Kim Kyung A, Chen Yu, Kwon Soon-Yong, Seo Kyung Won, Park Ki-Ho, Kim Seong-Hun
Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea.
J Craniofac Surg. 2015 Oct;26(7):e592-5. doi: 10.1097/SCS.0000000000002045.
OBJECTIVES/INTRODUCTION: This article represents clinical application of spike screw, novel design of miniscrew, for direct anchorage and indirect anchorage in orthodontic treatment. Accompanied by easy placement and removal, the spike screw provides good stability for the orthodontic anchorage.
The spike screw consists of 6 spikes attached to a washer with laser welded stainless-steel hook that is placed by self-drilling fixation miniscrew. The spike screws were applied to correct malocclusions in patients as follows: traction of impacted canines and protraction of posterior teeth as a direct anchorage and correction of midline discrepancy as an indirect anchorage. For orthodontic traction of impacted canines, spike screws were placed in the mandibular labial mucosal area to create extrusive forces. Afterward, it was utilized for the protraction of posterior teeth. In the second case of the indirect anchorage, spike screw was applied on the midpalatal area to correct midline discrepancy that occurred during orthodontic treatment. The extended hook of a washer was prebended along the curvature of the palate and then secured with a mini screw. The extended hook was bonded to maxillary left first molar.
In the first case, the spike screw provided adequate anchorage for the vertical traction of horizontally impacted canine. Since the spike screws were placed in the mandibular anterior lesion, the vertical traction force was applied simply with orthodontic elastics. Also, enough distance was achieved for up-down elastics to work by placing the spike screw in the opposite arch. The force of vertical traction was adjusted with selection of size and force of up-down elastics. Later, it was used to provide anchorage for protraction of mandibular molars without changing orientation of the spike screws. In the second case, the spike screw placed in the midpalatal area was attached to the left first molar and worked as an indirect anchorage. The midline discrepancy was resolved by consolidating the spaces to the left with securing the left first molar location.
The novel design of the spike screw permits clinicians to have minimum invasive and easy placement and removal of the appliance while maintaining a good control over tooth movement with improved stability in various clinical cases.
目的/引言：本文介绍了新型微型螺钉——尖牙螺钉在正畸治疗中直接支抗和间接支抗的临床应用。尖牙螺钉易于放置和取出，为正畸支抗提供了良好的稳定性。
尖牙螺钉由6个尖钉连接到一个带有激光焊接不锈钢钩的垫圈组成，通过自攻固定微型螺钉放置。尖牙螺钉应用于患者错颌畸形的矫治，如下：作为直接支抗牵引埋伏尖牙和后牙前突，作为间接支抗矫正中线偏差。对于埋伏尖牙的正畸牵引，将尖牙螺钉置于下颌唇黏膜区域以产生挤出力。之后，用于后牙前突。在间接支抗的第二个病例中，将尖牙螺钉应用于腭中区域以矫正正畸治疗期间出现的中线偏差。垫圈的延长钩沿腭部曲度预先弯曲，然后用微型螺钉固定。延长钩粘结在上颌左侧第一磨牙上。
在第一个病例中，尖牙螺钉为水平埋伏尖牙的垂直牵引提供了足够的支抗。由于尖牙螺钉置于下颌前部病变处，垂直牵引力仅通过正畸弹力圈施加。此外，通过将尖牙螺钉置于对侧牙弓，上下弹力圈有足够的工作距离。垂直牵引力通过选择上下弹力圈的尺寸和力来调整。后来，它被用于为下颌磨牙前突提供支抗，而不改变尖牙螺钉的方向。在第二个病例中，置于腭中区域的尖牙螺钉连接到左侧第一磨牙，作为间接支抗起作用。通过固定左侧第一磨牙位置，将间隙合并到左侧，解决了中线偏差。
尖牙螺钉的新颖设计使临床医生在保持对牙齿移动的良好控制并在各种临床病例中提高稳定性的同时，能够以微创方式轻松放置和取出矫治器。
