Jakovljevic Iva, Milanovic Pavle, Vasiljevic Milica, Milanovic Jovana, Stevanovic Momir Z, Jovicic Nemanja, Stepovic Milos, Ristic Vladimir, Selakovic Dragica, Rosic Gvozden, Arnaut Aleksandra
Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Diagnostics (Basel). 2025 May 15;15(10):1252. doi: 10.3390/diagnostics15101252.
Orthodontic temporary anchorage devices (TADs) in the lateral maxillary region are useful tools for successful orthodontic treatment. Radiological anatomical knowledge is crucial for the successful placement of TADs. The use of cone-beam computed tomography (CBCT) is essential for evaluating the relationship between the ideal placement point (IPP) and dental structures, particularly in cases with anatomical limitations. Accordingly, this study aims to assess the anatomical conditions for orthodontic mini-implant (MI) insertion in the posterior maxilla using CBCT as the gold standard. This retrospective study included 62 patients (37.1% male, 62.9% female) aged 11 to 50 years. CBCT scans (sagittal and axial cross-sections) were used to evaluate interdental bone characteristics in different regions. The evaluated regions were defined as follows: Region 1 (canine and first premolar), Region 2 (first and second premolars), Region 3 (second premolar and first molar), and Region 4 (first and second molars). All parameters were assessed at three predefined levels: A, B, and C, located 4, 3, and 2 mm, respectively, from the alveolar crest. At the aforementioned levels, we performed measurements, such as the interdental width (IDW) in the mesiodistal direction and buccopalatal depth (BPD). The last observation was the relationship between the ideal TAD placement point (IPP) and dental structures, such as contact points (CPs) and cusp tips (C1-cusp of mesial tooth, C2-cusp of distal tooth, in each region). A statistically significant positive correlation was found between the IDW and BPD at Levels A, B, and C in Region 1, while a negative correlation was observed between the IDW and BPD at Level C in Region 2'. The highest percentages of IDW exceeding 3 mm were found in Region 4 at Level A (67.7%), followed by Region 1' and 2', both at Level A. The mean interdental width measured at each level on the right and left sides was highest at Level A, exceeding 3 mm, and the width decreased with each successive level. The mean BPD measured at each level on the right and left sides was also highest at Level A. This methodological approach could assist in ensuring precise and efficient implant insertion. Furthermore, it can be concluded that the safe zone for buccal and interdental mini-implant placement is located 4 mm from the alveolar crest at Level A. Also, the CBCT analysis algorithm may serve as a valuable tool for clinicians in determining optimal TAD placement in different dental regions.
上颌外侧区域的正畸临时锚固装置（TADs）是正畸治疗成功的有用工具。放射解剖学知识对于TADs的成功植入至关重要。使用锥形束计算机断层扫描（CBCT）对于评估理想植入点（IPP）与牙齿结构之间的关系至关重要，特别是在存在解剖学限制的情况下。因此，本研究旨在以CBCT作为金标准，评估上颌后部正畸微型种植体（MI）植入的解剖条件。这项回顾性研究纳入了62例年龄在11至50岁之间的患者（男性占37.1%，女性占62.9%）。使用CBCT扫描（矢状面和横断面）评估不同区域的牙间骨特征。评估区域定义如下：区域1（尖牙和第一前磨牙）、区域2（第一和第二前磨牙）、区域3（第二前磨牙和第一磨牙）以及区域4（第一和第二磨牙）。所有参数均在三个预定义水平进行评估：A、B和C，分别距离牙槽嵴4、3和2 mm。在上述水平，我们进行了测量，如近远中方向的牙间宽度（IDW）和颊腭深度（BPD）。最后观察的是理想TAD植入点（IPP）与牙齿结构之间的关系，如接触点（CPs）和牙尖（每个区域中，C1-近中牙齿的牙尖，C2-远中牙齿的牙尖）。在区域1的A、B和C水平，IDW与BPD之间发现具有统计学意义的正相关，而在区域2的C水平，IDW与BPD之间观察到负相关。在A水平，IDW超过3 mm的百分比在区域4中最高（67.7%），其次是区域1和2在A水平的情况。左右两侧在每个水平测量的平均牙间宽度在A水平最高，超过3 mm，并且随着每个连续水平宽度减小。左右两侧在每个水平测量的平均BPD在A水平也最高。这种方法有助于确保种植体的精确和高效植入。此外，可以得出结论，颊侧和牙间微型种植体植入的安全区位于A水平距离牙槽嵴4 mm处。而且，CBCT分析算法可能成为临床医生在确定不同牙区最佳TAD植入位置时的有价值工具。
