1
|
Koç O, Pamukçu H, Kocabalkan AA. Comparison of 3 different bone-borne type expansion appliances used in surgically-assisted rapid palatal expansion: A finite element analysis. Am J Orthod Dentofacial Orthop 2023; 163:e23-e33. [PMID: 36572581 DOI: 10.1016/j.ajodo.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION This study aimed to compare the effects of 3 different bone-borne type expansion appliances used in the surgically-assisted rapid palatal expansion (SARPE) by finite element analysis. METHODS Three different miniscrew-supported palatal expansion appliances were modeled. Median and lateral osteotomies were performed without pterygomaxillary suture separation. Model I consisted of a palatal expander with 2 miniscrews placed 4 mm far from the midpalatal suture. In model II, 2 miniscrews were located at the alveolar ridge between the first molar and the second premolar. In model III, 4 miniscrews were placed as a combination of the first and second models. Stress distributions and amount of displacements were evaluated with Ansys software (version 19.2; Ansys, Canonsburg, Pa) for 5-mm expansion in a symmetrical finite element analysis model to reflect the clinical situation. RESULTS SARPE simulation using miniscrew-assisted maxillary expanders for all models showed a rotation and tipping of the maxilla. The largest displacement was found for the anterior part of the palate in model II and the posterior part in model III. Although a wedge-shaped expansion pattern was observed in all models, this form was more prominent in model II. The highest stress value (0.91 MPa) was measured in model I, and the lowest value (0.004 MPa) was measured in model II for the anterior nasal spine region. The highest stress value (0.51 MPa) was measured in model III, and the lowest value (0.12 MPa) was measured in model II for the posterior nasal spine region. The lowest stress values were measured in model II for all the craniofacial and maxillofacial structures. CONCLUSIONS Among the models, the lowest stress distribution conditions for craniofacial and maxillofacial structures were found in model II. The largest displacement was found at the incisors and anterior part of the maxilla for model II. The greatest displacement was found at the posterior region for model III.
Collapse
Affiliation(s)
- Osman Koç
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | - Hande Pamukçu
- Department of Orthodontics, School of Dentistry, Başkent University, Ankara, Turkey
| | | |
Collapse
|
2
|
Miglani A, C C. Effects of a Mini Implant’s Size and Site on its Stability Using Resonance Frequency Analysis. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/0301574220957532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: Temporary anchorage devices (TADs) have become the preferred method of skeletal anchorage in new-age orthodontics. Despite the remarkable success of mini implants in orthodontic treatment results, mini implants’ stability remains a vital issue that has to be resolved, due to the fact that failure rates are broadly variable and might be up to 25%. Objectives: To evaluate the effect of the diameter, implant bone surface contact, thickness of cortical bone, and implant insertion sites on mini implant stability using resonance frequency analysis (RFA). Materials and Method: CBCT of the dry skull was obtained. Buccal and lingual cortical plates of the maxillary and mandibular jaws were measured at 6 mm from the coronal part of the alveolar bone. After placing the implants, the stability was measured using resonance frequency analysis. Results: In the maxillary arch, Pearson correlation showed significant correlation of instability of the implant with the width of the buccal cortical plate and lingual cortical plate and implant contact surface area. In mandibular arch, Pearson correlation showed no significant effect of buccal/lingual cortical plate width, and implant surface contact area in primary stability of varied sized, mini implants. Conclusion: Statistically significant increases in the primary stability of mini implants with an increase in the implant bone contact surface area were found in the maxilla. In the mandible, no significant increase in mini implant stability was found with an increase in the implant contact surface area.
