Global scholarly output on orthodontic temporary anchorage devices (TADs): A silver jublee scientometric analysis.

OBJECTIVES: This study aimed to analyze the global scholarly production of articles related to temporary anchorage devices (TADs) from 1998-2023 in peer-reviewed dental journals indexed in the Web of Science. MATERIALS AND METHODS: A database of TADs-related articles was created via a Web of Sciences structured search. The bibliometric characteristics of the studies, including the number of citations, publication year, journal title, journal impact factor (IF), authorship, contributing institutions and countries, thematic field, and study design, were extracted. Keyword co-occurrence network analyses and the correlation between the number of citations and the article age, journal IF, and journal quartile of each article were performed. RESULTS: The top 50 cited articles were published from 1999-2016, and the total number of citations ranged from 82-602, with 160.36 citations/paper on average. Most of the articles originated from Japan (n = 12), with the most remarkable contributions from Nihon and Okayama Universities, Japan (n = 5, each). The American Journal of Orthodontics and Dentofacial Orthopedics had the most cited articles, with 196.57 citations/paper on average. A significant positive correlation occurred between the number of citations and publication age (rho = 0.392, P = 0.005). CONCLUSION: Our scientometric analysis reported the characteristics of TADs-related articles published over 25 years. Most highly-cited articles were published between 2005 and 2008. The positive correlation between articles' publication date and the number of citations might impact the top 50 within the next 5-10 years.

Comparación Morfológica de Zonas de Inserción de Miniplacas Ortodóncicas en la Región Mandibular entre Edad, Sexo, Biotipo y Clase Esqueletal

El manejo del anclaje en los tratamientos de ortodoncia ha sido un reto constante, por lo que la utilización de miniplacas aparece como un rescate a esta interrogante. Determinar las diferencias morfológicas en la zona de inserción de miniplacas ortodóncicas en las regiones anterior y posterior mandibular, comparandolas entre edad, sexo, biotipo y clase esqueletal. Se estudiaron 40 registros de cone-beam de pacientes y se realizaron mediciones de grosor del hueso, donde se identificaron los sitios que permitan posicionar una miniplaca y fueron comparados entre sexo, grupos etarios, biotipo y clase esqueletal. Se observó diferencias significativas entre hombres y mujeres a nivel anterior mandibular, en los hombres se observaron mayores grosores óseos y corticales. No se observaron diferencias significativas entre pacientes adultos y jóvenes a nivel anterior mandibular, pero sí hubo diferencias a nivel mandibular posterior. La zona 3 mm debajo del 2do molar no es una zona confiable para la inserción de mini placas, ya que muchos de los pacientes no presentaban hueso en esa zona. Las miniplacas son un recurso seguro de anclaje las cuales deben ser adaptadas a cada paciente.

The anchorage management in orthodontic treatments has been a constant challenge, the use of miniplates may be a viable solution to this query. The objective of this study was to determine the morphological differences in the area of insertion of orthodontic miniplates in the anterior and posterior mandibular regions, comparing them between age, sex, biotype and skeletal class. In this analysis 40 cone-beam records of patients were studied, bone thickness measurements were carried out, the sites that allowed the positioning of a miniplate were identified and compared between sex, age groups, biotype and skeletal class. Significant differences were observed between men and women at the anterior mandibular level, in men greater bone and cortical thicknesses were observed. No significant differences were observed between adult and young patients at the anterior mandibular level, but there were differences at the posterior mandibular level. The area 3 mm below the 2nd molar was not a reliable area for the insertion of mini plates, since many of the patients had no bone in that area. Miniplates are a safe anchoring resource which must be adapted to each patient.

Structural resistance of orthodontic mini-screws inserted for extra-alveolar anchorage.

