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Puls GL, Marañón-Vásquez GA, Ramos CAV, Reis CLB, Reis ACD, Stuani MBS, Romano FL, Matsumoto MAN. Insertion torque, flexural strength and surface alterations of stainless steel and titanium alloy orthodontic mini-implants: an in vitro study. Dental Press J Orthod 2024; 29:e2423282. [PMID: 38775601 PMCID: PMC11104944 DOI: 10.1590/2177-6709.29.2.e2423282.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/04/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study aimed to compare the insertion torque (IT), flexural strength (FS) and surface alterations between stainless steel (SS-MIs) and titanium alloy (Ti-MIs) orthodontic mini-implants. METHODS Twenty-four MIs (2 x 10 mm; SS-MIs, n = 12; Ti-MIs, n = 12) were inserted on artificial bone blocks of 20 lb/ft3 (20 PCF) and 40 lb/ft3 (40 PCF) density. The maximum IT was recorded using a digital torque meter. FS was evaluated at 2, 3 and 4 mm-deflection. Surface topography and chemical composition of MIs were assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). General linear and mixed models were used to assess the effect of the MI type, bone density and deflection on the evaluated outcomes. RESULTS The IT of Ti-MIs was 1.1 Ncm greater than that obtained for the SS-MIs (p= 0.018). The IT for MIs inserted in 40 PCF test blocks was 5.4 Ncm greater than that for those inserted in 20 PCF test blocks (p < 0.001). SS-MIs inserted in higher density bone (40 PCF) had significantly higher flexural strength than the other groups, at 2 mm (98.7 ± 5.1 Ncm), 3 mm (112.0 ± 3.9 Ncm) and 4 mm (120.0 ± 3.4 Ncm) of deflection (p< 0.001). SEM evidenced fractures in the Ti-MIs. EDS revealed incorporation of 18% of C and 2.06% of O in the loaded SS-MIs, and 3.91% of C in the loaded Ti-MIs. CONCLUSIONS Based on the findings of this in vitro study, it seems that SS-MIs offer sufficient stability and exhibit greater mechanical strength, compared to Ti-MIs when inserted into higher density bone.
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Affiliation(s)
- Gustavo Lopes Puls
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Guido Artemio Marañón-Vásquez
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Especialização em Ortodontia (Ribeirão Preto/SP, Brazil)
| | - Christian Andrew Vargas Ramos
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Caio Luiz Bitencourt Reis
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Andréa Cândido Dos Reis
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Materiais Odontológicos e Prótese (Ribeirão Preto/SP, Brazil)
| | - Maria Bernadete Sasso Stuani
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Fábio Lourenço Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
| | - Mírian Aiko Nakane Matsumoto
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontopediatria (Ribeirão Preto/SP, Brazil)
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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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Ferrillo M, Nucci L, Gallo V, Bruni A, Montrella R, Fortunato L, Giudice A, Perillo L. Temporary anchorage devices in orthodontics: a bibliometric analysis of the 50 most-cited articles from 2012 to 2022. Angle Orthod 2023; 93:591-602. [PMID: 37200455 PMCID: PMC10575636 DOI: 10.2319/010923-18.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To identify and analyze the 50 most cited articles on temporary anchorage devices (TADs) and investigate the achievement and development of scientific research about the topic through a bibliometric analysis. MATERIALS AND METHODS On August 22, 2022, a computerized database search was performed to detect papers published in the scientific literature about TADs from 2012 to 2022. Metrics data were identified using the Incites Journal Citation Reports (Clarivate Analytics) data set. The Scopus database was used to obtain information on the authors' affiliations, country of origin, and h-index. Key words were automatically harvested from the selected articles to implement the visualized analysis. RESULTS From a total of 1858 papers screened by searching the database, a list of the top 50 most cited articles was created. The total number of citations collected by the 50 most cited articles in TADs was 2380. Among the 50 most cited articles on TADs, 38 were original research papers (76.0%) and 12 were reviews (24.0%). As shown by the key word-network analysis, Orthodontic anchorage procedure was identified as the larger node. CONCLUSIONS Findings of this bibliometric study showed an increasing number of citations for papers on TADs, accompanied by a simultaneous rise in scientific interest in this topic in the past decade. The present work identifies the most influential articles, emphasizing the journals, the authors, and the topics addressed.
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Affiliation(s)
- Martina Ferrillo
- Corresponding author: Dr Martina Ferrillo, Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia,” Viale Europa, 88100 Catanzaro, Italy (e-mail: )
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Nookala H, Sreenivasagan S, Sivakumar A, S AK. Computed Tomographic Evaluation of Buccal Shelf Dimensions in South Indian Patients With Sagittal Skeletal Class III Malocclusion: A Retrospective Study. Cureus 2023; 15:e43883. [PMID: 37746425 PMCID: PMC10511672 DOI: 10.7759/cureus.43883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/20/2023] [Indexed: 09/26/2023] Open
Abstract
Background Computed tomographic evaluation of mandibular buccal shelf region in skeletal class III malocclusion cone beam computed tomography (CBCT) studies have been reported to have great alteration in the thickness of mandibular buccal shelf region owing to the different growth patterns and ethnic variations. The aim of this study was to determine the total and cortical bone thickness in the mandibular buccal shelf (MBS) region for extra-alveolar mini-screw placement in South Indian patients with sagittal skeletal class III malocclusion. Material and methods This retrospective computed tomographic study consisted of archived files of the Dravidian population with class III skeletal base that met the eligibility criteria. The total bone and cortical bone thickness of the buccal shelf regions were evaluated in relation to three anatomical sites at various depths and angulations. One-way ANOVA and Tukey honestly significant difference (HSD) post hoc tests were used for statistical analysis. Pearson correlation coefficient was performed to compare if any relation existed between bone thickness and the growth pattern. Results The maximum bone thickness in the buccal shelf region in our study was found at the distal portion of the second molar root, 8-12 mm from its cementoenamel junction (CEJ) and at 30-45 ° angulation (p-value<0.005). There was a positive correlation between the hypo-divergent growth pattern and the thickness of the bone. Conclusion Based on the sites recorded, the preferred site for mini screw placement in Class III patients is the distobuccal cusp region with respect to the second molar at a depth of 8-12 mm and at angulation of 30-45 °. There was a moderate correlation with hypo-divergent growth patterns, suggestive of a wider and thicker mandibular buccal shelf region in these subjects.
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Affiliation(s)
- Havisha Nookala
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
| | - Swapna Sreenivasagan
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
| | - Arvind Sivakumar
- Orthodontics and Dentofacial Orthopedics, Reface Dental Hospital, Chennai, IND
| | - Aravind Kumar S
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College and Hospital, Saveetha University, Chennai, IND
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Pinheiro PMDM, Freitas KMS, de Castro RCFR. Influence of the third molar presence on the thickness and height of the buccal cortical bone of the mandibular first and second molars. J Clin Exp Dent 2023; 15:e478-e487. [PMID: 37388434 PMCID: PMC10306385 DOI: 10.4317/jced.60428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/28/2023] [Indexed: 07/01/2023] Open
Abstract
Background This study aimed to evaluate the influence of the presence of the third molars on the thickness and height of the buccal cortical bone of the first and second mandibular molars. Material and Methods The retrospective cross-sectional observational sample consisted of 102 CBCTs of patients (mean age of 29 years), divided into two groups: G1: 51 patients (26 female; 25 male, mean age of 26 years) presenting the mandibular third molars and G2: 51 patients (26 female; 25 male, mean age of 32 years) with the absence of the mandibular third molars. The total and the cortical depth were evaluated at 4 and 6mm from the cementoenamel junction (CEJ). The total thickness of the buccal bone was evaluated in two horizontal reference lines located apically 6 mm and 11 mm from the CEJ. Statistical comparisons were performed with Mann Whitney and Wilcoxon tests. Results In the comparison of buccal bone thickness and height between the groups, there was a statistical difference in tooth 36. In tooth 37 there was a statistical difference in the mesial root. For tooth 47, there was a statistical difference for the total thickness at 6mm, 11mm and 4mm. Concerning age, there was a tendency to decrease the values of these variables with increasing age. Conclusions The mean values for buccal bone thickness, total and cortical depth of the mandibular molars were higher for patients with mandibular third molars because the buccal bone thickness of the mandibular molars increased in the posterior and apical direction. Key words:Molar tooth, jaw, bone, orthodontic anchorage procedures, cone-beam computed tomography.
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Ashton KY, Jiang SS, Melo MA, Bosio JA. International investigation on temporary anchorage device use: A survey of orthodontists. J World Fed Orthod 2023:S2212-4438(23)00036-X. [PMID: 37198009 DOI: 10.1016/j.ejwf.2023.04.003] [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: 02/12/2023] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND This study investigates characteristics of temporary anchorage devices (TADs) use by surveying a sample of international orthodontists. Furthermore, the survey investigates the stability, insertion technique, and failure rate of TADs and professionals' experience in residency, and it also attempts to establish guidelines for its use in everyday practice. METHODS A 19-question survey was sent to orthodontists worldwide asking opinion-based, case-specific, and placement technique questions regarding TADs. Results were collected from 251 survey respondents. The country/regions of practice and length of time practicing orthodontics were the independent variables. RESULTS Survey respondents indicated that most orthodontists rarely or sporadically use TADs. Significant differences were also found for TAD utilization purposes, sizes, and placement techniques among different countries/regions and for failure rates (1 or more of the last 6 TADs placed failed-61.6%). A significant difference was found in how many TADs orthodontists placed in residency versus private practice (56% vs. 15%) in relation to how long they have been practicing, but it did not greatly affect the frequency of use, mechanics, or placement technique. CONCLUSIONS The frequency of TAD use is similar in many different countries and among different age groups. Although the collected responses suggested significant differences among respondents from different countries, the variability of results for TAD use worldwide prevent the establishment of clear guidelines.
