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 Table of Contents  
SHORT COMMUNICATION
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 47-48

Micro-computed tomography evaluation of root damage caused by orthodontic mini-implant


1 Ministry of Health, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
2 Graduate Orthodontic Programs Director, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia

Date of Web Publication2-Feb-2015

Correspondence Address:
Zuhair Al Zeid
Ministry of Health, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-6816.150598

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  Abstract 

The use of mini-implants in anchorage control during orthodontic treatment has gained popularity over the past decade. While several factors have been attributed to the success of these implants, the risk of root damage due to inaccurate placement has been a major issue. Therefore, several techniques have been developed to improve the accuracy of placement of these implants. A quantitative comparison of these techniques has been difficult. Micro-computed tomography (micro-CT) is similar to CT but has an infinitely greater resolution. This short communication explores the possibility of the use of micro-CT as a method of assessing root damage caused by the placement of orthodontic implants.

Keywords: Micro-computed tomography, orthodontic mini-implant, root damage


How to cite this article:
Al Zeid Z, Al Sanea J. Micro-computed tomography evaluation of root damage caused by orthodontic mini-implant. Saudi J Oral Sci 2015;2:47-8

How to cite this URL:
Al Zeid Z, Al Sanea J. Micro-computed tomography evaluation of root damage caused by orthodontic mini-implant. Saudi J Oral Sci [serial online] 2015 [cited 2020 Sep 22];2:47-8. Available from: http://www.saudijos.org/text.asp?2015/2/1/47/150598

Anchorage control with mini-implants has gained enormous credibility in the clinical management of orthodontic space closure. Several factors have been attributed to the success of mini-implants, namely, mini-implant factors (type, diameter, site of mini-implant placement, and length), local host factors (occlusogingival positioning), bone quality, and management factors (angle of placement, onset and method of force application, ligature wire extension, exposure of mini-implant head, and oral hygiene). [1] The size of the mini-implants has become smaller with time since its early use in orthodontics. However, the placement of these implants between the roots of teeth has been challenging because of the limited inter-root space and risk of root injury. [2] Asscherickx et al., emphasized that placement of mini-implants in the alveolar process between dental roots is a critical procedure. [2] In a 2008 American Association of Orthodontists (AAO) survey, 45.5% of orthodontists reported that they were not placing their own implants with 32.8% citing root damage as their main concern. [3] Although "safe zones" have been developed to guide orthodontists in their mini-implant placement locations, anatomy is different for each patient. [4],[5]

Authors have used various modalities to help serve as a guide in the placement of the orthodontic implant. Initially, these included two-dimensional stents and the development several three-dimensional (3D) methods that have been reported to be simple and more accurate. [6],[7],[8],[9]

Furthermore, the advances made in the field of prosthodontic implant have led to orthodontists applying similar methods in orthodontics, including surgical stents and the use of cone-beam computed tomography for the planning and placement of orthodontic implants. [10] There is, however, little literature available on the comparative efficacies of these different methods.

One of the challenges in comparing such a vast array of methods is to find a noninvasive and nondestructive method that will accurately quantify the extent of root damage without damaging adjacent bone structure. While histological sections can accurately quantify bone damage, they are limited to the plane in which the section was made.

Real-time micro-CT is a tool that was developed in early 1980s and used in dental research in the late 1990s. It works on the same principle as CT; except that the resolution is infinitely higher. The technology has been used to effectively document and assess 3D trabecular bone architecture in laboratory animals. [11] Compact in vivo micro-CT systems have been developed which are more accessible to laboratories for performing longitudinal studies. [12] Recently, micro-CT is being used to perform in vivo studies which provide a nondestructive method to assess 3D bone micro-architecture. [13] While a detailed description of the results is beyond the scope of this presentation, micro-CT images clearly show the amount of root damage caused by the inaccurate placement of orthodontic mini-implants in a sheep's mandible. Furthermore, the use of micro-CT also helps to visualize the 3D bone architecture in the areas surrounding the implant [Figure 1]. This highlights the possibility of the use of micro-CT as a promising research tool for assessing the incidence and extent of root damage caused by the placement of orthodontic mini-implants and to quantify and compare the damage caused with and without the use of stents.
Figure 1: Micro-computed tomography image showing bone and mini-implants (Source: Engineer Abdullah Bagshan Research Chair for Growth Factors and Bone Regeneratoon)

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  References Top

1.
Park HS, Jeong SH, Kwon OW. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop 2006;130:18-25.  Back to cited text no. 1
    
2.
Asscherickx K, Vannet BV, Wehrbein H, Sabzevar MM. Root repair after injury from mini-screw. Clin Oral Implants Res 2005;16:575-8.  Back to cited text no. 2
    
3.
Buschang PH, Carrillo R, Ozenbaugh B, Rossouw PE. 2008 survey of AAO members on miniscrew usage. J Clin Orthod 2008;42:513-8.  Back to cited text no. 3
    
4.
Chaimanee P, Suzuki B, Suzuki EY. "Safe zones" for miniscrew implant placement in different dentoskeletal patterns. Angle Orthod 2011;81:397-403.  Back to cited text no. 4
    
5.
Poggio PM, Incorvati C, Velo S, Carano A. "Safe zones": A guide for miniscrew positioning in the maxillary and mandibular arch. Angle Orthod 2006;76:191-7.  Back to cited text no. 5
    
6.
Reddy KB, Kumar MP, Kumar MN. A grid for guiding miniscrew placement. J Clin Orthod 2008;42:531-2.  Back to cited text no. 6
    
7.
Sharma NS, Shrivastav SS, Hazarey PV, Kamble RH, Sharma PN. Universal wire grid for implant placement in three dimensions. World J Dent 2013;4:74-6.  Back to cited text no. 7
    
8.
Nandakumar A, Singla JK. "Jiffy Jig" A quick chair side micro implant guide. APOS Trends Orthod 2011;2:1-3S.  Back to cited text no. 8
    
9.
Kim SH, Choi YS, Hwang EH, Chung KR, Kook YA, Nelson G. Surgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2007;131:S82-9.  Back to cited text no. 9
    
10.
Qiu L, Haruyama N, Suzuki S, Yamada D, Obayashi N, Kurabayashi T, et al. Accuracy of orthodontic miniscrew implantation guided by stereolithographic surgical stent based on cone-beam CT-derived 3D images. Angle Orthod 2012;82:284-93.  Back to cited text no. 10
    
11.
Kinney JH, Lane NE, Haupt DL. In vivo, three-dimensional microscopy of trabecular bone. J Bone Miner Res 1995;10:264-70.  Back to cited text no. 11
    
12.
David V, Laroche N, Boudignon B, Lafage-Proust MH, Alexandre C, Ruegsegger P, et al. Noninvasive in vivo monitoring of bone architecture alterations in hindlimb-unloaded female rats using novel three-dimensional microcomputed tomography. J Bone Miner Res 2003;18:1622-31.  Back to cited text no. 12
    
13.
Al-Hezaimi K, Al-Shabeeb MS, Al-Askar M, Javed F, Nooh N, Al-Rasheed A, et al. Microcomputed tomographic analysis of the alveolar ridge alteration around extraction sites with and without immediate implants placement: In vivo study. Clin Implant Dent Relat Res 2014;16:223-9.  Back to cited text no. 13
    


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