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Junji Sugawara - One of the best experts on this subject based on the ideXlab platform.
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success rates of a Skeletal Anchorage system in orthodontics a retrospective analysis
Angle Orthodontist, 2018Co-Authors: Raymond W Lam, Mithran S Goonewardene, Brent Allan, Junji SugawaraAbstract:ABSTRACT Objectives: To evaluate the premise that Skeletal Anchorage with SAS miniplates are highly successful and predictable for a range of complex orthodontic movements. Materials and Methods: This retrospective cross-sectional analysis consisted of 421 bone plates placed by one clinician in 163 patients (95 female, 68 male, mean age 29.4 years ± 12.02). Simple descriptive statistics were performed for a wide range of malocclusions and desired movements to obtain success, complication, and failure rates. Results: The success rate of Skeletal Anchorage system miniplates was 98.6%, where approximately 40% of cases experienced mild complications. The most common complication was soft tissue inflammation, which was amenable to focused oral hygiene and antiseptic rinses. Infection occurred in approximately 15% of patients where there was a statistically significant correlation with poor oral hygiene. The most common movements were distalization and intrusion of teeth. More than a third of the cases involved...
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temporary Skeletal Anchorage devices the case for miniplates
American Journal of Orthodontics and Dentofacial Orthopedics, 2014Co-Authors: Junji SugawaraAbstract:he desire to have complete control over anchor-age is no doubt universal among orthodontists.About 100 years after orthodontists first startedusing tooth-borne Anchorage for orthodontic treat-ment, temporary Skeletal Anchorage devices appeared.It was clear that orthodontics would be a completelynew ball game; soon temporary Skeletal Anchorage de-vices had become indispensable modalities in modernorthodontic practices for adults. Beyond that, tempo-rary Skeletal Anchorage devices are at the center of in-novations of surgical orthodontics for jaw deformitiesand the orthopedic treatment of growing patientswith Skeletal disharmonies.As temporary Skeletal Anchorage devices were be-ing developed in the 1990s, 2 types were widely putinto use. There were great expectations for thosethat could osseointegrate with bone. This type in-cluded retromolar implants,
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nonextraction treatment with temporary Skeletal Anchorage devices to correct a class ii division 2 malocclusion with excessive gingival display
American Journal of Orthodontics and Dentofacial Orthopedics, 2014Co-Authors: Makoto Nishimura, Hiroshi Nagasaka, Minayo Sannohe, Kaoru Igarashi, Junji SugawaraAbstract:The patient was a 22-year-old Japanese woman who complained of a gummy smile. She had several other orthodontic problems, including crowding of the maxillary anterior teeth, retroclination of the maxillary central incisors, excessive maxillary incisor display, a deep overbite, Class II dental relationships, a Class II profile, and a long face. Two options for the correction of these problems were proposed. The first option was to extract the maxillary first premolars to correct the Class II relationship and implant a miniscrew to correct the gingival display; the second option was to place 2 miniplates for distalization of the maxillary molars and a miniscrew to correct the gingival smile without premolar extractions. The patient chose the second option. After placing a preadjusted bracketed system, 2 miniplates were placed in the zygomatic buttresses bilaterally with monocortical screws, and 1 miniscrew was fixed between the root apices of the maxillary central incisors. Distalization and intrusion of the maxillary molars and intrusion of the maxillary incisors were simultaneously started with those temporary Skeletal Anchorage devices functioning as absolute orthodontic anchors. The total treatment period was approximately 22 months. Her orthodontic problems were corrected. According to the cephalometric evaluation, the entire maxillary dentition was significantly distalized, and her maxillary incisors were successfully intruded, with the mandible showing a slight counterclockwise rotation. Thanks to the temporary Anchorage devices combined with miniplates and a miniscrew, we were able to predictably achieve her treatment goals without premolar extractions, orthognathic surgery, and the need for patient compliance.
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effects of maxillary molar intrusion on the nasal floor and tooth root using the Skeletal Anchorage system in dogs
Angle Orthodontist, 2009Co-Authors: Takayoshi Daimaruya, Junji Sugawara, Hiroshi Nagasaka, Mikako Umemori, Ichiro Takahashi, Hideo MitaniAbstract:Abstract The Skeletal Anchorage system (SAS) was developed to provide intraoral absolute Anchorage for the intrusion or distalization of molars. The purpose of this study was to verify the effects of remarkable molar intrusion on the tooth root and the maxillary sinus floor. Six adult female beagles with fully erupted dentition were used. Titanium miniplates were implanted bilaterally above the maxillary second premolar root apices using pentobarbital anesthesia. The second premolars were intruded for four or seven months after three months of healing after implantation. Standardized dental radiographs were taken periodically to evaluate the amount of tooth movement and root resorption. After the experimental animals were fixed by perfusion at the end of each experimental period, the second premolars were dissected along with the surrounding alveolar bone. Undecalcified (60 μm thick) and decalcified (five μm thick) sections were prepared. The average extent of intrusion was 1.8 mm after four months and 4....
