Abstract
Introduction: The selection of appropriate sites for miniscrew insertion is critical for clinical success. Objectives: The aim of the present study was to evaluate how interradicular spaces measured on panoramic radiograph compare with Cone-Beam Computed Tomography (CBCT), and how crowding can influence the presence of available space for miniscrew insertion, in order to define a new “safe zones” map. Methods: A total of 80 pre-treatment panoramic radiographs and 80 CBCT scans with corresponding digital models were selected from the archives of the department of Dentistry, Aarhus University. Crowding was measured on digital models, while interradicular spaces mesial to the second molars were measured on panoramic radiographs and CBCTs. For panoramic radiographs, a magnification factor was calculated using tooth widths measured on digital models. Statistical analyses were performed to investigate the correlation between the amount of crowding and the available interradicular space. Visual maps showing the amount of interradicular spaces measured were drawn. Results: The most convenient interradicular spaces are those between the second molar and the first premolar in the mandible, and between the central incisors in the maxilla. However, some spaces were revealed to be influenced by crowding. Conclusions: Calibration of panoramic radiographs is of utmost importance. Generally, panoramic radiographs underestimate the available space. Preliminary assessment of miniscrew insertion feasibility and the related selection of required radiographs can be facilitated using the new “safe zone” maps presented in this article.
Highlights
The selection of appropriate sites for miniscrew insertion is critical for clinical success
Many authors have defined maps of “safe zones” for miniscrew insertion; a few studies were conducted on panoramic radiographs,[9,10] whilst the majority used Cone Beam Computed Tomography (CBCT) to determine the “quality” and suitability of different insertion sites.[11,12,13,14,15,16,17,18,19,20]
The present paper addresses the following question: Is there a way of increasing the amount of information extrapolated from a traditional radiograph by combining it with specific clinical observations to ensure safe miniscrew placement at low radiation cost? The goal is to help the clinician from the first step of his orthodontic treatment planning, choosing the appropriate clinical and/or radiological examination, in order to determine the possible insertion site(s) of miniscrews
Summary
The selection of appropriate sites for miniscrew insertion is critical for clinical success. Objectives: The aim of the present study was to evaluate how interradicular spaces measured on panoramic radiograph compare with Cone-Beam Computed Tomography (CBCT), and how crowding can influence the presence of available space for miniscrew insertion, in order to define a new “safe zones” map. According to previous studies, there is little consensus regarding how much information CBCTs can provide over conventional radiographs, and in which cases increased radiation exposure can be justified.[27,28,29,30,31,32]
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