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Kotan S, Koç A, Öner Talmaç AG. The current overview of the devices of temporary anchorage placed on the palatal bone: CBCT study. Odontology 2024:10.1007/s10266-024-00931-3. [PMID: 38564121 DOI: 10.1007/s10266-024-00931-3] [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: 05/31/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
Temporary anchorage devices (TADs) are frequently applied to different anatomic areas with different protocols to increase skeletal effects and anchorage in orthodontic treatment planning. It has been reported in many literatures that primary stability for orthodontic TADs is significant for long-term survival rate. For this reason, different areas of the palatal region, which has many indications, have been widely used in the studies. In this evaluation where bone quality and thickness are important, density, bone thickness, and fractal dimension (FD) on cone beam computed tomography (CBCT) will provide more predictable clinical results. The aim of this study was to evaluate bone thickness, density, and FD in the palatal region of the first, and second premolars, and first molars. There was a remarkable difference (p < 0.05) between the parameters of FD, thickness and density of bone in the identified areas in the palatal region. In terms of thickness and FD, the 1st premolar region had significantly higher values than the other regions (p < 0.05). In terms of density, the values in the right 1st molar and right 1st premolar regions were significantly higher (p < 0.05). The 1st premolar region is an ideal site for placement of palatal TADs. CBCT-assisted preliminary evaluation of FD value, bone density, and thickness may increase clinical success when selecting the location of TADs to be applied to the palatal bone.
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Affiliation(s)
- Seda Kotan
- Department of Orthodontics, Faculty of Dentistry, Iğdır University, Iğdır, 76000, Turkey.
| | - Alaettin Koç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
| | - Ayşe Gül Öner Talmaç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
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Perinetti G, Primozic J. Reliability and safety of miniscrew insertion planning with the use of lateral cephalograms assessed on corresponding cone-beam computer tomography images. Eur J Orthod 2024; 46:cjae003. [PMID: 38364325 PMCID: PMC10873694 DOI: 10.1093/ejo/cjae003] [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] [Indexed: 02/18/2024]
Abstract
BACKGROUND/OBJECTIVES Recently, lateral cephalograms have been proposed for guided miniscrew insertion planning. Therefore, the aim was to assess the reliability and safety of such planning on corresponding cone-beam computer tomography (CBCT) images. MATERIALS/METHODS Intraoral scans, lateral cephalograms, and CBCT images of 52 subjects (even sexes distribution), aged 15.1 ± 2.5 years, were included. Miniscrew (n = 104) insertion planning was performed using lateral cephalograms superimposed on the maxillary intraoral scans, while the assessment of their bicortical placement, length in bone, contact with adjacent teeth, incisive canal, and nasal floor perforation was done on corresponding superimposed CBCT images. Moreover, maxillary incisor inclination, crowding, and the maxillary intercanine width were measured. RESULTS The overall miniscrew length in bone was 7.2 ± 1.3mm. Bicortical placement was seen in 58.7% of the sample (38.5% of subjects). Incisive canal and nasal floor perforation was seen in 25% and 21.2% of subjects, respectively. No contact of the miniscrew with adjacent teeth was recorded. A negative significant interaction was seen between the miniscrew length in bone, the percentage of total miniscrew length and maxillary anterior teeth crowding (β, -0.10, P = .047 and β, -0.90, P = .006, respectively). Moreover, a positive significant interaction was seen between the incisive canal perforation and maxillary anterior teeth crowding (OR = 1.32, P = .021). LIMITATIONS Exclusion of subjects with impacted teeth. CONCLUSIONS Miniscrew insertion planning using lateral cephalograms, despite being safe in preventing contact with adjacent teeth, is limited in achieving bicortical placement and insufficient in completely avoiding incisive canal and nasal floor perforation.
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Affiliation(s)
| | - Jasmina Primozic
- Department of Dental and Jaw Orthopaedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Puente de la Vega Mendigure N, Bashualdo Candia DR, Valer Jáuregui V. Palatal bone thickness for mini-implant insertion in different vertical growth patterns: a systematic review. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e152. [PMID: 38288456 PMCID: PMC10809969 DOI: 10.21142/2523-2754-1102-2023-152] [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: 04/21/2023] [Accepted: 05/12/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The purpose of this systematic review was to identify, evaluate, and provide information about palatal bone thickness in different vertical growth patterns for the placement of orthodontic anchorage devices. Methods We performed a systematic review of the published data in Medline via PubMed, Web of Science, Cochrane Library, and Scopus from January 2000 to August 2022 using eligibility criteria. Data collection analysis and data extraction were performed independently by three reviewers. Sensitivity analyses were performed with the Cochrane risk of bias tool and the ROBINS-I tool was used for non-randomized studies. Results A total of 343 articles were identified. The inclusion criteria included palatal bone thickness and vertical facial growth. However, both variables were found in 4 studies and only 2 had a control group. The different studies evaluated palatal bone thickness according to sex (male 14.1 mm; female 9.68 mm) and vertical malocclusion (normal 2.2 -12.6 mm; open bite 1.9 -13.2mm) with heterogeneous results. Likewise, the vertical growth pattern with a low angle (9.39 mm) was greater than the normal (8.55 mm) and high angle (7.53 mm). Conclusions Palatal bone thickness varies according tp different vertical growth patterns, with the greatest thickness being found near the incisive foramen in hypodivergent individuals.
