Orthodontic Mini-implants Research Articles

Identification of Senescent Cells in Peri-Implantitis and Prevention of Mini-Implant Loss Using Senolytics.

Peri-implantitis is a disease that causes the detachment of orthodontic mini-implants. Recently, stress-induced senescent cells have been reported to be involved in various inflammatory diseases. Senescent cell-eliminating drugs, termed "senolytics", can improve the symptoms of such diseases. However, the relationship between peri-implantitis and senescent cells remains unclear. In this study, we evaluated the presence of senescent cells in a rat peri-implantitis model developed with a gum ring. The effect on bone resorption and implant loss was also investigated with and without senolytics (Dasatinib and Quercetin). The number of senescence markers (p19, p21, and p16) was found to increase, and implant detachment occurred in 24 days. After the administration of senolytics, the number of senescence markers decreased and implant detachment was inhibited. This study suggests that senescent cells aggravate peri-implantitis and senolytic administration latently reduces implant loss by inhibiting senescence-related mechanisms.

In-vitro investigation of primary stability of orthodontic mini implants with different lengths using resonance frequency analysis

Out of various ways of gaining anchorage, mini implants are gaining attention due to its minimum compliance and maximum curative effects.Mini implants are considered successful if they have sufficient primary stability that comes from mechanical interlocking of mini implant with the bone.Factors which influence the implant stability are bone physiology, implant size, shape and surface characteristics. Considering all other factors within anatomic constraints, what may play a role in primary stability of mini implants is length. Literature search to correlate mini implant length with primary stability was found to be insufficient and hence this study was undertaken. In this study, two goat jaws were subjected to spiral 3D CT scan and the areas with D2 bone density were identified and marked. In these D2 density marked areas, 30 implants of 1.5 x 6mm (GROUP A) and 30 implants of 1.5 x8mm (GROUP B) were placed. Their stability was measured by Radio Frequency Analysis using Osstell ISQ device with its Smart Peg. A connector was fabricated to make the fit of smart peg compatible with the head of mini implant. Readings were made in 5 different directions for each implant and their average value was considered as final reading. It was noted that primary mini implant stability is significantly higher (p 0.034) with GROUP B implants than with GROUP A implants. The increased length of mini-implants positively affects its primary stability and should be taken into consideration when implants are used as anchorage devices.

The Use of Orthodontic Mini-Implants and Temporary Anchorage Devices (TADs) for the Management of Complex Orthodontic Cases

Orthodontic treatment often involves correcting improperly positioned teeth and jaws, as well as malocclusion or misaligned bite patterns. Anchorage is a critical component of all types of orthodontic tooth movement, and temporary anchorage devices (TADs) and orthodontic mini-implants (OMIs) have become popular adjuncts to conventional orthodontic treatment. TADs and OMIs provide stable anchorage, reduce the need for patient compliance, and can decrease treatment time. These devices can be used in various orthodontic cases, such as Class II and III malocclusions, deep bites, open bites, and impacted teeth. However, proper case selection, placement, and maintenance are crucial for achieving successful treatment outcomes with TADs and OMIs. The result of these devices is influenced by factors such as the insertion site, insertion angle, and amount of bone contact. The factors contributing to TAD and OMI failure are multifactorial and include conditions related to the device, the patient, and the clinician. The review provides a comprehensive analysis of the benefits and drawbacks of TADs and OMIs, their clinical applications, and the factors influencing their success.

Comparative Evaluation of Teeth Displacement and Stress Generated with Orthodontic Mini-Implant and Infra-Zygomatic Crestal Implant during Intrusion in the Maxillary Arch − A Three Dimensional Finite Element Analysis

Comparative Evaluation of Teeth Displacement and Stress Generated with Orthodontic Mini-Implant and Infra-Zygomatic Crestal Implant during Intrusion in the Maxillary Arch − A Three Dimensional Finite Element Analysis

Surgical Excision of Hypertrophic Tissue and Retrieval of Orthodontic Mini-implant using Diode Laser- A Rare Case Report

