Temporary replacement of missing maxillary lateral incisors with orthodontic miniscrew implants in growing patients: rationale, clinical technique, and long-term results.

The missing maxillary lateral incisor in adolescent patients presents an orthodontic challenge. Historically, there have been three treatment options to address this clinical problem: (1) canine substitution, (2) tooth auto-transplantation, and (3) dental restoration. Unfortunately, these methods are not without limitation. A novel treatment concept, originating in 2003 and utilizing orthodontic miniscrew implants, is presented along with the rationale, clinical technique and 8 years of follow-up.

Distalization of the mandibular dentition with mini-implants to correct a Class III malocclusion with a midline deviation.

This article describes the orthodontic treatment for a young woman, aged 23 years 5 months, with a Class III malocclusion and a deviated midline. Two orthodontic mini-implants (C-implants, CIMPLANT Company, Seoul, Korea) were placed in the interdental spaces between the mandibular second premolars and first molars. The treatment plan consisted of distalizing the mandibular dentition asymmetrically and creating space for en-masse retraction of the mandibular anterior teeth. C-implants were placed to provide anchorage for Class I intra-arch elastics. The head design of the C-implant minimizes gingival irritation during orthodontic treatment. Sliding jigs were applied buccally for distalization of the mandibular posterior teeth. The active treatment period was 18 months. Normal overbite and overjet were obtained, and facial balance was improved.

Experimental evaluation of tooth movement in the beagle dog with the mini-screw implant for orthodontic anchorage.

INTRODUCTION: The purposes of this study were to evaluate the stability of mini-screw implants (MSIs) and tooth movements in relation to the timing, amount, and location of force application. Additionally, clinical measurements of peri-implant health were recorded to determine predictors for MSI failure. METHODS: A randomized split-mouth design was used in 7 skeletally mature male beagle dogs. All third premolars were extracted to facilitate retraction of the second premolars via sectional orthodontic appliances. In the maxilla, the effect of delayed vs immediate loading was tested under constant force (25 g). In the mandible, the effect of force level (25 vs 50 g) was tested on immediately loaded MSIs. All experimental MSIs had a corresponding unloaded control. Clinical records and measurements of tooth movement were taken at specified intervals. RESULTS: The overall success rate of the implants was 93% with no significant effects of timing, amount, or location of force applied. Peri-implant tissue health was not predictive of MSI failure. The maxillary and the mandibular second premolars were moved 3.3 +/- 1.0 and 3.8 +/- 1.3 mm, respectively. No significant differences in tooth movement were observed between immediate and delayed loading, at either 25 or 50 g or force, or between the maxilla and the mandible. CONCLUSIONS: These results support the notion that immediate MSI loading with light forces (25 and 50 g) can be accomplished with high rates of success, producing clinically relevant amounts of tooth movement that are not influenced by the amount of force or the location at which they are applied.

Distraction osteogenesis and histogenesis in beagle dogs: the effect of gradual mandibular osteodistraction on bone and gingiva.

BACKGROUND: No study has systematically evaluated the effect of distraction osteogenesis on the gingival tissues. Therefore, this study was designed to analyze the newly formed bone and gingiva during the consolidation period of mandibular osteodistraction using standard histologic techniques. METHODS: Seventeen skeletally mature male beagle dogs underwent 10 mm of bilateral interdental mandibular lengthening. After distraction, the regenerates were allowed to consolidate for 0, 2, 4, 6, or 8 weeks, then the animals were sacrificed and tissues harvested for analysis. RESULTS: Mineralization began at the host bone margins at the end of the distraction period, followed by a progressive increase in bone surface area, with a concomitant decrease in fibrous tissue. The gingiva initially underwent mild inflammatory and reactive changes during distraction and during the first few weeks of consolidation. The rate of bone formation gradually increased from the end of distraction to the fourth week of consolidation, at which time it remained constant until sometime before the eighth week, when it tapered off slightly as remodeling began. From the second through the eighth week of consolidation, regenerative changes and neohistogenesis were seen in the gingival tissues. CONCLUSIONS: Osteodistraction has the potential to drastically decrease the total treatment time for alveolar bone augmentation prior to dentoalveolar implant placement since the regenerate bone rapidly mineralizes within approximately 8 to 10 weeks after the distraction period and the gingiva responds favorably to increased length by regeneration rather than by degeneration. Although the results appear favorable, similar data should be evaluated in human clinical trials.