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Bharadwaj A, Ahuja S, Bhambri E, Gupta S, Uppal J. A 3D Finite Element Analysis of biomechanical effects on teeth and bone during true intrusion of posteriors using miniscrews. Int Orthod 2024; 22:100819. [PMID: 37864876 DOI: 10.1016/j.ortho.2023.100819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE The primary objective of this study was to investigate the biomechanical effects and stresses on bone, PDL, cementum and displacement along X-,Y- and Z-axis during true intrusion of molars using mini-implants with finite element analysis; the secondary objective of the study was to find out the best method for posterior intrusion in clinical practice. MATERIAL AND METHODS A 3D finite element method was used to simulate true molar intrusion using sliding mechanics. Two groups were made, with mini-implants placed on buccal side and palatal side with a cap splint for MODEL1, and a single mini-implant placed buccally with transpalatal arch (TPA) for MODEL2. The material characteristics which include the Young's modulus and Poison's ratio were assigned. von Mises stress, principal stress on PDL and alveolar bone, displacements in all the 3 planes were determined. RESULTS Bone stress patterns showed compressive stresses on the buccal aspect and tensile stresses on the palatal aspect for both MODELS. Stresses in the PDL and cementum were mainly concentrated in the apex region, with a more uniform distribution of stresses for MODEL 1. Tooth displacement showed true intrusion for both MODELS, i.e. the Z axis, and a more controlled buccal tipping for MODEL 1. CONCLUSION Of the modalities compared, the best controlled tooth movements for posterior intrusion in the treatment of open bite were obtained with mini-implants placed with a cap splint (MODEL 1).
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Affiliation(s)
- Ankit Bharadwaj
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Sachin Ahuja
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Eenal Bhambri
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Sri Ganganagar, Rajasthan 335001, India
| | - Seema Gupta
- A.C.P.M Dental College, Maharashtra University of Health Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Dhule, Maharashtra 424002, India
| | - Japjee Uppal
- Surendera Dental College and Research Institute, Rajasthan University of Health Sciences, Department of Prosthodontics and Crown and Bridge, Sri Ganganagar, Rajasthan 335001, India.
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Ashil AM, Sharma A, Jose LK, Grover S, Kochar AS, Varghese ST, Sharma T, Ismail PMS. A CBCT Assessment of Orthodontic Mini-Implant Placement. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S927-S929. [PMID: 38595369 PMCID: PMC11000927 DOI: 10.4103/jpbs.jpbs_1102_23] [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: 10/24/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 04/11/2024] Open
Abstract
Objectives This study compares the precision of cone beam computed tomography (CBCT) and two-dimensional radiography for mini-implant implantation. Materials and Method For 30 sites (in 15 patients between the ages of 13 and 26 years), the buccal interradicular region among the 2nd premolar and 1st molar was found to be the best location for mini-implants. Next, two groups of the mini-implant implantation process were created. Mini-implants were positioned at the CBCT data-identified sites in the CBCT group. Mini-implants were inserted in the RVG group by using two-dimensional digital radiography and a specially constructed guide. To assess the precision of the mini-implant implantation, post-placement CBCT images were acquired. The obtained data were statistically analyzed. Result The two groups showed a statistically considerable variation in the mini-implant placement's departure from the optimal height. Due to the smaller interradicular space and decreased convenience in the posterior mandibular area, two out of 15 mini-implants in the RVG group demonstrated root contact in the mandibular jaw. Conclusion The two-dimensional intraoral radiograph of the interradicular area provides sufficient information for mini-implant placement even though CBCT accurately visualizes the interradicular space in three dimensions.
