Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment

Abstract

This research aimed to measure the bone depth and thickness of different insertion paths for safe placement of infrazygomatic crest miniscrews between the first (U6) and second maxillary molars (U7) by 3-dimensional (3D) reconstruction and to explore their clinical significance. Cone-beam computed tomography data from 36 adult orthodontic patients were obtained to generate 3D models (n=72) of the infrazygomatic crest region. For each model, the bone depth and thickness of 27 different insertion paths were measured in the region between U6 and U7. The relationship between bone depth and thickness was statistically analyzed. The clinical risk for each insertion path was assessed according to the impacts of bone depth and thickness on insertion failure. Maximum bone depth (median, 7.41mm; mean, 8.42mm) was present at 13mm insertion sites with a gingival tipping angle of 50° and a distal tipping angle of 30°. Maximum bone thickness (median, 3.73mm; mean, 4.00mm) was present at 17mm insertion site with a gingival tipping angle of 70° and a distal tipping angle of 30°. There was a significant negative correlation between bone depth and bone thickness (rs=-0.569, P<0.001). Failure rates were significantly different among different insertion paths (P<0.001). Because the bone depth and thickness may affect the safe insertion of infrazygomatic crest miniscrews in the region between U6 and U7 and they are negatively related, a safe insertion protocol design for distal tooth movement should take both into consideration.