Orthodontic mini-implant stability and the ratio of pilot hole implant diameter.

One notable complication of mini-implants that are used to provide anchorage in orthodontic treatment is loosening. The aim of this study was to evaluate the relationship between mini-implant mobility during the healing phase and the prognosis for implant stability. Twenty male Wistar rats (aged 20 weeks) were used. Drills with diameters of 0.8, 0.9, 1.0, and 1.1 mm were used to make pilot holes in the rat tibiae. The inserted mini-implants (diameter 1.4 mm; spearhead 1.2 mm; halfway between maximum and minimum 1.3 mm; length 4.0 mm) were subjected to an experimental traction of force for 3 weeks. Bone-to-implant contact (BIC) was observed histologically. Another 20 male rats (aged 20 weeks) underwent an identical procedure, and the stability of the mini-implants was measured using the Periotest before and after traction. The data were statistically analysed using Scheffé's test. The BIC ratios of the 0.9 and 1.0 mm groups were significantly greater than those of the other groups. The Periotest values measured 3 weeks after implant insertion were significantly lower (P < 0.05) than those measured at insertion, except in the 1.1 mm group. To obtain mini-implant stability, the hole diameter should be between 69 and 77 per cent of the diameter of the mini-implant. A significant decrease in the mobility of the mini-implants 3 weeks post-insertion implies a good prognosis for the subsequent mini-implant stability.

Factors affecting the long-term stability of orthodontic mini-implants.

INTRODUCTION: The placement and removal torques of mini-implants were evaluated as an index of implant stability. We examined factors affecting the initial and long-term stability of mini-implants. METHODS: We measured the placement and removal torques of 134 mini-implants placed in buccal posterior alveolar bone and assessed the relationships among placement and removal torques, placement period, age, sex, and cortical bone thickness. The mini-implants were machine-surfaced, 1.6 mm in diameter and 8 mm long. A torque screwdriver was used to measure the peak torque values. RESULTS AND CONCLUSIONS: The placement and removal torques averaged approximately 8 and 4 N cm, respectively. A torque of 4 N cm suggests sufficient anchorage capability for mini-implants. No significant correlation between placement and removal torques was found. Placement torque was significantly related to age and cortical bone thickness in the maxilla, whereas removal torque was not significantly related to placement period, age, sex, or cortical bone thickness.

Tapered orthodontic miniscrews induce bone-screw cohesion following immediate loading.

The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading. Twenty male Wistar rats with a mean age of 20 weeks were divided into two groups. In the immediate-loading groups, straight orthodontic miniscrews (S-type screws) and T-type screws (five rats each) underwent experimental traction force for 2 weeks (W) immediately after placement. In the healing groups (S- and T-type, five rats each), force was applied for 2 W after a 6-W healing period. The right tibia in each rat was identified as the test limb, while the left tibia in each rat was used as the control group, and underwent no experimental force during the experimental period. The screw-to-bone contact was observed histologically and the bone-screw contact ratio was calculated. Scheffe's test was performed to compare the bone-screw contact ratio in each group using statistical software package (SPSS 8.0 for Windows). In the control group, the bone-screw contact ratio improved from 34.8 +/- 16.0 to 74.8 +/- 12.0 per cent with S-type screws in proportion to the experimental period (2 to 8 W, respectively). With the T-type screws in the test group, there was no significant difference between the immediate-loading and healing groups. In the immediate-loading group, the bone-screw contact ratio with T-type screws was significantly greater (82.3 +/- 15.0 per cent) than with the S-type screws (33.3 +/- 11.8 per cent; P < 0.05), suggesting that T-type screws can be used for orthodontic anchorage immediately after placement.

Recommended placement torque when tightening an orthodontic mini-implant.

To determine an adequate placement torque for obtaining a better success rate of mini-implants that are screwed into the buccal alveolar bone of the posterior region as an anchor for orthodontic treatment, implant placement torque (IPT) was measured. The subjects were 41 orthodontic patients (124 implants), with an average age of 24.9 years (SD 6.5 years), who had surgery to place titanium mini-implants. The peak value of IPT was measured using a torque screwdriver. The success rate of the mini-implant anchor for 124 implants was 85.5%. The mean IPT ranged from 7.2 to 13.5 N cm, depending on the location of the implants. There was a significant difference in the IPT between maxilla and mandible. The IPT in the mandible was, unexpectedly, significantly higher in the failure group than in the success group. Therefore, a large IPT should not be used always. According to our calculations of the risk ratio for failure, to raise the success rate of 1.6-mm diameter mini-implants, the recommended IPT is within the range from 5 to 10 N cm.