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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.

Show MeSH
Intra-operative positioning of the transfer-jig and the retaining screws after elevation of the gingival tissue.
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Figure 5: Intra-operative positioning of the transfer-jig and the retaining screws after elevation of the gingival tissue.

Mentions: The type of surgical incision is based on the surgical site. In the case presented in FigureĀ 5, an arcuate incision was made with the convex portion directed coronally. Regardless of the incision type, it needs to be ensured that the site where the connection bar of the mini-plates, including the orthodontic attachment, penetrates the gingival tissue is located in the attached gingiva[27].


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

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

Intra-operative positioning of the transfer-jig and the retaining screws after elevation of the gingival tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Intra-operative positioning of the transfer-jig and the retaining screws after elevation of the gingival tissue.
Mentions: The type of surgical incision is based on the surgical site. In the case presented in FigureĀ 5, an arcuate incision was made with the convex portion directed coronally. Regardless of the incision type, it needs to be ensured that the site where the connection bar of the mini-plates, including the orthodontic attachment, penetrates the gingival tissue is located in the attached gingiva[27].

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