The Orthodontic Mini–implant Clinical Handbook

DESCRIPTION:

 

Offers the very latest on the theory and practice of integrating mini-implant techniques into clinical practice

This all-new second edition of The Orthodontic Mini-implant Clinical Handbook provides a thoroughly revised and expanded update to the theoretical and practical aspects of using mini-implants in orthodontic practice. Taking a practical step-by-step approach with hundreds of clinical images, it presents updated clinical techniques and new clinical cases, covering all topics of importance for utilising mini-implants. It also includes a new chapter on mini-implant anchored maxillary expansion appliances.

It begins with a chapter that looks at mini-implant principles and potential complications, before moving onto clinical and design factors for maximising mini-implant success. Other chapters cover incisor retraction; molar distalisation and protraction; intrusion and anterior openbite treatments; bone anchored rapid maxillary expansion; orthognathic surgical uses; and ectopic teeth.

Provides a comprehensive guide to both theoretical and practical advice for the use of mini-implants in orthodontic practice

Covers updated clinical techniques and new clinical cases

Presents a new chapter on mini-implant anchored maxillary expansion appliances

Takes a highly illustrated step-by-step approach ideal for clinical practice

The Orthodontic Mini-Implant Clinical Handbook is an essential resource to orthodontists, maxillofacial surgeons, practicing dentists, and anyone with an interest in mini-implant skeletal anchorage.

 

 

TABLE OF CONTENTS:

 

Preface to Second Edition xi

1 Orthodontic Mini-implant Principles and Potential Complications 1

1. 1 The Origins of Orthodontic Bone Anchorage 1

1. 2 The Evolution of Mini-implant Biomechanics 1

1. 3 3D Anchorage Indications 1

1. 4 Using the Right Terminology 2

1. 5 Principal Design Features 2

1. 6 Clinical Indications for Mini-implants 2

1.

6. 1 Routine Cases 2

1.

6. 2 Complex Cases 3

1.

6. 3 Direct and Indirect Anchorage 3

1. 7 Benefits and Potential Mini-implant Complications 3

1. 8 Mini-implant Success and Failure 4

1. 9 Medical Contraindications 5

1. 10 Root/Periodontal Damage 5

1. 11 Perforation of Nasal and Maxillary Sinus Floors 6

1. 12 Damage to Neurovascular Tissues 6

1. 13 Mini-implant Fracture 7

1. 14 Pain 7

1. 15 Soft Tissue Problems 8

1. 16 Mini-implant Migration 8

1. 17 Biomechanical Side-effects 10

1. 18 Factors Affecting Mini-implant Success 11

References 11

2 Maximising Mini-implant Success: Patient (Anatomical) Factors 15

2. 1 Cortical Bone Thickness and Density 15

2. 2 Interproximal Space 16

2. 3 Soft Tissue and Oral Hygiene 17

2. 4 Maxillomandibular Planes Angle 17

2. 5 Age 18

2. 6 Cigarette Smoking 18

2. 7 Body Mass Index 18

References 19

3 Maximising Mini-implant Success: Design Factors 21

3. 1 Mini-implant Design Factors 21

3. 2 The Infinitas™ Mini-implant System 22

3.

2. 1 Infinitas Mini-implant Design Features 22

3.

2. 2 Infinitas Guidance System 24

3. 3 Digital Stent Fabrication Processes 27

References 29

4 Maximising Mini-implant Success: Clinical Factors 31

4. 1 Clinical Technique Factors 31

4.

1. 1 Insertion Technique 31

4.

1. 2 Root Proximity 31

4.

1. 3 Force Application 33

4. 2 Introducing Mini-implants to your Clinical Practice 33

4. 3 Patient Consent 33

4. 4 Key Points to Consider for Valid Consent 35

4.

4. 1 Rationale for Mini-implant Anchorage 35

4.

4. 2 Patient Discomfort 35

4.

4. 3 Mini-implant Instability 35

4.

4. 4 Periodontal/Root Contact 35

4.

4. 5 Mini-implant Fracture 35

4.

4. 6 Mini-implant Displacement 35

4.

4. 7 Written Information 35

4. 5 Staff Training 35

4. 6 Patient Selection 35

References 37

5 Mini-implant Planning 41

5. 1 Mini-implant Planning 41

5.

