Stability of immediately loaded 3 mm long miniscrew implants: a feasibility study

ABSTRACT Introduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.

RESUMO Introdução: Mini-implantes (MIs) mais curtos são necessários para uma Ortodontia mais eficiente e efetiva. Objetivo: Avaliar a estabilidade, torque de inserção e de remoção e dor associada a MIs de 3mm instalados em humanos por um ortodontista principiante. Métodos: 82 MIs foram instalados na região vestibular da arcada superior de 26 adultos. Pares de mini-implantes adjacente receberam carga imediata de 100g. Após 1, 3, 5 e 8 semanas, os pacientes foram reavaliados para verificar a estabilidade e preencher um questionário sobre a dor e o desconforto relacionados aos MIs. Resultados: A taxa geral de falhas foi de 32,9%, sendo de 35,7% para os MIs anteriores e 30% para os MIs posteriores. Excluindo os 10 MIs que foram perdidos por trauma (12,2%), a taxa de falha nas regiões anterior e posterior foram de 30,1% e 15,2%, respectivamente e ocorreram no 420 dia ou antes. A taxa geral de falha primária foi de 23,6%. A taxa de falha foi significativamente maior (p=0,010) nos primeiros 41 MIs do que nos 41 últimos (46,3% vs. 19,5%). As experiências relacionadas à dor foram baixas (2,2% máximo), assim como ao desconforto (5,5% máximo) durante a primeira semana. Conclusão: MIs de 3mm instalados por um novato são mais propensos a falhas. Porém, as taxas de falha podem diminuir substancialmente com a instalação de mais MIs com o decorrer do tempo. A dor e o desconforto após a instalação desses dispositivos são mínimos e temporários.

IBC: índice Board CES / The IBC: CES Board Index

Resumen La medición de resultados de los tratamientos de ortodoncia es fundamental para evaluar objetivamente la calidad de la finalización y el éxito logrado por la terapia, y a su vez en la evaluación de los residentes del posgrado de ortodoncia. En la literatura se han reportado varios sistemas que permiten analizar dichos resultados, pero algunos no integran suficientes criterios o ayudas diagnósticas. La Universidad CES, basada en el American Board of Orthodontics-Objetctive Grading System (ABO-OGS), ha desarrollado un índice con 16 criterios analizados en modelos, radiografías y fotografías, que integran una medición objetiva de la finalización de los tratamientos. El propósito de este artículo fue describir el índice Board CES (IBC) como herramienta de evaluación de resultados clínicos de la ortodoncia y generar retroalimentación para el tratamiento de casos futuros mejorando la calidad de los mismos. Dicho índice podría ser empleado en universidades y en prácticas privadas.

The measurement of orthodontic treatment results is crucial to objectively assess the quality of the completion and success of therapy, and in turn in the evaluation of graduate orthodontic residents. The literature has reported several systems that analyze these results, but some do not integrate sufficient criteria or diagnostic aids. CES University, based on the American Board of Orthodontics - Objective Grading System (ABO - OGS), has developed an index with 16 criteria analyzed in models, radiographs and photographs, which allow an objective measurement of the completion of treatments. The purpose of this article was to describe the CES Board Index (IBC) as a tool for assessing clinical outcomes in orthodontics and generate feedback for the treatment of future cases improving their quality. This index could be used in Universities and in private practices.