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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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Chhatwani S, Kouji-Diehl O, Kniha K, Modabber A, Hölzle F, Szalma J, Danesh G, Möhlhenrich SC. Significance of bone morphology and quality on the primary stability of orthodontic mini-implants: in vitro comparison between human bone substitute and artificial bone. J Orofac Orthop 2023; 84:362-372. [PMID: 35304617 PMCID: PMC10587204 DOI: 10.1007/s00056-022-00385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 01/17/2022] [Indexed: 11/27/2022]
Abstract
AIM This study evaluated artificial bone models against a human bone substitute to assess the primary stability of orthodontic mini-implants (OMIs) at varying implant sites with different morphologies and qualities. MATERIALS AND METHODS A total of 1200 OMI placements of four types were inserted into four artificial bone models of different density (D1, D2, D3, D4) and into a human bone substitute (HB). The implants varied in diameter (2.0 and 2.3 mm) and length (9 and 11 mm). Each specimen had four implant sites: no defect, one-wall defect, three-wall defect, and circular defect. The implant stability quotient (ISQ) values were measured using resonance frequency analysis (RFA) and insertion placement torque values (IPT) were assessed for primary stability. Correlation analysis was performed to evaluate the different models. RESULTS The highest IPT value was registered for the 2.0 mm × 11 mm implant inserted into D1 with no defect (37.53 ± 3.02 Ncm). The lowest ISQ value was measured for the 2.3 mm × 9 mm OMI inserted into D3 with a circular defect (12.33 ± 5.88) and the highest for the 2.3 mm × 9 mm implant inserted into HB with no defect (63.23 ± 2.57). A strong correlation (r = 0.64) for IPT values and a very strong correlation (r = 0.8) for ISQ values was found between D2 and HB. CONCLUSION Bone defects and bone quality affected the primary stability of implants in terms of ISQ and IPT values. Results for bone model D2 correlated very well with the HB substitution material.
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Affiliation(s)
- Sachin Chhatwani
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany.
| | - Ouafaa Kouji-Diehl
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jozsef Szalma
- Department of Oral and Maxillofacial Surgery, University of Pecs, Dischka Győző str. 5, 7621, Pecs, Hungary
| | - Gholamreza Danesh
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
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Ferrillo M, Nucci L, Gallo V, Bruni A, Montrella R, Fortunato L, Giudice A, Perillo L. Temporary anchorage devices in orthodontics: a bibliometric analysis of the 50 most-cited articles from 2012 to 2022. Angle Orthod 2023; 93:591-602. [PMID: 37200455 PMCID: PMC10575636 DOI: 10.2319/010923-18.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To identify and analyze the 50 most cited articles on temporary anchorage devices (TADs) and investigate the achievement and development of scientific research about the topic through a bibliometric analysis. MATERIALS AND METHODS On August 22, 2022, a computerized database search was performed to detect papers published in the scientific literature about TADs from 2012 to 2022. Metrics data were identified using the Incites Journal Citation Reports (Clarivate Analytics) data set. The Scopus database was used to obtain information on the authors' affiliations, country of origin, and h-index. Key words were automatically harvested from the selected articles to implement the visualized analysis. RESULTS From a total of 1858 papers screened by searching the database, a list of the top 50 most cited articles was created. The total number of citations collected by the 50 most cited articles in TADs was 2380. Among the 50 most cited articles on TADs, 38 were original research papers (76.0%) and 12 were reviews (24.0%). As shown by the key word-network analysis, Orthodontic anchorage procedure was identified as the larger node. CONCLUSIONS Findings of this bibliometric study showed an increasing number of citations for papers on TADs, accompanied by a simultaneous rise in scientific interest in this topic in the past decade. The present work identifies the most influential articles, emphasizing the journals, the authors, and the topics addressed.
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Affiliation(s)
- Martina Ferrillo
- Corresponding author: Dr Martina Ferrillo, Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia,” Viale Europa, 88100 Catanzaro, Italy (e-mail: )
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Zheng DH, Hou FC, Zang YJ, Li B. Effects of low-level laser therapy on orthodontic miniscrew stability: a systematic review. Eur J Med Res 2023; 28:50. [PMID: 36707888 PMCID: PMC9881366 DOI: 10.1186/s40001-023-01010-z] [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: 10/03/2021] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Miniscrews as auxiliary anchorage devices in orthodontic treatment have definite advantages and efficacy. The aim of the present study was to investigate the scientific evidence including randomized controlled trials (RCTs) or controlled clinical trials (CCTs) to support the application of low-level laser therapy to improve miniscrews stability in orthodontic treatment. METHODS An extensive literature research was conducted with the Cochrane Library, PubMed, EMBASE, Web of Science and ScienceDirect without language limitations. All searches were inclusive until June 2020. The Cochrane Risk of Bias Tool was used to assess the risk of bias (RoB) in the included RCTs. RESULTS Through the electronic searches, 428 titles and abstracts were identified. From these, 4 articles were retrieved for review, and 3 of these met the inclusion criteria. Two RCTs reported increased miniscrews stability with low-intensity laser therapy, but the other one reported no difference. Except one study assessed as "high risk of bias" the other two were rated as "low risk of bias". CONCLUSION There is insufficient evidence to support or refute the effectiveness of LLLT for improvement of miniscrew stability. Further studies with a better study design, reliable evaluation method, comprehensive evaluation intervals and appropriate loading protocol are required to provide more reliable evidence for the clinical application of LLLT.