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Affiliation(s)
| | - Shuying S Jiang
- Research Associate I, Department of Institutional Assessment and Quality Improvement, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Mary Anne Melo
- Clinical Professor, Chair of the Department of Advance General Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland
| | - Jose A Bosio
- Endowed Clinical Associate Professor, Division Chief and Orthodontic Program Director, Division of Orthodontics, Department of Orthodontics and Pediatric Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland.
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Gill G, Shashidhar K, Kuttappa M, Kushalappa P B D, Sivamurthy G, Mallick S. Failure rates and factors associated with infrazygomatic crestal orthodontic implants - A prospective study. J Oral Biol Craniofac Res 2023; 13:283-289. [PMID: 36880016 PMCID: PMC9984842 DOI: 10.1016/j.jobcr.2023.02.010] [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: 04/13/2022] [Revised: 01/29/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023] Open
Abstract
Objective Infrazygomatic crestal (IZC) implants have gained increased popularity over the past few years. Hardly any studies have been done to assess the rate and reasons for failure of IZCs. This prospective study was planned and designed with the primary objective of assessing the rate of failure of bone-screws (BS) placed in the infrazygomatic crest. In continuation, the secondary objective was to assess the factors that were associated with the failure. Materials and methods The study was carried out by taking a detailed case history, (age, gender, vertical skeletal pattern, medical history), photographic records, radiographs, and clinical examination of a total of 32 randomly selected. patients of south indian origin who required infrazygomatic implants bilaterally as the choice of anchorage conservation to retract their incisors. All selected subjects were required to take a PA Cephalogram after the implant placement. The age of the patients ranged from 18 to 33 with an average age of 25 years. The patient log was maintained which included the treatment mechanics, status of oral hygiene, stability of implants, time of loading of the implant, presence of inflammation and time of failure of implant. The angulation of implant was measured on a digital PA cephalogram using Nemoceph software. These parameters were examined to evaluate independent and dependent variables using the Chi-Square test and Fischer's exact test. Result A failure rate 28.1% for IZC placed in the infrazygomatic crest region was observed. Patients with a high mandibular plane angle, poor oral hygiene, immediately loaded implant, peri-implantitis, and severe clinical mobility showed higher failure rates. Variables such as age, gender, sagittal skeletal pattern, length of the implant, type of movement, occluso-gingival position, method of force application, and angle of placement were not significantly associated with implant failure. Conclusion Oral hygiene and peri-screw inflammation must be controlled to minimize the failure of bone screws placed in the infrazygomatic crest region. Loading of the implant should be done after a latent period of two weeks. A higher failure rate was observed in patients with vertical growth pattern.
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Affiliation(s)
- Gauri Gill
- Gills Multispecialty Dental Solutions, Chandigarh, India
| | - Keerthan Shashidhar
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - M.N. Kuttappa
- Department of Orthodontics and Dentofacial Orthodontics, NITTE Deemed to Be University, AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Dhyan Kushalappa P B
- Department of Dentistry, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India
| | | | - Soham Mallick
- Dr Soham's Dental Clinic, Mumbai, Maharashtra, India
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Eto VM, Figueiredo NC, Eto LF, Azevedo GM, Silva AIV, Andrade I. Bone thickness and height of the buccal shelf area and the mandibular canal position for miniscrew insertion in patients with different vertical facial patterns, age, and sex. Angle Orthod 2023; 93:489663. [PMID: 36577089 PMCID: PMC9933561 DOI: 10.2319/060822-412.1] [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: 06/01/2022] [Accepted: 11/01/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The objectives of this article were the following: (1) to analyze bone thickness and height (BTH) of the buccal shelf area (BS) quantitatively in four different potentially eligible sites for miniscrew insertion; (2) to compare and contrast BTH and the changes in spatial position of the inferior alveolar nerve canal (IANC); and (3) to assess differences with age among vertical facial patterns (hypodivergent, normodivergent, and hyperdivergent) and well as by sex. MATERIALS AND METHODS Cone-beam computed tomography scans of 205 individuals (110 women and 95 men) were divided into groups according to age, vertical facial pattern, and sex. The BTH of the BS and the BTH to the IANC were measured in the mesial and distal roots of the first and second molars. RESULTS BTH progressively increased in a posterior direction (P < .001), while BTH to the IANC increased and decreased (P < .001) for thickness and height, respectively, in the same direction in all age groups, for the three different vertical facial patterns, and in both sexes. Women showed significantly less BTH to the IANC (P < .002). Hypodivergent patients had greater BTH (P < .024) and a smaller bone height to the IANC (P < .018) only in the first molar region. Patients over 40 years of age had lower bone height in the second molar area (P < .003). CONCLUSIONS The ideal place for BS miniscrew insertion is the region of the distal root of the second molars, regardless of facial pattern, sex, and age. The BS in women has less BTH and less BTH to the IANC.
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Revisiting the Complications of Orthodontic Miniscrew. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8720412. [PMID: 35958810 PMCID: PMC9359838 DOI: 10.1155/2022/8720412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Miniscrew has been used widely as an effective orthodontic anchorage with reliable stationary quality, ease of insertion and removal techniques, immediate or early loading, flexibility in site insertion, less trauma, minimal patient cooperation, and lower price. Nonetheless, it is not free of complications, and they could impact not only the miniscrew success rate but also patients’ oral health. In this article, literature was searched and reviewed electronically as well as manually to evaluate the complications of orthodontic miniscrew. The selected articles are analyzed and subcategorized into complications during and after insertion, under loading, and during and after removal along with treatment if needed according to the time. In addition, the noteworthy associated factors such as the insertion and removal procedures, characteristics of both regional and local anatomic structures, and features of the miniscrew itself that play a significant role in the performance of miniscrews are also discussed based on literature evidence. Clinicians should notice these complications and their related factors to make a proper treatment plan with better outcomes.
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Thread shape, cortical bone thickness, and magnitude and distribution of stress caused by the loading of orthodontic miniscrews: finite element analysis. Sci Rep 2022; 12:12367. [PMID: 35859046 PMCID: PMC9300621 DOI: 10.1038/s41598-022-16662-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Cortical bone thickness is assumed to be a major factor regulating miniscrew stability. We investigated stress distribution in two miniscrews with different thread shapes (type A and B) and in cortical bone of three different thicknesses using three-dimensional (3D) finite element (FE) models. More specifically, 3D FE models of two different miniscrews were created and placed obliquely or vertically into a cylindrical bone model representing different cortical bone thicknesses. When force was applied to the miniscrew, the stress distribution on the screw surface and in the peri-implant bone was assessed using FE methodology. Miniscrew safety was evaluated using a modified Soderberg safety factor. Screw head displacement increased with a decrease in cortical bone thickness, irrespective of screw type. The smallest minimum principal stresses on the screw surfaces remained constant in type A miniscrews on changes in cortical bone thickness. Minimum principal stresses also appeared on the cortical bone surface. Lower absolute values of minimum principal stresses were seen in type A miniscrews when placed vertically and with upward traction in obliquely placed type B miniscrews. Both miniscrews had acceptable safety factor values. Taken together, orthodontists should select and use the suitable miniscrew for each patient in consideration of bone properties.
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Quantitative Assessment of Posterior Maxillary Arch for Orthodontic Miniscrew Insertion Using Cone Beam Computed Tomography: A Cross-Sectional Analysis. Int J Dent 2022; 2022:8257256. [PMID: 35662891 PMCID: PMC9162861 DOI: 10.1155/2022/8257256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Methods and Materials Cone beam computed tomography records of 35 patients (70 quadrants) from maxilla were evaluated. The images were analyzed using the NNT viewer software (version 23). The measurements were made on axial sections at 2, 4, 6, and 8 mm from CEJ. The optimal sites were defined in terms of mesiodistal palatal or buccal interradicular distance, alveolar cortical bone thickness, and palatal or buccal safe depth of the bone for miniscrew insertion. Descriptive statistics, paired t-test, and repeated measure ANOVA were used to analyze the data. Results The mean buccal interradicular distance was the lowest between first and second molar (2.44 mm) and the highest between first and second premolar (3.28 mm). The mean palatal interradicular distance was the lowest between first and second premolar (3.64 mm) and the highest between second premolar and first molar (5.30 mm). The mean buccal safe depth was the lowest between canine and first premolar (1.96 mm) and the highest between first and second molar (2.61 mm). The mean palatal safe depth was the lowest between second premolar and first molar (3.35 mm) and the highest between first and second molar (3.56 mm). The thinnest and thickest buccal cortical thicknesses were detected on canine and first molar (1.04 mm) and on the second premolar and second molar (1.56 mm). Conclusion The quantity and quality of the maxillary alveolar process is an important factor to decide where to insert the orthodontic miniscrews, necessitating careful preoperative evaluation.
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Centeno ACT, Fensterseifer CK, Chami VDO, Ferreira ES, Marquezan M, Ferrazzo VA. Correlation between cortical bone thickness at mini-implant insertion sites and age of patient. Dental Press J Orthod 2022; 27:e222098. [PMID: 35239944 PMCID: PMC8896745 DOI: 10.1590/2177-6709.27.1.e222098.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/24/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction: Orthodontic mini-implants (MI) are a reliable alternative to provide temporary orthodontic anchorage. Prior to miniscrew insertion, the best approach would be to evaluate each possible insertion site and measure the cortical bone thickness, and verify whether it would provide adequate primary stability. Objective: This study aimed to evaluate the difference in cortical bone thickness in areas of mini-implants insertion in patients of different ages, by means of cone beam computed tomography (CBCT). Methods: The sample of this retrospective study was composed of 123 CBCT scans, which were used to measure cortical bone thickness in the buccal and palatal inter-radicular space in the mesial region of the first permanent molars. These measures were compared by using the Student’s t-test, ANOVA/Tukey tests, and Linear regression between male and female subjects, from 12 to 30 years old. Results: No significant difference was found in cortical bone thickness between sex, race and sagittal facial patterns. Significantly higher measurement values were observed in patients older than 12 years of age at all sites evaluated. The coefficient β at the adjusted linear regression analysis showed that at each increment in age, mean cortical thickness values increased by 0.06mm in the mandible, 0.03mm in the buccal region and 0.02mm in the palatal region of the maxilla. Conclusions: The increase in cortical bone thickness was positively associated with age; that is, the more advanced the patient’s age was, the less chance there was of failure due to primary stability.
