The Orthodontic Mini-Implant Clinical Handbook

ISBN-13: 9781119509752 / Angielski / Twarda / 2020 / 344 str.

Richard Cousley

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Preface to Second Edition xi1 Orthodontic Mini-implant Principles and Potential Complications 11.1 The Origins of Orthodontic Bone Anchorage 11.2 The Evolution of Mini-implant Biomechanics 11.3 3D Anchorage Indications 11.4 Using the Right Terminology 21.5 Principal Design Features 21.6 Clinical Indications for Mini-implants 21.6.1 Routine Cases 21.6.2 Complex Cases 31.6.3 Direct and Indirect Anchorage 31.7 Benefits and Potential Mini-implant Complications 31.8 Mini-implant Success and Failure 41.9 Medical Contraindications 51.10 Root/Periodontal Damage 51.11 Perforation of Nasal and Maxillary Sinus Floors 61.12 Damage to Neurovascular Tissues 61.13 Mini-implant Fracture 71.14 Pain 71.15 Soft Tissue Problems 81.16 Mini-implant Migration 81.17 Biomechanical Side-effects 101.18 Factors Affecting Mini-implant Success 11References 112 Maximising Mini-implant Success: Patient (Anatomical) Factors 152.1 Cortical Bone Thickness and Density 152.2 Interproximal Space 162.3 Soft Tissue and Oral Hygiene 172.4 Maxillomandibular Planes Angle 172.5 Age 182.6 Cigarette Smoking 182.7 Body Mass Index 18References 193 Maximising Mini-implant Success: Design Factors 213.1 Mini-implant Design Factors 213.2 The Infinitas(TM) Mini-implant System 223.2.1 Infinitas Mini-implant Design Features 223.2.2 Infinitas Guidance System 243.3 Digital Stent Fabrication Processes 27References 294 Maximising Mini-implant Success: Clinical Factors 314.1 Clinical Technique Factors 314.1.1 Insertion Technique 314.1.2 Root Proximity 314.1.3 Force Application 334.2 Introducing Mini-implants to your Clinical Practice 334.3 Patient Consent 334.4 Key Points to Consider for Valid Consent 354.4.1 Rationale for Mini-implant Anchorage 354.4.2 Patient Discomfort 354.4.3 Mini-implant Instability 354.4.4 Periodontal/Root Contact 354.4.5 Mini-implant Fracture 354.4.6 Mini-implant Displacement 354.4.7 Written Information 354.5 Staff Training 354.6 Patient Selection 35References 375 Mini-implant Planning 415.1 Mini-implant Planning 415.1.1 Treatment Goals and Anchorage Requirements 415.2 Mini-implant Location 415.3 Hard Tissue Anatomy and Radiographic Imaging 415.4 Soft Tissue Anatomy 455.5 Vertical Location and Inclination 465.6 Insertion Timing 465.7 Guidance Stent 495.8 Mini-Implant Dimensions 49References 516 Mini-implant Insertion 536.1 Mini-implant Kit Sterilisation 536.2 Superficial Anaesthesia 536.3 Antibacterial Mouthwash 546.4 Stent Application (Optional) 546.5 Soft Tissue Removal 546.6 Cortical Perforation 556.7 Mini-implant Insertion 556.8 Mini-implant Fracture 586.9 Postoperative Instructions 586.10 Force Application 596.11 Biomechanics 596.12 Explantation 596.13 Summary of Mini-implant Insertion Steps 606.14 Maximising Mini-implant Success: Ten Clinical Tips 60References 607 Retraction of Anterior Teeth 637.1 Clinical Objective 667.2 Treatment Options 667.3 Key Treatment Planning Considerations 667.4 Biomechanical Principles 677.5 Midtreatment Problems and Solutions 677.6 Clinical Steps for a Posterior Mini-implant 677.6.1 Preinsertion 677.6.2 Mini-implant Selection 687.6.3 Insertion 687.6.4 Postinsertion 697.7 Biomechanical Options for Anterior Teeth Retraction 697.8 Case Examples 70References 998 Molar Distalisation 1018.1 Alternatives to Mini-Implant Distalisation 1018.1.1 Class II Growth Modification Treatment, Involving Mini-implant Anchorage (Figure 8.1) 1028.1.2 Mandibular Distalisation Using Miniplate Anchorage (Figure 8.3) 1058.2 Clinical Objectives of Molar Distalisation 1058.3 Treatment Options 1058.4 Key Treatment Planning Considerations 1108.5 Biomechanical Principles 1108.6 Midtreatment Problems and Solutions 1108.7 Mandibular Arch Distalisation 1108.7.1 Clinical Steps for Mandibular Distalisation 1108.7.2 Case Examples 1138.8 Maxillary Arch Distalisation 1168.8.1 Clinical Steps for Palatal Alveolar Distalisation 1168.8.2 Case Examples 1178.9 Midpalatal Distaliser Options 1218.9.1 Pushcoil Distaliser 1278.9.2 Traction Distaliser 1278.9.3 Clinical Steps for a Midpalatal Distaliser 1278.9.4 Case Examples 129References 