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Histomorphometric analysis of microcrack healing after the installation of mini-implants

  • Shin, Soobin (Department of Orthodontics and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Park, Pan-Soo (Department of Orthodontics and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Baek, Seung-Hak (Department of Orthodontics and Dental Research Institute, Seoul National University School of Dentistry) ;
  • Yang, Il-Hyung (Department of Orthodontics and Dental Research Institute, Seoul National University School of Dentistry)
  • Received : 2015.03.18
  • Accepted : 2015.04.19
  • Published : 2015.04.30

Abstract

Purpose: The goal of this study was to investigate the histomorphometric characteristics of the healing process of microcracks in the cortical bone after the installation of mini-implants (MIs). Methods: Self-drilling MIs were inserted into the tibial diaphysis of twelve adult male New Zealand rabbits. Four MIs per rabbit were placed randomly. The animals were divided into four groups according to the length of the healing period: group A was sacrificed immediately, group B was sacrificed after one week, group C was sacrificed after two weeks, and group D was sacrificed after four weeks. Cortical bone thickness was measured using micro-computed tomography, and histomorphometric analyses of the cumulative length of the microcracks (CLCr) and the total number of microcracks (NCr) were performed using hematoxylin and eosin staining. Results: The microcracks were radially and concentrically aligned in the peri-MI bone. The CLCr decreased significantly one week after the surgery, mainly due to healing of the concentrically aligned microcracks. The CLCr showed another significant decrease from two weeks after the surgery to four weeks after the surgery, mainly reflecting healing of the radially aligned microcracks. A statistically significant decrease in the NCr occurred as the microcracks healed from zero weeks to two weeks. However, no significant difference in the NCr was found between groups C and D. Conclusions: In order to improve the primary stability of MIs, delayed loading and a healing period of a certain length are recommended to ensure the optimal healing of microcracks and bone remodeling.

