• The korean journal of orthodontics
• /
• v.52 no.3
• /
• pp.182-200
• /
• 2022

Objective: This study aims to examine the effectiveness of miniscrew assisted rapid palatal expansion (MARPE) treatment in late adolescents and adult patients using cone-beam computed tomography (CBCT). Methods: Literature search was conducted in five electronic databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) based on the PICOS keyword design focusing on MARPE. Out of the 18 CBCT screened outcomes, only nine parameters were sufficient for the quantitative meta-analysis. The parameters were classified into three main groups: 1) skeletal changes, 2) alveolar change, and 3) dental changes. Heterogeneity test, estimation of pooled means, publication bias, sensitivity analysis and risk of bias assessment were also performed. Results: Upon database searching, only 14 full-text articles were qualified from the 364 obtained results. Heterogeneity test indicated the use of the random-effects model. The pooled mean estimate were as follows: 1) Skeletal expansion: zygomatic width, 2.39 mm; nasal width, 2.68 mm; jugular width, 3.12 mm; and midpalatal suture at the posterior nasal spine and anterior nasal spine, 3.34 mm and 4.56 mm, respectively; 2) Alveolar molar width expansion, 4.80 mm; and 3) Dental expansion: inter-canine width, 3.96 mm; inter-premolar width, 4.99 mm and inter-molar width, 5.99 mm. The percentage of expansion demonstrated a skeletal expansion (PNS) of 55.76%, alveolar molar width expansion of 24.37% and dental expansion of 19.87%. Conclusions: In the coronal view, the skeletal and dental expansion created by MARPE was of the pyramidal pattern. MARPE could successfully expand the constricted maxilla in late adolescents and adult patients.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.2
• /
• pp.203-211
• /
• 2008

Minimizing damage to anatomical structure is a prerequisite for skeletal anchorage system to install a miniscrew. This research has focused on evaluating the stability and safety of installation in the maxillary molar buccal area, in which most miniscrews are installed clinically and initial fixation is weak. CT (computerized tomography)images were taken for surveying the possibility of damaging to adjucent teeth in accordance with installation angle. If we install a mini-screw($1.2{\times}6.0mm$) in the maxillary molar buccal area, it would be located generally in the 5~8mm upper of CEJ and 3~5mm inner of the cortical bone surface. We has measured the space between roots And comparison has been made for gender and the space between roots in accordance with the 3 different angles of installation(30 degree, 40 degree, 60 degree) in 3 categories. Category 1 : between 1st molar and 2nd molar Category 2 : between 1st molar and 2nd premolar Category 3 : between 1st premolar and 2nd premolar The result are as follow; 1. The space for category 1 was significantly small. 2. For the installation angle, it was safer to install with steeper angle in category 1 and category 2, but not in category 3. According to these results, the installation a miniscrew in category 2, 3 is safer than in category 1. And it is safer to install with steeper angle in category 1 and category 2.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.38 no.3
• /
• pp.250-259
• /
• 2011

The aim of this study was to suggest a design for an orthodontic miniscrew which may work most favorably in the thin cortical bone of the adolescent. In this study, orthodontic miniscrews with different diameters, lengths, and body types were manufactured and implanted in two artificial bone samples with different cortical bone thickness. Maximum insertion torque, maximum removal torque, and lateral alteration torque were measured. As a result, the bone quality, body type, diameter, and the length all had their effects on the maximum insertion torque, maximum removal torque, and lateral alteration torque. Cortical bone thickness was the most important factor. In initial stability, conical types showed better results than cylindrical types. Increase in the diameter had favorable effects in achieving mechanical stability. Increase in the length did not have as much influence as the other factors did on the initial stability, but there was a statistically significant difference between screws of 6 mm and 8 mm lengths(p<0.05). In conclusion, the conical type screw with a diameter of 1.8 mm is most favorable in the thin cortical bone of the adolescent. In terms of length, the 8 mm screw is expected to perform better than the 6 mm screw.

• The korean journal of orthodontics
• /
• v.39 no.6
• /
• pp.354-361
• /
• 2009

Objective: Miniscrews are widely used in orthodontic treatment for the purpose of anchorage control. Maximum anchorage can be acquired by the use of miniscrews. Maxillary miniscrew has many clinical advantage for orthodontic treatment. Maxillary sinus, tooth root can be an obstacle for maxillary miniscrew installation. The purpose of this study was to find the safest area and direction of miniscrew insertion in consideration of the maxillary sinus. Methods: The maxillary sinus area of 40 patients (20 male, 20 female) was measured using 3D computed tomography and 3D reconstruction program. Results: The maxillary sinus floor was located most inferiorly between the 1st molar and 2nd molar and located most superiorly between the 1st premolar and 2nd premolar. Buccal bone thickness from the maxillary sinus is significantly thicker between the 1st molar and 2nd molar and significantly thinner between the 1st premolar and 2nd premolar. The area between the 1st premolar and 2nd premolar has a significantly longer vertical distance from CEJ to sinus in consideration of buccal bone thickness. Conclusions: Considering maxillary bone thickness, the posterior area has advantages over the anterior area for installing miniscrews safely and preventing perforation.

