Cone-beam computed tomography evaluation of orthodontic miniplate anchoring screws in the posterior maxilla
Received November 2008; received in revised form February 2009; accepted February 2009.
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Editor's Summary and Q&A: Cone-beam computed tomography evaluation of orthodontic miniplate anchoring screws in the posterior maxilla
Gyu-Tae Kim, Seong-Hun Kim, Yong-Suk Choi, Young-Joon Park, Kyu-Rhim Chung, Kyung-Eun Suk, HyeRan Choo, John C. Huang
American Journal of Orthodontics & Dentofacial Orthopedics
November 2009 (Vol. 136, Issue 5, Pages 628-629) Abstract |
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Introduction
The purposes of this study were to evaluate the actual postplacement positions of orthodontic miniplate anchoring screws (MPAS) and to determine the risk factors for their failure and iatrogenic effects on the intraoral structures.
Methods
Three-dimensional cone-beam computed tomography images were generated to examine 31 orthodontic miniplates and their MPAS (diameter, 1.5 mm; length, 4 mm), which showed good clinical stability 6 months after placement in the posterior maxilla of 18 patients. The cone-beam computed tomography data were analyzed with analysis of variance (ANOVA) statistics to evaluate the difference of placement depth and vertical distance of the MPAS from the cementoenamel junction to the center of the screw. The Fisher exact test was used to determine differences in MPAS position, root proximity, and sinus penetration.
Results
The mean placement depth of the MPAS was 2.48 mm with no significant difference relative to their position. Twenty-six (of 74) MPAS were placed in the dentition area. Of these 26, 14 were placed in interdental spaces, and the other 12 followed the direction of the roots. Nine MPAS showed root proximity, and 7 MPAS had root penetration, all of which were placed in the central position of the miniplate. Thirty-nine MPAS penetrated the sinus, indicating a low interrelationship between placement depth and cortical bone thickness of the sinus.
Conclusions
Miniplates were successfully retained by MPAS even with less-than-ideal placement. Root contact and proximity of MPAS seem to have minimal effects on the successful stabilization of miniplates. Pertinent guidelines should, however, be followed during MPAS placement to minimize the risk of damage to adjacent roots.
aClinical fellow, Department of Oral and Maxillofacial Radiology, School of Dentistry, KyungHee University, Seoul, Korea
bAssistant professor, Division of Orthodontics, Department of Dentistry, Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea; visiting assistant professor, Division of Orthodontics, Department of Orofacial Science, University of California at San Francisco, San Francisco, Calif
cAssistant professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, KyungHee University, Seoul, Korea
dCaptain, Ministry of National Defense Health Policy Division, Seoul, Korea
ePresident, Korean Society of Speedy Orthodontics, Seoul, Korea
fResident, Department of Orthodontics, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
gAttending orthodontist, Children's Hospital of Philadelphia, Department of Orthodontics, University of Pennsylvania, Philadelphia, Pa
hAssociate clinical professor, Division of Orthodontics, Department of Orofacial Science, University of California at San Francisco, San Francisco, Calif
Reprint requests to: Seong-Hun Kim, Division of Orthodontics, Department of Dentistry, Catholic University of Korea, Uijongbu St. Mary's Hospital, 65-1 Geumo-dong, Uijeongbu, Gyeonggi-do 480-717, South Korea.
Supported in part by research grants from the Korean Society of Speedy Orthodontics, and alumni funds of the Department of Dentistry and the Graduate School of Clinical Dental Science, Catholic University of Korea.
The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.
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