Orthodontic Anchorage Procedures

Just like other subjects in medicine, orthodontics also uses some vague concepts to describe what are difficult to measure quantitatively. Anchorage control is one of them. With the development of evidence-based medicine, orthodontists pay more and more attention to the accuracy of the clinical evidence. The empirical description of anchorage control is showing inadequacy in modern orthodontics. This essay, based on author's recent series of studies on anchorage control, points out the inaccuracy of maximum anchorage concept, commonly neglected points in quantitative measurement of anchorage loss and the solutions. It also discusses the limitation of maximum anchorage control.
Bone Screws ; Humans ; Orthodontic Anchorage Procedures ; Orthodontics

Humans ; Orthodontic Anchorage Procedures ; Orthodontics, Corrective

Humans ; Orthodontic Anchorage Procedures ; Orthodontic Brackets ; Orthodontics, Corrective ; methods

OBJECTIVES: This study was performed to evaluate patterns of failure time after insertion, failure rate according to loading time after insertion, and the patterns of failure after loading. MATERIALS AND METHODS: A total of 331 mini-implants were classified into the non-failure group (NFG) and failure group (FG), which was divided into failed group before loading (FGB) and failed group after loading (FGA). Orthodontic force was applied to both the NFG and FGA. Failed mini-implants after insertion, ratio of FGA to NFG according to loading time after insertion, and failed mini-implants according to failed time after loading were analyzed. RESULTS: Percentages of failed mini-implants after insertion were 15.79%, 36.84%, 12.28%, and 10.53% at 4, 8, 12, and 16 weeks, respectively. Mini-implant failure demonstrated a peak from 4 to 5 weeks after insertion. The failure rates according to loading time after insertion were 13.56%, 8.97%, 11.32%, and 5.00% at 4, 8, 12, and 16 weeks, respectively. Percentages of failed mini-implants after loading were 13.79%, 24.14%, 20.69%, and 6.9% at 4, 8, 12, and 16 weeks, respectively. CONCLUSION: Mini-implant stability is typically acquired 12 to 16 weeks after insertion, and immediate loading can cause failure of the mini-implant. Failure after loading was observed during the first 12 weeks.
Dental Implants ; Immediate Dental Implant Loading ; Orthodontic Anchorage Procedures

OBJECTIVETo investigate the influence of the diameter and length of the mini-implant on the primary stability after loading with composite forces (CF) which contained torque and horizontal forces (HF).

METHODSNinety-six finite element models were established by the combination of mini-implant and bone, diameters (1.2 mm, 1.6 mm, 2.0 mm) and length (6 mm, 8 mm, 10 mm, 12 mm). There were 12 sizes, each size corresponded with 8 models. Group HF (each size n = 4) was loaded with 1.96 N horizontal force and Group CF (each size n = 4) was loaded with composite force which contained 6 N·mm torque and 1.96 N horizontal force. The maximum displacement of mini-implant with different force directions, implant diameters and lengths were evaluated.

RESULTSThe effect of force direction on the displacement related to diameter of mini-implant. The maximum displacement under load with HF respectively was changed with the changing of diameter[1.2 mm: (7.71 ± 0.49) µm; 1.6 mm: (3.94 ± 0.31) µm; 2.0 mm: (2.32 ± 0.43) µm], which were smaller than the maximum displacement of Group CF [1.2 mm: (9.22 ± 0.63) µm; 1.6 mm: (4.62 ± 0.52) µm; 2.0 mm: (2.69 ± 0.49) µm] (P < 0.05). When diameter was 1.2 mm, the difference of the maximum displacement [(1.61 ± 0.22) µm] between Group HF and CF was more obvious than that when the diameter was 1.6 mm or 2.0 mm [(0.64 ± 0.12), (0.49 ± 0.06) µm] (P < 0.05).

CONCLUSIONSThe composite force had unfavorable effect on the primary stability of the mini-implant. The diameter of the mini-implant had better be larger than 1.2 mm when the composite forces were applied.

After tooth has been removed for a long time, adjacent teeth may tilt to occupy the edentulous space, leading to a break in the occlusal 3D equilibrium and a lack of restorative space. This case report presents a mandibular second molar uprighting with anchorage from a dental implant.
Dental Implants ; Molar ; Orthodontic Anchorage Procedures ; Tooth Movement Techniques

Adult ; Dental Implantation, Endosseous ; instrumentation ; Dental Implants ; Female ; Humans ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design

PURPOSE: This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. MATERIALS AND METHODS: CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. RESULTS: The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. CONCLUSION: In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.
Child ; Female ; Humans ; Male ; Maxilla ; Maxillary Sinus ; Orthodontic Anchorage Procedures ; Zygoma

PURPOSE: Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. MATERIALS AND METHODS: Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of Ez3D2009trade mark (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. RESULTS: Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. CONCLUSION: Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.
Cone-Beam Computed Tomography ; Humans ; Jaw ; Mandible ; Maxilla ; Orthodontic Anchorage Procedures