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Affiliation(s)
- De-Hua Zheng
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Feng-Chun Hou
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Yan-Jun Zang
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Bing Li
- grid.410645.20000 0001 0455 0905Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, China ,grid.412521.10000 0004 1769 1119Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China ,No. 306, Ningxia Road, Shinan District, Qingdao, 266000 Shandong China
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Wilmes B, Drescher D. CAD-CAM workflows for palatal TAD anchored appliances. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Chang CH, Lin JH, Roberts WE. Success of infrazygomatic crest bone screws: patient age, insertion angle, sinus penetration, and terminal insertion torque. Am J Orthod Dentofacial Orthop 2022; 161:783-790. [DOI: 10.1016/j.ajodo.2021.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/01/2022]
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Nenen F, Garnica N, Rojas V, Oyonarte R. Comparison of the primary stability of orthodontic miniscrews after repeated insertion cycles. Angle Orthod 2021; 91:336-342. [PMID: 33378455 DOI: 10.2319/050120-375.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To compare the primary stability of miniscrews after repeated cycles of insertion through insertion torque (IT) measurements and resonance frequency analysis (RFA). MATERIALS AND METHODS Sixty titanium miniscrews were divided into two groups according to the insertion protocol: one with predrilled sites and the other self-drilled into porcine iliac crest bone specimens. Each group had three cycles of reinsertion. After each insertion, the IT and RFA were measured. The IT was measured by using a torque meter, and the RFA was measured using the Osstell ISQ device. A total of five miniscrews of each group were selected for sequential assessment of the morphology of their tip and threads using scanning electron microscopy after each insertion cycle. RESULTS No statistically significant differences were found in the IT values of miniscrews reinserted up to three times in the group with predrilled surgical sites. The IT value increased significantly with the number of reinsertions in the self-drilled group. The RFA value decreased as the number of insertions increased in both groups. CONCLUSIONS Under the conditions of this in vitro study, reinserting miniscrews deteriorates the integrity of their tip and thread. Reinsertion should be discouraged particularly when insertion sites are not predrilled.
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Costa ACDF, Maia TAC, de Barros Silva PG, Abreu LG, Gondim DV, Santos PCF. Effects of low-level laser therapy on the orthodontic mini-implants stability: a systematic review and meta-analysis. Prog Orthod 2021; 22:6. [PMID: 33586080 PMCID: PMC7882650 DOI: 10.1186/s40510-021-00350-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this systematic review and meta-analysis was to assess the effects of low-level laser therapy (LLLT) on the orthodontic mini-implants (OMI) stability. Materials and methods An unrestricted electronic database search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, Google Scholar, and ClinicalTrials.gov and a hand search were performed up to December 2020. Randomized clinical trials (RCTs) or non-randomized clinical trials (Non-RCTs) that assessed the effects of LLLT on the OMI stability were included. Data regarding the general information, LLLT characteristics, and outcomes were extracted. The authors performed risk of bias assessment with Cochrane Collaboration’s or ROBINS-I tool. Meta-analysis was also conducted. Results Five RCTs and one Non-RCT were included and 108 patients were evaluated. The LLLT characteristics presented different wavelength, power, energy density, irradiation time, and protocol duration. Five RCTs had a low risk of selection bias. Two RCTs had a low risk of performance and detection bias. All RCTs had a low risk of attrition bias, reporting bias and other bias. The Non-RCT presented a low risk of bias for all criteria, except for the bias in selection of participants. The meta-analysis revealed that LLLT significantly increased the OMI stability (p < 0.001, Cohen’s d = 0.67) and the highest clinical benefit was showed after 1 (p < 0.001, Cohen’s d = 0.75), 2 (p < 0.001, Cohen’s d = 1.21), and 3 (p < 0.001, Cohen’s d = 1.51) months of OMI placement. Conclusions LLLT shows positive effects on the OMI stability. Supplementary Information The online version contains supplementary material available at 10.1186/s40510-021-00350-y.
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Affiliation(s)
- Ana Carolina de Figueiredo Costa
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Monsenhor Furtado Street, Rodolfo Teófilo, Fortaleza, Ceará, 60430-350, Brazil.
| | - Thays Allane Cordeiro Maia
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Monsenhor Furtado Street, Rodolfo Teófilo, Fortaleza, Ceará, 60430-350, Brazil
| | - Paulo Goberlânio de Barros Silva
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Monsenhor Furtado Street, Rodolfo Teófilo, Fortaleza, Ceará, 60430-350, Brazil
| | - Lucas Guimarães Abreu
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Delane Viana Gondim
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Monsenhor Furtado Street, Rodolfo Teófilo, Fortaleza, Ceará, 60430-350, Brazil.,Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Pedro César Fernandes Santos
- Department of Clinical Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Monsenhor Furtado Street, Rodolfo Teófilo, Fortaleza, Ceará, 60430-350, Brazil
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Pradhan SP, Nambiar S, Shetty S, Shetty S, Jose NP. Is gingival biotype a critical determinant of secondary stability of orthodontic mini-implants – A prospective clinical study using resonance frequency analysis. APOS TRENDS IN ORTHODONTICS 2020. [DOI: 10.25259/apos_105_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The objectives of the study were to determine the association of gingival biotype and secondary stability of orthodontic mini-implants using resonance frequency analysis.
Materials and Methods:
Twenty patients, each receiving two mini-implants, were divided into two groups; thick and thin gingival biotype based on the thickness of gingiva before mini-implant placement. Implant stability was assessed at the time of placement; at the 1st, 2nd, 3rd, and 4th month by resonance frequency analysis. Peri-implant soft-tissue conditions were also examined at each month till 4 months interval using periodontal indices.
Results:
Thick and thin gingival biotype groups showed statistically different implant stability quotient (ISQ). Mini-implants showing signs of failure consistently displayed lesser ISQ. Statistically significant difference was observed in the scores of peri-implant indices of failure and no failure group of mini-implants.
Conclusion:
Mini-implants in thin gingival biotype are more susceptible to failure and peri-implantitis compared to thick gingival biotype. Longitudinal assessment of mini-implant stability may help predict failure so as to avoid long duration and cost of orthodontic treatment.