Orthodontic mini-implants or transient anchorage devices can be used to shift difficult teeth. There is substantial evidence showing the effectiveness of Temporary Anchorage Devices (TAD) and their anchorage requirements. However, there are also reports of failures and complications like soft tissue inflammation, tissue overgrowth, peri-implantitis and mini-implant fracture. The present case report of 22 years old female patient, discusses a rare occurrence of tissue overgrowth over the mini-implant on right buccal mucosa in relation to 45, 46 regions. A 1.3×9 mm stainless steel mini-implant was used as an interim anchorage device. The tissue overgrowth was attributed to soft tissue inflammation around the mini-implant. Under adequate anaesthesia, the tissue was removed using a laser, and the mini-implant was retrieved using tissue forceps. After achieving hemostasis, simple interrupted sutures were placed. It is recommended to administer antibiotics, analgesics, and along with postoperative instructions. When used correctly, mini-screws are valuable tools that enhance the effectiveness of orthodontic treatment. However, there is a scarcity of case studies discussing the complications and side-effects of mini-implants. Clinicians should carefully evaluate both general and unique side-effects and complications at the insertion site. This case report demonstrates the successful removal of an orthodontic mini-implant following diode laser ablation of hyperplastic tissue.

Stress distribution in lower second molar mesialization using mini-implants: a pilot study using 3D finite element analysis

Objective: to analyze the stress distribution in a 3D model that simulates second molar mesialization using twodifferent types of mini-implants. Material and Methods: a mandible bone model was obtained by recomposinga computed tomography performed by a software program. The cortical and trabecular bone, a lower secondmolar, periodontal ligament, orthodontic tube, resin cement and the mini-implants were designed and modeledusing the Rhinoceros 4.0 software program. The characteristics of self-drilling orthodontic mini-implants were:one with 7 mm length, 1 mm transmucosal neck section and 1.6 mm diameter and another with 5 mm lengthand 1.5 mm diameter. A total of 235.161 and 224.505 elements were used for the mesh. These models wereinserted into the bone block and then subjected to loads of 200 cN (centinewton). The results were calculatedand analyzed by the Ansys 17.0 software program for qualitative verification through displacement and maximumprincipal stress maps. Results: it was possible to observe that the periodontal ligament presented low displacementand stress values. However, the physiological values presented are among those capable to provide orthodonticmovement, with compression and tensile area visualization staggered between 0.1 and -0.1 MPa (megapascal).Conclusion: within the limitations of the study, the mini-implants tested showed similar results where theload on the tooth allowed dental displacement (molar mesialization), with a tendency to rotate it, theoreticallyallowing the second molar to take the location of the first molar. KEYWORDSFinite element analysis; Orthodontic anchorage procedures; Fixed orthodontic appliances; Mini dental implants;Tooth dislocation.

Mini-implant Supported Temporary Replacement of Teeth in ChildrenA Case Report

Dental agenesis or hypodontia is a frequent cause of tooth loss in children, most common being the maxillary lateral incisors. The absence of teeth affects aesthetics and results in functional impairment that hampers the psychological development of the young child. Treatment options available for replacement of congenitally missing teeth include fixed and removable dentures, resin-related retention devices, and single-tooth implants. The main deterring factor for implant placement in young children is the impending growth. To overcome this drawback, one can use self-drilling, one-piece orthodontic mini screw implants as a temporary abutment for the replacement of congenitally missing teeth. Mini-implant with temporary crown can serve as a permanent dental restoration for a growing child as the mini-implant is well maintained throughout his/her growth period without significant changes in skeletal morphology. This case report deals with a 12-year-old young girl patient, who has been treated with self-drilling orthodontic miniimplant with a strip crown for her congenitally missing bilateral lateral incisors, without any complications with six months follow-up.

A comparative surface evaluation of orthodontic mini-implants before and after en masse retraction-A SEM study.

To evaluate the changes in surface morphology of two different types of mini-implants after clinical en masse retraction using scanning electron microscopy. Fifty mini-implants of Dentos (Korea, Absoanchor, BH-1817-08) and Orlus (Korea, Yesanchor, C-1817) were inserted in patients in a split-mouth design who required en masse anterior retraction and absolute anchorage. Surface characteristics of mini-implants such as pitch (distance between consecutive threads), flank width (distance between root and crest), and taper were studied using scanning electron microscope (FEI nanosem450) before and after clinical use. Statistically significant difference (p value = 0.003) was found in a mean reduction of pitch dimension among the two groups with a mean difference of 25.000 μm. Also, a statistically significant difference was noted (p value = 0.001) in a mean reduction of flank width among Dentos implants as compared to Orlus implants. A statistically significant difference (p = 0.001) was seen in the mean reduction of taper dimension among Dentos group (0.0140 ± 0.02271) as compared to the Orlus group (0.0810 ± 0.05152). A marked reduction in surface morphology such as the pitch, flank width, and taper of both mini-implants after retrieval was observed. Dentos group of mini-implants displayed better dimensional stability post-retrieval as compared to the Orlus group of mini-implants. All the mini-screws showed milling defects in form of scratches on observation under scanning electron microscopy despite a smooth appearance to the naked eye.

