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PubMed2005

Implants for orthodontic anchorage. Meta-analysis.

The purpose of this article was to review and update current data of the use of implants for orthodontic anchorage. A meta-analysis of selected literature was carried out and a total of 415 articles were identified in this process. Having reviewed the articles or their abstracts/summaries the data were evaluated and the articles were categorized according to the journal and the year of publication, the type of the article and the type of the implant. The interest in the possibilities of the implant usage for orthodontic anchorage is noticeably increasing and today it has reached the peak. In order to facilitate the understanding of the wide range of implants, we suggested the classification of the implants for orthodontic anchorage according to the shape and size, the implant bone contact and the application of the implant. We systemized the information about types of implants and their advantages in respect of traditional orthodontic treatment.

Bone Plates↗
PubMed2006

[Uprighting of a tipped lower second molar with the aid of a microscrew anchorage. A case report].

Titanium microscrews for orthodontic anchorage purposes have been developed in different designs and dimensions by a number of manufacturers. Whereas conventional implants need a relatively extensive bone supply and the insertion sites are limited, microscrews offer a more flexible range of applications. They also offer crucial advantages such as simple, atraumatic insertion and removal, a minimum patient stress and a favourable cost-benefit ratio. In the present case report the successful orthodontic uprighting of a tipped second lower molar using a microscrew demonstrated.

Adolescent↗
PubMed2006

A comparative assessment of the failure rate of molar tubes bonded with a self-etching primer and conventional acid-etching.

OBJECTIVES: Comparative assessment of the failure rate of molar tubes bonded to first and second molars with a self-etching primer and conventional acid-etching. MATERIAL AND METHODS: Four hundred forty-four molar tubes (246 first molar tubes and 198 second molar tubes) were bonded, using a split-mouth design, on 62 patients (23 male, 39 female; mean age 13.7 years) with the 3M Transbond Plus self-etching primer combined with Transbond XT paste; or with conventional acid-etching, Orthosolo primer, and Enlight adhesive paste. First-time failures were recorded over a period of 15 months. RESULTS: Bond failure per adhesive system, arch (maxilla-mandible), quadrant (left, right) and tooth (first or second molar) were studied. Statistical analysis using logistic regression modeling (alpha = .05) showed that the overall failure rate for the first and second molar tubes was 11% (8% with self-etching primer and 13% with conventional acid-etching). No significant difference was found between the 2 bonding methods. Tooth location and type showed statistically significant associations. Mandibular tubes showed a 3:1 probability for failure compared to maxillary tubes. Right-sided tubes demonstrated 3 times more failures when compared to left-sided tubes, and second molar tubes showed a 3-fold increase in failure. CONCLUSION: Molar tube bonding with self-etching primer shows similar success rates to conventional acid-etching, whereas the mandibular right second molar presents the highest failure incidence.

Acid Etching, Dental↗
PubMed2006

Clinical modification in root correction phase in segmented arch technique.

The segmented arch technique uses the differential moment/force ratio in the anterior and posterior segments so that the extraction space in cases of critical anchorage can be closed with minimal or no anchorage loss. The objective of this article is to discuss the root correction phase, the force system involved, and the clinical problem of the tendency of space reopening during this phase. It also presents the use of a closed NiTi spring as a clinical alternative for this phase, concluding that this device can be used to avoid space reopening.

Biomechanical Phenomena↗
PubMed2006

Comparison between two orthodontic skeletal anchorage devices: osseointegrated implants and miniscrews - Medical-Legal Considerations.

The object of this article is to describe potential medical-legal problems concerning the use of miniscrews as orthodontic skeletal anchorage. The miniscrews, which are already used in rigid fixation, do not need either a healing period before loading, or complete osseo-integration as do implants. Their particular shape allows high primary stability and they can be placed in the sub-periosteal region. The dimensions of these miniscrews are minute, with dimensions of only 4-5 mm in length. They penetrate only slightly deeper than the cortical layer and therefore notably reduce the risk of lesions to roots, nerves, or maxillary sinus, when compared to other skeletal anchorage systems such as implants. The use of the miniscrew in oral surgery or periodontology does not need specific insurance coverage in contrast to the insertion of implants. Accordingly, orthodontic therapy completed by the dentist with orthopaedic microscrews as anchorage could also be included in a general civil insurance policy for orthodontics.