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Affiliation(s)
- Sayali Prashant Pradhan
- Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India,
| | - Supriya Nambiar
- Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India,
| | - Shravan Shetty
- Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India,
| | - Siddarth Shetty
- Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India,
| | - Nidhin Philip Jose
- Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India,
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Tsatalis AE, Watanabe K, Mitchell B, Kim DG, Lee DJ, Zheng F, Kyung HM, Deguchi T. Mechanical and clinical evaluation of the effect of microscrew on root proximity and cortical bone thickness. Eur J Orthod 2020; 42:206-210. [PMID: 31075176 DOI: 10.1093/ejo/cjz017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND/OBJECTIVES Primary stability is required for successful use of microscrew. This study investigated correlations among biomechanical, morphological, and clinical values in relationship to root contact and different placement locations. MATERIALS/METHODS Thirty-three microscrews were placed between the molars (n = 18) or in the body of the mandible (n = 15) in three pigs. Insertion torque, Periotest, resonance frequency analysis (RFA), and static and dynamic stiffness were measured. Cone beam computed tomography was performed before and after the insertion of microscrews. Interproximal microscrews were divided into root contacted microscrews (n = 9) and non-root contact microscrews (n = 9). Factorial analysis of variance was conducted, with significance set at P < 0.05. RESULTS A significant difference was observed between bodily and root contacted microscrews in Periotest, RFA, static and dynamic stiffness, Tanδ, and bone density (RFA, P = 0.045; all others, P < 0.001). A significant difference was observed between bodily and non-root contact microscrews in Periotest, RFA, and bone density (RFA, P = 0.025; all others, P < 0.001). A significant difference was observed in static (P = 0.01) and dynamic (P = 0.038) stiffness between microscrews with and without contact. Dynamic stiffness (P = 0.02) and Tanδ (P = 0.03) showed significant correlations with Periotest results only in bodily microscrews. LIMITATIONS Since a pig bone was used, some differences in the quality and quantity of the bone might be observed between humans. CONCLUSIONS/IMPLICATIONS Stiffness values distinguished between microscrews with and without contact. Periotest and RFA results indicated that bodily microscrews were more stable than interproximal microscrews. Periotest and RFA may be useful with large, microscrews and/or in thick cortical bone, but further investigation is required to determine the stability of interproximal microscrews.
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Affiliation(s)
| | - Keiichiro Watanabe
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus
| | | | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus
| | - Damian J Lee
- Division of Restorative Sciences and Prosthodontics, College of Dentistry, The Ohio State University Columbus, Columbus, USA
| | - Fengyuan Zheng
- Division of Restorative Sciences and Prosthodontics, College of Dentistry, The Ohio State University Columbus, Columbus, USA
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus
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Nienkemper M, Willmann JH, Drescher D. Long-term stability behavior of paramedian palatal mini-implants: A repeated cross-sectional study. Am J Orthod Dentofacial Orthop 2020; 157:165-171. [PMID: 32005467 DOI: 10.1016/j.ajodo.2019.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/01/2019] [Accepted: 01/01/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The initial stability of orthodontic mini-implants is well investigated over a period of 6 weeks. There is no clinical data available dealing with the long-term stability. The aim of this study was the assessment of long-term stability of paramedian palatal mini-implants in humans. METHODS Stability of 20 implants was measured after removal of the orthodontic appliance (sliding mechanics for sagittal molar movement 200 cN each side) before explantation (T4) using resonance frequency analysis (RFA). Data were compared with a matched group of 21 mini-implants assessing the stability immediately after insertion, and after 2, 4, and 6 weeks (T0-T3). The mini-implants used in this study were machined self-drilling titanium implants (2.0 × 9.0 mm). Gingival thickness at the insertion site was 1-2 mm. RESULTS The implant stability quotient (ISQ) values before removal of the implant at T4 were 25.2 ± 2.9 after 1.7 ± 0.2 years and did not show a statistically significant change over time compared with the initial healing group (T0-T3). CONCLUSIONS Comparing the stability of mini-implants just after completion of the healing period and at the end of their respective usage period revealed no significant difference. An increase of secondary stability could not be detected. The level of stability seemed to be appropriate for orthodontic anchorage.
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Affiliation(s)
- Manuel Nienkemper
- Private practice, Düsseldorf, Germany; Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany
| | - Jan H Willmann
- Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany.
| | - Dieter Drescher
- Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany
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Nienkemper M, Willmann JH, Becker K, Drescher D. RFA measurements of survival midpalatal orthodontic mini-implants in comparison to initial healing period. Prog Orthod 2020; 21:5. [PMID: 32064547 PMCID: PMC7024683 DOI: 10.1186/s40510-020-0305-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background In dental implantology, the development of stability over time is a well-investigated topic. In case of orthodontic mini-implants, quantitative data for long-term stability is not available yet. This study aims to clinically investigate the long-term stability of mini-implants inserted in the midsagittal suture of the anterior palate. Moreover, the influence of the length of implants was elucidated. The stability of 2 × 9 and 2 × 11 mm mini-implants after orthodontic treatment (9 mm, 2.84 years ± 1.25 years; 11 mm, 3.17 years ± 0.96 years) was assessed by resonance frequency analysis (RFA). The obtained long-term pieces of data were compared with each other (9 mm vs 11 mm), as well as with the data from the matched early stability groups, to assess the initial and early secondary stability after the insertion from previous clinical trials. Results For both lengths, the long-term stability (2 × 9 mm, 25.12 ± 7.11, n = 21; 2 × 11 mm, 24.39 ± 5.82, n = 18) was significantly lower than primary stability (2 × 9 mm, 36.14 ± 6.08, n = 19; 2 × 11 mm, 33.35 ± 3.53, n = 20). The differences within the groups disappeared over the initial healing period: after 4 weeks for the 2 × 9 mm implants and after 2 weeks for the 2 × 11 mm implants. Also, the 2 × 9 mm and 2 × 11 mm implants showed comparable long-term stability values. Conclusion The stability of midpalatal mini-implants does not change in the long term after the initial healing period. Moreover, 2 × 9 mm mini-implants seem to be appropriate for orthodontic anchorage, as the stability of 2 × 11 mm implants is not higher. Therefore, owing to lower invasiveness, 2 × 9 mm implants should be preferred.
