analysis was further divided into three groups, that is, patient-related, implant-related, and operator-related and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]). Twenty-one articles were identified according to the inclusion criteria in the form of retrospective, prospective, in vivo, and randomized controlled trial studies. Mini-implant failures due to patient-related showed six etiological factors, failures due to implant-related had eight etiological factors, and only one factor was operator-related, which may lead to mini-implant failure. The data was extracted without a computerized system and only in English. Mini-implant failure can be caused by many factors; we could not accuse one major factor as a cause. However, the quality or condition of the bones and oral hygiene are factors that play a significant role in obtaining the stability of implants. Mini-implant failure is highly influenced by poor oral hygiene and peri-implant inflammation. Comprehensive diagnostic prior to mini-implant insertion should be appropriately considered. This systematic review describes several factors that can influence mini-implant failure, divided into three groups: patient-related, implant-related, and operator-related (A graphical abstract provided as a Supplementary information [available in the online version]).
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Affiliation(s)
| | - Erliera Sufarnap
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Siti Bahirrah
- Orthodontic Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
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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:S2212-4438(24)00012-2. [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] [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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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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Kudo M, Shirakata Y. Multidisciplinary approach involving strategic implant placement before orthodontic (SIMBO) treatment for generalized stage IV grade C periodontitis: A case report with 10-year follow-up. J ESTHET RESTOR DENT 2023; 35:1171-1185. [PMID: 37350421 DOI: 10.1111/jerd.13075] [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: 01/29/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE The aim of this case report was to demonstrate the long-term effects of a multidisciplinary approach involving periodontal reconstructive surgery and strategic implant placement before orthodontic (SIMBO) treatment in a patient with severe periodontitis (e.g., stage IV/grade C). CLINICAL CONSIDERATIONS The patient presented with severe periodontitis and pathologic tooth migration (PTM) without stable occlusion or occlusal support. After performing cause-related therapy, periodontal regenerative surgery, pre-orthodontic posterior implant placement, and orthodontic treatment involving anterior implant placement with papilla reconstruction, the patient achieved full-mouth rehabilitation and improvement of dental and smile esthetics. The clinical and radiographic results obtained were maintained over a 10-year period. CONCLUSION Within the limits of this as a single case, multidisciplinary treatment involving the SIMBO approach appeared to allow long-term improvement of periodontal condition, stability of the dental arches and occlusion, and esthetics in a patient with severe periodontitis, PTM and posterior bite collapse. Future studies with more subjects are needed to evaluate and validate this approach. CLINICAL SIGNIFICANCE When addressing periodontal disease, SIMBO approach-based multidisciplinary treatment appears safe and effective as a clinical protocol for establishing esthetic and functional rehabilitation in generalized stage IV/grade C periodontitis.
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Affiliation(s)
| | - Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Maldonado Molina O. Insertion of orthodontic temporary anchorage devices with free gingival grafting for phenotype modification of the peri-implant mucosa. J Oral Biol Craniofac Res 2023; 13:727-730. [PMID: 37822582 PMCID: PMC10562162 DOI: 10.1016/j.jobcr.2023.09.005] [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: 08/05/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023] Open
Abstract
Background Mini Implants are widely used in contemporary orthodontics, they provide skeletal anchorage even in non-compliant patients, facilitate orthodontic tooth movement, are easy to place and are relatively inexpensive. Their failure is multifactorial, and the quality of the soft tissue can present a risk limitation for the insertion of TADS. Orthodontic Mini Implants inserted in keratinized gingiva present fewer tissue-related complications and higher survival rate, than those inserted in non-keratinized mucosa. The purpose of this report is to present and describe this novel technique to modify and enhance the peri-implant mucosa of Orthodontic Mini Implants inserted in nonkeratinized gingiva. Methods A free gingival graft was harvested from the palate in combination with a buccal recipient site preparation in the alveolar mucosa and a TAD insertion procedure. Results After twenty-one days of healing, graft integration was observed. One hundred and eighty days after insertion and twelve weeks of loading, none to mild signs of clinical inflammation were documented, and the patient reported no pain or discomfort. Conclusion Within the limitations of this report, free gingival grafting for phenotype modification of the peri-implant mucosa, can benefit patients who need insertion of orthodontic mini-implants in non-keratinized mucosa for orthodontic tooth movement.
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Affiliation(s)
- Oscar Maldonado Molina
- Postgraduate Orthodontic Program, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
- Postgraduate Orthodontic Program, Universidad Intercontinental, México City, Mexico
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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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Gopal H, Das SK, Barik AK, Mishra M, Rath SK, Samal R, Sharma G. Success rate of infrazygomatic crest mini-implants used for en-masse retraction of maxillary anterior teeth in first premolar extraction cases: A three-dimensional comparative prospective clinical trial between adolescents and young adults. J World Fed Orthod 2023; 12:197-206. [PMID: 37558596 DOI: 10.1016/j.ejwf.2023.06.001] [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: 04/05/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The purpose of this study was to compare the success rate of infrazygomatic mini-implants between adolescents and young adults. METHODS A total of 60 subjects of different age groups ie, (group I [adolescents]: 12-18 years, mean age: 14.9 ± 2.9 years; group II [young adults]: 19-25 years, mean age = 21.9 ± 3.1 years) were assessed in the study. En-masse retraction of maxillary anterior teeth was carried out with extraction of upper first premolars with infrazygomatic crest (IZC) mini-implants as anchorage units. Clinical parameters such as success rate, soft tissue thickness, maximum insertion torque, maximum removal torque, pain response, soft tissue response, and cone-beam computed tomography parameters such as embedded angulation, penetration depth, thickness of bone on buccal and palatal aspect of mini-implant, and peri-implant bone density were evaluated. RESULTS The success rate of IZC mini-implants in adolescents was found to be 96.6% and 98.3% in young adults respectively. There was no significant difference in success rate between the two groups. Intergroup comparison showed a significant difference (P < 0.05) in terms of maximum insertion torque, maximum removal torque, soft tissue thickness, cortical bone thickness, and peri-implant bone density values. Comparison between right and left side revealed a significant difference (P < 0.05) with regards to soft tissue response, soft tissue thickness, total bone thickness, cortical bone thickness, and peri-implant bone density. CONCLUSIONS There was no significant difference in the success rate of IZC mini-implants between adolescents and young adults. Thus, the use of IZC mini-implants can be recommended in adolescents for successful orthodontic treatment.
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Affiliation(s)
- Hasini Gopal
- Department of Orthodontics and Dentofacial Orthopedics, SCB Dental college and Hospital, Cuttack, Odisha, India.
| | - Surya Kanta Das
- Department of Orthodontics and Dentofacial Orthopedics, SCB Dental college and Hospital, Cuttack, Odisha, India
| | - Ashish Kumar Barik
- Department of Orthodontics and Dentofacial Orthopedics, SCB Dental college and Hospital, Cuttack, Odisha, India
| | - Mitali Mishra
- Department of Orthodontics and Dentofacial Orthopedics, SCB Dental college and Hospital, Cuttack, Odisha, India
| | - Sunil Kumar Rath
- Department of Orthodontics and Dentofacial Orthopedics, SCB Dental college and Hospital, Cuttack, Odisha, India
| | - Rajashree Samal
- Department of Oral and Maxillofacial surgery, Hitech Dental College and Hospital, Bhubaneshwar, Odisha, India
| | - Gaurav Sharma
- Department of Public Health Dentistry, S C B Dental college and Hospital, Cuttack, Odisha, India
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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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Abu Arqub S, Greene R, Greene S, Laing K, Kuo CL, Da Cunha Godoy L, Uribe F. Ridge mini-implants, a versatile biomechanical anchorage device whose success is significantly enhanced by splinting: a clinical report. Prog Orthod 2023; 24:27. [PMID: 37635155 PMCID: PMC10460761 DOI: 10.1186/s40510-023-00480-5] [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: 05/14/2023] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES This clinical report aims to highlight the factors affecting the clinical success of alveolar ridge mini-implants used for orthodontic anchorage and provide an overview of the biomechanical versatility of this miniscrew and steps involving the proper technique of its placement. METHODS For this clinical report, charts for 295 patients who had temporary anchorage devices (TADs) were screened. Twenty patients [15 females and 5 males: mean age = 38.15 ± 15.10 years] with 50 alveolar ridge mini-screws were assessed. A descriptive summary of the main factors affecting their clinical success and the technique employed for their placement was comprehensively discussed and illustrated, in addition to the presentation of some clinical cases illustrating their potential clinical uses. RESULTS The survival duration (7.32 ± 9.01 months) and clinical success of the alveolar ridge mini-implants that failed (19/50) seem to be affected primarily by 2 factors: splinting; none of the splinted mini-implants failed (0/10) compared to (19/40) of the single mini-implants that failed, and the length of the used mini-implant; the average length of the mini-implants that did not fail was 9.23 mm. Additionally, it appears that these mini-implants are biomechanically robust and durable, those that did not fail had an average survival duration of 35.97 ± 19.79 months. CONCLUSION Ridge mini-implants offer significant biomechanical versatility in patients with partially edentulous ridges needing complex pre-prosthetic orthodontic movements. The presence of splinting and the length of the used mini-implants are factors that might affect the clinical success of the alveolar ridge mini-implants.