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effects of maxillary molar intrusion on the nasal floor and tooth root using the Skeletal Anchorage system in dogs
Angle Orthodontist, 2009Co-Authors: Takayoshi Daimaruya, Junji Sugawara, Hiroshi Nagasaka, Mikako Umemori, Ichiro Takahashi, Hideo MitaniAbstract:The Skeletal Anchorage system (SAS) was developed to provide intraoral absolute Anchorage for the intrusion or distalization of molars. The purpose of this study was to verify the effects of remarkable molar intrusion on the tooth root and the maxillary sinus floor. Six adult female beagles with fully erupted dentition were used. Titanium miniplates were implanted bilaterally above the maxillary second premolar root apices using pentobarbital anesthesia. The second premolars were intruded for four or seven months after three months of healing after implantation. Standardized dental radiographs were taken periodically to evaluate the amount of tooth movement and root resorption. After the experimental animals were fixed by perfusion at the end of each experimental period, the second premolars were dissected along with the surrounding alveolar bone. Undecalcified (60 microm thick) and decalcified (five microm thick) sections were prepared. The average extent of intrusion was 1.8 mm after four months and 4.2 mm after seven months. The root apices of the intruded molars penetrated into the nasal cavity. Remodeled bone around the intruded molar toots was rich in woven bone on the buccal side, whereas that on the palatal side was rich in lamellar bone. Nasal floor membrane and a thin layer of newly formed bone, which lifted intranasally, covered the intruded molar root. Root resorption partly reached into the dentine without the formation of reparative cementum, and little or no serious pathological changes were seen in the pulp of the intruded molars. SAS effectively intruded maxillary molars, but some moderate root resorption was observed.
Moschos A Papadopoulos - One of the best experts on this subject based on the ideXlab platform.
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Skeletal Anchorage in orthodontic treatment of class ii malocclusion
Journal of Orthodontics, 2015Co-Authors: Moschos A PapadopoulosAbstract:Skeletal Anchorage in orthodontic treatment of class ll malocclusion , Skeletal Anchorage in orthodontic treatment of class ll malocclusion , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی
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Skeletal Anchorage in orthodontic treatment of class ii malocclusion
Journal of Orthodontics, 2015Co-Authors: Moschos A PapadopoulosAbstract:It is difficult to believe that the first articles on the use of Skeletal Anchorage only started to appear in the orthodontic literature less than two decades ago. Since then, thousands of articles...
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the use of miniscrew implants for temporary Skeletal Anchorage in orthodontics a comprehensive review
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2007Co-Authors: Moschos A Papadopoulos, Fadi TarawnehAbstract:Though not a novel therapeutic concept, the use of miniscrew implants to obtain absolute Anchorage has recently become very popular in clinical orthodontic approaches. The mode of Anchorage facilitated by these implant systems has a unique characteristic owing to their temporary use, which results in a transient, albeit absolute Anchorage. The foregoing properties together with the recently achieved simple application of these screws have increased their popularity, establishing them as a necessary treatment option in complex cases that would have otherwise been impossible to treat. The aim of this comprehensive review is to present and discuss the development, clinical use, benefits, and drawbacks of the miniscrew implants used to obtain a temporary but absolute/Skeletal Anchorage for orthodontic applications. Topics to be discussed include classification, types and properties (e.g., biocompatibility, osseointegration, types of Anchorage, screw head, and thread design), clinical applications, site and placement method selection, clinical procedures for implant insertion, and loading and removal processes. Lastly, the potential complications and the advantages and disadvantages accompanying their use are presented.
Mauro Cozzani - One of the best experts on this subject based on the ideXlab platform.
