Abstract
To analyze the effect of a computer-aided static navigation technique and mixed reality technology on the accuracy of orthodontic micro-screw placement. Material and methods: Two hundred and seven orthodontic micro-screws were placed using either a computer-aided static navigation technique (NAV), a mixed reality device (MR), or a conventional freehand technique (FHT). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic micro-screw placement. The deviation angle and horizontal deviation were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic micro-screws. In addition, any complications resulting from micro-screw placement, such as spot perforations, were also analyzed across all dental sectors. Results: The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001). The NAV study group showed statistically significant differences from the FHT (p < 0.001) and MR study groups (p < 0.001) at the apical end-point (p < 0.001), and the FHT group found significant differences from the angular deviations of the NAV (p < 0.001) and MR study groups deviations (p = 0.0011). Different dental sectors also differed significantly. (p < 0.001) Additionally, twelve root perforations were observed in the FHT group, while there were no root perforations in the NAV group. Conclusions: Computer-aided static navigation technique enable more accurate orthodontic micro-screw placement and fewer intraoperative complications when compared with the mixed reality technology and conventional freehand techniques.
Highlights
Anchorage systems pose a consistent issue in orthodontic treatments, as they are often uncomfortable, unattractive and their success relies heavily on patient cooperation [1]
Significant differences were shown between the computer-aided static navigation technique and conventional freehand technique study groups (p < 0.001), the computer-aided static navigation technique and the mixed reality technique study groups (p < 0.001) and the mixed reality technique and conventional freehand technique study groups with regard to the coronal entry point deviations of planned and placed orthodontic micro-screws (p < 0.001) (Figure 5)
Significant differences were shown between the coronal entry-point deviations of the orthodontic micro-screws placed using the computer-aided static navigation technique and conventional freehand technique in the incisive-canine premolar and molar dental sectors (p < 0.001)
Summary
Anchorage systems pose a consistent issue in orthodontic treatments, as they are often uncomfortable, unattractive and their success relies heavily on patient cooperation [1]. Success rate and intra-operative complications related to orthodontic micro-screws can be affected by a number of variables, including the inherent characteristics attributed to the patient (age, gender, systematic diseases, periodontal status, smoking, skeletal pattern) [4], experience of the clinician [5], mechanical properties of the orthodontic micro-screw [6], patient cares [7], placement torque [8], placement site [9,10], cortical bone thickness [8,9], insertion angle [11], root proximity [12], bone density [13], bone stress [14], and orthodontic force [12,13]. Mixed reality appliances have not been previously used in the field of orthodontics and especially for orthodontic micro-screw placement and could be useful due to the accurate tracking technology
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