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Affiliation(s)
- Sarah Abu Arqub
- Department of Orthodontics, University of Florida, Gainesville, FL USA
| | - Renee Greene
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, CT USA
| | - Sara Greene
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, CT USA
| | - Kolbe Laing
- UCONN School of Dental Medicine, University of Connecticut, Farmington, CT USA
| | - Chia-Ling Kuo
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT USA
| | - Lucas Da Cunha Godoy
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, CT USA
| | - Flavio Uribe
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, CT USA
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Kum J, Park KH, Kim HJ, Hong M, Yu W, Park HS. Minimum required length of orthodontic microimplant: a numerical simulation and clinical validation. Am J Orthod Dentofacial Orthop 2023; 163:858-866. [PMID: 36732093 DOI: 10.1016/j.ajodo.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION This study aimed to determine the minimum required length of microimplants (MIs) to prevent excessive micromotion during MI healing that can lead to MI failure. METHODS Hypothesizing that the implantation depth of MI in cancellous bone (IDcancel) is the key to the control of micromotion during MI healing, we numerically investigated the minimum IDcancel required to maintain MI micromotion to below the threshold (30 μm) that would threaten MI survival. Twenty MI and bone models were built using MIs of 4 lengths and bone specimens with 5 different cortical bone thicknesses to create IDcancel in the 0.5-5.5 mm. Then, applying a horizontal force of 1.5 N on the MI head, we calculated the micromotion (peak and average MI micromotions) and determined the minimum IDcancel. A clinical test was performed to verify the numerical result by placing 160 MIs in the posterior maxilla and mandible. RESULTS A strong correlation (r2= 0.694) was found to exist between IDcancel and MI micromotion. A minimum of 2.5 mm of IDcancel was needed to maintain the level of MI micromotion (peak micromotion) <30 μm threshold. The 6-month survival rate of MI was strongly correlated with IDcancel (r2= 0.744) and decreased sharply when IDcancel was ≤2 mm. CONCLUSIONS The minimum lengths of MIs to provide the minimum IDcancel of 2.5 mm required to promote successful MI healing in the posterior maxilla and mandible are 5.2 and 6.5 mm, respectively.
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Affiliation(s)
- Jaemin Kum
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | | | - Ho-Jin Kim
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Mihee Hong
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea.
| | - Wonjae Yu
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
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Zhao N, Zhang Q, Guo Y, Cui S, Tian Y, Zhang Y, Zhou Y, Wang X. Oral microbiome contributes to the failure of orthodontic temporary anchorage devices (TADs). BMC Oral Health 2023; 23:22. [PMID: 36650527 PMCID: PMC9844000 DOI: 10.1186/s12903-023-02715-7] [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: 08/24/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The stability of temporary anchorage devices (TADs) is critical in orthodontic clinics. The failure of TADs is multifactorial, and the role of the oral microbiome has not been clearly defined. Herein, we attempted to analyze the contribution of the oral microbiome to the failure of TADs. METHODS Next-generation sequencing was adopted for analyzing the microbiome on the TADs from orthodontic patients. 29 TADs (15 failed TADs and 14 successful TADs) were used for 16S rRNA gene sequencing. A total of 135 TADs (62 failed TADs and 73 successful TADs) were collected to conduct metagenomic sequencing. Additionally, 34 verified samples (18 failed TADs and 16 successful TADs) were collected for quantitative real-time polymerase chain reaction analysis (qRT-PCR). RESULTS Successful and failed TADs demonstrated discrepancies in microbiome structure, composition, and function. Clear separations were found in β-diversity in 16S rRNA gene sequencing as well as metagenomic sequencing (p < 0.05). Metagenomic sequencing showed that Prevotella intermedia, Eikenella corrodens, Parvimonas spp., Neisseria elongata, and Catonella morbi were enriched in the failed groups. qRT-PCR also demonstrated that the absolute bacteria load of Prevotella intermedia was higher in failed TADs (p < 0.05). Considering functional aspects, the failed group showed enriched genes involved in flagellar assembly, bacterial chemotaxis, and oxidative phosphorylation. CONCLUSIONS This study illustrated the compositional and functional differences of microorganisms found on successful and failed TADs, indicating that controlling bacterial adhesion on the surface of TADs is essential for their success rate.
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Affiliation(s)
- Ningrui Zhao
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Qian Zhang
- grid.11135.370000 0001 2256 9319Central Laboratory, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
| | - Yanning Guo
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Shengjie Cui
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Yajing Tian
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Yidan Zhang
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Yanheng Zhou
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
| | - Xuedong Wang
- grid.11135.370000 0001 2256 9319Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22 Zhongguancun South Avenue, Beijing, 100081 China
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12
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Zhao NR, Guo YN, Cui SJ, Tian YJ, Zhou YH, Wang XD. Microbiological Advances in Orthodontics: An Overview and Detailed Analysis of Temporary Anchorage Devices. Curr Med Sci 2022; 42:1157-1163. [PMID: 36544036 DOI: 10.1007/s11596-022-2653-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 08/08/2022] [Indexed: 12/24/2022]
Abstract
Dental biofilm is the initiating factor of oral diseases, such as periodontitis and caries. Orthodontic treatment could alter the microbiome structure balance, and increase the risk of such diseases. Furthermore, fixed appliances can induce temporary changes in the microbiome community, and the changes that clear aligners bring are smaller by comparison. Temporary anchorage devices (TADs) are skeletal anchorages that are widely used in orthodontic treatment. Microorganisms affect the occurrence and development of inflammation surrounding TADs. At present, existing researches have verified the existence of plaque biofilm on the surface of TADs, but the formation of plaque biofilm and plaque composition under different stable conditions have not been fully understood. The development of high-throughput sequencing, molecular biology experiments, and metabonomics have provided new research ideas to solve this problem. They can become an effective means to explore the microbiome surrounding TADs.
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Affiliation(s)
- Ning-Rui Zhao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yan-Ning Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Sheng-Jie Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Ya-Jing Tian
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Yan-Heng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Xue-Dong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
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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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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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Mohamed A, Wafaie K, Mohammed H, Mohamed AM, Xinrui W, Vandevska-Radunovic V, Yiqiang Q. Effect of Chlorhexidine Mouthwash on Gingival Health around Orthodontic Miniscrew Implants: A Pilot Placebo-Controlled Randomized Trial. Orthod Craniofac Res 2022; 26:163-170. [PMID: 35751508 DOI: 10.1111/ocr.12596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This randomized controlled trial (RCT) aims to investigate the short-term effects of chlorhexidine mouthwash (MW) on gingival health surrounding orthodontic miniscrew implants (OMIs) and their overall survivability. MATERIALS AND METHODS Thirty-two participants (mean age, 22.8 years) undergoing fixed orthodontic appliance treatment after maxillary premolar extraction were randomly allocated in a parallel fashion to either receive (1) MW with an active component of chlorhexidine, or (2) a placebo. Each participant received two maxillary buccal OMIs for anchorage reinforcement purposes. Participants were assessed for their gingival oral health status around all inserted OMIs and had their OMI survivability recorded at three time points; T1=1 month, T2=3 months, and T3=6 months after OMI placement. A Kaplan Meier plot was used to estimate the survival function of OMIs. RESULTS All randomized participants completed the follow-up period. In terms of gingival oral health, there were no statistically significant differences at any time point between the chlorhexidine MW group and the placebo-controlled group (P > 0.05). One OMI was lost in the chlorhexidine MW group and another two OMIs in the control group. There was no significant difference between both groups in terms of survivability (P = 0.585). CONCLUSION The use of chlorhexidine MW does not seem to have a significant clinical impact on the gingival health around OMIs or their survivability in this pilot study.
