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VOLUME 22 , ISSUE 1 ( January, 2021 ) > List of Articles

ORIGINAL RESEARCH

Assessment of Insertion Torque of Mini-implant and Its Correlation with Primary Stability and Pain Levels in Orthodontic Patients

Nivethigaa B

Keywords : Anchorage, Insertion torque, Mini-implants, Primary stability, Visual analog scale score

Citation Information : B N. Assessment of Insertion Torque of Mini-implant and Its Correlation with Primary Stability and Pain Levels in Orthodontic Patients. J Contemp Dent Pract 2021; 22 (1):84-88.

DOI: 10.5005/jp-journals-10024-2969

License: CC BY-NC 4.0

Published Online: 19-04-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim: The aim of this study was to assess the insertion torque of the mini-implant used in orthodontic patients and to assess the correlation between the insertion torque, primary stability, and perception of pain in patients undergoing orthodontic therapy with mini-implant-augmented anchorage. Material and methods: Among the patients undergoing orthodontic therapy, 31 samples who required mini-implant for anchorage purpose were selected. A total of 59 mini-implants were placed in these patients. This included interradicular mini-implants and extra-alveolar mini-screws. Immediately after placement, the insertion torque in all these was measured using a digital torque meter and primary stability was assessed by identifying any mobility of the implant placed. Primary stability was noted at two time intervals immediate post-placement and 1 week after that. All the mini-implants that were considered in this study were immediately loaded. Patients were asked to record any pain experienced on the visual analog scale (VAS) score sheet at 24 hours and 1 week post-placement. Results: Among the mini-implants placed, those with 2 mm diameter needed higher placement torque, i.e., infrazygomatic crest mini-implants and buccal shelf mini-implants were placed with average placement torque of 10.08 and 10.25 N cm, respectively. Extra-alveolar screws caused more pain, especially higher in the mandible than the maxilla. Decrease in pain scores was noted from T0 to T1 in almost all the cases. Conclusion: Thicker mini-implant needed more insertion torque and highest insertion torque was recorded with extra-alveolar screws. No direct correlation could be obtained with the pain levels experienced by the patients and with the primary stability of the mini-implants. Clinical significance: Mini-implants placed with an insertion torque above the recommended range tend to fail and break more often. Patients placed with extra-alveolar bone screws reported more pain than that of the smaller-dimension mini-implant.