The risk of fracture or strain in mini-screws is higher if diameter, length, type of alloy or insertion angle is selected inappropriately. The aims of this study were to test the structural resistance of two types of orthodontic mini-screws -one made of stainless steel and another of titanium- from an international brand and to evaluate the efficacy of two other titanium miniscrews of Brazilian origin, during an extra-alveolar anchorage procedure. The mini-screws analyzed were: Bomei stainless steel and Bomei titanium / Taiwan, Morelli titanium and Neodent titanium/ Brazil. Experiments were conducted on pig mandibles to simulate the process of extra-alveolar anchorage. Two insertion processes were used: Direct at 30º, and Indirect, starting at 60º and ending at 30º with gradual continuous movement. Strain was evaluated using Optical and Scanning Electron Microscopy. Data were evaluated using Kruskal-Wallis non-parametric statistical analysis and post hoc Tamhane test. Significant statistical differences in strain were observed among the mini-screws used in the extra-alveolar insertions, both for the direct and indirect procedures. In the indirect insertion tests, both stainless steel and titanium mini-screws suffered deformation, showing that angling can be an important factor in mini-screw failure rates. The change in angle during the insertion movement increased deformation rates independently of alloy type, increasing the risk of failure. These results could help orthodontists in choosing mini-screws for extra-alveolar anchorage, which can be performed with direct or indirect insertion. In vivo studies should be conducted to confirm the findings of this study.

O risco de fratura ou tensão nos mini-parafusos é maior se o diâmetro, comprimento, tipo de liga ou ângulo de inserção for selecionado de forma inadequada. Os objetivos deste estudo foram testar a resistência estrutural de dois tipos de miniaparafusos ortodônticos ­um feito de aço inoxidável e outro de titânio­ de uma marca internacional e avaliar a eficácia de dois outros mini-parafusos de titânio de origem brasileira, durante um procedimento de ancoragem extra-alveolar. Os miniaparafusos analisados foram: Bomei aço inoxidável e Bomei titânio / Taiwan, Morelli titânio e Neodent titânio / Brasil. Foram realizadas experiências em mandíbulas de porcos para simular o processo de ancoragem extra-alveolar. Foram utilizados dois processos de inserção (Direta a 30º, e Indireta, começando a 60º e terminando a 30º com movimento gradual contínuo). A deformação foi avaliada utilizando Microscopia Óptica e Microscopia Eletrônica de Varredura. Os dados foram avaliados utilizando análise estatística não paramétrica Kruskal-Wallis e teste post-hoc Tamhane. Diferenças estatísticas significativas na deformação foram observadas entre os miniparafusos utilizados nas inserções extra-alveolares, tanto para os procedimentos diretos como indiretos. Nos testes de inserção indireta, tanto os mini-parafusos de aço inoxidável como os de titânio sofreram deformação, mostrando que a angulação pode ser um fator importante nas taxas de falha dos mini-parafusos. A mudança no ângulo durante o movimento de inserção aumentou as taxas de deformação independentemente do tipo de liga, aumentando o risco de falha. Estes resultados podem ajudar os ortodontistas na escolha de mini-parafusos para ancoragem extra-alveolar, que pode ser realizada com inserção direta ou indireta. Estudos in vivo devem ser conduzidos para confirmar os resultados deste estudo.

Structural resistance of orthodontic mini-screws inserted for extraalveolar anchorage / Resistência estrutural de mini-aparafusos ortodônticos inseridos para ancoragem extra-alveolar

ABSTRACT The risk of fracture or strain in mini-screws is higher if diameter, length, type of alloy or insertion angle is selected inappropriately. The aims of this study were to test the structural resistance of two types of orthodontic mini-screws -one made of stainless steel and another of titanium- from an international brand and to evaluate the efficacy of two other titanium miniscrews of Brazilian origin, during an extra-alveolar anchorage procedure. The mini-screws analyzed were: Bomei stainless steel and Bomei titanium/Taiwan, Morelli titanium and Neodent titanium/ Brazil. Experiments were conducted on pig mandibles to simulate the process of extra-alveolar anchorage. Two insertion processes were used: Direct at 30°, and Indirect, starting at 60° and ending at 30° with gradual continuous movement. Strain was evaluated using Optical and Scanning Electron Microscopy. Data were evaluated using Kruskal-Wallis non-parametric statistical analysis and post hoc Tamhane test. Significant statistical differences in strain were observed among the mini-screws used in the extra-alveolar insertions, both for the direct and indirect procedures. In the indirect insertion tests, both stainless steel and titanium mini-screws suffered deformation, showing that angling can be an important factor in mini-screw failure rates. The change in angle during the insertion movement increased deformation rates independently of alloy type, increasing the risk offailure. These results could help orthodontists in choosing mini-screws for extra-alveolar anchorage, which can be performed with direct or indirect insertion. In vivo studies should be conducted to confirm the findings of this study.