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Affiliation(s)
- Ahmed Mohamed
- Department of orthodontics, Faculty of Dentistry, First affiliated hospital of Zhengzhou University, Henan, China
| | - Khaled Wafaie
- Department of orthodontics, Faculty of Dentistry, First affiliated hospital of Zhengzhou University, Henan, China
| | - Hisham Mohammed
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Abdelrahman Ma Mohamed
- Department of orthodontics, Faculty of Dentistry, First affiliated hospital of Zhengzhou University, Henan, China
| | - Wang Xinrui
- Department of orthodontics, Faculty of Dentistry, First affiliated hospital of Zhengzhou University, Henan, China
| | - Vaska Vandevska-Radunovic
- Head of department of orthodontics, Institute of clinical dentistry, University of Oslo, Oslo, Norway
| | - Qiao Yiqiang
- Department of orthodontics, Faculty of Dentistry, First affiliated hospital of Zhengzhou University, Henan, China
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Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults with the Dutch Maxillary Expansion Device: a prospective clinical cohort study. Clin Oral Investig 2022; 26:6253-6263. [PMID: 35731323 PMCID: PMC9525423 DOI: 10.1007/s00784-022-04577-9] [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: 02/28/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To provide a higher degree of evidence on the efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults, thereby applying the Dutch Maxillary Expansion Device (D-MED). MATERIALS AND METHODS D-MED was developed as an individualized, 3D-designed, and fabricated MARPE appliance supported by 4 palatal miniscrews. Patients from the age of 16 onwards with transverse maxillary deficiency were enrolled consecutively. Pre-expansion and immediate post-expansion CBCTs and intra-oral scans were acquired and measurements of skeletal, alveolar, and dental expansion as well as dental and periodontal side-effects were performed. RESULTS Thirty-four patients were enrolled (8 men, 26 women) with mean age 27.0 ± 9.4 years. A success rate of 94.1% was achieved (32/34 patients). The mean expansion duration, or mean observation time, was 31.7 ± 8.0 days. The mean expansion at the maxillary first molars (M1) and first premolars (P1) was 6.56 ± 1.70 mm and 4.19 ± 1.29 mm, respectively. The expansion was 60.4 ± 20.1% skeletal, 8.1 ± 27.6% alveolar, and 31.6 ± 20.1% dental at M1 and 92.2 ± 14.5% skeletal, 0.0 ± 18.6% alveolar, and 7.8 ± 17.7% dental at P1, which was both statistically (p < 0.001) and clinically significant. Buccal dental tipping (3.88 ± 3.92° M1; 2.29 ± 3.89° P1), clinical crown height increase (0.12 ± 0.31 mm M1; 0.04 ± 0.22 mm P1), and buccal bone thinning (- 0.31 ± 0.49 mm M1; - 0.01 ± 0.45 mm P1) were observed, while root resorption could not be evaluated. CONCLUSIONS MARPE by application of D-MED manifested its efficacy in a prospective clinical setting, delivering a high amount of skeletal expansion with limited side-effects in late adolescents and adults. CLINICAL RELEVANCE Higher quality evidence is supportive of MARPE as a safe and successful non-surgical treatment option for transverse maxillary deficiency.
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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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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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New and Recovered Temporary Anchorage Devices, In Vitro Assessment of Structural and Surface Properties. MATERIALS 2021; 14:ma14216271. [PMID: 34771795 PMCID: PMC8584799 DOI: 10.3390/ma14216271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022]
Abstract
The orthodontic miniscrew (TADs) is a device that is fixed into bone in the short term for the purpose of enhancing orthodontic anchorage. The aim of our study was to investigate the structural and surface properties of recovered TADs after orthodontic treatment, and compare them to new TADs. TADs (n = 15) from the same manufacturer (Absoanchor; Dentos, Daegu, Korea) were assessed; n = 10 were recovered from patients after orthodontic treatment and n = 5 were new. We performed electrochemical investigations, scanning electron microscopy (SEM) and microbiological analysis. Qualitative analysis on general electrochemical polarization revealed that the TADs retrieved from the patients provided much lower current densities in the passivity zone, and the oxidative processes taking place on their surface were of lower intensity. The surface morphologies of the tips of the retrieved mini-implants showed less sharp tips and smooth surfaces. Defects in the form of pores or cracks could be identified in both evaluated TAD groups. All retrieved TADs showed signs of biological materials (SEM analysis) and contamination on their surfaces. In conclusion, these results can assist orthodontists in comprehending the complexities of TAD behavior with respect to their design and structure.
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Oh SH, Lee SR, Choi JY, Ahn HW, Kim SH, Nelson G. Geometry of anchoring miniscrew in the lateral palate that support a tissue bone borne maxillary expander affects neighboring root damage. Sci Rep 2021; 11:19880. [PMID: 34615963 PMCID: PMC8494793 DOI: 10.1038/s41598-021-99442-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
Anchoring miniscrews used for a tissue bone borne maxillary expander (C-expander) can fail if they contact tooth roots or perforate the maxillary sinus. Cone beam computed tomography images were reviewed retrospectively to evaluate the geometric factors of miniscrew placement in the palate that contribute to root proximity (RP) and sinus perforation (SP), and to investigate the differences of miniscrew placement depth (PD) and placement angle (PA) among the groups in each variable from 340 anchoring miniscrews on 70 patients whose C-expanders showed sufficient stability after palatal expansion for orthodontic treatment. Two types of miniscrews were used: a self-tapping miniscrew with 1.8 mm-in-diameter, and a self-drilling miniscrew with 1.6 mm-in-diameter. While the self-tapping larger diameter miniscrew influenced root proximity significantly, the screw location and PD affected the rate of sinus perforation. PA was significantly different between the right and left sides of the palate. The results of this study confirmed that root proximity and sinus perforation of anchoring miniscrews in a tissue bone borne palatal expander occurred due to certain risk factors, even when the palates were expanded successfully. Knowledge of these factors can help the clinician place miniscrews with less risk of root proximity or sinus perforation.
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Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sae Rom Lee
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea.
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California San Francisco, San Francisco, CA, USA
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21
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Oh SH, Lee SR, Choi JY, Kim SH, Hwang EH, Nelson G. Quantitative cone-beam computed tomography evaluation of hard and soft tissue thicknesses in the midpalatal suture region to facilitate orthodontic mini-implant placement. Korean J Orthod 2021; 51:260-269. [PMID: 34275882 PMCID: PMC8290086 DOI: 10.4041/kjod.2021.51.4.260] [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: 10/15/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
Objective To identify the most favorable sites that optimize the initial stability and survival rate of orthodontic mini-implants, this study measured hard and soft tissue thicknesses in the median and paramedian regions of the palate using cone-beam computed tomography (CBCT) and determined possible sexand age-related differences in these thicknesses. Methods The study sample comprised CBCT images of 189 healthy subjects. The sample was divided into four groups according to age. A grid area was set for the measurement of hard and soft tissue thicknesses in the palate. Vertical lines were marked at intervals of 0, 1.5, and 3.0 mm lateral to the midpalatal suture, while horizontal lines were marked at 2-mm intervals up to 24 mm from the posterior margin of the incisive foramen. Measurements were made at 65 points of intersection between the horizontal and vertical lines. Results The palatal hard tissue thickness decreased from the anterior to the posterior region, with a decrease in the medial-to-lateral direction in the middle and posterior regions. While the soft tissue was rather thick around the lateral aspects of the palatal arch, it formed a constant layer that was only 1-2-mm thick throughout the palate. Statistically significant differences were observed according to sex and age. Conclusions The anterolateral palate as well as the midpalatal suture seem to be the most favorable sites for insertion of orthodontic mini-implants. The thickness of the palate differed by age and sex; these differences should be considered while planning the placement of orthodontic mini-implants.
