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Background: There is limited data about current utilization of miniscrews in orthodontic practices in India. If the respondent had used miniscrews in clinical practice, the questions required to be answered in the survey were; indications for treatment with miniscrews, miniscrew placement under topical or local anesthetic, personal placement or referral to other specialist, immediate or delayed loading of miniscrews, miniscrew complications, and utilization of surgical guide for miniscrew placement. A Smith, YK Hosein, CE Dunning, A Tassi The Angle Orthodontist.
The purpose of this survey was to obtain information on clinical utilization of miniscrews among orthodontists in India. If the respondent had never used miniscrews, the reasons for not employing miniscrews in their orthodontic practice, was required to be filled in the questionnaire.Blinded annotated data were obtained for statistical analysis. Miniscrew anchorage used to protract lower second molars into first molar extraction sites.
2008 JCO study of orthodontic diagnosis and treatment procedures, part 1: Results and trends. Factors associated with the success rate of orthodontic miniscrews placed in the upper and lower posterior buccal region.
A prospective study of the risk factors associated with failure of mini implants used for orthodontic anchorage.
Don’t consider orange peels as a waste because chewing small pieces of its peels help eliminate bad breath and give you long lasting fresh breath. Materials and Methods: A survey questionnaire was prepared and mailed to 2100 qualified and registered orthodontists in India.

These screws are low profile, easy to insert and remove, can be loaded immediately after insertion, and can provide absolute anchorage for many orthodontic procedures. Cross-tabulations were performed as appropriate and the significance of observed differences was assessed by means of the chi-square, Wilcoxon rank-sum, or Fisher exact test as appropriate.
Seven hundred and thirty-nine (739) (43.7%) had utilized miniscrews in their treatment, at some point of time. A total of 988 respondents practiced in an urban setup while 723 had practice in a semi urban or rural locality. There was more miniscrew usage among respondents of urban setup practice compared to semi-urban or rural locality practice. The questionnaire was broadly divided into two sections. Practice location and characteristicMiniscrew utilization in clinical practice.
Among the respondents who had utilized miniscrews, 54% placed the miniscrews under topical anesthetic combined with local anesthetic, while 44% placed them under local anesthetic and 2% placed them under only topical anesthetic [Table 1]. Among the 739 who had used miniscrews, 436 (59%) used a surgical guide for positioning the miniscrews, while 303 (41%) placed the miniscrews directly without the help of a surgical guide. Surveys had been previously done regarding miniscrew usage, among the American orthodontists.
However, most clinicians preferred local anesthetics for adequate pain control while placing miniscrews. A surgical guide provides three-dimensional surgical bur control, for accurate placement of self-tapping orthodontic mini-implants, at the desired location and angle.

This is different from the results obtained in other surveys [12],[14] where the most common indication was for molar intrusion and molar protraction.
In the survey done by Hyde et al, [14] the major indications were Molar protraction, indirect anchorage and intrusion of supra erupted teeth. Molar intrusion, open bite, and class II were the major indications according to the survey done by Keim et al. This is different, compared to the soft tissue overgrowth and irritation from auxillary spring, listed as the other major complications in the survey done by Hyde et al.
The main reason is improper surgical techniques such as lack of initial stability, overheating during placement and the use of large size pilot drill before miniscrew insertion. The reason for loose screws appears to be multi-factorial and is a disconcerting and unpredictable reality which we have to embrace in our clinical practice. They must also be aware of the potential risk for soft-tissue complications, particularly when associated with poor oral hygiene and that this area provides ample scope for further investigation and research.

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16.05.2014 admin

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