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Affiliation(s)
- Manuel Nienkemper
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany.,Private Practice, Düsseldorf, Germany
| | - Jan H Willmann
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany.
| | - Kathrin Becker
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany
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Han CM, Watanabe K, Tsatalis AE, Lee D, Zheng F, Kyung HM, Deguchi T, Kim DG. Evaluations of miniscrew type-dependent mechanical stability. Clin Biomech (Bristol, Avon) 2019; 69:21-27. [PMID: 31280063 DOI: 10.1016/j.clinbiomech.2019.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/13/2019] [Accepted: 06/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Miniscrew has been widely used as an absolute anchorage in orthodontic treatment. Types of miniscrew with different diameter, length, shape, and thread dimensions may have a substantial effect on mechanical stability of the miniscrew system. Thus, the objective of this study was to evaluate miniscrew type-dependent mechanical stability to assess mechanical properties of miniscrew systems in various thickness of artificial bone block using different measurement tools. METHODS Two types of miniscrews (15 Tomas and 15 AbsoAnchor) were placed in artificial bone block with different thickness of 1.5, 2.0, 3.0 mm. Values of maximum insertion torque, removal torque, Periotest, implant stability quotient, static stiffness, dynamic stiffness, and energy dissipation ability were assessed for each miniscrew system. FINDINGS The maximum insertion torque, removal torque, implant stability quotient, static and dynamic stiffness values significantly increased when the miniscrews were placed in thicker bone block while Periotest values decreased. The static stiffness, Periotest and implant stability quotient values were significantly correlated each other and also with other mechanical properties (p < 0.001) except tan δ (p > 0.35). However, the slopes of some correlations and absolute values of measurement were significantly different dependent on the miniscrew types (p < 0.025). INTERPRETATION The current findings suggest that miniscrew type-dependent calibrations are required to estimate mechanical stability of the miniscrew systems despite the utilization of same measurement tool.
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Affiliation(s)
- Cheol-Min Han
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Keiichiro Watanabe
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Andrea E Tsatalis
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Damian Lee
- Division of Restorative and Prosthetic dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Fengyuan Zheng
- Division of Restorative and Prosthetic dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
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14
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Möhlhenrich SC, Heussen N, Winterhalder P, Prescher A, Hölzle F, Modabber A, Wolf M, Kniha K. Predicting primary stability of orthodontic mini‐implants, according to position, screw‐size, and bone quality, in the maxilla of aged patients: a cadaveric study. Eur J Oral Sci 2019; 127:462-471. [DOI: 10.1111/eos.12651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nicole Heussen
- Department of Medical Statistics University Hospital of the RWTH Aachen Aachen Germany
- Center of Biostatistics and Epidemiology Medical School Sigmund Freud University Vienna Vienna Austria
| | - Philipp Winterhalder
- Department of Oral and Maxillofacial Surgery University Hospital of the RWTH Aachen AachenGermany
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy Medical Faculty of RWTH‐Aachen Aachen Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery University Hospital of the RWTH Aachen AachenGermany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery University Hospital of the RWTH Aachen AachenGermany
| | - Michael Wolf
- Department of Orthodontics University Hospital of the RWTH Aachen AachenGermany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery University Hospital of the RWTH Aachen AachenGermany
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15
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Romanos GE, Bastardi DJ, Kakar A, Moore R, Delgado-Ruiz RA, Javed F. In vitro comparison of resonance frequency analysis devices to evaluate implant stability of narrow diameter implants at varying drilling speeds in dense artificial bone blocks. Clin Implant Dent Relat Res 2019; 21:1023-1027. [PMID: 31464362 DOI: 10.1111/cid.12842] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/12/2019] [Accepted: 08/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND There are no studies that have assessed the implant stability quotient (ISQ) values of narrow diameter implants placed in artificial dense bone blocks at varying drilling speeds (DSs). PURPOSE The aim of the present in vitro experiment was to compare the performance of OSSTELL and Penguin devices to evaluate implant stability at DSs of 800 and 2000 rpm. MATERIALS AND METHODS A total of 360 osteotomies were created in dense artificial bone blocks at DSs of 800 and 2000 rpm. Dental implants from three manufacturers (group-1: NobelActive implants, Nobel Biocare, Yorba Linda, California; group-2: Zimmer, Eztetic-Zimmer implants, Zimmer Biomet Dental, Palm Beach Gardens, Florida; and group-3: Astra Tech implant system, Dentsply Sirona, York, Pennsylvania) were randomly placed in these osteotomies using an insertion torque of 15 Ncm (60 implants/group). Implant stability in all bone blocks immediately following implant placement was evaluated using the OSSTELL and Penguin devices. ISQ values were presented as means ± SD. Statistical significance was set at P < .05. RESULTS There was no significant difference in the ISQ values obtained from the OSSTELL and Penguin devices for implants in groups 1, 2, and 3. There was no significant difference when ISQ values obtained from the OSSTELL device were compared with the Penguin device for narrow diameter dental implants placed in dense bone blocks with osteotomies performed at 800 and 2000 rpm. ISQ values showed statistically significant higher values for OSSTELL compared to Penguin device. CONCLUSION The OSSTELL and Penguin devices are reliable for the assessment of implant stability in dense artificial bone. Implant design and site-DS does not seem to have a significant impact of implant stability in artificial dense bone blocks.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York.,Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Daniel J Bastardi
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Apoorv Kakar
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Rachel Moore
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Rafael A Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Fawad Javed
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York.,Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
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16
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Hosein YK, Dixon SJ, Rizkalla AS, Tassi A. A novel technique for measurement of orthodontic mini-implant stability using the Osstell ISQ device. Angle Orthod 2018; 89:284-291. [PMID: 30382751 DOI: 10.2319/011518-46.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To develop and validate a method for application of the Osstell ISQ device in the assessment of mini-implant stability. MATERIALS AND METHODS An adaptor was developed for attachment of Osstell's SmartPeg onto a variety of orthodontic mini-implants. For validation of the adaptor, Benefit mini-implants were inserted into bone blocks that mimicked different stability conditions. The Osstell device was used to assess mini-implant stability with the adaptor (test measurement) and conventional SmartPeg attachment (gold-standard measurement). Implant stability quotient (ISQ) values were assessed for agreement, repeatability, and reproducibility. RESULTS Strong positive correlations were found between ISQ values obtained using the novel adaptor and the conventional attachment. Repeatability and reproducibility of ISQ values with the adaptor were similar to those obtained with the conventional attachment. CONCLUSIONS A method was developed and validated to assess the stability of orthodontic mini-implants using the Osstell system. The novel mini-implant adaptor provided repeatable and reproducible measurements of mini-implant stability, which agreed with those obtained using a conventional SmartPeg attachment. This adaptor permits noninvasive stability assessment of various designs of mini-implants, most of which are incompatible with the conventional SmartPeg attachment.