1359 Molar Protraction 1379.1 Clinical Objective 1419.2 Treatment Options 1419.3 Key Treatment Planning Considerations 1419.4 Biomechanical Principles 1419.5 Midtreatment Problems and Solutions 1429.6 Clinical Steps for Molar Protraction Using Alveolar Site Anchorage 1429.6.1 Preinsertion 1429.6.2 Mini-implant Selection 1449.6.3 Insertion 1459.6.4 Postinsertion 1459.7 Case Examples 1459.8 Clinical Steps for Midpalate (Indirect) Anchorage (Figure 9.3) 1619.8.1 Preinsertion 1619.8.2 Mini-implant Selection 1619.8.3 Insertion 1619.8.4 Postinsertion 1619.9 Direct Palatal Anchorage Example (Figure 9.15) 162References 16610 Intrusion and Anterior Openbite Treatments 16710.1 Single-Tooth and Anterior Segment Intrusion Treatments 16910.1.1 Clinical Objectives 16910.1.2 Treatment Options 16910.1.3 Relevant Clinical Details 16910.1.4 Biomechanical Principles 16910.1.5 Clinical Tips and Technicalities 16910.1.6 Clinical Steps 17010.1.7 Case Examples 17010.2 Anterior Openbite Treatment 17210.2.1 Clinical Objectives 17410.2.2 Treatment Options 17410.2.3 Relevant Clinical Details 17410.2.4 Biomechanical Principles 17410.2.5 Clinical Tips and Technicalities 17610.2.6 Simultaneous Mandibular Molar Intrusion 18210.2.7 Clinical Steps for Maxillary Molar Intrusion 18210.2.8 Case Examples 185References 20611 Transverse and Asymmetry Corrections 20911.1 Asymmetry Problems 20911.2 Dental Centreline Correction 20911.2.1 Clinical Objective 20911.2.2 Treatment Options 20911.2.3 Relevant Clinical Details 21011.2.4 Biomechanical Principles 21011.2.5 Clinical Tips and Technicalities 21011.2.6 Midtreatment Problems and Solutions 21011.2.7 Clinical Steps for Centreline Correction 21011.2.8 Case Examples 21111.3 Unilateral Intrusion (Vertical Asymmetry Correction) 22711.3.1 Clinical Objective 22711.3.2 Treatment Options 22711.3.3 Relevant Clinical Details 22711.3.4 Biomechanical Principles 22811.3.5 Clinical Tips and Technicalities 22811.3.6 Midtreatment Problems and Solutions 22811.3.7 Clinical Steps for Unilateral Intrusion 23211.3.8 Case Example (Figure 11.7) 23412 Ectopic Teeth Anchorage 23912.1 Clinical Objectives 23912.2 Treatment Options 23912.3 Relevant Clinical Details 23912.4 Biomechanical Principles 24012.5 Clinical Tips and Technicalities 24112.6 Midtreatment Problems and Solutions 24112.7 Clinical Steps for Ectopic Tooth Alignment 24112.7.1 Preinsertion 24112.7.2 Mini-implant Selection 24112.7.3 Insertion 24212.7.4 Postinsertion 24212.7.5 Case Examples 24213 Bone-anchored Maxillary Expansion 25913.1 Conventional Rapid Maxillary Expansion 25913.2 Expansion Forces and Speed 26013.3 Potential Advantages of Mini-implant Anchored RME 26313.3.1 Greater Basal Skeletal Expansion 26313.3.2 Basal Expansion in Older Aged Patients (Postpuberty) 26313.3.3 Greater Posterior Palatal Expansion 26313.3.4 Increased Nasal Airflow 26313.3.5 Fewer Dental and Periodontal Side-effects 26313.4 Clinical Objective 26413.5 Treatment Options 26413.6 Relevant Clinical Details 26413.7 Design Options for Mini-implant Expanders 26413.8 Hybrid RME 26413.8.1 Mini-implant Assisted Rapid Palatal Expansion (MARPE) 26413.8.2 Hybrid Hyrax RME Appliance 26613.8.3 Biomechanical Principles for Hybrid RME Appliances 27113.8.4 Clinical Steps for Hybrid RME 27113.9 Non-tooth Borne Mini-Implant Only RME 27113.9.1 Case Examples 27113.10 Biomechanical Principles 27813.10.1 Clinical Steps for OMI-borne RME 27813.11 Haas-type (Mucosa) and Mini-implant RME 27813.11.1 Clinical Steps for Mucosa-OMI Borne RME 27913.11.2 Case Example 27913.12 Summary of RME Design Selection 279References 28314 Orthognathic Surgical Uses 28514.1 Clinical Objectives 28514.2 Treatment Options 30214.3 Relevant Clinical Details 30214.4 Biomechanical Principles 32214.5 Clinical Tips and Technicalities 32314.6 Clinical Steps 32414.6.1 Preinsertion 32414.6.2 Mini-implant Selection 32414.6.3 Insertion 32414.6.4 Postinsertion 32514.7 Case Examples 325References 328Index 329

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About the AuthorRichard Cousley is a Consultant Orthodontist based at the Priestgate Clinic in Peterborough and also an Honorary Consultant Orthodontist, Peterborough City Hospital, the North West Anglia NHS Foundation Trust, Peterborough, UK.