Positional guidelines for orthodontic mini-implant placement in the anterior alveolar region: A systematic review

To investigate the adequacy of potential sites for insertion of orthodontic mini-implants (OMIs) in the anterior alveolar region (delimited by the first premolars) through a systematic review of studies that used computed tomography (CT) or cone beam CT (CBCT) to assess anatomical hard tissue parameters, such as bone thickness, available space, and bone density. Materials and Methods: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched to identify all relevant papers published between 1980 and September 2011. An extensive search strategy was performed that included the key words "computerized (computed) tomography" and "mini-implants." Information was extracted from the eligible articles for three anatomical areas: maxillary anterior buccal, maxillary anterior palatal, and mandibular anterior buccal. Quantitative data obtained for each anatomical variable under study were evaluated qualitatively with a scoring system. Results: Of the 790 articles identified by the search, 8 were eligible to be included in the study. The most favorable area for OMI insertion in the anterior maxilla (buccally and palatally) and mandible is between the canine and the first premolar. The best alternative area in the maxilla (buccally) and the mandible is between the lateral incisor and the canine, while in the maxillary palatal area it is between the central incisors or between the lateral incisor and the canine. Conclusions: Although there is considerable heterogeneity among studies, there is a good level of agreement regarding the optimal site for OMI placement in the anterior region among investigations of anatomical hard tissue parameters based on CT or CBCT scans. In this context, the area between the lateral incisor and the first premolar is the most favorable. However, interroot distance seems to be a critical factor that should be evaluated carefully. © 2013 by Quintessence Publishing Co Inc

Morphological and structural characteristics of orthodontic mini-implants [Morphologische und strukturelle Merkmale kieferorthopädischer Mini-Implantate]

Aim. The purpose of this study was to investigate the geometric characteristics, composition, microstructure, and pullout strength of commercially available orthodontic mini-implants. Material and methods. The mini-implants used were AbsoAnchor®, Dual-Top™ JA, Spider Screws® K1, and Vector-TAS™. The geometric features were measured by optical microscopy. Surface texture and elemental composition were examined by scanning electron microscopy and energy dispersive X-ray microanalysis. Surface 3D roughness was estimated by optical profilometry, and pullout strength measured in artificial bone blocks with two bone densities. Results. The AbsoAnchor® showed the highest intra-osseous surface area, followed by the Dual-Top™, Spider Screw®, and Vector-TAS™. The mini-implants were composed of a Ti6Al4V alloy. The Vector-TAS™ had the highest oxygen and phosphorus content with the most homogeneous surface texture. No significant differences were detected in amplitude surface roughness parameters (Sa, Sz) between the implants. However, differences existed in hybrid (Sdr, Sds) and functional (Sci) parameters. AbsoAnchor® achieved the highest pullout strength, followed by the Dual- Top™, Spider Screw®, and Vector-TAS™, with highest values in the high density group. The intra-osseous surface area of mini-implants showed a positive correlation with pullout strength, especially in the high density group. Conclusion. All the mini-implants tested were made of Ti6Al4V alloy. Significant differences were found in the surface area of the threaded parts. The significant differences documented in 3D surface roughness parameters (hybrid and functional) and pullout strength may anticipate variations in their clinical performance. © Springer-Verlag

Orthodontic Implants and Orthodontic Implant Surfaces

Orthodontic implants as anchorage device has brought new dimensions to orthodontic treatment planning and biomechanics. Treatments that were previously not possible can now be accomplished successfully not only in children and adolescent but also in adults. The chapter covers evaluated concepts of orthodontic implant: anchorage, origin, nomenclature, and applications. Parameters affecting success rates including patient-related factors, implant-related factors, and factors related to clinical procedures are discussed more in detail. Particular attention has been paid to parameters related to implant materials and implant surface. These parameters have not been fully evaluated since it is claimed that osseointegration is of secondary importance because of the temporary nature of these implants. It could be concluded that in order to develop the concept of orthodontic implants all parameters need to be considered. Orthodontic implants would favor from having their surfaces modified for proper osseointegration. This would increase not only the success rate during favorable conditions but also maintain the success rate when compensating for other parameters being compromised in the clinical situation. Moreover, to be able to optimize on orthodontic implant parameters in general, all independent variables need to be controlled. In most studies so far, there are scatters of variables, making it impossible to draw any evidence-based scientific conclusion. © Springer-Verlag Berlin Heidelberg 2015