Abstract
To analyze the influence of the computer-aided static navigation technique on the accuracy of placement of orthodontic micro-screws. One hundred and thirty-eight orthodontic micro-screws were randomly assigned to the following study groups: Group A. orthodontic micro-screw placement using a computer-aided static navigation technique (n = 69); B. orthodontic micro-screw placement using the conventional freehand technique (n = 69). In addition, the accuracy in the canine–premolar, premolar and molar sectors was analyzed in each study group. Cone-beam computed tomography and intraoral scans were taken both prior and subsequent to orthodontic micro-screw placement. The images were then uploaded using a 3D implant planning software, where the deviation and horizontal angles were analyzed using a multivariate linear model. These measurements were taken at the coronal entry point and apical endpoint between the planned orthodontic micro-screws. In addition, any complications resulting from micro-screw placement, such as spot perforations, were also analyzed in all dental sectors. The statistical analysis showed significant differences between the two study groups with regard to the coronal entry-point, apical end-point (p < 0.001) and angular deviations (p < 0.001) between the computer-aided static navigation technique and freehand technique study groups. Moreover, statistically significant differences were showed between the different dental sectors (p < 0.001). Additionally, twelve root perforations were observed at the conventional free hand technique study group while there were no root perforations in the computer-aided static navigation technique study group. The results showed that the computer-aided static navigation technique enables a more accurate orthodontic micro-screw placement with less intraoperative complications when compared with the conventional freehand technique.
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]
The success rate and intra-operative complications related to orthodontic micro-screws can be affected upon a number of variables, including the inherent characteristics attributed to the patient [4], experience of the clinician [5], mechanical properties of the orthodontic micro-screw [6], patient care [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]
Root contact is considered one of the main drawbacks related to orthodontic micro-screw placement that it is possible to occur during insertion [7,10,12]
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]. The success rate and intra-operative complications related to orthodontic micro-screws can be affected upon 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 care [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]. A custom-designed 3D-printed splint can be fabricated to facilitate a fully guided placement of orthodontic micro-screws [22]
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