Miniplates For Anchorage Research Articles

Skeletal anchorage in surgery first orthognathic surgery

Surgery First is an orthodontic technique, not a surgical technique, in which the orthodontic appliances are placed on immediately before surgery. The orthodontic dental decompensation is performed after surgery, being the orthognathic surgery itself fundamentally the same.Surgery First has several advantages for patients. For instance, the total treatment time drops significantly, and patients have better oral health-related quality of life scores during treatment.Several patients require skeletal anchorage miniplates for the post surgery orthodontic treatment. In the maxilla, the anchorage miniplates compete for space in the positioning site of the rigid internal fixation miniplates in the posterior region and requires a change in the design of the Le Fort 1 osteotomy. This work presents a protocol for the use of skeletal anchorage miniplates during surgical orthodontic treatments within the Surgery First approach that our team has been implementing for 17 years.

Effect of maxillary molar intrusion on surrounding bone density during treatment of anterior open bite

The aim of the current work is to estimate the impact of posterior maxillary intrusion on the surrounding bone intensity during correction of anterior open bite (AOB). The sample was 14 patients suffering from mild to moderate (3-5mm) anterior open bite with increased posterior maxillary vertical height. This study sample was allocated into two groups according to the corticotomy the approach. Buccal miniplates and palatal mini screws were used as skeletal anchorage for maxillary molars’ intrusion. The density of the alveolar bone related to right and left maxillary first permanent molars were measured 4.5 months after intrusion commencement. The study revealed that the alveolar bone density of right and left first permanent molars had statistically significant decreases. In the right side, buccal and palatal cortical density had statistically significant decrease, however it was non significant for left both cortical bone. Absolute molar intrusion could be attained by skeletal anchorage miniplates and mini screws in patients with frontal open bite malocclusion. The variation of bone intensity between buccal and palatal sides may account for the variance bone thickness changes after intrusion from the buccal to the palatal sides.

Three-dimensional comparative evaluation of customized bone-anchored vs tooth-borne maxillary protraction in patients with skeletal Class III malocclusion

The aim of this prospective study was to assess the 3-dimensional skeletal and dental effects induced by a new maxillary protraction approach using customized miniplates for anchorage compared with a control group of traditional tooth-borne maxillary protraction. Forty-one growing patients at prepubescent stage with skeletal Class III malocclusion participated in this study. These patients were randomly split into 2 groups. In group 1 (n=20), patients underwent maxillary protraction anchored with customized miniplates. The miniplates were individually designed and inserted using the surgical templates. In group 2 (n=21), patients underwent tooth-borne maxillary protraction. Pretreatment and posttreatment cone-beam computed tomography scans were obtained, and 30 measurements of cone-beam computed tomography images were acquired and calculated. The changes after treatment and the comparison of the 2 groups were assessed. After maxillary protraction, group 1 showed a greater forward movement of the maxilla than group 2. The maxilla length increased more in group 1 than in group 2. The rotations of the palatal and mandibular planes in group 1 were less than those in group 2. In group 1, the maxillary incisors proclined less, the mandibular incisors retroclined less, and the maxillary first molars extruded less. Compared with tooth-borne maxillary protraction, customized miniplates anchored maxillary protraction produced more maxillary growth, fewer dental changes, and less maxillary and mandibular plane rotation.

Debonding Shear Strength of Orthodontic Tubes Bonded to Skeletal Anchorage Miniplates with Different Agents

Introduction: Most miniplates used for skeletal anchorage lack built-in orthodontic devices. To address this issue, orthodontists must use creative solutions, such as bonding buttons, brackets, or tubes directly to the miniplates, thus making them more versatile devices that provide a wider range of tooth movement possibilities. The purpose of the present study was to ascertain the debonding strength in Megapascals (MPa) of orthodontic accessories bonded to skeletal anchorage miniplates with different bonding agents. Methods: Forty specimens were divided into two equal groups by bonding agent: Group 1, resin (Transbond XT®, 3M ESPE); Group 2, cyanoacrylate (Scotchbond®, 3M ESPE). Shear strength testing was performed in an EMIC DL-2000 universal testing machine. Results: The results obtained were 2.28 ± 0.44 MPa for Group 1 and 4.90 ± 0.76 MPa for Group 2. The Kolmogorov-Smirnov test was used to assess the normality of data distribution. Student's t-test was used to compare means in the response variable. Conclusion: A statistically significant difference was observed between groups. However, both bonding agents provided strength in excess of that needed for secure orthodontic tooth movement.

