CAD-CAM–fabricated mini-implant insertion guides for the delivery of a distalization appliance in a single appointment

Abstract

This article reports on the technical aspects of using a computer-aided design-computer-aided manufacturing (CAD-CAM) insertion guide for the placement of orthodontic mini-implants used for the purpose of providing anchorage support for maxillary molar distalization. A 10-year-old girl presented with a bilateral full-step Angle Class II molar relationship in the permanent dentition, with anterior arch-length insufficiency and blocked out maxillary canine teeth. The primary treatment objective was to provide an esthetic and functional occlusal outcome, and secondarily to avoid the removal of multiple premolar teeth. The patient was initially treated with an implant-supported distalization device, and the occlusion was subsequently detailed with preadjusted fixed orthodontic appliances. The CAD-CAM procedure facilitates the safe and precise insertion of miniimplants in the anterior palate, potentially broadening the scope of use of palatal mini-implants for less experienced clinicians. The illustrated protocol allows for the insertion of mini-implants and fitting of a prefabricated appliance in a single office appointment.

Guided Insertion of Temporary Anchorage Device in Form of Orthodontic Titanium Miniscrews with Customized 3D Templates—A Systematic Review with Meta-Analysis of Clinical Studies

“…The number of articles included may appear small given the overall literature on guided mini-implant insertion [34][35][36][37][38][39][40][41][42]. However, most papers are based on a very limited numbers of cases and lack appropriate control groups to adequately assess the potential benefits of using 3D surgical guides [18][19][20][21][22][23][24][43][44][45][46]. It should be taken into account that guide fabrication makes guided mini-implant procedures more expensive and more time-consuming than direct manual insertion.…”

Suitability of virtual plaster models superimposed with the lateral cephalogram for guided paramedian orthodontic mini-implant placement with regard to the bone support

“…De Gabriele et al superimposed a plaster cast on a CBCT image to identify optimal sites for mini-implant placement in the anterior hard palate [7]. In this context, Wilmes et al reported that superimposition with lateral cephalometric radiographs is also possible [27]. After virtual placement planning, a surgical insertion guide, called Easy Driver, was produced by rapid prototyping, which allowed for insertion through the guide using a special contra-angle screwdriver.…”

“…In this context, Wilmes et al demonstrated the possibility of superimposition with lateral cephalograms [27]. Cassetta et al performed postoperative CBCT after OMI placement and compared results with preoperative planning.…”

“…In this context, Wilmes et al. demonstrated the possibility of superimposition with lateral cephalograms [ 27 ]. Cassetta et al.…”

A 3D finite element analysis of maxillary molar distalization using unilateral zygoma gear and asymmetric headgear

“…8,9 To overcome the loss of anchorage produced by intraoral appliances, temporary skeletal anchorage devices were placed palatally to support these appliances. [10][11][12][13] In addition, a new appliance called a zygoma gear, consisting of titanium plates placed in the zygomatic process of the maxilla, was described for bilateral maxillary molar distalization without inducing anchorage loss or depending on patient compliance. 14 Several studies have reported the treatment effects of this approach.…”