Abstract
Abstract Introduction The clinical success of orthodontic miniscrew implants may be improved after pre-drilling a pilot hole. However, the amount of microdamage to the bone surface produced by the pilot hole is largely unknown. The present study aimed to quantify the damage to cortical bone after the creation of a pilot hole. Materials and methods Porcine tibia bone was prepared into 30 rectangular bone block specimens with widths of 1.5, 2.0 or 2.5 mm. A pilot hole (0.9 mm diameter) was drilled into each bone specimen. Sequential staining allowed the microdamage on the entry and exit surfaces to be imaged by a confocal laser scanning microscope. Image analysis software was used to measure histomorphometric parameters. Results The specimens had a mean total damage area of 0.95 mm2, a maximum damage radius of 0.66 mm and a maximum crack length of 0.18 mm. There were no significant differences between the three bone thicknesses for any of the histomorphometric parameters on the entry and exit surfaces (p > 0.05). The total damage area was significantly greater on the exit surface compared to the entry surface (p < 0.0001). Conclusions Microdamage caused by the creation of a pilot hole in the cortical bone was minimal and did not appear to be influenced by bone thickness. Therefore, pilot hole pre-drill protocols may be implemented without introducing significant cortical bone microdamage.
Highlights
The clinical success of orthodontic miniscrew implants may be improved after pre-drilling a pilot hole
Orthodontic miniscrew implants (OMIs) are not designed to osseointegrate to the surrounding bone as they are usually only needed throughout orthodontic treatment and for a finite time period
The selected widths represented the thickness of cortical bone in the mandible and maxilla of humans and are the thicker bone segments that manufacturers may recommend for the preparation of pilot holes.[16,17]
Summary
The clinical success of orthodontic miniscrew implants may be improved after pre-drilling a pilot hole. There were no significant differences between the three bone thicknesses for any of the histomorphometric parameters on the entry and exit surfaces (p > 0.05). Conclusions: Microdamage caused by the creation of a pilot hole in the cortical bone was minimal and did not appear to be influenced by bone thickness. Pilot hole pre-drill protocols may be implemented without introducing significant cortical bone microdamage. High values of tension and compression between the bone and screw during insertion can generate adjacent microdamage.[8] The damage to bone has the potential to cause a failure of primary stability or induce an inflammatory process with subsequent loss of secondary stability.[2] The problems with primary or secondary stability can lead to overall failure of the OMI
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