Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jan 14;20(2):1562.
doi: 10.3390/ijerph20021562.

Tooth Complications after Orthodontic Miniscrews Insertion

Angelo Michele Inchingolo  1 , Giuseppina Malcangi  1 , Stefania Costa  1 , Maria Celeste Fatone  2 , Pasquale Avantario  1 , Merigrazia Campanelli  1 , Fabio Piras  1 , Assunta Patano  1 , Irene Ferrara  1 , Chiara Di Pede  1 , Anna Netti  1 , Elisabetta de Ruvo  1 , Giulia Palmieri  1 , Vito Settanni  1 , Vincenzo Carpentiere  1 , Gianluca Martino Tartaglia  3 , Ioana Roxana Bordea  4 , Felice Lorusso  5 , Salvatore Sauro  1   6 , Daniela Di Venere  1 , Francesco Inchingolo  1 , Alessio Danilo Inchingolo  1 , Gianna Dipalma  1
Affiliations
Review

Tooth Complications after Orthodontic Miniscrews Insertion

Angelo Michele Inchingolo et al. Int J Environ Res Public Health. .

Abstract

Orthodontic miniscrews (OM) are widely used in modern orthodontic clinical practice to improve skeletal anchorage and have a high safety profile. A complication at the time of OM insertion is tooth root perforation or periodontal ligament trauma. Rarely, OM injury can cause permanent damage, such as ankylosis, osteosclerosis, and loss of tooth vitality. The aim of this work was to analyze potential risks and dental complications associated with the use of OMs. A search of the PubMed, Cochrane, Web of Science, and Scopus databases was conducted without a time limit using the keywords "orthodontic mini-screw" and "dental damage", resulting in 99 studies. After screening and eligibility, including articles obtained through a citation search, 13 articles were selected. Four studies revealed accidental injuries caused by OM. Most of the damage was localized at the root level and resolved spontaneously with restorative cement formation after prompt removal of the OM, while the pain disappeared. In some cases, irreversible nerve damage, extensive lesions to the dentin-pulp complex, and refractory periapical periodontitis occurred, requiring endodontic and/or surgical treatment. The choice of insertion site was the most important element to be evaluated during the application of OMs.

Keywords: insertion; miniscrews; nerve; orthodontic; root; tooth complications.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Orthodontic miniscrews (OMs) are anchorage devices in orthodontic treatment.
Figure 2
Figure 2
Literature search Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram and database search indicators.
Figure 3
Figure 3
Dental trauma may occur in the insertion of the OMs.
Figure 4
Figure 4
Attention to the insertion of orthodontic miniscrew (OMs) in the presence of the inferior alveolar nerve.
See this image and copyright information in PMC

References

    1. Antoszewska-Smith J., Sarul M., Łyczek J., Konopka T., Kawala B. Effectiveness of Orthodontic Miniscrew Implants in Anchorage Reinforcement during En-Masse Retraction: A Systematic Review and Meta-Analysis. Am. J. Orthod. Dentofac. Orthop. 2017;151:440–455. doi: 10.1016/j.ajodo.2016.08.029. - DOI - PubMed
    1. Adina S., Dipalma G., Bordea I.R., Lucaciu O., Feurdean C., Inchingolo A.D., Septimiu R., Malcangi G., Cantore S., Martin D., et al. Orthopedic Joint Stability Influences Growth and Maxillary Development: Clinical Aspects. J. Biol. Regul. Homeost. Agents. 2020;34:747–756. doi: 10.23812/20-204-E-52. - DOI - PubMed
    1. Inchingolo A.D., Ferrara I., Viapiano F., Netti A., Campanelli M., Buongiorno S., Latini G., Carpentiere V., Ciocia A.M., Ceci S., et al. Rapid Maxillary Expansion on the Adolescent Patient: Systematic Review and Case Report. Children. 2022;9:1046. doi: 10.3390/children9071046. - DOI - PMC - PubMed
    1. Nucera R., Costa S., Bellocchio A.M., Barbera S., Drago S., Silvestrini A., Migliorati M. Evaluation of Palatal Bone Depth, Cortical Bone, and Mucosa Thickness for Optimal Orthodontic Miniscrew Placement Performed According to the Third Palatal Ruga Clinical Reference. Eur. J. Orthod. 2022;44:530–536. doi: 10.1093/ejo/cjac007. - DOI - PubMed
    1. Aiello D., Nucera R., Costa S., Figliuzzi M.M., Paduano S. A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite. Case Rep. Dent. 2021;2021:3883187. doi: 10.1155/2021/3883187. - DOI - PMC - PubMed