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Affiliation(s)
| | | | - Vitória de Oliveira Chami
- Universidade Federal de Santa Maria, Curso de Odontologia, Departamento de Estomatologia (Santa Maria/RS, Brazil)
| | - Eduardo Silveira Ferreira
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Ortodontia (Porto Alegre/RS, Brazil)
| | - Mariana Marquezan
- Universidade Federal de Santa Maria, Curso de Odontologia, Departamento de Estomatologia (Santa Maria/RS, Brazil)
| | - Vilmar Antônio Ferrazzo
- Universidade Federal de Santa Maria, Curso de Odontologia, Departamento de Estomatologia (Santa Maria/RS, Brazil)
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Abstract
The objective of this study was to evaluate the effect of bone–miniscrew contact percentage (BMC%) and bone quality and quantity on orthodontic miniscrew stability and the maximum insertion torque value (ITV). Orthodontic miniscrews of five different dimensions and several bovine iliac bone specimens were used in the evaluation. Miniscrews of each dimension group were inserted into 20 positions in bovine iliac bone specimens. The experiment was divided into three parts: (1) Bone quality and quantity were evaluated using cone-beam computed tomography (CBCT) and microcomputed tomography. (2) The 3D BMC% was calculated. (3) The ITVs during miniscrew insertion were recorded to evaluate the stability of the orthodontic miniscrews. The results indicated that longer and thicker miniscrews enabled higher ITVs. CBCT was used to accurately measure cortical bone thickness (r = 0.939, P < 0.05) and to predict the bone volume fraction of cancellous bone (r = 0.752, P < 0.05). BMC% was significantly influenced by miniscrew length. The contribution of cortical bone thickness to the ITV is greater than that of cancellous bone structure, and the contribution of cortical bone thickness to BMC% is greater than that of cancellous bone structure. Finally, the higher is BMC%, the greater is the ITV. This study concludes that use of CBCT may predict the mechanical stability of orthodontic miniscrews.
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Zhang S, Wei X, Wang L, Wu Z, Liu L, Yan X, Lai W, Long H. Evaluation of Optimal Sites for the Insertion of Orthodontic Mini Implants at Mandibular Symphysis Region through Cone-Beam Computed Tomography. Diagnostics (Basel) 2022; 12:diagnostics12020285. [PMID: 35204375 PMCID: PMC8871083 DOI: 10.3390/diagnostics12020285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 01/27/2023] Open
Abstract
This study aims to evaluate the overall bone thickness (OBT) and cortical bone thickness (CBT) of mandibular symphysis and to determine the optimal sites for the insertion of orthodontic mini implants. Cone-beam computed tomography (CBCT) images of 32 patients were included in this study. The sample was further categorized into three facial types: low-, average-, and high-angle. OBT and CBT were measured at the mandibular symphysis region. All measurements were performed at six different heights from the cementoenamel junction [CEJ] and at seven different angles to the occlusal plane. Analysis of variance (ANOVA) was used for statistical comparison and a p value less than 0.05 was considered statistically significant. Our results revealed that neither OBT nor CBT was influenced by age or sex, except for the observation that CBT was significantly greater in adults than in adolescents. OBT and CBT were significantly greater in low-angle cases than in average- and high-angle cases. Both OBT and CBT were significantly influenced by insertion locations, heights and angles, and their interactions. CBT and OBT were greatest at the location between two lower central incisors, and became greater with increases in insertion height and angle. Both recommended and optimal insertion sites were mapped. The mandibular symphysis region was suitable for the placement of orthodontic mini implants. The optimal insertion site was 6–10 mm apical to the CEJ between two lower central incisors, with an insertion angle being 0–60 degrees to the occlusal plane.
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Affiliation(s)
- Shizhen Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xiaoyu Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lufei Wang
- Department of Oral and Craniofacial Health Sciences, University of North Carolina Adams School of Dentistry, Chapel Hill, NC 27599, USA;
| | - Zhouqiang Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Lu Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Xinyu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (S.Z.); (X.W.); (Z.W.); (L.L.); (X.Y.)
| | - Wenli Lai
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
| | - Hu Long
- Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (W.L.); (H.L.)
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Ikenaka R, Koizumi S, Otsuka T, Yamaguchi T. Effects of root contact length on the failure rate of anchor screw. J Oral Sci 2022; 64:232-235. [DOI: 10.2334/josnusd.21-0536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - So Koizumi
- Department of Orthodontics, Kanagawa Dental University
| | - Takero Otsuka
- Department of Orthodontics, Kanagawa Dental University
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Palone M, Darsiè A, Maino GB, Siciliani G, Spedicato GA, Lombardo L. Analysis of biological and structural factors implicated in the clinical success of orthodontic miniscrews at posterior maxillary interradicular sites. Clin Oral Investig 2021; 26:3523-3532. [PMID: 34837567 DOI: 10.1007/s00784-021-04321-9] [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: 03/19/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aims to evaluate success factors implicated in clinical orthodontic miniscrew stability after their interradicular placement in maxilla. MATERIALS AND METHODS Six hundred seventy-six miniscrews were inserted in maxillary interradicular sites in a sample of 276 patients (109 males and 167 females; mean age 19 ± 1.7 years) and immediately loaded. Percentage failure rate was recorded, and the influence of the following factors was investigated: structural (miniscrew length, diameter and body shape), operative (side of insertion site, pilot hole drilling or not) and biological (maximal insertion torque [MIT] and type of gingiva). A chi-square test with Monte Carlo correction was performed to detect the influence of these variables on the failure rate of orthodontic miniscrews. Then both multivariate logistic regression and post hoc analysis were performed, followed by classification and regression tree (CART) analysis. RESULTS The average success rate was 88%. The principal factors implicated in the failure rate were miniscrew length, MIT values and type of gingiva. Specifically, 8 mm miniscrew length, alveolar mucosa and 5-10 Ncm MIT values were linked to higher failure rates. According to CART, the main variable influencing failure is miniscrew length (≤ 8 mm for higher failure rates). For others, MIT values of 5-10 Ncm are linked to higher failure rates (p < 0.05). CONCLUSION Orthodontic miniscrews inserted in the maxilla display good success rates. However, clinicians should be discouraged from using miniscrews of length ≤ 8 mm and MIT values < 10 Ncm, even with longer miniscrews. CLINICAL RELEVANCE Information about factors related to failure rate of miniscrews placed at posterior maxillary interradicular sites is given.
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Affiliation(s)
- M Palone
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy.
| | - A Darsiè
- Private Practice, Treviso, Italy
| | - G B Maino
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
| | - G Siciliani
- School of Dentistry, University of Ferrara, Via Luigi Borsari 46, 44121, FerraraFerrara, Italy
| | - G A Spedicato
- Faculty of Banking and Finance, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123, Milano, Italy
| | - L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy
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Evaluation of clinical parameters for the stability of 2 types of miniscrews. Am J Orthod Dentofacial Orthop 2021; 161:437-444. [PMID: 34799196 DOI: 10.1016/j.ajodo.2020.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The purpose of this research was to compare insertion techniques and effects on mechanical and clinical parameters between 2 types of miniscrews. METHODS Forty-four consecutive patients whose orthodontic treatment involved the use of miniscrews (miniscrew A [MA] and miniscrew B [MB]) for anchorage were included in this study. Miniscrews were placed with predrilling or self-drilling; peak maximum insertion torque (MIT) and Periotest values were measured. Cone-beam computed tomography was performed after the insertion of miniscrews and root proximity determination; cortical bone thickness was also analyzed. Periotest values were measured after the application of orthodontic force. RESULTS Self-drilling produced higher Periotest values (P <0.01) for MA and higher MIT (P <0.01) for MB with closer root proximity (P <0.05). MB had higher MIT and Periotest values with drilling compared with MA (P <0.05); MB also showed closer root proximity (P <0.05). Successful miniscrews had lower MIT (P <0.05) for MB and lower Periotest values (P <0.01) for both MA and MB, with significantly more distant root proximity (P <0.01). Self-drilling produced higher Periotest values at the time of placement (P <0.01) and after 4 weeks (P <0.05) in MA. Drilling produced higher Periotest values for MB at the time of placement (P <0.05). MIT had positive correlations with Periotest values for MB with self-drilling (P <0.01) and with root proximity for MA with drilling (P <0.01). Periotest values had negative correlations with root proximity for MA and the MB group with drilling (P <0.01). CONCLUSIONS For miniscrews with larger diameters, higher MIT may result in more mobility (higher Periotest values). Drilling can avoid root contact and enhance primary stability, thus producing lower Periotest values.