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Affiliation(s)
- AM Ashil
- Additional Professor, Department of Orthodontics, Government Dental College, Kannur Pariyaram Medical College, Kerala, India
| | - Aseem Sharma
- Reader, Department of Orthodontics and Dentofacial Orthopedics, Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
| | - Lijo K Jose
- Professor, Department of Orthodntics, PSM College of Dental Science and Research, Akkikavu, Thrissur, Kerala, India
| | - Shubhi Grover
- Senior Lecturer, Department of Prosthodntics, Crown and Bridge, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand, India
| | | | - Shaji T. Varghese
- Professor and HOD, PSM College of Dental Science, Thrissur, Kerala, India
| | - Tanushree Sharma
- Senior Resident, Department of Dentistry, Government Medical College, Kathua, Jammu and Kashmir, India
| | - Prabu Mahin Syed Ismail
- GCD, Pro Positive Health, Assistant Professor, Department of Restorative Dentistry, College of Dentistry in Arrass, Qassim Univesrity, Kingdom of Saudi Arabia
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Accuracy of Mini-Implant Placement Using a Computer-Aided Designed Surgical Guide, with Information of Intraoral Scan and the Use of a Cone-Beam CT. Dent J (Basel) 2022; 10:dj10060104. [PMID: 35735647 PMCID: PMC9221763 DOI: 10.3390/dj10060104] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 12/19/2022] Open
Abstract
Background: The purpose of the study was to investigate the accuracy of mini-implant placement with the use of a computer designed surgical guide derived by intraoral scanning alongside Cone-Beam Computed Tomography (CBCT) or the use of a 2D radiograph. Methods: Thirty-five mini-implants (Aarhus® System: n = 20, Ø: 1.5 mm and AbsoAnchor®: n = 15, Ø: 1.3–1.4 mm) were placed in the maxilla and mandible of 15 orthodontic patients for anchorage purposes in cases where a CBCT was needed due to impacted teeth or for safety reasons. All were placed with the help of a computer designed surgical guide. One implant became loose and was excluded from the study. For 18 mini-implants (study group), CBCT and intraoral scanning were used for guide design, while for 16 (control group) only intraoral scanning and panoramic imaging information were used. Mini-implant position was recorded by angular and linear measurements on digital models created by combining Digital Imaging and Communications in Medicine (DICOM) and stereolithography (.stl) files. Accuracy in positioning was determined by comparing corresponding measurements for virtual and real positioned mini-implants on digital models before and after operation. The results were statistically analyzed with t-tests and the Mann-Whitney test. Results: No significant statistical differences were found for pre- and post-operational angular measurements in the study group, while significant statistical differences occurred on the same measurements for the control group (coronal angle 13.6° pre-op and 22.7° post-op, p-value = 0.002, axial angle 13.4° pre-op and 15.9° post-op, p-value = 0.034). Linear measurements pre- and post-operational for either group presented no significant statistical differences. Conclusions: A 3D designed and manufactured surgical guide with information concerning CBCT and intraoral scanning ensures accuracy on mini-implant placement while design of the guide without the use of a CBCT is less accurate, especially on inclination of the implant.
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Zhang S, Wei X, Wang L, Wu Z, Liu L, Yan X, Lai W, Long H. Evaluation of Optimal Sites for the Insertion of Orthodontic Mini Implants at Mandibular Symphysis Region through Cone-Beam Computed Tomography. Diagnostics (Basel) 2022; 12:diagnostics12020285. [PMID: 35204375 PMCID: PMC8871083 DOI: 10.3390/diagnostics12020285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023] Open
Abstract
This study aims to evaluate the overall bone thickness (OBT) and cortical bone thickness (CBT) of mandibular symphysis and to determine the optimal sites for the insertion of orthodontic mini implants. Cone-beam computed tomography (CBCT) images of 32 patients were included in this study. The sample was further categorized into three facial types: low-, average-, and high-angle. OBT and CBT were measured at the mandibular symphysis region. All measurements were performed at six different heights from the cementoenamel junction [CEJ] and at seven different angles to the occlusal plane. Analysis of variance (ANOVA) was used for statistical comparison and a p value less than 0.05 was considered statistically significant. Our results revealed that neither OBT nor CBT was influenced by age or sex, except for the observation that CBT was significantly greater in adults than in adolescents. OBT and CBT were significantly greater in low-angle cases than in average- and high-angle cases. Both OBT and CBT were significantly influenced by insertion locations, heights and angles, and their interactions. CBT and OBT were greatest at the location between two lower central incisors, and became greater with increases in insertion height and angle. Both recommended and optimal insertion sites were mapped. The mandibular symphysis region was suitable for the placement of orthodontic mini implants. The optimal insertion site was 6–10 mm apical to the CEJ between two lower central incisors, with an insertion angle being 0–60 degrees to the occlusal plane.
