Source Of Anchorage Research Articles

Comparison between two types of grids for placement of mini-screw implant in posterior maxillary segment

Use of mini-screw implants is in vogue. It has brought about a drastic change in day to day practise for orthodontists. Despite being the most popular source of anchorage, it is not easy for newer clinicians to perfectly figure out the site of implant placement and the accuracy by which it should be placed to avoid failure. A customised grid or mesh is the simplest way to gain assistance for placement of miniscrew implants. This article focuses on comparison of two types of grids for placement of implant accurately and to guide the clinician in such a way that minimises all the possible errors.

Quantitative assessment of ramal bone width and the proximity of the inferior canal for the predictable insertion of ramal implants: Cone-beam computed tomography study

Objectives: The study aimed to investigate the optimum level for the placement of ramal implants as a source of anchorage for disimpacting mandibular molars. The criteria in relation to the maximum transverse width of the ramal bone and proximity of the implant to the inferior alveolar canal (IAC) were evaluated using a three-dimensional cone-beam computed tomography scan for predictable placement of ramal implants. Material and Methods: The cone-beam computed tomographic scans of 53 untreated patients (aged between 18 and 48 years) were utilized in this study. The maximum transverse width of the ramus and the proximity to the IAC from the site of insertion were measured at six different levels above the central groove of the mandibular first molar. To measure the proximity to the IAC, the mid-point of the maximum transverse width of the ramus was selected as the site of insertion of the implant. Results: The maximum and minimum transverse ramal width was 12.48 ± 1.76 mm at 3 mm and 10.42 ± 2.08 mm at 8 mm above the central groove of the permanent mandibular first molar. An average clearance of 9.62 ± 2.59 mm was measured from the site of insertion to the IAC at the different levels evaluated. Conclusion: The ramus of the mandible can be a predictable site for implant placement provided the variations in the anatomical structures have been carefully analyzed. It can be concluded that the ramal implants can be safely placed at a level 3–8 mm above the permanent mandibular first molar in relation to the occlusal plane.

CARD Predictive Modeling and SEI Formulation: COVID-19 Statistics in India

The current scenario of the pandemic COVID-19 has been a source of anchorage for researchers, healthcare professionals, and statisticians. Based on the immense data, it has been observed that the role of statistics has been crucial in researching and at the same for predicting the COVID-19 scenario of the entire globe. This paper deals with extensive data collection and predictive modeling to derive a CARD model using statistical tools like regression curve fitting. The exponential growth model has been prevalent in live updates via COVID-19 dashboards maintained by different organizations like WHO, Johns Hopkins University, Indian Council of Medical Research. In a similar tone, the paper discusses a time-varying exponential growth model specific to the Indian condition. However, a generic model has been derived by different researchers of other countries. The model accuracy has been considered satisfactory. Moreover, a State-wise Evaluation Indexing has been performed considering parameters like sanitation, population below the poverty line, literacy rate, and population density. Results have been shown for better data visualization through cartograms. The conclusions are noteworthy, and the CARD model can be trained and developed with better accuracy using the concept of machine and deep learning, keeping in context the huge amount of instantaneous data being generated every day all over the world.

Management of Early Loss of first Permanent Molar in Adolescent

The first molar is the largest tooth in the oral cavity and bears the maximum occlusal load, and they influence the vertical distance of the maxilla and mandible, the occlusal height, and aesthetic proportions. Since they have the maximum root surface area, they are also considered the best source of anchorage for moving the teeth (Mostafa Rezaie el al 2018). The timing of first molar eruption makes these teeth vulnerable to dental caries. The loss of a permanent first molar in adolescent patient creates a need for early space maintenance and restorative of function. This paper describes a conservative, functional and cost-effective bridge as an interim restoration after the loss of permanent first molar in an early adolescent dentition (Rajashekhara el al 2012).

Deciduous Molars a Useful Source of Anchorage

Deciduous Molars a Useful Source of Anchorage

Effectiveness of anchorage with temporary anchorage devices during anterior maxillary tooth retraction: A randomized clinical trial.

