Anchorage In Orthodontic Treatment Research Articles

Temporary skeletal anchorage – possibilities and mechanism of application. Literature review

To date, the use of a temporary skeletal anchorage in orthodontic treatment in almost every clinical case. Despite this, there are only two variants of this surgical instrument: mini-screws and mini-plates. Both variants of the skeletal anchorage have their positive and negative qualities, which, to one degree or another, affect the result and timing of treatment. The purpose of this literature review is to describe the main methods of using temporary skeletal anchorage, in which clinical cases their use is possible and contraindicated, as well as what positive and negative aspects can be observed during and after the treatment of orthodontic patients. The search for scientific data was carried out in the PubMed database using such keywords as: orthodontic skeletal anchorage, temporary anchorage, orthodontic mini-screw, orthodontic mini-plate. A literature search revealed that temporary skeletal anchorage allows the surgeon and orthodontist to predictably make changes to the jaw bones that were previously only possible with orthognathic surgery. Before installing a mini-screw or mini-plate, careful planning in the form of an examination and x-ray examination should be carried out. Ultimately, informed consent should be obtained explaining to the patient that orthognathia may still be necessary if the skeletal anchorage method fails. Although this is still a relatively new technique, some issues need to be considered and further clinical research is needed.

Unilateral mesialisation using Temporary anchorage device and segmental T loop – A case report

A temporary anchorage device is a device that is temporarily fixed to bone for the purpose of enhancing orthodontic anchorage either by supporting the teeth of the reactive unit or by obviating the need for the reactive unit altogether, and which is subsequently removed after use. Use of mini implants is one of the innovative approach for complex tooth movements such as mesialisation. Space closure from distal to mesial is one of the most difficult orthodontic tasks. Tooth-borne anchorage limits the scale of tooth movement. Extraoral or intraoral appliances are used especially for unilateral space closure. As an alternative to conventional mesialization appliances, osseointegrated implants may be used for maximum anchorage in orthodontic treatment. The use of direct anchorage in the form of installed mini-implant that is connected to the teeth requiring horizontal movement causes low levels of strains on anchor unit comparing to the results that were registered during indirect anchorage with one or two anchor teeth. This report presents the case of removal of mesiodens and blocked out and fractured premolar and the space closure by unilateral mesialisation with the help of mini implants and loops.

The use of lingual brackets and miniscrews as anchorage in orthodontic treatment in patients with a high-angle skeletal Class II relationship

The use of lingual brackets and miniscrews as anchorage in orthodontic treatment in patients with a high-angle skeletal Class II relationship

Evaluation of osseointegration of Ti-6Al-4V alloy orthodontic mini-screws with ibandronate-loaded TiO2 nanotube layer.

Recently, the use of orthodontic mini-screws as an anchorage for orthodontic treatment is increasing, and the degree of osseointegration of the mini-screws affects the performance of orthodontic treatment. This study aimed to evaluate the biocompatibility and osseointegration of Titanium 6Aluminum 4Vanadium (Ti-6Al-4V) alloy orthodontic mini-screws with an ibandronate-loaded TiO2 nanotube (TNT) layer. The TNT layer was formed on the surface of the Ti-6Al-4V alloy orthodontic mini-screws and loaded with ibandronate. The TNT formed by anodic oxidation formed a completely self-organized and compact structure and was stably released for 7 days after loading with ibandronate. Mini-screws loaded with ibandronate were implanted into both tibias of rats, confirming rapid initial bone regeneration. We demonstrate that the release of stable ibandronate from the TNT layer of Ti-6Al-4V alloy orthodontic mini-screws can effectively improve biocompatibility and osseointegration.

Retracted: The Efficacy of Orthodontics plus Implant Anchorage in Orthodontic Treatment: A Randomized Controlled Study.

[This retracts the article DOI: 10.1155/2022/4049076.].

Evaluation of the Application Effect of Micro-implant Anchorage in Orthodontic Treatment

Evaluation of the Application Effect of Micro-implant Anchorage in Orthodontic Treatment

The Efficacy of Orthodontics plus Implant Anchorage in Orthodontic Treatment: A Randomized Controlled Study.