Collapse
Affiliation(s)
- Anil Miglani
- Department of Orthodontics & Dentofacial Orthopedics, ITS Dental College, Hospital & Research Centre, Greater Noida, UP, India
| | - Cyan C
- Department of Orthodontics & Dentofacial Orthopedics, Divya Jyoti College of Dental Sciences, Modi Nagar, UP, India
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Bakopoulou A, Hoang P, Fathi A, Foley M, Dunstan C, Dalci O, Papadopoulou AK, Darendeliler MA. A comparative histomorphological and micro computed tomography study of the primary stability and the osseointegration of The Sydney Mini Screw; a qualitative pilot animal study in New Zealand rabbits. Eur J Orthod 2018; 41:360-369. [DOI: 10.1093/ejo/cjy059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
SummaryObjectiveThe aim of this study was to assess the potential of improving orthodontic miniscrews’ (MSs) primary stability in vivo by evaluating the dispersion capacity of an injectable bone graft substitute (iBGS) through a newly designed hollow MS [The Sydney Mini Screw (SMS)] and its integration with the cortical and trabecular bone by using the femur and tibia in a New Zealand rabbit animal model.MethodsIn total, 24 MSs were randomly placed in each proximal tibia and femur of 6 New Zealand rabbits with an open surgery process. Aarhus MSs were used as controls and the effect of injection of iBGS was studied by implanting SMSs with and without iBGS injection. The dispersion of iBGS and the integration of the SMS were studied by using micro Computed Tomography (μCT) and histochemical analysis at two time points, 0 day and 8 weeks post-implantation.ResultsiBGS was successfully injected through the SMS and hardened in situ. After 8 weeks, μCT results revealed that the iBGS particles were resorbed and bone tissue was formed around the SMS and within its lateral exit holes.ConclusionsThis pilot animal study showed the high potential of the combined use of iBGS and SMS as a newly developed technique to promote the primary stability of MSs.
Collapse
Affiliation(s)
- Anastasia Bakopoulou
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Peter Hoang
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Ali Fathi
- School of Chemical and Biomolecular Engineering, Faculty of Engineering and Information Technologies, The University of Sydney, Sydney, Australia
| | - Matthew Foley
- Australian Centre for Microscopy & Microanalysis, Department of Archaeology, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Colin Dunstan
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering and Information Technologies, The University of Sydney, Sydney, Australia
| | - Oyku Dalci
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - Alexandra K Papadopoulou
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| | - M Ali Darendeliler
- Sydney Dental School, The University of Sydney, Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, The University of Sydney, Sydney, Australia
| |
Collapse
|
5
|
Lee RJ, Moon W, Hong C. Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis. Am J Orthod Dentofacial Orthop 2017; 151:887-897. [PMID: 28457266 DOI: 10.1016/j.ajodo.2016.10.025] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Bone-borne palatal expansion relies on mini-implant stability for successful orthopedic expansion. The large magnitude of applied force experienced by mini-implants during bone-borne expansion may lead to high failure rates. Use of bicortical mini-implant anchorage rather than monocortical anchorage may improve mini-implant stability. The aims of this study were to analyze and compare the effects of bicortical and monocortical anchorages on stress distribution and displacement during bone-borne palatal expansion using finite element analysis. METHODS Two skull models were constructed to represent expansion before and after midpalatal suture opening. Three clinical situations with varying mini-implant insertion depths were studied in each skull model: monocortical, 1-mm bicortical, and 2.5-mm bicortical. Finite element analysis simulations were performed for each clinical situation in both skull models. Von Mises stress distribution and transverse displacement were evaluated for all models. RESULTS Peri-implant stress was greater in the monocortical anchorage model compared with both bicortical anchorage models. In addition, transverse displacement was greater and more parallel in the coronal plane for both bicortical models compared with the monocortical model. Minimal differences were observed between the 1-mm and the 2.5-mm bicortical models for both peri-implant stress and transverse displacement. CONCLUSIONS Bicortical mini-implant anchorage results in improved mini-implant stability, decreased mini-implant deformation and fracture, more parallel expansion in the coronal plane, and increased expansion during bone-borne palatal expansion. However, the depth of bicortical mini-implant anchorage was not significant.
