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This study evaluates the influence of different implant materials on the primary stability of orthodontic mini-implants by measuring the resonance frequency. Twenty-five orthodontic mini-implants with a diameter of 2 mm were used. The first group contained stainless steel mini-implants with two different lengths (10 and 12 mm). The second group included titanium alloy mini-implants with two different lengths (10 and 12 mm) and stainless steel mini-implants 10 mm in length. The mini-implants were inserted into artificial bones with a 2-mm-thick cortical layer and 40 or 20 lb/ft3 trabecular bone density at insertion depths of 2, 4, and 6 mm. The resonance frequency of the mini-implants in the artificial bone was detected with the Implomates® device. Data were analyzed by two-way analysis of variance followed by the Tukey honestly significant difference test (α = 0.05). Greater insertion depth resulted in higher resonance frequency, whereas longer mini-implants showed lower resonance frequency values. However, resonance frequency was not influenced by the implant materials titanium alloy or stainless steel. Therefore, the primary stability of a mini-implant is influenced by insertion depth and not by implant material. Insertion depth is extremely important for primary implant stability and is critical for treatment success.

Background Bilateral scissor bite is a rare malocclusion. For adult patients with skeletal disharmonies, orthognathic surgery is usually adopted for correction. Non-surgical orthodontic treatment is more difficult and rarely reported. During orthodontic treatment, it is necessary to reposition malpositioned molars. However, in some patients, excessive pneumatization of the maxillary sinus allows the molar roots to extend into the sinus cavity. This significantly increases the difficulty of moving the molars. Case presentation This case reports an adult patient with transverse maxillary hyperplasia, bilateral scissor bite, deep overbite, mandibular retrusion, and deviation. Additionally, due to excessive maxillary sinus pneumatization, the roots of the maxillary molars were located within the maxillary sinus. In this case, mini-implants were used in combination with palatal long-arm traction hooks of the first molars. Concurrently, the maxillary second molars were extracted, and the third molars were used as replacements. Following 45 months of treatment and a 12-month retention period, the patient displayed a normal overbite and overjet, proper molar relationships, improved facial aesthetics, and a healthy temporomandibular joint. Conclusions This case demonstrated that bodily movement of the tooth through the maxillary sinus can be achieved by using suitable force systems, correcting the bilateral scissor bite caused by transverse maxillary hyperplasia and avoiding surgical damage and complications.

Orthodontic Mini-Implants have a high success rate, but it is crucial to assess the load that they bear in order to maintain their primary stability. Increasing the diameter can improve this stability, but there are limitations due to the proximity of the tooth roots. To avoid damage, smaller diameters are used, which can decrease resistance and cause permanent deformations. Objective: The objective of this study is to evaluate the influence of the diameter of Mini-Implants through bending force tests, taking into account primary stability after one and two insertions. Methods: Here, 40 Ti6AI4V alloy Mini-Implants of two different brands and diameters were divided into eight groups, half of which received one insertion in the artificial bone, and the rest received two. All were subjected to a constant bending force using an INSTRON-Electropuls E10000LT (Norwood, MA, USA) until fracture. Results: The smaller-diameter Mini-Implants were less resistant to fracture, but both were able to withstand the necessary loads produced by orthodontic movements. As for the inserts, there were no statistically significant differences. Conclusions: There is an advantage to using 1.6 mm Mini-Implants over 2.0 mm ones, as a smaller diameter does not lead to fracture due to the forces used in orthodontic treatment. Having one or two inserts did not have a statistically significant effect.

