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Du B, Lin Y, Ji M, Yang Q, Jiang J, Wang F, Wang X, Tan J, Jia R, Li J. Effects of exposure length, cortical and trabecular bone contact areas on primary stability of infrazygomatic crest mini-screws at different insertion angles. BMC Oral Health 2024; 24:924. [PMID: 39123162 PMCID: PMC11316306 DOI: 10.1186/s12903-024-04626-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The infrazygomatic crest mini-screw has been widely used, but the biomechanical performance of mini-screws at different insertion angles is still uncertain. The aim of this study was to analyse the primary stability of infrazygomatic crest mini-screws at different angles and to explore the effects of the exposure length (EL), screw-cortical bone contact area (SCA), and screw-trabecular bone contact area (STA) on this primary stability. METHODS Ninety synthetic bones were assigned to nine groups to insert mini-screws at the cross-combined angles in the occlusogingival and mesiodistal directions. SCA, STA, EL, and lateral pull-out strength (LPS) were measured, and their relationships were analysed. Twelve mini-screws were then inserted at the optimal and poor angulations into the maxillae from six fresh cadaver heads, and the same biomechanical metrics were measured for validation. RESULTS In the synthetic-bone test, the LPS, SCA, STA, and EL had significant correlations with the angle in the occlusogingival direction (rLPS = 0.886, rSCA = -0.946, rSTA = 0.911, and rEL= -0.731; all P < 0.001). In the cadaver-validation test, significant differences were noted in the LPS (P = 0.011), SCA (P = 0.020), STA (P = 0.004), and EL (P = 0.001) between the poor and optimal angulations in the occlusogingival direction. The STA had positive correlations with LPS (rs = 0.245 [synthetic-bone test] and r = 0.720 [cadaver-validation test]; both P < 0.05). CONCLUSIONS The primary stability of the infrazygomatic crest mini-screw was correlated with occlusogingival angulations. The STA significantly affected the primary stability of the infrazygomatic crest mini-screw, but the SCA and EL did not.
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Affiliation(s)
- Bingran Du
- Department of Stomatology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, 528308, China
| | - Yuan Lin
- Department of Stomatology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, Guangdong, 528308, China
| | - Mohan Ji
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, Guangdong, 510515, China
| | - Qiaohua Yang
- Department of Ultrasound, The Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Jiang Jiang
- Department of Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, National Virtual and Reality Experimental Education Center for Medical Morphology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Fei Wang
- Department of Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, National Virtual and Reality Experimental Education Center for Medical Morphology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
- The Department of Anatomy, Nanchang Medical College, Nanchang, 330052, China
| | - Xiaoyi Wang
- The Department of Stomatology, The Seventh Affiliated Hospital, Southern Medical University, Foshan, Guangdong, 528244, China
| | - Jinchuan Tan
- Department of Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, National Virtual and Reality Experimental Education Center for Medical Morphology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
| | - Rui Jia
- Department of Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, National Virtual and Reality Experimental Education Center for Medical Morphology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106 Zhongshan Road II, Guangzhou, 510080, P. R. China
| | - Jianyi Li
- Department of Anatomy, Guangdong Provincial Key Laboratory of Digital Medicine and Biomechanics, Guangdong Engineering Research Center for Translation of Medical 3D Printing Application, National Virtual and Reality Experimental Education Center for Medical Morphology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, China.
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Abu Arqub S, Greene R, Greene S, Laing K, Kuo CL, Godoy LDC, Uribe F. Retrospective evaluation of the success rate and factors associated with the stability of alveolar ridge orthodontic miniscrews: Pilot study. J World Fed Orthod 2024; 13:181-188. [PMID: 38643033 DOI: 10.1016/j.ejwf.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND An uncommon location for placing miniscrews, used to provide anchorage control in various tooth movements, is the alveolar ridge. This study aimed to provide an evaluation of the success rate of alveolar ridge miniscrews and examine variables that might impact their success. METHODS Charts for 295 patients who had miniscrews were screened. Twenty patients (5 male and 15 female: average age = 38.15 ± 15.10 years) with a total of 50 alveolar ridge miniscrews were analyzed. A customized data form was used to collect patients' and miniscrews' related variables. Kaplan-Meier estimator was used for the survival function, whereas Cox proportional hazards regression models were used to associate collected variables with alveolar ridge miniscrew survival. RESULTS In total, 31 (62.0%) miniscrews were stable and 19 (38.0%) failed. The survival time for those that failed was 6.03 ± 7.08 months. The follow-up period for those that survived was 35.84 ± 19.47 months. Male gender versus female (hazard ratio [HR] 2.46; 95% confidence interval [CI] 1.35-4.48; P = 0.003), and if the miniscrew was a replacement versus non-replacement (HR 0.27; 95% CI 0.07-0.99; P = 0.048) influenced the survival. Additionally, miniscrews that were used for both indirect and direct or indirect anchorage alone plus those with evidence of splinting showed a 100% survival rate, which led to an HR 0 (P < 0.001). When the previously mentioned variables were modeled, none seemed to have a significant effect on failure except for splinting and type of anchorage (P < 0.001), because none of the splinted miniscrews failed. CONCLUSIONS The failure rate of alveolar ridge miniscrews was (38.0%) over 6.03 ± 7.08 months. The survival rate was (62.0%) over 35.84 ± 19.47 months. The evidence of splinting and the type of anchorage had a significant effect on survival probability.
