Determinants for success rates of temporary anchorage devices in orthodontics: a meta-analysis (n > 50).

INTRODUCTION: The aim of this study was to review the literature and evaluate the failure rates and factors that affect the stability and success of temporary anchorage devices (TADs) used as orthodontic anchorage. METHODS: Data were collected from electronic databases: MEDLINE database, Scopus, and Web of Knowledge. Four combinations of term were used as keywords: screw orthodontic failure, screw orthodontic success, implant orthodontic failure, and implant orthodontic success. The following selection criteria were used to select appropriate articles: articles on implants and screws used as orthodontic anchorage, data only from human subjects, studies published in English, studies with more than 50 implants/screws, and both prospective and retrospective clinical studies. RESULTS: The search provided 209 abstracts about TADs used as anchorage. After reading and applying the selection criteria, 26 articles were included in the study. The data obtained were divided into two topics: which factors affected TAD success and to what degree and in how many articles they were quoted. Clinical factors were divided into three main groups: patient-related, implant-related, and management-related factors. CONCLUSIONS: Although all articles included in this meta-analysis reported success rates of greater than 80 per cent, the factors determining success rates were inconsistent between the studies analysed and this made conclusions difficult.

Self-ligating fully customized lingual appliance and chair-time reduction: a typodont study followed by a randomized clinical trial.

In this study, we tested the hypothesis that self-ligation can reduce the chair time necessary for inserting and removing the archwire in a fully customized, multi-bracket, orthodontic, lingual appliance. A permuted-block, randomized trial design was employed to treat seven patients, each with Incognito(®) lingual appliances and Harmony(®) self-ligating lingual appliances. Three operators (a third year resident in orthodontics, an orthodontic specialist, and an experienced lingual orthodontist) were instructed, and they were allowed to familiarize themselves with two typodonts. Next, the operators were asked to insert and remove a.014 NiTi customized archwire for each patient, and they were timed. The time required for removing and inserting archwires decreased proportionally with operator experience: it was shorter with self-ligating appliances (114.82±18.06 seconds versus 595.83±289.09 seconds, P < 0.001) and when testing the typodonts' performances (480.61±285.74 seconds versus 518.65±296.97 seconds, P < 0.001). However, differences between operators were smaller when using typodonts (31.77±21.19 seconds versus 43.87±27.06 seconds, P < 0.001) and with self-ligation (15.17±9.29 seconds versus 45.37±25.44 seconds, P < 0.001). In vivo performance improved after typodont training, allowing for difference reductions between operators. Lingual self-ligation appears to require less hands-on ability and training of the orthodontist, for reduction of chair time.