Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, Ohio.
Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio.
Am J Orthod Dentofacial Orthop. 2022 Mar;161(3):437-444. doi: 10.1016/j.ajodo.2020.09.035. Epub 2021 Nov 17.
The purpose of this research was to compare insertion techniques and effects on mechanical and clinical parameters between 2 types of miniscrews.
Forty-four consecutive patients whose orthodontic treatment involved the use of miniscrews (miniscrew A [MA] and miniscrew B [MB]) for anchorage were included in this study. Miniscrews were placed with predrilling or self-drilling; peak maximum insertion torque (MIT) and Periotest values were measured. Cone-beam computed tomography was performed after the insertion of miniscrews and root proximity determination; cortical bone thickness was also analyzed. Periotest values were measured after the application of orthodontic force.
Self-drilling produced higher Periotest values (P <0.01) for MA and higher MIT (P <0.01) for MB with closer root proximity (P <0.05). MB had higher MIT and Periotest values with drilling compared with MA (P <0.05); MB also showed closer root proximity (P <0.05). Successful miniscrews had lower MIT (P <0.05) for MB and lower Periotest values (P <0.01) for both MA and MB, with significantly more distant root proximity (P <0.01). Self-drilling produced higher Periotest values at the time of placement (P <0.01) and after 4 weeks (P <0.05) in MA. Drilling produced higher Periotest values for MB at the time of placement (P <0.05). MIT had positive correlations with Periotest values for MB with self-drilling (P <0.01) and with root proximity for MA with drilling (P <0.01). Periotest values had negative correlations with root proximity for MA and the MB group with drilling (P <0.01).
For miniscrews with larger diameters, higher MIT may result in more mobility (higher Periotest values). Drilling can avoid root contact and enhance primary stability, thus producing lower Periotest values.
本研究旨在比较两种微型种植体的植入技术及其对机械和临床参数的影响。
本研究共纳入 44 例接受微型种植体(微型种植体 A [MA] 和微型种植体 B [MB])作为支抗的正畸治疗患者。微型种植体采用预钻孔或自钻植入;测量峰值最大插入扭矩(MIT)和 Periotest 值。植入微型种植体后进行锥形束 CT 检查,确定根尖距离,并分析皮质骨厚度。在施加正畸力后测量 Periotest 值。
自钻植入可使 MA 的 Periotest 值更高(P<0.01),MB 的 MIT 更高(P<0.01),根尖距离更近(P<0.05)。与 MA 相比,MB 钻孔时具有更高的 MIT 和 Periotest 值(P<0.05),根尖距离更近(P<0.05)。成功植入的微型种植体的 MB 的 MIT 较低(P<0.05),MA 和 MB 的 Periotest 值较低(P<0.01),根尖距离更远(P<0.01)。MA 自钻植入时的 Periotest 值更高(P<0.01),4 周后(P<0.05)更高。MB 钻孔时的 Periotest 值更高(P<0.05)。自钻植入时,MB 的 MIT 与 Periotest 值呈正相关(P<0.01),与根尖距离呈正相关(P<0.01)。MA 钻孔时的 MIT 与根尖距离呈负相关(P<0.01)。MB 组的 Periotest 值与根尖距离呈负相关(P<0.01)。
对于直径较大的微型种植体,较高的 MIT 可能导致更大的活动性(较高的 Periotest 值)。钻孔可以避免根尖接触,增强初始稳定性,从而产生较低的 Periotest 值。