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Affiliation(s)
- Sarah Abu Arqub
- Clinical assistant professor, Department of Orthodontics, University of Florida, Gainesville, Florida.
| | - Renee Greene
- Resident, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
| | - Sara Greene
- Resident, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
| | - Kolbe Laing
- Dental student, UConn School of Dental Medicine, University of Connecticut, Farmington, Connecticut
| | - Chia-Ling Kuo
- Associate Professor, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut
| | - Lucas Da Cunha Godoy
- Associate Professor, Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Connecticut
| | - Flavio Uribe
- Professor Ravi Nanda Endowed Professor Program Director and Chair, Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut Health, Farmington, Connecticut
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V B, Magesh V, Harikrishnan P. Effect of cortical bone thickness on shear stress and force in orthodontic miniscrew-bone interface - A finite element analysis. Biomed Phys Eng Express 2024; 10:055013. [PMID: 38986445 DOI: 10.1088/2057-1976/ad6160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/10/2024] [Indexed: 07/12/2024]
Abstract
Miniscrews are widely used in orthodontics as an anchorage device while aligning teeth. Shear stress in the miniscrew-bone interface is an important factor when the miniscrew makes contact with the bone. The objective of this study was to analyze the shear stress and force in the screw-bone interface for varying Cortical Bone Thickness (CBT) using Finite Element Analysis (FEA). Varying CBT of 1.09 mm (1.09CBT) and 2.66 mm (2.66CBT) with miniscrews of Ø1.2 mm, 10 mm length (T1), Ø1.2 mm, 6 mm length (T2) and Ø1.6 mm, 8 mm length (T3) were analyzed. Six Finite Element (FE) models were developed with cortical, cancellous bone, miniscrews and gingiva as a prism. A deflection of 0.1 mm was applied on the neck of the miniscrews at 0°, +30° and -30° angles. The shear stress and force in the screw-bone interface were assessed. The results showed that the CBT affects the shear stress and force in the screw-bone interface region in addition to the screw dimensions and deflection angulations. T1 screw generated lesser shear stress in 1.09CBTand 2.66CBTcompared to T2 and T3 screws. Higher CBT is preferred for better primary stability in shear aspect. Clinically applied forces of 200 gms to 300 gms to an anchorage device induces shear stress in the miniscrew-bone interface region might cause stress shielding. Thus, clinicians need to consider the effect of varying CBT and the size of the miniscrews for the stability, reduced stress shielding and better anchorage during orthodontic treatment.
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Affiliation(s)
- Balamurali V
- Department of Mechanical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Chennai - 603203, Tamil Nadu, India
| | - Varadaraju Magesh
- Department of Mechanical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Chennai - 603203, Tamil Nadu, India
| | - Pandurangan Harikrishnan
- Craniofacial Orthodontist and Oral Surgeon, Teeth 'N' Jaws Center, No. 23 & 25, 1st Cross Street, Lake Area, Nungambakkam, Chennai - 600034, Tamil Nadu, India
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Phusantisampan P, Chaiworawitkul M. Cortical Bone Thickness and Morphology at the Infrazygomatic Crest Area in Growing Thai Patients with UCLP: A CBCT Study. Cleft Palate Craniofac J 2024:10556656241228738. [PMID: 38291624 DOI: 10.1177/10556656241228738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES To determine and compare buccal cortical bone thickness and morphology (in terms of shape and height) at the infrazygomatic (IZ) crest in growing Thai patients with unilateral cleft lip and palate (UCLP) using cone-beam computed tomography (CBCT) with the ultimate goal of identifying potential sites that are suitable for the placement of miniplates. DESIGN Prospective study. SETTLING Institutional research. PATIENTS Twenty-four Thai patients with non-syndromic complete UCLP with Class III skeletal discrepancy aged 10-14 years. INTERVENTIONS A total of 48 CBCT images captured the IZ crest. Five horizontal and six vertical reference planes were established in the IZ crest area. MAIN OUTCOME MEASURE The mean buccal cortical bone thickness of the cleft and non-cleft sides were 1.13 ± 0.45 mm and 1.15 ± 0.46 mm, respectively. The most frequently observed shape for the IZ crest was the external concave contour. There were no statistically significant differences in cortical bone thickness and shape distribution between the cleft and non-cleft sides. (P > .05). RESULTS The thickness of the buccal cortical bone increased anteriorly and superiorly from V + 0 and H + 0. The average height of IZ crest on the cleft side was 16.20 ± 1.59 mm and 16.78 ± 1.84 mm on the non-cleft side. Notably, significant differences were detected in terms of height between the cleft and non-cleft side and cortical bone thickness by gender (P < .05). CONCLUSIONS The IZ crest was found to provide sufficient support for the insertion of a miniplate, particularly in the superior and anterior regions, ensuring primary stability in growing Thai patients with UCLP.