Objective To investigate the efficacy of orthodontics plus implant anchorage in orthodontic treatment. Methods This randomized controlled study was conducted on 90 patients who had orthodontic treatment in our hospital between October 2019 and October 2020, and they were assigned to either a control group (n = 45) or an observation group (n = 45) via the random number table method. Patients in the control group received orthodontics while those in the observation group underwent orthodontics plus implant anchorage. The two groups were compared in terms of clinical indexes, efficacy, orthodontic state, adverse reaction rate, quality of life, and satisfaction. Results After treatment, orthodontics plus implant anchorage led to lower gingival attachment level, gingival bleeding index, plaque index, and periodontal probing depth versus orthodontics alone (P < 0.05); orthodontics plus implant anchorage contributed to a higher efficacy versus orthodontics alone (91.11% vs. 73.33%, P < 0.05); orthodontics plus implant anchorage resulted in smaller molar displacement, larger protrusion distance of the upper central incisor, and larger inclination angle of the upper central incisor (P < 0.05); orthodontics plus implant anchorage was associated with fewer adverse reactions (4.44% vs. 26.67%, P < 0.05) and a higher quality of life scores versus orthodontics alone (P < 0.05); orthodontics plus implant anchorage yielded a higher satisfaction level versus orthodontics alone (95.56% vs. 66.67%, P < 0.05). Conclusion The orthodontics plus implant anchorage offers a promising solution in orthodontic treatment. It is conducive to restoring dental indicators and improving quality of life and satisfaction. It is therefore worthy of application.

Stability and Safety of Miniature Implant Anchorage in Orthodontic Treatment

Stability and Safety of Miniature Implant Anchorage in Orthodontic Treatment

Clinical effectiveness of orthodontic miniscrew implantation guided by a novel cone beam CT image-based computer aided design and computer aided manufacturing (CAD-CAM) template.

BackgroundAlthough miniscrews are widely used in orthodontic treatment as temporary anchorage devices, their correct and safe placement has attracted little attention. This study aimed to introduce a novel cone beam CT (CBCT) image-based computer aided design and computer aided manufacturing (CAD-CAM) template for orthodontic miniscrew implantation and to evaluate the effectiveness of miniscrews implanted under the guidance of this template.MethodsThe CBCT scans of ten patients requiring miniscrews as anchorage were analyzed in NNT software to predetermine the insertion sites of miniscrew implants. The DICOM data of the scans, along with virtual miniscrews acquired in Solidworks software, were imported into Mimics software to construct three-dimensional (3D) images of teeth and bone and to determine the virtual position of miniscrews and 3D virtual templates were designed following consideration of the virtual implantation plans. A STL (Stereolithography) file of the virtual template was output, and the resin template was then fabricated with a stereolithographic appliance (SLA). 24 Miniscrews were then implanted guided by the template and clinical evaluation of their safety and stability, as well as their placement deviations, were made. A dental casts model and cephalometric analysis before and after orthodontic treatment were made to assess the dentomaxillofacial changes.ResultsAll 24 miniscrews had no contact with adjacent roots. 18 miniscrews had a grade I safety score and six had a grade II. The miniscrews were stable at 1, 3, 6, and 9 months after implantation, although there was mild inflammation around two miniscrews. Implantation deviation of miniscrew in the crown was (1.03±0.65) and (1.26±0.72) mm in the apex, on average. Satisfactory dentomaxillofacial changes in 10 patients with these 24 miniscrews as anchorage were acquired.ConclusionsMiniscrews could be implanted in the targeted position safely and precisely when guided by the novel templates, and remained stable during orthodontic treatment. Patients treated with these miniscrews as anchorage in orthodontic treatment acquired satisfactory dentomaxillofacial changes.

Application of Microscrew Implant Anchorage in Orthodontics

Objective: To study the value of microscrew implant anchorage in orthodontic treatment. Methods: A total of 80 cases received orthodontic treatment in recent two years were selected and divided into experimental group and control group based on their received orthodontic measures, each group contains 40 cases. The control group was treated with general orthodontic treatment plan, while the study group received microscrew implant anchorage for the treatment. The clinical conditions of the two groups were counted and observed. Results: After different treatments, the effect of the study group was significantly better than that of the control group. All the indicators (including the improvement of molar displacement, incisor inclination angle and incisor convex distance) were available. In addition, there are obvious differences between the two groups in the occurrence of adverse reactions including inflammatory reaction, soft tissue edema and discomfort. Conclusion: In oral clinic, microscrew implant anchorage can achieve ideal curative effect for those who need orthodontics. Besides, its safety is relatively high, which is worth popularizing widely.

