Abstract
BackgroundHitting a dental root during the insertion of orthodontic mini-implants (OMIs) is a common adverse effect of this intervention. This condition can permanently damage these structures and can cause implant instability. Increased torque levels (index test) recorded during the insertion of OMIs may provide a more accurate and immediate diagnosis of implant-root contact (target condition) than radiographic imaging (reference standard). An accurate index test could reduce or eliminate X-ray exposure. These issues, the common use of OMIs, the high prevalence of the target condition, and because most OMIs are placed between roots warrant a systematic review. We will assess 1) the diagnostic accuracy and the adverse effects of the index test, 2) whether OMIs with root contact have higher insertion torque values than those without, and 3) whether intermediate torque values have clinical diagnostic utility.MethodsThe Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015 statement was used as a the guideline for reporting this protocol. Inserting implants deliberately into dental roots of human participants would not be approved by ethical review boards and adverse effects of interventions are generally underreported. We will therefore apply broad spectrum eligibility criteria, which will include clinical, animal and cadaver models. Not including these models could slow down knowledge translation.Both randomized and non-randomized research studies will be included. Comparisons of interest and subgroups are pre-specified. We will conduct searches in MEDLINE and more than 40 other electronic databases. We will search the grey literature and reference lists and hand-search ten journals. All methodological procedures will be conducted by three reviewers. Study selection, data extraction and analyses, and protocols for contacting authors and resolving conflicts between reviewers are described. Designed specific risk of bias tools will be tailored to the research question. Different research models will be analysed separately. Parameters for exploring statistical heterogeneity and conducting meta-analyses are pre-specified. The quality of evidence for outcomes will be assessed through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.DiscussionThe findings of this systematic review will be useful for patients, clinicians, researchers, guideline developers, policymakers, and surgical companies.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0014-6) contains supplementary material, which is available to authorized users.
Highlights
Hitting a dental root during the insertion of orthodontic mini-implants (OMIs) is a common adverse effect of this intervention
Target condition being diagnosed To control the reciprocal forces of tooth movement, orthodontists need some form of anchorage
In Orthodontic mini-implants (OMIs), what is the accuracy of the level of insertion torque values compared to radiography to distinguish those with and without implant-root contact
Summary
Hitting a dental root during the insertion of orthodontic mini-implants (OMIs) is a common adverse effect of this intervention. An accurate index test could reduce or eliminate X-ray exposure These issues, the common use of OMIs, the high prevalence of the target condition, and because most OMIs are placed between roots warrant a systematic review. Orthodontic mini-implants (OMIs) are used to provide anchorage during orthodontic tooth movement Contact between these devices and dental roots during implant insertion is a common problem, because inter-radicular spaces are narrow [1,2,3,4,5,6]. Target condition being diagnosed To control the reciprocal forces of tooth movement, orthodontists need some form of anchorage It is usually obtained by connecting these forces to groups of teeth in the same or the opposing jaw or through the use of intra-or extra-oral removable appliances. OMIs are not conditioned by most of these limitations, but they need to be inserted surgically
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