Complications reported with the use of orthodontic miniscrews: A systematic review

Abstract

Objective The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

Guided Insertion of Temporary Anchorage Device in Form of Orthodontic Titanium Miniscrews with Customized 3D Templates—A Systematic Review with Meta-Analysis of Clinical Studies

“…This is consistent with the Perio test values presented in the study by Dasomi et al [41]. It should be into consideration that not only the insertion, but also the removal of miniscrews have been associated with adverse effects such as secondary bleeding, miniscrew fracture, scars, and exostosis [4]. Future research could be directed towards the use of artificial intelligence, as it is successfully used in many branches of dentistry, for detailed surface analysis, tissue composition and CBCT images [57,58].…”

“…Studies on adverse effects or complications concurrent to the application of miniscrews are scarce and present a low methodological quality [3]. However, it has been proved that complications due to the incorrect introduction of MI may lead to root injury and periradicular lesion, of the buccal mucosa, or insertion into maxillary sinus or nasal floor (causing loss of vitality, pink discoloration or transitory loss of pulp sensitivity) [4][5][6].…”

Quantitative Assessment of Posterior Maxillary Arch for Orthodontic Miniscrew Insertion Using Cone Beam Computed Tomography: A Cross-Sectional Analysis

“…In the study of Giudice et al, the most common complication of miniscrew insertion in interradicular spaces was injury to adjacent tooth root, which may further cause pain and inflammation in patients [ 20 ].…”

A novel biomechanical system to intrude the upper incisors and control overbite: Posterior miniscrew-assisted lever arm and 2 cases report

“…[ 17 ] However, the usage of miniscrew is accompanied with multiple adverse effects, including biologic damage, inflammation, pain and discomfort. [ 18 , 19 ] With this method, at least 1 extra miniscrew needs to be inserted into maxillary anterior alveolar bone, which would increase the risk and cost and turn out to be not friendly enough for patients.…”