Does the planned miniscrew position reflect the achieved one? A clinical study on the reliability of guided miniscrew insertion using lateral cephalogram and maxillary stereolithography file for planning

Migliorati, Marco; Drago, Sara; Pozzan, Lucia; Contardo, Luca

doi:10.1016/j.ajodo.2022.08.017

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…In the present study, the clinical error generated between planned and placed mini-screws ranged from 5.79° to 7.15° on average. Our findings are similar to those reported in previous studies testing respectively monocorticalism [ 17 ] and bicorticalism [ 14 , 16 ] bone anchorage. However, in two studies, the authors used analogic surgical guides made of two-components silicone [ 17 ] or thermoformed polyethylene terephthalate glycol [ 14 ].…”

Section: Discussionsupporting

confidence: 93%

“…Our findings are similar to those reported in previous studies testing respectively monocorticalism [ 17 ] and bicorticalism [ 14 , 16 ] bone anchorage. However, in two studies, the authors used analogic surgical guides made of two-components silicone [ 17 ] or thermoformed polyethylene terephthalate glycol [ 14 ]. Both materials may allow some drill sleeve mobility during pick-up descent, compared to the rigidity of printable resin used in the present investigation [ 17 ].…”

Section: Discussionsupporting

confidence: 93%

“…Although free-hand insertion of miniscrews in the anterior palatal is a safe procedure [ 11 ], the literature suggests to use a digital guided system for two reasons: first, to better control miniscrews inclination and parallelism, which facilitates orthodontic appliance placement and prevents bone trauma during insertion [ 12 , 13 ]; second, to plan more precisely the relationship between the miniscrews and the cortical palatal and nasal bone [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols

et al. 2023

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Background This study aimed to assess the accuracy of digital workflow for guided insertion of miniscrews in the anterior palate using restorative implant dentistry software and licensed software for orthodontic applications. Methods Twenty subjects (8 males, 12 females, mean age = 16.7 ± 2.1 years) were prospectively selected to receive guided insertion of bicortical palatal miniscrews. Virtual planning was performed using restorative implant dentistry software (Blue Sky Plan*, version 4.7) (group 1 = 10 subjects) and licensed orthodontic software (Dolphin Imaging Software, version 11.0) (group 2 = 10 subjects). A specific 3D Imaging technology was applied to permit the registration of the planned and achieved position of the miniscrews based on the superimposition of maxillary models. The angular deviation (accuracy error) between the planned and the achieved positions of the miniscrews were recorded. Independent Student’s test was used with statistical significance set at p value < 0.05. Results The mean accuracy error recorded in group 1 was 7.15° ± 1.09 (right side) and 6.19 ± 0.80 (left side) while the mean error in group 2 was 6.74° ± 1.23 (right side) and 5.79 ± 0.95 (left side). No significant differences were recorded between the two groups (p > 0.05); instead, miniscrews placed on the right side were almost one degree higher than the left side (p < 0.05) in both groups. Conclusions The clinical accuracy error was similar when using generic and licensed orthodontic software for guided systems.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols

et al. 2023

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“…In addition, orthodontic mini-implants have been also placed in the anterior palate for orthodontic anchorage. Iodice et al reported that the use of surgical templates facilitates temporary anchorage devices insertion, allowing less-experienced clinicians to use palatal implants [ 32 ] .These results were aligned with those obtained by Migliorati et al who highlighted the efficiency of the digital workflow [ 33 ]. In addition, Pozzan et al reported statistically significant differences between the deviations of the digital placement technique and the deviations of the free-hand technique ( p < 0.001) [ 34 ].…”