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Zhang S, Choi Y, Li W, Shi D, Tang P, Yang L, Wang Y, Yang X, Wu J. The effects of cortical bone thickness and miniscrew implant root proximity on the success rate of miniscrew implant: A retrospective study. Orthod Craniofac Res 2021; 25:342-350. [PMID: 34582625 DOI: 10.1111/ocr.12538] [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: 07/16/2021] [Revised: 09/14/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effects of cortical bone thickness (CBT), miniscrew implant root proximity (MRP) and other related factors on the success rate of miniscrew implant (MSI). MATERIALS AND METHODS Four hundred and five MSIs placed in 171 patients were analysed in this retrospective study. The primary predictor variables were CBT and MRP at MSI insertion sites. The predictor variables also included patient, location, MSI design and procedure related factors. The outcome variable was the survival of MSI. The differences in measurement data between success group and failed group were evaluated by the analysis of variance and independent samples t tests. Patient, location, MSI design and procedure related factors associated with the MSI prognosis were analysed by survival analysis with Cox proportional hazard regression model. The P value was set at .05. And the survival curves of independent factors were plotted. RESULTS The overall success rate of MSI was 82.7%. The age of MSI host, CBT, interdental root distance (IRD) and MRP at MSI sites showed no significant differences between failed group and success group. CBT and insertion jaws were independent prognosis factors screened out by Cox proportional hazard regression model. Failure risk (hazard ratio) of MSI with CBT <1 mm was 4.72. The failure risk in the mandible was 3.80 times as high as that in the maxilla. CONCLUSION Inadequate CBT (<1 mm) contributed to the failure of MSI. MSI placed in the maxilla showed better prognosis compared to the mandible. MRP had no significant effect on the prognosis.
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Affiliation(s)
- Shuting Zhang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhsin Choi
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wa Li
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danni Shi
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Tang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li'an Yang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Wang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Yang
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyong Wu
- Department of Stomatology, XinHua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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19
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Keo P, Matsumoto Y, Shimizu Y, Nagahiro S, Ikeda M, Aoki K, Ono T. A pilot study to investigate the histomorphometric changes of murine maxillary bone around the site of mini-screw insertion in regenerated bone induced by anabolic reagents. Eur J Orthod 2021; 43:86-93. [PMID: 32202621 DOI: 10.1093/ejo/cjaa018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the histomorphometric changes around the site of mini-screw insertion in the regenerated bone which was induced by an anabolic-injection method using both anabolic peptide and bone morphogenetic protein 2 (BMP-2). METHODS Twenty-seven eight-week-old C57BL/6J male mice were used. Some mice received submucosal co-injections of anabolic peptide and BMP-2 just in front of the maxillary first molar. Screw insertion was then performed 4 weeks after injection. All mice underwent a weekly in vivo micro-focal X-ray computed tomography (µCT) analysis before being sacrificed at week 8. The bone formation activity was evaluated using fluorescent labelling in the undecalcified sections. The analyses, including screw insertion, were performed in the frontal plane, in front of the site of screw insertion. RESULTS Reconstructed µCT images revealed that the co-injection of anabolic reagents could lead to a gradual increase in the bone mineral density (BMD) of the injection-induced thickened bone by week 8. Both radiological and histomorphometric analyses indicated that screw insertion did not have any deleterious effects on either the BMD or the bone formation activity of the induced bone. Furthermore, the injection of anabolic reagents also led to an increase in the BMD of the underlying maxillary bone at the injection site. CONCLUSION Our histomorphometric analyses suggest that performing such anabolic injection to thicken bone could stimulate bone formation in the basal bone as well as in the induced bone. Similar augmentation of bone formation could be obtained even after subsequent screw insertion at the site of the induced bone.
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Affiliation(s)
- Preksa Keo
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiro Matsumoto
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhiro Shimizu
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigeki Nagahiro
- Department of Pediatric Dentistry/Special Needs Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masaomi Ikeda
- Department of Oral Prosthetic Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuhiro Aoki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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CBCT comparison of buccal shelf bone thickness in adult Dravidian population at various sites, depths and angulation - A retrospective study. Int Orthod 2021; 19:471-479. [PMID: 34172417 DOI: 10.1016/j.ortho.2021.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/30/2021] [Accepted: 06/05/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION It is important to understand the variations in the bone thickness of the buccal shelf region among different ethnic groups, as these variations will influence the placement and success of the buccal shelf mini-screw. OBJECTIVES The primary objective was to analyse the total buccal bone and cortical bone thickness of the mandibular buccal shelf region (MBS) at various depths, mesiodistal positions and angulations in Dravidian population and to find the best site for insertion of buccal shelf mini-implant. MATERIAL AND METHODS This was a retrospective study done on 30 cone-beam computed tomography samples collected from 30 subjects, aged 16 to 25 years and of Dravidian origin, who reported for orthodontic treatment. The total bone and cortical bone thicknesses of the buccal shelf regions were evaluated in relation to the Disto-Buccal cusp of 1st Molar (DB1M), Mesio-Buccal cusp of 1st Molar (MB1M), and Disto-Buccal cusp of 2nd Molar (DB2M) at the depths of 4mm, 8mm and 12mm from cemento-enamel junction (CEJ). The total bone thickness and the clearance from the root and cortical bone thickness were assessed at angulations of 30, 45 and 60 degrees from 5mm below the root apex. ANOVA and Post Hoc tests were done to compare the bone thickness measurements. Kappa statistics was done to assess the intraobserver reliability. Pearson's correlation test was done to find the correlation between growth pattern and thickness of the bone. RESULTS The mean age group of the included sample was 20.5 years. Maximum total bone thickness was observed at a depth of 8mm in relation to the MB2M (6.41±0.29mm) and 12mm in relation to the DB2M 6.56±0.28mm and the P value was 0.000. Maximum bone thickness was present in the DB2M at 30° followed by DB2M 45° of 11.42±0.35mm and 10.89±0.3mm and the P value was 0.000. The maximum clearance from the root was observed at 30° and 45° in the DB2M with 5.35±0.2mm and 5.18±0.27mm, the P value was 0.014 when comparing angulation 30 and 45°. The DB2M had a cortical bone thickness of 2.97±0.15mm and 2.8±0.2mm at 45° and 60° and was statistically significant. CONCLUSIONS The insertion site with optimal bone quantity was observed in relation to the buccal aspect of distobuccal cusp of 2nd molar at depth of 8mm or greater with a preferred angulation of 30-45° to have adequate clearance from the molar tooth roots and to penetrate a region of cortical bone of minimum 2mm.
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Tavares A, Montanha-Andrade K, Cury PR, Crusoé-Rebello I, Neves FS. Tomographic assessment of infrazygomatic crest bone depth for extra-alveolar miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. Orthod Craniofac Res 2021; 25:49-54. [PMID: 33908170 DOI: 10.1111/ocr.12485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate bone availability at the infrazygomatic crest for extra-alveolar bone miniscrew insertion in subjects with different vertical and sagittal skeletal patterns. SETTING AND SAMPLE POPULATION Measurements of the infrazygomatic crest were performed on multislice computed tomography scans from 58 adults with different skeletal patterns. MATERIALS AND METHODS Infrazygomatic crest bone depth was measured at 4, 5 and 6 mm from the cementoenamel junction (CEJ) of the maxillary first molar at three different angles (60°, 70° and 80°) in the first molar occlusal plane. The sagittal and vertical skeletal patterns were determined. Analysis of variance followed by Tukey's post hoc test was used (P ≤ .05). RESULTS Bone depth was greater near the CEJ (8.7 ± 3.1 mm) and lower in the apical area (5.8 ± 2.7 mm). In Class II subjects, considering 6 mm from the CEJ, there was a significantly lower depth at the 80° angle (5.4 ± 2.5 mm) than at 60° (8.6 ± 3.5 mm; P = .007). In mesofacial subjects, considering 5 and 6 mm from the CEJ, bone depth was lower at 80° (5.7 ± 3.2 mm and 5.3 ± 2.5 mm) than at 60° considering 4 mm from the CEJ (P ≤ .019). CONCLUSION Bone availability was lower at the apical level, especially in Class II and mesofacial subjects. Therefore, when the planned insertion site is located in the apical direction, it is recommended to choose shorter miniscrews (2.0 x 12mm) and a smaller insertion angle (60°) and/or to plan a miniscrew bone insertion deep enough to allow bicortical fixation.
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Affiliation(s)
- Alana Tavares
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Kátia Montanha-Andrade
- Post-graduate Program in Dentistry and Health, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Patricia Ramos Cury
- Division of Periodontics, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Ieda Crusoé-Rebello
- Division of Dentomaxillofacial Radiology, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
| | - Frederico Sampaio Neves
- Division of Dentomaxillofacial Radiology, School of Dentistry, Federal University of Bahia, Ufba, Salvador, Brazil
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Menezes CCD, Barros SE, Tonello DL, Aliaga-Del Castillo A, Garib D, Bellini-Pereira SA, Janson G. Influence of the growth pattern on cortical bone thickness and mini-implant stability. Dental Press J Orthod 2021; 25:33-42. [PMID: 33503123 PMCID: PMC7869807 DOI: 10.1590/2177-6709.25.6.033-042.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/01/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Controversial reports suggest a relationship between growth pattern and cortical alveolar bone thickness, and its effect in the use of mini-implants. OBJECTIVE The main purpose of this study was to assess the influence of the growth pattern on the cortical alveolar bone thickness and on the stability and success rate of mini-implants. METHODS Fifty-six mini-implants were inserted in the buccal region of the maxilla of 30 patients. These patients were allocated into two groups, based on their growth pattern (horizontal group [HG] and vertical group [VG]). Cortical thickness was measured using Cone Beam Computed Tomography. Stability of mini-implants, soft tissue in the insertion site, sensitivity during loading and plaque around the mini-implants were evaluated once a month. Intergroup comparisons were performed using t tests, Mann-Whitney tests, and Fisher exact tests. Correlations were evaluated with Pearson's correlation coefficient. RESULTS The cortical bone thickness was significantly greater in the HG at the maxillary labial anterior region and at the mandibular buccal posterior and labial anterior regions. There was a significant negative correlation between Frankfort-mandibular plane angle (FMA) and the labial cortical thickness of the maxilla, and with the labial and lingual cortical bone thicknesses of the mandible. No significant intergroup difference was found for mini-implant mobility and success rate. No associated factor influenced stability of the mini-implants. CONCLUSIONS Growth pattern affects the alveolar bone cortical thickness in specific areas of the maxilla and mandible, with horizontal patients presenting greater cortical bone thickness. However, this fact may have no influence on the stability and success rate of mini-implants in the maxillary buccal posterior region.
