Incidence of pulp sensibility loss of anterior teeth after paramedian insertion of orthodontic mini-implants in the anterior maxilla

Abstract

BackgroundThe aim of this retrospective investigation was to evaluate the incidence of loss to pulp sensibility testing (PST) of maxillary front teeth after paramedian (3 to 5 mm away from the suture) orthodontic mini-implant (OMI) insertion in the anterior palate.MethodsA total of 284 patients (102 males, 182 females; mean age was 14.4 years (±8.8) years at time of OMI-Insertion) with a total of 568 OMIs (1.7 mm diameter, length 8 mm) were retrospectively investigated. A binomial regression analysis was performed to explore covariates, such as age, gender, inclination of upper central incisors, dentition status and insertion position of OMIs that could have contributed to loss of sensibility. Statistical significance was set at p < 0.05.ResultsLoss of response to PST was encountered during retention in 3 out of 284 patients and the respective OMIs had been placed at height of the second rugae (R-2). Affected teeth were a right canine, a left lateral and a left central incisor. Subsequent root canal treatment was successful. Results of the binomial regression analysis revealed that the covariate insertion position (R-2) of OMIs (p = 0.008) had statistically significant influence on loss of response to PST.Conclusions(1) Although there was no radiographic evidence for direct root injury, the proximity of the implants to the anterior teeth was nevertheless statistically related to loss of PST. (2) In all cases of PST loss OMIs were inserted at the second rugae. Therefore OMIs should be placed either more posteriorly, at the third rugae or in the median plane. (3). Loss of PST was not increased for patients with palatal OMI (0.18%) compared to samples without OMI (0.25%).

Endodontic complications associated with orthodontic temporary anchorage devices: A systematic review of human studies

“…Table shows the main characteristics of the included studies; all were published in English . There were 327 participants with 736 TADs.…”

“…One case report was part of a previously published study; however, a separate analysis was undertaken in the latter . Authors of a single study were contacted and replied to requests for clarification . In 39 subjects, TAD placement was carried out aiming to cause intentional injury of teeth planned for extraction as part of the orthodontic treatment plan .…”

“…In 39 subjects, TAD placement was carried out aiming to cause intentional injury of teeth planned for extraction as part of the orthodontic treatment plan . There was a single retrospective clinical study that contributed with approximately 86% of the cases , and five case reports . Seven patients required treatment as a consequence of TAD‐related sequelae.…”

“…A fractured TAD following attempted retrieval was also described . One study assessed different insertion positions in the absence of evident contact .…”

“…The complications comprised loss of pulp vitality (due to placement of TADs in proximity to the tooth), PDL contact, root contact or pulpal exposure with the subsequent development of pulpal necrosis and chronic apical periodontitis. Six studies utilised pulp sensibility testing . Amongst these, five case reports assessed pulp sensibility following injury , with four studies reporting the development of pulpal necrosis, with subsequent chronic apical periodontitis that was confirmed radiographically .…”