Evaluations of miniscrew type-dependent mechanical stability

BackgroundMiniscrew has been widely used as an absolute anchorage in orthodontic treatment. Types of miniscrew with different diameter, length, shape, and thread dimensions may have a substantial effect on mechanical stability of the miniscrew system. Thus, the objective of this study was to evaluate miniscrew type-dependent mechanical stability to assess mechanical properties of miniscrew systems in various thickness of artificial bone block using different measurement tools. MethodsTwo types of miniscrews (15 Tomas and 15 AbsoAnchor) were placed in artificial bone block with different thickness of 1.5, 2.0, 3.0 mm. Values of maximum insertion torque, removal torque, Periotest, implant stability quotient, static stiffness, dynamic stiffness, and energy dissipation ability were assessed for each miniscrew system. FindingsThe maximum insertion torque, removal torque, implant stability quotient, static and dynamic stiffness values significantly increased when the miniscrews were placed in thicker bone block while Periotest values decreased. The static stiffness, Periotest and implant stability quotient values were significantly correlated each other and also with other mechanical properties (p < 0.001) except tan δ (p > 0.35). However, the slopes of some correlations and absolute values of measurement were significantly different dependent on the miniscrew types (p < 0.025). InterpretationThe current findings suggest that miniscrew type-dependent calibrations are required to estimate mechanical stability of the miniscrew systems despite the utilization of same measurement tool.

Effect of insertion angle on the stability of orthodontic mini-implants in a rabbit tibia model: A finite element analysis.

Mini-implants are an alternative to traditional methods of anchorage in orthodontic treatment. However, there are still questions concerning their application, in particular, with the insertion angle. To determine whether the angle of insertion of the mini-implant is a determining factor in their primary stability when they support orthodontic loads. A finite element model (FEM) of tibia bone, spring and mini-implant was developed. The three-dimensional model of the rabbit tibia was constructed based on tomographic slices. The angles that were analyzed were 90°, 80°, 70°, 60°, 50°, 45°, 40°, and 30°. A horizontal force of 2 N applied to the head of the mini-implants was simulated. The von Mises stresses and displacements were determined using FEM. Von Mises stresses were lower for an insertion angle of 40° followed by 90° and 70°; likewise, the displacements of the mini-implants with respect to the spring were lower for the 40° angle followed by 90° and 70°, we found a statistically significant association between the insertion angle and displacement. All mini-implants underwent a degree of angulation and displacement; however, mini-implants inserted to the bone surface at 40° tend to have better primary stability, and they can withstand loads immediately.

Comparative evaluation of anchorage reinforcement between orthodontic implants and conventional anchorage in orthodontic management of bimaxillary dentoalveolar protrusion

BackgroundIncreased upper lip procumbency is commonly associated with maxillary dentoalveolar protrusion with the major goal of reducing maxillary dentoalveolar protrusion. The treatment plan usually includes extraction of the maxillary first premolars, followed by retraction of anterior teeth with maximum anchorage. Dental implants have been widely accepted as successful adjuncts for obtaining maximum anchorage in orthodontic treatment. Methods50 subjects between the ages of 13 and 17 years having bimaxillary dentoalveolar protrusion were included in the study. The patients were divided into two groups. Both groups received treatment with 0.022″ MBT prescription preadjusted edgewise appliance system. In addition, subjects of Group ‘I’ received the Nance button and lingual arch as anchorage reinforcement in the upper and lower arches, respectively. Subjects of Group ‘II’ received self-drilling titanium OI for anchorage reinforcement. ResultsSignificant retraction was achieved in all cases with good vertical control. Anchor loss was observed in both groups. Anchor loss was much higher in Group I compared to Group II, and an intergroup comparison for anchor loss was highly significant. ConclusionImplants as anchorage, for en masse retraction, can be incorporated into orthodontic practice. The use of orthodontic implants for anchorage is a viable alternative to conventional molar anchorage.

Skeletal anchorage in orthodontic treatment of Class II malocclusion: Contemporary applications of orthodontic implants, miniscrew implants and miniplates

