正畸微种植体定位方法研究进展

doi:10.13701/j.cnki.kqyxyj.2023.02.002

摘要/Abstract

摘要： 正畸微种植体(orthodontic mini-implant,OMI)较传统支抗有体积小、应用灵活、患者依从性要求低等优势,是目前临床中常用的支抗手段。OMI的应用前提是安全与稳定,其应位于足够数量和质量的骨内,避免邻近解剖结构损伤,在此基础上准确设计OMI的位置和方向有利于实现预期力学机制,进一步提高临床疗效。本文主要阐述OMI的定位方法,以期为临床中安全高效地应用OMI,实现精准正畸理念提供参考。

关键词: 正畸微种植体, 定位装置, 手术导板, CAD/CAM, 三维打印

Abstract: Compared with traditional anchorage, orthodontic mini-implant (OMI) has advantages of small volume, flexible application, and low patient compliance requirements, and is a commonly used anchorage method in clinical practice at present. OMI is applied on the premise of safety and stability, which should be located in sufficient quantity and quality of bone to avoid damage to adjacent anatomical structures. On this basis, accurate design of OMI position and direction is conducive to realize the expected mechanical mechanism and further improving clinical efficacy. This paper mainly describes OMI localization methods, in order to provide reference for safe and efficient application of OMI in clinical practice and realization of accurate orthodontic concept.

Key words: orthodontic mini-implant, positioning device, surgical guides, CAD/CAM, 3D printing

徐静, 胡敏. 正畸微种植体定位方法研究进展[J]. 口腔医学研究, 2023, 39(2): 101-104.

XU Jing, HU Min. Advances in Orthodontic Mini-implant Localization[J]. Journal of Oral Science Research, 2023, 39(2): 101-104.

