Comparative evaluation of anchorage reinforcement between orthodontic implants and conventional anchorage in orthodontic management of bimaxillary dentoalveolar protrusion

Abstract

Implants as anchorage, for en masse retraction, can be incorporated into orthodontic practice. The use of orthodontic implants for anchorage is a viable alternative to conventional molar anchorage.

Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis

“…In detail, anchorage loss associated with indirect anchorage and a mid-palatal implant amounted to 1.5 ± 2.6 mm versus 3 ± 3.4 mm [ 5 ], 0.7 ± 0.4 (right molar) and 1.1 ± 0.3 mm (left molar) [ 54 ], 1.73 ± 0.39 mm (horseshoe), and 0.36 ± 0.11 mm (posterior reinforcement) versus 4.21 ± 1.17 mm [ 57 ]. An anchorage loss of 0.2 ± 0.35 mm versus 2.0 mm ± 0.65 mm was also observed in one study employing indirect anchorage using two implants in the alveolar ridge [ 9 ].…”

“…From the studies included in the meta-analysis, two studies were assessed at low risk of bias [ 11 , 49 ], three studies at moderate risk [ 1 , 28 , 50 ], and two at high risk of bias [ 4 , 52 ]. Risk of bias was not judged for the studies included in the qualitative synthesis that either had no control group, employed indirect anchorage (see above, the “ Study selection ” section), had more than one test group, or lacked a non-implant control group [ 5 , 9 , 48 , 54 , 57 ].…”

“…The study samples consisted of patients exhibiting an Angle Class II,1 malocclusion [ 1 , 5 ], patients with an Angle Class I requiring front retraction with maximum anchorage [ 4 ], patients exhibiting dental bi-maxillary protrusion with Angle Class I [ 9 ], patients with a need for extraction of four premolars (one in each quadrant) and maximum anchorage for front retraction [ 28 ], patients in need of extraction of the first upper premolars and front retraction [ 52 ], Angle Class I [ 49 ], patients with Angle Class II,1 with dental protrusion [ 50 ], or either Angle Class I or Class II with dental protrusion [ 11 ].…”

“…Whereas three studies used the Straumann® Ortho (Basel, Switzerland) system and employed loading after 3 months of healing [ 5 , 54 ], one study used either a 2 × 10 mm Dual Top™ (Jeil Medical Corporation, Seoul, South Korea) or a 2.0 × 11 mm BENEFIT® (Mondeal Medical Systems, Mühlheim, Germany) implant and employed immediate loading. One study employed indirect anchorage through a mini implant located in the alveolar ridge [ 9 ] (Table 2 ).…”

“…Extraction of the permanent teeth for retraction of the protruded front teeth is a routine approach in orthodontics. Various techniques such as headgear, Nance button, and transpalatal arches (TPA) have been proposed to achieve sufficient anchorage [ 5 , 8 , 9 , 12 , 28 , 31 , 45 ]. Nevertheless, anchorage control turned out to be highly demanding as the conventional approaches were commonly associated with anchorage loss, i.e., mesial migration of the posterior dental anchorage units.…”