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Affiliation(s)
- Shizhen Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xiaoyu Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lufei Wang
- Department of Oral and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, NC 27599, USA;
| | - Zhouqiang Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lu Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xinyu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Wenli Lai
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
| | - Hu Long
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
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Gus'kov AV, Oleinikov AA, Domashkevich NS, Osman A. [Possibilities and prospects for experimental and clinical instrumentation techniques for determining the primary stability of dental implants in comparative analysis]. STOMATOLOGIIA 2022; 101:96-102. [PMID: 35184542 DOI: 10.17116/stomat202210101196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The high primary stability of dental implants provides a favorable prognosis for orthopedic treatment with implant-supported structures. The importance of assessing the stability and the bone tissue surrounding the implant as a whole is due to the fact that the process of osseointegration is a structural and functional connection between the bone and the loaded surface of the implant. Determination of the dynamics of the stability of dental implants allows timely monitoring of unpredictable changes at the stages of osseointegration and remodeling of bone tissue around the implant. Currently, in addition to clinical and radiation diagnostic methods, there are generally recognized by clinicians frequency resonance analysis and periotestometry. However, there are some scientific discrepancies indicating the lack of objectivity of these methods and the impossibility of their full-fledged application without the support of radiation and clinical diagnostic methods. In addition to these methods, there are many experimental and less common methods in clinical practice for assessing the primary stability of implants, but with reasonable objectivity. Thus, the reasons are given that for a full assessment of the relationship between the efforts exerted on implants and their movements in the space of bone tissue, devices are needed that reflect the stability and density of the contact of the implant with bone tissue in physical quantities. In particular, methods based on lasers, sound, quantitative ultrasound, and others have found experimental practical application. The ultrasound method of assessing the primary stability of the implant is estimated as the most promising, since it allows you to demonstrate the results of studies in certain physical quantities, as well as to compare these results with histomorphological indicators of osseointegration of dental implants.
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Affiliation(s)
- A V Gus'kov
- Ryazan State Medical University, Ryazan, Russia
| | | | | | - A Osman
- Ryazan State Medical University, Ryazan, Russia
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Guided Insertion of Temporary Anchorage Device in Form of Orthodontic Titanium Miniscrews with Customized 3D Templates—A Systematic Review with Meta-Analysis of Clinical Studies. COATINGS 2021. [DOI: 10.3390/coatings11121488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
(1) Background: Miniscrew insertion, using a surgical guide, aims to avoid possible adverse effects or complications. With the higher availability of both 3D imaging and printing, 3D surgical guides have been used more frequently in orthodontics. The aim of the present systematic review was to find scientific clinical evidence concerning the precision of the 3D guided insertion of miniscrews for temporary orthodontic anchorage. (2) Methods: Literature searches were performed in the following five search engines: Pubmed (Medline), Pubmed Central, Scopus, Web of Science and Embase on 10 September 2021 (articles from 1950 to 10 September 2021). A meta-analysis was performed using the random-effect model, with Standardized Mean Differences (SMD) and 95% confidence intervals (95% CI) calculated as effect estimates. The heterogeneity was assessed quantitatively. (3) Results: The search strategy identified 671 potential articles. After the removal of duplicates, 530 articles were analyzed. Subsequently, 487 papers were excluded, because they were not associated with the subject of the study. Of the remaining 43 papers, 34 were excluded because they did not meet the methodological criteria. Finally, only nine papers were subjected to a qualitative analysis. (4) Conclusions: The current literature concerning guided miniscrew insertion reveals, for the most part, a low methodological level. High-quality clinical trials are in the minority. The use of surgical guides increases insertion accuracy, stability and reduces the failure rate of orthodontic miniscrews. Tooth-borne insertion guides supported on the edges of the teeth ensure a higher insertion precision compared to mucosa-borne ones. The study protocol was registered in PROSPERO under the number CRD42021267248.
