Assessment of the Mandibular Buccal Shelf for Safe Miniscrew Insertion in Teenagers and Adults: A Cone-Beam Computed Tomography Study
Journal of Dental School, Shahid Beheshti University of Medical Sciences,
Vol. 38 No. 3 (2020),
12 October 2021
,
Page 97-103
https://doi.org/10.22037/jds.v38i3.34970
Abstract
Objectives This study assessed the mandibular buccal shelf (MBS) for safe miniscrews insertion in teenagers and adults.
Methods Cone-beam computed tomography (CBCT) images of 30 teenagers and 30 adults were used to measure bone width and cortical bone thickness. Measurements were made at four sites buccal to the distobuccal cusp of mandibular 1st molar (D6), and mesiobuccal cusp (MB7), an area at the center of the bifurcation (Mid7), and distobuccal cusp (DB7) of mandibular second molar. Bone width was measured at four distances (4, 6, 8, and 10 mm) from the (CEJ). ANOVA was used for statistical analysis.
Results The MBS was significantly different within each age group and in different age groups, tooth sites, distances from the CEJ, and cortical bone thicknesses (P<0.001). A significant difference was detected in bone width between the two age groups in D6 at all distances from the CEJ, MB7 and Mid7 at 4 mm and 6 mm, and DB7 at 4 mm from the CEJ (P<0.05). Cortical bone thickness was significantly different between the two groups at MB7, Mid7, and DB7 (P<0.05).
Conclusion All distances from the CEJ at DB7 offered adequate bone width for safe miniscrew implantation. Mid7 showed suitable bone width at all distances from the CEJ in teenagers. In adults, miniscrews should be implanted at 6 mm from the CEJ. Miniscrews should be inserted in at least 8 mm distance from the CEJ at MB7. D6 is unsafe for miniscrew insertion in both groups at all distances from the CEJ.
- Miniscrew
- Mandibular buccal shelf (MBS)
- Cone-beam computed tomography (CBCT)
- Bone width
- Cortical bone thickness (C)
- NNT software
How to Cite
References
Park H-S, Jeong S-H, Kwon O-W. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2006;130(1):18-25.
Yu, Hyung Seog. Understanding Implant Sites for TADs. In: Park, Jae Hyun. Temporary Anchorage Devices in Clinical Orthodontics. first ed: John Wiley & Sons, Inc. 2020; Chap11: 91-98.
Park J, Cho HJ. Three-dimensional evaluation of interradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults. Am J Orthod Dentofacial Orthop. 2009;136(3):314.e1-12.
Kravitz ND, Kusnoto B. Risks and complications of orthodontic miniscrews. Am J Orthod Dentofacial Orthop. 2007;131(4 Suppl):S43-51.
Baumgaertel S, Hans MG. Buccal cortical bone thickness for mini-implant placement.
Am J Orthod Dentofacial Orthop. 2009;136(2):230-5.
Nucera R, Bellocchio AM, Oteri G, Farah AJ, Rosalia L, Giancarlo C, et al. Bone and cortical bone characteristics of mandibular retromolar trigone and anterior ramus region for miniscrew insertion in adults. Am J Orthod Dentofacial Orthop. 2019;155(3):330-8.
Elshebiny T, Palomo JM, Baumgaertel S. Anatomic assessment of the mandibular buccal shelf for miniscrew insertion in white patients. Am J Orthod Dentofacial Orthop. 2018;153(4):505-11.
Wilmes B, Rademacher C, Olthoff G, Drescher D. Parameters affecting primary stability of orthodontic mini-implants. J Orofac Orthop. 2006;67(3):162-74.
Marquezan M, Mattos CT, Sant'Anna EF, de Souza MMG, Maia LC. Does cortical thickness influence the primary stability of miniscrews?: a systematic review and meta-analysis. Angle Orthod. 2014;84(6):1093-103.
Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J Orthod. 2018;40(5):519-30.
