Beruflich Dokumente
Kultur Dokumente
Professor, Department of Orthodontics, School of Dentistry, Medical University of Vienna, Vienna, Austria.
Resident, Department of Orthodontics, School of Dentistry, Medical University
of Vienna, Vienna, Austria.
c
Professor, Division of Orthodontics, School of Dental Medicine, University of
Connecticut, Farmington.
The authors report no commercial, financial, or propriety interest in the products
or companies described in this article.
Reprint requests to: Adriano G. Crismani, University Clinic of Orthodontics,
Department of Dentistry and Maxillofacial Surgery, Medical University of
Innsbruck, Innsbruck, Austria; e-mail, adriano.crismani@i-med.ac.at.
Submitted, December 2007; revised and accepted, January 2008.
0889-5406/$36.00
Copyright 2010 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2008.01.027
b
108
Crismani et al
Table I.
109
Articles reviewed
Authors
Miyawaki et al
Cheng et al 4
Liou et al 5
Fritz et al 6
Park et al 7
Motoyoshi et al 8
Park et al 9
Chen et al 10
Tseng et al 11
Herman et al 12
Kuroda et al 13
Wiechmann et al 14
Motoyoshi et al 15
Chen et al16
Title
Journal
Year
Factors associated with the stability of titanium screws placed in the posterior
region for orthodontic anchorage
A prospective study of the risk factors associated with failure of mini-implants
used for orthodontic anchorage
Do miniscrews remain stationary under orthodontic forces?
Clinical suitability of titanium microscrews for orthodontic anchorage
preliminary experiences
Group distal movement of teeth using microscrew implant anchorage
Recommended placement torque when tightening an orthodontic mini-implant
Factors affecting the clinical success of screw implants used as orthodontic
anchorage
The use of microimplants in orthodontic anchorage
The application of mini-implants for orthodontic anchorage
Mini-implant anchorage for maxillary canine retraction: a pilot study
Clinical use of miniscrew implants as orthodontic anchorage: success rates and
postoperative discomfort
Success rate of mini- and micro-implants used for orthodontic anchorage:
a prospective clinical study
Application of orthodontic mini-implants in adolescents
A retrospective analysis of the failure rate of three different orthodontic skeletal
anchorage systems
2003
2004
2004
2004
Angle Orthod
Clin Oral Implants Res
Am J Orthod Dentofacial Orthop
2005
2006
2006
2006
2006
2006
2007
2007
2007
2007
The overall success rates were available in all 14 articles and ranged from 59.4% to 100%. The mean
success rate for all 14 studies averaged 83.6% 6
10.2%. Weighted by the number of screws in each study,
the mean success rate was 83.8% 6 7.4%. The number
of treated patients ranged from 13 to 129, with the number of miniscrews from 30 to 273. Overall, the analyzed
data comprised 452 patients treated with 1519 screws
(Table II).
The success rate of the miniscrews was broken down
by sex in 6 studies3,7-9,13,16 and by age in 4 studies.3,7,13,16
This did not include the findings of Liou et al,5 who
treated only female patients of 1 age group. No statistically significant findings in terms of patient sex were observed in any studies, but Chen et al16 found significantly
greater success in patients over 30 years of age (Table III).
The data for screw length and diameter were given
in all included studies. Length ranged from 4 to 21
mm and diameter from 1 to 2.3 mm. Nine studies reported success rates for screws of either different
lengths or different diameters.3,4,7,9-11,13,14,16 Three of
them reported statistically significant findings
(P \0.05). Miyawaki et al3 concluded that their 1-mm
thick screw performed significantly worse than those
with diameters of 1.5 and 2.3 mm. Similarly, Wiechmann et al14 reported worse results for 1.1-mm thick
screws than for 1.6-mm ones. In the study of Chen et
al,10 the success rate of 6-mm long screws was significantly lower than that of 8-mm long ones (P \0.05)
(Table IV).
Table II.
Authors
Miyawaki et al3
Cheng et al4
Liou et al5
Fritz et al6
Park et al7 (2005)
Motoyoshi et al8
(2006)
Park et al9 (2006)
Chen et al10 (2006)
Tseng et al11
Herman et al12
Kuroda et al13
Wiechmann et al14
Motoyoshi et al15
(2007)
Chen et al16 (2007)
Total
134
92
32
36
30
124
44
44*
16
17
13
41
77.8
91.3
100
70.0
90.0
85.5
227
59
45
49
116
133
169
87
29
25
16
58
49
57
91.6
84.7
91.1
59.4
86.2
76.7
85.2
273
1519
129*
452
81.0
Mean: 83.6 6 10.2
Mean weighted by
number of screws:
83.8 6 7.4
*P \0.05.
110
Crismani et al
Table III.
Authors
3
Miyawaki et al
Cheng et al4
Liou et al5
Fritz et al6
Park et al7 (2005)
Motoyoshi et al8 (2006)
Park et al9 (2006)
Chen et al10 (2006)
Tseng et al11
Herman et al12
Kuroda et al13
Wiechmann et al14
Motoyoshi et al15 (2007)
Chen et al16 (2007)
Male
Female
\20 years
20-30 years
.30 years
Mean age
80
91.7
90.0
88.8
85.7
84.4
84.7
100
88.9
85.1
93.5
88.9
85.4
80.3
83.3
92.5
78.3
78.3*
88.2
100
100
82.4
91.9
84.1*
85.0
100
93.6*
21.8
29.0
29.0
17.9
24.9
15.5
29.8
29.9
13.7
21.8
26.9
24.5
*P \0.05.
and the corresponding success rates were examined.3,12,13 Although Miyawaki et al3 and Kuroda et
al13 reported slightly higher success rates for flapless
placement, the results of Herman et al12 were considerably better with a flap (Fig).