Collapse
Affiliation(s)
- Robert J Lee
- Division of Orthodontics, University of California at San Francisco, San Francisco, Calif
| | - Won Moon
- Section of Orthodontics, University of California at Los Angeles, Los Angeles, Calif
| | - Christine Hong
- Section of Orthodontics, University of California at Los Angeles, Los Angeles, Calif.
| |
Collapse
|
6
|
Choi HW, Park YS, Chung SH, Jung MH, Moon W, Rhee SH. Comparison of mechanical and biological properties of zirconia and titanium alloy orthodontic micro-implants. Korean J Orthod 2017; 47:229-237. [PMID: 28670564 PMCID: PMC5466905 DOI: 10.4041/kjod.2017.47.4.229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the initial stability as insertion and removal torque and the clinical applicability of novel orthodontic zirconia micro-implants made using a powder injection molding (PIM) technique with those parameters in conventional titanium micro-implants. METHODS Sixty zirconia and 60 titanium micro-implants of similar design (diameter, 1.6 mm; length, 8.0 mm) were inserted perpendicularly in solid polyurethane foam with varying densities of 20 pounds per cubic foot (pcf), 30 pcf, and 40 pcf. Primary stability was measured as maximum insertion torque (MIT) and maximum removal torque (MRT). To investigate clinical applicability, compressive and tensile forces were recorded at 0.01, 0.02, and 0.03 mm displacement of the implants at angles of 0°, 10°, 20°, 30°, and 40°. The biocompatibility of zirconia micro-implants was assessed via an experimental animal study. RESULTS There were no statistically significant differences between zirconia micro-implants and titanium alloy implants with regard to MIT, MRT, or the amount of movement in the angulated lateral displacement test. As angulation increased, the mean compressive and tensile forces required to displace both types of micro-implants increased substantially at all distances. The average bone-to-implant contact ratio of prototype zirconia micro-implants was 56.88 ± 6.72%. CONCLUSIONS Zirconia micro-implants showed initial stability and clinical applicability for diverse orthodontic treatments comparable to that of titanium micro-implants under compressive and tensile forces.
Collapse
Affiliation(s)
- Hae Won Choi
- Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Seok Park
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Shin Hye Chung
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Min Ho Jung
- Department of Orthodontics, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
| | - Won Moon
- Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, USA
| | - Sang Hoon Rhee
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| |
Collapse
|
7
|
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.
Collapse
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
| | | | | | | |
Collapse
|
8
|
Miyawaki S, Tomonari H, Yagi T, Kuninori T, Oga Y, Kikuchi M. Development of a novel spike-like auxiliary skeletal anchorage device to enhance miniscrew stability. Am J Orthod Dentofacial Orthop 2015; 148:338-44. [PMID: 26232843 DOI: 10.1016/j.ajodo.2015.02.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 02/01/2015] [Accepted: 02/01/2015] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Miniscrews are frequently used for skeletal anchorage during edgewise treatment, and their clinical use has been verified. However, their disadvantage is an approximately 15% failure rate, which is primarily attributed to the low mechanical stability between the miniscrew and cortical bone and to the miniscrew's close proximity to the dental root. To solve these problems, we developed a novel spike-like auxiliary skeletal anchorage device for use with a miniscrew to increase its stability. METHODS The retention force was compared between miniscrews with and without the auxiliary skeletal anchorage device at each displacement of the miniscrew. The combined unit was also implanted into the bones of 2 rabbits in vivo, and implantation was visually assessed at 4 weeks postoperatively while the compression force was applied. RESULTS The retention force of the combined unit was significantly and approximately 3 to 5 times stronger on average than that of the miniscrew alone at each displacement. The spiked portion of the auxiliary anchorage device embedded into the cortical bone of the hind limb at approximately a 0.3-mm depth at 4 weeks postimplantation in both rabbits. CONCLUSIONS The auxiliary skeletal anchorage device may increase miniscrew stability, allow a shortened miniscrew, and enable 3-dimensional absolute anchorage. Further evaluation of its clinical application is necessary.
