How palatal vault morphology and screw length influence the accuracy of dynamic computer-guided orthodontic miniscrew insertion. A prospective clinical study

Brilli, Davide; Cauli, Isabella; Cassetta, Michele

doi:10.1016/j.jdent.2024.105093

Journal of Dentistry

2024

DOI: 10.1016/j.jdent.2024.105093

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How palatal vault morphology and screw length influence the accuracy of dynamic computer-guided orthodontic miniscrew insertion. A prospective clinical study

Davide Brilli,

Isabella Cauli,

Michele Cassetta

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Cited by 1 publication

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Safety and Accuracy of Guided Interradicular Miniscrew Insertion: A Systematic Review and Meta-Analysis

Santmartí-Oliver,

Jorba-García,

Moya-Martínez

et al. 2024

JCM

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Background: Achieving ideal anchorage is crucial in orthodontics for controlled tooth movement. Miniscrews (MSs) have improved skeletal anchorage, but freehand placement poses risks like root damage and limited precision. Guided techniques, including radiographic guides and computer-assisted methods (static [sCAS] and dynamic [dCAS]), were developed to enhance accuracy and safety. Objective: This systematic review and meta-analysis aimed to evaluate the safety and accuracy of MS placement using different guidance approaches. Materials: A systematic search up to March 2024 identified studies on guided MS insertion, assessing safety (root contact/damage) and accuracy (angular, coronal, and apical deviations) of guided vs. freehand placement. Two reviewers assessed the risk of bias and study quality using RoB 2 for RCTs, NOS for cohort studies, and an adapted tool for pre-clinical studies. Random-effects meta-analysis was performed for studies with common parameters, and safety outcomes were pooled using logit-transformed proportions. Heterogeneity was evaluated with I² and χ² tests. Results: Eleven studies (652 MSs) were included, though no dCAS studies were analyzed. The only RCT had “some concerns” regarding risk of bias, cohort studies ranged from medium to low quality, and most pre-clinical studies had high bias risk. sCAS significantly reduced root damage compared to freehand methods (OR = 0.11; 95% CI: 0.04–0.36; p < 0.001; I² = 1%) and reduced angular and linear deviations. Due to heterogeneity, no quantitative synthesis of accuracy outcomes was performed. Conclusions: sCAS improves the safety and accuracy of MS insertion compared to freehand and radiographic guide methods. These results highlight the clinical benefits of sCAS in orthodontics. Future studies should refine protocols and explore dCAS for further accuracy improvements.

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Safety and Accuracy of Guided Interradicular Miniscrew Insertion: A Systematic Review and Meta-Analysis

Santmartí-Oliver,

Jorba-García,

Moya-Martínez

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

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How palatal vault morphology and screw length influence the accuracy of dynamic computer-guided orthodontic miniscrew insertion. A prospective clinical study

Cited by 1 publication

References 21 publications

Safety and Accuracy of Guided Interradicular Miniscrew Insertion: A Systematic Review and Meta-Analysis

Safety and Accuracy of Guided Interradicular Miniscrew Insertion: A Systematic Review and Meta-Analysis

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