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  1. Motoyoshi M, Yano S, Tsuruoka T, et al. Biomechanical effect of abutment on stability of orthodontic mini-implant: a finite element analysis. Clin Oral Implants Res 2005;16(4):480–485.
  2. Saeed K, Nadim M, Morcos S, et al. In vitro assessment of maximum insertion and removal torque with three different miniscrews on artificial maxilla and mandible. J World Fed Orthod 2017;6(3): 115–119.
  3. Tseng YC, Hsieh CH, Chen CH, et al. The application of mini-implants for orthodontic anchorage. Int J Oral Maxillofac Surg 2006;35(8): 704–707.
  4. Suzuki EY, Suzuki B. Placement and removal torque values of orthodontic miniscrew implants. Am J Orthod Dentofacial Orthop 2011;139(5):669–678.
  5. Lim SA, Cha JY, Hwang CJ. Insertion torque of orthodontic miniscrews according to changes in shape, diameter and length. Angle Orthod 2008;78(2):234–240.
  6. Baumgaertel S. Cortical bone thickness and bone depth of the posterior palatal alveolar process for mini-implant insertion in adults. Am J Orthod Dentofacial Orthop 2011;140(6):806–811.
  7. Reynders RA, Ronchi L, Ladu L, et al. Insertion torque and success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofacial Orthop 2012;142(5):596–614.
  8. Motoyoshi M, Uchida Y, Inaba M, et al. Are assessments of damping capacity and placement torque useful in estimating root proximity of orthodontic anchor screws? Am J Orthod Dentofacial Orthop 2016;150(1):124–129.
  9. Nucera R, Lo Giudice A, Bellocchio AM, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod 2017;87(5):745–751.
  10. Łyczek J, Kawala B, Antoszewska-Smith J. Influence of antibiotic prophylaxis on the stability of orthodontic microimplants: a pilot randomized controlled trial. Am J Orthod Dentofacial Orthop 2018;153(5):621–631.
  11. Park HS, Jeong SH, Kwon OW. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofacial Orthop 2006;130(1):18–25.
  12. Motoyoshi M, Yoshida T, Ono A, et al. Effect of cortical bone thickness and implant placement torque on stability of orthodontic mini-implants. Int J Oral Maxillofac Implants 2007;22(5): 779–784.
  13. Sivamurthy G, Sundari S. Stress distribution patterns at mini-implant site during retraction and intrusion—a three-dimensional finite element study. Prog Orthod 2016;17(1):4.
  14. Jain RK, Kumar SP, Manjula WS. Comparison of intrusion effects on maxillary incisors among mini implant anchorage, j-hook headgear and utility arch. J Clin Diagn Res 2014;8(7):ZC21.
  15. Sivakumar A, Sivakumar I, Sharan J, et al. Bimaxillary protrusion trait in the Indian population: A cephalometric study of the morphological features and treatment considerations. Orthodontic Waves 2014;73(3):95–101.
  16. Farnsworth D, Rossouw PE, Ceen RF, et al. Cortical bone thickness at common miniscrew implant placement sites. Am J Orthod Dentofacial Orthop 2011;139(4):495–503.
  17. Parinyachaiphun S, Petdachai S, Chuenchompoonut V. Considerations for placement of mandibular buccal shelf orthodontic anchoring screw in class III hyperdivergent and normodivergent subjects–a cone beam computed tomography study. Orthodontic Waves 2018;77(1):44–56.
  18. Felicita AS, Chandrasekar S, Shanthasundari KK. Determination of craniofacial relation among the subethnic Indian population: a modified approach (vertical evaluation). Indian J Dent Res 2013;24(4):456.
  19. Felicita AS. Quantification of intrusive/retraction force and moment generated during en-masse retraction of maxillary anterior teeth using mini-implants: a conceptual approach. Dental Press J Orthod 2017;22(5):47–55.
  20. Dinesh SS, Arun AV, Sundari KS, et al. An indigenously designed apparatus for measuring orthodontic force. J Clin Diagn Res 2013;7(11):2623.
  21. Tang X, Cai J, Lin B, et al. Motivation of adult female patients seeking orthodontic treatment: an application of Q-methodology. Patient Prefer Adherence 2015;9:249–256.
  22. Vikram NR, Prabhakar R, Kumar SA, et al. Ball Headed mini implant. J Clin Diagn Res 2017;11(1):ZL02.
  23. Katranji A, Misch K, Wang HL. Cortical bone thickness in dentate and edentulous human cadavers. J Periodontol 2007;78(5):874–878.
  24. Meira TM, Tanaka OM, Ronsani MM, et al. Insertion torque, pull-out strength and cortical bone thickness in contact with orthodontic mini-implants at different insertion angles. Eur J Orthod 2013;35(6):766–771.
  25. Tseng YC, Pan CY, Liu PH, et al. Resonance frequency analysis of miniscrew implant stability. J Oral Sci 2018;60(1):64–69.
  26. Miyawaki S, Koyama I, Inoue M, et al. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofacial Orthop 2003;124(4):373–378.
  27. Schätzle M, Männchen R, Zwahlen M, et al. Survival and failure rates of orthodontic temporary anchorage devices: a systematic review. Clin Oral Implants Res 2009;20(12):1351–1359.
  28. Wilmes B, Su YY, Drescher D. Insertion angle impact on primary stability of orthodontic mini-implants. Angle Orthod 2008;78(6): 1065–1070.
  29. Ueda M, Matsuki M, Jacobsson M, et al. The relationship between insertion torque and removal torque Analyzed in fresh temporal bone. Int J Oral Maxillofac Implants 1991;6(4):442–447.
  30. Tepedino M, Masedu F, Chimenti C. Comparative evaluation of insertion torque and mechanical stability for self-tapping and self-drilling orthodontic miniscrews–an in vitro study. Head Face Med 2017;13(1):1–7.
  31. Lee NK, Baek SH. Effects of the diameter and shape of orthodontic mini-implants on microdamage to the cortical bone. Am J Orthod Dentofacial Orthop 2010;138(1):8.e1–8. discussion 8-9.
  32. Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998;11(5):491–501.
  33. Chen YH, Chang HH, Chen YJ, et al. Root contact during insertion of miniscrews for orthodontic anchorage increases the failure rate: an animal study. Clin Oral Implants Res 2008;19(1):99–106.
  34. Watanabe T, Miyazawa K, Fujiwara T, et al. Insertion torque and periotest values are important factors predicting outcome after orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2017;152(4):483–488.
  35. Brinley CL, Behrents R, Kim KB, et al. Pitch and longitudinal fluting effects on the primary stability of miniscrew implants. Angle Orthod 2009;79(6):1156–1161.
  36. Migliorati M, Signori A, Biavati AS. Temporary anchorage device stability: an evaluation of thread shape factor. Eur J Orthod 2012;34(5):582–586.
  37. Pandian KS, Krishnan S, Kumar SA. Angular photogrammetric analysis of the soft-tissue facial profile of Indian adults. Indian J Dent Res 2018;29(2):137.
  38. Brandão LB, Mucha JN. Degree of acceptance of mini-implants by patients undergoing orthodontic treatment: preliminary study. Dental Press J Orthod 2008;13(5):118–127.
  39. Valieri MM, Freitas KM, Valarelli FP, et al. Comparison of topical and infiltration anesthesia for orthodontic mini-implant placement. Dental Press J Orthod 2014;19(2):76–83.
  40. Kim SH, Yoon HG, Choi YS, et al. Evaluation of interdental space of the maxillary posterior area for orthodontic mini-implants with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2009;135(5):635–641.
  41. Kim TW, Kim H, Lee SJ. Correction of deep overbite and gummy smile by using a mini-implant with a segmented wire in a growing class II division 2 patient. Am J Orthod Dentofacial Orthop 2006;130(5): 676–685.
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