• Title/Summary/Keyword: Skeletal anchorage

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Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case

  • Wang, Xue-Dong;Zhang, Jie-Ni;Liu, Da-Wei;Lei, Fei-fei;Zhou, Yan-Heng
    • The korean journal of orthodontics
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    • v.46 no.4
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    • pp.253-265
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    • 2016
  • In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT$^{TM}$ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.

Orthodontic Treatment of an Impacted Immature Tooth Using C-tube as a Skeletal Anchorage : Case Reports (C-tube를 골격성 고정원으로 이용한 매복된 미성숙 영구치의 교정적 치료 : 증례 보고)

  • Choi, Sooyeon;Kong, Eunkyung;Chung, Kyurhim;Baek, Kwangwoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.157-165
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    • 2014
  • Skeletal anchorage is recommended as an orthodontic treatment for an impacted immature permanent tooth. Among these methods, C-tube is relatively safe because it is fixed to the cortical bone of interdental and the lower part of the root with several short miniscrews, which causes less damage to the root in patients of early permanent dentition. As it can be easily bent, the traction direction can be adjusted to favorable bone density sites. However, patient cooperation is important and traction based on physiological force in order to gain root and dentoalveolar tissue development in immature permanent teeth is required. Periodic follow-ups should be mandatory.

Anterior open bite with temporomandibular disorders treated with intermaxillary traction using skeletal anchorage system

  • Kim, Hye-Sun;Lee, Sang-Hoon;Youn, Taegyun;Kim, Hyung-Gon;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.284-294
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    • 2012
  • Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.

CONSIDERATIONS OF INTERMAXILLARY FIXATION METHODS IN THE MANAGEMENT OF MANDIBULAR FRACTURES (하악골 골절의 치료에 있어 악간 고정법에 관한 고찰)

  • Song, Kyung-Ho;Lee, Seul-Ki;Chung, Jae-An;Shin, Jin-Eob;Kim, Jwa-Young;Song, Sang-Hoon;Yang, Byoung-Eun;Choi, Young-Jun;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.513-519
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    • 2007
  • Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

Histologic assessment of the biological effects after speedy surgical orthodontics in a beagle animal model: a preliminary study (비글견에서 급속수술교정 치료 후 생물학적 효과에 대한 조직평가: 예비연구)

  • Kim, Hong-Suk;Lee, Young-Jun;Park, Young-Guk;Chung, Kyu-Rhim;Kang, Yoon-Goo;Choo, Hye-Ran;Kim, Seong-Hun
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.361-370
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    • 2011
  • Objective: Speedy surgical orthodontics (SSO), an innovative orthodontic treatment, involves the application of orthopedic forces against temporary skeletal anchorage devices following perisegmental corticotomy to induce movement of specific dental segments. Herein, we report the biological effects of SSO on the teeth and periodontal structures. Methods: Five beagle dogs were divided into 2 groups and their 6 maxillary incisors were retracted $en$ $masse$ by applying 500 g orthopedic force against a single palatal mini-plate. Retraction was performed without and with perisegmental corticotomy in groups I and II, respectively. All animals were killed on the 70th day, and their periodontal structures were processed for histologic analyses and scanning electronic microscopy (SEM). The linear distance between the third maxillary incisor and canine was used as a benchmark to quantify the retraction amount. Results: Retraction was markedly faster and retraction amount greater in group II than in Group I. Surprisingly, Group II did not show any root resorption despite extensive retraction, while Group I showed prominent root surface irregularities. Similarly, SEM showed multiple resorption lacunae in Group I, but not in Group II. Conclusions: SSO is an effective and favorable orthodontic approach for major en masse retraction of the maxillary anterior teeth.

Miniscrew insertion sites of infrazygomatic crest and mandibular buccal shelf in different vertical craniofacial patterns: A cone-beam computed tomography study

  • Matias, Murilo;Flores-Mir, Carlos;de Almeida, Marcio Rodrigues;da Silva Vieira, Bruno;de Freitas, Karina Maria Salvatore;Nunes, Daniela Calabrese;Ferreira, Marcos Cezar;Ursi, Weber
    • The korean journal of orthodontics
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    • v.51 no.6
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    • pp.387-396
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    • 2021
  • Objective: To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns. Methods: CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars' distal roots and second molars' mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test. Results: There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns. Conclusions: There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.