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a retrospective cephalometric study on pharyngeal airway space changes after rapid palatal expansion and herbst appliance with or without Skeletal Anchorage
Progress in Orthodontics, 2016Co-Authors: Antonio Manni, M Pasini, Maria Rita Giuca, Riccardo Morganti, Mauro CozzaniAbstract:The aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without Skeletal Anchorage. A 40-patient study group treated with the Herbst RME combination was included; moreover, a comparison between two subgroups based on whether miniscrews were used was evaluated. A subgroup 1 included 20 patients who were treated with RPE and an acrylic splint Herbst with miniscrews, and subgroup 2 included 20 patients who were treated with RPE and an acrylic splint Herbst. A cephalometric analysis was performed before (T1) and after (T2) treatment. The Skeletal parameters of the sagittal occlusion analysis of Pancherz were utilized together with some extra measurements to evaluate the airways. An increased nasopharyngeal airway space was observed in group 1 (p < 0.05) from T1 to T2. Furthermore, the increase in nasopharyngeal airway space was significantly higher in subgroup 1 (p < 0.05) in comparison to the subgroup 2. Oropharyngeal (OA) and laryngopharyngeal (LA) dimensions were significantly increased in the subgroup 1 at the end of the treatment. In the subgroup 1, a significant decrease in SNA, a significant increase in SNB, and a significant decrease in ANB were observed from T1 to T2. In the subgroup 2, the treatment resulted in a significant decrease in ANB. In both groups, Pogonion increased significantly from T1 to T2. The results suggest that the RPE and the Herbst appliance allow a slight improvement of the sagittal dimensions of the airways. The oropharyngeal dimension increased significantly more in the Skeletal Anchorage group.
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A retrospective cephalometric study on pharyngeal airway space changes after rapid palatal expansion and Herbst appliance with or without Skeletal Anchorage
SpringerOpen, 2016Co-Authors: Antonio Manni, M Pasini, Maria Rita Giuca, Riccardo Morganti, Mauro CozzaniAbstract:Abstract Background The aim of this study is to investigate the pharyngeal airway space changes in patients treated with rapid palatal expansion (RPE) and Herbst appliance with or without Skeletal Anchorage. Methods A 40-patient study group treated with the Herbst RME combination was included; moreover, a comparison between two subgroups based on whether miniscrews were used was evaluated. A subgroup 1 included 20 patients who were treated with RPE and an acrylic splint Herbst with miniscrews, and subgroup 2 included 20 patients who were treated with RPE and an acrylic splint Herbst. A cephalometric analysis was performed before (T1) and after (T2) treatment. The Skeletal parameters of the sagittal occlusion analysis of Pancherz were utilized together with some extra measurements to evaluate the airways. Results An increased nasopharyngeal airway space was observed in group 1 (p
Seonghun Kim - One of the best experts on this subject based on the ideXlab platform.
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accelerated tooth movement and temporary Skeletal Anchorage devices tsads
International Journal of Dentistry, 2014Co-Authors: Seonghun Kim, Gerald Nelson, Shinjae Lee, Ki Beom KimAbstract:Accelerated tooth movement (ATM) has been one of the vital treatment considerations in orthodontics. Currently, accelerated tooth movement is not limited in orthodontics only, but it extends into other parts of dentistry, such as periodontics, oral surgery, and prosthodontics. More and more, the dental treatments are approached interdisciplinary to achieve the best treatment outcomes and long-term prognosis in patients. There are increasing interests in defining the biologic changes to enhance the tooth movement and numerous in vitro and in vivo experimental studies contributed in understanding the modulators to enhance faster tooth movement to apply in mechanics. In accelerating the tooth movement, temporary Skeletal Anchorage devices (TSADs) have become one of the clinical modalities that gained so much recognition. TSADs can aid in targeting tooth movement control by providing Skeletal Anchorage without depending on adjacent teeth. In clinical practice, the combination of ATM and TSADs together can further advance treatment efficiency and efficacy of patients achieving treatment goals. The stability of TSADs is essential to fulfill the purpose of the treatment. This special issue delivers original research on the different aspects of TSADs' stability and also provides clinical research on new treatment method for ATM utilizing TSADs. N. Kaipatur et al.'s study was to develop an FE model of a TSAD in the rat maxilla to estimate the stress distribution in the surrounding cortical bone and the TSAD stability at different force levels followed by in vivo validation using a rodent model of orthodontic tooth movement. The strength of this article stems from the fact that there is no study published to date that used microimplants as TSAD for direct Anchorage to facilitate tooth movement. Most of the studies that published on tooth movement used incisors as Anchorage with iatrogenic and deleterious effects and concern for animal welfare. The significant amount of tooth movement they found would not have been possible without TSAD stability and resultant constant force levels although 6.7 microns/day distal drift and cranial growth could have had a minor influence on implant stability measurement. The stability of TSADs in healthy patients has been proved through numerous researches and journals. However, it would be meaningful to figure out factors that influence the stability of TSADs in systemic diseased patients. Diabetes mellitus affects bone healing and so it poses risk in stability of TSADs. J.