Issues‎ > ‎Vol 5, issue 1‎ > ‎

sdj-10075

Prospective Study of Oral Health, Pain and Discomfort and Success Rates Following Insertion of Orthodontic Mini-Implants

* Zana Q. Omer

Department of Pedo. Orthod. & Prevention, College of Dentistry, Hawler Medical University, Erbil, Iraq.

DOI: https://doi.org/10.17656/sdj.10075

Abstract

Objective: To evaluate oral health and compare the experience of pain and discomfort after the insertion of mini-implants TADs (temporary anchorage device) and to analyze potential factors associated with the stability of TADs used for orthodontic treatment in a sample of Erbil city orthodontics patients.

Methods: The sample included 47 patients of both genders (24 females, 23 males) between (13-35) years with mean ages 23.73 years. The patients were treated with fixed orthodontic appliance and TADs were inserted to reinforce anchorage as the cases required. The patients recall was performed for examination and recording through a questionnaire at baseline, few hours (evening), one day, one week and two weeks after TADs insertion. The inserted side of TADs was recorded by the researcher in anterior maxilla or mandible and posterior maxilla or mandible.

Results: The overall success rate was 85.1%. There were no significant relations in failure rates among the TADs related to the following variables: gender, pain (discomfort), implantation site (maxilla, mandible), location (anterior or posterior), and type of soft tissue (keratinized or non- keratinized mucosa). In the second week of TADs insertion females that complain from no pain was 43.3% versus 56.6% of males while moderate pain complain in the females was 64.7% versus 35.3% for males The success rates for non-inflamed gingiva around TADs were 96.3% in the second week post- insertion with significant differences during 1st and 2nd weeks post-insertion (P=0.020 and P=0.042 subsequently). An increased failure rate was noted for those presented with local inflammation of the surrounding soft tissue, especially those cases which loaded within 2 weeks after TADs insertion.

Conclusions: Inflammation of soft tissue surrounding a TADs and immediate loading (within 2 weeks) after insertion were the most significant factors affecting TADs failure. Gender, pain, age, jaws, soft tissue management, and placement sites are not related to the success of TADs.

                                                                                                                                                                                                                                                                                                                                                  

Keywords: TADs, Mini-implants, Orthodontics, Pain, Discomfort.

