AUGUST 2024
Comparative analysis of primary stability of single thread and double thread orthodontic mini screws & perception of mini-implants amongst oral maxillofacial surgeons, endodontists, orthodontists & general dental practitioners
Dr. Naseer Ahmed Kakar1*, Dr. Pirah Haque2, Dr. Alima Mohsin Zakai 3, Dr. Tariq4, Dr. Ghulam Habib5, Dr. Iqra Kamal6
BDS, FCPS (Oral and Maxillofacial Surgery) ,Bolan Medical College, Quetta, BDS, FCPS (PG. R), Department of Orthodontics, Dr. Ishrat-Ul-Ibad Khan Institute of Oral Health Sciences (DIKIOHS), DOW UNIVERSITY OF HEALTH SCIENCES (DUHS), Karachi, BDS, FCPS (Orthodontics), Lecturer- Orthodontics Department, Institute of Dentistry LUMHS, Jamshoro, BDS, FCPS (Orthodontics), Senior Registrar – Bhitai Dental and Medical College, Mirpur Khas, BDS, M.Sc. Oral & Maxillofacial Surgery, Lecturer- Institute of Dentistry LUMHS, Jamshoro. BDS, MDS, CHPE, PhD (Scholar), Lecturer – Department of Operative Dentistry, Dr. Ishrat-Ul-Ibad Khan Institute of Oral Health Sciences (DIKIOHS). Dow University of Health Sciences (DUHS), Karachi
Correspondence: Dr. Naseer Ahmed Kakar, BDS, FCPS (Oral & Maxillofacial Surgery), Bolan Medical College, Quetta
Abstract
This study aimed to examine the stability of double-thread and single-thread orthodontic mini-screws, as well as to investigate potential relationships between a patient and location-related factors and stability of mini screws. This study also aimed to investigate the perception about mini-implants amongst oral maxillofacial surgeons, endodontist, orthodontist & general dental practitioners. Methods: 50 mini-screws with the same dimensions—08 mm in length and 1.6 mm in diameter—twenty-five single-thread and twenty-five double-thread—were used in this retrospective cohort study. Mini-screws were placed in different parts of upper jaw in 46 individuals (mean age = 14.5 ± 2.5 years; 20 females, 23 males). Excessive movement or the loosening and loss of the mini-screw after placement were considered as a failure. Patient age, gender, insertion site, palatal or buccal side of insertion, force application time, and occurrence of failure were all documented. To investigate the perception about mini-implants, a questionnaire form comprising of 11 questions was distributed (by hand and via email) among 200 dental specialists and general dental practitioners. Results: The overall success rate in the study was 86%. Double-threaded mini-implants had considerably greater success rates than single-thread miniscrews (P = 0.059), with 98% and 76%, respectively. Gender, age, insertion site, and side of insertion did not significantly show failure (P > 0.05). Log-rank analysis found a significant difference (P = 0.051) between the two groups, indicating a greater probability of survival for the double-thread design. The results of present study also revealed that the experience and knowledge of majority of various dental specialists in this study have a sound knowledge about the indications, contraindications, technique of placement of mini-implants. 32.5% specialists preferred the mini-implants were orthodontist and 28.3% strongly disagreed that placement of traditional implants was easier than mini-implants were oral & maxillofacial surgeons who routinely perform various surgeries. 65% of dentists remained unaffected by showing up of patients with already placed mini-implants who visit the clinic for restoration of mini-implants, mainly these included experienced restorative dentist & endodontist. 25 participants who were all general dentist perceived that the restoration of mini-implants makes them fairly puzzled. Conclusions: In the current study, orthodontic mini-implants had a good overall success rate. When compared to single-threaded mini-screws, double-threaded mini-screws positioned in different sections of the maxillary arch showed better stability and survival rates. Double-threaded mini-screws may therefore be recommended in cases when bone quality is inadequate, such as in young patients. Success rate of mini-implants could be great if placed by a specialist dental surgeon with a sound knowledge regarding when and when-not to place the mini-implants, utilizing proper technique with a very good clinical experience.