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Affiliation(s)
- Song-Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Sae Rom Lee
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Eui-Hwan Hwang
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Gerald Nelson
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
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22
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Comparison of the Stability of Sandblasted, Large-Grit, and Acid-Etched Treated Mini-Screws With Two Different Surface Roughness Values: A Histomorphometric Study. J Craniofac Surg 2021; 33:41-47. [PMID: 34267129 DOI: 10.1097/scs.0000000000007837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the effects of 2 different surface roughness values produced by sandblasted, large-grit, and acid-etched treatments at different loading conditions on the stability of mini-screws. MATERIAL AND METHODS A total of 56 mini-screws (Group 1; 28 with Ra value of 1 μm, Group 2; 28 with Ra value of 1.5 μm) were inserted into the tibia of fourteen New Zealand rabbits. Surface analysis was performed before the placement of the miniscrews using multi-technique characterization. The mini-screws were loaded with 500 grf after different healing times: unloaded, immediate, 4 and 8 weeks. Resonance frequency analyses were performed immediately after mini-screw placement and at the end of loading. Biomechanical and histomorphometric analyses were also performed at the end of the loading period. RESULTS All mini-screws preserved their stability at the end of the loading period. However, the resonance frequency analyses showed higher implant stability quotient scores for 8-week group, unlike the immediate loading and unloaded groups (P < 0.05). According to the infinite focus microscopy results, prolongation of healing time resulted in a greater bone area on the loaded mini-screws in Group 2 (P < 0.05). Similarly, the histomorphometric analysis revealed higher bone-to-implant contact values in the 8-week group. There was no significant difference in the stability between the miniscrews with the Ra values of 1 and 1.5 μm. CONCLUSIONS Sandblasted, large-grit, and acid-etched treated mini-screws showed significantly higher stability with healing time under heavy forces. Sandblasted, large-grit, and acid-etched treated mini-screws can be removed without fracture of the screw or the bone surfaces.
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Sampson A, Figueiredo DSF, Jeremiah HG, Oliveira DD, Freitas LRP, Chahoud M, Soares RV, Cobourne MT. The effect of social media on patient acceptance of temporary anchorage devices. Angle Orthod 2021; 91:363-370. [PMID: 33461218 DOI: 10.2319/071020-618.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate the relationship between the use of social networking sites (SNSs) on patient perceptions, acceptance, and expectations of treatment using temporary anchorage devices (TADs) and to compare differences between patients from the United Kingdom and Brazil. MATERIALS AND METHODS Cross-sectional questionnaires were administered to 39 participants at orthodontic practices in the United Kingdom and Brazil about patients' use of SNSs, exposure to TADs on SNSs, and thoughts on extractions, jaw surgery, or TADs as treatment options. RESULTS UK patients prefer for clinicians to have SNS profiles (P = .022). Most UK and Brazilian patients want to see their clinician's work online (76.7%) and use SNSs to get information about treatment options (76.6%). There was a statistically significant difference in Brazilian patients' acceptance of TADs as a treatment option compared with UK patients, particularly if it meant avoiding extractions (P = .002), avoiding jaw surgery (P = .004), or reducing treatment time (P = .010). Knowledge of TADs was greater in Brazilian patients (P < .001). CONCLUSIONS Patients use SNSs to obtain information about treatments and prefer clinicians to have social media accounts. Patients exposed to TADs on SNSs are more likely to accept them as an orthodontic treatment option. UK patients have less knowledge of TADs and are therefore less sure to consider TADs as an option. Brazilian patients are more confident in considering the use of TADs. Clinicians should consider increasing their social media presence to accommodate patients' expectations and acceptance of TADs.
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Tavares A, Montanha-Andrade K, Cury PR, Crusoé-Rebello I, Neves FS. Tomographic assessment of infrazygomatic crest bone depth for extra-alveolar miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. Orthod Craniofac Res 2021; 25:49-54. [PMID: 33908170 DOI: 10.1111/ocr.12485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate bone availability at the infrazygomatic crest for extra-alveolar bone miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. SETTING AND SAMPLE POPULATION Measurements of the infrazygomatic crest were performed on multislice computed tomography scans from 58 adults with different skeletal patterns. MATERIALS AND METHODS Infrazygomatic crest bone depth was measured at 4, 5 and 6 mm from the cementoenamel junction (CEJ) of the maxillary first molar at three different angles (60°, 70° and 80°) in the first molar occlusal plane. The sagittal and vertical skeletal patterns were determined. Analysis of variance followed by Tukey's post hoc test was used (P ≤ .05). RESULTS Bone depth was greater near the CEJ (8.7 ± 3.1 mm) and lower in the apical area (5.8 ± 2.7 mm). In Class II subjects, considering 6 mm from the CEJ, there was a significantly lower depth at the 80° angle (5.4 ± 2.5 mm) than at 60° (8.6 ± 3.5 mm; P = .007). In mesofacial subjects, considering 5 and 6 mm from the CEJ, bone depth was lower at 80° (5.7 ± 3.2 mm and 5.3 ± 2.5 mm) than at 60° considering 4 mm from the CEJ (P ≤ .019). CONCLUSION Bone availability was lower at the apical level, especially in Class II and mesofacial subjects. Therefore, when the planned insertion site is located in the apical direction, it is recommended to choose shorter miniscrews (2.0 x 12mm) and a smaller insertion angle (60°) and/or to plan a miniscrew bone insertion deep enough to allow bicortical fixation.
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Affiliation(s)
- Alana Tavares
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Kátia Montanha-Andrade
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Patricia Ramos Cury
- Division of Periodontics, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Ieda Crusoé-Rebello
- Division of Dentomaxillofacial Radiology, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Frederico Sampaio Neves
- Division of Dentomaxillofacial Radiology, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
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Effect of Low Copper Addition to As-Forged 304 Stainless Steel for Dental Applications. METALS 2020. [DOI: 10.3390/met11010043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of this study was to investigate the effect of incorporating low copper (0, 0.5, 1, 1.5, and 2 wt.%) additions into as-forged AISI 304 stainless steel (304SS). The microstructures and mechanical properties of the steel were examined using scanning electron microscopy and a universal testing machine. The antibacterial properties of the Cu-bearing 304SS specimens were investigated using Escherichia coli. Each specimen was soaked in artificial saliva to detect the release of copper ions through inductively coupled plasma atomic emission spectrometry. The addition of copper had no significant effect on the microstructure of the as-forged Cu-bearing 304SS, but it slightly increased its maximum tensile strength. The antibacterial rate of the as-cast and as-forged 304SS with 2 wt.% Cu was over 80%, which corresponded to an increase in the release of copper ions. This study demonstrates that low-Cu-content stainless steel can reduce bacteria and can be a suitable material for the oral environment because of the low release of Cu ions.
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Mechanical Evaluation of the Stability of One or Two Miniscrews under Loading on Synthetic Bone. J Funct Biomater 2020; 11:jfb11040080. [PMID: 33167442 PMCID: PMC7711976 DOI: 10.3390/jfb11040080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to evaluate the primary stability of a two-miniscrew system inserted into a synthetic bone and to compare the system with the traditional one. Forty-five bi-layered polyurethane blocks were used to simulate maxillary cancellous and cortical bone densities. Samples were randomly assigned to three groups—one-miniscrew system (Group A, N = 23), two-miniscrew system (Group B, N = 22) and archwire-only (Group C, N = 10). A total of 67 new miniscrews were subdivided into Group A (23 singles) and Group B (22 couples). 30 mm of 19″ × 25″ archwires were tied to the miniscrew. The load was applied perpendicularly to the archwire. Maximum Load Value (MLV), Yield Load (YL) and Loosening Load (LL) were recorded for each group. The YL of Group B and C had a mean value respectively of 4.189 ± 0.390 N and 3.652 ± 0.064 N. The MLV of Group A, B and C had a mean value respectively of 1.871 ± 0.318N, of 4.843 ± 0.515 N and 4.150 ± 0.086 N. The LL of Group A and B had a mean value respectively of 1.871 ± 0.318 N and of 2.294 ± 0.333 N. A two- temporary anchorage device (TAD) system is on average stiffer than a one-TAD system under orthodontic loading.
