Comparison of anchorage capacity between implant and headgear during anterior segment retraction

Abstract

Objective: To compare the anchorage effects of the implants and the headgear for patients with anterior teeth retraction in terms of incisor retraction, anchorage loss, inclination of maxillary incisors, positional change of maxillary basal bone, and treatment duration. Materials and Methods: An electronic search for relative randomized controlled trials (RCTs) prospective and retrospective controlled trials was done through the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Medline, and CNKI, regardless of language of study. Study selection, methodological quality assessment, and data extraction were performed by two reviewers independently. Meta-analysis was performed when possible; otherwise descriptive assessment was done. Results: The search yielded 35 articles, of which eight met the inclusion criteria and were categorized into five groups according to types of intervention. For the midpalatal implant, the anchorage loss was much less than for the headgear group, with insignificant differences in terms of anterior teeth retraction, maxillary incisor inclination, positional change of basal bone, and treatment duration. For the mini-implant, greater anterior teeth retraction and less anchorage loss were demonstrated, with inconsistent results for the other measures. For the onplant, less anchorage loss was noted, with insignificant differences for the other measures. Conclusions: The skeletal anchorage of the midpalatal implant, mini-implant, and onplant offer better alternatives to headgear, with less anchorage loss and more anterior teeth retraction. There were inconsistent results from the included studies in terms of maxillary incisor inclination, positional change of maxillary basal bone, and treatment duration. More qualified RCTs are required to provide clear recommendations. (Angle Orthod. 2011;81:915-922.)

Comparison of the effects of mini-implant and traditional anchorage on patients with maxillary dentoalveolar protrusion

“…Of the 14 included studies, the 8 RCTs 1,12-18 were of high quality, and the 6 CCTs 4,19-23 were grade B (quality score, [6][7][8][9]. The methodological quality for RCT and CCT trials are presented in Tables 2 and 3, respectively.…”

“…8 The aim of this review is to compare the treatment effects with mini-implants in maxillary dental protrusion patients with conventional methods of anchorage reinforcement in terms of dentoskeletal and soft-tissue changes.…”

Impact of anchorage miniscrews in multibracket treatments without extractions

“…Their potential has been demonstrated repeatedly during multibracket treatments for mesial movements 3,23 , for molar distalization 25,53,61,62 , for intrusion 18,64,65 , for extrusion 10,12 , for ''in masse'' retraction of anterior teeth 19,57,69 , or for maintaining anchorage in cases of premolar extractions 35,39,44 . A recent meta-analysis provides an update on their results compared to those obtained with extraoral force 43 and demonstrates greater anterior retraction and less loss of posterior anchorage with miniscrews. Their importance for reducing treatment time as well as for providing ''absolute'' anchorage has been demonstrated many times over 17,24,43,50,60,68 and they are often used as a replacement for extraoral forces when managing extraction spaces.…”

“…A recent meta-analysis provides an update on their results compared to those obtained with extraoral force 43 and demonstrates greater anterior retraction and less loss of posterior anchorage with miniscrews. Their importance for reducing treatment time as well as for providing ''absolute'' anchorage has been demonstrated many times over 17,24,43,50,60,68 and they are often used as a replacement for extraoral forces when managing extraction spaces.…”

“…Since the very first clinical articles 56,70 , a great number of other treated cases have been published with sometimes outstanding results 1,2,[31][32][33]36,52,57,66,67 . The list of comparative studies 7,21,30,39,44 , experimental studies 26,45,51 , some randomized clinical trials 7,35,38,71 and systematic reviews 14,16,20,22,43 has continued to grow over the years. This can be seen as evidence for an ongoing therapeutic revolution that is impacting all aspects of orthodontics and that is suggesting new solutions for the buccal technique 8,15,28,34,36,46,55 as well as for lingual orthodontics 4,29,37,41,69 , for the aligner technique 11,73 or for orthopaedics 13 .…”