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17
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Farkasdi S, Pammer D, Rácz R, Hriczó-Koperdák G, Szabó BT, Dobó-Nagy C, Kerémi B, Blazsek J, Cuisinier F, Wu G, Varga G. Development of a quantitative preclinical screening model for implant osseointegration in rat tail vertebra. Clin Oral Investig 2018; 23:2959-2973. [PMID: 30374828 PMCID: PMC7398390 DOI: 10.1007/s00784-018-2661-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/25/2018] [Indexed: 11/24/2022]
Abstract
Objectives Functional tooth replacement and bone regeneration are parts of the daily practice in modern dentistry, but well-reproducible and relatively inexpensive experimental models are still missing. We aimed to develop a new small animal model to monitor osseointegration utilizing the combination of multiple evaluation protocols. Material and methods After cutting the tail between the C4 and C5 vertebrae in Wistar rats, costume made, parallel walled, non-threaded implants were placed into the center of the tail parallel with its longitudinal axis using a surgical guide. Osseointegration of the titanium implants was followed between 4 and 16 weeks after surgery applying axial extraction force, and resonance frequency analysis as functional tests, and histomorphometry and micro-CT as structural evaluations. Results In functional tests, we observed that both methods are suitable for the detection of the time-dependent increase in osseointegration, but the sensitivity of the pull-out technique (an approximately five times increase with rather low standard error) was much higher than that of the resonance frequency analysis. In structural evaluations, changes in the detected bone implant contact values measured by histomorphometry (yielding 1.5 times increase, with low variations of data) were more reliable than micro-CT based evaluations to screen the developments of contact between bone and implant. Conclusion Our results provide evidence that the caudal vertebrae osseointegration model is useful for the preclinical evaluation of implant integration into the bone. Clinical relevance The combination of the biomechanical and structural tests offers a well-reproducible small animal system that can be suitable for studying the integration of various implant materials and surface treatments.
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Affiliation(s)
- Sándor Farkasdi
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Dávid Pammer
- Department of Materials Science and Engineering, Budapest University of Technology and Economics, Budapest, Hungary
| | - Róbert Rácz
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Gergely Hriczó-Koperdák
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - József Blazsek
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Frederic Cuisinier
- Laboratoire Bioingénierie et Nanosciences EA4203, Université Montpellier, Montpellier, France
| | - Gang Wu
- Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije University Amsterdam and University of Amsterdam, Amsterdam, The Netherlands
| | - Gábor Varga
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary.
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18
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Tseng YC, Pan CY, Liu PH, Yang YH, Chang HP, Chen CM. Resonance frequency analysis of miniscrew implant stability. J Oral Sci 2018; 60:64-69. [PMID: 29576579 DOI: 10.2334/josnusd.16-0613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study used resonance frequency (RF) analysis to assess miniscrew implant (MSI) stability during wound healing in a sample of 68 patients (41 women, 27 men; mean age, 27.7 years). The 104 MSIs included 66 placements in the buccal shelf (BS; 2.0 × 12 mm) and 38 placements in interradicular (IR; 1.5 × 8 mm) sites. Thirteen (12.5%) of the MSIs failed. A new RF detection device was used to measure RF at baseline (T0) and at 3 (T1), 6 (T2), 9 (T3), 12 (T4), and 15 (T5) weeks after placement. A linear mixed-effects model was fitted to change in RF values. As compared with the BS group, the IR group had significantly lower RF values on the right side from T0 through T4 and on the left side from T0 through T2. Insertion site and time of visit were significantly associated with RF value. The effects of time of visit significantly differed between the BS and IR sites. Starting from T0, the MSIs placed at both sites had significantly lower RF values at all intervals, except for T0-T1. Future studies should examine how the present clinical protocols can optimize timing of MSI loading to maximize the success rate.
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Affiliation(s)
- Yu-Chuan Tseng
- School of Dentistry and Graduate Program of Dental Science, Kaohsiung Medical University.,Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital
| | - Chin-Yun Pan
- School of Dentistry and Graduate Program of Dental Science, Kaohsiung Medical University.,Department of Orthodontics, Dental Clinics, Kaohsiung Medical University Hospital
| | - Pao-Hsin Liu
- Department of Biomedical Engineering, College of Medicine, I-Shou University
| | - Yi-Hsin Yang
- Medical Informatics and Statistics Center, Research and Development Office, Kaohsiung Medical University.,Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital
| | - Hong-Po Chang
- School of Dentistry and Graduate Program of Dental Science, Kaohsiung Medical University.,Department of Dentistry (Orthodontics), Kaohsiung Municipal Hsiao-Kang Hospital
| | - Chun-Ming Chen
- School of Dentistry and Graduate Program of Dental Science, Kaohsiung Medical University.,Department of Oral and Maxillofacial Surgery, Dental Clinics, Kaohsiung Medical University Hospital
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19
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Singh AK, Kannan S, Arora N, Bajaj Y, Revankar AV. Measurement of Primary Stability of Mini Implants Using Resonance Frequency Analysis. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_20_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction
In the last decade, anchorage control with mini-implants has gained enormous credibility in maintaining orthodontic anchorage. Resonance frequency analysis (RFA) has proven to be an adequate method to measure the stability of these mini-implants because of its non-invasiveness and contactless measurement method.
Materials and Method
Tomas and S.K surgical mini-implants were tested. For this purpose custom fabricated attachment was fabricated to attach the smart peg on orthodontic mini-implant head, and 45 mini-implants were inserted in fresh swine pelvic bone in the density matched sites to that of most common sites where mini-implants are placed in human mandible. Mini-implants of two different lengths with diameter constant were also placed to assess the effect of length on primary stability.