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Ting CC, Hsu KJ, Hsiao SY, Chen CM. The correlation among gripping volume, insertion torque, and pullout strength of micro-implant. J Dent Sci 2020; 15:500-504. [PMID: 33505623 PMCID: PMC7816014 DOI: 10.1016/j.jds.2020.07.005] [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: 02/24/2020] [Revised: 07/08/2020] [Indexed: 12/02/2022] Open
Abstract
Background/purpose The fixation stability is the key factor for orthodontic micro-implant to succeed. This study evaluated the mechanical properties of three types of micro-implants by analyzing their structural configurations. Materials and methods Thirty micro-implants of three types (diameter 1.5 mm, Types A, B, C) were assessed. All micro-implants were manually driven into artificial bones at an 8-mm depth. The insertion torque (IT), pullout strength (PS), and gripping volume (GV) of each type were measured. The indexes of mechanical properties denoted as the PS/IT, GV/IT and PS/GV ratios. Intergroup comparisons and intragroup correlation were examined using statistical analysis. Results Type B had the greatest inner–outer diameter ratio (0.67), and Type A had the smallest (0.53). The IT of Type A (5.26 Ncm) was significantly (p = 0.038) lower than that of Type C (8.8 Ncm). There was no significant difference in the pullout strength. The GV of Type A (9.7 mm3) was significantly greater than Type C (8.4 mm3). Type C was significantly greater than Type B (7.2 mm3). The ratios of mechanical properties (PS/IT, PS/GV, and GV/IT) were found significant in intergroup comparison. The PS/GV ratio was in order: Type B (26.5) > Type A (23.0) > Type C (20.2). Spearman's rho rank correlation test showed that PS of Type B was correlated significantly with GV. Conclusion The design of thread and gripping volume were the important factors that contributes to the mechanical strengths of micro-implant.
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Affiliation(s)
- Chun-Chan Ting
- School of Dentistry, Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kun-Jung Hsu
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Yu Hsiao
- Department of Dentistry for Child and Special Needs, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- Graduate Institute of Dental Sciences, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Lyu X, Guo J, Chen L, Gao Y, Liu L, Pu L, Lai W, Long H. Assessment of available sites for palatal orthodontic mini-implants through cone-beam computed tomography. Angle Orthod 2020; 90:516-523. [PMID: 33378492 PMCID: PMC8028458 DOI: 10.2319/070719-457.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To measure the palatal thickness of both hard and soft tissues and to determine safe regions for the placement of mini-implants. The influences of sex and age on palatal thickness were also examined. MATERIALS AND METHODS Cone-beam computed tomography images of 30 patients (12 males, 18 females), including 15 adults and 15 adolescents, were used in this study. The thicknesses of palatal hard tissue, soft tissue, and hard+soft tissues were measured at the coronal planes of first premolars, second premolars, first molars, and second molars (P1, P2, M1, and M2 planes, respectively). RESULTS The hard tissue was thickest at the P1 plane, followed by at the P2, M1, and M2 planes, while the thickness of soft tissue was similar among the four planes. The trends in the changes of palatal thickness from midline to the lateral sides (V-pattern) were similar for the four planes. Palatal thickness was influenced by sex, age, and their interaction. Mapping of recommended and optimal sites for palatal mini-implants was accomplished. CONCLUSIONS Sex and age factors could influence palatal thickness. Therefore, the findings might be helpful for clinicians in guiding them to choose the optimal sites for palatal mini-implants.
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Casaña-Ruiz MD, Bellot-Arcís C, Paredes-Gallardo V, García-Sanz V, Almerich-Silla JM, Montiel-Company JM. Risk factors for orthodontic mini-implants in skeletal anchorage biological stability: a systematic literature review and meta-analysis. Sci Rep 2020; 10:5848. [PMID: 32246125 PMCID: PMC7125198 DOI: 10.1038/s41598-020-62838-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/18/2020] [Indexed: 11/09/2022] Open
Abstract
The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.
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Haddad R, Saadeh M. Distance to alveolar crestal bone: a critical factor in the success of orthodontic mini-implants. Prog Orthod 2019; 20:19. [PMID: 31081528 PMCID: PMC6512897 DOI: 10.1186/s40510-019-0273-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/12/2019] [Indexed: 11/22/2022] Open
Abstract
Background To evaluate the success rate of orthodontic mini-implant (MI) in relation to implant characteristics, mainly implant distance to alveolar crestal bone (AC) and root proximity (RP) to adjacent teeth. Methods Two hundred sixty MIs (209 in maxilla, 51 in mandible) were categorized into success (n = 229) and failure (n = 31) groups. Distances from MI to the most adjacent tooth (DT) and to AC level (DC) were measured on periapical radiographs taken with the orthoradial projection technique. Appropriate statistical tests (chi-square, t test, logistic regression) were applied. Results DC measurements were statistically significantly greater in the success group (7.46 ± 1.7 mm) compared to 3.43 ± 0.81 mm in the failure group. Root proximity was not associated with miniscrew failure. Patient age, mini-implant site, and DC were significant predictors of mini-implant failure (p < 0.001), which decreased significantly with increasing age (Coef = − 0.345; p = 0.013) and when the mini-implant was placed between premolars (p = 0.028) or between premolar and first molar (p = 0.045). The probability of failure also decreased with increasing DC distance (Coef = − 3.595; p < 0.001). Conclusion The distance to alveolar crest was strongly associated with long-term stability. More apical placement of the MI from the crest would be compatible with a denser and thicker bucco-lingual/palatal bone level.
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Affiliation(s)
- Ramzi Haddad
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Maria Saadeh
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Orthodontics, Lebanese University Faculty of Dental Medicine, Beirut, Lebanon.,Department of Forensic Odontology, Anthropology and Human Identification, Lebanese University Faculty of Dental Medicine, Beirut, Lebanon
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Analysis of the association of IL4 polymorphisms with orthodontic mini-implant loss. Int J Oral Maxillofac Surg 2019; 48:982-988. [PMID: 30683542 DOI: 10.1016/j.ijom.2018.12.008] [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: 03/04/2017] [Revised: 10/16/2018] [Accepted: 12/13/2018] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the association of clinical characteristics and IL4 tag single nucleotide polymorphisms (SNPs; rs2227284 and rs2243268) with orthodontic mini-implant (MI) failure. The sample included 135 subjects of both sexes, mean age 48.7±10years (range 20-76years): 104 in the control group (patients without any MI loss) and 31 in the study group (patients presenting ≥1 MI loss). Genotypes were determined by real-time PCR. Bivariate and multivariate analyses were performed (P<0.05). No association was found between the selected tag SNPs and MI loss. The C allele of the IL4 rs2243268 polymorphism in the recessive model was more frequent in patients who had fewer MIs installed (≤2 vs. >2; P=0.043, odds ratio 0.65, 95% confidence interval 0.58-0.74). On multivariate analysis, smoking habit was significantly associated with the group with multiple MIs installed (P=0.036), however the significance of the association with rs2243268 was not maintained. No association was found between the socio-demographic, smoking, or genetic factors studied and MI loss. This study supports the interaction between host and environmental factors and its influence on susceptibility to orthodontic MI failure.
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Retrospective comparison of the number of screws used for fixation of skeletal anchorage plates in orthodontics, and their failure rates. Br J Oral Maxillofac Surg 2018; 56:941-945. [PMID: 30415962 DOI: 10.1016/j.bjoms.2018.10.275] [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: 04/12/2018] [Accepted: 10/22/2018] [Indexed: 11/20/2022]
Abstract
The aim of this study was to compare the failure rate of fixation of skeletal orthodontic anchorage plates (SAP) with two screws with that of three screws, and to find out if there is a relation between the number of screws used to fix the plates and the failure rate. We reviewed clinical records of 65 patients from five hospitals with 176 SAP, and took into account other factors that may have affected the failure. The overall failure rate was 15/176 (8.5%), and for with two-screw fixation it was 9/86 compared with 6/90 for those with three-screw fixation. Age, sex, and coexisting medical conditions did not affect the failure rate. There was a higher failure rate for those placed in the mandible (11/105) than for those placed in the maxilla (4/71). SAP provide a stable source of skeletal anchorage for orthodontic treatment. Our results show that those fixed with two screws may be marginally more likely to fail than those fixed with three, but further studies are needed to investigate the association between failure and the number of screws used.
