• The korean journal of orthodontics
• /
• v.36 no.1 s.114
• /
• pp.55-62
• /
• 2006

Orthodontic mini-implants, despite its usefulness as anchorage, have some limits such as loosening. Therefore, various shapes and lengths have been studied. The aim of this study is to analyze the shape and length of mini-implants mechanically. The shapes of mini-implants (1.6 mm, Dual Top, Jeil Medical Co., Seoul, Korea) were cylindrical and taper. The lengths of mini-implants were 6 mm and 8 mm. The tested groups were 5 groups (cylindrical 6 mm, cylindrical 8 mm, taper 6 mm, taper 8 mm and taper 8 mm modified whose thread is reduced from the middle to upper part). All were inserted and removed on the polyurethane foam with the torque measured. During insertion and removal, the taper shape needed higher torque than the cylindrical shape, and the 8 mm length than the 6 mm length (p<0.001). The taper 6mm group showed superior insertion torque (p<0.001) and similar removal torque to the cylindrical 8 mm group. The taper 8 mm modified group with gradually reduced threads, showed continuous high removal torque after the peak. The initial mechanical stability can be provided by the tapered shape and also, affected by length and thread design.

• The korean journal of orthodontics
• /
• v.41 no.1
• /
• pp.36-41
• /
• 2011

Objective: The aim of this study was to measure tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) levels around miniscrews used for anchorage during a 3-month period of canine distalization. Methods: Sixteen patients (8 boys, 8 girls; mean age, $16.6{\pm}2.4$ years) whose upper first premolars were extracted for orthodontic treatment were included in this study. Miniscrews were used as an anchorage unit in canine distalization. Thirty-two (32) miniscrew implants were placed bilaterally in the alveolar bone between the maxillary second premolars and first molars. The treatment, miniscrew, and control groups comprised upper canines, miniscrew implants, and upper first premolars, respectively. Peri-miniscrew implant crevicular fluid and gingival crevicular fluid were obtained before applying force and at 1, 24, and 48 hours, and at 7 and 21 days, and 3 months after applying force. Results: During the 3-month period, the (TNF-${\alpha}$) levels increased significantly at 24 hours only in the treatment group (p < 0.01). In the miniscrew and control groups, there were no statistically Significant changes. No significant differences were observed between groups. Conclusions: Miniscrews can be conveniently used for anchorage in orthodontics.

• The korean journal of orthodontics
• /
• v.51 no.6
• /
• pp.397-406
• /
• 2021

Objective: The purpose of this study was to evaluate the effects of self-ligating brackets (SBs) and other factors that influence orthodontic treatment outcomes. Methods: This two-armed cohort study included consecutively treated patients in a private practice. The patients were asked to choose between SBs and conventional brackets (CBs); if any patient did not have a preference, he or she was randomly allocated to the CB or SB group. All patients were treated using an identical archwire sequence. Evaluated parameters were as follows: treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, extraction, use of orthodontic mini-implants (OMI), OMI failure, American Board of Orthodontics (ABO) Discrepancy Index (DI), arch length discrepancy, and ABO Cast-Radiograph Evaluation (CRE) score. Stepwise regression analysis was performed to generate the equation for prediction of the CRE. Results: The final sample comprised 134 patients with an average age of 22.73 years. The average DI, CRE, and treatment duration were 21.81, 14.25, and 28.63 months, respectively. Analysis of covariance showed a significant difference in CRE between the CB and SB groups after adjusting for the effects of confounding variables. Stepwise regression analysis using four variables, namely extraction, SB use, poor elastic wear, and additional appliance use, could explain only 25.2% of the variance in the CRE. Conclusions: Although the CRE was significantly better for CBs than for SBs, the clinical significance of this result seems to be limited. Extraction, SB use, poor elastic wear, and additional appliance use may have significant effects on treatment outcomes.

