Stability and success rate of dual-thread miniscrews

The Influence of the Diameter of Orthodontic Mini-Implants on Primary Stability: Bending Tests-An In Vitro Study

Orthodontic Mini-Implants have a high success rate, but it is crucial to assess the load that they bear in order to maintain their primary stability. Increasing the diameter can improve this stability, but there are limitations due to the proximity of the tooth roots. To avoid damage, smaller diameters are used, which can decrease resistance and cause permanent deformations.

OBJECTIVE

The objective of this study is to evaluate the influence of the diameter of Mini-Implants through bending force tests, taking into account primary stability after one and two insertions.

METHODS

Here, 40 Ti6AI4V alloy Mini-Implants of two different brands and diameters were divided into eight groups, half of which received one insertion in the artificial bone, and the rest received two. All were subjected to a constant bending force using an INSTRON-Electropuls E10000LT (Norwood, MA, USA) until fracture.

RESULTS

The smaller-diameter Mini-Implants were less resistant to fracture, but both were able to withstand the necessary loads produced by orthodontic movements. As for the inserts, there were no statistically significant differences.

CONCLUSIONS

There is an advantage to using 1.6 mm Mini-Implants over 2.0 mm ones, as a smaller diameter does not lead to fracture due to the forces used in orthodontic treatment. Having one or two inserts did not have a statistically significant effect.

Success rates of single-thread and double-thread orthodontic miniscrews in the maxillary arch

AIM

There is limited research on the clinical performance of double-thread orthodontic miniscrews. This study aimed to compare the stability of double-thread and single-thread orthodontic miniscrews and identify the potential associations between patient-related and location-related factors with miniscrew stability.

METHODS

This retrospective cohort study involved 90 orthodontic miniscrews (45 single-thread, 45 double-thread) with identical dimensions (8 mm length, 1.6 mm diameter). The screws were inserted in various locations within the upper jaw of 83 patients (54 females, 29 males; mean age = 15.1 ± 2.4 years). Failure was defined as excessive mobility or loss of miniscrew after placement. The data recorded were patient age, gender, insertion site, side of insertion (buccal or lingual), duration of force application, and failure occurrence.

RESULTS

The overall success rate within the sample was 92.2%. Double-thread miniscrews exhibited a significantly higher success rate than single-thread miniscrews (P = 0.049), with 97.8% and 86.7% success rates, respectively. Gender, age, insertion location, and side of insertion did not show significant associations with failure (P > 0.05). Log-rank analysis revealed a significant difference between the two groups (P = 0.046), indicating a higher probability of survival for the double-thread design.

CONCLUSIONS

The overall success rate of orthodontic miniscrews was high in the present sample. Double-thread miniscrews placed in various locations within the maxillary arch demonstrated superior stability and survival rates compared to their single-thread counterparts. Therefore, double-thread miniscrews may be preferred when bone quality is inadequate, such as in young patients.

The success rate of mini-screws for incisors intrusion and patient age, gender, and insertion angle in the maxilla using CBCT and implant-guided surgery. A split-mouth, randomized control trail

BACKGROUND AND OBJECTIVES

The intrusion of anterior teeth is a routine procedure in orthodontics, which has been performed efficiently with the help of mini-screws in the anterior region, especially the upper maxilla. This study aimed to investigate the effect of insertion angle and sociodemographic features on the success rate of mini-screws at the anterior maxillary region.

MATERIALS AND METHODS

Twenty-nine patients (18 Females and 11 Males) aged 18-40 years old were involved in the current study. A split-mouth design was carried out in which recruited patients needed bilateral anterior screws at the labial bone in the region of the incisor for the intrusion of upper anterior incisor teeth as part of their orthodontic treatment with a fixed appliance (upper right side received 90-degree insertion angle mini-screw and 45° for left side) using a surgical guide fabricated from patients CBCT and intraoral scans. The mini-screws were inserted at the attached gingiva bilaterally to achieve intrusion of upper anterior teeth with a power chain ligated from the main archwire to the anterior min-implants. The patient was recalled monthly for orthodontic appliance activation and screw assessment for 6 months. The intrusion force was 15 g on each side.