ObjectiveThis study evaluated the efficiency of anchorage provided by temporary anchorage devices (TADs) in maxillary bicuspid extraction cases during retraction of the anterior teeth using a fixed appliance.MethodsPatients aged 12 to 50 years with malocclusion for which bilateral first or second maxillary bicuspid extractions were indicated were included in the study and randomly allocated to the TAD or control groups. Retraction of the anterior teeth was achieved using skeletal anchorage in the TAD group and conventional dental anchorage in the control group. A computed tomography (CT) scan was performed after alignment of teeth, and a second CT scan was performed at the end of extraction space closure in both groups. A three-dimensional superimposition was performed to visualize and quantify the maxillary first molar movement during the retraction phase, which was the primary outcome, and the stability of TAD movement, which served as the secondary outcome.ResultsThirty-four patients (17 in each group) underwent the final analysis. The two groups showed a significant difference in the movement of the first maxillary molars, with less significant anchorage loss in the TAD group than that in the control group. In addition, TAD movement showed only a slight mesial movement on the labial side. On the palatal side, the mesial TAD movement was greater.ConclusionsIn comparison with conventional dental anchorage, TADs can be considered an efficient source of anchorage during retraction of maxillary anterior teeth. TADs remain stable when correctly placed in the bone during the anterior tooth retraction phase.

A CBCT evaluation of molar uprighting by conventional versus microimplant-assisted methods: an in-vivo study.

ABSTRACTObjective: The aim of this prospective study was to compare the three-dimensional effects of the conventional helical uprighting spring (CA) and the mini-implant assisted helical uprighting spring (MIA), using CBCT scans. Methods: Twenty patients with mesially tipped second mandibular molars were divided into two groups: CA group, in which 10 patients were treated using a conventional helical uprighting spring with conventional anchorage; and MIA group, in which 10 patients were treated using a mini-implant supported uprighting spring. Molar uprighting was observed in both groups for a period of four months. Two standardized 11×5-cm CBCT sections of the mandible were taken, being one prior to uprighting and one at the end of the four month follow-up. Statistical analyses at the beginning of treatment and after a 4 month follow-up were performed, with a significance level of p< 0.05.Results: The mean amount of change in mesiodistal angulation in the MIA group was 8.53 ± 2.13o (p< 0.001) and in the CA group was 9.8 ± 0.5o (p< 0 .001). Statistically significant differences were found between the two groups with regard to buccolingual inclination of canine, first and second premolars (p< 0.05), second molar (p< 0.001) and extrusion of second molar (p< 0.05). Conclusions: The mean amount of change in the mesial angulation of the second molar in the CA as well as the MIA groups was similar. MIA, which used mini-implant as a source of anchorage, was more effective in preventing movement of the anchorage teeth as well as preventing extrusion of the second molar in the vertical plane, when compared to the CA group, which used dental units as a source of anchorage.

Comparison of labial corticotomy vs palatal corticotomy during en masse retraction with mini screws as anchorage units

Aim: The aim of this study was to evaluate and compare the treatment effects and duration of en-masse retraction combined with labial corticotomy and that with palatal corticotomy using miniscrews as source of anchorage. Methods: Twenty adult patients with bimaxillary or maxillary protrusion requiring orthodontic treatment with upper anterior retraction in the extraction space of first premolars were selected. Patients were divided into two groups; labial corticotomy gruop and palatal corticotomy group, each group consisted of 10 subjects. The retraction time was estimated. Cephalometric radiographs were taken before treatment (T1) and after treatment (T2). Results: There was no significant difference in retraction time between labial and palatal corticotomy groups. Radiographic evaluation showed significant maxillary incisor retraction. Conclusion: The use of corticotomy technique from labial side only could be beneficial for adult patients with difficult surgical access from the palatal side.

Maxillary Molar Intrusion Evaluation using Mini-implants along with Transpalatal Arch Bar

