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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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Virtual planning of screw position. (a) Buccal view, (b) Lingual view.
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Figure 2: Virtual planning of screw position. (a) Buccal view, (b) Lingual view.

Mentions: In order to perform all pre-surgical preparations, a cone-beam computed tomography (CT) scan of the patient is required. Dedicated software (Galaxis, Sirona, Bensheim, Germany) is used to construct a three-dimensional image of the scanned area and determine the preferred position of the mini-plate and the fixation screws (FigureĀ 2a and b)[32]. The software provides the option of virtually placing the screws in the selected area of bone and allows the clinician to accurately visualize the desired result prior to surgery. In cases, for example, where space closure mechanics are designed to protract the posterior dentition, the mini-plate is placed in the area between the canine and the first premolar.


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

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

Virtual planning of screw position. (a) Buccal view, (b) Lingual view.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Virtual planning of screw position. (a) Buccal view, (b) Lingual view.
Mentions: In order to perform all pre-surgical preparations, a cone-beam computed tomography (CT) scan of the patient is required. Dedicated software (Galaxis, Sirona, Bensheim, Germany) is used to construct a three-dimensional image of the scanned area and determine the preferred position of the mini-plate and the fixation screws (FigureĀ 2a and b)[32]. The software provides the option of virtually placing the screws in the selected area of bone and allows the clinician to accurately visualize the desired result prior to surgery. In cases, for example, where space closure mechanics are designed to protract the posterior dentition, the mini-plate is placed in the area between the canine and the first premolar.

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