Infinitas mini implant system from DB Orthodontics. We have strived for absolute perfection from the design stage to the manufacturing of the Infinitas mini implant system. We are continually developing the Infinitas mini implant system, working with leading Orthodontic experts to ensure that our mini implants meet the highest standards expected by todays Orthodontic profession. In essence, the Infinitas mini implant system has been designed by an Orthodontist, for Orthodontists, so that precise, reliable bone anchorage can be achieved using as simple a clinical process as possible.
Infinitas mini implants system has been designed with Dr Richard Cousley who is a Consultant Orthodontist working in the UK hospital service and private practice. Vertical anchorage loss with molar extrusion was another common observation for the control interventions [ 1 , 11 , 28 , 49 , 50 , 52 ]. In the majority of the studies, molar intrusion was commonly associated with direct skeletal anchorage [ 11 , 28 , 48 , 49 , 50 , 52 ], but one study observed a minor extrusion tendency of 0.
Vertical anchorage loss associated with indirect anchorage has not been evaluated.
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- Applications of Orthodontic Mini Implants!
Transversal anchorage loss with a mean expansion of 1. This tendency of transversal expansion could be reduced to 0. In contrast, a significant decrease in inter-molar width was observed in two studies employing direct anchorage through mini implants in the alveolar ridge [ 48 , 50 ].
The remaining studies, which analyzed lateral cephalograms only, did not report on anchorage loss in the transversal dimension. None of the studies compared transversal changes following skeletal anchorage with conventional control measures. In the test groups, the monthly rate of posterior movement from the incisors amounted to 0.
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The overall success rates of the orthodontic mini implants varied among the studies. A success rate of Two patients developed a peri-implant inflammation which was resolved through improved oral hygiene.
A loss of 5 of 72 implants was reported by Upadhyay et al. Davoody et al.
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In their study, 4 of 14 implants became loose during treatment but could be replaced subsequently. In further 4 patients, treatment was discontinued due to inflammation, which was resolved through improvement of oral hygiene. Similar values were reported by Benson et al. In their study, in 6 of 24 patients, the implant failed to reach primary stability. In 4 patients, the implant had to be replaced during treatment, and in 2 patients, treatment was compromised due to implant failure. All implant failures occurred among the first implants placed by the surgeon, and no implant loss was observed for implants with sufficient primary stability.
Summarizing these findings, implant loss was observed at 8 of 93 implants 8. In the direct anchorage groups, implant loss was reported for 16 of implants 9. Funnel plots of the intervention effect estimates presented as mean differences plotted against standard errors are presented in Figs.
Their symmetricity suggests the absence of publication bias. Funnel plot for anchorage loss in the horizontal dimension MD mean difference, SE standard error. The literature search revealed that efficacy of anchorage control of orthodontic mini implants in comparison to conventional devices was evaluated in nine randomized clinical trials RCTs [ 1 , 4 , 5 , 9 , 11 , 28 , 48 , 49 , 50 , 52 ].
Seven of these studies employed direct anchorage in the alveolar ridge, whereas one study employed indirect anchorage together with a buccal implant [ 9 ], and one study used a mid-palatal implant and indirect anchorage [ 5 ]. Each of these studies reported on anchorage loss in the horizontal dimension, whereas vertical and transversal anchorage loss was only addressed in six and one of these studies, respectively. One cohort study also evaluated vertical anchorage loss associated with mini implants [ 48 ], whereas transversal changes have also been addressed in one controlled clinical trial and in one cohort study [ 54 , 57 ].
Data syntheses of respective RCTs revealed a gain of anchorage for direct anchorage in the horizontal and vertical dimension, whereas indirect anchorage was associated with minor amounts of anchorage loss.
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Conventional treatments were commonly associated with a mesial migration and extrusion of the first upper molars. Even though all studies favored orthodontic mini implants over conventional devices, distal migration and slight molar intrusion were only observed in groups employing direct anchorage through mini implants in the alveolar ridge.
It has been suggested that the distal and intrusive forces result from the direction of the retraction forces causing some binding or increase in friction of the archwire to the brackets or tubes. Friction may have prevented sliding thus causing the force to be transmitted through the archwire to the dentition [ 11 , 48 , 50 ]. Whether this effect will be more pronounced if a coil spring is left in place for a couple of months after completion of front retraction as suggested by Upadhyay et al.
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Hence, the underlying biomechanical causes need to be further analyzed. Indirect anchorage through implants in the alveolar ridge was associated with mesial molar migration in all studies included in the present review [ 5 , 9 , 54 , 57 ]. Nonetheless, anchorage loss with indirect anchorage was significantly lower compared to the conventional devices [ 5 , 9 , 57 ].
It has been suggested that the anchorage loss at indirectly anchored mid-palatal implants may be caused by a slight bending of the transpalatal bars which pass from the implant to the anchor teeth [ 54 ].
Additionally, implant migration, which describes a displacement of an implant while maintaining stability, may have contributed to the findings [ 5 ]. Transversal changes have not been compared to conventional devices, and controversial transversal effects have been reported in orthodontic mini implant groups [ 48 , 54 , 57 ]. Whereas an expansion tendency was observed in conjunction with palatal implants and indirect anchorage [ 57 ], inter-molar width reduction and palatal tipping of the molar crowns were observed in a study employing direct anchorage and implants in the alveolar ridge [ 48 ].
Hence, posterior reinforcement and application of differential moments have been suggested to avoid these side effects in the respective studies.
Discontinuation of treatment owing to inflammation was reported for implants placed in the alveolar ridge only. However, in several cases, resolution was successfully achieved through improved oral hygiene [ 4 , 48 , 49 ]. Also, no failures due to root contact have been reported in the included studies, even though root proximity is considered to be a major risk factor for implant loosening [ 53 ]. The implant failure rates of 9. In the other study evaluating mid-palatal implants, implant failure was observed only among the first series of implants placed by an unexperienced surgeon, and no implant losses were noted for implants that had reached primary stability [ 5 ].
This finding is in line with other studies reporting on high success rates for orthodontic implants in the alveolar palate [ 20 , 24 , 36 , 58 ]. However, the ideal implant location anterior palate versus alveolar ridge and the most beneficial concept direct or indirect anchorage need to be further evaluated. The heterogeneity was high among the included studies, control groups were not always homogenous, and two included studies were judged of high risk of bias.
Further high-quality prospective, randomized clinical trials are needed to investigate the anchorage efficacy of orthodontic mini implants in comparison to conventional techniques. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Root resorption of maxillary incisors retracted with and without skeletal anchorage.
A J Orthod Dent Orthop. Comparative study between conventional en-masse retraction sliding mechanics and en-masse retraction using orthodontic micro implant. Implant Dent. Midpalatal implants vs headgear for orthodontic anchorage--a randomized clinical trial: cephalometric results. Am J Orthod Dentofac Orthop. Bilodeau JE. Retreatment of a transfer patient with bialveolar protrusion with mini bone-plate anchorage. Tooth movement using palatal implant supported anchorage compared to conventional dental anchorage. Ann Anat. Absolute anchorage with universal t-loop mechanics for severe deepbite and maxillary anterior protrusion and its year stability.
Angle Orthod. Comparative evaluation of anchorage reinforcement between orthodontic implants and conventional anchorage in orthodontic management of bimaxillary dentoalveolar protrusion. Med J Armed Forces India. Treating high angle bimaxillary protrusion with three kinds of extraction method: a clinical study. West China J Stomat. A prospective comparative study between differential moments and miniscrews in anchorage control.