ABSTRACTAimThe prospective clinical study was undertaken to evaluate the amount of maxillary molar intrusion achieved during orthodontic treatment using mini-implants along with transpalatal arch bar.Materials and MethodsThe treated group consisted of 10 subjects having over-erupted maxillary molars with mean age of 20.75 years. Mini-implants of 8 mm length and 1.3 mm diameter (Dentos-Absoanchor, Dentos Inc., Korea) were placed in the inter-radicular region between the second premolar and first molar on the buccal side where the molar intrusion was planned. Transpalatal arch bar was placed 5 mm away from the palate. Intrusive force of 100 to 150 gm was applied using prestretched elastic chain. Lateral cephalograms were taken before beginning of molar intrusion and 3 months after the molar intrusion. The intrusion was measured from the distobuccal cusp tip of maxillary first molar to the true vertical and rotation of the mandibular plane was assessed in relation to Go-Me and SN plane. The mean changes in the cephalometric parameters were subjected to paired t-test to determine results under statistical evaluation.ResultsStatistically significant (p &lt; 0.001) amount of molar intrusion was achieved following the usage of mini-implant with a mean value of 1.95 mm and significant anti-clockwise rotation of the mandibular plane (Go-Me) in relation to SN plane (p &lt; 0.001) was seen as a result of molar intrusion.ConclusionThe study revealed that mini-implant served as an efficient source of anchorage for achieving maxillary molar intrusion in correction of malocclusion in vertical dimensions.How to cite this articleGupta G, Rozario JE, Patil AK, Singh RK, Kannan S, Gupta A. Maxillary Molar Intrusion Evaluation using Mini-implants along with Transpalatal Arch Bar. J Contemp Dent 2015;5(3):158-164.

Comparison of Two Methods for Canine Retraction Depending on Direct Skeletal Anchorage System (CR-DSAS)

Introduction: Various anchorage techniques have been used for canine retraction. Traditional anchorage techniques have not always been very efficient. Recently, Temporary anchorage devices such as miniscrews are considered to be an effective source of anchorage for canine retraction. The purpose of this study was to compare between elastic chain and closed coil in retracting upper canines when using miniscrews as skeletal anchorage in class 2 division1 cases. Methods: Twenty-two patients with class 2 division 1 were treated with preadjusted appliances. Depending on miniscrews as direct skeletal anchorage, elastic chain and closed coil were used to retract upper canines after first premolar extraction. Cephalometric radiographs and cast models were been used to evaluate canine retraction. Results were analyzed by SPSS 15 using T student test. Results: Upper canines were retracted in 5-5.5 month; Canine crowns were retracted 6.97mm by elastic chain and 7.08 mm by closed coil. Canine apices were retracted 1.06mm by elastic chain and 1.43mm by closed coil. Anchorage loss with miniscrews was 0.07-0.2 mm. Conclusions: Miniscrews provide absolute skeletal anchorage, Canine movement with skeletal anchorage is faster than traditional techniques, Canines tipped distally when retracted depending on direct skeletal anchorage, and there was no statistical differences between elastic chain and closed coil in retracting canines. Received August 30, 2014; Accepted September 18, 2014 ; Published December 31, 2014

Cone-beam computerized tomography evaluation of canine retraction using micro implant and conventional anchorage

ObjectiveVarious anchorage techniques have been designed for canine retraction. The aim was to measure and compare the rate of canine retraction with conventional method and micro implant using CBCT. Materials and methodsSample size comprising of 17 subjects were scheduled for extraction of all first premolars. After leveling and aligning, titanium micro implants were placed between the roots of the second premolar and the first molars on right side, in both the arches. Pre and post retraction CBCT scans were taken. Retraction was done using sliding mechanics using stainless steel arch wire. ResultsThe maxillary right canine (micro implant) retracted by 6.75 mm and tipped distally by 9.51° at a rate of 1.05 mm/month while the mandibular right canine retracted by 4.83 mm and tipped distally by 7.88° at a rate of 1.13 mm/month. On the left side (conventional) with molar as a source of anchorage, maxillary canine retracted by 6.03 mm and tipped distally by 6.51° at a rate of 1.46 mm/month while the mandibular canine retracted by 5.03 mm and tipped distally by 4.34° at a rate of 1.15 mm/month. ConclusionImplants can serve as a source of anchorage.

En-masse retraction with a preformed nickel-titanium and stainless steel archwire assembly and temporary skeletal anchorage devices without posterior bonding.

ObjectiveTo evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction.MethodsThirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with pre-adjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed.ResultsBoth groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group.ConclusionsPreformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.