Zawawi KH. Acceptance of orthodontic miniscrews as temporary anchorage devices. Patient Prefer Adherence. 2014;8:933-7.
Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop. 2012;142(5):577-95.e7.
Baumgaertel S. Cortical bone thickness and bone depth of the posterior palatal alveolar process for mini-implant insertion in adults. Am J Orthod Dentofacial Orthop. 2011;140(6):806-11.
Kau, Chung H. TADs and Successful Clinical Outcomes. In: Park, Jae Hyun. Temporary Anchorage Devices in Clinical Orthodontics. first ed: John Wiley & Sons, Inc. 2020; Chap8: 69-76.
Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745-51.
Parinyachaiphun S, Petdachai S, Chuenchompoonut V. Considerations for placement of mandibular buccal shelf orthodontic anchoring screw in Class III hyperdivergent and normodivergent subjects–A cone beam computed tomography study. Orthod Waves. 2018;77(1):44-56.
Landin M, Jadhav A, Yadav S, Tadinada A. A comparative study between currently used methods and Small Volume-Cone Beam Tomography for surgical placement of mini implants. Angle Orthod. 2015;85(3):446-53.
Kim S-H, Kang S-M, Choi Y-S, Kook Y-A, Chung K-R, Huang JC. Cone-beam computed tomography evaluation of mini-implants after placement: is root proximity a major risk factor for failure? Am J Orthod Dentofacial Orthop. 2010;138(3):264-76.
Nakajima A, Sameshima GT, Arai Y, Homme Y, Shimizu N, Dougherty Sr H. Two-and three-dimensional orthodontic imaging using limited cone beam–computed tomography. Angle Orthod. 2005;75(6):895-903.
Cassetta M, Stefanelli LV, Pacifici A, Pacifici L, Barbato E. How accurate is CBCT in measuring bone density? A comparative CBCT‐CT in vitro study. Clin Implant Dent Relat Res.. 2014;16(4):471-8.
Ono A, Motoyoshi M, Shimizu N. Cortical bone thickness in the buccal posterior region for orthodontic mini-implants.Int J Oral Maxillofac Surg. 2008 Apr;37(4):334-40. 2008;37(4):334-40.
Kuroda S, Yamada K, Deguchi T, Hashimoto T, Kyung H-M, Yamamoto TT. Root proximity is a major factor for screw failure in orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2007;131(4 Suppl):S68-73.
Chang C, Liu SS, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod. 2015;85(6):905-10.
Baumgaertel S. Quantitative investigation of palatal bone depth and cortical bone thickness for mini-implant placement in adults. Am J Orthod Dentofacial Orthop. 2009;136(1):104-8.
Escobar-Correa N, Ramírez-Bustamante MA, Sánchez-Uribe LA, Upegui-Zea JC, Vergara-Villarreal P, Ramírez-Ossa DM. Evaluation of mandibular buccal shelf characteristics in the Colombian population: A cone-beam computed tomography study. Korean J Orthod. 2021;51(1):23-31.
Kolge NE, Patni VJ, Potnis SS. Tomographic mapping of buccal shelf area for optimum placement of bone screws: A three-dimensional cone-beam computed tomography evaluation. APOS Trends Orthod 2019;9(4):241-5.
Gandhi V, Upadhyay M, Tadinada A, Yadav S. Variability associated with mandibular buccal shelf area width and height in subjects with different growth pattern, sex, and growth status. Am J Orthod Dentofacial Orthop. 2021;159(1):59-70.
Farnsworth D, Rossouw PE, Ceen RF, Buschang PH. Cortical bone thickness at common miniscrew implant placement sites. Am J Orthod Dentofacial Orthop. 2011;139(4):495-503.
Motoyoshi M, Inaba M, Ono A, Ueno S, Shimizu N. The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone. Int J Oral Maxillofac Surg. 2009;38(1):13-8.
Tsunori M, Mashita M, Kasai K. Relationship between facial types and tooth and bone characteristics of the mandible obtained by CT scanning. Angle Orthod. 1998;68(6):557-62.
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