Jahanbin Arezoo, Ziya Farnaz, Bardideh Erfan, Hafez Sara, Abtahi Mostafa
Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Resident of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
J World Fed Orthod. 2025 Apr;14(2):97-110. doi: 10.1016/j.ejwf.2024.09.005. Epub 2024 Oct 29.
While orthodontic miniscrews have been widely documented for their successful application, limited research exists on the stability and effectiveness of reused miniscrews. This systematic review aims to evaluate the stability and effectiveness of reused miniscrews in orthodontic treatments.
An electronic search was conducted for studies published up to February 2024 across MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane CENTRAL. Additionally, gray literature sources and manual searches of prominent orthodontic journals from 2010 to 2023, were also examined. Studies that investigated the use of miniscrews after retrieval and sterilization involving both in vitro studies and clinical trials were included.
From 946 searched studies, 18 were finally included in our review. Thirteen studies investigated retrieved and sterilized miniscrews, while five examined unused and sterilized miniscrews to isolate the effects of sterilization. After performing a meta-analysis on in vitro studies, no significant difference in insertion, removal, or fracture torque between retrieved and unretrieved miniscrews was found, though sterilized miniscrews had a statistically significant increase in insertion torque without affecting fracture resistance. Meta-analysis of clinical studies revealed that retrieved miniscrews exhibited a significantly higher failure rate with a risk ratio of 0.46 (95% confidence interval = 0.24, 0.69), indicating a higher likelihood of failure on reuse.
There were no significant differences in insertion and fracture torque between new and reused miniscrews. However, reused miniscrews were associated with a higher failure rate. This outcome may be influenced by factors such as sterilization methods, insertion technique, and patient-specific anatomical considerations.
尽管正畸微螺钉的成功应用已有广泛记载，但关于重复使用微螺钉的稳定性和有效性的研究有限。本系统评价旨在评估重复使用的微螺钉在正畸治疗中的稳定性和有效性。
对截至2024年2月发表在MEDLINE、科学网、EMBASE、Scopus和Cochrane CENTRAL上的研究进行电子检索。此外，还查阅了灰色文献来源以及2010年至2023年主要正畸期刊的手工检索文献。纳入了调查微螺钉取出和消毒后使用情况的研究，包括体外研究和临床试验。
在检索的946项研究中，最终有18项纳入我们的综述。13项研究调查了取出并消毒的微螺钉，5项研究检查了未使用但消毒的微螺钉以分离消毒的影响。对体外研究进行荟萃分析后发现，取出和未取出的微螺钉在插入、取出或断裂扭矩方面没有显著差异，尽管消毒后的微螺钉插入扭矩有统计学显著增加，且不影响抗断裂性。临床研究的荟萃分析表明，取出的微螺钉失败率显著更高，风险比为0.46（95%置信区间 = 0.24, 0.69），表明重复使用时失败的可能性更高。
新的和重复使用的微螺钉在插入和断裂扭矩方面没有显著差异。然而，重复使用的微螺钉失败率更高。这一结果可能受到消毒方法、插入技术和患者特定解剖因素等因素的影响。