• The korean journal of orthodontics
• /
• v.46 no.1
• /
• pp.55-61
• /
• 2016

Skeletal anchorage-assisted upper molar distalization has become one of the standard treatment modalities for the correction of Class II malocclusion. The purpose of this study was to analyze maxillary molar movement patterns according to appliance design, with the simultaneous use of buccal fixed orthodontic appliances. The authors devised two distinct types of midpalatal miniscrew-assisted maxillary molar distalizers, a lingual arch type and a pendulum type. Fourteen patients treated with one of the two types of distalizers were enrolled in the study, and the patterns of tooth movement associated with each type were compared. Pre- and post-treatment lateral cephalograms were analyzed. The lingual arch type was associated with relatively bodily upper molar distalization, while the pendulum type was associated with distal tipping with intrusion of the upper molar. Clinicians should be aware of the expected tooth movement associated with each appliance design. Further well designed studies with larger sample sizes are required.

• The korean journal of orthodontics
• /
• v.42 no.3
• /
• pp.144-154
• /
• 2012

This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

• The korean journal of orthodontics
• /
• v.51 no.3
• /
• pp.217-227
• /
• 2021

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

• The korean journal of orthodontics
• /
• v.41 no.4
• /
• pp.280-287
• /
• 2011

Objective: This study compared the stability of cylindrical miniscrews (Cy, 7 mm in length) with that of tapered miniscrews (Ta, 5 mm in length), using torque values to determine if the healing time before loading affects the stability of the miniscrew and if the insertion torque is associated with the removal torque measured after a few weeks of healing. Methods: Ta and Cy with different thread lengths were placed in the tibias of 12 female New Zealand white rabbits (body weight: 3.0 - 3.5 kg), and the maximum insertion torque values (ITV) were measured. No orthodontic forces were applied so as to allow us to determine the pure effects of the different shapes. After 3 different healing periods (2, 4, and 6 weeks), maximum removal torque values (RTV) were measured immediately before the rabbits were sacrificed. Results: No miniscrews were loosened. There were no significant differences in ITV or RTV between the Ta and Cy nor were there any significant differences in the ITV and RTV between the 3 groups, which had different healing periods. There was a correlation between the ITV and RTV. Conclusions: Shorter Ta showed similar stability as Cy, as determined by torque values. This result strongly suggests that the tapered shape is more advantageous than the cylindrical shape. The RTV did not increase significantly over time. It is recommended that a miniscrew be loaded immediately; waiting a few weeks before loading should be avoided. The correlation between the ITV and RTV suggests that the ITV can be used to estimate a screw's future stability.

• The korean journal of orthodontics
• /
• v.41 no.6
• /
• pp.384-398
• /
• 2011

Objective: The purpose of this study was to analyze the stress distribution and the displacement pattern of mandibular anterior teeth under various intrusive force vectors according to the position of orthodontic miniscrews and hooks, using three-dimensional finite element analysis. Methods: A three-dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament, and alveolar bone. The displacement of individual tooth on three-dimensional planes and the von Mises stress distribution were compared when various intrusion force vectors were applied. Results: Intrusive forces applied to 4 mandibular anterior teeth largely resulted in remarkable labial tipping of the segment according to the miniscrew position. All 6 mandibular anterior teeth were labially tipped and the stress concentrated on the labiogingival area by intrusive force from miniscrews placed mesial to the canine. The distointrusive force vector led to pure intrusion and the stress was evenly distributed in the whole periodontal ligament when the hook was placed between the central and lateral incisors and the miniscrew was placed distal to the canine. Conclusions: Within the limits of this study, it can be concluded that predictable pure intrusion of the 6 anterior teeth segment may be accomplished using miniscrews placed distal to the canine and hooks located between the central and lateral incisors.

• The korean journal of orthodontics
• /
• v.45 no.1
• /
• pp.3-12
• /
• 2015

Objective: We compared the skeletal and dental changes that resulted from the use of two methods of intermaxillary fixation (IMF)-miniscrews and surgical archwire-in 74 adult patients who had Class III malocclusion and were treated with the same orthognathic surgical procedure at a hospital in Korea. Methods: All the patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with rigid fixation. They were divided into two groups according to the type of IMF used-group 1 underwent surgical archwire fixation and group 2 underwent orthodontic miniscrew fixation. In a series of cephalograms for each patient, we compared vertical and horizontal tooth-position measurements: (a) immediately after surgery ($T_0$), (b) 3 months after surgery ($T_1$), and (c) 6 months after surgery ($T_2$). Cephalometric changes within each group were examined using one-way analysis of variance (ANOVA) while the independent samples t -test procedure was used to compare the two groups. Results: After surgery, the maxillary incisors tended to be proclined in both groups although there were no significant differences. Incisor overbite increased significantly in both groups from $T_0$ to $T_1$, and the miniscrew group (group 2) showed slightly greater overbite than the archwire group (group 1). Conclusions: This study suggest that the use of orthodontic miniscrews and orthodontic surgical archwire for IMF in adult patients results in similar skeletal and dental changes.