Mini Implants for Orthodontics?

Anon. asks:

I am an orthodontist. Some of my colleagues are using mini implant screws for anchorage, eliminating or minimizing the need to apply mechanical forces to other teeth. I would like to learn more about this procedure. Are any of you out there using this technique? What has been your experience?

12 thoughts on “Mini Implants for Orthodontics?

  1. Dear Anon,

    I myself am not a fan. I am more of a palatal implant or wilckodontics fan as i got much better results than with screws. Not to say the screws dont work, I just like the above better.

  2. Dear Anon
    Using mini Implants for orthodontic anchorage is a simple and effective treatment reducing the time period of the ortho treatment.I have been using mini implants for ortho for more than two years with high success.Placing them as well as retrieving them is very easy.

  3. Implants as a useful tool in orthodontic therapy are quickly gaining acceptance. They provide the qualities of an ideal orthodontic anchor: 1) patient compliance unnecessary; 2) absolute anchorage as there is no periodontal ligament; 3) easily used under a variety of treatment modalities; 4) easily placed; and 5) removable, if necessary. The dentition with various intraoral and/or extra-oral appliances is used to create anchorage for alignment and retraction of teeth. During orthodontic treatment, the planned movement of one tooth or group of teeth causes reciprocal movement of the teeth used for anchorage. Gauging force dynamics is difficult as unwanted tooth movements often occur. These unwanted movements must be compensated for. Excessive care needs to be taken in dealing with the adult patients, particularly in situations where the patient exhibits a severe attachment loss from missing teeth or severe periodontal disease. This attachment loss adds to the difficulty of estimating anchorage and stability treatment becomes exponentially more difficult. Mini-implants were introduced by Kanomi in 1997. He showed in a case report that titanium mini-implants can be used to intrude mandibular incisors to correct a deep bite. They required a two stage surgical procedure with an unloaded period for healing. The mini-implant is originally 1.2 mm in diameter and 6 mm long, making it much more useful in orthodontic applications. Kanomi has extrapolated that as well as incisor intrusion, the mini-implants may be used for horizontal traction if placed on the alveolar ridge. The fixture diameter is small enough to be inserted between the mesial and distal roots of a molar for molar intrusion. Kanomi also pointed to the possible use of the implant in distraction osteogenesis, with the implant placed intraorally instead of extraorally.

  4. I am an OMS and bought a GAC kit with 8 implants that I will make you a great deal on. The best orthodontists in my area are using TAD’s successfully but they place them themselves and don’t refer them. They just include the treatment in thier overall fee and don’t make a big deal out of it. They are even doing it w/o LA injections and use an effective topical anesthetic called TAC 20, compounded by a pharmacy in Louisiana. I think placement by the treating orthodontist is the way to go as they know the direstion of forces they want to have. 10 to 20% will fail but the wound heals quickly so just find a different site and put a new one in. Get trained and start doin it.

  5. If the goal is to reduce tx time / chair time how is that acheived with such a high failure rate. Don’t you have to reset the applicances and lose time compared to an Osseointegrated Palatal implant?

  6. I want to use the skeletal anchorage for intruding a upper first premolar.
    It’s someone who can advise me about this ?
    My question is if I must to use both labial and palatal sides for the intruding force . Another question is releted with root resorbtion. Among the doctors who used it (implant-intrusion ) is any who experienced such a problem ?
    Thank you.
    Paula

  7. i have a case that i placed 4 TOMAS implants to intrude super-erupted #’s 14-15 for an orthodontist, as the patient refused orthognathic surgery/segmental osteotomy and wanted them intruded, if possible non-surgically. i had to place them way high up in the vestibule and the palatal vault, which stinks b/c of mucosal inflammation/soreness and oral hygiene, as the roots were very proximal interdentally and he couldn’t give me more room to place them in the KG, as they are usually supposed to be placed.

    however, the case worked out great and after 4-6 months, the teeth have been nicely intruded without placing forces on any other teeth and she can now get implants in the 18-19 region, as the freeway spacing is now ideal and is not cramped. i took a PA of the case today and there are no signs of pathology and she can get them removed under local when the implants are placed.

    they are easy to do when the teeth are properly aligned, but in cases where the roots are close, these implants make you sweat like a mad dog as you fear perforation of a root on a young child. i now ask the orthodontist to accentuate the opening of the roots b/4 placing them, if the case is risky. they can easily be done under local or topical, but each case is very different-that is, some are risky and some are very easy.

    hope this helps. scott

  8. I am a 42 year old (orthodontist’s patient). I am also a Mechanical Engineer and I also work with mechanical medical devices. My doctor recommended TADs. The procedure was going to be simple and easy. While he wa installing the first TAD the screw broke when it was 3/4 of the way in. The screw was a self drilling screw 1.2mm in diameter. He didn’t know what to do after it happened, and said he never heard of screws failing like that. So, he send me to an oral surgeon to have the screw “extracted”. The oral surgeon drill out the screw four times until he got 90% out of it. The screw may have failed due to defective materials, excessive torque, improper loading, lack of a pilot hole or all of the above. Not having a procedure in place by the manufacturer to remove broken screws surprise me. My teeth are still very tender and I experience sharp pain when I chew food. I am very disappointed and I am also planning on filing a claim/litigation against my doctor.

  9. The possibility of the screw braking should be discussed beforehand. I would have left the broken screw as is – it would have osseointegrated and likely caused less problems than the surgical removal. The plates after corrective jaw surgery are usually left undefinitely.

  10. I am an orthodontist. I think Mini implant is (not) good for anchorage. It’s too dangerous to place it (some of the mini implant surgical procedure will be done in a very dark and narrow space in mouth), the length of mini implant (not sufficient to penetrate into cortical bone which is the hardest part of the bone) and immediate loading procedure (it’s living tissue, not a wall. the mechanical loading of implant will decrease in weeks, and it will replace with the biological aspect -ossteointegration-but mini implant doesn’t need ossteopintegration, so..it will easily loose after loading)

  11. I have been using orthodontic implants since 2004 with good success.
    My experience was with Dentos Micro-implants (more than 1000 pieces) and Ortho Bone Screws (40+ pieces). So far my results have been very good.
    Yes, there was failure (screw loosening due to various reasons) of 15-20% at the beginning i.e the learning curve everyone needs to go through. Today, my failure rate is definitely less than 5% (Dentos Micro-implants). Did encounter a few broken tips with the OBS.
    Most of the screws placed (Dentos Micro-implants) are of diameter 1.3 tapered down to 1.2mm, ranging from 5-12mm, made of Titanium. Majority of lengths used are around 7-8mm. Better to use 1.5-1.4mm at upper midline and softer bone area.
    The OBS are of 2mm diameter, 12mm length and made of stainless steel (316L).
    So far fractured screw during placement has not been a big problem. Just happened once when practising on typodont and 2 other times when placing implants at the retromolar and lower molar region. You have to use the Torque Driver to place these tiny titanium screws to avoid breakage!
    Skeletal anchorage provided by ortho implants has definitely changed the way I practice ortho :)

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