1. 1 Treatment Goals and Anchorage Requirements 41

5. 2 Mini-implant Location 41

5. 3 Hard Tissue Anatomy and Radiographic Imaging 41

5. 4 Soft Tissue Anatomy 45

5. 5 Vertical Location and Inclination 46

5. 6 Insertion Timing 46

5. 7 Guidance Stent 49

5. 8 Mini-Implant Dimensions 49

References 51

6 Mini-implant Insertion 53

6. 1 Mini-implant Kit Sterilisation 53

6. 2 Superficial Anaesthesia 53

6. 3 Antibacterial Mouthwash 54

6. 4 Stent Application (Optional) 54

6. 5 Soft Tissue Removal 54

6. 6 Cortical Perforation 55

6. 7 Mini-implant Insertion 55

6. 8 Mini-implant Fracture 58

6. 9 Postoperative Instructions 58

6. 10 Force Application 59

6. 11 Biomechanics 59

6. 12 Explantation 59

6. 13 Summary of Mini-implant Insertion Steps 60

6. 14 Maximising Mini-implant Success: Ten Clinical Tips 60

References 60

7 Retraction of Anterior Teeth 63

7. 1 Clinical Objective 66

7. 2 Treatment Options 66

7. 3 Key Treatment Planning Considerations 66

7. 4 Biomechanical Principles 67

7. 5 Midtreatment Problems and Solutions 67

7. 6 Clinical Steps for a Posterior Mini-implant 67

7.

6. 1 Preinsertion 67

7.

6. 2 Mini-implant Selection 68

7.

6. 3 Insertion 68

7.

6. 4 Postinsertion 69

7. 7 Biomechanical Options for Anterior Teeth Retraction 69

7. 8 Case Examples 70

References 99

8 Molar Distalisation 101

8. 1 Alternatives to Mini-Implant Distalisation 101

8.

1. 1 Class II Growth Modification Treatment, Involving Mini-implant Anchorage (Figure

8. 1) 102

8.

1. 2 Mandibular Distalisation Using Miniplate Anchorage (Figure

8. 3) 105

8. 2 Clinical Objectives of Molar Distalisation 105

8. 3 Treatment Options 105

8. 4 Key Treatment Planning Considerations 110

8. 5 Biomechanical Principles 110

8. 6 Midtreatment Problems and Solutions 110

8. 7 Mandibular Arch Distalisation 110

8.

7. 1 Clinical Steps for Mandibular Distalisation 110

8.

7. 2 Case Examples 113

8. 8 Maxillary Arch Distalisation 116

8.

8. 1 Clinical Steps for Palatal Alveolar Distalisation 116

8.

8. 2 Case Examples 117

8. 9 Midpalatal Distaliser Options 121

8.

9. 1 Pushcoil Distaliser 127

8.

9. 2 Traction Distaliser 127

8.

9. 3 Clinical Steps for a Midpalatal Distaliser 127

8.

9. 4 Case Examples 129

References 135

9 Molar Protraction 137

9. 1 Clinical Objective 141

9. 2 Treatment Options 141

9. 3 Key Treatment Planning Considerations 141

9. 4 Biomechanical Principles 141

9. 5 Midtreatment Problems and Solutions 142

9. 6 Clinical Steps for Molar Protraction Using Alveolar Site Anchorage 142

9.

6. 1 Preinsertion 142

9.

6. 2 Mini-implant Selection 144

9.

6. 3 Insertion 145

9.

6. 4 Postinsertion 145

9. 7 Case Examples 145

9. 8 Clinical Steps for Midpalate (Indirect) Anchorage (Figure

9. 3) 161

9.

8. 1 Preinsertion 161

9.

8. 2 Mini-implant Selection 161

9.

8. 3 Insertion 161

9.

8. 4 Postinsertion 161

9. 9 Direct Palatal Anchorage Example (Figure

9. 15) 162

References 166

10 Intrusion and Anterior Openbite Treatments 167

10. 1 Single-Tooth and Anterior Segment Intrusion Treatments 169

10.

1. 1 Clinical Objectives 169

10.

1. 2 Treatment Options 169

10.

1. 3 Relevant Clinical Details 169

10.

1. 4 Biomechanical Principles 169

10.

1. 5 Clinical Tips and Technicalities 169

10.

1. 6 Clinical Steps 170

10.