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Affiliation(s)
- Carolina Carmo de Menezes
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Sérgio Estelita Barros
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Ortodontia (Porto Alegre/RS, Brazil)
| | - Diego Luiz Tonello
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Aron Aliaga-Del Castillo
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Daniela Garib
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | | | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
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Aleluia RB, Duplat CB, Crusoé‐Rebello I, Neves FS. Assessment of the mandibular buccal shelf for orthodontic anchorage: Influence of side, gender and skeletal patterns. Orthod Craniofac Res 2021; 24 Suppl 1:83-91. [DOI: 10.1111/ocr.12463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 12/01/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Roberta Basañez Aleluia
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Candice Belchior Duplat
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Iêda Crusoé‐Rebello
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
| | - Frederico Sampaio Neves
- Division of Oral Radiology Department of Propedeutics and Integrated Clinic School of Dentistry Federal University of Bahia Salvador Brazil
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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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Chang CH, Lin LY, Roberts WE. Orthodontic bone screws: A quick update and its promising future. Orthod Craniofac Res 2020; 24 Suppl 1:75-82. [PMID: 33225592 DOI: 10.1111/ocr.12429] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
Orthodontic bone screws (OBSs) provide intraoral anchorage by penetrating oral mucosa and seating firmly in basilar bone (BB). Retromolar (prosthetic-type) implants introduced the extra-alveolar (E-A) concept for BB anchorage to move teeth throughout the alveolar process, but the clinical procedures were complex and expensive. Titanium alloy (Ti) miniscrews placed in inter-radicular (I-R) alveolar bone are more convenient and provide some tooth movement potential, but multiple screws are usually required and the devices often interfere with the path of tooth movement. The advantages of BB anchorage and the convenience of miniscrew are combined into the E-A OBS system. These miniscrews are relatively large in diameter (2 mm), and strong (stainless steel), which are placed intraorally in the BB of the infra-zygomatic crest (IZC) and mandibular buccal shelf (MBS). E-A OBSs provide osseous anchorage to retract the dentition and/or rotate either arch. Recovery of impactions is effectively managed with lever arm springs anchored with IZC or MBS bone screws. An emerging frontier is BB anchorage for correcting severe malocclusions with clear aligners. Since the osseous-anchored mechanics are complementary, fixed appliances and clear aligners can be used individually or in tandem to resolve a broad variety of malocclusions. This report summarizes current concepts for conservatively managing complex malocclusions such as severe crowding, skeletal discrepancies, asymmetries and impactions with the OBS system.
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Affiliation(s)
| | - Lexie Y Lin
- Beethoven Orthodontic Center, HsinChu, Taiwan
| | - Wilbur Eugene Roberts
- Department of Orthodontics, School of Dentistry, Indiana University, Indianapolis, IN, USA.,Department of Mechanical Engineering, IUPUI, Indianapolis, IN, USA.,Department of Orthodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA
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de Elío Oliveros J, Del Canto Díaz A, Del Canto Díaz M, Orea CJ, Del Canto Pingarrón M, Calvo JS. Alveolar Bone Density and Width Affect Primary Implant Stability. J ORAL IMPLANTOL 2020; 46:389-395. [PMID: 32221558 DOI: 10.1563/aaid-joi-d-19-00028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary implant stability (PIS) depends on surgical technique, implant design, and recipient bone characteristics, among other factors. Bone density (BD) can be determined in Hounsfield units (HUs) using cone beam computerized tomography (CBCT). Reliable prediction of PIS could guide treatment decisions. We assessed whether PIS was associated with recipient bone characteristics, namely, BD and alveolar ridge width (ARW), measured preoperatively by CBCT. We studied a convenience sample of 160 implants placed in 48 patients in 2016 and 2017. All underwent CBCT with a radiologic/surgical guide yielding values for ARW and BD. PIS measures used were the implant stability quotient (ISQ) from resonance frequency analysis and insertion torque (IT). IT was most influenced by the HU value at 0.5 mm outside the implant placement area, followed by the value within this area, and ISQ by the HU value at 0.5 mm outside the placement area, followed by implant placement site and apical ARW. ISQ values were significantly related to ARW in coronal (P < .05), middle (P < .01), and apical (P < .01) thirds. ISQs were higher with larger-diameter implants (P < .01). ISQ and IT were strongly correlated (P < .001). PIS in terms of ISQ and IT is positively correlated with edentulous alveolar ridge BD measured by CBCT, implying that implant stability may be predicted preoperatively. Wide alveolar ridges favored lateral PIS but did not affect rotational PIS. The most significant predictor of lateral and rotational PIS in our patients was the HU value at 0.5 mm outside the implant placement area.
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Affiliation(s)
| | | | | | - Clara Jacobo Orea
- Oral Surgery, Implantology and Periodontics, University of León, León, Spain
| | | | - Jesús Seco Calvo
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
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Ye YS, Yi WM, Zhuang PL, Liu M, Yu YS, Lu YJ, Yao QH, Wang W, Chang SH. Thread shape affects the stress distribution of torque force on miniscrews: a finite element analysis. Comput Methods Biomech Biomed Engin 2020; 23:1034-1040. [PMID: 32619356 DOI: 10.1080/10255842.2020.1784884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aimed to investigate the effect of miniscrews thread shape on the stress distribution receiving a torque load. Seven thread shapes (S,V1,V2,B1,B2,R1,R2) models were constructed and a 6 Nmm-torque load was applied. The order of maximum equivalent stress (EQV) value was V1 > V2 > B1 > R1 > R2 > B2 > S. The order of maximum displacement of miniscrew (Max DM) value was S > B2 > R1 = V1 > B1 > V2 > R2. Model R2 may be the most appropriate thread shape affording a torque force.
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Affiliation(s)
- Yu-Shan Ye
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei-Min Yi
- Department of Integrative medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pei-Lin Zhuang
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mo Liu
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan-Song Yu
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying-Juan Lu
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qing-He Yao
- School of Engineering, Sun Yat-sen University, Guangzhou, China
| | - Wei Wang
- Urumqi DW Innovation Info Tech Co., Ltd, Urumqi, China
| | - Shao-Hai Chang
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Matys J, Flieger R, Gedrange T, Janowicz K, Kempisty B, Grzech-Leśniak K, Dominiak M. Effect of 808 nm Semiconductor Laser on the Stability of Orthodontic Micro-Implants: A Split-Mouth Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E2265. [PMID: 32423127 PMCID: PMC7287787 DOI: 10.3390/ma13102265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/03/2020] [Accepted: 05/11/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND To evaluate the effect of photobiomodulation (PBM) on orthodontic micro-implants (n = 44; 14 women, 8 men). METHODS PBM with 808 nm diode laser was applied immediately, 3, 6, 9, 12, 15, and 30 days post the implantation. Results were assessed within same time frames and additionally after 60 days to check for implants stability using the Periotest device. Patients pain experiences following the first day post-treatment and potential loss of micro-implants after 60 days were recorded. The procedure involved insertion of mini-implants in the maxilla for the laser group (L, n = 22) and negative control group (C, n = 22). Irradiation was carried buccally and palatally with respect to the maxillary ridge (2 points). The energy per point was 4 J (8 J/cm2), total dose was 56 J. RESULTS Patients did not report significant differences in terms of pain experiences comparing the L and C groups (p = 0.499). At 30 days post-treatment, higher secondary stability of implants was observed in the laser group (Periotest Test Value, PTV 6.32 ± 3.62), in contrast to the controls (PTV 11.34 ± 5.76) (p = 0.004). At 60 days post-treatment, significantly higher stability was recorded in the laser group (PTV 6.55 ± 4.66) compared with the controls, PTV (10.95 ± 4.77) (p = 0.009). Conclusions: Application of the 808 nm diode laser increased secondary micro-implant stability.
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Affiliation(s)
- Jacek Matys
- Laser Laboratory at Dental Surgery Department, Medical University of Wroclaw, 50-425 Wrocław, Poland;
| | | | - Tomasz Gedrange
- Dental Surgery Department, Medical University of Wroclaw, 50-425 Wrocław, Poland; (T.G.); (M.D.)
- Department of Orthodontics, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Krzysztof Janowicz
- Department of Anatomy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (K.J.); (B.K.)
- Department of Histology and Embryology, Poznań University of Medical Sciences, 60-781 Poznań, Poland
| | - Bartosz Kempisty
- Department of Anatomy, Poznan University of Medical Sciences, 60-781 Poznan, Poland; (K.J.); (B.K.)
- Department of Histology and Embryology, Poznań University of Medical Sciences, 60-781 Poznań, Poland
- Department of Obstetrics and Gynaecology, University Hospital and Masaryk University, 602 00 Brno, Czech Republic
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Kinga Grzech-Leśniak
- Laser Laboratory at Dental Surgery Department, Medical University of Wroclaw, 50-425 Wrocław, Poland;
| | - Marzena Dominiak
- Dental Surgery Department, Medical University of Wroclaw, 50-425 Wrocław, Poland; (T.G.); (M.D.)