Comparison of Structural Topography, Elemental Composition and Qualitative Analysis of two Indian mini-implants: A cross-sectional study

Objectives: This research was conducted to evaluate the surface topography, elemental composition and manufacturing defects of two brands of mini-implants commonly used in India. Clinical significance was derived based on the data of this research. Materials and methods: This research was conducted on 15 orthodontic mini-implants each from two brands commonly used in India. Scanning electron microscope imaging of the head, transmucosal neck, body, and tip was done to assess mini-implant topography and manufacturing defects (n=15/group). Analysis of elemental composition was done using an X-ray Powder Diffractor (n=1/group). Results: The results showed significant differences in both groups. Differences in structural topography of the implant body and tip were observed in both brands. Tip defects were detected in one brand. X-ray Powder Diffraction analyses revealed an alpha and alpha-beta titanium grain structure in both the groups. Conclusions: All the mini-implants tested were composed of titanium alloy. Significant differences were found in the surface area of the threaded parts. We conclude that differences in surface topography and presence of manufacturing defects impact the primary stability of the implants thereby influencing the efficacy of orthodontic anchorage.

Mini-implant assisted posterior intrusion: A quantification of anterior bite closure in nongrowing subjects

This study aimed to identify the vertical radiographic changes in nongrowing patients after treatment of anterior open bites (AOBs) using mini-implant assisted intrusion and to provide a predictive model to quantify the achievable intrusion. This retrospective radiographic study evaluated the dentoskeletal changes in adults using orthodontic mini-implants in 53 treated patients with AOB. Radiographs before and after posterior intrusion were utilized to evaluate the associated changes. Conventional cephalometric analyses provided data for assessment. A paired t test was used to identify significant changes. A regression model (best subsets selection algorithm) was generated to quantify the relationship between mini-implant-assisted intrusion and the resultant change in overbite. A matched, untreated control sample was used for comparison. One hundred percent of AOBs were corrected using mini-implant-assisted intrusion of the maxillary molars. The overbite increased by an average of 3.6 mm. The average amount of maxillary first molar intrusion was 2.67 mm. The mandibular first molar moved an average of 1.93 mm closer to the palatal plane because of an average clockwise mandibular rotation of 0.78°. The occlusal plane steepened by an average of 3.95°. If all other inputs are held constant, 1 mm of intrusion of the maxillary first molar results in a 0.86 mm increase in overbite. Mini-implant-assisted intrusion successfully treated AOB in adults with significant dentoalveolar but no significant skeletal changes. An average of 2.67 mm of intrusion of the maxillary first molars is achievable with this method showing that 1 mm of intrusion of the maxillary first molar increased overbite by 0.86 mm. Longer periods of intrusion resulted in greater amounts of bite closure.

Evaluation of hard and soft tissue changes after en- masse retraction using orthodontic mini-implants: An in-vivo study

Introduction: The procedures used for closing the extraction space results in the correction of proclination of incisors, reduction in overjet and elimination of extraction sites. This space closure has been achieved using different mechanics but most recently orthodontic mini-implants (TAD’s) have been used efficiently.Aim: To evaluate the skeletal, dental, soft tissue changes and amount of anchor loss in the treatment outcomes using orthodontic mini-implants.Materials and Methods: 25 subjects with Class I bimaxillary protrusion were selected from the patients visiting the department of orthodontics for seeking orthodontic treatment. In all the patients, after extraction of the 1st premolars, retraction was carried out by using mini implants in the maxillary arch. Results: Significant retraction was achieved in all the cases with minimum anchorage loss and significant improvement in patient’s profile.Conclusion: Orthodontic mini-implants have revolutionized the orthodontic world and have been an effective way of achieving desired tooth movement in an effective way.

Analysis for Predictors of Failure of Orthodontic Mini-implant Using Patient-Specific Finite Element Models.

