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

Abstract

Background/aimRetraction of the upper incisors/canines requires maximum anchorage. The aim of the present study was to analyze the efficacy of mini implants in comparison to conventional devices in patients with need for en masse retraction of the front teeth in the upper jaw.Material and methodsAn electronic search of PubMed, Web of Science, and EMBASE and hand searching were performed. Relevant articles were assessed, and data were extracted for statistical analysis. A random effects model, weighted mean differences (WMD), and 95% confidence intervals (CI) were computed for horizontal and vertical anchorage loss at the first molars in the analyzed patient treatments.ResultsA total of seven RCTs employing direct anchorage through implants in the alveolar ridge were finally considered for qualitative and quantitative analysis, and further five publications were considered for the qualitative analysis only (three studies: indirect anchorage through implant in the mid-palate, two studies: direct/indirect anchorage in the alveolar ridge). In the control groups, anchorage was achieved through transpalatal arches, headgear, Nance buttons, intrusion arches, and differential moments.WMD [95% CI, p] in anchorage loss between test and control groups amounted to − 2.79 mm [− 3.56 to − 2.03 mm, p < 0.001] in the horizontal and − 1.76 mm [− 2.56 to − 0.97, p < 0.001] favoring skeletal anchorage over control measures. The qualitative analysis revealed that minor anchorage loss can be associated with indirect anchorage, whereas anchorage gain was commonly associated with direct anchorage. Implant failures were comparable for both anchorage modalities (direct 9.9%, indirect 8.6%).ConclusionWithin its limitations, the meta-analysis revealed that maximum anchorage en masse retraction can be achieved by orthodontic mini implants and direct anchorage; however, the ideal implant location (palate versus alveolar ridge) and the beneficial effect of direct over indirect anchorage needs to be further evaluated.Electronic supplementary materialThe online version of this article (10.1186/s40729-018-0144-4) contains supplementary material, which is available to authorized users.

A clinical comparative study using anchorage from mini-implants and conventional anchorage methods to retract anterior teeth

“…noticed gain of anchorage with anchorage from mini-implants. [ 19 ] These results were in similar to our study.…”

Can implants move in bone? A longitudinal in vivo micro‐CT analysis of implants under constant forces in rat vertebrae

“…Since the introduction of palatal implants and orthodontic mini‐screws in the mid‐1990s (Kanomi, ; Melsen & Costa, ; Park, Bae, Kyung, & Sung, ; Wehrbein, Glatzmaier, Mundwiller, & Diedrich, ; Wehrbein, Merz, Diedrich, & Glatzmaier, ), skeletal anchorage is increasingly employed to enhance orthodontic anchorage. In recent years, therapeutic advantage could be demonstrated for several indications including en‐masse retraction of the front (Becker, Pliska, et al, ), skeletally anchored protraction of the maxilla in early class III treatments (Meyns, Brasil, Mazzi‐Chaves, Politis, & Jacobs, ; Rodriguez de Guzman‐Barrera et al, ), and for the mesialization and distalization of molars (Becker, Wilmes, Grandjean, Vasudavan, & Drescher, ; Wilmes, Katyal, & Drescher, ).…”

“…demonstrated for several indications including en-masse retraction of the front (Becker, Pliska, et al, 2018), skeletally anchored protraction of the maxilla in early class III treatments (Meyns, Brasil, Mazzi-Chaves, Politis, & Jacobs, 2018;Rodriguez de Guzman-Barrera et al, 2017), and for the mesialization and distalization of molars (Becker, Wilmes, Grandjean, Vasudavan, & Drescher, 2018;Wilmes, Katyal, & Drescher, 2014).…”

Effectiveness of anchorage with temporary anchorage devices during anterior maxillary tooth retraction: A randomized clinical trial

“…In a systematic review published in 2014, Jambi et al23 showed that the mean mesiodistal movement of the upper first permanent molars in the control group ranged from 1.47 to 3.22 mm and was 1.68 mm lower (2.27 to 1.09 mm lower) in the TAD group. Some recent meta-analyses and systematic reviews242526272829 confirmed the efficacy of en masse retraction of the anterior teeth in comparison to conventional anchorage or two-step retraction, with the difference in anchorage loss of around 2.5 mm being in favor of en masse retraction with TADs. In our study, the difference in anchorage loss between the TAD group and conventional anchorage group was significant but at a lower level (0.74 mm).…”