Bone Screws↗
PubMed2006

European Board of Orthodontics case report: malocclusion in adult patient.

The patient presented with a Class II Division I sub-division malocclusion, notable labial inclination of the upper and lower incisors and a missing lower incisor. A treatment plan included the extraction of 24 and the placement of a mid-plant splinted to the lingual brackets of the second upper bicuspids in order to provide anchorage for retracting the anterior segments.

Adult↗
PubMed2006

[Bone anchorage in orthodontics. A review].

The achievement of absolute anchorage in orthodontics overcoming the reaction forces and moments has been problematic for a long time. This was caused on the one hand by the limitations of the devices available and on the other hand by the dependence on patient cooperation. The introduction of bone anchorage systems changed the traditional way of thinking on orthodontic anchorage. Whereas the application of anchor systems, such as palatal implants and onplants, has specific indications, bone screws with or without plates seem to have the potential of being used on a routine basis. However, appropriate data for more complete understanding of the biological and biomechanical background of this concept of orthodontic anchorage are still lacking. Furthermore, studies on the effectiveness of these systems when compared to the traditional orthodontic anchorage and based on large groups of patients are not available. Well-designed prospective clinical trials substantiating the evidence-based use of these devices are needed.

Bone Screws↗
PubMed2006

[Stability of upper molars with the application of implant anchorage].

OBJECTIVE: To investigate the stability of upper molars with the application of micro-screw implant anchorage during orthodontic treatment. METHODS: Fifteen adult patients with severe maxillary protrusion were included. Upper first premolars were extracted and upper posterior anchorage was reinforced with micro-screw implant in all patients. The average treatment period to close the extraction space was 10.5 months. Cephalometric and cast analysis were carried out. RESULTS: During the treatment, the micro-screw implants kept stable in sagittal plane; neither the mesial-distal movement nor the rotation or tipping of the upper molars during the treatment was of statistic significance (P > 0.05); the edge of upper incisors was retracted by 6.99 mm on average, and no significant vertical change was observed (P > 0.05). CONCLUSIONS: Micro-screw implant could provide good anchorage control in the orthodontic treatment.

Adolescent↗
PubMed2006

Orthodontic implants as anchorage appliances for unilateral mesialization: a case report.

Space closure from distal to mesial is one of the most difficult orthodontic tasks. Toothborne 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. Temporary implants inserted in the palatal suture are most common in maxillary treatment. In the case presented, temporary implants were placed in the palatal bone of a 17-year-old male patient with hypodontia of the mandibular central incisors and second premolars and the maxillary left second premolar for mesialization of the molars. Slight irritations of the tongue were registered in the first 2 weeks of use of the palatal implant. There were no other effects during treatment.

Adolescent↗
PubMed2006

A comparison of the effects of 2 mandibular anchorage systems used with a 3-dimensional bimetric maxillary distalizing arch.

The purpose of this study was to compare the effects of 2 mandibular anchorage systems used with a 3-dimensional bimetric maxillary distalizing arch. The Wilson rapid molar distalization appliance for Class II molar correction was used with 26 patients; two groups of 13 patients each were formed. In the first group (9 girls, 4 boys with a mean age 11 years 5 months), mandibular anchorage was gained by a modified lip bumper with a standard lingual arch of 0.9-mm stainless steel. The second group (7 girls, 6 boys, with a mean age of 13 years) had a 0.016 x 0.016-inch utility arch, with a 3-dimensional lingual arch for anchorage. Cephalometric radiographs were taken before and after maxillary first molar distalization. The treatment results showed that the extrusion of the mandibular first molar was statistically significant in both the modified lip bumper and utility arch groups (P < .01 and P <.05, respectively). The incisal edge of the mandibular incisor moved forward significantly in the modified lip bumper and utility arch groups (P < .05 and P < .01, respectively); however, the protrusion in the utility arch group was significantly greater than in the lip bumper group (P <.05). In both groups, significant proclination of the mandibular incisor was observed (P < .01). Comparison of the anchor units showed that there was significantly greater proclination in the utility arch group than in the modified lip bumper group (P < .05). Both anchor units similarly enhanced the mandibular first molar anchorage. However, particularly in the utility group, mandibular incisor anchorage control seemed to be inadequate.

Cephalometry↗