Suitability of virtual plaster models superimposed with the lateral cephalogram for guided paramedian orthodontic mini-implant placement with regard to the bone support
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie, vol. 81, pp. 340–349
Abstract
PURPOSE: The purpose of this study was twofold: first, to evaluate the precision of guided orthodontic mini-implant (OMI) placement planned on virtual superimposition of plaster models and lateral cephalograms with regard to the bone support and, second, to investigate the effects of silicone guide extension. METHODS: A total of 40 OMIs were placed in the paramedian area of the anterior palates of 20 cadaver heads. Digitalized models and the corresponding lateral cephalograms were superimposed for planning the OMI positions, and tooth-supported (TS) and soft-tissue-supported (STS) templates were manufactured. Thereafter, postoperative cone beam computed tomography (CBCT) was performed, and the straight (A) and right-angle distance (B) from the implant tip to the nasal floor, the distance from the implant shoulder to the hard palate (C) and the angle (α) between the implant and palate plane with the preoperative (T0) and postoperative (T1) positions were measured. RESULTS: The postoperative distances A, B, and C were less than the planned implant positions. However, significant difference between T0 and T1 was only noted in terms of distance A using the TS templates (T0: 4.7 ± 2.3 mm, T1: 3.0 ± 2.3 mm; p = 0.008) and distance B using the STS template (T0: 3.1 ± 3.5 mm, T1: 2.3 ± 3.2 mm; p = 0.041). There were no significant differences in all average deviations (∆ Ceph/CBCT) between the two templates. CONCLUSIONS: Guided OMI placement planned by virtual superimposition of digitized models and the corresponding lateral cephalogram is fundamentally feasible. However, the position closer to the nasal floor needs critical assessment for correct implantation. The silicone template expansion seems to have only a minor effect on transfer accuracy.
Authors 8
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Stephan Christian Möhlhenrich corresponding
Affiliation as printed
Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen-Str. 45, 58455, Witten, Germany. stephan.moehlhenrich@uni-wh.de
Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen-Str. 45, 58455, Witten, Germany
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Affiliation as printed
Private Practice for Orthodontics, Blumenstraße 29, 73728, Esslingen, Germany
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Affiliation as printed
Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Affiliation as printed
Institute of Molecular and Cellular Anatomy, Medical Faculty, RWTH-Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Affiliation as printed
Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen-Str. 45, 58455, Witten, Germany
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