ABSTRACT Objectives: This clinical trial was conducted to evaluate the stability and failure rate of surface-treated orthodontic mini-implants and determine whether they differ from those of non-surface-treated orthodontic mini-implants. Trial Design: Randomized clinical trial with a split-mouth study design. Setting: Department of Orthodontics, SRM Dental College, Chennai. Participants: Patients who required orthodontic mini-implants for anterior retraction in both arches. Methods: Self-drilling, tapered, titanium orthodontic mini-implants with and without surface treatment were placed in each patient following a split-mouth design. The maximum insertion and removal torques were measured for each implant using a digital torque driver. The failure rates were calculated for each type of mini-implant. Results: The mean maximum insertion torque was 17.9 ± 5.6 Ncm for surface-treated mini-implants and 16.4 ± 9.0 Ncm for non-surface-treated mini-implants. The mean maximum removal torque was 8.1 ± 2.9 Ncm for surface-treated mini-implants and 3.3 ± 1.9 Ncm for non-surface-treated mini-implants. Among the failed implants, 71.4% were non-surface-treated mini-implants and 28.6% were surface-treated mini-implants. Conclusion: The insertion torque and failure rate did not differ significantly between the groups, whereas the removal torque was significantly higher in the surface-treated group. Thus, surface treatment using sandblasting and acid etching may improve the secondary stability of self-drilling orthodontic mini-implants. Trial registration: The trial was registered in the Clinical Trials Registry, India (ICMR NIMS). Registration number: CTRI/2019/10/021718 RESUMO Objetivos: Este ensaio clínico foi conduzido para avaliar a estabilidade e a taxa de falha de mini-implantes ortodônticos com superfície tratada, e determinar se elas diferem das dos mini-implantes ortodônticos sem superfície tratada. Desenho do estudo: Ensaio clínico randomizado com desenho de boca dividida. Instituição: Department of Orthodontics, SRM Dental College, Chennai/India. Participantes: Pacientes que necessitavam de mini-implantes ortodônticos para retração anterior em ambas as arcadas. Métodos: Mini-implantes ortodônticos autoperfurantes, cônicos, de titânio com ou sem tratamento de superfície, foram colocados em cada paciente, seguindo um desenho de boca dividida. Os torques máximos de inserção e de remoção foram medidos para cada mini-implante, usando um torquímetro digital. As taxas de falha foram calculadas para cada tipo de mini-implante. Resultados: O valor médio do torque máximo de inserção foi de 17,9 ± 5,6 Ncm para mini-implantes com superfície tratada e 16,4 ± 9,0 Ncm para mini-implantes sem superfície tratada. O valor médio do torque máximo de remoção foi de 8,1 ± 2,9 Ncm para mini-implantes com superfície tratada e 3,3 ± 1,9 Ncm para mini-implantes sem superfície tratada. Entre os implantes que falharam, 71,4% eram mini-implantes sem superfície tratada e 28,6% eram mini-implantes com superfície tratada. Conclusão: O torque de inserção e a taxa de falha não diferiram significativamente entre os grupos; porém, o torque de remoção foi significativamente maior no grupo com superfície tratada. Assim, o tratamento de superfície com jateamento e condicionamento ácido pode melhorar a estabilidade secundária dos mini-implantes ortodônticos autoperfurantes. Registro do estudo: Esse estudo foi registrado no Clinical Trials Registry, Índia (ICMR NIMS). Número de registro: CTRI/2019/10/021718

Aim This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2). Materials and methods The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18–54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group ( n  = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance. Results The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups ( p  < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87–1.35 mm, p  < 0.001) compared to MARPE-G (2.70–3.04 mm, p  < 0.001 to 0.009). Dental measurements were similar ( p  < 0.001 to 0.023), but the ratio “Mid-palatal suture Opening Related to Expander opening” (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G. Conclusion Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.

To measure the palatal soft tissue thickness and cortical bone density to determine safe regions for the placement of orthodontic mini-implants and to examine the influence of sex and age on soft tissue thickness and cortical bone density. Cone-beam computed tomography images of 42 patients (22 males and 20 females), including 21 adults and 21 adolescents, were examined in this study. The palatal soft tissue thickness and cortical bone density were measured at the coronal planes between the premolars (P4-5), between the second premolars and first molars (P5-6), and between the first molars and second molars (P6-7). The thickness of the soft tissue revealed similar coronal planes, but the bone density varied. The mean thickness was 3.8 mm at 0°-60° and 1.5 mm at 60°-90°. P4-5 had the highest bone density (>600 HU), decreasing toward P6-7 (<600 HU). Bone density decreased from 90° to 0° coronally, whereas the soft tissue thickness increased. Age, sex, and their interaction affected bone and soft tissues. In general, areas with a high bone density tended to have thin soft tissue coronally, thus the preferred implant site tends to be more anterior to the P4-5 plane and closer to 60°-90°. Considering individual variances, mapping of the recommended regions for palatal mini-implants is suggested.