A CLINICAL STUDY ON SKELETAL ANCHORAGE SYSTEM USING MINISCREW (구내고정원을 이용한 교정 치료중 miniscrew 탈락에 관한 연구)

  • Woo, Soon-Seop;Jeong, Soon-Tai;Huh, Young-Sung;Hwang, Kyung-Gyun;Yoo, Im-Hag;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.102-107
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    • 2003
  • At orthodontic treatment, we have made every effort to get rigid anchorage which is not stirred when teeth move. As a result, the miniscrew that is rigid anchorage was invented recently, and now it is used widely. Concerning the advantage of miniscrew, it is reduced dependence of extraoral anchorage and it shortens treatment time for rapid tooth movement. In contrast, the defect of miniscrew is falling off it resulted from increasing of the mobility. So the purpose of this research is to be of help to prognose clinical use of miniscrew, which is inserted for intraoral anchorage, by investigating and comparing the failure rate of miniscrew for loading time. This study researches the failure rate of miniscrew for teeth movement at the orthodontic treatment. The failure rate of miniscrew in mid course, after inserting 147 miniscrews in 51 patients, is 13%(20/147). It showed no statistically significant differences as compared man with woman, maxilla with mandible, double-head with uni-head miniscrew, and drilling and non-drilling before inserting the miniscrew. In comparison below twenties with over twenties and the times that we give load to miniscrew, it produced that the failure rate of miniscrew is 9.7% higher in the case of below the twenties than over the twenties. Also, the failure rate of loading immediately is 10.8% higher than loading after 7 days. According to using driver for the insertion of miniscrew, the failure rate of miniscrew is higher in the case of using machined driver than in the case of using hand driver when the level of significance is 95%. According to the research, we can suppose that the failure rate has no concern with using miniscrew on man or woman, maxilla or mandible, the shape of head, and drilling or non-drilling before insertion of miniscrew. Therefore, we can choose eclectic miniscrew as demands. In addition, we must notify the patient, below twenties, to be possibility of high failure rate. And It is strongly recommended to give load after $1{\sim}2$ weeks for healing of the insertion area.

Microimplant mandibular advancement (MiMA) therapy for the treatment of snoring and obstructive sleep apnea (OSA) (코골이 및 수면 무호흡 치료를 위한 마이크로 임프란트를 이용한 하악골 전진술)

  • Ngiam, Joachim;Kyung, Hee-Moon
    • The korean journal of orthodontics
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    • v.40 no.2
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    • pp.115-126
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    • 2010
  • This case report describes the treatment of a 66 year old adult patient with a diagnosis of severe obstructive sleep apnea who was intolerant of nasal continuous positive airway pressure (nCPAP) treatment and oral appliance therapy. An alternative treatment of snoring and obstructive sleep apnea (OSA) with 2 orthodontic microimplants anchored to the mandible providing skeletal anchorage for mandibular advancement was implemented. After a 2 week healing period, a custom designed facemask provided extraoral anchorage to which the microimplants were connected to for titratable mandibular advancement. Microimplant Mandibular Advancement (MiMA) therapy resulted in resolution of the symptoms of severe OSA with a reduction of the apnea-hypopnea index (AHI), snoring and OSA symptoms.

Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage

  • Tanaka, Eiji;Yamano, Eizo;Inubushi, Toshihiro;Kuroda, Shingo
    • The korean journal of orthodontics
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    • v.42 no.3
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    • pp.144-154
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    • 2012
  • This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

Study on the Retraction of Anterior Teeth for the Lingual Orthodontics with the Three-Dimensional Finite Element Method (유한요소법을 이용한 설측 치아교정시 전치부 후방견인에 관한 연구)

  • Song Jung-Han;Huh Hoon;Park Hyun-Sang
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.28 no.8 s.227
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    • pp.1237-1244
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    • 2004
  • The orthodontic surgery including lingual orthodontics has recently attracted a person's attention due to its functional and esthetic appreciation. The skeletal anchorage with the miniscrew is newly adopted in the lingual orthodontics to assist the upholding ability. The appliciation needs to understand the mechanism of the orthodontic appliance and its related orthodontic correction for optimal orthodontic treatment. There is, however, few information about the qualitative and quantitative effect of the orthodontic appliance with the miniscrew has not been well identified. In this paper, three dimensional finite element analysis is introduced to the lingual orthodontics in order to investigate the effect of the anterior retraction force on the miniscrew and transpalatal arch wire. The analysis determines the adequate location of the miniscrew and the point of force application of the anchorage system in the lingual orthodontics. The analysis results demonstrate the effect of the position of the miniscrew and the transpalatal arch wire on the lingual orthodontics.