Infection predictive factors with orthodontic anchorage miniplates

Inflammation and/or infection around skeletal anchorage miniplates is a relatively common complication. The aim of this study was to assess potential predictive factors behind soft tissue infection associated with titanium miniplates used for orthodontic anchorage. A cross-sectional study enrolled 60 patients who had miniplates for at least 6 months. Infection around miniplates (dependent variable) was defined according to the presence of exudate and edema in the region and was used in a conditional multiple logistic regression model to investigate the possible role of several independent variables as predictive factors. A total of 20 men and 40 women used 139 miniplates. In all, 72.7% of miniplates were installed in female patients and 27.3% in male patients. Infection occurred in 24 (17.3%) of the 139 miniplates installed. This study showed that greatest impact for infection was the distance from the exposed link of the miniplate to the mucogingival junction, probing depth and oral hygiene frequency were also important to explain infection. However, age was the least factor to obtaining the infection around the miniplate.

Surgical difficulties, success, and complication rates of orthodontic miniplate anchorage systems: Experience with 382 miniplates.

The aim of this study was to evaluate the complications and success rates of the miniplates using both maxilla and mandible for orthodontic anchorage in growing patients. One hundred and fifty-five consecutive patients (range 8.7-13.8 years) with Class II and III malocclusion without congenital or acquired deformities were included in this study. A total of 382 titanium miniplates were placed by the same surgeon. All miniplates were inserted under local anesthesia. Loading of the miniplates with a force of 200 g with the help of elastics or functional devices were initiated 3 weeks after surgery. The overall success rate of miniplate anchorage in terms of stability was 96.8%. Twenty-one patients reported irritation of the mucosa of the cheeks or lower lip after the surgery in the mandible group. Twelve miniplates needed to be removed and were successfully replaced. Skeletal anchorage miniplates is effective for correcting malocclusions. Success depends on proper presurgical patient counseling, minimally invasive surgery, good postsurgical instructions, and orthodontic follow-up.

Effects of maxillary molar distalization with Zygoma-Gear Appliance

To evaluate the dentoalveolar, skeletal, and soft tissue effects of the Zygoma-Gear Appliance (ZGA) when used for bilateral distalization of the maxillary molars. The study group included 15 patients (mean age, 15.87 ± 1.09 years; range: 14-18 years) treated with the ZGA system supported with zygomatic anchorage miniplates. The changes due to the distalization were evaluated from the lateral cephalometric films taken before and after distalization by means of a paired t-test. The mean treatment period required to achieve a Class I molar relationship was 5.21 months. The distalization amount of the maxillary molars was 4.37 ± 2.15 mm (P < .001), and, thus, the rate for the distal movement of the molars was 0.84 mm per month. Maxillary first molars showed a slight intrusion (0.50 mm) (P > .05), while distal tipping was only 3.30° ± 2.31° (P > .05). Furthermore, there was a decrease in overjet (-0.50 mm) (P > .05), indicating that there was no anchorage loss with use of the ZGA. Maxillary molar distalization without anchorage loss can be achieved in a short time with ZGA.

The benefits of using anchorage miniplates. Are they compatible with everyday orthodontic practice?

Nowadays, it is difficult to ignore the major role played by orthodontic anchorage. Given our convictions and after several years of using these systems, we believe it is time to take stock. Is there any real benefit to using them? And if so, when? What systems should we use? Miniscrews or miniplates? What are the indications for each of these systems? Are they compatible with everyday orthodontic practice? In a nutshell, are these orthodontic anchorage devices myth or practical reality?

Essential technic in the use of the open tube appliance

Progressive improvements in digital technology and surgical techniques have synergized the speed, predictability, and favorable outcomes for patients undergoing surgical-orthodontic treatment with handicapping dentofacial deformities. This case report will demonstrate the management of a patient with severe mandibular hypoplasia, condylar hypoplasia, and mandibular asymmetry. The dentofacial deformity, and consequently, the unaesthetic facial appearance, led to psychosocial stress, symptoms of excessive daytime sleepiness, and functional limitations, especially related to mandibular movements. A modified surgery-first approach was used, which was successfully performed using computer-assisted surgical planning. Postsurgical orthodontics was accomplished with the aid of temporary skeletal anchorage mini-plates. An additional alloplastic enhancement of the chin addressed the severe microgenia, which the osseous advancement could not achieve. This resulted in a total advancement of the pogonion by 26 mm yielding a remarkable improvement in the patient's facial esthetics. Furthermore, a considerable improvement in mandibular function and reduction in daytime sleepiness occurred. The severe malocclusion with a discrepancy index value of 47 was treated to a successful final occlusion in 21 months of treatment time.