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      Insertion angle of orthodontic mini-implants and their biomechanical performance: finite element analysis Translated title: Ângulo de inserção de mini-implantes ortodônticos e seu desempenho biomecânico: análise de elementos finitos

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          Abstract

          AbstractObjectiveThe aim of this study was to assess the stresses and strains generated after the application of two types of forces (traction of 200 gf and torsion of 20 N.cm) in two types of orthodontic mini-implants inserted at different (45° and 90° to the cortical bone) angles.Material and methodthree-dimensional models of two brands of mini-implant (SIN – Sao Paulo, Brazil, and RMO – South Korea) were exported and analyzed by finite element analysis (FEA). Analyses were performed on simulations of cortical bone, cancellous bone and the screw.ResultFEA analysis showed that RMO mini-implants had greater elastic deformation when subjected to tensile and torsional forces when compared with SIN mini-implants. For both trademarks and insertion angles tested, there was greater cortical bone deformation, but with the greatest strain located on the mini-implant. Tension on the mini-implant was located in its transmucosal profile region.ConclusionWhen comparing the two brands of mini-implants by FEA, it is fair to conclude that that the larger number of threads and their greater angle of inclination resulted in less resistance to deformation and induced a higher level of tension in the mini-implant and cortical bone when subjected to forces, especially when inserted at an angle of 45º to the cortical bone.

          Translated abstract

          ResumoObjetivoO objetivo deste estudo foi avaliar as tensões e deformações de duas marcas comerciais de mini-implantes ortodônticos geradas após a aplicação de dois tipos de forças (de tração de 200 gf e torção de 20 N.cm) inseridos em duas angulações (45° e 90° em relação ao osso cortical).Material e métodoModelos tridimensionais das duas marcas de mini-implantes (SIN - Sao Paulo, Brasil, e RMO – Coréia do Sul) foram construídos e analisados por análise de elementos finitos (FEA). As análises foram realizadas em simulações no osso cortical, osso esponjoso e no parafuso.ResultadoA análise FEA mostrou que os mini-implantes da marca RMO apresentaram maior deformação elástica quando submetidos à tração e as forças de torção quando comparado aos mini-implantes da marca SIN. Em ambas as marcas testadas, e para os diferentes ângulos de inserção, houve uma maior deformação do osso cortical, com maior tensão localizado no mini-implante. A tensão no mini-implante foi localizado na região do perfil transmucoso.ConclusãoAo comparar as análises de elementos finitos das duas marcas comerciais de mini-implantes, concluiu-se que um maior número de roscas e maior inclinação resultam em menor resistência à deformação e induzem uma maior tensão no osso cortical quando submetidos à forças de torção e tração, especialmente quando inserido em um ângulo de 45º com o osso cortical.

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          Root proximity is a major factor for screw failure in orthodontic anchorage.

          The purpose of this study was to evaluate root proximity as a risk factor for the failure of miniscrews used as orthodontic anchorage. We used dental radiographs and 3-dimensional computed tomography images to examine 216 titanium screws in 110 patients. Each screw was classified according to its proximity to the adjacent root. Category I, the screw was absolutely separate from the root; category II, the apex of the screw appeared to touch the lamina dura; and category III, the body of the screw was overlaid on the lamina dura. If the orthodontic force could be applied to the screw for 1 year (or until completion of orthodontic treatment), we recorded the screw anchorage as a success. The screws had a high success rate--above 80%. Screws placed in the maxilla had a significantly higher success rate than those in the mandible. There was a significant correlation between success rate and root proximity. There were significant differences in the success rates between categories I and II, I and III, and II and III. Although screws in all 3 categories in the maxilla and categories I and II in the mandible showed high success rates above 75%, screws in category III in the mandible had a low success rate of 35%. The proximity of a miniscrew to the root is a major risk factor for the failure of screw anchorage. This tendency is more obvious in the mandible.
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            Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage.

            Recently, implant anchors such as titanium screws have been used for absolute anchorage during edgewise treatment. However, there have been few human studies reporting on the stability of implant anchors placed in the posterior region. The purpose of this study was to examine the success rates and to find the factors associated with the stability of titanium screws placed into the buccal alveolar bone of the posterior region. Fifty-one patients with malocclusions, 134 titanium screws of 3 types, and 17 miniplates were retrospectively examined in relation to clinical characteristics. The 1-year success rate of screws with 1.0-mm diameter was significantly less than that of other screws with 1.5-mm or 2.3-mm diameter or than that of miniplates. Flap surgery was associated with the patient's discomfort. A high mandibular plane angle and inflammation of peri-implant tissue after implantation were risk factors for mobility of screws. However, we could not detect a significant association between the success rate and the following variables: screw length, kind of placement surgery, immediate loading, location of implantation, age, gender, crowding of teeth, anteroposterior jaw base relationship, controlled periodontitis, and temporomandibular disorder symptoms. We concluded that the diameter of a screw of 1.0 mm or less, inflammation of the peri-implant tissue, and a high mandibular plane angle (ie, thin cortical bone), were associated with the mobility (ie, failure) of the titanium screw placed into the buccal alveolar bone of the posterior region for orthodontic anchorage.
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              Risks and complications of orthodontic miniscrews.

              The risks associated with miniscrew placement should be clearly understood by both the clinician and the patient. Complications can arise during miniscrew placement and after orthodontic loading that affect stability and patient safety. A thorough understanding of proper placement technique, bone density and landscape, peri-implant soft-tissue, regional anatomic structures, and patient home care are imperative for optimal patient safety and miniscrew success. The purpose of this article was to review the potential risks and complications of orthodontic miniscrews in regard to insertion, orthodontic loading, peri-implant soft-tissue health, and removal.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rounesp
                Revista de Odontologia da UNESP
                Rev. odontol. UNESP
                Universidade Estadual Paulista Júlio de Mesquita Filho (Araraquara )
                1807-2577
                October 2015
                : 44
                : 5
                : 273-279
                Affiliations
                [1 ] Centro Universitário de Araraquara Brazil
                [2 ] Universidade Estadual de Campinas Brazil
                [3 ] Aarhus University Denmark
                Article
                S1807-25772015000500273
                10.1590/1807-2577.0081
                9512e36b-46aa-4767-ac35-acbd628a0757

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1807-2577&lng=en
                Categories
                DENTISTRY, ORAL SURGERY & MEDICINE

                Dentistry
                Orthodontic anchorage procedures,Procedimentos de ancoragem ortodôntica,ortodontia,análise de elementos finitos,orthodontic,finite element analysis

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