Mandibular molar uprighting using orthodontic miniscrew implants: a systematic review

Panagiota Magkavali-Trikka,Moschos A Papadopoulos,Georgios Emmanouilidis

doi:10.1186/s40510-017-0200-2

Abstract

The purpose of this systematic review was to identify studies and present the use of miniscrew implants (MIs) as an alternative treatment to mandibular molar uprighting. An electronic search and handsearching were conducted by two independent reviewers to identify relevant articles, published up to January 27, 2017. In order to methodologically assess the eligible studies, a pilot checklist consisting of 22 items was also implemented. After exclusion of all the irrelevant papers, only 17 studies were included, presenting 27 cases of mandibular molar uprighting in all planes using both direct and indirect force traction by MIs. Regarding the quality evaluation, the mean score of the included studies was 13.2, indicating a rather poor methodology implemented in the majority of the included cases. Due to many advantages, MIs provide a unique treatment alternative and constitute a reliable solution for treating tipped or impacted molars. Regarding the force application, a direct method is simpler, as it requires one MI and a single bracket or button, minimizing the patient’s discomfort and also reducing chair time compared to more complex indirect anchorage. It also eliminates the possibility of unwanted movement of the anchorage unit, which can occur even with indirect anchorage as a result of technical errors. However, direct anchorage has limitations in cases of lingually tipped or rotated molars because a single force may be insufficient to upright the tooth.

Highlights

A tipped mandibular molar is a frequent situation among orthodontic patients, which usually occurs after premature loss of adjacent teeth leading to the inclination of the molars [1, 2]
Materials and methods In order to find the appropriate articles to be included in this systematic review, Medline was electronically searched via PubMed on January 27, 2017, using the following search strategy: AND AND ((molar) OR (“preprosthetic”) OR OR OR OR)
After excluding 15 non-relevant articles, only 17 papers remained for inclusion and their findings are reported in this systematic review (Fig. 1)

Summary

Introduction

A tipped mandibular molar is a frequent situation among orthodontic patients, which usually occurs after premature loss of adjacent teeth leading to the inclination of the molars [1, 2]. Inadequate mandibular arch length, excessive teeth size, loss of the adjacent first molar, premature eruption of the mandibular third molar, and unusually mesial eruption pathway of the second molar can cause its partial or total impaction with a reported incidence of 0.03–0.3% of the general population and 2–3% of orthodontic patients [3–5]. Tilted molars can cause numerous problems in a patient’s mouth, especially if a prosthetic rehabilitation is planned. According to Zachrisson, periodontal status can be aggravated, with signs of inflammation, angular bone loss, and an apparent pocket at the mesial surface of a tipped mandibular molar [6].

Methods

Results

Discussion

Conclusion