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Comparative Study
. 2015 May;85(3):420-6.
doi: 10.2319/101813-772.1. Epub 2014 Aug 6.

Cross-sectional evaluation of the prevalence and factors associated with soft tissue scarring after the removal of miniscrews

Sung-ah Jung  1 , Yoon Jeong Choi, Dong-Won Lee, Kyung-Ho Kim, Chooryung J Chung
Affiliations
Comparative Study

Cross-sectional evaluation of the prevalence and factors associated with soft tissue scarring after the removal of miniscrews

Sung-ah Jung et al. Angle Orthod. 2015 May.

Abstract

Objective: To investigate the prevalence of distinguishable soft tissue scarring after the removal of temporary anchorage devices (TADs) such as orthodontic miniscrews and to analyze the factors associated with scar formation.

Materials and methods: The prevalence of soft tissue scarring in 66 patients (202 miniscrew removal sites) was clinically investigated at least 1 year after miniscrew removal. To determine the clinical factors associated with soft tissue scar formation, miniscrew stability; host factors including age, gender, and gingival biotype; and miniscrew-related factors such as insertion site, vertical position, and insertion period were evaluated.

Results: The prevalence of a distinguishable scar remaining at least 1 year after miniscrew removal was 44.6%. Patients with flat gingiva showed a significantly higher prevalence of soft tissue scar formation than did those with pronounced scalloped gingiva (P < .05). Maxillary buccal removal sites showed a significantly higher prevalence of soft tissue scar formation than did those in the mandible or palatal slope (P < .05). Miniscrew sites at the alveolar mucosa showed a significantly lower prevalence of soft tissue scar formation than did those in the mucogingival junction or the attached gingiva (P < .01).

Conclusion: The prevalence of distinguishable scarring after miniscrew removal was fairly high. On the basis of our results, patients with flat gingiva and buccal interdental gingival insertion sites are more susceptible to scar formation.

Keywords: Miniscrew; Prevalence; Removal; Scar; Wound healing.

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Figures

Figure 1. Typical soft tissue scar detected after miniscrew removal. (A, B) Development of a typical soft tissue scar at identical miniscrew removal sites (black arrow) just after debonding and miniscrew removal (A) and 18 months after removal (B). (C, D) Scarless healing of identical miniscrew removal sites (black arrow) just after debonding and miniscrew removal (C) and 12 months after removal (D). Note the presence of distinguishable, whitish, lumplike soft tissue scarring in (B) compared with scarless healing in (D).
Figure 1.
Typical soft tissue scar detected after miniscrew removal. (A, B) Development of a typical soft tissue scar at identical miniscrew removal sites (black arrow) just after debonding and miniscrew removal (A) and 18 months after removal (B). (C, D) Scarless healing of identical miniscrew removal sites (black arrow) just after debonding and miniscrew removal (C) and 12 months after removal (D). Note the presence of distinguishable, whitish, lumplike soft tissue scarring in (B) compared with scarless healing in (D).
Figure 2. The determination of gingival biotypes. Crown length (CL, arrow), the distance between the gingival margin and the incisal edge of the crown and the crown width (CW, dotted arrow), and the distance between the approximal tooth surface of the borderline between the portion of the cervical and middle third of the of the maxillary right central incisor were measured, and the crown form ratio (CW/CL) was calculated to determine the pronounced scalloped and flat gingival biotypes. Flat gingival biotype (A) indicates a higher anatomical crown width/crown length ratio than pronounced scalloped gingival biotype (B).
Figure 2.
The determination of gingival biotypes. Crown length (CL, arrow), the distance between the gingival margin and the incisal edge of the crown and the crown width (CW, dotted arrow), and the distance between the approximal tooth surface of the borderline between the portion of the cervical and middle third of the of the maxillary right central incisor were measured, and the crown form ratio (CW/CL) was calculated to determine the pronounced scalloped and flat gingival biotypes. Flat gingival biotype (A) indicates a higher anatomical crown width/crown length ratio than pronounced scalloped gingival biotype (B).
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