Section: Discussionsupporting

confidence: 63%

Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques

et al. 2023

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Objective The aim of the present systematic review and network meta-analysis (NMA) is to analyze the accuracy of image-guided-based orthodontic mini-implants placement techniques in the inter-radicular space. Methods The study was conducted under the PRISMA recommendations. Three databases were searched up to July 2022. In vitro randomized experimental trials (RETs) including static computer-aided implant surgery (s-CAIS), mixed reality (MR), soft tissue static computer-aided implant surgery (ST s-CAIS) and conventional free-hand technique (FHT) for the orthodontic mini-implants placement in the inter-radicular space were selected. The risk of bias was assessed using the Current Research Information System scale. A random effects model was used in the NMA. Direct comparisons were combined with a random effects model in a frequentist NMA to estimate indirect comparisons, and the estimated effect size of the comparisons between techniques were analyzed by difference of means. Inconsistency was assessed with the Q test, with a significance level of p < 0.05, and a net heat plot. Results A total of 92 articles was identified, and 8 RETs (8 direct comparisons of 4 techniques) were included in the NMA, which examined 4 orthodontic mini-implants placement techniques: s-CAIS, MR, ST s-CAIS, and FHT. Taking FHT as reference, s-CAIS and ST s-CAIS showed statistically significant coronal and apical deviation. In addition, s-CAIS showed statistically significant angular deviation. However, MR did not show statistically significant differences with respect to FHT, which presented the highest p-score. At the coronal deviation, ST s-CAIS presented the highest P-score (0.862), followed by s-CAIS (0.721). At the apical deviation, s-CAIS presented the highest P-score (0.844), followed by ST s-CAIS (0.791). Finally, at the angular deviation s-CAIS presented again the highest P-score (0.851). Conclusions Within the limitations of this study, it was found that the image-guided-based orthodontic mini-implants placement techniques showed more accuracy than the free-hand conventional placement technique; specially the computer-aided static navigation techniques for the orthodontic mini-implants placed in the inter-radicular space.

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“…Every patient received a customized miniscrew insertion planning, this allowed a better identification of bone availability, but also represented not a perfect repeatable standard position even though the insertion areas were always the same. Moreover, the present study was based on the position of the screws in the planning model, and the mean self-parallelism loss of a screw between the planned position and the achieved one has been estimated between 3.74° and 4.68° by a recent study [ 24 ]; particularly, part of this parallelism would be already lost in the 3D-printed model. The linear displacement of the miniscrews did not exceed a unilinear mean value of 1.16 mm; a 0.44 mm mean difference in anterior miniscrew’s length measurements was found; this slight difference can be addressed to the segmentation phase and had a limited influence on the overall analysis.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional analysis of miniscrew position changes during bone-borne expansion in young and late adolescent patients

Migliorati

Mari

Annarumma³

et al. 2023

Prog Orthod.

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Introduction Maxillary expansion in patients at the end of their growth relies on the possibility to use miniscrew supported expanders to apply expansion forces directly to the midpalatal suture. Although miniscrews provide a stable anchorage unit, several studies have reported that they do not remain in exactly the same position during treatment. The aim of the present study was to analyze miniscrew position changes after the expansion using bone-borne appliances in late adolescent patients. Methods Nineteen patients (13 females, 6 males), with a mean age of 17.81 (SD = 4.66), were treated with a Bone-Borne Expander Device. The appliance was designed with 4 miniscrews: 2 in the anterior palatal area, at the third rugae level; 2 in the posterior area. A CBCT and an intraoral scan were obtained before treatment (T0), and then, a second CBCT was obtained after the expansion (T1). Data on peri-suture bone thickness were collected at T0, then the CBCTs were superimposed, and changes between mini-screws position on T0 and T1 were evaluated, both by linear and angular displacements. Results Significant longitudinal differences were found in the distance of the head and the tip of miniscrews measured at the occlusal plane, as well as angular changes. Correlations between displacement measurements and peri-suture bone thickness and height measurements were found as well. Conclusions While acting as bone anchor units, miniscrews do not remain in the same position during bone-borne expansion. The amount of displacement was related to peri-sutural total bone height and cortical thickness, especially in the anterior area of the naso-frontal maxillary complex.

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Does the planned miniscrew position reflect the achieved one? A clinical study on the reliability of guided miniscrew insertion using lateral cephalogram and maxillary stereolithography file for planning

Cited by 5 publications

References 14 publications

Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols

Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols

Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques

Three-dimensional analysis of miniscrew position changes during bone-borne expansion in young and late adolescent patients

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