Miniscrew implant applications in contemporary orthodontics

Abstract

The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality) obtained by preoperative diagnostic computed tomography (CT) or by cone-beam computed tomography (CBCT) prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.

Keywords: Miniscrew implants; Orthodontic anchorage; Risk factors.

Figure 1

An adult Class III malocclusion with lateral deviation of the mandible (B) resulted in facial asymmetry (A). The posteroanterior cephalometric radiograph detected no cant of the maxilla. However, an occlusal cant (C) and a chin point deviation to the right side from the facial midline (A) were noted. The buccally inclined right maxillary posterior teeth were corrected with elastomeric chains from an orthodontic miniscrew inserted in the midpalate (D). The maxilla was treated without surgery. Modified intraoral vertical ramus osteotomy was performed to correct a lateral deviation in the prognathic mandible after the presurgical orthodontic treatment (E, F).