Rationalization of Mechanical Factors affecting Primary Stability of Orthodontic Miniscrew using Engineering Principles of Simple Machines

Miniscrews have become the regular components as an anchorage source in orthodontics. Stability and failure of miniscrew is materializing to be multifactorial with no consensus on causative factors. Factors that influence the load transfer at the bone-implant interface and miniscrew stability include host factors, biomechanical factors, sterilization protocol and hygiene. Biomechanical influences on bone structure play an important role in the longevity of bone. Incorrect loading or overloading as a result of ineffective implant geometries may lead to implant loss. Miniscrews are not an exception for following the mechanical behavior or engineering principles. More certainly, they are based on the simple machines, which is a mechanical device that changes the direction or magnitude of a force. This article produces an insight for rationalization of mechanical factors controlling the stability with principles of simple machines, namely (i) lever, (ii) wheel and axle, (iii) inclined plane, (iv) wedge and (v) screw.

Evaluation of Titanium Miniscrew Implants as a Source of Intraoral Anchorage for en masse Intrusion of Maxillary Anterior Teeth: A Clinical Study

Objectives: Deep bite or increased overbite correction often offers a challenge to the clinician during orthodontic treatment. Bite opening with conventional mechanics in high angle cases which require intrusion of anteriors cause reciprocal forces in the posteriors which is undesired. Absolute or true en masse intrusion mechanics using mini-implants are ideal for such cases. This study explores the rate, amount of intrusion and torque changes of maxillary anteriors over a period of 6 months using mini-implants between canine and lateral incisors bilaterally. Materials and methods: Bilateral mini-implants made by Dentos were placed between lateral incisors and canines and a force of 45 gm per side was applied. Preand postlateral cephalograms were evaluated for the rate, amount of intrusion and torque changes. Results: Rate of intrusion of incisors was found out to be 0.43 mm/month and rate of intrusion of canines was found out to be 0.18 mm/month and the torque changes observed were nonsignificant. Conclusion: Mini-implants were used to deliver light continuous forces of optimal magnitudes and they were observed to be efficient and stable source of anchorage for en masse intrusion of the maxillary anterior teeth. The amount of intrusion achieved for six maxillary anterior teeth was statistically and clinically significant without significant torque changes.

Torque control during lingual anterior retraction without posterior appliances

ObjectiveTo evaluate the factors that affect torque control during anterior retraction when utilizing the C-retractor with a palatal miniplate as an exclusive source of anchorage without posterior appliances.MethodsThe C-retractor was modeled using a 3-dimensional beam element (0.9-mm-diameter stainless-steel wire) attached to mesh bonding pads. Various vertical heights and 2 attachment positions for the lingual anterior retraction hooks (LARHs) were evaluated. A force of 200 g was applied from each side hook of the miniplate to the splinted segment of 6 or 8 anterior teeth.ResultsDuring anterior retraction, an increase in the LARH vertical height increased the amount of lingual root torque and intrusion of the incisors. In particular, with increasing vertical height, the tooth displacement pattern changed from controlled tipping to bodily displacement and then to lingual root displacement. The effects were enhanced when the LARH was located between the central and lateral incisors, as compared to when the LARH was located between the lateral incisors and canines.ConclusionsThree-dimensional lingual anterior retraction of the 6 or 8 anterior teeth can be accomplished using the palatal miniplate as the only anchorage source. Using LARHs at different heights or positions affects the quality of torque and intrusion.

Root perforation associated with the use of a miniscrew implant used for orthodontic anchorage: a case report

To highlight one of the possible complications associated with the inter-radicular placement of orthodontic miniscrews. This case report describes the endodontic treatment and surgical repair of an iatrogenic root perforation involving a maxillary first molar tooth following the placement of an orthodontic miniscrew placed for anchorage purposes in the treatment of an adult patient. The orthodontic treatment plan was completed. The long-term follow-up shows a successful treatment outcome. Inter-radicular placement of orthodontic miniscrews is a valuable source of anchorage in the treatment of orthodontic patients. Root perforation is a possible complication from inter-radicular placement of orthodontic miniscrews. Root perforation can be successfully treated, but may involve apical surgery.

