Root Contact during Drilling for Microimplant Placement

Abstract

Objective: To determine the surgery site dependency of root contact during drilling for orthodontic microimplant placement and to analyze the influence of clinicians' expertise on the results. Materials and Methods: Dental arches with resin teeth were mounted on a dental phantom (P-5/3 TS, Frasaco, Germany). Drilling was conducted in six locations frequently selected for microimplant placement: between the central incisors, between the maxillary first molar and second premolar, and between the mandibular first and second molars, bilaterally. The 28 qualified dentists who participated were divided into two groups based on their clinical experience. A total of 192 drillings were performed by the experienced group and 240 by the inexperienced group. The damaged root surfaces were classified as ''moderate'' or ''severe.'' Results: Significant differences in both overall and site-dependent rates of root contacts were found between the groups. Overall rates for the experienced and inexperienced groups were 13.5% and 21.3%, respectively. For the experienced group, the incidents occurred predominantly in the lower left (34.4%) and upper right (18.8%) posterior regions. The most susceptible teeth were numbers 36 and 16. In contrast, for the inexperienced group, all four posterior regions were susceptible. Conclusions: The surgery site and clinicians' expertise had significant effects on the rate as well as the pattern of root contacts. (Angle Orthod 2010;80:130-136.)

Analysis of Factors Associated with Orthodontic Microscrew Failure

“…This inflammation may be more a result than a cause of failure since it cannot be controlled by improving oral hygiene (11). We agree with Cho et al (10) that, between the three right-handed operators observed in this study, the habitual posture developed with clinical experience could have a negative impact on success rates, depending on the surgery site, which may affect the view angle and instrument access, although these factor deserves further investigation.…”

“…This side also exhibited greater failure rates in other studies, with (22) or without (1,4,15,16) statistically significant evidence to account for differences in the success rate. This result may be related to factors such as preferred side of mastication, access difficulties when placing the OMS or viewing the right or left side (7,10,22), different levels of oral hygiene among righties and lefties (23,24), and random statistical errors (5). Studies differ when trying to show that right-handed (24) or left-handed (25) patients keep better hygiene, or attempting to prove that manual dexterity is not linked to plaque control (23), but motivation is.…”

“…Amongst these categories, some variables deserve special attention from the orthodontists because they are related to the necessary knowledge for the orthodontic diagnosis (facial pattern) (3,4), orthodontic mechanics (upper/lower jaw (5,6), insertion side (5,7), type of desired movement (4,8,9), and for the installation of the microscrew (caliber of the microscrew), teacher/student (10), learning curve (9,11,12).…”

Fundamental factors related to orthodontic micro-implant stability: Review of the literature

“…43 What is more, Cho et al found that the higher the number of performed micro-implantations, the lower the risk of damaging an adjacent root. 44 A comparison of the stability of micro-implants inserted by a maxillofacial surgeon and an orthodontist showed no significant differences, indicating that orthodontists are fully capable of performing successful micro-implantations after they have gained the necessary experience.…”

Biological Evaluation of a Prototype Material made of Polyglycolic Acid and Hydroxyapatite

“…Although orthodontic anchor screws reduce the burden on patients and help in attaining treatment goals, many patients develop complications such as loosening and deciduation of anchor screws, infection, pain and swelling around the placement site, and contact with and injury to the proximal teeth roots [9][10][11][12] . Despite their advantages over extraoral anchorage methods, anchor screws can occasionally loosen during treatment and eventually fail to provide firm anchorage [13][14][15] .…”