Abstract
Abstract Introduction Orthodontic miniscrews are used to obtain skeletal anchorage during orthodontic treatment and their application is growing due to the simple method of placement and removal, which invites improved patient compliance without significant impact on function and aesthetics. However, complications and risks are reported that underscore the need for a thorough preoperative assessment to enable accurate placement, especially in confined sites. A novel approach is presented which employs a custom-designed 3D-printed splint to facilitate a fully-guided placement of orthodontic miniscrews. Materials and methods The presented splint was virtually planned using coDiagnostiX® software after matching the DICOM data and STL file, to enable fully-guided screw insertion. Insertion depth was defined by a sleeve tube height that provided a depth stop when contact was reached with the head of the hand piece. Additionally, to prevent movement of the insertion instrument, a custom metallic sleeve was designed and 3D-printed by a metallic printer. Results Accurate placement was achieved and no complications were experienced during insertion and use. Conclusions The insertion approach provides more predictable results and enables accurate placement of orthodontic screws. The procedure avoids associated risks and complications primarily encountered in difficult cases.
Highlights
Orthodontic miniscrews are used to obtain skeletal anchorage during orthodontic treatment and their application is growing due to the simple method of placement and removal, which invites improved patient compliance without significant impact on function and aesthetics
Given that orthodontic miniscrews (OMS) are fixed into cortical bone and remain for a pre-defined time period, good preoperative assessment is crucial to evaluate the quality and quantity of bone and to avoid damage to adjacent anatomical structures.[5]
The accurate placement of an OMS is required for optimal retention, to avoid complications and improve long-term treatment outcomes while enhancing patient acceptance.[1,12,13]
Summary
Miniscrews are widely used to support anchorage during orthodontic treatment.[1,2] They provide skeletal anchorage and reduce reliance on conventional means of anchorage such as the teeth or extra-oral devices.[3] The placement and removal of orthodontic miniscrews (OMS) is usually straightforward, minimises patient compliance and does not compromise aesthetics.[2,4,5] Given that OMS are fixed into cortical bone and remain for a pre-defined time period, good preoperative assessment is crucial to evaluate the quality and quantity of bone and to avoid damage to adjacent anatomical structures.[5] Preoperative planning helps to ensure accurate placement of the OMS to facilitate stability and reduce associated risks.[3,6]. The accurate placement of an OMS is required for optimal retention, to avoid complications and improve long-term treatment outcomes while enhancing patient acceptance.[1,12,13] A novel customdesigned 3D-printed splint is presented that allows fully-guided OMS placement
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