In this study, we analyzed the clinical factors and mechanical parameters for predicting orthodontic mini-implant (OMI) failure in the mandible, which has different properties from the maxilla. A patient-specific finite element analysis was applied to 32 OMIs (6 failures and 26 successes) implanted between the mandibular second premolars and first molars used for anchorage. The peak stress and strain parameters were calculated for each sample. A logistic regression of the failure (vs. success) of OMIs on the mechanical parameters in the models was conducted. In addition, the influence of clinical factors on the mechanical parameters considered to be related to OMI failure was examined by a regression analysis. The mechanical parameter which best predicts OMI failure in the mandible was found to be a minimum principal strain of between 0.5 to 1.0mm from the OMI surface (R2 = 0.8033). The results indicate the patient's bone density, distance between the OMIs and adjacent root, and vertical implantation angle of the OMIs are potential clinical predictors of OMI failure in the mandible.

How Does Orthodontic Mini-Implant Thread Minidesign Influence the Stability?-Systematic Review with Meta-Analysis.

Background: Clinical guidelines are lacking for the use of orthodontic mini-implants (OMIs) in terms of scientific evidence referring to the choice of proper mini-design. Thus, the present study aimed to investigate to what extent orthodontic mini-implant thread design influences its stability. Methods: Search was conducted in five search engines on 10 May. Quality assessment was performed using study type specific scales. Whenever possible, meta-analysis was performed. Results: The search strategy identified 118 potential articles. Twenty papers were subjected to qualitative analysis and data from 8 papers—to meta-analysis. Studies included were characterized by high or medium quality. Four studies were considered as low quality. No clinical studies considering the number of threads, threads depth, or TSF have been found in the literature. Conclusions: Minidesign of OMIs seems to influence their stability in the bone. Thread pitch seems to be of special importance for OMIs retention—the more dense thread—the better stability. Thread depth seems to be of low importance for OMIs stability. There is no clear scientific evidence for optimal thread shape factor. Studies present in the literature vary greatly in study design and results reporting. Research received no external funding. Study protocol number in PROSPERO database: CRD42022340970.

Intrusion of overerupted periodontally compromised posterior teeth using orthodontic mini implants: A mechanobiological finite element study.

The intrusion of posterior teeth had been considered challenging up to the development of orthodontic mini implants. In periodontally compromised teeth, the challenge is even greater, because of the root resorption risk due to periodontal ligament over-compression. Still, the precise strategy to determine the force reduction level remains uncertain. The objective of the study was to determine, by a finite element analysis (FEA), the force reduction needed to avoid root resorption and maintain the efficiency of orthodontic mechanics of periodontally compromised teeth similar to the sound one. An anatomical model was constructed representing a premolar inserted into a maxillary bone. Based on the initial model (R0), three bone height loss conditions were simulated (R2=2 mm, R4=4 mm, and R6=6 mm). Two intrusive movements were simulated: pure intrusion (bilateral mini implant) and uncontrolled-tipping intrusion (buccal mini implant). The hydrostatic stress at the periodontal ligament was used to evaluate the risk of root resorption due to over-compression. For bilateral mini implant intrusion, the force had to be decreased by 16%, 32% and 48% for R2, R4 and R6, respectively. For buccal mini implant intrusion, the required reductions were higher (20%, 36% and 56%). A linear relationship between the intrusive force reduction and the alveolar bone height loss was observed in both intrusion mechanics. According to the FE results, 8% or 9.3% of force reduction for each millimetre of bone height loss is suggested for intrusion with bilateral or buccal mini implant, respectively. The buccal mini implant anchorage must be associated with a supplemental strategy to avoid buccal crown tipping.

Accuracy of palatal orthodontic mini-implants placed by conventionally or CAD/CAM-based surgical guides: a comparative in vitro study.