Over the past decade, orthodontic skeletal anchorage devices have gained significant traction in the orthodontic community. These devices have become instrumental in vertical control of the dentition, anteroposterior movement of the dentition, and in particular, molar distalization for the treatment of Class II malocclusion. The collaborative efforts of numerous clinicians are pooled in this new textbook on the treatment of Class II malocclusions with skeletal anchorage, especially with miniscrew implants and miniplates. This well-organized book begins with a brief review of Class II malocclusions and their treatments using conventional noncompliance appliances and quickly transitions to an extensive review of temporary anchorage devices, covering the range of traditional implants, onplants, miniplates, and miniscrew implants. Because of the abundance of brands in the marketplace, particular attention is given to miniscrew implants, with a detailed analysis of their composition and mechanical structure. This left this reviewer amazed at the progress with miniscrew implants since our first publication on the topic.1Baumgaertel S. Razavi M.R. Hans M.G. Mini-implant anchorage for the orthodontic practitioner.Am J Orthod Dentofacial Orthop. 2008; 133: 621-627Abstract Full Text Full Text PDF PubMed Scopus (65) Google Scholar The detailed and particular attention given to the insertion site and the insertion technique makes this a must-read book for every orthodontic resident and novice user of temporary anchorage devices because various fabrication techniques for surgical guides are discussed to assist clinicians in avoiding common placement complications. The text is peppered with abundant, high-quality photographs that aid the reader in developing a thorough understanding of the treatment mechanics used in the presented cases. An extensive review of molar distalization is presented, using both direct and indirect anchorage techniques with onplants, zygomatic anchorage, and palatal and interdental miniscrew implant anchorage. Although high-quality treatment results are presented with many unique treatment techniques and treatment mechanics, some presented cases had complicated and at times inefficient treatment techniques that may be best suited for educational institutions, rather than the moderate to large private practices that are often found in North America. The book concludes with a review of risk factors, complications including root and bone responses, inadvertent root contact during placement, maxillary sinus perforation, and risk-management must-knows for practitioners placing miniscrew implants. Overall, the book is a valuable resource and reference for any orthodontist, periodontist, and maxillofacial surgeon who places miniscrew implants and miniplates as anchorage aids during orthodontic treatment.

Micro-Implant Anchorage for Orthodontic Treatment of Bialveolar Protrusion: A Case Report

Conventional methods of reinforcing orthodontic anchorage have several disadvantages, including complicated appliance design and the need for exceptional patient cooperation. Recently, Kanomi introduced the use of titanium microscrews and miniscrews for orthodontic anchorage. This case report demonstrates the use of microscrews or mini-implants in a 15-year-old female patient having a convex profile and a Class I skeletal pattern with bialveolar protrusion. Brackets were bonded after extraction of upper and lower first premolar teeth and initial aligning and leveling of teeth was carried out in both the arches. The micro-implants (4 in number) were then inserted buccally in the interdental space between the second premolar and the first molar in both upper and lower arches. For the upper arch 8 mm long and for the lower arch 6 mm long micro-implants [diameter of 1.2 mm] (Dentos Co., Taegu City, Korea) were used. Then en-masse retraction of six anterior teeth was carried out in both upper and lower arches on rectangular 19 × 25 stainless steel archwires with soldered hooks between lateral incisors and canines in each quadrant. Light forces (200 g) were used by applying power chains from the soldered hooks to the microimplants in each quadrant for simultaneous upper and lower retraction It was observed that micro-implant treatment had many advantages: As it does not depend on patient compliance with extraoral appliances, produces an early profile improvement giving the patient even more incentive to cooperate, shortens treatment time by retracting the six anterior teeth simultaneously and provides absolute anchorage for orthodontic tooth movement.

Book review: Skeletal anchorage in orthodontic treatment of Class II malocclusion

Book review: Skeletal anchorage in orthodontic treatment of Class II malocclusion

Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion

It is difficult to believe that the first articles on the use of skeletal anchorage only started to appear in the orthodontic literature less than two decades ago. Since then, thousands of articles...

Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion (2015)

Skeletal Anchorage in Orthodontic Treatment of Class II Malocclusion (2015) Editor: Moschos A. Papadopoulos, Publisher: Mosby Elsevier, New York, Price: $170, ISBN: 9780723436492, Pages: 293 This textbook provides a comprehensive review of contemporary technological development, biomechanics and handling of orthodontic implants, miniscrew implants, and miniplates. Notwithstanding the limitation to Class II malocclusion, as implied by …

Assessment of stability of orthodontic mini-implants under orthodontic loading: A computed tomography study.

Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. This prospective clinical study was undertaken to evaluate the mobility of orthodontic miniscrews under orthodontic loading using computed tomography. Ten adult patients (7 females and 3 males with mean age of 19 years, 7 mm overjet) who required en masse retraction of upper and lower anterior teeth infirst premolar extraction spaces were included in this study. After initial alignment of anterior teeth, the 0.019" ×0.025" stainless steel archwire were placed in preadjusted edgewise appliance. The miniscrews (diameter - 1.3 mm, length - 7 mm) were inserted in between second premolar and thefirst molar in the maxilla (zygomatic buttress) and in mandible on the buccal side as direct anchorage. Immediately after placement of miniscrews without waiting period, NiTi coil springs (force of 150 g in the maxilla and 100 g in the mandible) were placed for the retraction. Denta Scans were taken immediately before force application (T1) and 6 months later (T2). The mean changes obtained at T1 and T2 in Denta Scans (axial plane, coronal plane, paraxial plane) were evaluated to determine any movement of different parts of miniscrews using one-way ANOVA test and Student's unpaired t-test. On average, miniscrews were extruded and tipped forward significantly, by 1 mm at the screw head in the axial plane (Group III) and 0.728 mm in the coronal plane (Group IV). Tail of miniscrews showed average tipping of 0.567 mm in the axial plane (Group I) and 0.486 mm in the paraxial plane (Group V). Least average mobility was shown by screw body of 0.349 mm in the axial plane (Group II). Clinically, no significant mobility was observed. Miniscrews are a stable anchorage for orthodontic tooth movement but do not remain absolutely stationary like an endosseous implant throughout orthodontic loading although miniscrews might move according to placement site, orthodontic loading, and inflammation of peri-implant tissue. Waiting period between miniscrews placement and orthodontic loading does not significantly affect the miniscrew mobility so immediate loading can be recommended. To prevent hitting any vital organs because of miniscrew mobility, it is recommended that they can be placed in a nontooth-bearing area that has no foramen, major nerves, or blood vessel pathway, or in a tooth-bearing area allowing a 1.5 mm safety clearance between the miniscrew and dental root.

Reinforcement of anchorage during orthodontic brace treatment with implants or other surgical methods.

The term anchorage in orthodontic treatment refers to methods of controlling unwanted tooth movement. This is provided either by anchor sites within the mouth, such as the teeth and the palate, or from outside the mouth (headgear). Recently, new methods of providing anchorage have been developed using orthodontic implants which are surgically inserted into the bone in the mouth. This is termed surgical anchorage. This is an update of a Cochrane review first published in 2007. To assess the effects of surgical anchorage techniques compared to conventional anchorage in the prevention of unwanted tooth movement in patients undergoing orthodontic treatment by evaluating the mesiodistal movement of upper first molar teeth. A secondary objective was to compare the effects of one type of surgical anchorage with another. We searched the Cochrane Oral Health Group's Trials Register (to 28 October 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9), MEDLINE via OVID (1946 to 28 October 2013) and EMBASE via OVID (1980 to 28 October 2013). We handsearched key international orthodontic and dental journals, and searched the trial database ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing and unpublished studies. Randomised controlled trials comparing surgical anchorage with conventional anchorage in orthodontic patients. Trials comparing two types of surgical anchorage were also included. At least two review authors independently and in duplicate extracted data and carried out risk of bias assessments. We contacted study authors to clarify aspects of study design and conduct, and to obtain unreported data. Fourteen new studies were added in this update resulting in a total of 15 studies reporting data from 561 randomised patients. The studies were conducted in Europe, India, China, South Korea and the USA. The age range of patients was commonly restricted to adolescents or young adults, however the participants of two studies were from a much wider age range (12 to 54 years). The distribution of males and females was similar in eight of the studies, with a predominance of female patients in seven studies.Eight studies were assessed to be at high overall risk of bias; six studies at unclear risk of bias; one study at low risk of bias.Ten studies with 407 randomised and 390 analysed patients compared surgical anchorage with conventional anchorage for the primary outcome of mesiodistal movement of upper first molars. We carried out a random-effects model meta-analysis for the seven studies that fully reported this outcome. There was strong evidence of an effect of surgical anchorage on this outcome. Compared with conventional anchorage, surgical anchorage was more effective in the reinforcement of anchorage by 1.68 mm (95% confidence interval (CI) -2.27 mm to -1.09 mm; seven studies, 308 participants analysed) with moderate quality of evidence (one study at high overall risk of bias, five studies at unclear risk of bias, one study at low risk of bias). This result should be interpreted with some caution, however, as there was a substantial degree of heterogeneity for this comparison. There was no evidence of a difference in overall duration of treatment between surgical and conventional anchorage (-0.15 years; 95% CI -0.37 years to 0.07 years; three studies, 111 analysed patients) with low quality of evidence (one study at high overall risk of bias and two studies at unclear risk of bias). Information on patient-reported outcomes such as pain and acceptability was limited and inconclusive.When direct comparisons were made between two types of surgical anchorage, there was a lack of evidence to suggest that any one technique was better than another.No included studies reported adverse effects. There is moderate quality evidence that reinforcement of anchorage is more effective with surgical anchorage than conventional anchorage, and that results from mini-screw implants are particularly promising. While surgical anchorage is not associated with the inherent risks and compliance issues related to extraoral headgear, none of the included studies reported on harms of surgical or conventional anchorage.