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Affiliation(s)
- Ploypailin Phusantisampan
- Division of Orthodontics, Department of Orthodontic and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Marasri Chaiworawitkul
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Pan S, Gao X, Sun J, Yang Z, Hu B, Song J. Effects of novel microimplant-assisted rapid palatal expanders manufactured by 3-dimensional printing technology: A finite element study. Am J Orthod Dentofacial Orthop 2023; 164:700-711. [PMID: 37330728 DOI: 10.1016/j.ajodo.2023.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION The expansion effects of several new microimplant-assisted rapid palatal expanders (MARPEs) manufactured by 3-dimensional printing technology were evaluated by finite element analysis (FEA). The aim was to identify a novel MARPE suitable for treating maxillary transverse deficiency. METHODS The finite element model was established using MIMICS software (version 19.0; Materialise, Leuven, Belgium). First, the appropriate microimplant insertion characteristics were identified via FEA, and several MARPEs with the above insertion patterns were manufactured by 3-dimensional printing technology. Then, the stress distribution and displacement prediction of the 4 MARPEs and hyrax expander (model E) were evaluated via FEA: bone-borne (model A), bone-tooth-borne (model B), bone-mucous-borne (model C), bone-tooth-mucous-borne (model D). RESULTS Monocortical microimplants perpendicular to the cortical bone on the coronal plane resulted in better expansion effects. Compared with a conventional hyrax expander, the orthopedic expansion of each of the 4 MARPEs was far larger, the parallelism was greater, and the posterior teeth tipping rate was lower. Among them, the expansion effects of models C and D were the best; the von Mises peak values on the surfaces of the microimplants were smaller than those of models A and B. CONCLUSIONS This study may demonstrate that the 4 MARPEs obtained more advantageous orthopedic expansion effects than a hyrax expander. Models C and D obtained better biomechanical effects and had better primary stability. Overall, model D is the recommended expander for treating maxillary transverse deficiency because its structure acts like an implant guide and is beneficial for the accurate insertion of the microimplant.
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Affiliation(s)
- Shengyuan Pan
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiang Gao
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zun Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Sarika K, Kumaran NK, Seralathan S, Sathishkumar RK, Preethi SK. A Three-Dimensional Finite Element Analysis of the Stress Distribution Around the Bone Mini-Implant Interface Based on the Mini-Implant Angle of Insertion, Diameter, and Length. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S535-S539. [PMID: 37654398 PMCID: PMC10466509 DOI: 10.4103/jpbs.jpbs_524_22] [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: 10/27/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 09/02/2023] Open
Abstract
Background Temporary anchorage devices or mini implants have gained great attraction due to their capability to provide absolute anchorage, low cost, versatility, and can be loaded immediately after placement. Material and Methods Finite element analysis was used to evaluate the distribution of stress at the bone mini implant interface based on different angles of insertion (30°, 45°, 60°, and 90°) mini implant diameter (1.3 mm, 1.6 mm, and 2 mm) and mini implant length (6 mm, 8 mm, and 10 mm). A retraction force of 2 N was applied. Results Areas of maximum stress concentration were the head and neck of the mini implant and cortical bone around the mini implant. A very minimal amount of stress was found in the cancellous bone. The maximum stress found in the cortical bone was 5.1301 MPa and in the mini implant was 26.355 MPa with an angle of insertion of 30°, a 1.3 mm diameter, and a 6 mm length. The minimum stress found in the cortical bone was 1.4702 MPa and that in the mini implant was 5.3895 MPa with an angle of insertion of 90°, a 2 mm diameter, and a 10 mm length. Conclusion For maximum stability, mini implants should be placed at a perpendicular angle of insertion with sufficient diameter and length.
