Orthodontic Miniscrew Implants: Clinical Applications PDF
Preview Orthodontic Miniscrew Implants: Clinical Applications
And we know that in all things, God works for the good of those who love him, who have been called according to his purpose (Romans 8:28) Commissioning Editor: Alison Taylor Development Editor: Barbara Simmons Copy Editor: Lotika Singha Project Manager: Frances Affleck Designer: Stewart Larking Illustration Manager: Bruce Hogarth Illustrator: Bong-Kyu Chang Dgi]dYdci^X iniscrew M >beaVcih 8A > C > 8 6 A 6 E E A > 8 6 I > D C H 8]Zda"=dEV^`99HE]9;689 Dgi]dYdci^hi!Eg^kViZegVXi^XZ!HZdja!@dgZV >c"@ldcEVg`99HBH9E]9 Dgi]dYdci^hi!Eg^kViZegVXi^XZ!HZdja!@dgZV Ndjc\_dd?jY^ZLdd99H Dgi]dYdci^hi!Eg^kViZegVXi^XZ!HZdja!@dgZV IVZ"Ldd@^b99HBH9E]9 8]V^gbVcVcYEgd[Zhhdg! 9ZeVgibZcid[Dgi]dYdci^Xh!HX]ddad[9Zci^hign! HZdjaCVi^dcVaJc^kZgh^in!@dgZV 8dchjaiVci:Y^idg C^\Za=VggVY^cZ79H;9HG8H:Y^cBDgi]G8H:c\BHXB77H 8dchjaiVciDgi]dYdci^hi! 7g^hida9ZciVa=dhe^iVaVcYHX]dda! 7g^hida! An imprint of Elsevier Limited ©2009, Elsevier Limited. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: Preface The idea of writing of this book began when we implant anchorage might have helped complete the made a presentation at a meeting of the Southern treatment without the need for orthognathic surgery. Californian Component of the Edward H Angle Society of Orthodontists, of which two of the authors, Cheol- Skeletal Class II malocclusions with vertical excess Ho Paik and In-Kwon Park, are members. Immediately are common in the Caucasian population, and such after the meeting, we were offered an opportunity patients are often treated with orthognathic surgery to publish a textbook on the orthodontic miniscrew involving maxillary impaction and autorotation of implant. We would like to thank Dr Richard P the mandible. However, this aggressive procedure may McLaughlin and Dr John C Bennett for encouraging us be substituted by intrusion of the maxillary dentition in writing this textbook. using midpalatal miniscrew implant anchorage. This is one of the reasons we have written this book in English. Orthodontic movements that are considered difficult to Our work will be worthwhile if even a few patients are accomplish with traditional methods can be achieved spared unnecessary orthognathic surgery with the help with minimal patient cooperation by using miniscrew of the orthodontists who read this book. implants. This book brings together our knowledge and experience of using miniscrew implants in orthodontic In Asian populations, Class III malocclusions are more practice. As practicing orthodontists, we have mainly common. However, many of these patients have mild focused on the clinical applications of the miniscrew to moderate Class III malocclusion and orthognathic implant, illustrated with cases treated at our clinic. surgery is not always an acceptable treatment option. Details of basic research have been kept to a minimum, In such patients, miniscrew implants can be used very as the book is designed to be an easy to read guide, effectively to retract the entire mandibular dentition. In aimed at the orthodontist wishing to adopt miniscrew South Korea, most of the orthodontists use miniscrew implant anchorage in their everyday practice. We have implants in daily clinical practice. This phenomenon attempted to demonstrate how miniscrew implants can is unique, and it may have been triggered by the be used to simplify orthodontic treatment. publication in 2001 of a textbook on the microscrew implant in Korean by Dr Hyo-Sang Park. We remember an impressive case presented by an orthodontic resident more than 10 years ago. The We specially thank Dr Youn Sic Chun, Dr Jong-Suk Lee patient, who presented with the complaint of mild and Dr Jong-Wan Kim, who shared their data with us, crowding of his front teeth, had undergone bimaxillary and we appreciate the passion and commitment of Dr surgery following a reassessment of his malocclusion Sungmin Kang, which helped complete the writing of midway through his orthodontic treatment. This was this book in a short time. required because with the orthodontic leveling of the teeth his underlying mild vertical skeletal excess Cheol-Ho Paik led to the development of an anterior open bite with In-Kwon Park asymmetry. If orthodontic miniscrew implants had been available back then, a small amount of intrusion Youngjoo Woo and retraction