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Affiliation(s)
- Nguyen Puente de la Vega Mendigure
- Division of orthodontic, Universidad Científica del Sur. Lima, Peru. , , Universidad Científica del Sur Division of orthodontic Universidad Científica del Sur Lima Peru
| | - Denisse Rosario Bashualdo Candia
- Division of orthodontic, Universidad Científica del Sur. Lima, Peru. , , Universidad Científica del Sur Division of orthodontic Universidad Científica del Sur Lima Peru
| | - Valery Valer Jáuregui
- Division of orthodontic, Universidad Científica del Sur. Lima, Peru. , , Universidad Científica del Sur Division of orthodontic Universidad Científica del Sur Lima Peru
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Assessment of the bone thickness of the palate on cone-beam computed tomography for placement of miniscrew-assisted rapid palatal expansion appliances. Am J Orthod Dentofacial Orthop 2022; 161:849-857. [DOI: 10.1016/j.ajodo.2021.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/20/2022]
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OUP accepted manuscript. Eur J Orthod 2022; 44:530-536. [DOI: 10.1093/ejo/cjac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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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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Migliorati M, Cevidanes L, Sinfonico G, Drago S, Dalessandri D, Isola G, Biavati AS. Three dimensional movement analysis of maxillary impacted canine using TADs: a pilot study. Head Face Med 2021; 17:1. [PMID: 33451343 PMCID: PMC7809730 DOI: 10.1186/s13005-020-00252-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of the present study was to compare two different anchorage systems efficiency to disinclude impacted maxillary canines using as evaluation tool superimposed Cone Beam Computed Tomography (CBCTs). METHODS The study has been conducted with two parallel groups with an allocation ratio of 1:1. Group test received treatment using as anchorage a miniscrew, control group was treated using an anchorage unit a trans palatal arch (TPA). Both groups received a calibrated traction force of 50 g. CBCT before treatment and 3 months after traction were superimposed and canine tip and root movement were evaluated in mm/month ratio. RESULTS No differences were observed between groups for apex displacement, tip displacement and observation timespan. Twenty-two patients (12 female, 10 male, mean age:13.4 years) undergoing orthodontic treatment for impacted maxillary canines were recruited for this study. No differences were observed between groups for apex displacement, tip displacement and observation timespan. CONCLUSIONS The present pilot study provided no evidence that indirect anchorage on miniscrews could make canine disimpaction faster than anchorage on a TPA. An apex root movement of 0.4-0.8 mm per month was found, while average canine tip movement ranged between 1.08 mm and 1.96 mm per month. No miniscrews failures were observed. TRIAL REGISTRATION The study reports the preliminary results of the randomized clinical trial registered at www.register.clinicaltrials.gov (registration number: NCT01717417 ).
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Affiliation(s)
- Marco Migliorati
- Orthodontics Department, School of Dentistry University of Genova largo Rosanna Benzi, 10 16132, Genoa, Italy.