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Affiliation(s)
- K Sarika
- Department of Orthodontics and Dentofacial Orthopedics, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Aims Health Sciences Campus, AIMS, Ponekkara, Kochi, Kerala, India
| | - Navaneethakrishnan Kurunji Kumaran
- Department of Orthodontics and Dentofacial Orthopedics, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
| | - Sakthidaran Seralathan
- Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College Melmaruvathur, Kancheepura District, Tamil Nadu, India
| | - Rathinavel Kumar Sathishkumar
- Division of Orthodontics and Dentofacial Orthopaedics, Safwat Al-Muhaideb Dental Hospital, Khamis Mushait, Saudi Arabia
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Migliorati M, De Mari A, Annarumma F, Aghazada H, Battista G, Campobasso A, Menini M, Lo Giudice A, Cevidanes LHS, Drago S. Three-dimensional analysis of miniscrew position changes during bone-borne expansion in young and late adolescent patients. Prog Orthod 2023; 24:20. [PMID: 37271798 DOI: 10.1186/s40510-023-00469-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/06/2023] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Maxillary expansion in patients at the end of their growth relies on the possibility to use miniscrew supported expanders to apply expansion forces directly to the midpalatal suture. Although miniscrews provide a stable anchorage unit, several studies have reported that they do not remain in exactly the same position during treatment. The aim of the present study was to analyze miniscrew position changes after the expansion using bone-borne appliances in late adolescent patients. METHODS Nineteen patients (13 females, 6 males), with a mean age of 17.81 (SD = 4.66), were treated with a Bone-Borne Expander Device. The appliance was designed with 4 miniscrews: 2 in the anterior palatal area, at the third rugae level; 2 in the posterior area. A CBCT and an intraoral scan were obtained before treatment (T0), and then, a second CBCT was obtained after the expansion (T1). Data on peri-suture bone thickness were collected at T0, then the CBCTs were superimposed, and changes between mini-screws position on T0 and T1 were evaluated, both by linear and angular displacements. RESULTS Significant longitudinal differences were found in the distance of the head and the tip of miniscrews measured at the occlusal plane, as well as angular changes. Correlations between displacement measurements and peri-suture bone thickness and height measurements were found as well. CONCLUSIONS While acting as bone anchor units, miniscrews do not remain in the same position during bone-borne expansion. The amount of displacement was related to peri-sutural total bone height and cortical thickness, especially in the anterior area of the naso-frontal maxillary complex.
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Affiliation(s)
- Marco Migliorati
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy.
| | - Anna De Mari
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
| | | | - Hussein Aghazada
- Private Practice, Piazzale Ardeatino, 1G, 00154, Rome, RM, Italy
| | | | | | - Maria Menini
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Dental Clinic, Unit of Orthodontics, University of Catania, Catania, Italy
| | - Lucia H S Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Harbor, MI, USA
| | - Sara Drago
- Orthodontic Department, Genova University, Largo R. Benzi 10, 16100, Genoa, Italy
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Cui MX, Qi Y, Xue LF, Xu YX, Yue J, Zhao JZ, Li C, Xiao WL. Comparative study of stress characteristics around the adjacent teeth tissues during insertion of mini-screws with different insertion angles: A three-dimensional finite element study. J Mech Behav Biomed Mater 2023; 142:105879. [PMID: 37141745 DOI: 10.1016/j.jmbbm.2023.105879] [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: 02/09/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/06/2023]
Abstract
With a limited alveolar bone position, there is a high risk that mini-screws (MS) implants could cause damage to the adjacent teeth. To reduce this damage, the position and tilt angle of the MS must be optimized. The aim of this study was to assess the effect of MS implantation angle on the stress exerted on adjacent periodontal membrane and roots. A three-dimensional finite element model containing dentition, periodontal ligament, jaw and MS were established based on the CBCT images and MS scanning data. The MS was first inserted perpendicular to the surface of the bone at specific locations and then tilted at an angle of 10° and 20° to the mesial and distal teeth, respectively. The stress distribution in the periodontal tissue of the adjacent teeth was analyzed after MS implantation at different angles.The stress on the adjacent tooth root and periodontal ligament was most uniformly distributed when the MS was inserted vertically. It changed 9.4-97.7% when the axis of MS was tilted at 10-degree and 20-degree angles from the point of vertical insertion. The stresses experienced by the periodontal ligament and the root are similar. When the horizontal angle of the MS insertion was changed, the MS was closer to the adjacent tooth, resulting in greater stress near the PDL and root. It was recommended to insert the MS vertically into the alveolar bone surface to avoid root damage due to excessive stress.
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Affiliation(s)
- Ming-Xue Cui
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Yan Qi
- Department of Stomatology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, 250014, China
| | - Ling-Fa Xue
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Yao-Xiang Xu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Jin Yue
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Jin-Ze Zhao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Cong Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China
| | - Wen-Lin Xiao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China; School of Stomatology, Qingdao University, Qingdao, Shandong, 266071, China.
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Golshah A, Gorji K, Nikkerdar N. Effect of miniscrew insertion angle in the maxillary buccal plate on its clinical survival: a randomized clinical trial. Prog Orthod 2021; 22:22. [PMID: 34337677 PMCID: PMC8326233 DOI: 10.1186/s40510-021-00370-8] [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: 04/12/2021] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This study sought to assess the effect of miniscrew insertion angle (vertical and oblique) on its clinical survival under shearing forces in orthodontic patients undergoing canine retraction. MATERIALS AND METHODS In this split-mouth randomized controlled clinical trial, 50 miniscrews were placed bilaterally in 25 patients with 45° and 90° insertion angles relative to a line perpendicular to the occlusal plane distal to the maxillary first premolar extraction site. Allocation of insertion angles to the right/left side was random using the Random Allocation Software. The patients, clinician, and statistician were blinded to the allocation of miniscrews to the side of jaw. The patients were followed-up monthly for 6 months. The primary outcome was the clinical survival of miniscrews, which was evaluated at each follow-up session. The secondary outcomes were the miniscrew stability based on the Periotest value (PTV) and the level of pain experienced by patients at 1, 12, and 24 h, and 7 days after miniscrew placement using a visual analog scale (VAS). Data were analyzed using paired t-test, repeated measures ANOVA, and McNemar's test. RESULTS The clinical survival rate of miniscrews placed at 90° and 45° angles was 76% and 88%, respectively. This difference was not statistically significant (P = 0.375). No significant difference was noted between the two groups regarding the PTV or the pain score either (P > 0.05). CONCLUSION Clinically, the insertion angle of miniscrews (90° versus 45° relative to a line perpendicular to the occlusal plane) has no significant effect on the miniscrew survival rate or stability during orthodontic treatment. TRIAL REGISTRATION This trial was registered at www.irct.ir ( IRCT20190901044659N1 ). PROTOCOL The protocol was published after trial commencement.