Collapse
Affiliation(s)
- Shouichi Miyawaki
- Professor and chair, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Hiroshi Tomonari
- Assistant professor, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takakazu Yagi
- Lecturer, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takaharu Kuninori
- Assistant professor, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yasuhiko Oga
- Postgraduate student, Department of Orthodontics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masafumi Kikuchi
- Professor and chair, Department of Biomaterials Science, Field of Oral and Maxillofacial Rehabilitation, Advanced Therapeutic Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| |
Collapse
|
9
|
Evolution of Class III treatment in orthodontics. Am J Orthod Dentofacial Orthop 2015; 148:22-36. [DOI: 10.1016/j.ajodo.2015.04.012] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 11/22/2022]
|
10
|
Moon W, Wu KW, MacGinnis M, Sung J, Chu H, Youssef G, Machado A. The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander (MARPE) and the novel N2 mini-implant-a finite element study. Prog Orthod 2015; 16:16. [PMID: 26061987 PMCID: PMC4456601 DOI: 10.1186/s40510-015-0083-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maxillary protraction with the novel N2 mini-implant- and micro-implant-assisted rapid palatal expander (MARPE) can potentially provide significant skeletal effects without surgery, even in older patients where conventional facemask therapy has limited skeletal effects. However, the skeletal effects of altering the location and direction of force from mini-implant-assisted maxillary protraction have not been extensively analyzed. In this study, the application of the novel N2 mini-implant as an orthopedic anchorage device is explored in its ability to treat patients with class III malocclusions. METHODS A 3D cranial mesh model with associated sutures was developed from CT images and Mimics modeling software. Utilizing ANSYS simulation software, protraction forces were applied at different locations and directions to simulate conventional facemask therapy and seven maxillary protraction protocols utilizing the novel N2 mini-implant. Stress distribution and displacement were analyzed. Video animations and superimpositions were created. RESULTS By changing the vector of force and location of N2 mini-implant, the maxilla was displaced differentially. Varying degrees of forward, downward, and rotational movements were observed in each case. For brachyfacial patients, anterior micro-implant-supported protraction at -45° or intermaxillary class III elastics at -45° are recommended. For dolicofacial patients, either anterior micro-implants at -15° or an intermaxillary spring at +30° is recommended. For mesofacial patients with favorable vertical maxillary position, palatal micro-implants at -30° are recommended; anterior micro-implants at -30° are preferred for shallow bites. For patients with a severe mid-facial deficiency, intermaxillary class III elastics at -30° are most effective in promoting anterior growth of the maxilla. CONCLUSIONS By varying the location of N2 mini-implants and vector of class III mechanics, clinicians can differentially alter the magnitude of forward, downward, and rotational movement of the maxilla. As a result, treatment protocol can be customized for each unique class III patient.
Collapse
Affiliation(s)
- Won Moon
- UCLA Section of Orthodontics, UCLA School of Dentistry, 10833 Le Conte Avenue, CHS - Box 951668, Los Angeles, CA, 90095-1668, USA,
| | | | | | | | | | | | | |
Collapse
|
11
|
Migliorati M, Drago S, Schiavetti I, Olivero F, Barberis F, Lagazzo A, Capurro M, Silvestrini-Biavati A, Benedicenti S. Orthodontic miniscrews: an experimental campaign on primary stability and bone properties. Eur J Orthod 2014; 37:531-8. [DOI: 10.1093/ejo/cju081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
12
|