RESUMO O risco de fratura ou tensao nos mini-parafusos é maior se o diámetro, comprimento, tipo de liga ou ángulo de insergao for selecionado de forma inadequada. Os objetivos deste estudo foram testar a resistencia estrutural de dois tipos de mini-aparafusos ortodónticos -um feito de ago inoxidável e outro de titànio- de uma marca internacional e avaliar a eficácia de dois outros mini-parafusos de titànio de origem brasileira, durante um procedimento de ancoragem extra-alveolar. Os mini-aparafusos analisados foram: Bomei ago inoxidável e Bomei titànio / Taiwan, Morelli titànio e Neodent titànio / Brasil. Foram realizadas experiencias em mandíbulas de porcos para simular o processo de ancoragem extra-alveolar. Foram utilizados dois processos de insergao (Direta a 30°, e Indireta, comegando a 60° e terminando a 30° com movimento gradual continuo). A deformagao foi avaliada utilizando Microscopia Optica e Microscopia Eletrónica de Varredura. Os dados foram avaliados utilizando análise estatistica nao paramétrica Kruskal-Wallis e testepost-hoc Tamhane. Diferengas estatisticas significativas na deformagao foram observadas entre os mini-parafusos utilizados nas insergoes extra-alveolares, tanto para os procedimentos diretos como indiretos. Nos testes de insergao indireta, tanto os mini-parafusos de ago inoxidável como os de titánio sofreram deformagao, mostrando que a angulagao pode ser um fator importante nas taxas de falha dos mini-parafusos. A mudanga no ángulo durante o movimento de insergao aumentou as taxas de deformagao independentemente do tipo de liga, aumentando o risco de falha. Estes resultados podem ajudar os ortodontistas na escolha de mini-parafusos para ancoragem extra-alveolar, que pode ser realizada com insergao direta ou indireta. Estudos in vivo devem ser conduzidos para confirmar os resultados deste estudo.

Management of skeletal class II malocclusion using bimaxillary skeletal anchorage supported fixed functional appliances : A novel technique.

AIM: To evaluate the treatment effects in growing skeletal class II patients subjected to a novel treatment technique, i.e., bimaxillary miniplates supported fixed functional appliance. The null hypothesis was that there is no statistically significant difference in skeletal changes of patients with class II malocclusion treated with bimaxillary skeletal anchorage supported fixed functional appliance and those who were not provided any intervention. METHODS: The sample comprised 32 skeletal class II subjects (17 males and 15 females) with a Cervical Vertebrae Maturity Index (CVMI) demonstrating peak of pubertal growth spurt. Sixteen patients (12.37 ±1.09 years of age) were treated with bimaxillary skeletal anchorage supported fixed function appliance, while 16 well-matched subjects (12.06 ± 1.34 years of age) were included as controls. For both groups, cephalograms (T1, T2) were taken with a matched observational interval of about 7.5 months; 17 linear and 10 angular measurements were recorded. The intraclass correlation coefficient (ICC) was used to determine reliability of measurements recorded. Student t test was carried out to determine the changes produced by the treatment relative to control. RESULTS: When compared with the control group, the treatment group demonstrated significant maxillary retrusion. No significant changes were seen in mandibular growth pattern, whereas mandibular length increased significantly more than in the control group (B-VP: 3.05 mm; Co-Gn: 2.65 mm). Treatment mechanics had minimal effects on maxillary dentition. Mandibular incisors proclined by an average of 3.06°. Maxilla-mandibular relation improved significantly (ANB: -4.29°; NA-Pog: -3.76°). CONCLUSION: The new bimaxillary skeletal anchorage supported fixed functional appliance technique was found to be highly effective in the treatment of class II malocclusion with significant skeletal changes.

Efficient Distalization of Maxillary Molars with Temporary Anchorage Devices for the Treatment of Class II Malocclusion.

