Safe zones of the maxillary alveolar bone in Down syndrome for orthodontic miniscrew placement assessed with cone-beam computed tomography

Abstract

The aim of this study was to quantify the available maxillary alveolar bone in a group of individuals with Down syndrome (DS) to determine the best areas for orthodontic miniscrew placement. The study group consisted of 40 patients with DS aged 12–30 years. We also selected an age and sex-matched control group. All measurements were performed on cross-sectional images obtained with cone-beam computed tomography. The selected areas of interest were the 4 interradicular spaces between the distal wall of the canine and the mesial wall of the second molar, in both maxillary quadrants. We measured the vestibular-palatine (VP) and mesiodistal (MD) dimensions to depths of 3, 6 and 9 mm from the alveolar ridge. We also measured the bone density in the same interradicular spaces of interest to 6 mm of depth from the alveolar crest. VP measurements were longer in the more posterior sectors and as the distance from the alveolar ridge increased. MD measurements also increased progressively as the distance from the alveolar ridge increased. In general, both the VP and MD measurements in the DS group were similar among the male and female participants. As age increased, the MD distance increased, while the VP distance decreased. The VP distance was ≥6 mm in at least 75% of the DS group in practically all assessed interdental spaces. The MD distance was ≥2 mm in at least 75% of the DS group only between the first and second molar, to 9 mm of depth from the alveolar ridge. The safe area for inserting orthodontic miniscrews in DS patients is restricted to the most posterior and deepest area of the maxillary alveolar bone.

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

“…Besides, the vestibular sulcus depth or alveolar bone areas of some patients may not enough to support miniscrews inserted at the needed height. [ 23 ]…”

“…Besides, the vestibular sulcus depth or alveolar bone areas of some patients may not enough to support miniscrews inserted at the needed height. [23] There is also a classical method that uses utility arch, a conventional auxiliary arch whose effects on intruding incisors are similar with that of anterior miniscrews. [24,25] However, the traditional utility arch is a segmented arch wire with which the incisor intrusion and dentition aligning could not be applied at the same time.…”

A cone beam computed tomography study on inter-radicular bone to determine the safe zone for miniscrew implants placement

“…[3][4][5] These variations could have a profound impact on the scale and morphology of the inter-radicular bone, which, in turn, affects the feasibility and protection of miniscrew implant placement. 6,8 Hence, the aim of this CBCT study is to quantify the inter-radicular bone dimensions at numerous degrees inside the maxillary and mandibular arches among sufferers displaying exclusive increase styles. The findings of this examination have the capacity to manual orthodontists in deciding on the highest quality websites for miniscrew implant placement based on the affected person's unique growth sample, therefore enhancing the overall achievement and balance of orthodontic treatments.…”