-B. Park et al. and N.-H. Oh et al. made various attempts to improve the success rate of TSADs in DM patients. J.-B. Park et al.'s study aimed to evaluate effects of type 1 diabetes mellitus and mini-implant placement method on the primary stability of mini-implants by comparing mechanical stability and microstructural/histological differences. Through their animal study, type 1 diabetes mellitus and placement method of mini-implant did not affect primary stability of mini-implants. Study of N.-H. Oh et al. was to investigate effects of surface treatment of mini-implants in diabetes-induced rabbits by comparing osseointegration around mini-implants. In surface-treated mini-implants, maximum removal torque was higher in both diabetic and control groups. Type 1 diabetes mellitus and surface treatment method of mini-implant affected primary stability of mini-implants. In addition, the use of orthodontic mini-implants in a diabetic patient is likely to show results similar to that of the healthy patient. Further study is necessary; nevertheless from the studies by J.-B. Park et al. and N.-H. Oh et al., it has been confirmed that the surface treatment of TSADs and the implant method influence the stability of TSADs. When loosening and failure were experienced during TSADs usage, they were often replanted via recycling in a patient. Study by S. Estelita et al. provides another solution about the consequences of mechanical stimulation occurring during recycling of TSADs on mechanical stability of mini-implants. They evaluated the influence of recycling process on the torsional strength of mini-implants. The recycling protocols did not influence torsional strength of bone screws even when sandblast cleaning produced an abrasive mechanical stripping of the screw surface, but the structural loss was not sufficient to significantly influence the fracture torque. The stability of TSADs with minimum number of TSADs for enabling the detailed 3-dimensional tooth movement has been suggested by 3D CAD/CAM clinical study of S.-Y. Kwon et al. In their study, custom lingual orthodontic appliances named kinematics of lingual bar on nonparalleling technique (KILBON) were virtually designed by merging 3D model images with lateral and posterior-anterior cephalograms (Figure 1). This report describes CAD/CAM fabrication of the complex anteroposterior lingual bonded retraction appliance for intrusive retraction of the maxillary anterior dentition. Figure 1 In conclusion, TSADs have tremendously broadened the orthodontic treatment scope and impacted on reducing the need for surgical treatment. Application of TSADs for the ATM and the stability of TSADs within alveolar bone are critical; therefore, the original articles in this special issue on the methods of TSADs implantation and surface finish in terms of stability would pose significant role in future of contemporary orthodontics. In addition, recent advancement of 3D CAD/CAM imaging would permit least number of TSADs for the maximum treatment effect accurately. There are anatomic limitations in placement of TSADs and orthodontic tooth movement and also challenges in the improvement of medical image for detailed CAD/CAM appliance fabrications; nonetheless, the progress of science and the further researches would overcome these obstacles. Seong-Hun Kim Shin-Jae Lee Gerald Nelson Ki Beom Kim
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miniplate with a bendable c tube head allows the clinician to alter biomechanical advantage without physically moving the Skeletal Anchorage device
Journal of Craniofacial Surgery, 2014Co-Authors: Kyungwon Seo, Hyowon Ahn, Seonghun Kim, Kyurhim Chung, Gerald NelsonAbstract:BACKGROUNDS This article introduces a binary function of a miniplate with a bendable C-tube head used in corticotomy-assisted segment intrusion. The advantage of the device is that the point of force application can be altered without having to move the miniplate or place an additional Anchorage device. METHODS Cases for this study were selected from patients who received perisegmental corticotomy with compression osteogenesis (Speedy Surgical Orthodontics) for segmental intrusion. For the Skeletal Anchorage on patients who received Speedy Surgical Orthodontics for posterior segment intrusion to improve on severe open bite correction, the C-tube was placed on the buccal wall of the maxilla for traction of orthopedic force as a temporary Skeletal Anchorage. The C-tube head portion is made with titanium grade II, which makes bending easy with a Weingart plier. This adjustment regains distance and range needed to continue intrusion of posterior segment. RESULTS As an alternative to orthognathic surgery to correct a severe open bite, perisegmental corticotomy combined with orthopedic force application from a temporary Skeletal Anchorage device can be used. The corticotomy-assisted segment intrusion is a 2-stage procedure: first, the corticotomy is performed in the palate and 2 weeks later in the buccal alveolus. A C-plate was placed in the midpalatal area, and a C-tube was placed apical to the buccal corticotomy site. Elastics were used with orthopedic forces to induce compression osteogenesis. As the intrusion took place, the elastic stretched, and resultant force and range in the buccal segment decreased. The C-tube head was adjusted by bending to gain more distance, reviving the elastic force on the posterior segment until desired intrusion was accomplished. CONCLUSIONS The miniplate with a bendable C-tube head serves for temporary Skeletal Anchorage of orthopedic traction force to achieve segmental intrusion and has the advantage that the bendable head can be adjusted to improve the force application for intrusion without having to move or place another temporary Skeletal Anchorage device.