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Riad Deglow E, Toledano Gil S, Zubizarreta-Macho Á, Bufalá Pérez M, Rodríguez Torres P, Tzironi G, Albaladejo Martínez A, López Román A, Hernández Montero S. Influence of the Computer-Aided Static Navigation Technique and Mixed Reality Technology on the Accuracy of the Orthodontic Micro-Screws Placement. An In Vitro Study. J Pers Med 2021; 11:jpm11100964. [PMID: 34683105 PMCID: PMC8539767 DOI: 10.3390/jpm11100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/03/2022] Open
Abstract
To analyze the effect of a computer-aided static navigation technique and mixed reality technology on the accuracy of orthodontic micro-screw placement. Material and methods: Two hundred and seven orthodontic micro-screws were placed using either a computer-aided static navigation technique (NAV), a mixed reality device (MR), or a conventional freehand technique (FHT). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic micro-screw placement. The deviation angle and horizontal deviation were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic micro-screws. In addition, any complications resulting from micro-screw placement, such as spot perforations, were also analyzed across all dental sectors. Results: The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001). The NAV study group showed statistically significant differences from the FHT (p < 0.001) and MR study groups (p < 0.001) at the apical end-point (p < 0.001), and the FHT group found significant differences from the angular deviations of the NAV (p < 0.001) and MR study groups deviations (p = 0.0011). Different dental sectors also differed significantly. (p < 0.001) Additionally, twelve root perforations were observed in the FHT group, while there were no root perforations in the NAV group. Conclusions: Computer-aided static navigation technique enable more accurate orthodontic micro-screw placement and fewer intraoperative complications when compared with the mixed reality technology and conventional freehand techniques.
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Affiliation(s)
- Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
| | - Sergio Toledano Gil
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
- Correspondence:
| | - María Bufalá Pérez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
| | - Paulina Rodríguez Torres
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
| | - Georgia Tzironi
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
| | - Alberto Albaladejo Martínez
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
| | - Antonio López Román
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (E.R.D.); (S.T.G.); (M.B.P.); (P.R.T.); (A.L.R.); (S.H.M.)
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Torres PR, Gil ST, Zubizarreta-Macho Á, Pérez MB, Deglow ER, Tzironi G, Martínez AA, Montero SH. Influence of the Computer-Aided Static Navigation Technique on the Accuracy of the Orthodontic Micro-Screws Placement: An In Vitro Study. J Clin Med 2021; 10:jcm10184127. [PMID: 34575238 PMCID: PMC8469331 DOI: 10.3390/jcm10184127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022] Open
Abstract
To analyze the influence of the computer-aided static navigation technique on the accuracy of placement of orthodontic micro-screws. One hundred and thirty-eight orthodontic micro-screws were randomly assigned to the following study groups: Group A. orthodontic micro-screw placement using a computer-aided static navigation technique (n = 69); B. orthodontic micro-screw placement using the conventional freehand technique (n = 69). In addition, the accuracy in the canine–premolar, premolar and molar sectors was analyzed in each study group. Cone-beam computed tomography and intraoral scans were taken both prior and subsequent to orthodontic micro-screw placement. The images were then uploaded using a 3D implant planning software, where the deviation and horizontal angles were analyzed using a multivariate linear model. These measurements were taken at the coronal entry point and apical endpoint between the planned orthodontic micro-screws. In addition, any complications resulting from micro-screw placement, such as spot perforations, were also analyzed in all dental sectors. The statistical analysis showed significant differences between the two study groups with regard to the coronal entry-point, apical end-point (p < 0.001) and angular deviations (p < 0.001) between the computer-aided static navigation technique and freehand technique study groups. Moreover, statistically significant differences were showed between the different dental sectors (p < 0.001). Additionally, twelve root perforations were observed at the conventional free hand technique study group while there were no root perforations in the computer-aided static navigation technique study group. The results showed that the computer-aided static navigation technique enables a more accurate orthodontic micro-screw placement with less intraoperative complications when compared with the conventional freehand technique.
