Maximum insertion torque loss after miniscrew placement in orthodontic patients: A randomized controlled trial

Abstract

To compare torque recordings of immediately loaded orthodontic miniscrews between insertion time and different post-placement timepoints (2weeks, 4weeks and removal time, respectively). Parallel trial with an allocation ratio of 1:1. Eligibility criteria were needs of fixed orthodontic treatment, no systemic disease and absence of using drugs altering bone metabolism. Patients received miniscrews, 2.0mm diameter and 10mm length. All miniscrews underwent inter-radicular placement, and they were placed in the maxilla or in the mandible, palatally or buccally. No pre-drilling was performed. Miniscrews were loaded immediately after the insertion and were used for distalization, intrusion, extrusion, mesialization or indirect anchorage. Patients were randomly divided into three groups. For each patient, Maximum Insertion Torque (MIT) was evaluated at baseline. MIT was measured again after 2weeks and after 4weeks by tightening the screw a quarter of turn in Groups 1 and 2, respectively. At the end of the treatment, maximal removal torque was evaluated in Group 3. Torque variation with respect to insertion time was considered as the primary outcome. Baseline and longitudinal differences were tested using the linear mixed-effects (LME) model. Forty seven patients and 74 miniscrews were followed up. An association existed between maximum insertion torque and the observation time. A torque decrease of 26.9% and 30% after 2weeks was observed for mandibular and maxillary miniscrews, respectively. After 1month, torque values were similar to the baseline records. The overall success rate was 79.7%. No serious harm was observed. Maximum insertion torque undergoes a loss during the first 2weeks, and its values may depend on the insertion site and the anchorage purpose. Removal torque value is almost the same as the initial torque after 1month.