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Comparison of two treatment protocols for intrusion and retraction of maxillary anterior teeth using mini-implants

A prospective clinical trial

Vergleich zweier Behandlungsprotokolle für die Intrusion und Retraktion von Oberkieferfrontzähnen mit Mini-Implantaten

Eine prospektive klinische Studie

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie (2022)Cite this article

Abstract

Objective

The primary objective of this study was to compare the magnitude of incisor intrusion and retraction between two different treatment protocols and the secondary objective was to evaluate overall treatment effects.

Materials and methods

Thirty-four patients with proclined upper anterior teeth, increased overbite, and incisal show were randomly assigned to two treatment groups (G1 and G2). Upper first premolar extractions were performed in all cases. In G1, space closure was performed with conventional straight-wire friction mechanics with NiTi (nickel titanium) coil springs placed on 0.019″ × 0.025″ stainless steel wires in a 0.022 slot system with an additional intrusive force via a midline mini-implant. In G2, NiTi coil springs were placed from buccal mini-implants placed onto 0.016″ × 0.022″ SS wires in a 0.022 slot system bilaterally. Lateral cephalograms and study models taken at the beginning and at the end of 6 months of treatment were assessed.

Results

Both groups showed a statistically significant mild maxillary incisor intrusion, reduction in overjet, overbite, incisal show and a reduction in lower anterior facial height. There was a mild intrusion of the maxillary first permanent molar in G2 (not significant). Mesial movement of the maxillary first permanent molar was noted in G1 but distal movement occurred in G2. Constriction of the entire maxillary arch was noted in G1, whereas constriction was seen in the molar region only in G2. Root resorption was noticed in both groups.

Conclusion

Both groups produced comparable results. Except for molar control, all the results obtained were comparable between the two mechanics. Application of an intrusive force in the midline may be beneficial in patients treated with conventional straight-wire mechanics to treat increased overbite when anchorage requirement is not high.

Zusammenfassung

Zielsetzung

Das primäre Ziel dieser Studie bestand darin, das Ausmaß der Intrusion und Retraktion der Schneidezähne zwischen zwei verschiedenen Behandlungsprotokollen zu vergleichen, und das sekundäre Ziel war die Bewertung der allgemeinen Behandlungseffekte.

Materialien und Methoden

Vierunddreißig Patienten mit proklinierten Oberkieferfrontzähnen, erhöhtem Overbite und Frontzahnsichtbarkeit wurden nach dem Zufallsprinzip 2 Behandlungsgruppen zugeteilt (G1 und G2). In allen Fällen wurden Extraktionen der oberen ersten Prämolaren durchgeführt. In G1 wurde der Lückenschluss mit konventioneller Straight-wire-Friktionsmechanik mit NiTi(Nickel-Titan)-Schraubenfedern durchgeführt, die auf 0,019″ × 0,025″ Edelstahldrähten in einem 0,022-Slot-System platziert waren, mit einer zusätzlichen Intrusionskraft über ein Midline-Miniimplantat. Bei G2 wurden NiTi-Schraubenfedern von bukkalen Miniimplantaten aus platziert, die auf 0,016″ × 0,022″ Edelstahldrähten in einem 0,022-Slot-System bilateral platziert waren. Seitliche Kephalogramme und Studienmodelle, aufgenommen zu Beginn und am Ende der 6‑monatigen Behandlung, wurden bewertet.

Ergebnisse

In beiden Gruppen kam es zu einer statistisch signifikanten leichten Intrusion der oberen Schneidezähne, zu einer Verringerung des Overjet, des Overbite und der Frontzahnsichtbarkeit sowie zu einer Verringerung der unteren anterioren Gesichtshöhe. Bei G2 kam es zu einer leichten Intrusion des ersten bleibenden Molaren im Oberkiefer (nichtsignifikant). Eine mesiale Bewegung des ersten bleibenden Molaren des Oberkiefers wurde bei G1 festgestellt, während bei G2 eine distale Bewegung auftrat. Bei G1 wurde eine Verengung des gesamten Oberkieferbogens festgestellt, während bei G2 nur im Bereich der Molaren eine Verengung zu beobachten war. Eine Wurzelresorption wurde in beiden Gruppen festgestellt.

Schlussfolgerung

Die Ergebnisse in beiden Gruppen waren vergleichbar. Mit Ausnahme der Kontrolle der Molaren waren alle Ergebnisse zwischen den beiden Verfahren vergleichbar. Die Anwendung einer Intrusionskraft in der Mittellinie kann bei Patienten, die mit konventionellen geraden Drähten behandelt werden, von Vorteil sein, um einen verstärkten Overbite bei geringem Verankerungsbedarf zu behandeln.

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Acknowledgements

Our gratitude to all the patients who participated in the study

Funding

No funding was received.

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Authors and Affiliations

  1. Department of Orthodontics and Dentofacial Orthopedics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Ponnamallee High Road, 600077, Chennai, Tamil Nadu, India

    A. Sumathi Felicita & Shabeena Abdul Khader

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  1. A. Sumathi Felicita
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  2. Shabeena Abdul Khader
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Contributions

ASF: Design of the work; analysis, interpretation of data; drafted and substantively revised it; SAK: Acquisition of data

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Correspondence to A. Sumathi Felicita.

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Conflict of interest

A.S. Felicita and S.A. Khader declare that they do not have financial interests that are directly or indirectly related to the work submitted for publication.

Ethical standards

This study was approved by the scientific review board of Saveetha University (reference number SRB/SDMDS110RT6) and further reviewed by the Institutional Human Ethics Committee of Saveetha University. It was approved under the reference number IHEC/SDMDS1106ORT6. Consent to participate: Written informed consent has been obtained from all patients prior to the start of the study.

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Felicita, A.S., Khader, S.A. Comparison of two treatment protocols for intrusion and retraction of maxillary anterior teeth using mini-implants. J Orofac Orthop (2022). https://doi.org/10.1007/s00056-022-00394-7

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