Do dual-thread orthodontic mini-implants improve bone/tissue mechanical retention?

PURPOSE: The aim of this study was to understand whether the pitch relationship between micro and macro thread designs with a parametrical relationship in a dual-thread mini-implant can improve primary stability. MATERIALS AND METHODS: Three types of mini-implants consisting of single-thread (ST) (0.75 mm pitch in whole length), dual-thread A (DTA) with double-start 0.375 mm pitch, and dual-thread B (DTB) with single-start 0.2 mm pitch in upper 2-mm micro thread region for performing insertion and pull-out testing. Histomorphometric analysis was performed in these specimens in evaluating peri-implant bone defects using a non-contact vision measuring system. RESULTS: The maximum inserted torque (Tmax) in type DTA was found to be the smallest significantly, but corresponding values found no significant difference between ST and DTB. The largest pull-out strength (Fmax) in the DTA mini-implant was found significantly greater than that for the ST mini-implant regardless of implant insertion orientation. Mini-implant engaged the cortical bone well as observed in ST and DTA types. CONCLUSION: Dual-thread mini-implant with correct micro thread pitch (parametrical relationship with macro thread pitch) in the cortical bone region can improve primary stability and enhanced mechanical retention.

Biomechanical evaluation of an orthodontic miniimplant used with revolving (translation and rotation) temporary anchorage device by finite element analysis and experimental testing.

PURPOSE: To evaluate the biomechanical interactions of a miniimplant using a temporary anchorage device (TAD) for orthodontic traction. MATERIALS AND METHODS: A miniimplant was designed with dual thread (DT) with a TAD that can be connected optionally onto the miniimplant with 60-degree switching unit and an extended arm for tying orthodontic wire. Finite element analysis was used to calculate the relative miniimplant displacement and bone strain under immediate load (500 gW) on behalf of the maximum lateral force during orthodontic treatment. The TAD removal forces were measured by pullout testing. RESULTS: Simulated results showed that the maximum von Mises bone strain concentrated at the cervical regions around the miniimplant. The corresponding strain value in DT miniimplant assembled with TAD was greater than those for DT and single-thread implants with 2.24 and 1.73 times, respectively. Small relative miniimplant displacement (<20 µm) was found in all cases. The TAD removal force remained larger than 2 times the finger-pulling force (9.3 N) after 5 repeated removal tests. CONCLUSION: The DT miniimplant connected with TAD can provide translation and rotation features to change the angles and directions of orthodontic tractions for most effective anchorage preparation.

Creating high-resolution 3D cranial implant geometry using deep learning techniques.

Creating a personalized implant for cranioplasty can be costly and aesthetically challenging, particularly for comminuted fractures that affect a wide area. Despite significant advances in deep learning techniques for 2D image completion, generating a 3D shape inpainting remains challenging due to the higher dimensionality and computational demands for 3D skull models. Here, we present a practical deep-learning approach to generate implant geometry from defective 3D skull models created from CT scans. Our proposed 3D reconstruction system comprises two neural networks that produce high-quality implant models suitable for clinical use while reducing training time. The first network repairs low-resolution defective models, while the second network enhances the volumetric resolution of the repaired model. We have tested our method in simulations and real-life surgical practices, producing implants that fit naturally and precisely match defect boundaries, particularly for skull defects above the Frankfort horizontal plane.

Three-dimensional deep learning to automatically generate cranial implant geometry.

We present a 3D deep learning framework that can generate a complete cranial model using a defective one. The Boolean subtraction between these two models generates the geometry of the implant required for surgical reconstruction. There is little or no need for post-processing to eliminate noise in the implant model generated by the proposed approach. The framework can be used to meet the repair needs of cranial imperfections caused by trauma, congenital defects, plastic surgery, or tumor resection. Traditional implant design methods for skull reconstruction rely on the mirror operation. However, these approaches have great limitations when the defect crosses the plane of symmetry or the patient's skull is asymmetrical. The proposed deep learning framework is based on an enhanced three-dimensional autoencoder. Each training sample for the framework is a pair consisting of a cranial model converted from CT images and a corresponding model with simulated defects on it. Our approach can learn the spatial distribution of the upper part of normal cranial bones and use flawed cranial data to predict its complete geometry. Empirical research on simulated defects and actual clinical applications shows that our framework can meet most of the requirements of cranioplasty.

Registration for frameless brain surgery based on stereo imaging.

This paper presents an implementation of stereo vision techniques to capture the geometric model of patient's face for registration in the frameless neurosurgery. A distance transform is applied on 2D CT/MRI multi-slices for on-site registration, further reducing requisite computation. In order to validate accuracy of the system, we designed a phantom to directly measure its target registration error (TRE). Experimental results show that the TRE is 2.72 ± 0.735 mm.

Biomechanical evaluation of an orthodontic mini-implant with plastic removal cap: an in-vitro experimental testing.

This study evaluates the biomechanical interactions of a mini-implant using a plastic revolving cap (PRC) with translation/rotation features for optional orthodontic traction. An orthodontic mini-implant and the PRC consisting of a hexagon connection onto mini-implant with 60 degree switching unit and an extended arm to provide orthodontic wire tied at different positions. The PRC removal force was measured by pull-out testing. The PRC removal force remained larger than three times the finger pulling force (9.3N) after 5 repeated removal tests. The results for the PRC resistant testing showed that the PRC rotational resistant force (20.31±0.83N) is larger than the maximum traction force (about 4.9N) for orthodontic treatment. The mini-implant used with PRC can provide translation and rotation features to change the angles and directions of orthodontic tractions for most effective anchorage preparation under safety consideration.

Application of non-destructive impedance-based monitoring technique for cyclic fatigue evaluation of endodontic nickel-titanium rotary instruments.

This study investigates the application of non-destructive testing based on the impedance theory in the cyclic fatigue evaluation of endodontic Ni-Ti rotary instruments. Fifty Ni-Ti ProTaper instruments were divided into five groups (n=10 in Groups A to E). Groups A to D were subjected to cyclic fatigue within an artificial canal (Group E was the control group). The mean value of the total life limit (TLL), defined as the instrument being rotated until fracture occurred was found to be 104 s in Group A. Each rotary instrument in Groups B, C and D were rotated until the tested instruments reached 80% (84 s), 60% (62 s) and 40% (42 s) of the TLL. After fatigue testing, each rotary instrument was mounted onto a custom-developed non-destructive testing device to give the tip of the instrument a progressive sideways bend in four mutually perpendicular directions to measure the corresponding impedance value (including the resistance and the reactance). The results indicated that the impedance value showed the same trend as the resistance, implying that the impedance was primarily affected by the resistance. The impedance value for the instruments in the 80% and 60% TLL groups increased by about 6 mΩ (about 7.5%) more than that of the instruments in the intact and 40% TLL groups. The SEM analysis result showed that crack striations were only found at the tip of the thread on the cracked surface of the instrument, consistent with the impedance measurements that found the impedance value of the cracked surface to be significantly different from those in other surfaces. These findings indicate that the impedance value may represent an effective parameter for evaluating the micro-structural status of Ni-Ti rotary instruments subjected to fatigue loading.