Evaluation of miniscrew stability using an automatic embedding auxiliary skeletal anchorage device.

OBJECTIVE: To clarify the in vivo effect of an automatic embedding device on miniscrew stability. MATERIALS AND METHODS: 42 miniscrews were implanted into rabbit femurs. The miniscrews with the novel auxiliary device formed the auxiliary group (n = 11 at 4 weeks; n = 11 at 8 weeks) and the miniscrews without the auxiliary device formed the nonauxiliary control group (n = 9 at 4 weeks; n = 11 at 8 weeks). Cortical bone thickness, distance from the cortical bone surface to the miniscrew head, and implantation depth of the spike were measured using micro-computed tomography. The mechanical retention force was evaluated by measuring the displacement of the miniscrew head after it was loaded perpendicular to its long axis. In the lateral displacement test, effects of the auxiliary (with vs without auxiliary), and time (4 vs 8 weeks) were assessed using the Brunner-Langer nonparametric analysis of longitudinal data in factorial experiments. RESULTS: The mean implantation depth of the spike in the auxiliary group at 4 and 8 weeks was 0.28 mm (median: 0.33; SD: 0.12) and 0.37 mm (median: 0.33; SD: 0.19), respectively. The retention force was approximately 2.0 to 2.8 and 1.6 to 1.8 times greater in the auxiliary group than in the nonauxiliary group at 4 and 8 weeks, respectively. CONCLUSIONS: The auxiliary device improved the mechanical retention force without the need to increase miniscrew length or diameter. This may enable the safe use of miniscrews in difficult areas.

Differences between the chewing and non-chewing sides of the mandibular first molars and condyles in the closing phase during chewing in normal subjects.

OBJECTIVE: This study aimed to assess differences between the closing paths of the chewing and non-chewing sides of mandibular first molars and condyles during natural mastication, using standardized model food in healthy subjects. DESIGN: Thirty-two healthy young adults (age: 19-25 years; 22 men, 10 women) with normal occlusion and function chewed on standardized gummy jelly. Using an optoelectric jaw-tracking system with six degrees of freedom, we recorded the path of the mandibular first molars and condyles on both sides for 10 strokes during unilateral chewing. Variables were compared between the chewing side and the non-chewing side of first molars and condyles on frontal, sagittal, and horizontal views during the early-, middle- and late-closing phases. RESULTS: On superior/inferior displacements, the chewing side first molar and condyle were positioned superior to those on the non-chewing side during the early- and middle-closing phases. Conversely, the first molar and condyle on the non-chewing side were positioned significantly superior to those on the chewing side during the late-closing phase. On anterior/posterior displacements, the chewing side mandibular first molar and condyle were positioned significantly posterior to those on the non-chewing side throughout all closing phases. CONCLUSION: Our results showed the differences between the mandibular first molars and condyles on both sides with respect to masticatory path during natural chewing of a model food. These differences can be useful for informing initial diagnostic tests for impaired masticatory function in the clinical environment.

Modulation of the masticatory path at the mandibular first molar throughout the masticatory sequence of a hard gummy jelly in normal occlusion.

OBJECTIVE: In this study, the authors investigated the modulation of the masticatory path at the mandibular first molar during natural chewing of a hard gummy jelly in adults with normal occlusion. METHODS: The unilateral mastication sequence was divided into three stages, and the masticatory path of the mandibular first molar on the working side was analyzed at 2.0, 3.0, 4.0, and 5.0 mm vertical slice levels below the intercuspation in the frontal and sagittal views. RESULTS: In the frontal view, the closing and opening angles and cycle width of the final stage at 3.0, 4.0, and 5.0 mm slice levels were smaller and narrower than those of the initial stage, although those at the 2.0 mm slice level were little changed. DISCUSSION: Masticatory paths of the mandibular first molar at slice levels greater than 3.0 mm were evidently modulated to adapt to the changing properties of the food, and those at the 2.0 mm slice level remained stable throughout the masticatory sequence.

Development of a novel spike-like auxiliary skeletal anchorage device to enhance miniscrew stability.

INTRODUCTION: Miniscrews are frequently used for skeletal anchorage during edgewise treatment, and their clinical use has been verified. However, their disadvantage is an approximately 15% failure rate, which is primarily attributed to the low mechanical stability between the miniscrew and cortical bone and to the miniscrew's close proximity to the dental root. To solve these problems, we developed a novel spike-like auxiliary skeletal anchorage device for use with a miniscrew to increase its stability. METHODS: The retention force was compared between miniscrews with and without the auxiliary skeletal anchorage device at each displacement of the miniscrew. The combined unit was also implanted into the bones of 2 rabbits in vivo, and implantation was visually assessed at 4 weeks postoperatively while the compression force was applied. RESULTS: The retention force of the combined unit was significantly and approximately 3 to 5 times stronger on average than that of the miniscrew alone at each displacement. The spiked portion of the auxiliary anchorage device embedded into the cortical bone of the hind limb at approximately a 0.3-mm depth at 4 weeks postimplantation in both rabbits. CONCLUSIONS: The auxiliary skeletal anchorage device may increase miniscrew stability, allow a shortened miniscrew, and enable 3-dimensional absolute anchorage. Further evaluation of its clinical application is necessary.

Replacement of a first molar and 3 second molars by the mesial inclination of 4 impacted third molars in an adult with a Class II Division 1 malocclusion.

This case report presents the successful replacement of 1 first molar and 3 second molars by the mesial inclination of 4 impacted third molars. A woman, 23 years 6 months old, had a chief complaint of crowding of her anterior teeth and linguoclination of a second molar on the left side. The panoramic radiographic images showed that the maxillary and mandibular third molars on both sides were impacted. Root resorption on the distal surfaces of the maxillary second molars was suspected. The patient was given a diagnosis of Angle Class II Division 1 malocclusion with severe crowding of the anterior teeth and 4 impacted third molars. After we extracted the treated maxillary second premolars and the second molars on both sides, the treated mandibular second premolar and the second molar on the left side, and the root canal-filled mandibular first molar on the right side, the 4 impacted third molars were uprighted and formed part of the posterior functional occlusion. The total active treatment period was 39 months. The maxillary and mandibular third molars on both sides successfully replaced the first and second molars. The replacement of a damaged molar by an impacted third molar is a useful treatment option for using sound teeth.