Vale Francisco, Travassos Raquel, Couto Isabela, Ribeiro Madalena, Marques Filipa, Caramelo Francisco, Marto Carlos Miguel, Spagnuolo Gianrico, Paula Anabela Baptista, Nunes Catarina, Francisco Inês
Faculty of Medicine, Institute of Orthodontics, University of Coimbra, Coimbra, Portugal.
Laboratory for Evidence-Based Sciences and Precision Dentistry (LACBE-MDP), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Orthod Craniofac Res. 2025 Apr;28(2):217-241. doi: 10.1111/ocr.12864. Epub 2024 Oct 8.
During orthodontic treatment, undesirable reciprocal forces are generated during tooth movement, which explains the use of anchorage strategies to minimise their harmful effects through intra and/or extraoral appliances. Miniscrews are intraoral devices used for temporary skeletal anchorage. Miniscrews are small-sized intraoral devices used for temporary skeletal anchorage and are easy to place and remove. However, some studies refer to adverse effects such as inflammation, pain, and discomfort. This systematic review aims to synthesise the available evidence on the use of miniscrews during orthodontic treatment from the patient's perspective. The literature search was conducted using various databases MedLine through PubMed, Cochrane Library, Web of Science Core Collection, and EMBASE. A search was also carried out in the grey literature. The search terms used were "Orthodontic Anchorage Procedures," "mini-implant," "Mini Dental Implant," "Miniscrew," and "microimplant." Cochrane risk of bias tools was used to assess the quality of included studies. Patients tend to overestimate the pain inherent in this procedure. The insertion of micro implants is more accepted than the tooth extraction procedure, with less postoperative pain reported. The location, surgical technique, and type of anaesthesia used in the placement of miniscrews influence levels of discomfort. Additionally, the execution of a good surgical technique and the clinician's communication skills are factors that influence patient satisfaction and positive perception. The most frequent outcome reported is pain and discomfort, which varies depending on its location (less with mini interradicular screws than with extra-alveolar screws). Most patients are satisfied or very satisfied with this application.
在正畸治疗过程中,牙齿移动时会产生不良的相互作用力,这就解释了为何要采用支抗策略,通过口内和/或口外矫治器将其有害影响降至最低。微型螺钉是用于临时骨支抗的口内装置。微型螺钉是小型口内装置,用于临时骨支抗,易于放置和取出。然而,一些研究提到了诸如炎症、疼痛和不适等不良反应。本系统评价旨在从患者角度综合正畸治疗中使用微型螺钉的现有证据。通过PubMed使用各种数据库(MedLine、Cochrane图书馆、科学网核心合集和EMBASE)进行文献检索。还在灰色文献中进行了搜索。使用的检索词为“正畸支抗程序”、“微型种植体”、“微型牙种植体”、“微型螺钉”和“微种植体”。使用Cochrane偏倚风险工具评估纳入研究的质量。患者往往高估了该程序固有的疼痛。与拔牙程序相比,微型种植体的植入更容易被接受,术后疼痛报告较少。微型螺钉植入的位置、手术技术和使用的麻醉类型会影响不适程度。此外,良好手术技术的实施和临床医生的沟通技巧是影响患者满意度和积极认知的因素。报告的最常见结果是疼痛和不适,其程度因位置而异(微型根间螺钉引起的疼痛和不适比牙槽外螺钉少)。大多数患者对这种应用感到满意或非常满意。