Miniscrews failure rate in orthodontics: systematic review and meta-analysis

Alharbi, Fahad; Almuzian, Mohammed; Bearn, David

doi:10.1093/ejo/cjx093

Cited by 111 publications

(69 citation statements)

References 72 publications

(96 reference statements)

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“…Societal costs for treatment with miniscrews would have been even higher if the success rate had been 86.5% as it was recently published in a systematic review. 18 The difference between the success rate in this trial (96%) and the systematic review might be a result from the heterogeneity of data since reviews mix data from different screw types, insertion sites and treatment concepts.…”

Section: Discussionmentioning

confidence: 84%

“…15 Inserted by orthodontists, miniscrews can be loaded and used immediately. 16,17 The failure rate is reported to be at acceptable 86.5% 18 and the experience of pain and discomfort is reported to be comparable to other orthodontic procedures. 19 A recent RCT has shown that miniscrews in comparison to molar blocks delivered significantly superior anchorage reinforcement during space closure (N. Ganzer, I. Feldmann and L. Bondemark, manuscript in preparation).…”

Section: Introductionmentioning

confidence: 90%

See 1 more Smart Citation

A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial

Ganzer

Feldmann

Petrén

et al. 2018

European Journal of Orthodontics

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Objective To analyse cost-effectiveness of anchorage reinforcement with buccal miniscrews and with molar blocks. We hypothesized that anchorage with miniscrews is more cost-effective than anchorage with molar blocks. Trial design A single-centre, two-arm parallel-group randomized controlled trial. Methods Adolescents (age 11-19 years) in need of treatment with fixed appliance, premolar extractions, and en masse retraction were recruited from one Public Dental Health specialist centre. The intervention arm received anchorage reinforcement with buccal miniscrews during space closure. The active comparator received anchorage reinforcement with molar blocks during levelling/alignment and space closure. The primary outcome measure was societal costs defined as the sum of direct and indirect costs. Randomization was conducted as simple randomization stratified on gender. The patients, caregivers, and outcome assessors were not blinded. Results Eighty patients were randomized into two groups. The trial is completed. All patients were included in the intention-to-treat analysis. The median societal costs for the miniscrew group were € 4681 and for the molar block group were € 3609. The median of the difference was € 825 (95% confidence interval (CI) 431-1267). This difference was mainly caused by significantly higher direct costs consisting of material and chair time costs. Differences in chair time costs were related to longer treatment duration. No serious harms were detected, one screw fractured during insertion and three screws were lost during treatment. Generalizability and limitations The monetary variables are calculated based on a number of local factors and assumptions and cannot necessarily be transferred to other countries. Variables such as chair time, number of appointments, and treatment duration are generalizable. Owing to the study protocol, the benefit of miniscrews as a stable anchorage has not been fully utilized. Conclusions When only moderate anchorage reinforcement is needed, miniscrews are less cost-effective than molar blocks. The initial hypothesis was rejected. Miniscrews provide better anchorage reinforcement at a higher price. They should be used in cases where anchorage loss cannot be accepted.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 90%

A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial

Ganzer

Feldmann

Petrén

et al. 2018

European Journal of Orthodontics

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“…Some included articles reported that the installation site, 21 patient age, 20,21 jaw of insertion, 14 and MI length 20 were factors associated with stability. A recent meta-analysis, 30 however, showed that MI diameter, length and design, patient age, and jaw of insertion had little effect on the failure rate. Insertion into attached gingiva was strongly related to higher success rates, whereas smoking was related to failure.…”

Section: Summary Of Evidencementioning

confidence: 98%

Stainless steel or titanium mini-implants?

Mecenas¹,

Espinosa²,

Cardoso³

et al. 2020

The Angle Orthodontist

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Objectives To investigate whether there was a difference in success rates when stainless steel (SS) was compared to titanium mini-implants (MIs) in orthodontic patients. Materials and Methods PubMed, Cochrane, Scopus, Web of Science, Lilacs, Google Scholar, Clinical Trials, and OpenGray were searched without restrictions. A manual search was also performed in the references of the included articles. Studies comparing the success rate between SS and titanium MIs were included. Risk of bias (RoB) was assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool or RoB 2.0 according to the study design. The level of evidence was assessed through GRADE (Grading of Recommendation, Assessment, Development, and Evaluation). Results Six studies met the eligibility criteria. One study was a randomized clinical trial that evaluated extraalveolar MIs, and nonrandomized trials examined interradicular MIs. The RCT presented a low RoB, two nonrandomized trials presented a moderate risk, and three presented a high risk. The quality of the evidence was high for the randomized clinical trial and moderate for the nonrandomized trials. Most studies found no difference between materials, with good success rates for both (SS, 74.6%–100%; titanium: 80.9%–100%) and only one study, with a high RoB, showed a higher success rate with titanium MIs (90%) when compared with SS (50%). A quantitative analysis was not because of the great heterogeneity among the studies. Conclusions Although limited, the current evidence seems to show that the material used is not a major factor in the success rate of MIs. Because it has a lower cost than titanium and presents similar clinical efficiency, SS is a great material for orthodontic MIs.

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“…Wie viele neue Techniken tauchte sie zuerst mit Einzelfallberichten und technischen Publikationen in der Fachliteratur auf. Später wurden retrospektive Daten zu Überlebensraten in Bezug auf Implantationsstellen veröffentlicht, die zwischen 70 und 100 % lagen [25,26]. Schließlich wurden einige prospektiv angelegte klinische Studien veröffentlicht, in denen die skelettale Verankerung mit anderen Arten der konventionellen Verankerung verglichen wurde [27].…”

Section: Skelettale Verankerungunclassified

Evidenzbasierte Medizin: Was ist ihre Bedeutung in der aktuellen kieferorthopädischen Praxis

DiBiase

Cobourne

2019

Inf Orthod Kieferorthop

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ZusammenfassungDer vorliegende Beitrag hat zum Ziel, das Konzept der evidenzbasierten Medizin für die Kieferorthopädie vorzustellen. Dazu werden Geschichte und Philosophie der evidenzbasierten Medizin ebenso diskutiert, wie ihre Implementierung in die tägliche kieferorthopädische Praxis. Der Einfluss der evidenzbasierten Medizin wird dann am Beispiel der Frühbehandlung von Dysgnathien der Klassen III und II, der kieferorthopädischen Bewegung von Zähnen und der skelettalen Verankerung demonstriert. Damit eröffnet sich eine moderne Perspektive auf die bewährtesten Behandlungsverfahren in diesen klinischen Bereichen.

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Miniscrews failure rate in orthodontics: systematic review and meta-analysis

Cited by 111 publications

References 72 publications

A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial

A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents: a randomized controlled trial

Stainless steel or titanium mini-implants?

Evidenzbasierte Medizin: Was ist ihre Bedeutung in der aktuellen kieferorthopädischen Praxis

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