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Schneider S, Gandhi V, Upadhyay M, Allareddy V, Tadinada A, Yadav S. Sex-, growth pattern-, and growth status-related variability in maxillary and mandibular buccal cortical thickness and density. Korean J Orthod 2020; 50:108-119. [PMID: 32257936 PMCID: PMC7093665 DOI: 10.4041/kjod.2020.50.2.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 12/14/2019] [Indexed: 11/15/2022] Open
Abstract
Objective The primary objective of this study was to quantitatively analyze the bone parameters (thickness and density) at four different interdental areas from the distal region of the canine to the mesial region of the second molar in the maxilla and the mandible. The secondary aim was to compare and contrast the bone parameters at these specific locations in terms of sex, growth status, and facial type. Methods This retrospective cone-beam computed tomography (CBCT) study reviewed 290 CBCT images of patients seeking orthodontic treatment. Cortical bone thickness in millimeters (mm) and density in pixel intensity value were measured for the regions (1) between the canine and first premolar, (2) between the first and second premolars, (3) between the second premolar and first molar, and (4) between the first and second molars. At each location, the bone thickness and density were measured at distances of 2, 6, and 10 mm from the alveolar crest. Results The sex comparison (male vs. female) in cortical bone thickness showed no significant difference (p > 0.001). The bone density in growing subjects was significantly (p < 0.001) lower than that in non-growing subjects for most locations. There was no significant difference (p > 0.001) in bone parameters in relation to facial pattern in the maxilla and mandible for most sites. Conclusions There was no significant sex-related difference in cortical bone thickness. The buccal cortical bone density was higher in females than in males. Bone parameters were similar for subjects with hyperdivergent, hypodivergent, and normodivergent facial patterns.
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Affiliation(s)
- Sydney Schneider
- Department of Orthodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Vaibhav Gandhi
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
| | - Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, Brodie Laboratory for Craniofacial Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - Aditya Tadinada
- Division of Oral and Maxillofacial Radiology, University of Connecticut Health, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, University of Connecticut Health, Farmington, CT, USA
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Low-Level Laser Therapy with a 635 nm Diode Laser Affects Orthodontic Mini-Implants Stability: A Randomized Clinical Split-Mouth Trial. J Clin Med 2019; 9:jcm9010112. [PMID: 31906190 PMCID: PMC7019927 DOI: 10.3390/jcm9010112] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/28/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022] Open
Abstract
Background: The study aimed to clinically estimate an influence of a 635 nm diode laser on the stability of orthodontic mini-implants, to assess mini-implants loss, and to evaluate a pain level after the treatment. Materials and Methods: The randomized clinical split-mouth trial included 20 subjects (13 women and 7 men; age: 32.5 ± 6.1 years), 40 implants (RMO, West Colfax Ave., Denver, CO, USA) with a diameter 1.4 mm and length of 10 mm. Mini-implants were placed in the area of the attached gingiva between the second premolar and first molar teeth, 2 mm below the mucogingival junction of both sides of the maxilla. Each implant on the right side (G1, n = 20) of the maxilla was irradiated with a diode laser, and the implants on the opposite side (left, G2, n = 20) were a control group (without laser irradiation). The 635-nm laser parameters; dose: 10 J per point (20 J/cm2), time: 100 s per point, two points (irradiation on a buccal, and a palatal side of the alveolus/implant), the total energy per session 20 J. Laser application protocol: immediately and 3, 6, 9, 12, 15, and 30 days after surgery. The total energy after all therapeutic sessions was 140 J. The implants’ stability was measured employing a Periotest device (Periotest Test Value—PTV) immediately and 3, 6, 9, 12, 15, 30, and 60 days after the insertion of the mini-implants. Results: We found significantly higher secondary stability, lower mean PTV (6.18 ± 5.30) and (1.51 ± 2.25), for self-drilling mini-implants (G1, test group) in contrast to the control, G2 group (9.17 ± 8.25) and (5.00 ± 3.24), after 30 (p = 0.0003) and 60 days (p = 0.0000). Moreover, the analysis of the mini-implants stability after 635-nm diode laser application revealed significant higher stability in comparison with none irradiated implants (G2 group) after 3 days. (p = 0.0000) There was no significant difference in pain level measured on the NRS-11 scale on both sides of the maxilla. (p = 0.3665) An important finding was that all inserted mini-implants survived during a two-month observation period. Conclusions: 635-nm diode laser at laser irradiation increases the secondary stability of orthodontic mini-implants.
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Liu H, Wu X, Tan J, Li X. Safe regions of miniscrew implantation for distalization of mandibular dentition with CBCT. Prog Orthod 2019; 20:45. [PMID: 31814037 PMCID: PMC6900385 DOI: 10.1186/s40510-019-0297-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/01/2019] [Indexed: 12/04/2022] Open
Abstract
Background To assess the anatomy of the mandibular buccal shelf (MBS) with cone-beam computed tomography (CBCT) and to identify the region of miniscrew implantation for the distalization of mandibular dentition. Materials and methods The MBS was assessed in 80 patients at four regions as follows: (i) between the buccal root of the mandibular second premolar and the mesiobuccal root of the first molar (L5b–L6mb), (ii) between the mesiodistal root of the first molar (L6mb–L6db), (iii) between the distobuccal root of the first molar and the mesiobuccal root of the second molar (L6db–L7mb), and (iv) between the mesiodistal roots of the second molar (L7mb–L7db). The buccal alveolar bone thickness, the narrowest inter-radicular space at the buccal side of the roots, and the distance between the implantation site and the mandibular neural tube were measured at horizontal planes of 3, 5, 7, and 9 mm from the alveolar crest. Results The buccal alveolar bone thickness increased from the premolar to the molar and from the crest edge to the mandibular roots. The L7mb–L7db region had the thickest buccal alveolar bone of 7.61 mm at a plane of 9 mm. The buccal inter-radicular spaces were smallest in the L7mb–L7db region and greatest in the L6db–L7mb region. The distances from the implantation site to the mandibular neural tube at planes of 3, 5, 7, and 9 mm were all > 13 mm from the L6 region to the L7 region. Conclusions The L6db–L7mb region should be the first choice for miniscrew implantation in the MBS for the distalization of mandibular dentition.
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Affiliation(s)
- Haibo Liu
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China
| | - Xiaoxue Wu
- Department of Orthodontics, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, Guangdong, China
| | - Jun Tan
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China
| | - Xiao Li
- Department of Stomatology, General Hospital of Southern Theater Command of the Chinese People's Liberation Army (Guangzhou Liuhuaqiao Hospital), No.111, Liuhua road, Guangzhou, 510016, Guangdong, China.
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Han CM, Watanabe K, Tsatalis AE, Lee D, Zheng F, Kyung HM, Deguchi T, Kim DG. Evaluations of miniscrew type-dependent mechanical stability. Clin Biomech (Bristol, Avon) 2019; 69:21-27. [PMID: 31280063 DOI: 10.1016/j.clinbiomech.2019.06.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/13/2019] [Accepted: 06/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Miniscrew has been widely used as an absolute anchorage in orthodontic treatment. Types of miniscrew with different diameter, length, shape, and thread dimensions may have a substantial effect on mechanical stability of the miniscrew system. Thus, the objective of this study was to evaluate miniscrew type-dependent mechanical stability to assess mechanical properties of miniscrew systems in various thickness of artificial bone block using different measurement tools. METHODS Two types of miniscrews (15 Tomas and 15 AbsoAnchor) were placed in artificial bone block with different thickness of 1.5, 2.0, 3.0 mm. Values of maximum insertion torque, removal torque, Periotest, implant stability quotient, static stiffness, dynamic stiffness, and energy dissipation ability were assessed for each miniscrew system. FINDINGS The maximum insertion torque, removal torque, implant stability quotient, static and dynamic stiffness values significantly increased when the miniscrews were placed in thicker bone block while Periotest values decreased. The static stiffness, Periotest and implant stability quotient values were significantly correlated each other and also with other mechanical properties (p < 0.001) except tan δ (p > 0.35). However, the slopes of some correlations and absolute values of measurement were significantly different dependent on the miniscrew types (p < 0.025). INTERPRETATION The current findings suggest that miniscrew type-dependent calibrations are required to estimate mechanical stability of the miniscrew systems despite the utilization of same measurement tool.
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Affiliation(s)
- Cheol-Min Han
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Keiichiro Watanabe
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Andrea E Tsatalis
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Damian Lee
- Division of Restorative and Prosthetic dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Fengyuan Zheng
- Division of Restorative and Prosthetic dentistry, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA.
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Pan CY, Liu PH, Tseng YC, Chou ST, Wu CY, Chang HP. Effects of cortical bone thickness and trabecular bone density on primary stability of orthodontic mini-implants. J Dent Sci 2019; 14:383-388. [PMID: 31890126 PMCID: PMC6921117 DOI: 10.1016/j.jds.2019.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/13/2019] [Indexed: 11/18/2022] Open
Abstract
Background/purpose Mini-implant screws are now routinely used as anchorage devices in orthodontic treatments. This study used synthetic bone models to investigate how the primary stability of an orthodontic mini-implant (OMI) as measured by resonance frequency (RF) is affected by varying cortical bone thickness and trabecular bone density. Materials and methods Three synthetic cortical shells (thicknesses of 1, 2, and 3 mm) and three polyurethane foam blocks (densities of 40, 20, and 10 pound/cubic foot) were used to represent jawbones of varying cortical bone thicknesses and varying trabecular bone densities. Twenty-five stainless steel OMIs (2 × 10 mm) were sequentially inserted into artificial bone blocks to depths of 2, 4, and 6 mm. Five experimental groups of bone blocks with OMIs were examined by Implomates® RF analyzer. Statistical and correlation analyses were performed by Kruskal-Wallis test, Wilcoxon rank-sum test, and simple linear regression. Results As trabecular bone density decreased, RF decreased; as cortical bone thickness decreased, RF also decreased. Simple linear regression analysis showed highly linear correlations between trabecular bone density and RF (R2 > 0.99; P < 0.0001) and between cortical bone thickness and RF (R2 > 0.98; P < 0.0001). Conclusion The stability of an OMI at the time of placement is influenced by both cortical bone thickness and trabecular bone density. Both cortical bone thickness and trabecular bone density have strong linear correlations with RF.