Factors controlling anterior torque during C-implant-dependent en-masse retraction without posterior appliances

Our objective was to evaluate the factors that affect effective torque control during en-masse incisor and canine retraction when using partially osseointegrated C-implants (Cimplant, Seoul, Korea) as the exclusive source of anchorage without posterior bonded or banded appliances. Base models were constructed from a dental study model. No brackets or bands were placed on the maxillary posterior dentition during retraction. The working archwire was modeled by using a 3-dimensional beam element (ANSYS beam 4, Swanson Analysis System, Canonsburg, Pa) with a cross section of 0.016 × 0.022-in stainless steel. Different heights of anterior retraction hooks and different degrees of gable bends were applied to the working utility archwire that was placed into the 0.8-mm diameter hole of the C-implant to generate anterior torque on the anterior segment of the teeth. The amount of tooth displacement after finite element analysis was exaggerated 70 times and compared with tooth-axis graphs of the central and lateral incisors and the canine. The height of the anterior retraction hook and the degree of the gable bend had a combined effect on the labial crown torque applied to the incisors during en-masse retraction. By using 30° gable bends and the longest hook, lingual root movement of the 6 anterior teeth occurred. By using 20° gable bends, the 6 anterior teeth showed a translation tendency during retraction. Three-dimensional en-masse retraction of the 6 anterior teeth can be accomplished by using partially osseointegrated C-implants as the only source of anchorage, gable bends, and a long retraction hook (biocreative therapy type I technique).

Analysis of lingual en masse retraction combining a C-lingual retractor and a palatal plate

To analyze the results of employing en masse retraction of the maxillary anterior dentition using palatal temporary skeletal anchorage devices (TSADs) as the exclusive source of anchorage. A retrospective clinical investigation supported by preliminary case reports was performed comparing pretreatment cephalometric radiographs with those taken after en masse retraction of the six anterior teeth. The sample consisted of 35 nongrowing patients with an average age of 22.9 years. The average retraction period was 10 months (range, 6-15 months). No brackets or bands were placed on the posterior dentition during retraction. A total of 35 C-palatal plates (C-plates) were used as the only source of anchorage for maxillary anterior retraction with the C-lingual retractor (C-retractor), thereby eliminating the need for bonded or banded anchor teeth. The cephalometric radiographs were analyzed for differences between pretreatment and postretraction variables that included skeletal, dental, and soft tissue relationships. Significant incisor and canine retraction was achieved in all patients, and the upper posterior teeth did not show significant mesial drifting during the retraction period. According to the length of the lever arm of the C-retractor, tooth movement showed different directions. En masse retraction of the six anterior teeth with good torque control and effective intrusion is possible using palatal TSADs as the only source of anchorage.

Factors controlling anterior torque with C-implants depend on en-masse retraction without posterior appliances: Biocreative therapy type II technique

Our objective was to evaluate the factors that affect effective torque control during en-masse anterior retraction by using intrusion overlay archwire and partially osseointegrated C-implants as the exclusive sources of anchorage without posterior bonded or banded attachments. Base models were constructed from a dental study model. No brackets or bands were placed on the posterior maxillary dentition during retraction. Different heights of the anterior retraction hooks to the working segment archwire and different intrusion forces with an overlay archwire placed in the 0.8-mm diameter hole of the C-implant were applied to generate torque on the anterior segment of the teeth. The amount of tooth displacement after finite element analysis was exaggerated 70 times and compared with tooth axis graphs of the central and lateral incisors and the canine. The height of the anterior retraction hook and the amount of intrusion force had a combined effect on the labial crown torque applied to the incisors during en-masse retraction. The difference of anterior retraction hook length highly affected the torque control and also induced a tendency for canine extrusion. Three-dimensional en-masse retraction of the anterior teeth as an independent segment can be accomplished by using partially osseointegrated C-implants as the only source of anchorage, an intrusion overlay archwire, and a retraction hook (biocreative therapy type II technique).

Orthosurgical treatment including anchorage from a palatal implant to correct an infraoccluded maxillary first molar in a young adult

Tooth ankylosis during adolescence and early adulthood can lead to infraocclusion and several interrelated, adverse sequelae at the intra-arch and interarch levels. An orthosurgical treatment modality that includes surgical luxation and immediate orthodontic traction is recommended as a conservative approach in many patients. The key to success in this approach is the timely delivery of relatively heavy and continuous forces to the luxated tooth to prevent its reankylosis. Because high reactive forces are inevitably generated, it is crucial to create a reliable source of anchorage. This report describes the successful use of an osseointegrated orthodontic implant to reinforce the anchorage during the orthosurgical repositioning of an infraoccluded molar in a young adult.