IP Indian Journal of Orthodontics and Dentofacial Research

Print ISSN: 2581-9356

Online ISSN: 2581-9364

CODEN : IIJOCV

IP Indian Journal of Orthodontics and Dentofacial Research (IJODR) open access, peer-reviewed quarterly journal publishing since 2015 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster and better dissemination of knowledge, we will be publishing the more...

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Get Permission Jadhav and Kangane: Accuroguide: A precision template for optimizing mini implant placement in orthodontics


Introduction

In orthodontics, anchorage is typically achieved by leveraging the movement of malaligned teeth with the support of a single tooth or a group of teeth. With the advancements in orthodontic techniques over recent decades, mini-implants have emerged as a reliable source of anchorage, offering several advantages. Their ease of insertion and removal, small size, and high patient compliance have contributed to their widespread success.

The selection of the optimal mini-implant placement site is determined through clinical and radiographic evaluation. Critical factors such as bone thickness, quality, and quantity at the site of placement play a pivotal role in the stability and effectiveness of orthodontic mini-screws. Various techniques have been developed to simplify the placement process and enhance outcomes. 1

Primary factors 2, 3

  1. The thickness and mobility of soft tissue.

  2. The quality of cortical bone.

  3. The quantity of cortical bone.

  4. The site of screw implantation.

Secondary factors

  1. The angulations of mini-screw to bone.

  2. Degree of mini-screw to bone contact.

  3. Degree of inflammation of the peri-orthodontic mini-screw tissue.

  4. Craniofacial morphology.

  5. Screw dimensions.

  6. Insertion and removal torque.

The miniscrew implantation site is one of the most important elements influencing the stability of mini-screw implants. 4, 5 To precisely insert the miniscrew into interradicular gaps, a screw placement site can be evaluated using a number of ways. 6 Brass wires 7 or metallic markers 8 are simple to position in the interproximal areas, although their relative positions may not always line up across radiographic images. 9

An orthodontic mini implant guide contributes to the overall success of orthodontic treatment by ensuring. 10, 11

  1. Precise placement.

  2. Reducing complications.

  3. Improving predictability.

  4. Enhancing the overall patient experience.

This article describes a new template for orthodontic mini-implant placement that is accurate in determining the implant placement site and is simple to fabricate.

Materials

  1. 21-gauge stainless steel wire.(Figure 1A).

  2. Universal plier.(Figure 1B).

  3. Small portion of 19x25 stainless steel wire.(Figure 1C).

  4. Metal scale(Figure 1D).

  5. Soldering unit(Figure 1E).

Method of fabrication

  1. The guide is fabricated using 21-gauge stainless steel wire.

  2. Wire is marked at 5mm from one end.

  3. Using universal plier, wire is bent in a u loop fashion and compressed.

  4. A 90˚ bend is given at the end of this u loop.

  5. Leaving 2mm, another 90˚ bend is given for fabrication of following loop.

  6. Multiple loops can be fabricated as per the depth of vestibule.

  7. This template is soldered to base arch wire leaving 4mm from latest U loop.(Figure 2 A,B).

  8. A stiffer base arch wire(19x25 SS) makes minimal movement of the template.

Clinical procedure

The guide is placed in buccal vestibule and inserted in molar tube on one side and premolar bracket on the other(Figure 3 A) An RVG is taken after securing this position(Figure 3 B). Mini-Implant placement site is located by using the template as a measurement guide. We get a precise vertical height for implant placement, the horizontal length is set at 5 mm to facilitate a straightforward estimation of half its length, thereby enhancing the likelihood of successful placement within the interradicular bone Probing is done in the determined location to induce a bleeding point, thus obtaining a site for Mini Implant placement(Figure 3 C,D).

Figure 1

A) 21-gauge stainlesssteel wire, B) Universal plier, C) Small portion of 19x25 stainless steel wire, D) Metal scale, E) Soldering unit.

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/a8e58a9f-badd-4b1c-9b3b-05f7848d4744/image/371c1806-be61-4b6a-b839-e74f0d11de26-uimage.png

Figure 2

A) Template soldered to base arch wire, B) Template compared with metal scale.

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https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/a8e58a9f-badd-4b1c-9b3b-05f7848d4744/image/d4f39fb5-a975-4d7b-9d3a-dfe338ae0a93-uimage.png

Figure 3

A) Template placed in the vestibule, B) RVG of the secured template, C) Probing done to obtain bleeding point, D) Mini implant loading site obtained.

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/a8e58a9f-badd-4b1c-9b3b-05f7848d4744/image/4f6cc722-de84-44fc-b77e-b4db089ec6cf-uimage.png

Advantages

  1. Easy to fabricate.

  2. Easy to install.

  3. Materials readily available.

  4. Increases accuracy of mini implant placement.

  5. Minimizes complications due to incorrect mini implant position.

  6. Cost effective.

Conclusion

Mini implant placement site determines the stability and success of the implant.Hence choosing an implant loading location with a greater accuracy is essential. Such guide can be easy to fabricate and help in choosing a precise location for our mini implants.

Source of Funding

None.

Conflict of Interest

None.

References

1 

HS Park SH Jeong OW Kwon Am J Orthod Dentofacial Orthop . 2006 Jul;130(1) Factors Affecting the Clinical Success of Screw Implants Used as Orthodontic AnchorageAm J Orthod Dentofacial Orthop200613011825

2 

HS Park An Anatomical Study Using CT Images for the Implantation of Micro-ImplantsKorean J Orthod200232643541

3 

HS Park Clinical Study on Success Rate of Microscrew Implants for Orthodontic AnchorageKorean J Orthod20033331516

4 

A Costa M Raffaini B Melsen Miniscrews as Orthodontic Anchorage: A Preliminary ReportInt J Adult Orthodon Orthognath Surg19981332019

5 

HS Park TG Kwon JH Sung Angle Orthod . 2004 Aug;74(4):539-49. Nonextraction Treatment with Microscrew ImplantsAngle Orthod200474453949

6 

C Morea JE Hayck C Oleskovicz GC Dominguez I Chilvarquer Precise Insertion of Orthodontic Miniscrews with a Stereolithographic Surgical Guide Based on Cone Beam Computed Tomography Data: A Pilot StudyInt J Oral Maxillofac Implants20112648605

7 

HM Kyung HS Park SM Bae JH Sung IB Kim Development of Orthodontic Microimplants for Intraoral AnchorageJ Clin Orthod 20033763218

8 

A Carano S Velo P Leone G Siciliani Clinical Applications of the Miniscrew Anchorage SystemJ Clin Orthod2005391924

9 

A Ambekar S Kangane SS Zadake Simplified Guiding Template for Miniscrew Implant PlacementInt J Orthod20182946870

10 

SJ Cheng IY Tseng JJ Lee SH Kok 6. A Prospective Study of the Risk Factors Associated with Failure of Mini-Implants Used for Orthodontic AnchorageInt J Oral Maxillofac Implants20041911006

11 

I Ericsson T Berglundh C Marinello B Liljenberg J Lindhe Long-Standing Plaque and Gingivitis at Implants and Teeth in the DogClin Oral Implants Res19923399103



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Article type

Short Communication


Article page

316-318


Authors Details

Siddhant Ramesh Jadhav*, Suresh Kundalikrao Kangane


Article History

Received : 07-09-2024

Accepted : 19-10-2024


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