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      Distance to alveolar crestal bone: a critical factor in the success of orthodontic mini-implants

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          Abstract

          Background

          To evaluate the success rate of orthodontic mini-implant (MI) in relation to implant characteristics, mainly implant distance to alveolar crestal bone (AC) and root proximity (RP) to adjacent teeth.

          Methods

          Two hundred sixty MIs (209 in maxilla, 51 in mandible) were categorized into success ( n = 229) and failure ( n = 31) groups. Distances from MI to the most adjacent tooth (DT) and to AC level (DC) were measured on periapical radiographs taken with the orthoradial projection technique. Appropriate statistical tests (chi-square, t test, logistic regression) were applied.

          Results

          DC measurements were statistically significantly greater in the success group (7.46 ± 1.7 mm) compared to 3.43 ± 0.81 mm in the failure group. Root proximity was not associated with miniscrew failure. Patient age, mini-implant site, and DC were significant predictors of mini-implant failure ( p < 0.001), which decreased significantly with increasing age (Coef = − 0.345; p = 0.013) and when the mini-implant was placed between premolars ( p = 0.028) or between premolar and first molar ( p = 0.045) . The probability of failure also decreased with increasing DC distance (Coef = − 3.595; p < 0.001).

          Conclusion

          The distance to alveolar crest was strongly associated with long-term stability. More apical placement of the MI from the crest would be compatible with a denser and thicker bucco-lingual/palatal bone level.

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          Most cited references28

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          Factors affecting the clinical success of screw implants used as orthodontic anchorage.

          The purposes of this study were to examine the success rates and find factors affecting the clinical success of screw implants used as orthodontic anchorage. Eighty-seven consecutive patients (35 male, 52 female; mean age, 15.5 years) with a total of 227 screw implants of 4 types were examined. Success rates during a 15-month period of force application were determined according to 18 clinical variables. The overall success rate was 91.6%. The clinical variables of screw-implant factors (type, diameter, and length), local host factors (occlusogingival positioning), and management factors (angle of placement, onset and method of force application, ligature wire extension, exposure of screw head, and oral hygiene) did not show any statistical differences in success rates. General host factors (age, sex) had no statistical significance. Mobility, jaw (maxilla or mandible), and side of placement (right or left), and inflammation showed significant differences in success rates. Mobility, the right side of the jaw, and the mandible were the relative risk factors in the logistic regression analysis when excluding mobility, inflammation around the screw implants was added to the risk factors. To minimize the failure of screw implants, inflammation around the implant must be controlled, especially for screws placed in the right side of the mandible.
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            Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage

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              Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis.

              Risk factors concerning orthodontic miniscrew implants have not been adequately assessed. In this systematic review, we summarize the knowledge from published clinical trials regarding the failure rates of miniscrew implants used for orthodontic anchorage purposes and identify the factors that possibly affect them. Nineteen electronic databases and reference lists of included studies were searched up to February 2011, with no restrictions. Only randomized controlled trials, prospective controlled trials, and prospective cohort studies were included. Study selection and data extraction were performed twice. Failure event rates, relative risks, and the corresponding 95% confidence intervals were calculated. The random-effects model was used to assess each factor's impact. Subgroup and meta-regression analyses were also implemented. Fifty-two studies were included for the overall miniscrew implant failure rate and 30 studies for the investigation of risk factors. From the 4987 miniscrew implants used in 2281 patients, the overall failure rate was 13.5% (95% confidence interval, 11.5-15.8). Failures of miniscrew implants were not associated with patient sex or age and miniscrew implant insertion side, whereas they were significantly associated with jaw of insertion. Certain trends were identified through exploratory analysis; however, because of the small number of original studies, no definite conclusions could be drawn. Orthodontic miniscrew implants have a modest small mean failure rate, indicating their usefulness in clinical practice. Although many factors seem to affect their failure rates, the majority of them still need additional evidence to support any possible associations. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
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                Author and article information

                Contributors
                +9613575704 , rh52@aub.edu.lb
                maria_saadeh@hotmail.com
                Journal
                Prog Orthod
                Prog Orthod
                Progress in Orthodontics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1723-7785
                2196-1042
                13 May 2019
                13 May 2019
                2019
                : 20
                : 19
                Affiliations
                [1 ]ISNI 0000 0004 0581 3406, GRID grid.411654.3, Division of Orthodontics and Dentofacial Orthopedics, , American University of Beirut Medical Center, ; Beirut, Lebanon
                [2 ]ISNI 0000 0001 2324 3572, GRID grid.411324.1, Department of Orthodontics, , Lebanese University Faculty of Dental Medicine, ; Beirut, Lebanon
                [3 ]ISNI 0000 0001 2324 3572, GRID grid.411324.1, Department of Forensic Odontology, Anthropology and Human Identification, , Lebanese University Faculty of Dental Medicine, ; Beirut, Lebanon
                Author information
                http://orcid.org/0000-0002-4432-0087
                Article
                273
                10.1186/s40510-019-0273-1
                6512897
                31081528
                04179eaf-f81f-4c06-8d46-9f4a0351c19d
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 8 February 2019
                : 12 April 2019
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                orthodontic mini-implants,alveolar crestal bone,root proximity

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