Self-drilling screws for the prevention of dental and skeletal injuries during open reduction and internal fixation of pediatric mandibular fractures

Facial trauma in pediatric population predisposes the child to injury of both the developing skeleton and dentition. This article aims to highlight the experience of the authors through a case report, in using self-drilling screws for fixation of mandibular fractures in pediatric age group. The use of self-drilling screws minimizes the complications such as thermal and/or mechanical damage to the developing dentition and the bone. They also provide significant advantages including ease of availability and technique, superior anchorage with primary stability, and minimizing or avoiding permanent damage to the developing tooth germs in the site of fracture. The use of self-drilling screws for mandibular open reduction and internal fixation in children is an easy, reliable, and safe technique which may have significant value addition in preventing inadvertent injury to the developing tooth germs.

Effect of surface anodization on stability of orthodontic microimplant / 대한치과교정학회지

OBJECTIVE: To determine the effect of surface anodization on the interfacial strength between an orthodontic microimplant (MI) and the rabbit tibial bone, particularly in the initial phase after placement. METHODS: A total of 36 MIs were driven into the tibias of 3 mature rabbits by using the self-drilling method and then removed after 6 weeks. Half the MIs were as-machined (n = 18; machined group), while the remaining had anodized surfaces (n = 18; anodized group). The peak insertion torque (PIT) and the peak removal torque (PRT) values were measured for the 2 groups of MIs. These values were then used to calculate the interfacial shear strength between the MI and cortical bone. RESULTS: There were no statistical differences in terms of PIT between the 2 groups. However, mean PRT was significantly greater for the anodized implants (3.79 +/- 1.39 Ncm) than for the machined ones (2.05 +/- 1.07 Ncm) (p < 0.01). The interfacial strengths, converted from PRT, were calculated at 10.6 MPa and 5.74 MPa for the anodized and machined group implants, respectively. CONCLUSIONS: Anodization of orthodontic MIs may enhance their early-phase retention capability, thereby ensuring a more reliable source of absolute anchorage.

Influence of surface treatment on the insertion pattern of self-drilling orthodontic mini-implants / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to compare self-drilling orthodontic mini-implants of different surfaces, namely, machined (untreated), etched (acid-etched), RBM (treated with resorbable blasting media) and hybrid (RBM + machined), with respect to the following criteria: physical appearance of the surface, measurement of surface roughness, and insertion pattern. METHODS: Self-drilling orthodontic mini-implants (Osstem implant, Seoul, Korea) with the abovementioned surfaces were obtained. Surface roughness was measured by using a scanning electron microscope and surface-roughness-testing machine, and torque patterns and vertical loadings were measured during continuous insertion of mini-implants into artificial bone (polyurethane foam) by using a torque tester of the driving-motor type (speed, 12 rpm). RESULTS: The mini-implants with the RBM, hybrid, and acid-etched surfaces had slightly increased maximum insertion torque at the final stage (p < 0.05). Implants with the RBM surface had the highest vertical load for insertion (p < 0.05). Testing for surface roughness revealed that the implants with the RBM and hybrid surfaces had higher Ra values than the others (p < 0.05). Scanning electron microscopy showed that the implants with the RBM surface had the roughest surface. CONCLUSIONS: Surface-treated, self-drilling orthodontic mini-implants may be clinically acceptable, if controlled appropriately.

Finite element analysis of cortical bone strain induced by self-drilling placement of orthodontic microimplant / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. METHODS: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. RESULTS: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. CONCLUSIONS: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.