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Affiliation(s)
- Amin Golshah
- Department of Orthodontic, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Kimia Gorji
- Students Research Committee, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nafiseh Nikkerdar
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Sana S, Reddy R, Talapaneni AK, Hussain A, Bangi SL, Fatima A. Evaluation of stability of three different mini-implants, based on thread shape factor and numerical analysis of stress around mini-implants with different insertion angle, with relation to en-masse retraction force. Dental Press J Orthod 2021; 25:59-68. [PMID: 33503126 PMCID: PMC7869798 DOI: 10.1590/2177-6709.25.6.059-068.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/03/2020] [Indexed: 11/22/2022] Open
Abstract
Objectives: Assess the stability of three different mini-implants, based on thread shape
factor (TSF), and evaluate stresses at the mini-implant site and surrounding
cortical bone on application of retraction force, at two different insertion
angles. Methods: Mini-implants of three different diameters (M1 - Orthoimplant, 1.8mm), (M2 -
Tomas, 1.6mm) and (M3 - Vector TAS, 1.4mm) and length of 8mm were used.
Using scanning electronic microscopy, the mean thread depth, pitch and
relationship between the two (TSF) were calculated. The mini-implants were
loaded into a synthetic bone block and the pull-out strength was tested. One
way ANOVA and Tukey post-hoc tests were used to compare the
pull-out strength of mini-implants. P values < 0.05 were considered
statistically significant. Finite element models (FEM) were constructed with
insertion angulation at 90° and 60°, with retraction force of 150 g. The
results were analyzed using ANSYS software. Results: Statistically significant difference was found among all the three
mini-implants for thread depth and pitch (< 0.001). Statistically
significant higher pull-out force value was seen for Orthoimplant. The
stress distribution level in mini-implant and surrounding bone was observed
to be smaller for Orthoimplant. Conclusion: Orthoimplant mini-implants have more favorable geometric characteristics
among the three types, and less stress with 90°angulation.
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Affiliation(s)
- Safiya Sana
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
| | - Rekha Reddy
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
| | - Ashok Kumar Talapaneni
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
| | - Arshad Hussain
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
| | - Sayeeda Laegue Bangi
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
| | - Asma Fatima
- Al-Badar Rural Dental College & Hospital, Department of Orthodontics & Dentofacial Orthopaedics (Gulbarga/KA, India)
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Ugarte OM, Gialain IO, de Carvalho NM, Fukuoka GL, Ballester RY, Cattaneo PM, Roscoe MG, Meira JBC. Can maxilla and mandible bone quality explain differences in orthodontic mini-implant failures? Biomater Investig Dent 2021; 8:1-9. [PMID: 33521649 PMCID: PMC7808375 DOI: 10.1080/26415275.2020.1863155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose: This study aimed to compare the risk of orthodontic mini-implant (OMI) failure between maxilla and mandible. A critical analysis of finite-element studies was used to explain the contradiction of the greatest clinical success for OMIs placed in the maxilla, despite the higher quality bone of mandible. Materials and Methods: Four tridimensional FE models were built, simulating an OMI inserted in a low-dense maxilla, control maxilla, control mandible, and high-dense mandible. A horizontal force was applied to simulate an anterior retraction of 2 N (clinical scenario) and 10 N (overloading condition). The intra-bone OMI displacement and the major principal bone strains were used to evaluate the risk of failure due to insufficient primary stability or peri-implant bone resorption. Results: The OMI displacement was far below the 50–100 µm threshold, suggesting that the primary stability would be sufficient in all models. However, the maxilla was more prone to lose its stability due to overload conditions, especially in the low-dense condition, in which major principal bone strains surpassed the pathologic bone resorption threshold of 3000 µstrain. Conclusions: The differences in orthodontic mini-implant failures cannot be explained by maxilla and mandible bone quality in finite-element analysis that does not incorporate the residual stress due to OMI insertion.