• The korean journal of orthodontics
• /
• v.38 no.3
• /
• pp.149-158
• /
• 2008

Objective: The purpose of this study was to investigate the stability of mini-implants in relation to loading time. Methods: A total of 48 mini-implants (ORLUS, Ortholution, Korea) were placed into the buccal alveolar bone of the mandible in 8 male beagle dogs. Orthodontic force (200-250gm) was applied immediately for the immediate loading group while force application was delayed for 3 weeks in the delayed loading group. For the subsequent loading periods (3, 6, 12 weeks), BIC (bone implant contact) and BV/TV (bone volume/total volume) and mobility test were carried out. Results: The immediate loading group showed no changes in BIC from 3 to 12 weeks, while the delayed loading group showed a significant increase in BIC between 3 and 12 weeks (p<0.05). The BV/TO of the delayed loading group significantly increased from 6 to 12 weeks of loading (p<0.05), while the BV/TV of the immediate loading group decreased from 3 to 12 weeks of loading. However, there was no significant difference in BV/TV between experimental groups. The mobility of the immediate loading group was not significantly different from that of the delayed loading group after 12 weeks of loading (p<0.05). Conclusions: These results showed that immediate loading does not have a negative effect on the stability of mini-implants compared to the early loading method in both the clinical and histomorphometric point of view.

• The korean journal of orthodontics
• /
• v.36 no.3 s.116
• /
• pp.178-187
• /
• 2006

The present study was performed to evaluate the stress distribution on the diameter of the mini-implant and insertion angle to the bone surface. To perform three dimensional finite element analysis, a hexadron of $15{\times}15{\times}20mm^3$ was used, with a 1.0 mm width of cortical bone. Mini-implants of 8 mm length and 1.2 mm, 1.6 mm, and 2.0 mm in diameter were inserted at $90^{\circ},\;75^{\circ},\;60^{\circ},\;45^{\circ},\;and\;30^{\circ}$ to the bone surface. Two hundred grams of horizontal force was applied to the center of the mini-implant head and stress distribution and its magnitude were analyzed by ANSYS, a three dimensional finite element analysis program. The findings of this study showed that maximum von Mises stresses in the mini-implant and cortical and cancellous bone were decreased as the diameter increased from 1.2 mm to 2.0 mm with no relation to the insertion angle. Analysis of the stress distribution in the cortical and cancellous bone showed that the stress was absorbed mostly in the cortical bone, and little was transmitted to the cancellous bone. The contact area increased according to the increased diameter and decreased insertion angle to the bone surface, but maximum von Mises stress in cortical bone was more significantly related with the contact point of the mini-implant into the cortical bone surface than the insertion angle to the bone surface. The above results suggest that the maintenance of the mini-implant is more closely related with the diameter and contact point of the mini-implant into the cortical bone surface rather than the insertion angle.

• The korean journal of orthodontics
• /
• v.51 no.3
• /
• pp.199-216
• /
• 2021

Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

• Journal of Periodontal and Implant Science
• /
• v.45 no.2
• /
• pp.62-68
• /
• 2015

Purpose: The goal of this study was to investigate the histomorphometric characteristics of the healing process of microcracks in the cortical bone after the installation of mini-implants (MIs). Methods: Self-drilling MIs were inserted into the tibial diaphysis of twelve adult male New Zealand rabbits. Four MIs per rabbit were placed randomly. The animals were divided into four groups according to the length of the healing period: group A was sacrificed immediately, group B was sacrificed after one week, group C was sacrificed after two weeks, and group D was sacrificed after four weeks. Cortical bone thickness was measured using micro-computed tomography, and histomorphometric analyses of the cumulative length of the microcracks (CLCr) and the total number of microcracks (NCr) were performed using hematoxylin and eosin staining. Results: The microcracks were radially and concentrically aligned in the peri-MI bone. The CLCr decreased significantly one week after the surgery, mainly due to healing of the concentrically aligned microcracks. The CLCr showed another significant decrease from two weeks after the surgery to four weeks after the surgery, mainly reflecting healing of the radially aligned microcracks. A statistically significant decrease in the NCr occurred as the microcracks healed from zero weeks to two weeks. However, no significant difference in the NCr was found between groups C and D. Conclusions: In order to improve the primary stability of MIs, delayed loading and a healing period of a certain length are recommended to ensure the optimal healing of microcracks and bone remodeling.