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en masse retraction dependent on a temporary Skeletal Anchorage device without posterior bonding or banding in an adult with severe bidentoalveolar protrusion seven years posttreatment
American Journal of Orthodontics and Dentofacial Orthopedics, 2012Co-Authors: Kyurhim Chung, Seonghun Kim, Domin Jeong, Gerald NelsonAbstract:This report describes a novel concept of en-masse retraction with temporary Skeletal Anchorage devices in place of posterior bonding or banding. The patient was a Korean woman, aged 24 years 4 months, with a Class II Division 1 malocclusion with severe mandibular anterior crowding. Both molars showed decalcification of the cervical areas. Partial osseointegration-based C-implants and C-tube plates were placed bilaterally between the maxillary second premolars and the first molars and in the posterior mandible. These temporary Skeletal Anchorage devices were used as independent appliances for full retraction of the maxillary and mandibular anterior teeth 3-dimensionally without the assistance of posterior bonded appliances. The posterior occlusion was not changed during treatment, and Class I occlusal relationships with optimal overjet and overbite were achieved. The 7-year posttreatment records showed a stable result.
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atypical orthodontic extraction pattern managed by differential en masse retraction against a temporary Skeletal Anchorage device in the treatment of bimaxillary protrusion
American Journal of Orthodontics and Dentofacial Orthopedics, 2011Co-Authors: Kyurhim Chung, Hyeran Choo, Jinhwa Lee, Seonghun KimAbstract:This report introduces an innovative treatment approach of selecting atypical and unconventional teeth for orthodontic extraction without compromising the quality of treatment outcomes by using temporary Skeletal Anchorage devices in patients with bimaxillary protrusion. Both patients introduced in this report had solid Class I molar relationships with bimaxillary anterior protrusion without facial or dental midline asymmetry. Their chief concerns were significant facial convexity, which conventionally requires the extraction of all 4 first premolars. However, 3 second premolars and 1 first premolar were removed in the first patient, and 2 second premolars and 2 first premolars were removed in the second patient. All second premolars extracted had previously had root canal treatment and large prosthodontic restorations, which resulted in a compromised short lifespan of the teeth relative to the natural dentition. To manage these cases of asymmetric extraction space in a symmetric dental and Skeletal environment, 2 mini-implants were placed in the posterior maxillary interradicular spaces, 1 on each side. Despite the unusual asymmetric extraction of teeth, superimposition of the pretreatment and posttreatment cephalometric tracings shows excellent treatment outcomes of facial convexity reduction by asymetric maximum retraction of the anterior teeth with no change in the molar relationships.
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speedy surgical orthodontic treatment with Skeletal Anchorage in adults sagittal correction and open bite correction
Journal of Oral and Maxillofacial Surgery, 2009Co-Authors: Kyurhim Chung, Masaharu Mitsugi, Baeksoo Lee, Takahiro Kanno, Won Lee, Seonghun KimAbstract:Purpose The present report describes a new type of corticotomy-assisted orthodontic treatment called Speedy orthodontics, which allows faster movements of the dental segments using Skeletal Anchorage. Materials and Methods To minimize the risk of necrosis, 2 procedures are performed. During the initial surgery, bilateral and horizontal corticotomies are performed in the palatal area with the patient under local anesthesia. After 2 to 3 weeks, a second buccal corticotomy is performed and 500 to 900 g of force per side is immediately applied to the corticotomized segment. Results Successful alveolar bone bending can be obtained in cases of adult protrusion or open bite. Conclusions Speedy orthodontics allows for more precise control of anterior segment retraction in adult protrusion patients and can be used for posterior segment intrusion. This technology is powerful, easy to apply, and provides a significant advance in surgical orthodontics.
Ricardo Alves De Souza - One of the best experts on this subject based on the ideXlab platform.
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maxillary protraction with rapid maxillary expansion and facemask versus Skeletal Anchorage with mini implants in class iii patients a non randomized clinical trial
Progress in Orthodontics, 2019Co-Authors: Ricardo Alves De Souza, Jose Rino Neto, Joao Batista De PaivaAbstract:The use of Skeletal Anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM). In this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) (n = 12), the individuals received orthopedic treatment with RME/FM. In group MI (n = 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05). Improvement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences (P ≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference (P > 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI. The protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.