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Affiliation(s)
- Omar Melendres Ugarte
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Ivan Onone Gialain
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Naor Maldonado de Carvalho
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Gisele Lie Fukuoka
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Rafael Yague Ballester
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Paolo Maria Cattaneo
- Department of Dentistry, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Marina Guimarães Roscoe
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
| | - Josete Barbosa Cruz Meira
- School of Dentistry, Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, Brazil
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Popa A, Dehelean C, Calniceanu H, Watz C, Brad S, Sinescu C, Marcu OA, Popa CS, Avram S, Nicolov M, Szuhanek CA. A Custom-Made Orthodontic Mini-Implant-Effect of Insertion Angle and Cortical Bone Thickness on Stress Distribution with a Complex In Vitro and In Vivo Biosafety Profile. MATERIALS 2020; 13:ma13214789. [PMID: 33120951 PMCID: PMC7663474 DOI: 10.3390/ma13214789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Orthodontic mini-implant failure is a debatable subject in clinical practice. However, the most important parameter to evaluate the success rate of mini-implant is the primary stability, which is mainly influenced by cortical bone thickness (CBT) and insertion angle. MATERIALS AND METHODS Three-dimensional finite element models of the maxilla were created and a custom-made, self-drilling, tapered mini-implant was designed. For the pull-out test, 12 simulations were performed, sequentially increasing the thickness of the cortical bone (1, 1.5 and 2 mm) and the insertion angle (30°, 60°, 90°, 120°). For the force analysis, 24 simulations were performed using an experimental orthodontic traction force of 2 N both in the horizontal and vertical axis. RESULTS Insertion angle and CBT have significant impact on force reaction values (p < 0.05). Cortical bone stress had the lowest value when the mini-implant had a 30° insertion angle and the highest value when the implant had a 120° insertion angle, while the CBT was 1 mm. Cortical bone stress had the lowest value with an insertion angle of 90° and the highest value when the implant was inserted at an angle of 30°, while the CBT was 2 mm independent of the force direction. Regarding the biosafety profile of the mini-implant alloy, the present results reveal that the custom-made mini-implant presents good biocompatibility. CONCLUSIONS When the CBT is reduced, we recommend inclined insertion while, when the CBT is appropriate, perpendicular insertion is advised.
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Affiliation(s)
- Adelina Popa
- 2nd Department of Orthodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (C.A.S.)
| | - Cristina Dehelean
- 2nd Department of Toxicology and Drug Industry, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Horia Calniceanu
- 1st Department/Periodontology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (H.C.); (C.W.); Tel.: +40-745-322-649 (H.C.); +40-746-227-217 (C.W.)
| | - Claudia Watz
- 1st Department of Pharmaceutical Physics and Biophysics, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Correspondence: (H.C.); (C.W.); Tel.: +40-745-322-649 (H.C.); +40-746-227-217 (C.W.)
| | - Silviu Brad
- 2nd Department of Radiology, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Cosmin Sinescu
- 2nd Department of Prostheses Technology and Dental Material, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Olivia A. Marcu
- Dental Medicine Department, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania;
| | | | - Stefana Avram
- 2nd Department of Pharmacognosy, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mirela Nicolov
- 1st Department of Pharmaceutical Physics and Biophysics, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Camelia A. Szuhanek
- 2nd Department of Orthodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.P.); (C.A.S.)
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Shyagali TR, Aghera D. Evaluation of stress generation on the cortical bone and the palatal micro-implant complex during the implant-supported en masse retraction in lingual orthodontic technique using the FEM: Original research. J Dent Res Dent Clin Dent Prospects 2019; 13:192-199. [PMID: 31857865 PMCID: PMC6904918 DOI: 10.15171/joddd.2019.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background. This study aimed to evaluate and analyze the distribution of stresses on the palatal micro-implants and the cortical bone at the micro-implant site with optimal orthodontic retraction force in lingual orthodontics. Methods. ANSYS 12.1 software was used to construct the finite element model of the maxillary bone, teeth and the periodontal ligament along with the lingual bracket set-up with wire and the micro-implant. Six- and 8-mm micro-implants were constructed. The final model consisted of 99190 nodes and 324364 elements. A 200-gram of retraction force was applied from the micro-implant to the anterior retraction hook. The micro-implant was embedded between the second premolar and the first molar. Hyper-view software was used to get the results in X-Y-Z dimensions. Results. The maximum von Mises stresses detected were 52.543 MPa for 6-mm micro-implant and 54.489 MPa for 8-mm micro-implant. Maximum stress was at the neck of the micro-implant. The 8-mm implant model showed 6×10-3 mm of lingual displacement. The least displacement of 1×10-3 mm was noticed for both the implant models in the apico-occlusal direction. The maximum von Mises stresses in the cortical bone at the micro-implant site was 18.875 MPa for 6-mm micro-implant and 21.551 MPa for 8-mm micro-implant. Conclusion. Six-mm micro-implant can be the choice for the implant-supported lingual orthodontic retraction as it produced minimal stresses on the cortical bone, and the initial stress displacements produced on the micro-implant were also minimal.