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Affiliation(s)
- Paulina Rodríguez Torres
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
| | - Sergio Toledano Gil
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
- Correspondence:
| | - María Bufalá Pérez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
| | - Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
| | - Georgia Tzironi
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
| | - Alberto Albaladejo Martínez
- Department of Orthodontics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (G.T.); (A.A.M.)
| | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (P.R.T.); (S.T.G.); (M.B.P.); (E.R.D.); (S.H.M.)
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Kapetanović A, Oosterkamp BCM, Lamberts AA, Schols JGJH. Orthodontic radiology: development of a clinical practice guideline. LA RADIOLOGIA MEDICA 2021; 126:72-82. [PMID: 32462471 PMCID: PMC7870627 DOI: 10.1007/s11547-020-01219-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Radiographs are considered essential in orthodontics. However, their diagnostic value and indications for use are still uncertain, while exposure to radiation carries health risks. This study aimed to report on the development of a clinical practice guideline on orthodontic radiology. METHODS A Guideline Development Taskforce was set up. The GRADE methodology was used for development and the RIGHT Statement for reporting of the guideline. We systematically reviewed articles to address the main clinical question: how different types of radiographs contribute to orthodontic diagnosis, treatment planning and post-treatment outcome evaluation. After a literature search and data extraction, we formulated conclusions and assessed the strength of the evidence according to the GRADE method. Both literature conclusions and the most important considerations, such as patient preferences, organizational matters and expert opinions were taken into account to finally issue recommendations. RESULTS 7 clinical questions focused on orthopantomograms, lateral cephalograms, hand-wrist radiographs, peri-apical radiographs, bitewings, antero-occlusal radiographs, and cone-beam computer tomographic imaging. The literature search lead to 484 unique studies, of which 17 were included in the analysis. The strength of evidence of the conclusions was graded low or very low. We formulated considerations and took them into account when issuing the 13 clinical recommendations to address the clinical questions. CONCLUSIONS There was a considerable lack of scientific evidence on this topic. Nonetheless, this guideline provides clinicians with a tool for decision-making regarding radiographic records while enhancing patient radiation protection. More research of higher quality is recommended for a future update.
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Affiliation(s)
- Aldin Kapetanović
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Barbara C M Oosterkamp
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoon A Lamberts
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
| | - Jan G J H Schols
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
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X-ray beam angulation can compromise 2-dimensional diagnosis of interradicular space for mini-implants. Am J Orthod Dentofacial Orthop 2019; 156:593-602. [PMID: 31677667 DOI: 10.1016/j.ajodo.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of this research was to evaluate the influence of x-ray projection geometry on interradicular space of the posterior maxillary arch. METHODS Cone-beam computed tomography (CBCT) scans of 32 patients (16.85 ± 4.93 years) who met the selection criteria were enrolled. One hundred ninety-two interradicular sites of the posterior maxillary arch were evaluated. Before measurements, each side of the maxillary arch was orientated in all 3 planes of space to obtain CBCT synthesized periapical radiographs with 0° projection geometry (orthogonal x-ray beam-orthogonal X-ray angulation [OX]). Standardized CBCT axial rotations (10°, 20°, -10°, and -20°) were used to simulate periapical radiographs taken with mesial and distal angulation of the x-ray beam (mesial x-ray angulation [MX] and distal x-ray angulation [DX]). Interradicular space widths were measured on OX, MX, and DX CBCT synthesized periapical radiographs. Measurements were performed parallel to the occlusal plane at 3 mm and 6 mm apical to the midpoint of the alveolar crest. Interradicular distances were statistically compared (P <0.05). RESULTS Interradicular distances measured on MX and DX CBCT synthesized periapical radiographs were significantly smaller than those measured on OX. Interradicular distance was significantly correlated with the horizontal angulation of the x-ray beam. X-ray projection angle was the most influential variable on interradicular distance. About 30% reduction in interradicular space was observed for every 10° of deviation from orthogonal x-ray. CONCLUSION Two-dimensional radiographs obtained away from the 0° projection geometry can reduce the actual interradicular space for mini-implants, inducing misdiagnosis.