Keywords

References

  1. Proffit WR, Fields HW. Mechanical principles in orthodontic force control. In: Contemporary orthodontics. 3rd ed. St. Louis (MO): Mosby; 2000. p.326-62.
  2. Carano A, Velo S, Leone P, Siciliani G. Clinical applications of the Miniscrew Anchorage System. J Clin Orthod 2005;39:9-24.
  3. Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-Yamamoto T. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop 2003;124:373-8. https://doi.org/10.1016/S0889-5406(03)00565-1
  4. Cheng SJ, Tseng IY, Lee JJ, Kok SH. A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage. Int J Oral Maxillofac Implants 2004;19:100-6.
  5. Park HS, Jeong SH, Kwon OW. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop 2006;130:18-25. https://doi.org/10.1016/j.ajodo.2004.11.032
  6. Wiechmann D, Meyer U, Buchter A. Success rate of mini-and micro-implants used for orthodontic anchorage: a prospective clinical study. Clin Oral Implants Res 2007;18:263-7. https://doi.org/10.1111/j.1600-0501.2006.01325.x
  7. Brinley CL, Behrents R, Kim KB, Condoor S, Kyung HM, Buschang PH. Pitch and longitudinal fluting effects on the primary stability of miniscrew implants. Angle Orthod 2009;79:1156-61. https://doi.org/10.2319/103108-554R.1
  8. Florvaag B, Kneuertz P, Lazar F, Koebke J, Zoller JE, Braumann B, et al. Biomechanical properties of orthodontic miniscrews. An in-vitro study. J Orofac Orthop 2010;71:53-67. https://doi.org/10.1007/s00056-010-9933-y
  9. Cha JY, Kil JK, Yoon TM, Hwang CJ. Miniscrew stability evaluated with computerized tomography scanning. Am J Orthod Dentofacial Orthop 2010;137:73-9. https://doi.org/10.1016/j.ajodo.2008.03.024
  10. Lee NK, Baek SH. Effects of the diameter and shape of orthodontic mini-implants on microdamage to the cortical bone. Am J Orthod Dentofacial Orthop 2010;138:8.e1-8.
  11. Moon SH, Um HS, Lee JK, Chang BS, Lee MK. The effect of implant shape and bone preparation on primary stability. J Periodontal Implant Sci 2010;40:239-43. https://doi.org/10.5051/jpis.2010.40.5.239
  12. Bartold PM, Kuliwaba JS, Lee V, Shah S, Marino V, Fazzalari NL. Influence of surface roughness and shape on microdamage of the osseous surface adjacent to titanium dental implants. Clin Oral Implants Res 2011;22:613-8. https://doi.org/10.1111/j.1600-0501.2010.02024.x
  13. Shin SY, Shin SI, Kye SB, Chang SW, Hong J, Paeng JY, et al. Bone cement grafting increases implant primary stability in circumferential cortical bone defects. J Periodontal Implant Sci 2015;45: 30-5. https://doi.org/10.5051/jpis.2015.45.1.30
  14. Liu SS, Cruz-Marroquin E, Sun J, Stewart KT, Allen MR. Orthodontic mini-implant diameter does not affect in-situ linear microcrack generation in the mandible or the maxilla. Am J Orthod Dentofacial Orthop 2012;142:768-73. https://doi.org/10.1016/j.ajodo.2012.07.014
  15. Herman BC, Cardoso L, Majeska RJ, Jepsen KJ, Schaffler MB. Activation of bone remodeling after fatigue: differential response to linear microcracks and diffuse damage. Bone 2010;47:766-72. https://doi.org/10.1016/j.bone.2010.07.006
  16. Chapurlat RD, Delmas PD. Bone microdamage: a clinical perspective. Osteoporos Int 2009;20:1299-308. https://doi.org/10.1007/s00198-009-0899-9
  17. Carter DR, Hayes WC. Compact bone fatigue damage: a microscopic examination. Clin Orthop Relat Res 1977:265-74.
  18. Lee TC, Mohsin S, Taylor D, Parkesh R, Gunnlaugsson T, O'Brien FJ, et al. Detecting microdamage in bone. J Anat 2003;203:161-72. https://doi.org/10.1046/j.1469-7580.2003.00211.x
  19. Taing-Watson E, Katona TR, Stewart KT, Ghoneima A, Chu GT, Kyung HM, et al. Microdamage generation by tapered and cylindrical mini-screw implants after pilot drilling. Angle Orthod. Forthcoming 2014.
  20. Yadav S, Upadhyay M, Liu S, Roberts E, Neace WP, Nanda R. Microdamage of the cortical bone during mini-implant insertion with self-drilling and self-tapping techniques: a randomized controlled trial. Am J Orthod Dentofacial Orthop 2012;141:538-46. https://doi.org/10.1016/j.ajodo.2011.12.016
  21. Zar JH. Biostatistical analysis. 2nd ed. Englewood Cliffs (NJ): Prentice Hall International; 1984.
  22. Chugh T, Ganeshkar SV, Revankar AV, Jain AK. Quantitative assessment of interradicular bone density in the maxilla and mandible: implications in clinical orthodontics. Prog Orthod 2013;14:38. https://doi.org/10.1186/2196-1042-14-38
  23. Wang X, Mabrey JD, Agrawal CM. An interspecies comparison of bone fracture properties. Biomed Mater Eng 1998;8:1-9.
  24. Martin RB. Osteonal remodeling in response to screw implantation in canine femora. J Orthop Res 1987;5:445-52. https://doi.org/10.1002/jor.1100050317
  25. Huja SS, Katona TR, Burr DB, Garetto LP, Roberts WE. Microdamage adjacent to endosseous implants. Bone 1999;25:217-22. https://doi.org/10.1016/S8756-3282(99)00151-9
  26. Eraslan O, Inan O. The effect of thread design on stress distribution in a solid screw implant: a 3D finite element analysis. Clin Oral Investig 2010;14:411-6. https://doi.org/10.1007/s00784-009-0305-1
  27. Wu J, Bai YX, Wang BK. Biomechanical and histomorphometric characterizations of osseointegration during mini-screw healing in rabbit tibiae. Angle Orthod 2009;79:558-63. https://doi.org/10.2319/0003-3219(2009)079[0558:BAHCOO]2.0.CO;2
  28. Zhang L, Zhao Z, Li Y, Wu J, Zheng L, Tang T. Osseointegration of orthodontic micro-screws after immediate and early loading. Angle Orthod 2010;80:354-60. https://doi.org/10.2319/021909-106.1
  29. Wang L, Ye T, Deng L, Shao J, Qi J, Zhou Q, et al. Repair of microdamage in osteonal cortical bone adjacent to bone screw. PLoS One 2014;9:e89343. https://doi.org/10.1371/journal.pone.0089343
  30. Schaffler MB. Role of bone turnover in microdamage. Osteoporos Int 2003;14 Suppl 5:S73-7. https://doi.org/10.1007/s00198-003-1477-1
  31. Hazenberg JG, Freeley M, Foran E, Lee TC, Taylor D. Microdamage: a cell transducing mechanism based on ruptured osteocyte processes. J Biomech 2006;39:2096-103. https://doi.org/10.1016/j.jbiomech.2005.06.006
  32. Martin RB. Targeted bone remodeling involves BMU steering as well as activation. Bone 2007;40:1574-80. https://doi.org/10.1016/j.bone.2007.02.023
  33. Parfitt AM. The mechanism of coupling: a role for the vasculature. Bone 2000;26:319-23. https://doi.org/10.1016/S8756-3282(00)80937-0
  34. Eriksen EF. Cellular mechanisms of bone remodeling. Rev Endocr Metab Disord 2010;11:219-27. https://doi.org/10.1007/s11154-010-9153-1

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