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan, School of Dentistry, Ann Arbor, USA
| | | | - Sara Drago
- Orthodontics Department, School of Dentistry University of Genova largo Rosanna Benzi, 10 16132, Genoa, Italy
| | - Domenico Dalessandri
- Department Of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Armando Silvestrini Biavati
- Orthodontics Department, School of Dentistry University of Genova largo Rosanna Benzi, 10 16132, Genoa, Italy
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Ahn HW, Kang YG, Jeong HJ, Park YG. Palatal temporary skeletal anchorage devices (TSADs): What to know and how to do? Orthod Craniofac Res 2020; 24 Suppl 1:66-74. [PMID: 33278057 DOI: 10.1111/ocr.12451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/09/2020] [Accepted: 11/29/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Since palatal temporary skeletal anchorage devices (TSADs) have become important tools for orthodontic treatment, this narrative review was aimed to provide an updated and integrated guidelines for the clinical application of palatal TSADs. SETTING AND SAMPLE POPULATION A narrative review article including researches on palatal TSADs in orthodontics related to anatomy, success rate and clinical application. MATERIALS AND METHODS The anatomical characteristics, success rate and its consideration factors and clinical application of palatal TSADs based on the direction of tooth movement were evaluated. RESULTS To improve the stability of TSADs, hard tissue factors such as bone depth, cortical bone thickness, bone density and soft tissue thickness were evaluated. Anatomically risky structures, including the nasopalatine foramen, canal and the greater palatine foramen, nerve, vessel need to be identified before placement. The success rate of palatal TSADs was greater than that of the buccal inter-radicular space. Palatal TSADs have been used for various purposes because they can control tooth movement in all directions and, three-dimensionally; their applications include the retraction of anterior teeth, protraction of posterior teeth, distalization, intrusion, expansion and constriction. They can be applied directly or indirectly to the lingual arch or transpalatal arch. Design modifications using splinted 2 miniscrews have been suggested. CONCLUSION Palatal TSADs allow clinicians to perform minimally invasive and easy placement with good stability by understanding the anatomical characteristics of the palatal region, and they show good control over 3-dimensional tooth movements in various clinical cases.
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Affiliation(s)
- Hyo-Won Ahn
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Yoon-Goo Kang
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Hyun-Joo Jeong
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Young-Guk Park
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, South Korea
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Tirado Núñez AP, Castrejón Jaime S, Silva Zatarain AN, Gutiérrez Rojo JF. Comparación del grosor óseo palatino bilateral para inserción de miniimplantes. ACTA ODONTOLÓGICA COLOMBIANA 2019. [DOI: 10.15446/aoc.v9n2.78843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: comparar el grosor óseo palatino bilateral e identificar zonas seguras para inserción de miniimplantes. Métodos: se llevó a cabo un estudio transversal que incluyó 100 tomografías de haz cónico (CBCT) pretratamiento de pacientes que asistieron a la Especialidad de Ortodoncia en la Universidad Autónoma de Nayarit (UAN). Las imágenes fueron orientadas utilizando el mismo protocolo. En el corte sagital, las mediciones se realizaron de los 0 a los 24mm, con intervalos de 3mm entre cada una, con la primera medición en el borde posterior del foramen incisivo. Las mediciones del grosor palatino se realizaron en el corte coronal a los 2, 4, 6 y 8mm de la sutura media palatina hacia ambos lados. Resultados: se encontró mayor grosor en la zona anterior en las medidas sagitales de 0 mm y 3 mm, a diferencia del resto del paladar. Se hallaron diferencias estadísticamente significativas al comparar los valores tanto sagitales como transversales. Con la prueba Post Hoc de Tukey no se encontraron diferencias estadísticamente significativas al comparar el lado derecho con el izquierdo en cada una de las medidas transversales. Conclusiones: no se encontraron diferencias significativas entre los dos lados, se determinó como zona segura la región anterior del paladar de 0mm a 6mm y es primordial la CBCT en todos los pacientes con indicación de miniimplantes en paladar.
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Poorsattar-Bejeh Mir A. Monocortical versus bicortical hard palate anchorage with the same total available cortical thickness: a finite element study. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2017; 8. [PMID: 27157504 DOI: 10.1111/jicd.12218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/01/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE We aimed to compare the bicortical fixation of a palatal miniscrew in comparison to monocortical anchorage when total anchored cortical layer thicknesses are the same. MATERIALS AND METHODS Six models were designed: I, monocortical, 1.1 mm palatal cortical thickness, 8.5 mm bone height; II, bicortical, 0.4 mm palatal, 0.7 mm nasal cortical thickness, 8 mm bone height; III, bicortical, 0.7 mm palatal and 0.4 mm nasal cortical thickness, 8 mm bone height; IV, monocortical, 1.1 mm palatal cortical thickness, 7 mm bone height; V, bicortical, 0.4 mm palatal, 0.7 mm nasal cortical thickness, 7 mm bone height; VI, bicortical, 0.7 mm palatal and 0.4 mm nasal cortical thickness, 8.5 mm bone height. An 8 mm miniscrew was fully engaged in the bone and was subjected to vertical pull out until displaced 0.01 mm and 0.05 mm or horizontal traction load of 2 N. RESULTS Monocortical fixation provides higher retention in comparison to bicortical fixations with the same total cortical thicknesses in terms of vertical pull-out test. Models with bicortical fixation and thicker nasal cortex sustained lower strain energy when subjected to horizontal traction load. CONCLUSION Bicortical fixation of hard palate exhibit different reactions to vertical and horizontal tractions.
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