Abstract
Abstract Background/objective The alternative use of Orthodontic Miniscrew Implants (OMIs), traditionally used for skeletal anchorage, to facilitate micro-osteoperforations (MOPs) for accelerating orthodontic tooth movement has been reported in previous studies. The objective of the present in vitro study was to compare the microdamage generated by OMIs and MOP-purposed screws of similar dimensions in porcine cortical bone. Materials and methods Forty rectangular porcine cortical bone specimens of 1.5 mm thickness were produced and divided into two equal groups. According to group allocation, either a single MOP screw or OMI was inserted and later removed. A sequential staining protocol was carried out to distinguish true microdamage created upon screw insertion and removal from iatrogenic damage. The bone specimens were imaged by a confocal laser scanning microscope, and five histomorphometric measurements described and quantified the generated microdamage. Results On the entry (outer) bone surface, the OMI screws produced greater microdamage which reached statistical significance across all of the histomorphometric parameters. In contrast, a statistically significant increase in microdamage was created following MOP screw insertion on the exit (inner) bone surface, but only in three assessment parameters, recorded as total damage area, as well as diffuse damage area and radius. Conclusions Overall, the present study showed that 1.5 mm OMIs produced slightly greater microcrack-type and diffuse damage-type microdamage than the 1.6 mm diameter MOP screws. However, these differences were small and considered clinically insignificant.
Highlights
Surgical adjuncts rely upon the induction of a regional acceleratory phenomenon (RAP) in which a localised intensified remodelling process occurs as a response to a noxious stimulus
The use of corticotomies for the purpose of accelerating tooth movement dates back to the 1950s, when it was first introduced by Köle, who created surgical incisions limited to cortical bone.[11]
There was a statistically significant difference in diffuse damage of both histomorphometric parameters, as well as in total damage area, where greater damage was displayed following the use of MOP screws
Summary
The average active duration of orthodontic treatment ranges between 18 months and 3 years.[1,2,3] The ratelimiting factor in controlling tooth movement is considered to be bone resorption at the bone and periodontal ligament interface.[4,5,6] Surgical and nonsurgical adjuncts marketed to reduce orthodontic treatment duration aim to accelerate tooth movement by increasing the number and function of osteoclasts through a variety of mechanisms.[7,8,9] Surgical adjuncts rely upon the induction of a regional acceleratory phenomenon (RAP) in which a localised intensified remodelling process occurs as a response to a noxious stimulus. Various procedures have evolved and in 2001, Wilcko et al described the Accelerated Osteogenic Orthodontic
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