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Fully customized placement of orthodontic miniplates: a novel clinical technique.

Hourfar J, Kanavakis G, Goellner P, Ludwig B - Head Face Med (2014)

Bottom Line: In areas with limited bone availability, mini-plates are preferred to provide effective skeletal anchorage.This significantly reduces the duration of the surgical procedure and improves its outcome.The technique facilitates accurate adaptation of mini-plates and insertion of retaining surgical screws; thereby enabling clinicians to more confidently increase the use of bone plates, especially in anatomical areas where the success of non-osseointegrated mini-screws is less favorable.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthodontics and Dentofacial Orthopedics, Tufts University School of Dental Medicine, 1 Kneeland Street DHS#1145, Boston, MA, USA. gkanavak@gmail.com.

ABSTRACT

Introduction: The initial stability and survival rate of orthodontic mini-implants are highly dependent on the amount of cortical bone at their insertion site. In areas with limited bone availability, mini-plates are preferred to provide effective skeletal anchorage. The purpose of this paper was to present a new clinical technique for the insertion of mini-plates.

Methods: In order to apply this new technique, a cone-beam image of the insertion area is required. A software (Galaxy Sirona, Bensheim, Germany) is used to construct a three-dimensional image of the scanned area and to virtually determine the exact location of the mini-plate as well as the position of the fixation screws. A stereolithographic model (STL) is then created by means of a three-dimensional scanner.Prior to its surgical insertion, the bone plate is adapted to the stereo-lithographic model. Finally, a custom transfer jig is fabricated in order to assist with accurate placement of the mini-plate intra-operatively.

Results: The presented technique minimizes intra-operative decision making, because the final position of the bone plate is determined pre-surgically. This significantly reduces the duration of the surgical procedure and improves its outcome.

Conclusions: A novel method for surgical placement of orthodontic mini-plates is presented. The technique facilitates accurate adaptation of mini-plates and insertion of retaining surgical screws; thereby enabling clinicians to more confidently increase the use of bone plates, especially in anatomical areas where the success of non-osseointegrated mini-screws is less favorable.

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Diagrammatic sequence of steps for the proposed technique.
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Figure 1: Diagrammatic sequence of steps for the proposed technique.

Mentions: The proposed technique begins with virtual planning of the surgical procedure and the creation of a stereo-lithographic model as well as a drill guide. The orthodontic mini-plates are then adapted with the aid of the drill guide to the model and a transfer jig is fabricated. The jig is subsequently used to accurately position the plates during the surgical procedure. A schematic overview of all stages of the technique is displayed in FigureĀ 1.


Fully customized placement of orthodontic miniplates: a novel clinical technique.

Hourfar J, Kanavakis G, Goellner P, Ludwig B - Head Face Med (2014)

Diagrammatic sequence of steps for the proposed technique.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4016661&req=5

Figure 1: Diagrammatic sequence of steps for the proposed technique.
Mentions: The proposed technique begins with virtual planning of the surgical procedure and the creation of a stereo-lithographic model as well as a drill guide. The orthodontic mini-plates are then adapted with the aid of the drill guide to the model and a transfer jig is fabricated. The jig is subsequently used to accurately position the plates during the surgical procedure. A schematic overview of all stages of the technique is displayed in FigureĀ 1.

Bottom Line: In areas with limited bone availability, mini-plates are preferred to provide effective skeletal anchorage.This significantly reduces the duration of the surgical procedure and improves its outcome.The technique facilitates accurate adaptation of mini-plates and insertion of retaining surgical screws; thereby enabling clinicians to more confidently increase the use of bone plates, especially in anatomical areas where the success of non-osseointegrated mini-screws is less favorable.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthodontics and Dentofacial Orthopedics, Tufts University School of Dental Medicine, 1 Kneeland Street DHS#1145, Boston, MA, USA. gkanavak@gmail.com.

ABSTRACT

Introduction: The initial stability and survival rate of orthodontic mini-implants are highly dependent on the amount of cortical bone at their insertion site. In areas with limited bone availability, mini-plates are preferred to provide effective skeletal anchorage. The purpose of this paper was to present a new clinical technique for the insertion of mini-plates.

Methods: In order to apply this new technique, a cone-beam image of the insertion area is required. A software (Galaxy Sirona, Bensheim, Germany) is used to construct a three-dimensional image of the scanned area and to virtually determine the exact location of the mini-plate as well as the position of the fixation screws. A stereolithographic model (STL) is then created by means of a three-dimensional scanner.Prior to its surgical insertion, the bone plate is adapted to the stereo-lithographic model. Finally, a custom transfer jig is fabricated in order to assist with accurate placement of the mini-plate intra-operatively.

Results: The presented technique minimizes intra-operative decision making, because the final position of the bone plate is determined pre-surgically. This significantly reduces the duration of the surgical procedure and improves its outcome.

Conclusions: A novel method for surgical placement of orthodontic mini-plates is presented. The technique facilitates accurate adaptation of mini-plates and insertion of retaining surgical screws; thereby enabling clinicians to more confidently increase the use of bone plates, especially in anatomical areas where the success of non-osseointegrated mini-screws is less favorable.

Show MeSH