When information was available, 958 screws were
used in the maxilla with a mean success rate 89.0% 6
10.0%. In the mandible, 508 screws averaged a success
rate of 79.6% 6 8.7%. Weighted by the number of
screws in each location, the mean success rates were
87.9% 6 7.6% for the maxilla and 80.4% 6 8.5% for
the mandible. In 3 studies, the differences between the
maxilla and the mandible were significant (P \0.05)
in favor of the maxilla (Table V).4,9,16
Three studies explored the differences between
screws placed in the patients left or right side.8,9,15
There was a significant finding (P \0.05) by Park et
al9 in favor of the left side. The success rate for the
left side was also higher in the studies by Motoyoshi
et al,8,15 although not significantly different.
The loading variables under evaluation were latency
period (time from placement to first loading), overall
time of loading, and force applied to the screws.
Data on the time until loading were available in 13
studies and ranged from immediate loading (#48hours20)
to 149 days. Most screws were thereby incorporated in the
orthodontic mechanics, according to the definitions for immediate and early loading of implants.20 Four studies provided success rates for different healing periods.3,13,15,16
Motoyoshi et al15 reported significant differences between
the adolescent early-load group and the late-load group but
also for the adult early-load group (P \0.05).
The amount of loading, available in 13 studies, ranged
from 50 to 400 cN. Kuroda et al13 analyzed different
forces but found no significant differences (Table VI).
DISCUSSION
Crismani et al
Table IV.
111
(mm)
Authors
Miyawaki et al3
Cheng et al4
Liou et al5
Fritz et al6
Park et al7 (2005)
12
Herman et al
Kuroda et al13
Wiechmann et al14
Motoyoshi et al15 (2007)
Chen et al16 (2007)
Screws
(n)
Length
Diameter
Success
rate
10
101
23
48
31
31
20
10
32
36
4
14
8
2
2
124
19
157
46
5
18
41
15
10
12
8
49
37
13
6
45
12
3
79
54
169
72
201
6
11
14
5, 7
9
11
13
15
17
6, 8, 10
4
6
8
10
15
8
5
6-8
4-10
10-15
6
8
8
10
12
14
6-10
7, 11
6
7
8
10
12
5-10
5-10
8
4-10
5-21
1
1.5
2.3
2
2
2
2
2
2
1.4, 1.6, 2
1.2
1.2
1.2
1.2
2
1.6
1.2
1.2
1.2
2
1.2
1.2
2
2
2
2
1.8
2, 2.3
1.3
1.3
1.3
1.3
1.3
1.1
1.6
1.6
1.2
2
0.0*
83.9*
85*
85.4
93.5
93.0
85.0
90.0
100
70.0
75.0
86.7
100
100
100
85.5
84.2
93.6
89.1
80.0
72.2*
90.2*
80.0
90.0
100
100
61.2
81.1
69.2
83.3
93.3
91.7
100
59.6*
87.0*
91.9
76.4
82.6
*P \0.05.
Table V.
ment
Maxilla
Authors
Miyawaki et al3
Cheng et al4
Liou et al5
Fritz et al6
Park et al7 (2005)
Motoyoshi et al8 (2006)
Park et al9 (2006)
Chen et al10 (2006)
Tseng et al11
Herman et al12
Kuroda et al13
Wiechmann et al14
Motoyoshi et al15 (2007)
Chen et al16 (2007)
Total
Weighted by number
of screws
Mandible
Screws
(n)
Success
rate
Screws
(n)
63
32
18
8
80
124
43
27
49
61
90
100
263
958
84.1
93.3*
100
100
88.8
96.0*
86.0
96.3
61.2
91.8
86.7
84.0
88.2*
Mean: 89.0
6 10.0
Mean weighted
by number
of screws:
87.9 6 7.6
61
18
22
44
103
16
18
18
43
69
96
508
Success
rate
83.6
77.1*
86.4
79.5
86.4*
81.3
83.3
77.8
55.8
87.0
77.1*
Mean: 79.6
6 8.7
Mean weighted
by number
of screws:
80.4 6 8.5
*P \0.05.
112
Crismani et al
Table VI.
Success rate (%) by latency period (days), duration (months), and amount of loading (cN)
Authors
Miyawaki et al
Cheng et al4
Liou et al5
Fritz et al6
Park et al7 (2005)
Motoyoshi et al8 (2006)
Park et al9 (2006)
Chen et al10 (2006)
Tseng et al11
Herman et al12
Kuroda et al13
Wiechmann et al14
Motoyoshi et al15 (2007)
Chen et al16 (2007)
Screws (n)
Duration of loading
Force
Success rate
20
29
72
92
32
36
30
124
227
59
45
49
59
14
6
5
55
8
11
133
133
36
98
79
40
\30
30-90
$90
14-28
14
\28
14
Immediate
14
14
1-149
Immediate
#30
.30
12
\200
9
5.3 6 3.2
12.3 6 5.7
6
15
12
100-200
400
\200
\200
\200
100-200
100-200
150
6
6
6
50
100
150
200
100-200
200
200
100-300
85.0
82.8
87.5
91.3
100
70.0
90.0
85.5
91.6
84.7
91.1
61.2
89.8
85.7
83.3
80.0
89.1
75.0
100
76.7
82.0
97.2
85.7
88.6
92.5
Immediate
\30
90
7-28
35-84
$91
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