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Yadav S, Sachs E, Vishwanath M, Knecht K, Upadhyay M, Nanda R, Tadinada A. Gender and growth variation in palatal bone thickness and density for mini-implant placement. Prog Orthod 2018; 19:43. [PMID: 30393829 PMCID: PMC6215790 DOI: 10.1186/s40510-018-0241-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective was to compare the palatal bone thickness (PBT) and palatal bone density (PBD) in the anterior, middle, and posterior part of the palate in males and females. METHODS This retrospective study reviewed cone beam computed tomography scans of 359 patients. The scans were divided into 99 growing males, 105 growing females, 74 non-growing males, and 81 non-growing females. The measurements of PBT and PBD were made in between the canine and first premolar, the first premolar and second premolar, the second premolar and first molar, and the first molar and second molar. The measurements were made in the center of the palate and 4 mm away from the center. ANOVA was used to analyze the PBT and PBD in different areas between four different groups. RESULTS The PBT was lower (P < 0.0001) as we moved from the anterior to the posterior palate. The PBT was more (P < 0.001) in the center of the palate than 4 mm away from the center, except in between the canine and first premolar. The growing male and non-growing male had higher (P < 0.0001) PBT than the growing female and non-growing female in between the canine and first premolar and the first premolar and second premolar both in the center and 4 mm away from it. The PBD was higher (P < 0.05) in between the canine and first premolar area at the center of the palate and between the second premolar and first molar 4 mm away from the center in all the experimental groups. CONCLUSIONS There exists a definite gender and growth variation in the PBT and PBD in different parts of the palate. Palatal bone thickness between the males and females revealed that the males had significantly higher PBT than the females.
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Affiliation(s)
- Sumit Yadav
- Division of Orthodontics, University of Connecticut Health Center, Farmington, USA. .,School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Avenue, L7062A MC1725, Farmington, CT, 06030, USA.
| | - Emily Sachs
- School of Dental Medicine, University of Connecticut Health Center, 263 Farmington Avenue, L7062A MC1725, Farmington, CT, 06030, USA
| | - Meenakshi Vishwanath
- Division of Orthodontics, University of Nebraska Medical Center, Farmington, USA
| | | | - Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health Center, Farmington, USA
| | - Ravindra Nanda
- Division of Orthodontics, University of Connecticut Health Center, Farmington, USA
| | - Aditya Tadinada
- Division of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, USA
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Matys J, Flieger R, Tenore G, Grzech-Leśniak K, Romeo U, Dominiak M. Er:YAG laser, piezosurgery, and surgical drill for bone decortication during orthodontic mini-implant insertion: primary stability analysis-an animal study. Lasers Med Sci 2017; 33:489-495. [PMID: 29127605 PMCID: PMC5862928 DOI: 10.1007/s10103-017-2381-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
It is important to identify factors that affect primary stability of orthodontic mini-implants because it determines the success of treatment. We assessed mini-implant primary stability (initial mechanical engagement with the bone) placed in pig jaws. We also assessed mini-implant insertion failure rate (mini-implant fracture, mini-implants to root contact). A total of 80 taper-shaped mini-implants (Absoanchor® Model SH1312-6; Dentos Inc., Daegu, Korea) 6 mm long with a diameter of 1.1 mm were used. Bone decortication was made before mini-implant insertion by means of three different methods: Group G1: Er:YAG laser (LiteTouch®, Light Instruments, Yokneam, Israel) at energy of 300 mJ, frequency 25 Hz, fluence 38.2 J/cm2, cooling 14 