Applications of Orthodontics Mini-Implantsz

Applications of Orthodontics Mini-Implants
• Introduction:
• Orthodontic treatment enhances dental and facial functions and appearance, improving overall quality of life.
• Anchorage is critical for treatment success,
• Traditional methods include intra-oral and extra-oral techniques.
• Various approaches, including implants, are used with varying effectiveness.
• The Revolution of Mini Implants:
• Mini-screws, also called TADs (Temporary Anchorage Devices), micro-implants, or ortho-implants, have transformed clinical Orthodontics.
• In 1945, Gainsforth and Higley used screws and wires in a dog's mandible, proving the effectiveness of bone anchorage.
• Various bone anchor systems, such as miniplates, palatal implants, miniscrews, and dental implants, show high success rates.
• Mini Implant:
A tiny screw placed in the jawbone during orthodontic treatment to assist in moving and aligning teeth.
• Used For:
Mini implants provide stable anchorage for braces and other orthodontic devices, allowing for precise tooth adjustments and improved alignment.
Type of mini-implants
• Screw-Type Mini-Implants: These are the most common type and consist of a screw-shaped body that is anchored into the bone. They are versatile and can be used for various
orthodontic purposes.
• Plate-Type Mini-Implants: Plate-style mini implants have a flat, plate-like design and are often used when a larger surface area is required for stability. They are suitable for
applications like molar intrusion or vertical control.
• Cortical Bone Mini-Implants: These mini implants are designed for placement in the outer layer (cortical bone) of the jaw, providing excellent stability for applications that require
high resistance to forces.
• Skeletal Anchorage Mini-Implants: These are specifically designed for providing stable anchorage in the craniofacial skeleton, making them ideal for complex orthodontic cases
involving significant skeletal movements.
• Palatal Mini-Implants: Palatal or mid-palatal mini-implants are inserted into the midline of the hard palate. They are used for specific orthodontic purposes, such as midline correction
and expansion.
• Buccal Shelf Mini-Implants: These are placed in the buccal (cheek) area, providing anchorage for various orthodontic movements, especially in cases where palatal or inter-radicular
sites are not suitable.
• Inter-Radicular Mini-Implants: These mini implants are inserted between the roots of teeth, commonly in the maxillary and mandibular premolar or molar regions. They are versatile
and useful for a wide range of orthodontic treatments.
• Anterior Nasal Spine Mini-Implants: These mini-implants are inserted near the anterior nasal spine and are suitable for applications requiring anterior-posterior control or intrusion of
anterior teeth.
• Temporary Mini-Implants: Some mini-implants are designed for temporary use and are removed once their orthodontic purpose is achieved.
Protocol for Orthodontic Mini Implant
Insertion
1. Diagnosis and Treatment Planning
• Start by diagnosing the orthodontic issue and planning the treatment, considering the use of mini implants
for anchorage.
• 2. Clinical and Radiological Investigations
• Conduct clinical examinations and use 2D/3D radiological investigations to assess bone quality, quantity,
and nearby structures.
• 3. Selecting Insertion Sites
• Determine the ideal insertion site based on inter-radicular distance, bone quality, and other anatomical
factors. Common sites include between teeth in both the upper and lower jaws..
Insertion
4. Instrument Selection:
Choose mini implants with appropriate dimensions based on the insertion site
and use the correct insertion kit, which may vary depending on the technique.
5. Sterilization:
Ensure proper sterilization of the insertion kit following manufacturer
instructions.
Insertion
6. Anesthesia:
• Administer local or topical anesthesia to numb the area while keeping
neighboring teeth's periodontal receptors active for guidance.
7.Surgical Guide (Optional):
• Consider using surgical guides for precise insertion site identification and
control of the insertion angle.
Insertion
8.Mini-Implant Insertion:
Insert the mini implant, possibly with pre-drilling in thicker cortical bone. Monitor torque
during insertion to avoid complications
9.Post-Insertion:Provide post-operative instructions for managing inflammation and

discomfort. Apply appropriate forces if immediate loading is possible.
10.Removal:Remove mini implants when no longer needed, typically without the need for
anesthesia. Be cautious to prevent fractures during removal, especially in dense cortical bone.
Special part :Case 1
(the potential of non-surgical skeletal expansion in adult orthodontic treatment planning.)
• 31-year-old male with orthodontic issues.

• Bilateral cross-bite, anterior open-bite, and mild crowding in the anterior upper
teeth.
• Patient's choice: Opted for non-surgical treatment.
•
Treatment Approach:
we decided to proceed with a rapid palatal expansion using a skeletal expander
anchored on 4 OrthoEasy Pal mini-implants.
Special part :Case 1
(the potential of non-surgical skeletal expansion in adult orthodontic treatment
planning.)
• Planning with CBCT:
To determine the optimal site for placing the mini-implants, a cone beam
computed tomography (CBCT) scan was performed. This allowed for precise
evaluation and planning of the mini-implant placement.
Digital insertion plan
The digital model was overlaid onto the CBCT scan, and a surgical guide was
created to aid in achieving the optimal placement of the 4 mini-implants in the
anterior hard palate
Surgical Guide
• The surgical guide was printed , and the implants were accurately placed using a hand
driver at a rotational speed of less than 30 rpm (1/4 rotation per second). Impression
caps were secured onto the mini-implants, and an elastomeric impression was taken
and sent to the laboratory. Using the miniimplant analogs, a bone anchored maxillary
expansion appliance was fabricatedThe expander was attached to the mini-implants
using fixation screws.
Conclusions
• The procedure is predictable and stable, preserving tooth health.

• Precise planning with CBCT and surgical guides ensures accurate mini-implant
placement.
• A suitable option for well-informed adults avoiding surgery.
• More research and long-term follow-ups needed to assess stability and impact on
occlusion, aesthetics, and patient satisfaction.
• This case highlights the potential of non-surgical skeletal expansion in adult
orthodontic treatment planning.

Applications of Orthodontics Mini-Implantsz

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Applications of Orthodontics Mini-Implants

9.Post-Insertion:Provide post-operative instructions for managing inflammation and

• 31-year-old male with orthodontic issues.

• The procedure is predictable and stable, preserving tooth health.

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