Average interradicular sites for miniscrew insertion: should dental crowding be considered?

Abstract

Objective: To define a map of interradicular spaces where miniscrew can be likely placed at a level covered by attached gingiva, and to assess if a correlation between crowding and availability of space exists. Methods: Panoramic radiographs and digital models of 40 patients were selected according to the inclusion criteria. Interradicular spaces were measured on panoramic radiographs, while tooth size-arch length discrepancy was assessed on digital models. Statistical analysis was performed to evaluate if interradicular spaces are influenced by the presence of crowding. Results: In the mandible, the most convenient sites for miniscrew insertion were in the spaces comprised between second molars and first premolars; in the maxilla, between first molars and second premolars as well as between canines and lateral incisors and between the two central incisors. The interradicular spaces between the maxillary canines and lateral incisors, and between mandibular first and second premolars revealed to be influenced by the presence of dental crowding. Conclusions: The average interradicular sites map hereby proposed can be used as a general guide for miniscrew insertion at the very beginning of orthodontic treatment planning. Then, the clinician should consider the amount of crowding: if this is large, the actual interradicular space in some areas might be significantly different from what reported on average. Individualized radiographs for every patient are still recommended.

Prevalence of maxillary canine impaction in skeletal Class III malocclusions compared to Class I malocclusions

“…Predicting the risk of maxillary canine impaction is of great clinical importance, due to the complexity of the treatment of this eruption anomaly: the forced eruption of an impacted canine requires careful biomechanical planning(14) and the use of an orthodontic force magnitude in a physiologic range (15-17) to reduce the risks of root resorption and loss of vitality of the impacted tooth. In addition, a proper anchorage is needed, sometimes involving the use of a miniscrew (18,19), which, on the other hand, represents an additional surgical procedure with its own risks and clinical assessment, requiring also the availability of a sufficient space in a convenient location (20-22). If the risk of maxillary canine impaction is recognized at an early age, an attempt can be made to try to change the eruptive path of the canine; this involves the extraction of the deciduous canine (23,24) and rapid maxillary expansion (25,26), possibly with a device anchored onto the deciduous molars to reduce the side effects on permanent teeth (27-30).…”

Optimal Implantation Site of Orthodontic Micro-Screws in the Mandibular Anterior Region Based on CBCT

“…In clinical practice, it is necessary to consider the proper safety range of both the alveolar bone and the soft tissue. The closer the implant anchor is to the edge of the lip mucosa, the more friction is encountered, and the more difficult it is to maintain oral hygiene, causing the planting anchor to fall off due to inflammation ( Aras and Tuncer, 2016 ; Michele et al, 2017 ). At 2 mm below the alveolar ridge crest, the interradicular distance and buccolingual dimension between the two central incisors are 2.700 and 4.99 mm, respectively, and those between the central incisors and lateral incisors are 1.38 and 5.88 mm, respectively.…”

Uma nova alternativa de Ancoragem Esquelética Ortodôntica com Mini-Implantes: Revisão de Literatura / A new alternative of Orthodontic Skeleton Anchorage with Mini-Implants: Literature Review

“…Todavia, ao se analisar a colocação do mini-implante entre as raízes, nota-se que muitos autores tentaram definir um mapa de "zonas seguras" para a inserção dos mesmos (FARNSWORTH et al, 2011;TEPEDINO et al, 2017) e apesar de não existir um consenso, um revisão sistemática da literatura traz que os locais ideais para a colocação de mini-implantes ortodônticos tanto na maxila quanto na mandíbula, levando em consideração a quantidade e qualidade do osso, são espaços entre os primeiro e segundo molares, tanto vestibular como lingualmente. Já no palato, a área paramediana, situada entre 3 a 6 mm para posterior e, de 2 a 9 mm lateralmente ao forame incisivo foi identificada como o melhor local (ALSAMAK et al, 2012).…”