1. 7 Case Examples 170

10. 2 Anterior Openbite Treatment 172

10.

2. 1 Clinical Objectives 174

10.

2. 2 Treatment Options 174

10.

2. 3 Relevant Clinical Details 174

10.

2. 4 Biomechanical Principles 174

10.

2. 5 Clinical Tips and Technicalities 176

10.

2. 6 Simultaneous Mandibular Molar Intrusion 182

10.

2. 7 Clinical Steps for Maxillary Molar Intrusion 182

10.

2. 8 Case Examples 185

References 206

11 Transverse and Asymmetry Corrections 209

11. 1 Asymmetry Problems 209

11. 2 Dental Centreline Correction 209

11.

2. 1 Clinical Objective 209

11.

2. 2 Treatment Options 209

11.

2. 3 Relevant Clinical Details 210

11.

2. 4 Biomechanical Principles 210

11.

2. 5 Clinical Tips and Technicalities 210

11.

2. 6 Midtreatment Problems and Solutions 210

11.

2. 7 Clinical Steps for Centreline Correction 210

11.

2. 8 Case Examples 211

11. 3 Unilateral Intrusion (Vertical Asymmetry Correction) 227

11.

3. 1 Clinical Objective 227

11.

3. 2 Treatment Options 227

11.

3. 3 Relevant Clinical Details 227

11.

3. 4 Biomechanical Principles 228

11.

3. 5 Clinical Tips and Technicalities 228

11.

3. 6 Midtreatment Problems and Solutions 228

11.

3. 7 Clinical Steps for Unilateral Intrusion 232

11.

3. 8 Case Example (Figure

11. 7) 234

12 Ectopic Teeth Anchorage 239

12. 1 Clinical Objectives 239

12. 2 Treatment Options 239

12. 3 Relevant Clinical Details 239

12. 4 Biomechanical Principles 240

12. 5 Clinical Tips and Technicalities 241

12. 6 Midtreatment Problems and Solutions 241

12. 7 Clinical Steps for Ectopic Tooth Alignment 241

12.

7. 1 Preinsertion 241

12.

7. 2 Mini-implant Selection 241

12.

7. 3 Insertion 242

12.

7. 4 Postinsertion 242

12.

7. 5 Case Examples 242

13 Bone-anchored Maxillary Expansion 259

13. 1 Conventional Rapid Maxillary Expansion 259

13. 2 Expansion Forces and Speed 260

13. 3 Potential Advantages of Mini-implant Anchored RME 263

13.

3. 1 Greater Basal Skeletal Expansion 263

13.

3. 2 Basal Expansion in Older Aged Patients (Postpuberty) 263

13.

3. 3 Greater Posterior Palatal Expansion 263

13.

3. 4 Increased Nasal Airflow 263

13.

3. 5 Fewer Dental and Periodontal Side-effects 263

13. 4 Clinical Objective 264

13. 5 Treatment Options 264

13. 6 Relevant Clinical Details 264

13. 7 Design Options for Mini-implant Expanders 264

13. 8 Hybrid RME 264

13.

8. 1 Mini-implant Assisted Rapid Palatal Expansion (MARPE) 264

13.

8. 2 Hybrid Hyrax RME Appliance 266

13.

8. 3 Biomechanical Principles for Hybrid RME Appliances 271

13.

8. 4 Clinical Steps for Hybrid RME 271

13. 9 Non-tooth Borne Mini-Implant Only RME 271

13.

9. 1 Case Examples 271

13. 10 Biomechanical Principles 278

13.

10. 1 Clinical Steps for OMI-borne RME 278

13. 11 Haas-type (Mucosa) and Mini-implant RME 278

13.

11. 1 Clinical Steps for Mucosa-OMI Borne RME 279

13.

11. 2 Case Example 279

13. 12 Summary of RME Design Selection 279

References 283

14 Orthognathic Surgical Uses 285

14. 1 Clinical Objectives 285

14. 2 Treatment Options 302

14. 3 Relevant Clinical Details 302

14. 4 Biomechanical Principles 322

14. 5 Clinical Tips and Technicalities 323

14. 6 Clinical Steps 324

14.

6. 1 Preinsertion 324

14.

6. 2 Mini-implant Selection 324

14.

6. 3 Insertion 324

14.

6. 4 Postinsertion 325

14. 7 Case Examples 325

References 328

Index 329