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Affiliation(s)
- Chin-Yun Pan
- School of Dentistry and Graduate Program of Dental Science (Orthodontics), College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pao-Hsin Liu
- Department of Biomedical Engineering, I-Shou University (Medical Campus), Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry and Graduate Program of Dental Science (Orthodontics), College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Szu-Ting Chou
- School of Dentistry and Graduate Program of Dental Science (Orthodontics), College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chao-Yi Wu
- School of Dentistry and Graduate Program of Dental Science (Orthodontics), College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthodontics, Faculty of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hong-Po Chang
- School of Dentistry and Graduate Program of Dental Science (Orthodontics), College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dentistry (Orthodontics), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
- Corresponding author. School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Min District, Kaohsiung, 80708, Taiwan.
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Nucera R, Bellocchio AM, Oteri G, Farah AJ, Rosalia L, Giancarlo C, Portelli M. Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults. Am J Orthod Dentofacial Orthop 2019; 155:330-338. [PMID: 30826035 DOI: 10.1016/j.ajodo.2018.04.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 04/01/2018] [Accepted: 04/01/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate bone depth, cortical bone thickness, and vestibulolingual bone dimension of the mandibular retromolar trigone and anterior ramus region to evaluate what are its most suitable sites for miniscrew insertion in adults. METHODS The sample included cone-beam computerized tomography (CBCT) records of 60 adult subjects retrospectively evaluated. All CBCT examinations were performed with the use of an i-CAT CBCT scanner (Imaging Sciences International). Each exam was converted into DICOM format and processed with the use of Osirix Medical Imaging software. On reproducible sagittal scan views, bone depth and cortical bone thickness were evaluated on specific lines parallel and at a 45° angle to the occlusal plane, and at 3 mm and at 6 mm distance from it. Vestibulolingual bone dimension was computed in 4 different cross-section scans and at 3 different levels of depth (0, 6, and 11 mm). RESULTS All of the considered insertion sites showed on average more than 10 mm of bone depth. Inferential statistics showed significantly (P <0.05) greater bone depth (+3 mm) in cross-sectional scans parallel to the occlusal plane compared with those at a 45° angle to it. Cortical bone thickness showed average values from 3 mm to 5 mm. Vestibulolingual bone dimension showed a significant (P <0.05) reduction (-10 mm) in the posterior region of retromolar region. No significant differences were found between subjects with and without third molars. CONCLUSIONS The retromolar trigone and anterior ramus region showed enough bone quantity and adequate bone quality for safe miniscrew insertion in adults.
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Affiliation(s)
- Riccardo Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy.
| | - Angela Mirea Bellocchio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - Athena Janan Farah
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - Leonardi Rosalia
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - Cordasco Giancarlo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - Marco Portelli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
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Kim SJ, Ha YD, Kim E, Jang W, Hwang S, Nguyen T, Ko CC, Choi YJ, Kim KH, Chung CJ. Dynamics of alveolar bone healing after the removal of orthodontic temporary anchorage devices. J Periodontal Res 2019; 54:388-395. [PMID: 30677138 DOI: 10.1111/jre.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/12/2018] [Accepted: 12/23/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the dynamics of alveolar bone formation and healing pattern after the removal of orthodontic temporary anchorage devices (TADs). METHODS Miniscrews (N = 32) were inserted into the buccal inter-radicular alveolar bone in beagle dogs. Afterward, miniscrews were removed at different time points during a 13-week period and six different in vivo fluorescent markers were injected at 1, 2, 6, 8, 10, and 12 weeks. Serial changes in bone apposition at the removal and intact control sites were evaluated using μCT, histology, and bone histomorphometry. RESULTS Gradual bone apposition at the TAD removal site was noted with bone volume/tissue volume (BV/TV) reaching the level of the control alveolar bone by 7 weeks. Histologically, newly formed woven bone was detected within the removal site which was distinct from the surrounding pre-existing alveolar bone at 13 weeks. Accelerated mineral apposition rate (MAR) and bone formation rate (BFR) were noted between 2 and 6 weeks in the removal site (P < 0.05). Although MAR and BFR gradually decreased after its peak at 2-4 weeks, BFR in the removal site was still higher than the control site at 10-12 weeks (P < 0.05). CONCLUSIONS Spontaneous bone healing was noted after TAD removal with regional acceleration of MAR and BFR within 2-6 weeks. However, the removal site was mainly filled with woven bone even after 13 weeks, suggesting a longer healing period is required for the quality of the alveolar bone to reach levels comparable to the surrounding alveolar bone.
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Affiliation(s)
- Sung-Jin Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.,Department of Oral biology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Young Don Ha
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Eunji Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Woowon Jang
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.,Gangnam Severance Hospital, Seoul, Korea
| | - Soonshin Hwang
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.,Gangnam Severance Hospital, Seoul, Korea
| | - Tung Nguyen
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina
| | - Ching-Chang Ko
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.,Gangnam Severance Hospital, Seoul, Korea
| | - Chooryung J Chung
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.,Gangnam Severance Hospital, Seoul, Korea.,Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina
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Manzanera E, Llorca P, Manzanera D, García-Sanz V, Sada V, Paredes-Gallardo V. Anatomical study of the maxillary tuberosity using cone beam computed tomography. Oral Radiol 2018; 34:56-65. [PMID: 30484092 DOI: 10.1007/s11282-017-0284-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/21/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To examine the dimensions (width, length, and height) of the maxillary tuberosity (MT) and their correlations with age and sex, and to identify different anatomical types for adequate positioning of miniscrews in this area. METHODS The study enrolled 39 patients attending the University of Valencia. The patients comprised 21 males and 18 females with a mean age of 39.7 ± 8.4 years. The dimensions of all 78 MTs were measured on cone beam computed tomography (CBCT) images using Invivo Dental 5 software. RESULTS The intraobserver and interobserver errors were good for all measurements. A total of 858 MT measurements were taken. The widths were greater in men than in women, with significant differences. The MT dimensions showed correlations with patient age, whereby older patients presented with greater widths and lengths, but reduced heights. Three different anatomical types were detected according to patient age. CONCLUSIONS The dimensions (width, length, and height) of the MT vary according to patient age and sex. The MT dimensions conform to particular anatomical types, which should be taken into account when placing miniscrews in this region.
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Affiliation(s)
- Ester Manzanera
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Paula Llorca
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - David Manzanera
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Verónica García-Sanz
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain
| | - Vicente Sada
- Private Practice, 26 San Fermín Street, 31003, Pamplona, Navarra, Spain
| | - Vanessa Paredes-Gallardo
- Department of Orthodontics, Dentistry and Medicine Faculty, University of Valencia, C/Gasco Oliag nº1, 46010, Valencia, Spain.
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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.
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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
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Uesugi S, Kokai S, Kanno Z, Ono T. Stability of secondarily inserted orthodontic miniscrews after failure of the primary insertion for maxillary anchorage: Maxillary buccal area vs midpalatal suture area. Am J Orthod Dentofacial Orthop 2018; 153:54-60. [DOI: 10.1016/j.ajodo.2017.05.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 10/18/2022]
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How do geometry-related parameters influence the clinical performance of orthodontic mini-implants? A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46:1539-1551. [DOI: 10.1016/j.ijom.2017.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/14/2017] [Indexed: 01/27/2023]
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Matys J, Flieger R, Tenore G, Grzech-Leśniak K, Romeo U, Dominiak M. Er:YAG laser, piezosurgery, and surgical drill for bone decortication during orthodontic mini-implant insertion: primary stability analysis-an animal study. Lasers Med Sci 2017; 33:489-495. [PMID: 29127605 PMCID: PMC5862928 DOI: 10.1007/s10103-017-2381-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
It is important to identify factors that affect primary stability of orthodontic mini-implants because it determines the success of treatment. We assessed mini-implant primary stability (initial mechanical engagement with the bone) placed in pig jaws. We also assessed mini-implant insertion failure rate (mini-implant fracture, mini-implants to root contact). A total of 80 taper-shaped mini-implants (Absoanchor® Model SH1312-6; Dentos Inc., Daegu, Korea) 6 mm long with a diameter of 1.1 mm were used. Bone decortication was made before mini-implant insertion by means of three different methods: Group G1: Er:YAG laser (LiteTouch®, Light Instruments, Yokneam, Israel) at energy of 300 mJ, frequency 25 Hz, fluence 38.2 J/cm2, cooling 14 ml/min, tip 1.0 × 17 mm, distance 1 mm, time of irradiation 6 s; Group G2: drill (Hager & Meisinger GmbH, Hansemannstr, Germany); Group G3: piezosurgery (Piezotom Solo, Acteon, NJ, USA). In G4 group (control), mini-implants were driven by a self-drilling method. The primary stability of mini-implants was assessed by measuring damping characteristics between the implant and the tapping head of Periotest device (Gulden-Medizinteknik, Eschenweg, Modautal, Germany). The results in range between − 8 to + 9 allowed immediate loading. Significantly lower Periotest value was found in the control group (mean 0.59 ± 1.57, 95% CI 0.7, 2.4) as compared with Er:YAG laser (mean 4.44 ± 1.64, 95% CI 3.6, 5.3), piezosurgery (mean 17.92 ± 2.73, 95% CI 16.5, 19.3), and a drill (mean 5.91 ± 1.52, 95% CI 5.2, 6.6) (p < 0.05). The highest failure rate (33.3%) during mini-implant insertion was noted for self-drilling method (G4) as compared with G1, G2, and G3 groups (p < 0.05). The small diameter decortication by Er:YAG laser appeared to provide better primary stability as compared to drill and piezosurgery. Decortication of the cortical bone before mini-implant insertion resulted in reduced risk of implant fracture or injury of adjacent teeth. The high initial stability with a smaller diameter of the mini-implant resulted in increased risk of fracture, especially for a self-drilling method.
