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Skeletal anchorage for everybody? A questionnaire study on frequency of use and clinical indications in daily practice

Skelettale Verankerung für Alle? – Eine Fragebogenstudie zu Häufigkeit und Indikationen in der täglichen Praxis

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

An Erratum to this article was published on 20 May 2015

Abstract

Aim

The purpose of this survey was to determine how commonly, and in what clinical situations, German-based orthodontists use skeletal anchorage devices in daily clinical practice.

Method

In early 2013, a set of questionnaires on the subject of skeletal anchorage devices was mailed to 2459 members of the German Orthodontic Society (Deutsche Gesellschaft für Kieferorthopädie, DGKFO). The questions dealt separately with miniscrews (MSCs) and osseointegrated palatal implants (OPIs). The addressees were asked whether or not, as well as how frequently and in what clinical situations, they used these MSCs and/or OPIs, what their experience was, and to elaborate on their reasons for using or not using these devices.

Results

The rate of returned questionnaires was 48 %. To correctly interpret our data, it should be kept in mind that an unknown number of respondents did not distinguish between OPIs and palatally inserted MSCs. Overall, 62 % indicated that they did use MSCs and/or OPIs, although most of them (> 50 %) infrequently (≤ 2 new patients/3 months). Only ≤ 2 % were frequent users (> 2 new patients/week). While most users (> 70 %) indicated that their experience was mostly good, only ≤ 50 % considered the devices easy and trouble-free to use in daily clinical practice. The median percentage of insertion procedures conducted by the respondents themselves was 2 % for MSCs and 0 % for OPIs.

Many of the non-users indicated that their treatment concept did not include suitable clinical indications (≥ 50 %), expressed skepticism about the success rates (56 % of MSC and 21 % of OPI non-users), or thought that the insertion procedures involved were too complex or time-consuming (33 % of MSC and 56 % of OPI non-users).

Conclusion

A total of 62 % of German-based orthodontists participating in this survey indicated using skeletal anchorage devices, although most of them infrequently. Major reasons for non-use were lack of clinical indications, skepticism about the success rate of MSCs, and overly complex or time-consuming procedures of surgical OPI insertion.

Zusammenfassung

Ziel

Ziel dieser Fragebogenstudie war es zu erheben, wie häufig und bei welchen Indikationen skeletale Verankerungselemente in der Praxis tatsächlich eingesetzt werden.

Methode

Ein Fragebogen zur Anwendung skeletaler Verankerungselemente (Mini-Pins, Gaumenimplantate) und der damit verbundenen Erfahrung wurde Anfang 2013 an 2459 Mitglieder der Deutschen Gesellschaft für Kieferorthopädie (DGKFO) versandt. Außerdem wurden die Hauptindikationen sowie die Gründe für eine eventuelle Nichtanwendung erfragt.

Ergebnisse

Die Rücklaufquote der Fragebögen betrug 48 %. Bei der Interpretation der Ergebnisse muss berücksichtigt werden, dass eine unbestimmte Anzahl Teilnehmer nicht zwischen Gaumenimplantaten und am Gaumen inserierten Mini-Pins differenziert hat. Insgesamt 62 % der Teilnehmer gaben an, skelettale Verankerungselemente zu verwenden – die meisten (> 50 %) tun dies allerdings selten (≤ 2 neue Patienten/Quartal). Eine häufige Anwendung (> 2 neue Patienten/Woche) wird von ≤ 2 % der Teilnehmer angegeben. Die meisten Anwender (> 70 %) berichten von überwiegend guten Erfahrungen, allerdings beurteilen nur ≤ 50 % die Anwendung im klinischen Alltag als einfach und unproblematisch. Eine eigenständige Insertion erfolgt im Median in 2 % (Mini-Pins) bzw. 0 % (Gaumenimplantate) der Fälle.

Die Nichtanwender gaben unter anderem folgende Gründe dafür an: fehlende Indikation im eigenen Behandlungskonzept (≥ 50 %), Skepsis bezüglich der Erfolgs-/Verlustrate (Mini-Pins: 56 %/Gaumenimplantate: 21 %), Insertion/OP zu aufwendig (Mini-Pins: 33 %/Gaumenimplantate: 56 %).

Schlussfolgerung

Skelettale Verankerungselemente werden von 62 % der teilnehmenden, in Deutschland tätigen Kieferorthopäden angewendet, von den meisten jedoch selten. Nichtanwender begründen ihre Entscheidung vor allem mit fehlenden Indikationen und mit Skepsis bezüglich der Erfolgsrate bei Mini-Pins bzw. einem großen Insertionsaufwand bei Gaumenimplantaten.

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Acknowledgments

We wish to extend our most sincere gratitude to all colleagues without whose participation this study would not have been possible. Thank you!

Danksagung

Wir bedanken uns ganz herzlich bei allen Kolleginnen und Kollegen, die durch ihre Teilnahme die Studie ermöglicht haben – vielen Dank!

Compliance with ethical guidelines

Conflict of interest. N.C. Bock and S. Ruf state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

Einhaltung ethischer Richtlinien

Interessenkonflikt. N.C. Bock und S. Ruf geben an, dass kein Interessenkonflikt besteht.

Der Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Department of Orthodontics, University of Giessen, Schlangenzahl 14, 35392, Giessen, Germany

    N.C. Bock & S. Ruf

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  1. N.C. Bock
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  2. S. Ruf
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Correspondence to N.C. Bock.

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Bock, N., Ruf, S. Skeletal anchorage for everybody? A questionnaire study on frequency of use and clinical indications in daily practice. J Orofac Orthop 76, 113–128 (2015). https://doi.org/10.1007/s00056-014-0275-z

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