Abstract
To analyze the influence of the operator experience on the accuracy of orthodontic self-tapping micro-screws placement, a total of 60 orthodontic self-tapping micro-screws were randomly distributed into two study groups: Group A. Orthodontic micro-screws placement by an orthodontist with 10 years of experience (n = 30); and B. Orthodontic micro-screws placement by an orthodontist student without experience (n = 30). Cone-beam computed tomography scans and intraoral scans were performed before and after the orthodontic self-tapping micro-screws placement and uploaded in 3D implant-planning software to analyze the deviation angle and the horizontal deviation measured at the coronal entry point and apical endpoint between orthodontic micro-screws planned and performed. In addition, intraoperative complications such as root perforations after orthodontic self-tapping micro-screws placement and fracture of the orthodontic self-tapping micro-screws during their placement were also analyzed. The paired t-test revealed statistically significant differences at the apical endpoint (p = 0.004) of planned and performed orthodontic self-tapping micro-screws between the orthodontist with 10 years of experience and the orthodontist student without experience. However, the paired t-test revealed no statistically significant differences at the coronal entry point (p = 0.220) and angular deviations (p = 0.602) of planned and performed orthodontic self-tapping micro-screws between the orthodontist with 10 years of experience and the orthodontic student without experience. Furthermore, five root perforations were observed in the no experience study group and three orthodontic self-tapping micro-screws were fractured in each study group. In conclusion, the results show that the greater experience of the operator influences the accuracy of orthodontic micro-screws placement, resulting in less intraoperative complications.
Highlights
A randomized controlled in vitro study was conducted on 84 maxillary teeth, extracted for periodontal and orthodontic reasons, which were selected between December 2019 and February 2020 at the Dental Centre of Innovation and Advanced Specialties of Alfonso
Dontic self-tapping micro-screws are displayed in Table
Micro-screws are frequently used to achieve absolute anchorage during tooth movement, and one of the most frequent intraoperative complications is screw loss and pulpal and periodontal ligament damage resulting from root contact [16]
Summary
Self-tapping and self-drilling micro-screws are mainly used as TADs thanks to their reported short- and long-term success rates compared to conventional methods in the maxillary buccal area. Self-tapping orthodontic micro-screws require a pre-drilled hole before inserting a larger micro-screw. This process might increase inaccuracy and potentially risk root perforation [6]. Micro-screws are usually placed in maxillary buccal insertion sites, mainly between the maxillary first molars and second premolars, because this allows a simple and effective technique for managing premolar extraction cases, which shows a high success rate (90.3%) [7]. Mandible insertion sites have a lower success rate due to the higher bone density of the mandible that might require the use of self-tapping orthodontic micro-screws to penetrate the cortical bone [8,9]. Papageorgiou et al [10]
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