To investigate and compare the transfer accuracy of five different surgical guides (SGs) for the insertion of orthodontic mini-implants (OMIs) in the anterior palate. Stereolithographic files of 10 maxillary patient models and their corresponding lateral cephalograms were virtually matched and used for planning the position of two parallel OMIs in the paramedian region of the anterior palate. For each patient model, three 3-dimensional (3D)-printed and two conventional SGs were manufactured from different materials, and a total of 96 OMIs were transferred to the anterior palates of the respective 50 molded resin models. The planned (T0) and the actual (T1) OMI positions were analyzed and compared after superimposition of the digitized models. The deviations between the OMI positions in T0 and T1 were described as the distance between the head and the tip, respectively, of each OMI in millimeters and the deviating angle between the OMI axes for each patient and SG. The conventionally manufactured SGs of Pattern Resin LS (GC Europe N.V., Leuven, Belgium) showed the highest linear and angular transfer accuracy for the insertion of OMIs. The highest deviations were found with the SGs made of IMPRIMO LC Splint (3D-printed; Scheu-Dental, Iserlohn, Germany) and Memosil 2 (conventional SG; Kulzer, Hanau, Germany). The 3D-printed SGs did not reach the accuracy of the conventional SGs made of Pattern Resin but may provide sufficient accuracy for palatal OMI placement.

An interactive dual-branch network for hard palate segmentation of the oral cavity from CBCT images

Automatic and accurate segmentation of the hard palate from Cone Beam and Computed Tomography (CBCT) images is a fundamental task for the insertion of orthodontic mini-implants. U-Net and its variants fail to handle it well when facing the hard palate with diversity of shape. Further, hard palate has low-density soft tissues and high-density hard bones so as to exhibit different intensity of regions in CBCT images, which may result in mis-segmentation or missing-segmentation. Motivated by these challenges, a novel Interactive Dual-Branch Network (IDBNet) is presented to achieve automatic and accurate segmentation of the hard palate in the oral cavity from CBCT images. Specifically, we introduce the designs for hard palate segmentation as follows: (1) Dual-branch encoder–decoder is developed for hard palate with the ability of data expansion and extracting multi-scale interactive features. (2) Channel map interaction module is proposed to reinforce the cross-channel information communication between different level features, thereby enhancing feature representations for variable hard palate. (3) Guide map interaction module is designed to model the similarities and differences of dual-branch hard palate boundaries. Owing to the remarkable designs, our IDBNet has the ability to gradually mine ambiguous hard palate affected by different intensity of regions. Moreover, we collected an in-house dataset with 30 challenging cases, which contained 2260 CBCT slices. Among them, 70% for training and 30% for testing are considered. Five-fold cross-validation experiments on this dataset demonstrate that our method outperforms the Res-UNet method by 8.05% of mean Dice score and 7.97% of structure measure. The utilization of our proposed segmentation approach for hard palate of the oral cavity warrants further investigation on implantable area, which could aid in formulating clinical plans on the insertion regions of palatal mini-implants.

Risk factors and diagnosis of iatrogenic damage of periodontal structures and roots during orthodontic Mini-Implants implantation procedures - a systematic literature review

Introduction and purpose
 In recent years, Mini-Implants (MI) have gained popularity and new complications have emerged with them. The article assesses the current reports on the scale of the problem, factors and diagnostic possibilities related to iatrogenic injuries of periodontal tissues and roots.
 
 Description of the state of knowledge
 The incidence of complications was estimated to be 13.5%. Complications are more common in the mandible and are estimated at 20-27.1%. Periodontal and root damage are an important risk factor for treatment failure. The fact that the implant does not interfere with the alveolus structure gives the treatment effectiveness in 90%, and the contact with the alveolar “lamina dura” is 62.5%. Interference with the root structure is successful in only 31.2%.
 Risk factors for failure include: young age, poor hygiene, smoking, area of mandibular molars, contact with the root, thickness of the bone and lack of experience. The implant between the roots is a risk of root trauma, as the location close to the tooth cemento-enamel junction, no preparation for surgery, not using surgical templates, strenuous implantation or implant migration under the influence of orthodontic forces. Radiographs are the gold standard in the diagnosis of complications, but they do not allow for a full assessment of the three-dimensional structures of the implant. A promising method is the evaluation of the torque as the implant is placed in its final location. The patient's subjective feelings are questionable in diagnosis and require further research.
 Summary
 There are many complications in using MI and the most important of these is damage to the structures of the periodontium and the tooth root. Despite the low failure rate, failure should be prevented by pre-operative evaluation, in-operative monitoring, and post-operative diagnostics.

