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ISSN 2063-5346
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Evaluation of risk factors leading to failure of orthodontic mini-implants in the maxilla: A radiographic study

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Santosh Kumar Goje, Sanjana Basu
» doi: 10.48047/ecb/2023.12.si7.236

Abstract

Absolute/skeletal anchorage is used frequently in current clinical orthodontic practice. Using orthodontic miniscrews/mini-implants/bone-screws as temporary anchorage devices, cases requiring critical anchorage can easily be treated without taxing the anchorage unit/units. Success of the orthodontic treatment involving absolute anchorage depends on the survival and stability of the miniscrew. Knowledge of factors that can increase the risk of miniscrew failure are vital to the clinician. Aim: This study aimed to evaluate the factors responsible for inter-radicular mini-implant failure in the maxilla. Study design: This retrospective-radiographic study was conducted using archived case record books and CBCT records of patients who received orthodontic miniscrews/mini-implants in the maxillary bone during treatment from January 2022 to January 2023. A total of 30 patients were included in this study. The sample was divided into two groups (15 participants each). Group A-successful miniscrews and Group B-failed miniscrews. The stability was assessed by checking mobility of the mini-implant clinically right after placement (T0), at the time of loading/orthodontic force application (T1) and at the time of removal (T3). The differences in cortical bone thickness and root proximity between the two groups were calculated using unpaired Student’s t-test. Results: Each failed implant was associated with previously recorded hygiene status, quantitative (root proximity, bicortical/mono-cortical anchorage, cortical bone thickness) and qualitative radiological imaging (bone density etc). Statistically significant difference was seen between the two groups regarding bone density, cortical bone thickness, proximity to adjacent roots and oral hygiene (p<0.05). Age, gender, the type of force applied on the mini-implant and mono/bi-cortical anchorage did not affect the implant stability significantly. Conclusions: The most common factor that led to failure of mini-implant was reduced cortical bone thickness, followed by lesser bone density, close proximity with adjacent roots and root contact. Poor oral hygiene was found to be the most prevalent host factor for mini-implant failure

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