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Araghbidikashani M, Golshah A, Nikkerdar N, Rezaei M. In-vitro impact of insertion angle on primary stability of miniscrews. Am J Orthod Dentofacial Orthop 2016; 150:436-43. [DOI: 10.1016/j.ajodo.2016.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 11/16/2022]
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Anchoring structure of the calvarial periosteum revealed by focused ion beam/scanning electron microscope tomography. Sci Rep 2015; 5:17511. [PMID: 26627533 PMCID: PMC4667224 DOI: 10.1038/srep17511] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/30/2015] [Indexed: 11/09/2022] Open
Abstract
An important consideration in regeneration therapy is the fact that the tissue surrounding an organ supports its function. Understanding the structure of the periosteum can contribute to more effective bone regeneration therapy. As a cellular source, the periosteum also assists bone growth and fracture healing; this further necessitates its direct contact with the bone. However, its anchoring strength appears to be inexplicably stronger than expected. In this study, we used focused ion beam/scanning electron microscope tomography to investigate ultrathin serial sections as well as the three dimensional ultrastructure of the periosteum to clarify the architecture of its anchoring strength, as such assessments are challenging using conventional methods. We discovered perforating fibres that arise from the bone surface at 30 degree angles. Additionally, the fibres across the osteoblast layer were frequently interconnected to form a net-like structure. Fibroblast processes were observed extending into the perforating fibres; their morphologies were distinct from those of typical fibroblasts. Thus, our study revealed novel ultrastructures of the periosteum that support anchorage and serve as a cellular source as well as a mechanical stress transmitter.
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Arantes VDOR, Corrêa CB, Lunardi N, Boeck Neto RJ, Spin-Neto R, Boeck EM. Insertion angle of orthodontic mini-implants and their biomechanical performance: finite element analysis. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.0081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AbstractObjectiveThe aim of this study was to assess the stresses and strains generated after the application of two types of forces (traction of 200 gf and torsion of 20 N.cm) in two types of orthodontic mini-implants inserted at different (45° and 90° to the cortical bone) angles.Material and methodthree-dimensional models of two brands of mini-implant (SIN – Sao Paulo, Brazil, and RMO – South Korea) were exported and analyzed by finite element analysis (FEA). Analyses were performed on simulations of cortical bone, cancellous bone and the screw.ResultFEA analysis showed that RMO mini-implants had greater elastic deformation when subjected to tensile and torsional forces when compared with SIN mini-implants. For both trademarks and insertion angles tested, there was greater cortical bone deformation, but with the greatest strain located on the mini-implant. Tension on the mini-implant was located in its transmucosal profile region.ConclusionWhen comparing the two brands of mini-implants by FEA, it is fair to conclude that that the larger number of threads and their greater angle of inclination resulted in less resistance to deformation and induced a higher level of tension in the mini-implant and cortical bone when subjected to forces, especially when inserted at an angle of 45º to the cortical bone.
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Gene profiling of bone around orthodontic mini-implants by RNA-sequencing analysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:538080. [PMID: 25759820 PMCID: PMC4339713 DOI: 10.1155/2015/538080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 01/23/2015] [Indexed: 11/03/2022]
Abstract
This study aimed to evaluate the genes that were expressed in the healing bones around SLA-treated titanium orthodontic mini-implants in a beagle at early (1-week) and late (4-week) stages with RNA-sequencing (RNA-Seq). Samples from sites of surgical defects were used as controls. Total RNA was extracted from the tissue around the implants, and an RNA-Seq analysis was performed with Illumina TruSeq. In the 1-week group, genes in the gene ontology (GO) categories of cell growth and the extracellular matrix (ECM) were upregulated, while genes in the categories of the oxidation-reduction process, intermediate filaments, and structural molecule activity were downregulated. In the 4-week group, the genes upregulated included ECM binding, stem cell fate specification, and intramembranous ossification, while genes in the oxidation-reduction process category were downregulated. GO analysis revealed an upregulation of genes that were related to significant mechanisms, including those with roles in cell proliferation, the ECM, growth factors, and osteogenic-related pathways, which are associated with bone formation. From these results, implant-induced bone formation progressed considerably during the times examined in this study. The upregulation or downregulation of selected genes was confirmed with real-time reverse transcription polymerase chain reaction. The RNA-Seq strategy was useful for defining the biological responses to orthodontic mini-implants and identifying the specific genetic networks for targeted evaluations of successful peri-implant bone remodeling.