Results
The mean ISQ of Group 1 (Tomas 10 mm) was 55.53±3.39 while that of Group 2 (S.K Surgical 10mm) was 56.63±3.48 and that of Group 3(S.K Surgical 8 mm) was 55.90±3.48. Difference among the groups were not statistically significant when ANOVA test was used (P >0.05).
Conclusion
The resonance frequency analysis is applicable to comparatively assess the primary stability of orthodontic mini-implants. There was no difference in primary stability of Tomas and S.K Surgical mini-implant and primary stability was not affected by the length of the mini-implant.
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Affiliation(s)
- Ashish Kumar Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Faridabad, India
| | - Sridhar Kannan
- Department of Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Faridabad, India
| | - Nitin Arora
- Department of Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Faridabad, India
| | - Yatin Bajaj
- Private Orthodontics Practice, Faridabad, Haryana, India
| | - Ameet V. Revankar
- Department of Orthodontics and Dentofacial Orthopedics, SDM College of Dental Sciences, Dharwad, India
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20
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Abohabib AM, Fayed MM, Labib AH. Effects of low-intensity laser therapy on the stability of orthodontic mini-implants: a randomised controlled clinical trial. J Orthod 2018; 45:149-156. [PMID: 29874972 DOI: 10.1080/14653125.2018.1481710] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To investigate the effect of low-intensity laser therapy on mini-implant stability using resonance frequency analysis during canine retraction with fixed appliances. DESIGN A split-mouth randomised clinical trial. SETTING Subjects were recruited and treated in the outpatient clinic, Department of Orthodontics, Faculty of Dentistry, Cairo University. PARTICIPANTS Fifteen subjects with mean age 20.9 (±3.4) years who required extraction of maxillary first premolar teeth and mini-implant-supported canine retraction. METHODS Thirty orthodontic mini-implants were inserted bilaterally in the maxillary arches of recruited subjects following alignment and levelling. Mini-implants were immediately loaded with a force of 150 g using nickel titanium coil springs with split-mouth randomisation to a low-intensity laser-treated side and control side. The experimental sides were exposed to low-intensity laser therapy from a diode laser with a wavelength of 940 nm at (0, 7, 14, 21 days) after mini-implant placement. Mini-implant stability was measured using resonance frequency analysis at (0, 1, 2, 3, 4, 6, 8, 10 weeks) after implant placement. RESULTS A total sample of 28 mini-implants were investigated with 14 in each group. Clinically, both mini-implant groups had the same overall success rate of 78.5%. There were no significant differences in resonance frequency scores between low-intensity laser and control sides from baseline to week 2. However, from week 3 to 10, the low-intensity laser sides showed significantly increased mean resonance frequency values compared to control (P > 0.05). CONCLUSIONS Despite evidence of some significant differences in resonance frequency between mini-implants exposed to low-intensity laser light over a 10 weeks period there were no differences in mini-implant stability. Low-intensity laser light cannot be recommended as a clinically useful adjunct to promoting mini-implant stability during canine retraction.
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Affiliation(s)
| | - Mona Mohamed Fayed
- b Department of Orthodontics, Faculty of Dentistry , Cairo University , Cairo , Egypt.,c Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry , University of Malaya , Kuala Lumpur , Malaysia
| | - Amr H Labib
- b Department of Orthodontics, Faculty of Dentistry , Cairo University , Cairo , Egypt
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21
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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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22
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Hosein YK, Dixon SJ, Rizkalla AS, Tassi A. A Comparison of the Mechanical Measures Used for Assessing Orthodontic Mini-Implant Stability. IMPLANT DENT 2016; 26:225-231. [PMID: 27918313 DOI: 10.1097/id.0000000000000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Mechanical loosening remains a common complication associated with mini-implant failure. The purpose of this study was to compare common mechanical measures of mini-implant stability to determine their association and reliability. MATERIALS AND METHODS Ninety self-drilling orthodontic mini-implants from 6 manufacturers were inserted into artificial bone blocks. Insertion torques (ITs) and Periotest values (PVs) were measured. Subsequently, mini-implants underwent pull-out testing for measures of pull-out load (POL) and screw displacement (ScrD). Stability measurements were compared using one-way ANOVA, associations among them were assessed using correlation analyses, and reliability was evaluated using coefficients of variation (COVs). RESULTS Variations in stability of mini-implants were found, specific to the mechanical measure used for assessment (P < 0.05). The strongest correlations were found between IT and PV (r = -0.68) and between IT and POL (r = 0.66). Overall, PV showed the greatest variability (COV: 11%-100%) compared with IT (≤11%), POL (≤4%), and ScrD (≤19%). CONCLUSIONS IT, PV, and POLs only agreed moderately in their assessment of mini-implant stability, and Periotest showed the least reliability in predicting mini-implant stability. As such, independent and interchangeable use of these stability measures should be avoided.
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Affiliation(s)
- Yara K Hosein
- *Postdoctoral Fellow, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry; Bone and Joint Institute; Western University, London, Ontario, Canada. †Distinguished University Professor, Division of Graduate Orthodontics, Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry; Bone and Joint Institute; Western University, London, Ontario, Canada. ‡Professor, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry; Department of Chemical and Biochemical Engineering, Faculty of Engineering; Bone and Joint Institute; Western University, London, Ontario, Canada. §Assistant Professor, Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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23
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Seifi M, Matini NS. Evaluation of primary stability of innovated orthodontic miniscrew system (STS): An ex-vivo study. J Clin Exp Dent 2016; 8:e255-9. [PMID: 27398174 PMCID: PMC4930633 DOI: 10.4317/jced.52676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 03/12/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Stability is determined as one of the requirements in use of Temporary Anchorage Devices (TAD) in orthodontics. Miniscrew has been a widely used Bone Anchor. Compared with mini-implant that necessitates osseointegration; mechanical retention is a determining factor for primary stability of miniscrew. Studies investigated various ways to increase primary stability. The aim of this study is to introduce a new configuration of miniscrew system which is believed to obtain more primary stability. MATERIAL AND METHODS Freshly ovine mandibles were cut in blocks. Twenty-seven miniscrews (diameter 1.6 × 8 mm; G2, Dual Top Anchor System, Jeil Medical, Seoul, Korea) were inserted in the blocks and divided in 2 experimental groups: single miniscrew and the innovated design "Seifi Twin Screw (STS)". Primary stability was evaluated by Periotest "M"® device. RESULTS Independent t-test showed a significant difference between 2 experimental groups in periotest evaluation (p< 0.05). STS demonstrated higher primary stability due to its mechanical configuration and design. CONCLUSIONS The STS provides higher primary stability and was found to be effective in increased success rate of miniscrew systems from the standpoint of primary stability. KEY WORDS Anchorage procedures, anchorage techniques, orthodontic anchorage procedures, miniscrews, temporary anchorage device.