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Inami T, Ito G, Miyazawa K, Tabuchi M, Goto S. Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect. Angle Orthod 2018; 88:830-840. [PMID: 29717632 PMCID: PMC8174079 DOI: 10.2319/072717-498.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 03/01/2018] [Indexed: 11/23/2022] Open
Abstract
This case report demonstrates the treatment of a skeletal Class II high-angle adult patient with bimaxillary protrusion, angle Class I occlusion, and crowded anterior teeth. A ribbon-wise arch wire and a customized lingual appliance with anterior vertical slots were used to achieve proper torque control of the maxillary anterior teeth. An orthodontic anchor screw and a palatal bar were used for vertical control to avoid increasing the Frankfort-mandibular plane angle (FMA) by maxillary molar extrusion. Through the combined use of the ribbon-wise customized lingual appliance, palatal bar, and orthodontic anchor screw, vertical control and an excellent treatment result were achieved without the vertical and horizontal bowing effects peculiar to conventional lingual treatment.
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Oga Y, Tomonari H, Kwon S, Kuninori T, Yagi T, Miyawaki S. Evaluation of miniscrew stability using an automatic embedding auxiliary skeletal anchorage device. Angle Orthod 2018; 89:47-53. [PMID: 30203984 DOI: 10.2319/121117-857.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To clarify the in vivo effect of an automatic embedding device on miniscrew stability. MATERIALS AND METHODS 42 miniscrews were implanted into rabbit femurs. The miniscrews with the novel auxiliary device formed the auxiliary group (n = 11 at 4 weeks; n = 11 at 8 weeks) and the miniscrews without the auxiliary device formed the nonauxiliary control group (n = 9 at 4 weeks; n = 11 at 8 weeks). Cortical bone thickness, distance from the cortical bone surface to the miniscrew head, and implantation depth of the spike were measured using micro-computed tomography. The mechanical retention force was evaluated by measuring the displacement of the miniscrew head after it was loaded perpendicular to its long axis. In the lateral displacement test, effects of the auxiliary (with vs without auxiliary), and time (4 vs 8 weeks) were assessed using the Brunner-Langer nonparametric analysis of longitudinal data in factorial experiments. RESULTS The mean implantation depth of the spike in the auxiliary group at 4 and 8 weeks was 0.28 mm (median: 0.33; SD: 0.12) and 0.37 mm (median: 0.33; SD: 0.19), respectively. The retention force was approximately 2.0 to 2.8 and 1.6 to 1.8 times greater in the auxiliary group than in the nonauxiliary group at 4 and 8 weeks, respectively. CONCLUSIONS The auxiliary device improved the mechanical retention force without the need to increase miniscrew length or diameter. This may enable the safe use of miniscrews in difficult areas.
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Ngan P, Nguyen UK, Nguyen T, Tremont T, Martin C. Skeletal, Dentoalveolar, and Periodontal Changes of Skeletally Matured Patients with Maxillary Deficiency Treated with Microimplant-assisted Rapid Palatal Expansion Appliances: A Pilot Study. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_27_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction
Microimplant-assisted rapid palatal expansion (MARPE) has recently been offered to adult patients for correcting maxillary transverse deficiency. However, there is limited information in the literature on the success of this appliance and its skeletal and dental effects on skeletally matured patients. The purpose of this study was to investigate the immediate skeletal, dentoalveolar, and periodontal response to MARPE appliance using cone-beam computed tomography in a skeletally matured patient as assessed by the cervical vertebral maturation method.
Materials and Methods
Eight consecutively treated patients (2 females, 6 males; mean age of 21.9 ± 1.5 years) treated with a maxillary skeletal expander were included in the study. Measurements were taken before and after expansion to determine the amount of midpalatal suture opening, upper facial bony expansion, alveolar bone bending, dental tipping, and buccal bone thickness (BBT). Data were analyzed using a one-way ANOVA and matched-pair t-test (α = 0.05).
Results
Midpalatal suture separation was found in 100% of the patients with no dislodged microimplants. Total maxillary expansion was attributed to 41% skeletal, 12% alveolar bone bending, and 48% dental tipping. Pattern of midpalatal suture opening was found to be parallel in both the coronal and axial planes. On average, the absolute dental tipping ranged from 4.17° to 4.96° and the BBT was reduced by an average of 39% measured at the premolars and molars.
Conclusions
The MARPE appliance can be a clinically acceptable, nonsurgical treatment option for correcting mild to moderate maxillary transverse discrepancies for skeletally matured adult patients with a healthy periodontium.
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Affiliation(s)
- Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, WV, USA
| | | | - Tung Nguyen
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, USA
| | - Timothy Tremont
- Department of Orthodontics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chris Martin
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, WV, USA
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Łyczek J, Kawala B, Antoszewska-Smith J. Influence of antibiotic prophylaxis on the stability of orthodontic microimplants: A pilot randomized controlled trial. Am J Orthod Dentofacial Orthop 2018; 153:621-631. [PMID: 29706210 DOI: 10.1016/j.ajodo.2017.11.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aims of this 2-arm parallel pilot randomized controlled trial were to investigate the influence of antibiotic prophylaxis on the stability of orthodontic microimplants and to evaluate the efficacy of systemic inflammatory marker measurements in detecting infections in tissues surrounding microscrews. METHODS Orthodontic patients requiring en-masse distalization in the maxilla received antibiotics or a placebo before microimplant placement. Eligibility criteria included 13 years of age, and good general and oral health. Exclusion criteria comprised allergy to antibiotics, severe systemic allergy, heart and kidney diseases, and recent antibiotic treatment. Stability of the microimplants was the primary outcome; inflammation of the tissues surrounding the microscrews, pain related to the microimplantation, and serum levels of inflammatory markers were the secondary outcomes. Randomization in a 1:1 ratio was performed by auxilliary staff via a flip of a coin between 2 participants of the same sex and developmental stage, and the "winner" was allocated to the intervention group. Pharmaceutically prepared identical capsules with either amoxicillin (intervention) or glucose (control) given 1 hour before microimplant placement according to the allocation provided blinding of the participants. Subsequently, 1 clinician unaware of the allocation inserted the microimplants and assessed the outcomes, which simultaneously blinded the operator-assessor. Blood samples for laboratory analysis of inflammatory markers were collected a day before and 1, 3, and 7 days postoperatively. RESULTS Out of 80 participants initially assessed for eligibility, 41 received the randomized allocation. Three patients were lost to follow-up. Eventually, data of 18 and 20 participants (mean age, 20.4 ± 5.9 years) were available for analysis in the intervention and control groups, in which 1 and 2 patients lost a microimplant, respectively, resulting in odds ratio of 0.53 (95% confidence interval [CI], 0.0084-11.23; P = 1.0). The odds ratio for inflammation development was 1.22 (95% CI, 0.34-4.38), and the odds ratio for feeling milder pain was 1.174 (95% CI, 0.350-3.941) in the intervention compared with the control group, but the result was not statistically significant (P = 0.758; P = 0.795, respectively). The inflammatory marker levels did not increase due to either microimplantation (procalcitonin, P = 0.445; C-reactive protein, P = 0.4) or peri-implantitis. Antibiotic prophylaxis slightly decreased the levels of the biomarkers in the intervention group; however, the results were not statistically significant (P = 0.68; P = 0.908, respectively). No harms caused by the microimplantation procedure or drug intake were noted. CONCLUSIONS Antibiotics provided no benefit in terms of microimplant stability, inflammation of soft tissues, or postoperative pain in our pilot sample. Measurements of serum levels of inflammatory markers were inefficient in detecting soft tissue inflammations. These initial results should be interpreted with caution until validated by a large multicenter definitive trial. REGISTRATION This trial was not registered. PROTOCOL The protocol was not published before trial commencement. FUNDING The trial was funded by Wroclaw Medical University; grant number pbmn91 and supported by Diagnostyka.