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Hazan-Molina H, Aizenbud I, Kaufman H, Teich S, Aizenbud D. The Influence of Shockwave Therapy on Orthodontic Tooth Movement Induced in the Rat. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 878:57-65. [DOI: 10.1007/5584_2015_179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kuroda S, Nishii Y, Okano S, Sueishi K. Stress distribution in the mini-screw and alveolar bone during orthodontic treatment: a finite element study analysis. J Orthod 2014; 41:275-84. [DOI: 10.1179/1465313314y.0000000098] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Revisiting the stability of mini-implants used for orthodontic anchorage. J Formos Med Assoc 2014; 114:1122-8. [PMID: 25260551 DOI: 10.1016/j.jfma.2014.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 07/31/2014] [Accepted: 08/04/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND/PURPOSE The aim of this study is to comprehensively analyze the potential factors affecting the failure rates of three types of mini-implants used for orthodontic anchorage. METHODS Data were collected on 727 mini-implants (miniplates, predrilled titanium miniscrews, and self-drilling stainless steel miniscrews) in 220 patients. The factors related to mini-implant failure were investigated using a Chi-square test for univariate analysis and a generalized estimating equation model for multivariate analysis. RESULTS The failure rate for miniplates was significantly lower than for miniscrews. All types of mini-implants, especially the self-drilling stainless steel miniscrews, showed decreased stability if the previous implantation had failed. The stability of predrilled titanium miniscrews and self-drilling stainless steel miniscrews were comparable at the first implantation. However, the failure rate of stainless steel miniscrews increased at the second implantation. The univariate analysis showed that the following variables had a significant influence on the failure rates of mini-implants: age of patient, type of mini-implant, site of implantation, and characteristics of the soft tissue around the mini-implants. The generalized estimating equation analysis revealed that mini-implants with miniscrews used in patients younger than 35 years, subjected to orthodontic loading after 30 days and implanted on the alveolar bone ridge, have a significantly higher risk of failure. CONCLUSION This study revealed that once the dental surgeon becomes familiar with the procedure, the stability of orthodontic mini-implants depends on the type of mini-implant, age of the patient, implantation site, and the healing time of the mini-implant. Miniplates are a more feasible anchorage system when miniscrews fail repeatedly.
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Ozdemir F, Uyar VO, Ulkur F. Treatment of Class II Maxillary Retrusion Case Using Miniscrew (Nonextraction Treatment of Adolescent Patient). Turk J Orthod 2014. [DOI: 10.13076/tjo-d-14-00023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Perillo L, Jamilian A, Shafieyoon A, Karimi H, Cozzani M. Finite element analysis of miniscrew placement in mandibular alveolar bone with varied angulations. Eur J Orthod 2014; 37:56-9. [DOI: 10.1093/ejo/cju006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hazan-Molina H, Reznick AZ, Kaufman H, Aizenbud D. Periodontal cytokines profile under orthodontic force and extracorporeal shock wave stimuli in a rat model. J Periodontal Res 2014; 50:389-96. [PMID: 25073624 DOI: 10.1111/jre.12218] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Extracorporeal shock wave therapy has been used in various clinical conditions as a result of its ability to stimulate healing processes in acute and chronic inflammatory states. Orthodontic force application triggers an inflammatory reaction in the periodontal tissue surrounding the involved teeth, resulting in tooth movement. Preliminary work revealed that extracorporeal shock wave therapy increased the expression of the inflammatory cytokines involved. Our aim was to investigate the expression of inflammatory cytokines in the periodontal tissues following orthodontic force induction, with and without shock wave therapy, in experimental rats. MATERIAL AND METHODS An orthodontic appliance was fabricated and applied between the molars and the incisors of adult Wistar rats. In conjunction with orthodontic force commencement, the rats were treated with a single episode of 1000 shock waves. Every day, during the 3 d of the study, rats were killed and the immunolocalization of RANKL, interleukin (IL)-1β, IL-6 and tumor necrosis factor-alpha was evaluated. RESULTS The percentage of the area staining positively for all inflammatory cytokines during the first 2 d decreased statistically significantly more in the shock wave-treated group compared with the nontreated control group. On the first day, the percentage of the area staining positively for IL-1β and RANKL on the compression side peaked in both groups, with a sequential rise in the number of TRAP-positive cells. CONCLUSION The induction of shock wave therapy during orthodontic tooth movement influences the expression of different inflammatory cytokines in the tissue and might alter the expected periodontal remodeling rate.
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Affiliation(s)
- H Hazan-Molina
- Orthodontic and Craniofacial Department, Graduate School of Dentistry, Rambam Health Care Campus and the Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Systematic review of mini-implant displacement under orthodontic loading. Int J Oral Sci 2013; 6:1-6. [PMID: 24357855 PMCID: PMC3967307 DOI: 10.1038/ijos.2013.92] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 10/22/2013] [Indexed: 11/17/2022] Open
Abstract
A growing number of studies have reported that mini-implants do not remain in exactly the same position during treatment, although they remain stable. The aim of this review was to collect data regarding primary displacement immediately straight after loading and secondary displacement over time. A systematic review was performed to investigate primary and secondary displacement. The amount and type of displacement were recorded. A total of 27 studies were included. Sixteen in vitro studies or studies using finite element analysis addressed primary displacement, and nine clinical studies and two animal studies addressed secondary displacement. Significant primary displacement was detected (6.4–24.4 µm) for relevant orthodontic forces (0.5–2.5 N). The mean secondary displacement ranged from 0 to 2.7 mm for entire mini-implants. The maximum values for each clinical study ranged from 1.0 to 4.1 mm for the head, 1.0 to 1.5 for the body and 1.0 to 1.92 mm for the tail part. The most frequent type of movement was controlled tipping or bodily movement. Primary displacement did not reach a clinically significant level. However, clinicians can expect relevant secondary displacement in the direction of force. Consequently, decentralized insertion within the inter-radicular space, away from force direction, might be favourable. More evidence is needed to provide quantitative recommendations.
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