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Affiliation(s)
- Massoud Seifi
- DDS, MSD, MS Med Edu. Dentofacial Deformities Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin-Sadat Matini
- DDS. Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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24
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Nienkemper M, Santel N, Hönscheid R, Drescher D. Orthodontic mini-implant stability at different insertion depths : Sensitivity of three stability measurement methods. J Orofac Orthop 2016; 77:296-303. [PMID: 27272055 DOI: 10.1007/s00056-016-0036-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/30/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this work was to evaluate the influence of insertion depth on the stability of orthodontic mini-implants. Sensitivity of three different methods to measure implant stability based on differences in insertion depth were determined. METHODS A total of 82 mini-implants (2 × 9 mm) were inserted into pelvic bone of Swabian Hall pigs. Each implant was inserted stepwise to depths of 4, 5, 6, 7, and 8 mm. At each of these depths, three different methods were used to measure implant stability, including maximum insertion torque (MIT), resonance frequency analysis (RFA), and Periotest(®). Differences between the recorded values were statistically analyzed and the methods tested for correlations. RESULTS Almost linear changes from each insertion depth were measured with the values of RFA [implant stability quotient (ISQ) values range from 1-100], which increased from 6.95 ± 2.85 ISQ at 4 mm to 34.63 ± 5.51 ISQ at 8 mm, and with those of Periotest(®) [periotest values (PTV) range from -8 to 50], which decreased from 13.24 ± 4.03 PTV to -2.89 ± 1.87 PTV. Both methods were found to record highly significant (p < 0.0001) changes for each additional millimeter of insertion depth. The MIT increased significantly (p < 0.0001) from 153.67 ± 69.32 Nmm to 261 ± 103.73 Nmm between 4 and 5 mm of insertion depth but no further significant changes were observed as the implants were driven deeper. The RFA and Periotest(®) values were highly correlated (r = -0.907). CONCLUSIONS Mini-implant stability varies significantly with insertion depth. The RFA and the Periotest(®) yielded a linear relationship between stability and insertion depth. MIT does not appear to be an adequate method to determine implant stability based on insertion depth.
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Affiliation(s)
- Manuel Nienkemper
- Department of Orthodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - Natascha Santel
- Department of Orthodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Ralf Hönscheid
- Department of Orthodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, Heinrich-Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
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Migliorati M, Drago S, Barberis F, Schiavetti I, Dalessandri D, Benedicenti S, Biavati AS. Torque Loss After Miniscrew Placement: An In-Vitro Study Followed by a Clinical Trial. Open Dent J 2016; 10:251-60. [PMID: 27386011 PMCID: PMC4911753 DOI: 10.2174/1874210601610010251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 12/18/2022] Open
Abstract
To evaluate torque loss a week after insertion, both in an in vivo and an in vitro experimental setup were designed. In the in vivo setup a total of 29 miniscrews were placed in 20 patients who underwent orthodontic treatment. Maximum insertion torque (MIT) was evaluated at insertion time (T1). A week later, insertion torque was measured again by applying a quarter turn (T2); no load was applied on the screw during the first week. In the in vitro setup a total of 20 miniscrews were placed in pig rib bone samples. MIT was evaluated at insertion time (T1). Bone samples were kept in saline solution and controlled environment for a week during which the solution was refreshed every day. Afterwards, torque was measured again by applying a quarter turn (T2). The comparison of MIT over time was done calculating the percentage difference of the torque values between pre- and post-treatment and using the parametric two independent samples t-test or the non-parametric Mann–Whitney test. After a week unloaded miniscrews showed a mean loss of rotational torque of 36.3% and 40.9% in in vitro and in in vivo conditions, respectively. No statistical differences were found between the two different setups. Torque loss was observed after the first week in both study models; in vitro experimental setup provided a reliable study model for studying torque variation during the first week after insertion.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Sara Drago
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering (DICCA), University of Genova, Via Montallegro 1, 16145 Genova, Italy
| | - Irene Schiavetti
- Department of Health Sciences (DISSAL), University of Genova, Via Pastore 1, 16132 Genova, Italy
| | - Domenico Dalessandri
- Department of Orthodontics, School of Dentistry, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Integrated Sciences, University of Genova, Largo Benzi 8, 16132 Genova, Italy
| | - Armando Silvestrini Biavati
- Department of Orthodontics, School of Dentistry, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
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Satwalekar P, Nalla S, Reddy R, Chowdary SG. Clinical evaluation of osseointegration using resonance frequency analysis. J Indian Prosthodont Soc 2016; 15:192-9. [PMID: 26929512 PMCID: PMC4762340 DOI: 10.4103/0972-4052.165171] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The stability of the implant at the time of placement and during the development of the osseointegration process are the two major issues governing the implant survival. Implant stability is a mechanical phenomenon related to local factors such as bone quality, quantity, type of placement technique and type of implant used. The application of a user-friendly, clinically reliable, non-invasive method to assess implant stability and the osseointegration process is considered highly desirable. Resonance frequency analysis (RFA) is one such method which shows almost perfect reproducibility and repeatability after statistical analysis. The aim of this paper is to review the various methods used to assess implant stability and on the currently used RFA method which is being highly accepted in the recent times.