ml/min, tip 1.0 × 17 mm, distance 1 mm, time of irradiation 6 s; Group G2: drill (Hager & Meisinger GmbH, Hansemannstr, Germany); Group G3: piezosurgery (Piezotom Solo, Acteon, NJ, USA). In G4 group (control), mini-implants were driven by a self-drilling method. The primary stability of mini-implants was assessed by measuring damping characteristics between the implant and the tapping head of Periotest device (Gulden-Medizinteknik, Eschenweg, Modautal, Germany). The results in range between − 8 to + 9 allowed immediate loading. Significantly lower Periotest value was found in the control group (mean 0.59 ± 1.57, 95% CI 0.7, 2.4) as compared with Er:YAG laser (mean 4.44 ± 1.64, 95% CI 3.6, 5.3), piezosurgery (mean 17.92 ± 2.73, 95% CI 16.5, 19.3), and a drill (mean 5.91 ± 1.52, 95% CI 5.2, 6.6) (p < 0.05). The highest failure rate (33.3%) during mini-implant insertion was noted for self-drilling method (G4) as compared with G1, G2, and G3 groups (p < 0.05). The small diameter decortication by Er:YAG laser appeared to provide better primary stability as compared to drill and piezosurgery. Decortication of the cortical bone before mini-implant insertion resulted in reduced risk of implant fracture or injury of adjacent teeth. The high initial stability with a smaller diameter of the mini-implant resulted in increased risk of fracture, especially for a self-drilling method.
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Affiliation(s)
- Jacek Matys
- "Sapienza" University of Rome, Rome, Italy. .,Private Dental Healthcare, Lipowa 18, 67-400, Wschowa, Poland.
| | | | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Marzena Dominiak
- Dental Surgery Department, Medical University of Wroclaw, Wroclaw, Poland
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Hourfar J, Bister D, Lux CJ, Al-Tamimi B, Ludwig B. Anatomic landmarks and availability of bone for placement of orthodontic mini-implants for normal and short maxillary body lengths. Am J Orthod Dentofacial Orthop 2017; 151:878-886. [PMID: 28457265 DOI: 10.1016/j.ajodo.2016.09.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Increasing numbers of orthodontic mini-implants are placed in the anterior maxilla. To our knowledge, bone levels and root proximity of patients with cephalometrically short maxillae have not been investigated before. The first, second, and third rugae were used as clinical reference lines, and the aim of this study was to measure bone availability in that area by comparing patients with short and normal maxillary body lengths. METHODS The sample consisted of 21 patients in each group: short maxillary body length and normal maxillary body length. The patients' study models were bisected, and the outline of the palatal contour was marked on the surface. The models were scanned, and the palatal contours were superimposed on the palatal structures of their respective initial cephalometric headfilms, and the vertical and oblique bone levels of the sagittal plane were compared using the Student t test. The level of significance was set at P <0.05. RESULTS Compared with maxillae of normal maxillary body length, less bone was available in maxillae of short maxillary body length. However, the differences did not reach clinical or statistical significance (P >0.05) at the third rugae. CONCLUSIONS Almost equivalent average bone depth at the third rugae in patients with normal and short maxillary body lengths suggests that this site can be used for 8-mm long obliquely inserted orthodontic mini-implants.
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Affiliation(s)
- Jan Hourfar
- Private Practice, Reinheim, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher J Lux
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Bouthayna Al-Tamimi
- Dental and Maxillofacial Surgery Department, Great Ormond Street Hospital, NHS Foundation Trust, London, United Kingdom
| | - Björn Ludwig
- Private Practice, Traben-Trarbach, Germany; Department of Orthodontics, University of Saarland, Homburg, Germany.