Taing-Watson E, Katona TR, Stewart KT, Ghoneima A, Chu GTM, Kyung HM, Liu SS. Microdamage generation by tapered and cylindrical mini-screw implants after pilot drilling. Angle Orthod 2014; 85:859-67. [PMID: 25469670 DOI: 10.2319/062314-452.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the relationship between mini-screw implant (MSI) diameter (1.6 vs 2.0 mm) and shape (tapered vs cylindrical) and the amount of microdamage generated during insertion. MATERIALS AND METHODS Thirty-six cylindrical and 36 tapered MSIs, 6 mm long, were used in this study. Half of each shape was 1.6 mm in diameter, while the other half was 2.0 mm. After pilot drilling, four and five MSIs were inserted, respectively, into fresh cadaveric maxillae and mandibles of dogs. Bone blocks containing the MSIs were sectioned and ground parallel to the MSI axis. Epifluorescent microscopy was used to measure overall cortical thickness, crack length, and crack number adjacent to the MSI. Crack density and total microdamage burden per surface length were calculated. Three-way analysis of variance (ANOVA) was used to test the effects of jaw, and MSI shape and diameter. Pairwise comparisons were made to control the overall significance level at 5%. RESULTS The larger (2.0 vs 1.6 mm) cylindrical MSIs increased the numbers, lengths, and densities of microcracks, and the total microdamage burden. The same diameter cylindrical and tapered MSIs generated a similar number of cracks and crack lengths. More total microdamage burden was created by the 2.0-mm cylindrical than the 2.0-mm tapered MSIs. Although higher crack densities were produced by the insertion of 1.6-mm tapered MSIs, there was no difference in total microdamage burden induced by 1.6-mm tapered and 1.6-mm cylindrical MSIs. CONCLUSIONS Pilot drilling is effective in reducing microdamage during insertion of tapered MSIs. To prevent excessive microdamage, large diameter and cylindrical MSIs should be avoided.
Collapse
Affiliation(s)
- Emily Taing-Watson
- a Former resident, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Thomas R Katona
- b Associate Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry; Department of Mechanical Engineering, School of Engineering and Technology, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Kelton T Stewart
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Ahmed Ghoneima
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Gabriel T M Chu
- d Associate Professor, Department of Restorative Dentistry, Division of Dental Biomaterials, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| | - Hee-Moon Kyung
- e Professor and Chair, Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Sean S Liu
- c Assistant Professor, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indiana University - Purdue University Indianapolis, Indianapolis, Ind
| |
Collapse
|
13
|
Biologic evaluation of a hollow-type miniscrew implant: an experimental study in beagles. Am J Orthod Dentofacial Orthop 2014; 145:626-37. [PMID: 24785927 DOI: 10.1016/j.ajodo.2013.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 12/01/2013] [Accepted: 12/01/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aims of this study were to assess the biologic stability of a newly designed hollow (H-type) miniscrew compared with conventional (C-type) miniscrews through histomorphometric and histologic analysis. METHODS Both types of miniscrews were placed into the maxillae and the mandibles of 12 beagles. Maximum insertion torque, Periotest (Siemens AG, Bensheim, Germany) value, bone-implant contact, and bone volume were measured. RESULTS The overall success rates of the H-type were 78.3% in the maxilla and 60.0% in the mandible. Mean maximum insertion torque values of the H-type were 14.2 N-cm in the maxilla and 20.9 N-cm in the mandible. The Periotest values of the H-type were -1.5 in the maxilla and -6.4 in the mandible. Mean maximum insertion torque and Periotest values of the H-type were higher than those of the C-type. In the maxilla, the bone-implant contact values of the H-type were 37.3% and 32.3% at 3 and 12 weeks, respectively. In the mandible, the bone-implant contact values were 31.4% and 18.5% at 3 and 12 weeks, respectively. CONCLUSIONS Considering the lower success rate and the insufficient bone-implant contact and bone volume of the H-type in the mandible, the clinician should choose a suitable combination of miniscrews depending on local bone quality and implantation site, such as an H-type in the maxilla and a C-type in the mandible.
Collapse
|
14
|
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.
Collapse
|
15
|
Walter A, Winsauer H, Marcé-Nogué J, Mojal S, Puigdollers A. Design characteristics, primary stability and risk of fracture of orthodontic mini-implants: pilot scan electron microscope and mechanical studies. Med Oral Patol Oral Cir Bucal 2013; 18:e804-10. [PMID: 23722125 PMCID: PMC3790656 DOI: 10.4317/medoral.18674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 11/13/2012] [Indexed: 11/09/2022] Open
Abstract
Objectives: Orthodontic mini-implants (OMIs) are increasingly used in orthodontics but can fail for various reasons. This study investigates the effects of OMI design characteristics on the mechanical properties in artificial bone.