References:
1. 
Sandhu SS, Sandhu J. A randomized clinical trial investigating pain associated with superelastic nickel-titanium and multistranded stainless steel archwires during the initial leveling and aligning phase of orthodontic treatment. J Orthod. 2013;40(4):276-85.
2. Favero L, Brollo P, Bressan E. Orthodontic anchorage with specific fixtures: Related study analysis. Am J Orthod Dentofacial Orthop. 2002;122(1):84-94.
3. Reynders R, Ronchi L, Bipat S. Mini-implants in orthodontics: a systematic review of the literature. Am J Orthod Dentofacial Orthop. 2009;135(5):e1-19.
4. Brown DF, Moerenhout RG. The pain experience and psychological adjustments to orthodontic treatment of preadolescents, adolescents, and adults. Am J Orthod Dentofacial Orthop. 1991;100(4):349-56.
5. Lehnen S, McDonald F, Bourauel C, Baxmann M. Patient expectations, acceptance and preferences in treatment with orthodontic mini-implants. a randomly controlled study. Part I: insertion techniques. J Orofac Orthop. 2011;72(2):93–102.
6. Baxmann M, McDonald F, Bourauel C, Jager A. Expectations, acceptance, and preferences regarding microimplant treatment in orthodontic patients: a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2010;138(3):250.el-250.e10.
7. Kuroda S. Tanaka E. Risks and complications of miniscrew anchorage in clinical orthodontics. Jpn Dent Sci Rev. 2014;50(4):79-85.
8. Lee TC, McGrath CP, Wong RW, Rabie AB. Patients’ perceptions regarding microimplant as anchorage in orthodontics. Angle Orthod. 2008;78(2):228-33.
9. Cheng SJ, Tseng IY, Lee JJ, Kok SH. A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage. Int J Oral Maxillofac Implants. 2004;19:100-6.
10.Motoyoshi M, Yoshida T, Ono A, Shimizu N. Effect of cortical bone thickness and implant placement torque on stability of orthodontic mini-implants. Int J Oral Maxillofac Implants. 2007;22(5):779-84.
11. Reynders R, Ronchi L, Bipat S. Mini-implants in orthodontics: a systematic review of the literature. Am J Orthod Dentofacial Orthop. 2009;135(5):564.e1-9.
12. Lai T.-T., Chen M.-H. Factors affecting the clinical success of orthodontic anchorage: Experience with 266 temporary anchorage devices. JDS. 2014;9(1):49-55.
13. Flaherty S. A. Pain measurement tools for clinical practice and research. AANA J. 1996;64(2):133-140.
14. Kumar P, Tripathi L, Challenges in pain assessment: Pain intensity scales Indian J Pain. 2014;28(2):61-70.
15. Moon CH, Lee DG, Lee HS, Im JS, Baek SH, Factors Associated with the Success Rate of Orthodontic Miniscrews Placed in the Upper and Lower Posterior Buccal Region. Angle Orthod. 2008;78(1):101-6.
16. Feldmann I, List T, Feldmann H, Bondemark L. Pain intensity and discomfort following surgical placement of orthodontic anchoring units and premolar extraction: a randomized controlled trial. Angle Orthod. 2007;77(4):578-85.
17. Krekmanova L, Bergius M, Robertson A, Sabel N, Hafström C, Klingberg G, et al. Every day and dental-pain experiences in healthy Swedish 8-19-year-olds: an epidemiological study. Int J Paediatr Dent. 2009;19(6):438-47.
18. Feldmann I, List T, John MT, Bondemark L. Reliability of a questionnaire assessing experiences of adolescents in orthodontic treatment. Angle Orthod. 2007;77(2):311-17.
19. Breivik EK, Bjo¨rnsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin J Pain. 2000;16(1):22-28.
20. Lee SJ, Ahn SJ, Lee JW, Kim SH, Kim TW. Survival analysis of orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2010;13(2):194-99.
21. Moon CH, Park HK, Nam J S, Im JS, Baek SH.  Relationship between vertical skeletal pattern and success rate of orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2010;138(1): 51-57.
22. Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-Yamamoto T. Factors associated with the stability of titanium screw placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2003;124(4):373-78.
23. Aly SHA,  Alyan D, Fayed MS, Alhammadi MS, Mostafa YA. Success rates and factors associated with failure of temporary anchorage devices: A prospective clinical trial. J Investig Clin Dent. 2018. (Article in press).
24. Park HS, Jeong SH, Kwon OW, Park HS, Jeong S-H, Kwon O- W. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2006;130(1):18-25.
25. Kim T W, Kim H. Clinical application of orthodontic mini-implant. Seoul, Korea: Myung Mun; 2008. p. 44.
26. Kuroda S, Sugawara Y, Deguchi T, Kyung HM, Takano-Yamamoto T. Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort. Am J Orthod Dentofacial Orthop. 2007;13(1):9-15.
27. Lee SJ, Kim JK, Park YC, Vanarsdall RL Jr. Applications of Orthodontic Mini-Implant. Hanover Park, IL: Quintessence Publishing Co, Inc.; 2007.
28. Park HS, Jeong SH, Kwon OW, Park H-S, Jeong S-H, Kwon OW. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2006;130(1):18-25.
29. Chen YJ, Chang HH, Lin HY, Lai EH, Hung HC, Yao CC. Stability of miniplates and miniscrews used for orthodontic anchorage: experience with 492 temporary anchorage devices. Clin Oral Implants Res. 2008;19(11):1188-96. 
30. Cerroni MLL, Pasquantonio G, Condò SG, Condo R. Temporary anchorage devices (TADs) in orthodontics : review of the factors that influence the clinical success rate of the mini-implants. Clin Ter. 2016;167(3):e70-77.
31. Sharma P, Valiathan A, Sivakumar A. Success rate of microimplants in a university orthodontic clinic. ISRN Surg. 2011;2011:982671.
32. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;10(1):17-24.
33. Ganzer N, Feldmann I, Bondemark L. Pain and discomfort following insertion of miniscrews and premolar extractions: A randomized controlled trial. Angle Orthod. 2016;86(6):891-99.
34. Valieri MM, Freitas KMS, Valarelli FP, Cançado RH. Comparison of topical and infiltration anesthesia for orthodontic mini-implant placement. Dental Press J Orthod. 2014;19(2):76-83.
35. Kravitz ND. and Kusnoto B. Risks and complications of orthodontic miniscrews . Am J Orthod Dentofacial Orthop. 2007;131(suppl4):S43-51.
36. Dalessandri D, Salgarello S, Dalessandri M, Lazzaroni E, Piancino M, Paganelli M, et al. Determinants for success rates of temporary anchorage devices in orthodontics: a meta-analysis (n > 50). Eur J Orthod. 2014;36(3):303-13.
37. Uribe F, Mehr R, Mathur A, Janakiraman N, Allareddy V. Failure rates of mini-implants placed in the infrazygomatic region. Prog.Orthod. 2015;16:31.
38. Leo M, Cerroni L, Pasquantonio G, Condò S.G, Condò R. Temporary anchorage devices (TADs) in orthodontics: review of the factors that influence the clinical success rate of the mini-implants. Clin Ter. 2016;167(3):e70-7. 
39. Costa A, Pasta G, Bergamaschi G. Intraoral hard and soft tissue depths for temporary anchorage devices. Semin Orthod. 2005;11(1):10-5.
40. Chen YH, Chang HH, Chen YJ, Lee D, Chiang HH, Yao CC. Root contact during insertion of miniscrews for orthodontic anchorage increases the failure rate: an animal study. Clin Oral Implants Res. 2008;19(1):99-106.
41. Faber J, Morum T, Jamilian A, Eslami S, and Leal S. Infection predictive factors with orthodontic anchorage miniplates. Semin Orthod. 2018;24(1):37-44.
42. Freitas AO, Alviano CS, Alviano DS, Siqueira JF Jr, Nojima LI, Nojima MC. Microbial colonization in orthodontic mini-implants. Braz Dent J. 2012;23(4):422-27.
43. Choi BH, Zhu SJ, Kim YH. Clinical evaluation of titanium miniplates as anchors for orthodontic treatment. Am J Orthod Dentofacial Orthop. 2005;128(3):382-84.