Abstract
This systematic review identified and qualified the current evidence of dental root damage and repair after contact with mini-implants. The electronic databases Cochrane library, Ovid, Scirus, Scopus, and Virtual Health Library were used to search original articles from 1980 to December 2011. The inclusion criteria to select the articles were 1. randomized controlled trials and prospective clinical studies based on trials involving humans, 2. randomized controlled studies in animals, 3. use of mini-implants with a diameter less than 2.5 mm, and 4. root contact evaluation associated with the use of orthodontic mini-implants. Two authors independently reviewed and extracted data from the selected studies and a methodological quality assessment process was used to rank the studies classifying them as low moderate or high quality. The searches retrieved 579 citations. After initial selection, 17 studies were considered eligible and their full texts were assessed. Four of those were excluded because root damage was not evaluated and two were excluded because of overlapping samples. Eleven articles, nine in animals and two in humans, fulfilled the inclusion criteria. From these, two studies were ranked as presenting high methodological quality, eight were judged to be of moderate, and one of low quality. The evidence found suggested that the quality of root repair depends on the amount of damage caused by the mini-implant. When the damage is limited to the cementum or dentin, healing and almost complete and repair of the periodontal structure can occur. Mini-implants that injured the pulp were less likely to result in complete repair of the periodontal tissues.
Highlights
Suggested as a possibility for skeletal anchorage, the miniimplants were rst introduced in orthodontics by Creekmore and Eklund (1983) for intrusion of the maxillary incisors
The evidence found suggested that the quality of root repair depends on the amount of damage caused by the mini-implant
The full texts of 17 studies were assessed and 4 (Cheng et al, 2004; Kravitz and Kusnoto, 2007; Yanosky and Holmes, 2008; El-Beialy et al, 2009) studies were excluded because root damage was not evaluated, the authors had reported complications associated with orthodontic mini-implants in title and/or abstract
Summary
Suggested as a possibility for skeletal anchorage, the miniimplants were rst introduced in orthodontics by Creekmore and Eklund (1983) for intrusion of the maxillary incisors. Because of their small size, mini-implants can be inserted in different regions of the oral cavity. The use of orthodontic mini-implants can lead to complications such as mini-implant fracture, periimplant mucositis, ulceration of the mucosa, and root injury of the teeth adjacent to the implants. After more extensive injuries, root tissue did not heal fully (Bae, 2005) and that may lead to ankylosis
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