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      Accuracy of Microimplant Placement Using a 3D Guide Plate for Orthodontic Anchorage


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          This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for orthodontic treatment and investigate the accuracy and feasibility of a 3D guide plate in clinical practice. A total of 30 microimplants were placed in 15 patients in the Department of Stomatology, Affiliated Hospital of Jiangnan University. Before surgery, DICOM data from cone-beam computed tomography (CBCT) scans and STereoLithography data from the 3D model scan were imported to 3Shape Dental System. Data fitting and matching were performed, and 3D guide plates were designed primarily focusing on the thickness of guide plates, amount of concave compensation, and dimensions of the ring. Assist implantation method was used to place the microimplants, and postoperative CBCT images were used to evaluate the position and implantation angle. The feasibility of placing microimplants and precise implantation guided by the 3D guide plate. CBCT data before and after the placement of microimplants were compared. Regarding the secure positioning of microimplants based on CBCT data, 26 implants were categorized as Grade i, four as Grade ii, and none as Grade iii. No loosening of microimplants 1 and 3 months after surgery was reported. The implantation of microimplants is more accurate under the guidance of a 3D guide plate. This technology can achieve accurate implant positioning, thus ensuring safety, stability, and improved success rates after implantation.

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          Most cited references27

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          Accuracy of Implant Placement with Computer-Guided Surgery: A Systematic Review and Meta-Analysis Comparing Cadaver, Clinical, and In Vitro Studies

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            A radiographic evaluation of the availability of bone for placement of miniscrews.

            Monocortical screws are increasingly being used to enhance orthodontic anchorage. The most frequently cited clinical complication is soft tissue irritation. It is thus clinically advantageous for these miniscrews to be placed in attached mucosa. The purpose of this study was to (1) determine radiographically the most coronal interradicular sites for placement of miniscrews in orthodontic patients and (2) determine if orthodontic alignment increases the number of sites with adequate interradicular bone for placement of these screws. Sixty panoramic radiographs (n = 30 pretreatment, n = 30 posttreatment) of orthodontic patients were obtained from an archival database after Institutional Review Board approval. Selection criteria included minimal radiographic distortion and complete eruption of permanent second molars. Interradicular sites were examined with a digital caliper for presence of three and four mm of bone. If three or four mm of bone existed, then a vertical measurement from the cementoenamel junction (CEJ) to first measurement was made. In addition, the magnification error inherent in panoramic radiographs was estimated. Ninety-five percent confidence intervals were calculated for the vertical distances from the CEJ to the horizontal bone location. Bone stock for placement of screws was found to exist primarily in the maxillary (mesial to first molars) and mandibular (mesial and distal to first molars) posterior regions. Typically, adequate bone was located more than halfway down the root length, which is likely to be covered by movable mucosa. Inability to place miniscrews in attached gingiva may necessitate design modifications to decrease soft tissue irritation.
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              Insertion angle impact on primary stability of orthodontic mini-implants.

              To analyze the impact of the insertion angle on the primary stability of mini-implants. A total of 28 ilium bone segments of pigs were embedded in resin. Two different mini-implant sizes (Dual-Top Screw 1.6 x 8 mm and 2.0 x 10 mm) were inserted at seven different angles (30 degrees , 40 degrees , 50 degrees , 60 degrees , 70 degrees , 80 degrees , and 90 degrees ). The insertion torque was recorded to assess primary stability. In each bone, five Dual-Top Screws were used to compensate for differences in local bone quality. The angle of mini-implant insertion had a significant impact on primary stability. The highest insertion torque values were measured at angles between 60 degrees and 70 degrees (63.8 degrees for Dual-Top 1.6 mm and 66.7 degrees for Dual-Top 2.0 mm). Very oblique insertion angles (30 degrees ) resulted in reduced primary stability. To achieve the best primary stability, an insertion angle ranging from 60 degrees to 70 degrees is advisable. If the available space between two adjacent roots is small, a more oblique direction of insertion seems to be favorable to minimize the risk of root contact.

                Author and article information

                Appl Bionics Biomech
                Appl Bionics Biomech
                Applied Bionics and Biomechanics
                26 June 2023
                : 2023
                : 9060046
                1Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
                2Department of Stomatology, Wuxi People's Hospital, 214000 Wuxi, China
                Author notes

                Academic Editor: Raimondo Penta

                Author information
                Copyright © 2023 Fangyong Zhu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 15 August 2022
                : 31 March 2023
                : 7 June 2023
                Funded by: Health Committee of Wuxi
                Award ID: HB2020045
                Funded by: Wuxi Municipal Commission of Health and Family Planning
                Award ID: M202240
                Funded by: Affiliated Hospital of Jiangnan University
                Award ID: LCYJ202223
                Research Article


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