Material and Methods: Twelve self-drilling OMIs (2 small, 6 medium, 4 large) from 8 manufacturers were tested for their primary stability in simulated medium-high cancellous bone and the risk to fracture in high-density methacrylate blocks. For the assessments of the maximum insertion torque (IT) and torsional fracture (TF) 5 of each OMI were used and for the pull-out strength (POS) 10. The OMIs were inserted with a torque screwdriver (12 sec/360°) until the bottom at 8 mm depth was reached. OMI designs were analyzed with a scan electron microscope (SEM).
Results: SEM images revealed a great variation in product refinement. In the whole sample, a cylindrical OMI shape was associated with higher POS (p<0.001) but lower IT (p=0.002) values. The outer and inner OMI diameters were design characteristics well correlated with POS, IT and TF values (ranging from 0.601 to 0.961). Greater thread depth was related to greater POS values (r= 0.628), although OMIs with similar POS values may have different IT values. Thread depth and pitch had some impact on POS. TF depended mainly on the OMI inner (r= 0.961) and outer diameters (r=0.892). A thread depth to outer diameter ratio close to 40% increased TF risk.
Conclusions: Although at the same insertion depth the OMI outer and inner diameters are the most important factors for primary stability, other OMI design characteristics (cylindrical vs. conical, thread design) may significantly affect primary stability and torsional fracture. This needs to be considered when selecting the appropriate OMI for the desired orthodontic procedures.
Key words:Orthodontic mini-implants, primary stability, insertion torque, pullout strength, torsional fracture.
Collapse
Affiliation(s)
- André Walter
- Universitat Internacional de Catalunya, Campus Sant Cugat, Josep Trueta s/n, 08195, St. Cugat del Vallès, Barcelona, Spain,
| | | | | | | | | |
Collapse
|
16
|
Meursinge Reynders R, Ronchi L, Ladu L, Van Etten-Jamaludin F, Bipat S. Insertion torque and orthodontic mini-implants: A systematic review of the artificial bone literature. Proc Inst Mech Eng H 2013; 227:1181-202. [DOI: 10.1177/0954411913495986] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This article systematically reviewed the literature to (1) identify variables that were associated with maximum insertion torque values during the insertion of orthodontic mini-implants into artificial bone, (2) quantify such associations and (3) assess adverse effects of this procedure. Computerized and manual searches were conducted up to 24 February 2012. Selection criteria included studies that (1) recorded maximum insertion torque during the insertion of orthodontic mini-implants into artificial bone, (2) used sample sizes of five screws or more, (3) assessed maximum insertion torque with electronic torque sensors, and (4) used orthodontic mini-implants with a diameter smaller than 2.5 mm. ASTM Standards F543-07ε1 and F1839-08ε1 and the Cochrane Handbook for Systematic Reviews were used as guidelines for this systematic review. Quality assessments were rated according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 23 studies were selected, many of which were multiple publications of the same study. Many domains in the risk of bias assessments were scored as “high” or “unclear” risk of bias. A wide variety of implant, test block, and insertion procedure–related associations with maximum insertion torque were recorded. The quality of most outcomes was classified as “moderate.” Outcomes could not be combined in a meta-analysis because of high risk of bias, poor standardization, high heterogeneity, or inconsistency in direction of outcomes within or between studies. Adverse effects were only assessed in one study. Future studies should control publication bias, consult existing standards for conducting torque tests, and focus on transparent reporting.