The antimicrobial effect of doxycycline and doped ZnO in TiO2 nanotubes synthesized on the surface of orthodontic mini-implants

Objectives: Anchorage preservation is crucial in orthodontic treatment success. Mini-implants make a revolution in this domain. The failure of orthodontic mini-implants due to inflammation and infection is one of the reasons for anchorage loss. The purpose of this study was to evaluate the effect of a novel mini-implant surface modification to improve resistance against microbial contamination and surrounding tissue inflammation. Material and Methods: Twenty-four orthodontic mini-implants (Jeil Medical Corporation, Korea) with 1.6 mm diameter and 8 mm length were randomly divided into three groups: Group 1: Control group, Group 2: Nanotubes were made on the surface with anodisation, and Group 3: Zinc Oxide (ZnO) doped into nanotubes, and then doxycycline is added to them. The anti-bacterial efficacy against Porphyromonas gingivalis was evaluated using the disk diffusion method. To analyze data, Kruskal–Wallis, Friedman, and Wilcoxon tests were done. The significance level was set at 0.05. Results: No zone of the inhibition was formed in Groups 1 and 2. In Group 3, the mean (SD) diameter of the inhibition zone in the first 5-day to sixth 5-day were 38.7(8.2), 25(4.8), 17.8(5.6), 7.63(5.37), 1.5(2.83), and 0 millimeters, respectively. Conclusion: Nanotubes containing doped ZnO and Doxycycline are capable of preventing bacterial growth around the mini implant surfaces for at least up to 30 days. To manage inflammation of surrounding tissues of mini-implants, nanotubes are not effective alone. Therefore, the presence of diffusible materials in addition to nanotubes on the surface of mini-implants is necessary.

The Effect of Photobiomodulation Therapy on the Stability of Orthodontic Mini-implants in Human and Animal Studies: A Systematic Review and Meta-analysis.

Introduction: The present study aimed to systematically explore available literature on the possible impact of photobiomodulation (PBM) therapy on the stability and success of orthodontic mini-implants. Methods: A comprehensive electronic search was conducted in PubMed, ISI Web of Science, Scopus, Cochrane and Embase databases for human and animal studies published until July 2021. Two independent researchers reviewed the studies based on specific eligibility criteria. Results: 15 studies were included in the systematic review after a comprehensive search. Ten studies were included in the meta-analysis. Four were human RCT studies that evaluated the stability with Preriotest. Three other human RCT studies and two animal studies had evaluated the Implant stability quotient (ISQ). Two human RCTs that had evaluated displacement of mini-implants were also analyzed. The analysis of Periotest stability results showed a positive effect of PBM on mini-implant stability at 30 and 60 days after implantation (P<0.05). In human studies using the ISQ method, a slight improvement was seen in the PBM groups; however, this was not statistically significant (CI=-1.92-2.70, SMD=0.39). In studies that examined the displacement of mini-implants, no statistically significant difference was observed between irradiated and non-irradiated groups (CI=-1.92-2.70, SMD=0.03). According to the results of animal studies, which had used the ISQ method, the use of laser was statistically effective in increasing the stability of mini-implants (SMD=1.43, CI=1.00-1.85). Conclusion: PBM therapy can be suggested as an adjunctive clinical method to improve the stability of mini-implant treatment. Further well-designed clinical studies can help establish evidence-based dosing and irradiation protocols.

Comparison of Biomechanical Properties of Surface-Treated and Untreated Machined Orthodontic Mini-Implants: An In Vitro Study

Background and Objectives: The use of mini-implants has become more popular, and there has been a heightened focus on factors that contribute to their success. The purpose of the study is to compare the effects of various surface treatment methods of mini-implants on their bone cutting capacity, insertion torque required, and fracture resistance when compared with the untreated machined mini-implants. Materials and Methods: The study included 4 groups. Each group consisted of 10 orthodontic mini-implants (OMIs). The first experimental group contains titanium oxide coated mini-implants, the second group contains grit-blasted implants with aluminum oxide, the third group consists of mini-implants coated with hydroxyapatite crystals, and the control group is formed by untreated machined mini-implants. Each group is evaluated for cutting efficiency, maximum insertion torque, and fracture resistance using a customized torque testing gauge. Results: The results showed that surface treating OMIs with hydroxyapatite particles increases the surface roughness, thereby enhancing their stability without decreasing the bone cutting ability compared with OMIs without surface treatment. Conclusion: Roughened surface of OMIs with hydroxyapatite particles exhibited maximum fracture resistance without decreased corresponding bone cutting efficiency.