• The korean journal of orthodontics
• /
• v.36 no.4
• /
• pp.251-262
• /
• 2006

Objective: The purpose of this study was to compare the bacterial flora at the peri-implant sulcus of the orthodontic mini-implant placed in the alveolar mucosa with the bacterial flora at the adjacent healthy gingival sulcus. Methods: Two plaque samples from 7 patients were collected by inserting paper points into the sulcus between the mini-implant and ligature wire connected to the mini-implant head and inflamed alveolar mucosa, and from the gingival sulcus of a healthy tooth adjacent to the mini-implant. Results: Using 16S rDNA clone library, the 24 kinds of bacteria including Haemophilus aphrophilus, Sphingomonas species, Capnocytophaga species, Prevotella melaninogenica, Lachnospiraceae species, Porphyromonas species, Neisseria flava were identified only from the sulcus around the mini-implant. These bacteria constituted only 9.2% of total clones, and the bacteria identified from both the sulcus around mini-implants and the gingival sulcus constituted 80.4% of total clones. Of these bacteria, clones of Prevotella species, Atopobium rimae, Veillonella species, Streptococcus intermedius/constellatus, Streptococcus salivarius were more frequently isolated from the peri-implant sulcus. Conclusion: This study suggests that a broad epidemiological study is needed to find causative bacteria which induce inflammation from the peri-implant sulcus.

• The korean journal of orthodontics
• /
• v.38 no.6
• /
• pp.397-406
• /
• 2008

Objective: The purpose of this study was to provide clinical guidelines to indicate the best location for mini-implants as it relates to the cortical bone thickness and root proximity. Methods: CT images from 14 men and 14 women were used to evaluate the buccal interradicular cortical bone thickness and root proximity from mesial to the central incisor to the 2nd molar. Cortical bone thickness was measured at 4 different angles including $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, and $45^{\circ}$. Results: There was a statistically significant difference in cortical bone thickness between the second premolar/first permanent molar site, central incisor/central incisor site, between the first/second permanent molar site and in the anterior region. A statistically significant difference in cortical bone thickness was also found when the angulation of placement was increased except for the 2 mm level from the alveolar crest. Interradicular spaces at the 1st/2nd premolar, 2nd premolar/1st permanent molar and 1st/2nd permanent molar sites are considered to be wide enough for mini-implant placement without root damage. Conclusions: Given the limits of this study, mini-implants for orthodontic anchorage may be well placed at the 4 and 6 mm level from the alveolar crest in the posterior region with a $30^{\circ}$ and $45^{\circ}$ angulation upon placement.

• The korean journal of orthodontics
• /
• v.44 no.5
• /
• pp.236-245
• /
• 2014

Objective: To evaluate the therapeutic effects of a preformed assembly of nickel-titanium (NiTi) and stainless steel (SS) archwires (preformed C-wire) combined with temporary skeletal anchorage devices (TSADs) as the sole source of anchorage and to compare these effects with those of a SS version of C-wire (conventional C-wire) for en-masse retraction. Methods: Thirty-one adult female patients with skeletal Class I or II dentoalveolar protrusion, mild-to-moderate anterior crowding (3.0-6.0 mm), and stable Class I posterior occlusion were divided into conventional (n = 15) and preformed (n = 16) C-wire groups. All subjects underwent first premolar extractions and en-masse retraction with preadjusted edgewise anterior brackets, the assigned C-wire, and maxillary C-tubes or C-implants; bonded mesh-tube appliances were used in the mandibular dentition. Differences in pretreatment and post-retraction measurements of skeletal, dental, and soft-tissue cephalometric variables were statistically analyzed. Results: Both groups showed full retraction of the maxillary anterior teeth by controlled tipping and space closure without altered posterior occlusion. However, the preformed C-wire group had a shorter retraction period (by 3.2 months). Furthermore, the maxillary molars in this group showed no significant mesialization, mesial tipping, or extrusion; some mesialization and mesial tipping occurred in the conventional C-wire group. Conclusions: Preformed C-wires combined with maxillary TSADs enable simultaneous leveling and space closure from the beginning of the treatment without maxillary posterior bonding. This allows for faster treatment of dentoalveolar protrusion without unwanted side effects, when compared with conventional C-wire, evidencing its clinical expediency.