of the dentition using miniscrew Tae-Woo Kim Korean norms and cephalometric abbreviations 9:CI6A6C9;68>6A8:E=6ADB:IG>8 @dgZVccdgb B:6HJG:B:CIH/@DG:6CCDGBH m Korean norms and cephalometric abbreviations 9:CI6A6C9;68>6A8:E=6ADB:IG>8 B:6HJG:B:CIH/677G:K>6I>DCH JH:9>CI=>H 8=6EI:G & C h a p t e r & Introduction 8VhZZmVbeaZ ( 6Wdjii]^hWdd` * GZ[ZgZcXZh + ' ORTHODONTIC MINISCREW IMPLANT 1 When Brånemark invented the first successful as the cost, need for extensive surgery, time required for osseointegrated implant, he certainly would not have osseointegration, and limited availability of sufficient envisaged how it would transform the practice of bone to act as an implant site. More recently, titanium dentistry in the years to come. Such implants have miniplates have been shown to successfully intrude 5 significantly enhanced the scope and quality of dental posterior teeth in patients with skeletal open bite, but treatment and to a lesser extent, this has included flap surgery for placement and removal is unavoidable. orthodontic treatment. In spite of these disadvantages, osseointegrated implants are proving to be an extremely useful adjunct For a long time, orthodontists have struggled to achieve to conventional orthodontic treatment in a minority of efficient control of anchorage. However, their efforts cases. have only had partial success owing to Newton’s third law of motion, which states that for each action there The miniscrew, which was originally designed to fix is an equal and opposite reaction. A variety of extraoral bony segments, has shown great promise as a simpler appliances have been designed to overcome this and more versatile solution for obtaining absolute limitation, but these have their own problems, such as anchorage. Many authors have reported successful use inadequate patient compliance. of miniscrews in a wide range of orthodontic tooth 6–8 movements. Miniscrews are used as temporary Dissatisfaction with conventional methods of fixtures in bone and their greatest advantage lies in anchorage led some pioneer orthodontists to explore their small size, which permits rapid and atraumatic the use of implants as a source of absolute anchorage. placement in almost all sites within the mouth. In the In 1990, a temporary retromolar implant was shown to past decade, there have been rapid advances in the 2 work as an absolute anchor to move molars mesially. development of miniscrews and they are increasingly In 1995, the midpalatal onplant was proposed as used in orthodontics. It is the authors’ goal, and the another means of providing absolute anchorage aim of this book, to popularize the use of the miniscrew 3 for tooth movement, and this has since become an implant among orthodontists and to reduce the need 4 accepted form of treatment mechanics. From the for orthognathic surgery in patients with mild or orthodontic viewpoint these conventional endosseous moderate skeletal discrepancy. implants and onplants have many disadvantages, such 8=6EI:G & >cigdYjXi^dc ( 86H::M6BEA: molars can be intruded to reduce face height, thus avoiding costly and extensive orthognathic surgery. A 30-year-old full-time career woman attended the One of the best examples of the ability of miniscrew authors' clinic with the complaint of severe open bite implants to open whole new possibilities in and difficulty biting. On examination she had skeletal orthodontics is in the treatment of anterior open bite vertical excess with incompetent lips (Figs 1.1–1.5). with vertical skeletal excess. With these implants, ;^\#&#& ;^\#&#' ;^\#&#( ;^\#&#) ;^\#&#* ) ORTHODONTIC MINISCREW IMPLANT If this patient had presented in the era before the dental relapse and no realistic possibility of intruding introduction of the miniscrew implant, the treatment the molars and therefore reducing the face height. options would have been either the extensive and However, this patient was fortunate that her invasive procedure of bimaxillary anterior subapical orthodontist offered non-surgical treatment using osteotomy with simultaneous impaction of the miniscrew implants. The improvement in esthetics and maxilla, or conventional orthodontic treatment with function following this treatment has remained stable the probability of some degree of post-treatment for 3 years (Figs 1.6–1.10). ;^\#&#+ ;^\#&#, ;^\#&#- ;^\#&#. ;^\#&#&%
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