RESULTS

The results of the study showed that screw stability was higher in the male group than the female group at the 6th monthly follow-up visit with a statistically significant difference between both genders (P = .044). Concerning insertion angle, results showed a statistically significant difference between 45° and 90° as an insertion angle with a P-value <.01 in most of the follow-up months.

CONCLUSION

This study found that male patients with mini-screws inserted at 90° showed greater screw stability over time.

Comparative analysis of anchorage strength and histomorphometric changes after implantation of miniscrews in adults and adolescents: an experimental study in Beagles

OBJECTIVES

This study aimed to explore the differences in anchorage strength and histomorphometric changes in orthodontic miniscrews between adult and adolescent beagles.

MATERIAL AND METHOD

Six adult beagles and six young beagles were used as experimental subjects, and eight miniscrews were symmetrically placed in the posterior mandible of each dog. Measurement of the displacement (mm) of two adjacent miniscrews after load application was performed to compare the anchorage strength between the adult and adolescent groups. Three intravital bone fluorochromes (oxytetracycline, calcein green, xylenol orange) were administered postoperatively to mark the active bone-forming surface. Subsequently, the mineral apposition rate and bone-implant contact ratio were measured for dynamic and static histomorphometry. Finally, the expression levels of the RANKL/OPG ratio were evaluated by immunohistochemistry.

RESULTS

The average displacement of miniscrews in the adult group was significantly less than that in the adolescent group after load application. For histomorphometry analysis, the mineral exposure rate in the adolescent group was higher than that in the adult group with or without force application. In addition, more fractures and new bone formation but deceased bone-implant contact ratios were observed in the adolescent group than in the adult group. The ratio of RANKL/OPG expression increased more in the adolescent group than in the adult group.

CONCLUSION

Miniscrews do not remain in the same position as skeletal anchors, and the amount of displacement was higher in adolescent group than that in adult group, reflecting the weaker anchorage strength of miniscrews in adolescents due to the higher bone turnover rate and active bone remodelling. Therefore, it is feasible to apply orthodontic loading to the miniscrews in adult patients earlier, even immediately, but it is recommended to wait a period for the adolescents.

Revisiting the Complications of Orthodontic Miniscrew

Miniscrew has been used widely as an effective orthodontic anchorage with reliable stationary quality, ease of insertion and removal techniques, immediate or early loading, flexibility in site insertion, less trauma, minimal patient cooperation, and lower price. Nonetheless, it is not free of complications, and they could impact not only the miniscrew success rate but also patients’ oral health. In this article, literature was searched and reviewed electronically as well as manually to evaluate the complications of orthodontic miniscrew. The selected articles are analyzed and subcategorized into complications during and after insertion, under loading, and during and after removal along with treatment if needed according to the time. In addition, the noteworthy associated factors such as the insertion and removal procedures, characteristics of both regional and local anatomic structures, and features of the miniscrew itself that play a significant role in the performance of miniscrews are also discussed based on literature evidence. Clinicians should notice these complications and their related factors to make a proper treatment plan with better outcomes.

Mechanical stability of orthodontic miniscrew depends on a thread shape

Background/purpose

Primary stability of orthodontic miniscrew system is of great importance in maintaining stable anchorage during a treatment period. Thus, this study aimed to examine whether the thread shape of orthodontic miniscrew had an effect on its mechanical stability in bone.

Materials and methods

Three different types of miniscrews (type A and B with a regular thread shape; type C with a novel thread shape) were placed in artificial bone block with different artificial cortical bone thickness of 1.5, 2.0 and 3.0 mm. Values of maximum insertion torque (MIT), removal torque (RT), torque ratio (TR), screw mobility, static stiffness (K), dynamic stiffness (K∗) and energy dissipation (tan δ) ability were assessed for each miniscrew system.

Results

The MIT, RT, TR and K of type C miniscrew were significantly greater than those of type A and B miniscrews when the miniscrews were placed in the thinner artificial bone. Furthermore, the TR value of type C miniscrew was more than 1, indicating the MRT value was larger than the MIT value in the novel miniscrew. The values of K∗ and tan δ were almost similar among the three types of miniscrews.

Conclusion

The miniscrew with a novel thread shape showed a higher initial stability compared to those with a regular thread shape. Thus, in order to obtain a sufficient initial stability, it is important to select the type of screw thread that is appropriate for the thickness of the cortical bone.