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Safe zones for miniscrews in maxillary dentition distalization assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2017; 151:500-506. [DOI: 10.1016/j.ajodo.2016.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/21/2022]
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Kalra S, Tripathi T. Letters From Our Readers. Angle Orthod 2016; 86:522. [DOI: 10.2319/angl-86-03-522-522.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Shilpa Kalra
- Maulana Azad Institute of Dental Sciences, New Delhi, India
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Tadinada A. Letters From Our Readers. Angle Orthod 2016; 86:523. [PMID: 27123897 DOI: 10.2319/angl-86-03-523-523.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Aditya Tadinada
- Assistant Professor, Associate Program Director: OMFR Residency, Director of Student Research, UCONN School of Dental Medicine, Farmington, CT
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Uribe F, Mehr R, Mathur A, Janakiraman N, Allareddy V. Failure rates of mini-implants placed in the infrazygomatic region. Prog Orthod 2015; 16:31. [PMID: 26373730 PMCID: PMC4571029 DOI: 10.1186/s40510-015-0100-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/31/2015] [Indexed: 12/02/2022] Open
Abstract
Background The purpose of this pilot study was to evaluate the failure rates of mini-implants placed in the infrazygomatic region and to evaluate factors that affect their stability. Methods A retrospective cohort study of 30 consecutive patients (55 mini-implants) who had infrazygomatic mini-implants at a University Clinic were evaluated for failure rates. Patient, mini-implant, orthodontic, surgical, and mini-implant maintenance factors were evaluated by univariate logistic regression models for association to failure rates. Results A 21.8 % failure rate of mini-implants placed in the infazygomatic region was observed. None of the predictor variables were significantly associated with higher or lower odds for failed implants. Conclusions Failure rates for infrazygomatic mini-implants were slightly higher than those reported in other maxilla-mandibular osseous locations. No predictor variables were found to be associated to the failure rates.
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Affiliation(s)
- Flavio Uribe
- Division of Orthodontics, Department of Craniofacial Sciences, Charles Burstone Professor, University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA.
| | | | | | - Nandakumar Janakiraman
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Nosouhian S, Rismanchian M, Sabzian R, Shadmehr E, Badrian H, Davoudi A. A Mini-review on the Effect of Mini-implants on Contemporary Orthodontic Science. J Int Oral Health 2015. [PMID: 26225113 PMCID: PMC4516069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this literature review was to screen the valuable published articles regarding to the impacts of mini-implants on orthodontic science, briefly. The searching category was performed on the Pubmed using MeSH words such as "dental (mini) implants, orthodontic anchorage procedures, and orthodontic appliances." After preliminary sketch, they were grouped as follow: Those evaluating (a) common appliances for providing orthodontic anchorage, (b) biomechanical details of mini-implants and their insertion, (c) clinical application of mini-implants for orthognathic treatments, (d) limitations and possible complications. In conclusion, mini-implant evolved the orthodontic treatment plans and compromised the required orthognathic surgery. Malocclusion treatment and pure orthodontic or orthopedic movements in the three-dimensions have become recently possible by using mini-implant to provide skeletal anchorage.
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Affiliation(s)
- Saeid Nosouhian
- Assistant Professor, Dental Implants Research Center and Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Rismanchian
- Associate Professor, Department of Prosthodontics, Dental Implants Research Center and Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Sabzian
- Dentistry Student, Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Shadmehr
- Assistant Professor, Torabinejad Research Center and Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Badrian
- Post-graduate Student, Department of Operative Dentistry, Dental School, Shahid Sadoughi University of Medical sciences, Yazd, Iran
| | - Amin Davoudi
- Dentistry Student, Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence: Davoudi A, Dental Implant Research Center, Hezarjarib Street, Isfahan, Iran. Phone: +959132949318.
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