Background: Orthodontic mini-implant failure is a debatable subject in clinical practice. However, the most important parameter to evaluate the success rate of mini-implant is the primary stability, which is mainly influenced by cortical bone thickness (CBT) and insertion angle. Materials and methods: Three-dimensional finite element models of the maxilla were created and a custom-made, self-drilling, tapered mini-implant was designed. For the pull-out test, 12 simulations were performed, sequentially increasing the thickness of the cortical bone (1, 1.5 and 2 mm) and the insertion angle (30°, 60°, 90°, 120°). For the force analysis, 24 simulations were performed using an experimental orthodontic traction force of 2 N both in the horizontal and vertical axis. Results: Insertion angle and CBT have significant impact on force reaction values (p < 0.05). Cortical bone stress had the lowest value when the mini-implant had a 30° insertion angle and the highest value when the implant had a 120° insertion angle, while the CBT was 1 mm. Cortical bone stress had the lowest value with an insertion angle of 90° and the highest value when the implant was inserted at an angle of 30°, while the CBT was 2 mm independent of the force direction. Regarding the biosafety profile of the mini-implant alloy, the present results reveal that the custom-made mini-implant presents good biocompatibility. Conclusions: When the CBT is reduced, we recommend inclined insertion while, when the CBT is appropriate, perpendicular insertion is advised.

This Finite Element Analysis (FEA) study examined the stability of Polyetheretherketone (PEEK) miniscrews and tissue response in the posterior maxilla under varying angulations. A Cone beam computed tomography (CBCT)-derived three-dimensional model of the fully dentate maxilla was generated, featuring anatomical structures (teeth, periodontal ligament (PDL), alveolar bone) and orthodontic components (brackets, transpalatal arch, archwires). PEEK miniscrews were positioned bilaterally in the regions of the second premolar-first molar and first molar-second molar. A force of 100 g was applied perpendicular to the archwire. Four insertion angulations (45°, 70°, 90°, and 110°) were simulated. FEA revealed a consistent posterior displacement pattern: crowns tipped distally and buccally, while roots moved mesially, with intrusion. The first molar’s PDL peaked at 110°. Cortical bone stress was greatest in molars (1.41 × 105 Pa at 70–110°). Cancellous bone stress peaked under 70° loading in the second molar (1.25 × 105 Pa). PEEK miniscrews exhibited minimal deformation and low interfacial stress, confirming stable anchorage across all angles. Posterior PEEK miniscrews demonstrated excellent stability across all insertion angles, with 70° providing optimal biomechanical efficiency for intrusion. The first molar’s PDL experienced the highest stress concentrations at extreme angles. These findings offer clinical guidance for miniscrew placement to achieve effective intrusion while maintaining tissue safety.

Background/Objectives: This study evaluated the influence of key biomechanical parameters—orthodontic force magnitude, loading direction, and insertion depth—on stress and strain distribution in orthodontic mini-implants using three-dimensional finite element analysis (FEM). Methods: A three-dimensional model of a titanium orthodontic mini-implant inserted into a mandibular bone segment was developed and analyzed under varying force magnitudes (1–10 N), loading directions (30°, 45°, and 60°), and insertion depths (2–4 mm). Cortical and cancellous bone components were included, and static loading conditions were applied using simplified, linear elastic material assumptions. Results: Stress and strain levels increased with higher force magnitudes, with implant stresses approaching critical values at loads above 9 N. Cortical bone stresses remained within physiological limits, whereas cancellous bone exceeded the microdamage strain threshold at forces greater than 3 N. A 60° loading direction reduced implant bending and strain, while deeper insertion significantly decreased strain and displacement, indicating improved primary stability. Conclusions: Within the limits of this computational model, optimal mechanical behavior was observed under 1–3 N forces, a 60° loading direction, and a 2–4 mm insertion depth. Loads above 9 N approached fatigue and interfacial risk. These findings provide computational insight into the biomechanical behavior of orthodontic mini-implants under the modeled conditions.

Orthodontic mini-implants are well-known anchorage devices and stand out as a particularly effective tool for ensuring maximum anchorage without relying on patient compliance. Therefore, it is necessary to understand what levels of torque strains remain in the physiological limits and can guarantee the stability of these mini-implants. The aim of this study was to investigate and measure the initial and final torque values of orthodontic mini-implants when placed perpendicular to the maxillary and mandibular bone surfaces. In our study, orthodontic mini-implants from different companies were inserted perpendicularly using different insertion torques on the plate of both maxillary and mandibular bones from pig specimens. The torque values were then analyzed. The results of this study highlight the need for continued research to analyze the ideal insertion torque of different types of mini-implants depending on the insertion area, in order to achieve clinical success of mini-implants.