参考文献

[1] 李巍然.种植体支抗在正畸的应用现状与思考[J].中华口腔正畸学杂志,2020,27(1):2-3.
[2] Pan CY, Liu PH, Tseng YC, et al. Effects of cortical bone thickness and trabecular bone density on primary stability of orthodontic mini-implants [J]. J Dent Sci, 2019, 14(4): 383-388.
[3] Albogha MH, Takahashi I. Effect of loaded orthodontic miniscrew implant on compressive stresses in adjacent periodontal ligament [J]. Angle Orthod, 2019, 89(2): 235-241.
[4] Mallick S, Murali PS, Kuttappa MN, et al. Optimal sites for mini-implant insertion in the lingual or palatal alveolar cortical bone as assessed by cone beam computed tomography in South Indian population [J]. Orthod Craniofac Res, 2021, 24(1): 121-129.
[5] Rodriguez JC, Suarez F, Chan HL, et al. Implants for orthodontic anchorage: success rates and reasons of failures [J]. Implant Dent, 2014, 23(2): 155-161.
[6] Liu H, Wu X, Tan J, et al. Safe regions of miniscrew implantation for distalization of mandibular dentition with CBCT [J]. Prog Orthod, 2019, 20(1): 45.
[7] Lee JA, Ahn HW, Oh SH, et al. Evaluation of interradicular space, soft tissue, and hard tissue of the posterior palatal alveolar process for orthodontic mini-implant, using cone-beam computed tomography [J]. Am J Orthod Dentofacial Orthop, 2021, 159(4): 460-469.
[8] Chang CJ, Lin WC, Chen MY,et al. Evaluation of total bone and cortical bone thickness of the palate for temporary anchorage device insertion [J]. J Dent Sci, 2021, 16(2): 636-642.
[9] Du B, Zhu J, Li L, et al. Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment [J]. Am J Orthod Dentofacial Orthop, 2021, 160(1): 113-123.
[10] Landin M, Jadhav A, Yadav S, et al. A comparative study between currently used methods and Small Volume-Cone Beam Tomography for surgical placement of mini implants [J]. Angle Orthod, 2015, 85(3): 446-453.
[11] Estelita S, Janson G, Chiqueto K, et al. Predictable drill-free screw positioning with a graduated 3-dimensional radiographic-surgical guide: a preliminary report [J]. Am J Orthod Dentofacial Orthop, 2009, 136(5): 722-735.
[12] Estelita S, Janson G, Chiqueto K, et al. Mini-implant insertion based on tooth crown references: a guide-free technique [J]. Int J Oral Maxillofac Surg, 2012, 41(1): 128-135.
[13] Chhatwani S, Rose-Zierau V, Haddad B, et al. Three-dimensional quantitative assessment of palatal bone height for insertion of orthodontic implants - a retrospective CBCT study [J]. Head Face Med, 2019, 15(1):9.
[14] Möhlhenrich SC, Kniha K, Peters F, et al. Anatomical assessment by cone beam computed tomography with the use of lateral cephalograms to analyse the vertical bone height of the anterior palate for orthodontic mini-implants [J]. Orthod Craniofac Res, 2021, 24(1): 78-86.
[15] 张栋梁,崔祥生,李梦华.微螺钉种植辅助定位装置的设计及临床应用[J].北京口腔医学,2007,15(4):207-209.
[16] An JH, Kim YI, Kim SS, et al. Root proximity of miniscrews at a variety of maxillary and mandibular buccal sites:Reliability of panoramic radiography [J]. Angle Orthod, 2019, 89(4): 611-616.
[17] Miyazawa K, Kawaguchi M, Tabuchi M, et al. Accurate pre-surgical determination for self-drilling miniscrew implant placement using surgical guides and cone-beam computed tomography [J]. Eur J Orthod, 2010, 32(6): 735-740.
[18] Torres PR, Gil ST, Zubizarreta-Macho Á,et al. Influence of the computer-aided static navigation technique on the accuracy of the orthodontic micro-screws placement: An in vitro study [J]. J Clin Med, 2021, 10(18): 4127.
[19] Liang S, Wang F, Chang Q, et al. Three-dimensional comparative evaluation of customized bone-anchored vs tooth-borne maxillary protraction in patients with skeletal Class Ⅲ malocclusion [J]. Am J Orthod Dentofacial Orthop, 2021, 160(3): 374-384.
[20] Riad Deglow E, Toledano Gil S, Zubizarreta-Macho Á, et al. Influence of the computer-aided static navigation technique and mixed reality technology on the accuracy of the orthodontic micro-screws placement. An in vitro study [J]. J Pers Med, 2021, 11(10): 964.
[21] Cornelis MA, Tepedino M, Cattaneo PM, et al. Root repair after damage due to screw insertion for orthodontic miniplate placement [J]. J Clin Exp Dent, 2019, 11(12): e1133-e1138.
[22] Kapetanovi A, Oosterkamp BCM, Lamberts AA, et al. Orthodontic radiology: development of a clinical practice guideline [J]. Radiol Med, 2021, 126(1): 72-82.
[23] Kniha K, Brandt M, Bock A, et al. Accuracy of fully guided orthodontic mini-implant placement evaluated by cone-beam computed tomography: a study involving human cadaver heads [J]. Clin Oral Investig, 2021, 25(3): 1299-1306.
[24] Kim SH, Choi YS, Hwang EH, et al. Surgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography [J]. Am J Orthod Dentofacial Orthop, 2007, 131(4 Suppl): S82-S89.
[25] Qiu L, Xu H, Feng P, et al. Clinical effectiveness of orthodontic miniscrew implantation guided by a novel cone beam CT image-based computer aided design and computer aided manufacturing (CAD-CAM) template [J]. Ann Transl Med, 2021, 9(12): 1025.
[26] Yu JH, Wang YT, Lin CL. Customized surgical template fabrication under biomechanical consideration by integrating CBCT image, CAD system and finite element analysis [J]. Dent Mater J, 2018, 37(1): 6-14.
[27] 朱玉佳,蒋博,孙玉春,等.口腔三维冠根整合模型构建方法的研究进展[J].中华口腔医学杂志,2020,55(4):280-284.
[28] Qiu L, Haruyama N, Suzuki S, et al. Accuracy of orthodontic miniscrew implantation guided by stereolithographic surgical stent based on cone-beam CT-derived 3D images [J]. Angle Orthod, 2012, 82(2): 284-293.
[29] 陈妍曲,唐敏,黄旋平,等.高精度三维整合牙颌模型个体化OMI手术导板的计算机辅助设计与制作[J].中国组织工程研究,2018,22(10):1529-1533.
[30] Ludwig B, Krause L, Venugopal A. Accuracy of sterile and non-sterile CAD/CAM insertion guides for orthodontic mini-implants [J]. Frontiers in Dental Medicine, 2022, 3.
[31] Minervino BL, Barriviera M, Curado MM, et al. MARPE guide: A case report [J]. J Contemp Dent Pract, 2019, 20(9): 1102-1107.
[32] Nilius M, Hess K, Haim D, et al. Multifunctional templates for minimized osteotomy, implantation, and palatal distraction with a mini-screw-assisted expander in schizodontism and maxillary deficit [J]. Case Rep Dent, 2020, 2020: 8816813.
[33] Li N, Sun W, Li Q, et al. Skeletal effects of monocortical and bicortical mini-implant anchorage on maxillary expansion using cone-beam computed tomography in young adults [J]. Am J Orthod Dentofacial Orthop, 2020, 157(5): 651-661.
[34] Wilmes B, Vasudavan S, Drescher D. CAD-CAM-fabricated mini-implant insertion guides for the delivery of a distalization appliance in a single appointment [J]. Am J Orthod Dentofacial Orthop, 2019, 156(1): 148-156.
[35] Chen W, Zhang K, Liu D. Palatal bone thickness at the implantation area of maxillary skeletal expander in adult patients with skeletal Class Ⅲ malocclusion: a cone-beam computed tomography study [J]. BMC Oral Health, 2021, 21(1): 144.
[36] Cantarella D, Savio G, Grigolato L, et al. A new methodology for the digital planning of micro-implant-supported maxillary skeletal expansion [J]. Med Devices (Auckl), 2020, 13: 93-106.
[37] Lo Giudice A, Quinzi V, Ronsivalle V, et al. Description of a digital work-flow for CBCT-guided construction of micro-implant supported maxillary skeletal expander [J]. Materials (Basel), 2020, 13(8): 1815.