Collapse
Affiliation(s)
| | | | | | | | - Shandra Bipat
- Departments of Radiology, Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
17
|
Song HN, Hong C, Banh R, Ohebsion T, Asatrian G, Leung HY, Wu BM, Moon W. Mechanical stability and clinical applicability assessment of novel orthodontic mini-implant design. Angle Orthod 2013; 83:832-41. [PMID: 23627420 DOI: 10.2319/111412-876.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the stability and clinical applicability of a novel orthodontic mini-implant design (N2) with the most widely used commercially available (CA) design. MATERIALS AND METHODS Two groups of mini-implants were tested: a CA design (1.5-mm diameter, 6-mm length) and N2 (3-mm diameter, 2-mm length, tapered shape). Implants were inserted in bone blocks of cortical bone simulation with varying densities (20 pounds per cubic foot [pcf], 30 pcf, and 40 pcf). A torque test was used to measure maximum insertion torque (MIT) and maximum removal torque (MRT). Compression and tension force vectors were applied at angles of 10°, 20°, 30°, and 40° using customized load pins to determine primary stability. RESULTS Mean MIT and MRT were higher in the N2 than the CA design at all three cortical bone densities except MRT in 20 pcf bone (not statistically significant). The mean compression force required to displace the N2 at all distances and angulations was greater for the N2 than the CA design. At all displacement distances, the highest mean tension force required for N2 displacement was at 10° angulation, whereas at 30° and 40°, the mean tension force required to displace the CA design was greater. CONCLUSIONS The primary stability of the N2 is superior to that of the CA design and is promising for both orthodontic and orthopedic clinical applicability, especially under compression force. The short length of the N2 reduces risk of damage to anatomic structures and root proximity during placement and orthodontic treatment. The stability of the N2 may be compromised in areas of high bone density and highly angulated tension force.
Collapse
Affiliation(s)
- Ha Na Song
- Section of Orthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, Calif 90095, USA
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Akyalcin S, McIver HP, English JD, Ontiveros JC, Gallerano RL. Effects of repeated sterilization cycles on primary stability of orthodontic mini-screws. Angle Orthod 2012; 83:674-9. [PMID: 23244461 DOI: 10.2319/082612-685.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine if repeated sterilization has deleterious effects on the clinical stability of mini-screws. MATERIALS AND METHODS Thirty each of the following mini-screws were tested: Aarhus (American Orthodontics, Sheboygan, Wisc), VectorTAS (Ormco Corporation, Orange, Calif), Dual-Top (RMO, Denver, Colo), and Ortho Anchor (KLS Martin, Jacksonville, Fla). Controls were sterilized once using a steam autoclave (Statim 5000, SciCan USA, Canonsburg, Pa). Each group of mini-screws was divided into three groups: the control (n = 10) and two test groups (n =10, each). Test groups were cycled five and 10 times respectively. All screws were inserted into custom-designed synthetic blocks that simulated mandibular bone. Maximum insertion torque and lateral displacement force data were recorded and subjected to statistical testing. Two-way analysis of variance (ANOVA) and three-way mixed ANOVA were used for statistical analyses for maximum insertion torque data and lateral displacement force data, respectively. Level of significance was established at P < .05. RESULTS Insertion torque values displayed significant differences between both of the groups and sterilization cycles (P < .05). Significant differences were observed between American Aarhus mini-screws and both RMO and KLS Martin mini-screws. Ormco Vector mini-screws also differed significantly from the KLS Martin mini-screws in this comparison (P < .05). For lateral displacement, there was a significant main effect of groups, F(1,36) = 14.5 (P < .05). Significant differences were observed between American Aarhus mini-screws and all three of the other groups (P < .05). CONCLUSIONS The examined groups displayed statistical differences of variable quality that may not affect their clinical stability.
Collapse
Affiliation(s)
- Sercan Akyalcin
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX 77054, USA.
| | | | | | | | | |
Collapse
|
19
|
Insertion torque and success of orthodontic mini-implants: A systematic review. Am J Orthod Dentofacial Orthop 2012; 142:596-614.e5. [DOI: 10.1016/j.ajodo.2012.06.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 06/01/2012] [Accepted: 06/01/2012] [Indexed: 12/26/2022]
|