Orthotown August 2015 - (Page 50)

case presentation // Clinical Orthodontics THE MINI-SCREW FOR SKELETAL ANCHORAGE IN PRE-PROSTHETIC ORTHODONTICS The mini-screw is an effective skeletal anchorage system for different types of tooth movement, especially in clinical situations involving incomplete dental arches and limited cooperation, such as many typical adult orthodontic cases. Mini-screw implants, often referred to as temporary anchorage devices (TADs), have become an accepted component of orthodontic treatment. The stability of the anchorage unit plays a very important role in orthodontic control. Controlled orthodontic movements such as retraction and/or protraction of teeth, and intrusion of overerupted teeth, are very difficult to achieve without patient cooperation, and without causing undesirable reciprocal movement in the anchorage unit. The comparatively simple technique for the placement of these mini-screws is described with emphasis on the importance of correct site selection, as well as an understanding of the possible complications that may arise. While the technique is of primary relevance to orthodontists, the use of miniscrews as an aid for pre-prosthodontic tooth movement is also of relevance to prosthodontists. From the examples here, extrapolations can be made by individual clinicians to situations relevant to their particular treatment plans. Introduction Orthodontic movements such as canine and incisor retraction, molar protraction and intrusion of overerupted teeth require a suitable anchorage system to avoid undesirable anchorage loss.1-3 Intrusion of molars is particularly 50 JULY / AUGUST 2015 // orthotown.com by Davide Spadoni, DDS difficult to achieve and unpredictable because these teeth have the largest periodontal support in the mouth4 and are located on the terminal part of the archwire, which is less efficient than the intermediate zone. The ability to control anchorage and patient compliance are critical factors that can influence the fi nal outcome of treatment. The use of mini-screws as a component of pre-prosthodontic tooth movement needs to be further explored. In the context of multidisciplinary treatment plans, prosthodontists need to be made aware of this comparatively new tool available to orthodontists. From some of the examples described in this article, it is hoped that prosthodontists can extrapolate aspects relevant to their treatment protocols.5-8 With clinical examples, I will illustrate how both vertical and sagittal movements of the teeth can be achieved without patient cooperation and in "extreme" clinical situations. Clinical case A 68-year-old male presented with some missing teeth and wanted to replace them with implants, particularly in UL quadrant. Both upper first and second premolar left were missing, and the first molar left was tipped mesially. The patient refused the complete orthodontics treatment and so I used a miniscrew between Continued on p. 52 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown August 2015

Orthotown.com Highlights
Embrace Progress: AAO Reflections
Poll
Managing Missing Upper Canines
Adult Class II Patient Possibility for Pre-Prosthetic Treatment
The Truth About Phase I Orthodontics
Ten Steps to Hire Slow— And Achieve Success Fast
Townie Choice Awards
A Review of “Uncomplicate Business”
Separating Your Practice from the Rest
10 Best Practices for Patient- Referral and Retention Programs
The Mini-Screw for Skeletal Anchorage in Pre-Prosthetic Orthodontics
The Use of Laser Technology in the Modern Orthodontic Practice
Ad Index

Orthotown August 2015