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Replacing a failed mini-implant with a miniplate to prevent interruption during orthodontic treatment.

Authors
Lee, JH; Choo, H; Kim, SH; Chung, KR; Giannuzzi, LA; Ngan, P
Citation
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 139(6):849-857, 2011
Journal Title
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics
ISSN
0889-54061097-6752
Abstract
INTRODUCTION: When mini-implants fail during orthodontic treatment, there is a need to have a backup plan to either replace the failed implant in the adjacent interradicular area or wait for the bone to heal before replacing the mini-implant. We propose a novel way to overcome this problem by replacement with a miniplate so as not to interrupt treatment or prolong treatment time.



METHODS: The indications, advantages, efficacy, and procedures for switching from a mini-implant to a miniplate are discussed. Two patients who required replacement of failed mini-implants are presented. In the first patient, because of the proximity of the buccal vestibule to the mini-implant, it was decided to replace the failed mini-implant by an I-shaped C-tube miniplate. In the second patient, radiolucencies were found around the failed mini-implants, making the adjacent alveolar bone unavailable for immediate placement of another mini-implant. In addition, the maxillary sinus pneumatization was expanded deeply into the interradicular spaces; this further mandated an alternative placement site. One failed mini-implant was examined under a scanning electron microscope for bone attachment.



RESULTS: Treatment was completed in both patients after replacement with miniplates without interrupting the treatment mechanics or prolonging the treatments. Examination under the scanning electron microscope showed partial bone growth into the coating pores and titanium substrate interface even after thorough cleaning and sterilization.



CONCLUSIONS: Replacement with a miniplate is a viable solution for failed mini-implants during orthodontic treatment. The results from microscopic evaluation of the failed mini-implant suggest that stringent guidelines are needed for recycling used mini-implants.
MeSH terms
AdolescentAlveolar Process/pathologyBiomechanics*Bone Plates*Dental ImplantsEquipment FailureEquipment ReuseFemaleHumansMalocclusion/therapyMaxilla/pathologyMaxillary Sinus/pathologyMicroscopy, Electron, ScanningOrthodontic Anchorage Procedures/*instrumentationOrthodontic Appliance DesignOsseointegration/physiologyStress, MechanicalSurface PropertiesTooth Movement/instrumentation
DOI
10.1016/j.ajodo.2009.08.032
PMID
21640893
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Dentistry
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