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Affiliation(s)
- Parth Satwalekar
- SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sandeep Nalla
- SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Ramaswamy Reddy
- SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Carney LO, Campbell PM, Spears R, Ceen RF, Melo AC, Buschang PH. Effects of pilot holes on longitudinal miniscrew stability and bony adaptation. Am J Orthod Dentofacial Orthop 2014; 146:554-64. [DOI: 10.1016/j.ajodo.2014.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/01/2014] [Accepted: 07/01/2014] [Indexed: 11/16/2022]
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Marquezan M, Mattos CT, Sant'Anna EF, de Souza MMG, Maia LC. Does cortical thickness influence the primary stability of miniscrews?: A systematic review and meta-analysis. Angle Orthod 2014; 84:1093-103. [PMID: 24694015 DOI: 10.2319/093013-716.1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate whether there is evidence to support the association between cortical thickness (CtTh) and the primary stability of mini-implants (MI). MATERIALS AND METHODS A search was performed including articles published until September 2013. The inclusion criteria comprised observational clinical studies conducted in patients who received monocortical MI for orthodontic anchorage and in vivo or ex vivo experimental studies performed to evaluate the primary stability of MI, studies that evaluated the association between CtTh and MI primary stability, CtTh measurement performed numerically, and MI primary stability evaluated by implant stability quotient value, Periotest value , pull-out strength, or insertion torque. Studies conducted exclusively in artificial bone or finite elements were excluded. RESULTS Abstract and title reading identified 15 possible articles to be included. After reading the complete text, three were excluded. One article was found by hand searching and another excluded for an overlapping sample. Finally, 12 articles were selected. A positive correlation was found between primary stability and CtTh when studies that evaluated primary stability through PS were grouped (r = .409) and when studies that evaluated stability in humans were grouped (r = .338). CONCLUSIONS There is a positive association between MI primary stability and CtTh of the receptor site. However, there is still a lack of well-designed clinical trials.
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Son S, Motoyoshi M, Uchida Y, Shimizu N. Comparative study of the primary stability of self-drilling and self-tapping orthodontic miniscrews. Am J Orthod Dentofacial Orthop 2014; 145:480-5. [DOI: 10.1016/j.ajodo.2013.12.020] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 12/01/2013] [Accepted: 12/01/2013] [Indexed: 11/24/2022]
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Nienkemper M, Pauls A, Ludwig B, Drescher D. Stability of paramedian inserted palatal mini-implants at the initial healing period: a controlled clinical study. Clin Oral Implants Res 2013; 26:870-875. [DOI: 10.1111/clr.12321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Manuel Nienkemper
- Department of Orthodontics; Heinrich-Heine-University; Düsseldorf Germany
| | | | | | - Dieter Drescher
- Department of Orthodontics; Heinrich-Heine-University; Düsseldorf Germany
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Nienkemper M, Wilmes B, Pauls A, Drescher D. Impact of mini-implant length on stability at the initial healing period: a controlled clinical study. Head Face Med 2013; 9:30. [PMID: 24382059 PMCID: PMC4029568 DOI: 10.1186/1746-160x-9-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 10/09/2013] [Indexed: 11/16/2022] Open
Abstract
Introduction Aim of the study was to assess the impact of the length of mini-implants inserted in the midpalatal region on the stability at the initial healing period. Methods A sample of 20 consecutively treated patients (15.6 ± 7.2 years) was examined. A long mini-implant with a length of 11 mm and a diameter of 2 mm was inserted into the anterior palate of each patient. Resonance frequency analysis (RFA) was performed after insertion (T0), two weeks (T1), four weeks (T2), and six weeks (T3). Insertion depth (ID) and the maximum insertion torque (IT) were measured. RFA, ID and IT data were tested for correlations. RFA values were tested for statistical differences between the different times. Data was compared to a matched control group of patients who received short mini-implants with a length of 9 mm and a diameter of 2 mm. Results Mean ID was 9.5 ± 0.6 mm and mean IT was 17.9 ± 3.8 Ncm. A correlation was found between RFA and ID (r = 0.59, P < .01). From T0 to T1 the stability (33.4 ± 3.5 ISQ) decreased highly significantly by 5.3 ± 3.5 ISQ values (P < .001) and significantly from T1 and T2 (P < .05) by 3.5 ± 3.7 ISQ values. From T2 on RFA nearly remained unchanged (−1.7 ± 3.9 ISQ; P > .05). At T1 stability was significantly lower than the control group. From T2 on there were no significant differences between the groups. Conclusions Long mini-implants provide high stability when inserted in the midpalatal region. After initial decrease RFA values remained stable from four weeks on and did not differ from the control group. Trial registration ID: 2013081293 (Clinical study register, University of Düsseldorf, Germany).
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Assessment of damping capacity as an index of root proximity in self-drilling orthodontic mini-implants. Clin Oral Investig 2013; 18:321-6. [PMID: 23519743 DOI: 10.1007/s00784-013-0965-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study aims to investigate orthodontic mini-implant root proximity, placement torque, and damping capacity and to determine whether placement torque and damping capacity (Periotest value (PTV)) are useful indices for the estimation of mini-implant root proximity. MATERIALS AND METHODS The root proximity of 143 orthodontic mini-implants (1.6 mm diameter, 8 mm screw thread length) was evaluated in 79 patients (24 males, 55 females; mean age, 22.5 ± 8 years) using cone-beam computed tomography. The placement torque and PTV of each implant were determined using a torque tester and the Periotest, respectively. Variability in these values according to root proximity was evaluated. RESULTS PTVs of mini-implants with multiple (two or more) points of contact between the root and implant were significantly larger than those of mini-implants with no root contact in the self-drilling group. Placement torque did not differ significantly according to root proximity. In the self-drilling group, the odds ratio for root contact was 20.82 (P = 0.000) for a PTV >6. CONCLUSIONS Placement torque could not be used to estimate root proximity. The PTV was significantly affected by root proximity in the self-drilling group. CLINICAL RELEVANCE A threshold of PTV >6 could be applied clinically for the estimation of self-drilling mini-implant root proximity.
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