Three-dimensional evaluation of interradicular areas and cortical bone thickness for orthodontic miniscrew implant placement using cone-beam computed tomography

Abstract

A BSTRACT Background: Factors that influence anchorage of the orthodontic miniscrew implants are interradicular areas and cortical bone thickness. Aims and Objectives: The aim of this study was to evaluate the three-dimensional interradicular areas and the buccal cortical bone thickness in Indian patients using cone beam computed tomography (CBCT) images, and to find the suitable and safe sites for orthodontic miniscrew implant placement. Materials and Methods: CBCT images of 20 patients were divided into three planes as axial, coronal, and sagittal. Measurements, that is, mesiodistal distance and buccal cortical bone thickness were taken at five different heights from the cementoenamel junction (CEJ) toward apical region. Results: In the maxilla, the safe sites for placing miniscrew implant were between the second premolar and first molar at 10-mm height, whereas in the mandible, the safe sites for placing miniscrew implant were between the first and second premolar at 6-, 8-, and 10-mm height, between the second premolar and first molar at 10-mm height, and between the first and second molar at 8- and 10-mm height. Conclusion: CBCT can be effectively used to evaluate interradicular areas and cortical bone thickness in predicting the safe and suitable sites for placing orthodontic miniscrew implants.

Interradicular distance and alveolar bone thickness for miniscrew insertion: a CBCT study of Persian adults with different sagittal skeletal patterns

“…With respect to the importance of inter-radicular distance in miniscrew placement, Mohammed et al [ 19 ] reported the lower clinical success rate of interradicular mini-screws due to their contact with the roots. A minimum of 1 mm clearance from the alveolar bone around the miniscrew has been suggested for periodontal health [ 7 ]. Thus, the interradicular distance should be > 3 mm for miniscrew placement [ 30 , 31 ].…”

“…Miniscrews, as the providers of skeletal anchorage, are gaining increasing popularity among orthodontists due to advantages such as provision of excellent anchorage, easy placement and retrieval, low cost, and small size [ 1 , 4 – 6 ]. Nonetheless, miniscrews may become loose in the course of orthodontic treatment [ 5 , 7 ]. Thus, their primary stability is a key factor in their success rate [ 8 ].…”

“…Adequate bone is required for placement of miniscrews with the desired length to prevent perforation of the maxillary sinus or the nasal cavity [ 11 ]. Evidence shows that cortical bone thickness may be the most important factor in stability of miniscrews [ 7 , 10 ]. The primary stability of miniscrews is significantly correlated with the trabecular bone thickness, indicating the significance of trabecular bone in miniscrew stability [ 12 ].…”

“…The majority of the available literature regarding miniscrews have focused on their morphological parameters such as type, shape, diameter, and length, or assessed different anatomical sites for safe placement of miniscrews in inter-radicular spaces in the maxilla and mandible, reporting controversial results [ 2 , 7 , 11 , 13 – 20 ]. A previous study discussed that vertical skeletal pattern can serve as an important factor in success of miniscrew placement in the posterior buccal areas [ 21 ].…”

A User-Friendly Protocol for Mandibular Segmentation of CBCT Images for Superimposition and Internal Structure Analysis

“…As early as 2010, Nalçaci et al demonstrated that 3D cephalometric approaches are fairly reliable and comparable with traditional 2D cephalometry [ 1 ]. In addition, a growing body of evidence continues to demonstrate the application of CBCT in orthodontics as a front-line technology development topic [ 2 , 3 , 4 , 5 , 6 , 7 ]. However, the radiation exposure of cranial CBCTs is still not acceptable in most orthodontic patients, even though the dosage is dramatically reduced compared to when CBCT technology was first applied to orthodontics.…”