Treatment of Class II malocclusion often requires maxillary molar distalization. However, when applying distalization forces on the maxillary molars, anchorage loss may occur in different degrees not only during molar distalization (such as distal tipping of maxillary molars and mesial movement and proclination of the anterior teeth) but also during the subsequent stage of anterior teeth retraction (such as mesial movement of maxillary molars). All these movements are considered as unwanted side effects, which diminish the clinical effectiveness of distalization. Miniscrew implants can be used as temporary anchorage devices (TADs) to enhance anchorage and, if properly used, to counterbalance the side effects. Among the different available systems, the TAD-supported amda® can be considered as a simple, noncompliant, minimally invasive, and very efficient approach that can be used for the comprehensive treatment of patients with Class II malocclusion not only to distalize the maxillary molars bodily without or with minimal distal tipping and without proclination of the anterior teeth but also in combination with full-fixed appliances to retract and intrude the anterior teeth.

Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report.

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile.This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. A vertical discrepancy of about 4 mm was exhibited between teeth 11 and 12. To reposition the crown and gingival margins of the ankylosed tooth to an ideal level, single-tooth dento-osseous osteotomy and distraction of the block of bone containing the tooth was planned. In order to separate the roots of adjacent teeth for opening a space for osteotomy incision, fixed orthodontic treatment with multibracket appliances was initiated on her maxilla. After five weeks, a single-tooth dento-osseous osteotomy was performed using a piezoelectric device. To move the tooth in occlusal and buccal directions, two temporary anchorage devices (miniscrews) on her mandible and interarch elastics were applied. Approximately three weeks later, the ankylosed tooth successfully had an ideal position-relative to the adjacent teeth-and a harmonious gingival margin was achieved by minor gingivoplasty on all incisors.

Treatment of Class II, Division 2 Malocclusion with Miniscrew Supported En-Masse Retraction: Is Deepbite Really an Obstacle for Extraction Treatment?

A 17-year-old female patient, whose chief complaint was her unpleasing smile, had skeletal and dental class II malocclusion, hypodivergent facial type with a severely increased overbite. Among the treatment options, upper-first-premolar extractions followed by miniscrew-supported en-masse retraction was the treatment of choice. After the initial levelling and alignment, miniscrews with 1.5- to 1.4-mm diameter and 7-mm lenght, were installed between the roots of the second premolars and the first molars, bilaterally. En-masse retraction was achieved on a 0.016×0.022-inch stainless steel archwire with 7-mm long power hooks placed distal to the lateral incisors, and with nickel-titanium (NiTi) closed coil springs exerting 250-gr of force per side. At the end of the treatment, deepbite, incisor inclinations and interincisal angle were corrected, and Class II molar relationship with good intercuspation was achieved. Upper 2-2, lower 3-3 retainers were bonded for retention. As a result, deepbite and Class II canine relationship was successfully corrected with simultaneous incisor intrusion and retraction using miniscrew-supported en-masse retraction.

Multiscale analyses of the bone-implant interface.

Implants placed with high insertion torque (IT) typically exhibit primary stability, which enables early loading. Whether high IT has a negative impact on peri-implant bone health, however, remains to be determined. The purpose of this study was to ascertain how peri-implant bone responds to strains and stresses created when implants are placed with low and high IT. Titanium micro-implants were inserted into murine femurs with low and high IT using torque values that were scaled to approximate those used to place clinically sized implants. Torque created in peri-implant tissues a distribution and magnitude of strains, which were calculated through finite element modeling. Stiffness tests quantified primary and secondary implant stability. At multiple time points, molecular, cellular, and histomorphometric analyses were performed to quantitatively determine the effect of high and low strains on apoptosis, mineralization, resorption, and collagen matrix deposition in peri-implant bone. Preparation of an osteotomy results in a narrow zone of dead and dying osteocytes in peri-implant bone that is not significantly enlarged in response to implants placed with low IT. Placing implants with high IT more than doubles this zone of dead and dying osteocytes. As a result, peri-implant bone develops micro-fractures, bone resorption is increased, and bone formation is decreased. Using high IT to place an implant creates high interfacial stress and strain that are associated with damage to peri-implant bone and therefore should be avoided to best preserve the viability of this tissue.

Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study.

PURPOSE: This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. MATERIALS AND METHODS: CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. RESULTS: The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. CONCLUSION: In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.

Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study

PURPOSE: This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. MATERIALS AND METHODS: CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. RESULTS: The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. CONCLUSION: In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.