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Affiliation(s)
- Jan Łyczek
- Department of Orthodontics and Dentofacial Orthopedics, Medical University of Wroclaw, Wroclaw, Poland.
| | - Beata Kawala
- Department of Orthodontics and Dentofacial Orthopedics, Medical University of Wroclaw, Wroclaw, Poland
| | - Joanna Antoszewska-Smith
- Department of Orthodontics and Dentofacial Orthopedics, Medical University of Wroclaw, Wroclaw, Poland
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Uesugi S, Kokai S, Kanno Z, Ono T. Stability of secondarily inserted orthodontic miniscrews after failure of the primary insertion for maxillary anchorage: Maxillary buccal area vs midpalatal suture area. Am J Orthod Dentofacial Orthop 2018; 153:54-60. [DOI: 10.1016/j.ajodo.2017.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 10/18/2022]
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Meros GC, Shoji A, Suzuki S, Paranhos LR, Manfroi R, Claus J, Garcez A. An Alternative Approach for Space Opening in a Bilateral Maxillary Lateral Incisor Agenesis Patient using Miniplates. J Contemp Dent Pract 2017; 18:1198-1205. [PMID: 29208799 DOI: 10.5005/jp-journals-10024-2200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM This case report aimed to present an orthodontic mechanic alternative for space opening in a patient missing maxillary lateral incisors, using miniplates as anchorage, associated with self-ligating brackets. BACKGROUND Dental agenesis affects the population causing esthetic and functional damages. The prevalence of missing maxillary lateral incisors should be considered for its significant rate and negative impact on smile esthetics. CASE REPORT This treatment was chosen based on the presence of balanced facial pattern, large canine anatomy, the need to improve dental occlusion to prevent further wear, and patient's esthetic complaint. To obtain the results, upper third molars were extracted, and two miniplates were installed to distalize the upper arch with no need for patient compliance or auxiliary devices. Self-ligating brackets were used to reduce friction on posterior teeth, thus facilitating movement with light force application. At the end of 19 months, the patient presented with class I good overbite and overjet, and adequate space for implant and prosthetics; also, good facial esthetic was maintained. CONCLUSION When indicated, space opening may provide excellent esthetics and functional results, and even more predictable results when skeletal anchorage miniplates are used to distalize all posterior teeth. CLINICAL SIGNIFICANCE Considering the high level of esthetic and functional compromise caused by dental agenesis, the technique hereby described represents a viable mechanic alternative within orthodontic possibilities.
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Affiliation(s)
- Gladistone C Meros
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil, Phone: +554699117799 e-mail:
| | - Aline Shoji
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Selly Suzuki
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Luiz R Paranhos
- Department of Dentistry, Federal University of Sergipe, Lagarto Sergipe, Brazil
| | - Rodrigo Manfroi
- Department of Prosthesis, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
| | - Jonathas Claus
- Department of Oral Surgery, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Aguinaldo Garcez
- Department of Orthodontics, Sao Leopoldo Mandic Dental School and Research Center, Campinas, Sao Paulo, Brazil
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How do geometry-related parameters influence the clinical performance of orthodontic mini-implants? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46:1539-1551. [DOI: 10.1016/j.ijom.2017.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/14/2017] [Indexed: 01/27/2023]
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Tsai CC, Chang HP, Pan CY, Chou ST, Tseng YC. A prospective study of factors associated with orthodontic mini-implant survival. J Oral Sci 2017; 58:515-521. [PMID: 28025435 DOI: 10.2334/josnusd.16-0145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The orthodontic mini-implant (MI) is a widely used anchorage device in orthodontic treatment. This prospective study analyzed MI survival and factors associated with MI survival in 139 patients (114 females and 25 males; average age, 25.7 years; age range, 12-56 years) who had received orthodontic treatment with MIs. Survival analysis and Kaplan-Meier curves were used to identify clinical variables associated with MI survival. For the 254 MIs investigated, the overall success rate was 85.8%, and the 1-year cumulative survival rate was 81.6%. MI survival was significantly associated with patient age and MI size. Notably, MI survival was significantly longer in patients aged 20-30 years than in older patients. The Cox proportional-hazards model revealed a 5% increase in failure risk for every 1-year increase in age among participants older than 30 years. Additionally, MI failure risk was inversely associated with MI length. MIs are generally reliable anchorage devices for orthodontic treatment but should be used with caution in older patients, due to the higher rate of failure in that population. Another important factor in MI survival is implant size. Future studies should attempt to clarify associations between MI survival and clinical variables.(J Oral Sci 58, 515-521, 2016).
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Watanabe T, Miyazawa K, Fujiwara T, Kawaguchi M, Tabuchi M, Goto S. Insertion torque and Periotest values are important factors predicting outcome after orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2017; 152:483-488. [PMID: 28962732 DOI: 10.1016/j.ajodo.2017.01.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 01/01/2017] [Accepted: 01/01/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Approximately 14% of orthodontic anchor screws (miniscrews) become dislodged regardless of the accuracy of placement. It is therefore important to investigate the factors causing dislodgement. We evaluated the stability of miniscrews after placement to identify factors influencing outcome in orthodontic treatment using miniscrews. METHODS We investigated 120 miniscrews (Dual-top Auto Screw III; Jeil Medical, Seoul, Korea) (diameter, 1.4 mm; length, 6 mm) placed on the buccal or lingual side between the maxillary second premolar and the first molar in women. Patient age and rate and time of screw dislodgement were examined. Insertion torque values and Periotest (Tokyo Dental Industrial, Tokyo, Japan) measurements indicating horizontal and vertical mobility of the inserted screws were compared between groups with and without dislodgement (failure and success groups, respectively). RESULTS Mean insertion torque values were 10.7 ± 1.9 N·cm and 8.5 ± 2.1 N·cm in the failure and success groups, respectively. Cortical bone thickness measurements (success group, 1.34 ± 0.35 mm; failure group, 0.99 ± 0.09 mm) were significantly higher, whereas Periotest values at placement (success group, horizontal, 4.9 ± 1.4; vertical, 4.7 ± 1.3; failure group, horizontal, 7.0 ± 0.8; vertical, 7.1 ± 0.9) were significantly lower in the success group than in the failure group. CONCLUSIONS The Periotest value, together with insertion torque and cortical bone thickness, could serve as an index of initial stability for predicting the outcome of miniscrew placement.
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Affiliation(s)
- Takashi Watanabe
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan; private practice, Aichi, Japan.
| | - Ken Miyazawa
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Takuya Fujiwara
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Misuzu Kawaguchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masako Tabuchi
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shigemi Goto
- Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
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Prognosis of primary and secondary insertions of orthodontic miniscrews: What we have learned from 500 implants. Am J Orthod Dentofacial Orthop 2017; 152:224-231. [PMID: 28760284 DOI: 10.1016/j.ajodo.2016.12.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although the success of using orthodontic miniscrews for primary insertion has been reported in the literature, few studies have followed up on secondary insertions after failure of the first insertion. In this study, we investigated not only the primary but also secondary success rates of miniscrews and considered the risk factors influencing their stability. METHODS Five hundred miniscrews were inserted for orthodontic anchorage in 240 patients. Ninety-eight miniscrews lacked stability; thus, 77 of these were removed and reinserted. We calculated and compared the primary and secondary success rates of insertion. Moreover, we investigated which clinical parameters affected the stability of miniscrews. RESULTS The success rate of secondary insertion (44.2%) was significantly lower than that of primary insertion (80.4%). The screw length and jaw receiving the insertion were significantly associated with the stability of miniscrews. The 8.0-mm miniscrews were significantly more stable than the 6.0-mm miniscrews, and the success rate for insertions into the maxilla was significantly higher than that for the mandible. CONCLUSIONS Secondary insertions lack stability; therefore, clinicians should be aware of the reduced success rate of reinsertion and know the risk factors to avoid failure of secondary insertions.