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Affiliation(s)
- Jacek Matys
- "Sapienza" University of Rome, Rome, Italy. .,Private Dental Healthcare, Lipowa 18, 67-400, Wschowa, Poland.
| | | | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | | | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Marzena Dominiak
- Dental Surgery Department, Medical University of Wroclaw, Wroclaw, Poland
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Prognosis of primary and secondary insertions of orthodontic miniscrews: What we have learned from 500 implants. Am J Orthod Dentofacial Orthop 2017; 152:224-231. [PMID: 28760284 DOI: 10.1016/j.ajodo.2016.12.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although the success of using orthodontic miniscrews for primary insertion has been reported in the literature, few studies have followed up on secondary insertions after failure of the first insertion. In this study, we investigated not only the primary but also secondary success rates of miniscrews and considered the risk factors influencing their stability. METHODS Five hundred miniscrews were inserted for orthodontic anchorage in 240 patients. Ninety-eight miniscrews lacked stability; thus, 77 of these were removed and reinserted. We calculated and compared the primary and secondary success rates of insertion. Moreover, we investigated which clinical parameters affected the stability of miniscrews. RESULTS The success rate of secondary insertion (44.2%) was significantly lower than that of primary insertion (80.4%). The screw length and jaw receiving the insertion were significantly associated with the stability of miniscrews. The 8.0-mm miniscrews were significantly more stable than the 6.0-mm miniscrews, and the success rate for insertions into the maxilla was significantly higher than that for the mandible. CONCLUSIONS Secondary insertions lack stability; therefore, clinicians should be aware of the reduced success rate of reinsertion and know the risk factors to avoid failure of secondary insertions.
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Biomechanical evaluation of implant-supported prosthesis with various tilting implant angles and bone types in atrophic maxilla: A finite element study. Comput Biol Med 2017; 86:47-54. [DOI: 10.1016/j.compbiomed.2017.04.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/22/2017] [Accepted: 04/23/2017] [Indexed: 12/13/2022]
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Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, Matarese G, Cordasco G. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod 2017; 87:745-751. [PMID: 28598220 DOI: 10.2319/011117-34.1] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyze the buccal bone thickness, bone depth, and cortical bone depth of the mandibular buccal shelf (MBS) to determine the most suitable sites of the MBS for mini-screw insertion. MATERIALS AND METHODS The sample included cone-beam computed tomographic (CBCT) records of 30 adult subjects (mean age 30.9 ± 7.0 years) evaluated retrospectively. All CBCT examinations were performed with the i-CAT CBCT scanner. Each exam was converted into DICOM format and processed with OsiriX Medical Imaging software. Proper view sections of the MBS were obtained for quantitative and qualitative evaluation of bone characteristics. RESULTS Mesial and distal second molar root scan sections showed enough buccal bone for mini-screw insertion. The evaluation of bone depth was performed at 4 and 6 mm buccally to the cementoenamel junction. The mesial root of the mandibular second molar at 4 and 6 mm showed average bone depths of 18.51 mm and 14.14 mm, respectively. The distal root of the mandibular second molar showed average bone depths of 19.91 mm and 16.5 mm, respectively. All sites showed cortical bone depth thickness greater than 2 mm. CONCLUSIONS Specific sites of the MBS offer enough bone quantity and adequate bone quality for mini-screw insertion. The insertion site with the optimal anatomic characteristics is the buccal bone corresponding to the distal root of second molar, with screw insertion 4 mm buccal to the cementoenamel junction. Considering the cortical bone thickness of optimal insertion sites, pre-drilling is always recommended in order to avoid high insertion torque.
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Seifi M, Matini NS. Evaluation of primary stability of innovated orthodontic miniscrew system (STS): An ex-vivo study. J Clin Exp Dent 2016; 8:e255-9. [PMID: 27398174 PMCID: PMC4930633 DOI: 10.4317/jced.52676] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 03/12/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Stability is determined as one of the requirements in use of Temporary Anchorage Devices (TAD) in orthodontics. Miniscrew has been a widely used Bone Anchor. Compared with mini-implant that necessitates osseointegration; mechanical retention is a determining factor for primary stability of miniscrew. Studies investigated various ways to increase primary stability. The aim of this study is to introduce a new configuration of miniscrew system which is believed to obtain more primary stability. MATERIAL AND METHODS Freshly ovine mandibles were cut in blocks. Twenty-seven miniscrews (diameter 1.6 × 8 mm; G2, Dual Top Anchor System, Jeil Medical, Seoul, Korea) were inserted in the blocks and divided in 2 experimental groups: single miniscrew and the innovated design "Seifi Twin Screw (STS)". Primary stability was evaluated by Periotest "M"® device. RESULTS Independent t-test showed a significant difference between 2 experimental groups in periotest evaluation (p< 0.05). STS demonstrated higher primary stability due to its mechanical configuration and design. CONCLUSIONS The STS provides higher primary stability and was found to be effective in increased success rate of miniscrew systems from the standpoint of primary stability. KEY WORDS Anchorage procedures, anchorage techniques, orthodontic anchorage procedures, miniscrews, temporary anchorage device.
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Affiliation(s)
- Massoud Seifi
- DDS, MSD, MS Med Edu. Dentofacial Deformities Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin-Sadat Matini
- DDS. Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Predisposing Factors for Orthodontic Mini-Implant Failure Defined by Bone Strains in Patient-Specific Finite Element Models. Ann Biomed Eng 2016; 44:2948-2956. [DOI: 10.1007/s10439-016-1584-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/01/2016] [Indexed: 01/08/2023]
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Influence of Screw Length and Bone Thickness on the Stability of Temporary Implants. MATERIALS 2015; 8:6558-6569. [PMID: 28793582 PMCID: PMC5512929 DOI: 10.3390/ma8095322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/16/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this work was to study the influence of screw length and bone thickness on the stability of temporary implants. A total of 96 self-drilling temporary screws with two different lengths were inserted into polyurethane blocks (n = 66), bovine femurs (n = 18) and rabbit tibia (n = 12) with different cortical thicknesses (1 to 8 mm). Screws insertion in polyurethane blocks was assisted by a universal testing machine, torque peaks were collected by a digital torquemeter and bone thickness was monitored by micro-CT. The results showed that the insertion torque was significantly increased with the thickness of cortical bone from polyurethane (p < 0.0001), bovine (p = 0.0035) and rabbit (p < 0.05) sources. Cancellous bone improved significantly the mechanical implant stability. Insertion torque and insertion strength was successfully moduled by equations, based on the cortical/cancellous bone behavior. Based on the results, insertion torque and bone strength can be estimate in order to prevent failure of the cortical layer during temporary screw placement. The stability provided by a cortical thickness of 2 or 1 mm coupled to cancellous bone was deemed sufficient for temporary implants stability.
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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.
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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
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A study of success rate of miniscrew implants as temporary anchorage devices in singapore. Int J Dent 2015; 2015:294670. [PMID: 25861272 PMCID: PMC4377511 DOI: 10.1155/2015/294670] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 02/15/2015] [Accepted: 02/15/2015] [Indexed: 12/04/2022] Open
Abstract
Objective. To find out the success rate of miniscrew implants in the National Dental Centre of Singapore (NDCS) and the impact of patient-related, location-related, and miniscrew implant-related factors.
Materials and Methods. Two hundred and eighty-five orthodontic miniscrew implants were examined from NDCS patient records. Eleven variables were analysed to see if there is any association with success. Outcome was measured twice, immediately after surgery prior to orthodontic loading (T1) and 12 months after surgery (T2). The outcome at T2 was assessed 12 months after the miniscrew's insertion date or after its use as a temporary anchorage device has ceased. Results. Overall success rate was 94.7% at T1 and 83.3% at T2. Multivariate analysis revealed only the length of miniscrew implant to be significantly associated with success at both T1 (P = 0.002) and T2 (P = 0.030). Miniscrew implants with lengths of 10–12 mm had the highest success rate (98.0%) compared to other lengths, and this is statistically significant (P = 0.035). At T2, lengths of 10–12 mm had significantly (P = 0.013) higher success rates (93.5%) compared to 6-7 mm (76.7%) and 8 mm (82.1%) miniscrew implants. Conclusion. Multivariate statistical analyses of 11 variables demonstrate that length of miniscrew implant is significant in determining success.
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Chang C, Liu SSY, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod 2015; 85:905-10. [PMID: 25603272 DOI: 10.2319/092714.695.1] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the initial failure rate (≤4 months) for extra-alveolar mandibular buccal shelf (MBS) miniscrews placed in movable mucosa (MM) or attached gingiva (AG). MATERIALS AND METHODS A total of 1680 consecutive stainless steel (SS) 2 × 12-mm MBS miniscrews were placed in 840 patients (405 males and 435 females; mean age, 16 ± 5 years). All screws were placed lateral to the alveolar process and buccal to the lower first and second molar roots. The screw heads were at least 5 mm superior to the soft tissue. Loads from 8 oz-14 oz (227 g-397 g, 231-405 cN) were used to retract the mandibular buccal segments for at least 4 months. RESULTS Overall, 121 miniscrews out of 1680 (7.2%) failed: 7.31% were in MM and 6.85% were in AG (statistically insignificant difference). Failures were unilateral in 89 patients and bilateral in 16. Left side (9.29%) failures was significantly greater (P < .001) compared with those on the right (5.12%). Average age for failure patients was 14 ± 3 years. CONCLUSION MBS miniscrews were highly successful (approximately 93%), but there was no significant difference between placement in MM or AG. Failures were more common on the patient's left side and in younger adolescent patients. Having 16 patients with bilateral failures suggests that a small fraction of patients (1.9%) are predisposed to failure with this method.
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Affiliation(s)
- Chris Chang
- a Private Practice, Beethoven Orthodontic Center, Hsinchu City, Taiwan
| | - Sean S Y Liu
- b Assistant Professor, Department of Orthodontics and Orofacial Genetics, Indiana University School of Dentistry, Indianapolis, Ind
| | - W Eugene Roberts
- c Professor Emeritus of Orthodontics and Adjunct Professor of Mechanical Engineering, Indiana University and Purdue University, Indianapolis, Ind
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