Monocortical versus bicortical hard palate anchorage with the same total available cortical thickness: a finite element study

Mir, Arash Poorsattar-Bejeh

doi:10.1111/jicd.12218

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Another advantage of pre-operative planning with a cone-beam computed tomography is the possibility of planning a bicortical position. Bicortical miniscrews show greater stability, better mechanical results, lower stress and strain values, decreased deformation and fracture [ 14 – 18 ]. Despite the number of studies describing the advantage of a bicortical insertion, studies analyzing the deviations between the planned and positioned TADs often fails to indicate whether insertion was monocortical or bicortical.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of the digital workflow for guided insertion of orthodontic palatal TADs: a step-by-step 3D analysis

et al. 2022

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Background The introduction in the orthodontic field of the digital workflow for guided insertion of palatal TADs and the development of the 1-visit protocol led to the reduction of chair time and the possibility of complete customization of designs and materials. Conversely, the reduction of operative steps implicates a lower tolerance of deviations between the planned and the actual position of the miniscrews, particularly when the orthodontic device is fixed on 4 palatal TADs or has a rigid structure. This study aims to analyze the influence of each step of the digital workflow on the deviation of the miniscrews’ axis of insertion in a bicortical sample. The null hypothesis is that there are no significant differences in the deviations among the operative steps. Methods 33 subjects were selected for insertion of bicortical palatal miniscrews with a 1-visit protocol. Digital files were collected at the three stages of the workflow (i.e., digital planning, laboratory prototype, post-insertion impression). A 3D software analysis was performed on a total of 64 miniscrews. After automatic shape recognition of the guiding holes of the digital plan and the scanbodies of the laboratory prototype and post-insertion impression as geometric cylinders, their three-dimensional longitudinal axis was traced and the deviation among them was calculated. Friedman test with Bonferroni correction was performed to assess the significance of the deviations among the three steps, with significance set at p < 0.05. Results The laboratory step has a significantly lower degree of deviations (2.12° ± 1.62) than both the clinical step (6.23° ± 3.75) and the total deviations (5.70° ± 3.42). No significant differences were found between miniscrews inserted on the left or the right side. Conclusions This study suggests that laboratory procedures such as surgical guide production or rapid prototyping don’t play a significant role in the degree of deviations between the planned and the positioned palatal TADs. Conversely, the clinical steps have a bigger influence and need to be carefully evaluated. Despite this difference, there is a cumulative effect of deviations that can lead to the failure of the 1-visit protocol.

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Section: Introductionmentioning

confidence: 99%

Accuracy of the digital workflow for guided insertion of orthodontic palatal TADs: a step-by-step 3D analysis

et al. 2022

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“… 18 , 19 Recent studies have assessed the effectiveness of monocortical versus bicortical MI anchorage in MSE by evaluating the stress distribution and displacement. 11 , 20 However, this method represents a simulation of clinical situations using virtual 3-dimensional skull models. Meanwhile, CBCT allows the study of the actual pattern of movement of maxillofacial bones, dentoalveolar structures, and MIs by any type of expansion device in 3 dimensions, with minimum image distortion and radiation dosage.…”

Section: Introductionmentioning

confidence: 99%

Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

Paredes,

Gargoum,

Dominguez-Mompell

et al. 2023

Korean J Orthod

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Objective To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT). Methods Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared. Results The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs ( P > 0.05). The posterior MI to hemiplate line was greater than that anteriorly ( P < 0.05). The apical distance between the posterior MIs was greater than that anteriorly ( P < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly ( P > 0.01). Conclusions In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.

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“…This type of appliance seems to considerably reduce the therapeutic indications for the surgically assisted expansion (SARPE) reducing the operational risks of this kind of therapy [ 9 ]. Based on the information available about implant surgery [ 10 , 11 ] and the new concepts of digital odontology [ 12 ], many firms have begun to develop surgical guidance systems to insert the TADS with a greater control over the positioning of the same [ 13 , 14 ], thus guaranteeing bicorticality [ 15 , 16 ] and allowing greater safety of the anatomic structures present. However, these methods still require the taking of an impression that can lead to imprecisions in the manufacture of the devices and do not permit an immediate fitting of the TADs as is usually advised in orthodontics [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite

Aiello

Nucera

Costa

et al. 2021

Case Reports in Dentistry

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Monolateral and bilateral crossbites are amongst the most frequent forms of malocclusion in the world population. The lack of early correction of this type of malocclusion leads to the partial or total ossification of the sutures which then require surgical treatment in adult patients. In recent years, devices on minipalatal screws have noticeably increased the time window in which it is possible to correct these types of alterations. In this case report, we show how it is possible to correct a third-class skeletal malocclusion associated with a posterior bilateral crossbite in a young woman using a rapid expander on miniscrews and fixed orthodontic device to finalise the process. The procedure for the insertion of the palatal screws was aided by the use of a digitally printed surgical guide, and the appliance was applied in the same sitting thanks to the use of a digital flow software and a systematic easy driver. The CBCT scans show how the orthopaedic expansion of the upper maxilla was obtained without any important alterations that damaged the permanent teeth. This case report wishes to demonstrate how easy and predictable it can be to resolve cases of this type with optimal aesthetic and functional results even when body growth has ended.

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Monocortical versus bicortical hard palate anchorage with the same total available cortical thickness: a finite element study

Abstract: Bicortical fixation of hard palate exhibit different reactions to vertical and horizontal tractions.

Cited by 5 publications

References 25 publications

Accuracy of the digital workflow for guided insertion of orthodontic palatal TADs: a step-by-step 3D analysis

Accuracy of the digital workflow for guided insertion of orthodontic palatal TADs: a step-by-step 3D analysis

Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

A Simplified Digital Approach to the Treatment of a Postpuberty Patient with a Class III Malocclusion and Bilateral Crossbite

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