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Peres FG, Padovan LEM, Kluppel LE, Albuquerque GC, Souza PCUD, Claudino M. Use of miniplates as a method for orthodontic anchorage: a case report. Dental Press J Orthod 2016; 21:95-102. [PMID: 27901235 PMCID: PMC5125177 DOI: 10.1590/2177-6709.21.5.095-102.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 06/13/2016] [Indexed: 12/03/2022] Open
Abstract
Introduction: Temporary anchorage devices (TADs) have been developed to be used as direct adjuncts in orthodontic treatment and have facilitated treatment of more complex orthodontic cases, including patients with dental impaction. Objectives: This clinical case reports the applicability of TADs in the orthodontic treatment of a patient with impacted mandibular second molars. Surgical and orthodontic procedures related to the use of miniplates were also discussed in this study. Conclusions: The use of temporary anchorage devices, such as miniplates, can be suggested as an alternative to treat patients with impacted mandibular second molars.
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Affiliation(s)
- Fernando Gianzanti Peres
- MSc in Implantology, Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO), Curitiba, Paraná, Brazil
| | - Luis Eduardo Marques Padovan
- Professor of Implantology, Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO), Curitiba, Paraná, Brazil
| | - Leandro Eduardo Kluppel
- Professor of Implantology, Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO), Curitiba, Paraná, Brazil
| | | | | | - Marcela Claudino
- Professor, Universidade Estadual de Ponta Grossa (UEPG), Graduation Course, Ponta Grossa, Paraná, Brazil
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Monsour P, Huang T. Morphology of the greater palatine grooves of the hard palate: a cone beam computed tomography study. Aust Dent J 2016; 61:329-32. [DOI: 10.1111/adj.12375] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- P Monsour
- Dentomaxillofacial Radiology; UQ Oral Health Centre; School of Dentistry; The University of Queensland; Herston Queensland Australia
| | - T Huang
- Private Practice; Perth Western Australia Australia
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Abstract
INTRODUCTION The aims of this study were to analyze the success rate of mini-implants and miniscrews and to report the reasons behind them. MATERIALS AND METHODS An electronic literature search from PubMed databases and a hand search in implant- and orthodontic-related journals were performed until December 31, 2011. Human clinical studies in English that reported temporary anchorage devices used for orthodontic purpose with at least 6 months follow-up were included. In addition, the minimal number of implants had to be at least 10. Implants placed in maxilla, mandible, and hard palate were included. RESULTS The initial search resulted in 847 articles, of which 46 were further evaluated. Finally, 29 studies were qualified and classified into 2 groups: implants placed in maxilla and mandible (group 1) and implants placed in hard palate (group 2). A meta-analysis performed for groups 1 and 2 showed 87.8% and 93.8% survival rate, respectively. In addition, the most common cause for implants failure was surgery-related factors. CONCLUSION Mini-implant survival rate is location dependent, with those placed in the palate showing higher success rates. In addition, failures most commonly occur because of surgery-related factors.
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Ferreira NO, Andrucioli MCD, Nelson-Filho P, Zanella EP, Consolaro A, Romano FL, Matsumoto MAN. Bacterial biofilm on successful and failed orthodontic mini-implants--a scanning electron microscopy study. Microsc Res Tech 2015; 78:1112-6. [PMID: 26515408 DOI: 10.1002/jemt.22592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 10/04/2015] [Indexed: 11/08/2022]
Abstract
Mini-implants have been extensively used in Orthodontics as temporary bone anchorage devices. However, early failure of mini-implants due to mobility might occur and the colonization of their surfaces by pathogenic bacteria has been referred to as one of the contributing factors. In this study, scanning electron microscopy (SEM) was used to assess the presence of microorganisms adhered to the surface of mini-implants that failed due to loss of stability. Twelve self-drilling titanium mini-implants (1.6 mm diameter × 9.0 mm long) were collected from 12 patients undergoing orthodontic treatment-7 successful and 5 failed mini-implants. The mean time of permanence in the mouth was 15.8 and 2.4 months for successful and failed mini-implants, respectively. The devices were placed in the maxilla and/or mandible and removed by the same surgeon and were processed for SEM analysis of the presence of microorganisms on their surfaces (head, transmucosal profile, and body). Extensive bacterial colonization on mini-implant head and transmucosal profile was observed in all successful and failed mini-implants. None of the failed mini-implants exhibited bacteria on its body and only one mini-implant belonging to the successful (stable) group exhibited bacteria on its body. The results did not suggest a relationship between failure and presence of bacterial colonies on mini-implant surfaces.
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Affiliation(s)
- Nayra Oliveira Ferreira
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Eduardo Pereira Zanella
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Alberto Consolaro
- Department of Stomatology, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Abstract
Various factors influence where orthodontic mini-implants will be placed. This article highlights the pertinent variables that should find consideration when planning the placement of orthodontic mini-implants.
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Affiliation(s)
- Sebastian Baumgaertel
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
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A study of success rate of miniscrew implants as temporary anchorage devices in singapore. Int J Dent 2015; 2015:294670. [PMID: 25861272 PMCID: PMC4377511 DOI: 10.1155/2015/294670] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 12/04/2022] Open
Abstract
Objective. To find out the success rate of miniscrew implants in the National Dental Centre of Singapore (NDCS) and the impact of patient-related, location-related, and miniscrew implant-related factors.
Materials and Methods. Two hundred and eighty-five orthodontic miniscrew implants were examined from NDCS patient records. Eleven variables were analysed to see if there is any association with success. Outcome was measured twice, immediately after surgery prior to orthodontic loading (T1) and 12 months after surgery (T2). The outcome at T2 was assessed 12 months after the miniscrew's insertion date or after its use as a temporary anchorage device has ceased. Results. Overall success rate was 94.7% at T1 and 83.3% at T2. Multivariate analysis revealed only the length of miniscrew implant to be significantly associated with success at both T1 (P = 0.002) and T2 (P = 0.030). Miniscrew implants with lengths of 10–12 mm had the highest success rate (98.0%) compared to other lengths, and this is statistically significant (P = 0.035). At T2, lengths of 10–12 mm had significantly (P = 0.013) higher success rates (93.5%) compared to 6-7 mm (76.7%) and 8 mm (82.1%) miniscrew implants. Conclusion. Multivariate statistical analyses of 11 variables demonstrate that length of miniscrew implant is significant in determining success.
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Chang C, Liu SSY, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod 2015; 85:905-10. [PMID: 25603272 DOI: 10.2319/092714.695.1] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the initial failure rate (≤4 months) for extra-alveolar mandibular buccal shelf (MBS) miniscrews placed in movable mucosa (MM) or attached gingiva (AG). MATERIALS AND METHODS A total of 1680 consecutive stainless steel (SS) 2 × 12-mm MBS miniscrews were placed in 840 patients (405 males and 435 females; mean age, 16 ± 5 years). All screws were placed lateral to the alveolar process and buccal to the lower first and second molar roots. The screw heads were at least 5 mm superior to the soft tissue. Loads from 8 oz-14 oz (227 g-397 g, 231-405 cN) were used to retract the mandibular buccal segments for at least 4 months. RESULTS Overall, 121 miniscrews out of 1680 (7.2%) failed: 7.31% were in MM and 6.85% were in AG (statistically insignificant difference). Failures were unilateral in 89 patients and bilateral in 16. Left side (9.29%) failures was significantly greater (P < .001) compared with those on the right (5.12%). Average age for failure patients was 14 ± 3 years. CONCLUSION MBS miniscrews were highly successful (approximately 93%), but there was no significant difference between placement in MM or AG. Failures were more common on the patient's left side and in younger adolescent patients. Having 16 patients with bilateral failures suggests that a small fraction of patients (1.9%) are predisposed to failure with this method.
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Affiliation(s)
- Chris Chang
- a Private Practice, Beethoven Orthodontic Center, Hsinchu City, Taiwan
| | - Sean S Y Liu
- b Assistant Professor, Department of Orthodontics and Orofacial Genetics, Indiana University School of Dentistry, Indianapolis, Ind
| | - W Eugene Roberts
- c Professor Emeritus of Orthodontics and Adjunct Professor of Mechanical Engineering, Indiana University and Purdue University, Indianapolis, Ind
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Cousley RRJ. A clinical strategy for maxillary molar intrusion using orthodontic mini‐implants and a customized palatal arch. J Orthod 2014; 37:202-8. [DOI: 10.1179/14653121043101] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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