Orthodontic mini-implants
Comment: might be notable....however noticed the prior note on LLM Ozzie10aaaa (talk) 16:03, 24 September 2026 (UTC)
In orthodontics, anchorage control is very important, this is to prevent unwanted orthodontic tooth movement, for example when sticky out (protruded) upper incisors are pushed back the back teeth in upper jaw also tend to come forward which is unwanted. Orthodontic mini-implants, or temporary anchorage devices (TADs), are small titanium or titanium-alloy or stainless steel screws [1] [2] that are temporarily inserted into the jawbone to provide stable, skeletal anchorage during orthodontic tooth movement. TADs are anchored directly in bone and therefore don't move when orthodontic forces are applied to them, allowing orthodontists to move teeth more predictably while reducing dependence on patient cooperation with wearing elastics or removable orthodontic appliances to achieve some tooth movements. [3][4]
Skeletal anchorage
The use of bone-anchored devices, to resist orthodontic reactionary forces or "skeletal anchorage", was introduced by American orthodontists, Creekmore and Eklund, in 1983. They used a vitallium alloy bone screw placed beneath the anterior nasal spine to intrude maxillary incisors.[5] However, there are other reports of using endosseous implants for orthodontic tooth movement prior to this [6][7][8] a Japanese orthodontist, Kanomi, in 1997, used the term "orthodontic mini-implant" as a small titanium screw designed specifically for orthodontic anchorage.[9] Gradually, mini-implants have become a widely used tool in orthodontics, facilitating orthodontic tooth movements without patient-compliance. They have expanded the range of treatment options available for patient, in some cases eliminating the need for more invasive treatments such as orthognathic surgery (i.e., open bite cases)[3][4]Orthodontic mini-implants are typically 1.4–2.3 mm in diameter and 6–14 mm in length[2], with a screw-shaped body and an exposed head that can be engaged directly by orthodontic wires, springs, or elastics, or connected indirectly via a rigid framework to another anchorage unit. Orthodontic mini-implants with diameters under 1.3 mm or over 2 mm, and lengths under 8 mm, were associated with higher failure rates.[10][11]TADs are often placed in the inter-radicular (between the roots of the teeth) alveolar bone of the posterior maxilla and mandible, where the greatest volume of bone is available: in the maxilla, between the second premolar and first molar, and in the mandible, between the second premolar and second molar. Less common sites for placing TADs are the zygomatic buttress, palate, and retromolar area, though these are used less frequently than posterior alveolar sites.[12][13] Orthodontists preferer posterior (back) over anterior (front) placement sites, and maxillary over mandibular sites. [14]
Use
Review of the literature reveals that the relative popularity of specific indications varies internationally. In a 2024 survey of orthodontists in Australia and the United Kingdom, molar protraction was the most frequently reported use, followed by anchorage reinforcement and intrusion.[14] In a survey of orthodontists across five U.S. network states, molar protraction was likewise the leading indication, followed by indirect anchorage for space closure. [15]
TADs are used to facilitate a wide range of tooth-movements such as;
- Distalization (pushing back) of posterior (back) teeth[16]
- Intrusion of over-erupted anterior or posterior teeth (AOB cases)[17][18]
- Molar up-righting (when molars next to extraction site are tilted) and protraction (bringing forward back teeth)[17]
- Midline correction (when dental midline of upper of lower jaws are not coincident or not exactly centred)[19]
- Skeletal expansion of the maxilla and maxillary protraction by incorporating the TADs into fixed Hyrax type expander[20][21]
Prevalence
Approximately, 69.2% of the American Association of Orthodontists (AAO) members,[22] 91% of orthodontists in five U.S. network states,[15] 50% in Switzerland,[23] 62% in Germany,[24] 63% in South Africa,[25] 92% in Taiwan,[26] 77.0% in Australia and 68.6% in the United Kingdom,[14] and 96.6% of specialist orthodontists in Iran used TADs.[27]
Complications
Reported complications associated with mini-implant placement are mostly of low consequences. Peri-implant soft-tissue inflammation with mucosal overgrowth, root injury with associated periradicular lesions, loss of pulp vitality, transient loss of pulp sensitivity, tooth discoloration, and soft-tissue necrosis as among the reported complications, along with rarer perforation of anatomical structures such as the maxillary sinus or nasal cavity floor. [28] Mini-implant fracture and scarring have also been reported following removal.[28]Across surveys, the most frequently reported complications are typically minor: insertion-site pain, soft-tissue irritation or ulceration, and implant loosening or failure requiring replacement. Loss or mobility of the implant was the complication most frequently reported by respondents to international AAO[29] and UK/Australian surveys.[14]
References
- ↑ Cornelis MA, Scheffler NR, De Clerck HJ (2007). "Systematic review of the experimental use of temporary skeletal anchorage devices in orthodontics". Am J Orthod Dentofacial Orthop. 131: S52–58. doi:10.1016/j.ajodo.2006.05.033.
- ↑ 2.0 2.1 Inyang UM, Adam NI (2026). "Selecting screws: an overview of the key features of common temporary anchorage devices". Orthodontic Update. 18 (4): 181–188.
- ↑ 3.0 3.1 Jones, J. P.; Elnagar, M. H.; Perez, D. E. (2020). "Temporary Skeletal Anchorage Techniques". Oral and Maxillofacial Surgery Clinics of North America. 32 (1): 27–37. doi:10.1016/j.coms.2019.08.003. PMID 31685345.
- ↑ 4.0 4.1 Choi, S. H.; Jeon, J. Y.; Lee, K. J.; Hwang, C. J. (2021). "Clinical applications of miniscrews that broaden the scope of non-surgical orthodontic treatment". Orthodontics & Craniofacial Research. 24 (Suppl 1): 48–58. doi:10.1111/ocr.12452. PMID 33275826 Check
|pmid=value (help). - ↑ Creekmore, T. D.; Eklund, M. K. (1983). "The possibility of skeletal anchorage". Journal of Clinical Orthodontics. 17 (4): 266–269. PMID 6574142.
- ↑ Linkow LI (December 1970). "Implanto-orthodontics". J Clin Orthod. 4 (12): 685-90 passim. PMID 5278480.
- ↑ Linkow LI (December 1969). "The endosseous blade implant and its use in orthodontics". Int J Orthod. 7 (4): 149–54. PMID 5264326.
- ↑ Gainsforth BL, Higley LB (1945). "A study of orthodontic anchorage possibilities in basal bone". Am J Orthod Oral Surg. 31: 406–417.
- ↑ Kanomi, R. (1997). "Mini-implant for orthodontic anchorage". Journal of Clinical Orthodontics. 31 (11): 763–767. PMID 9511584.
- ↑ Chen, Y.; Kyung, H. M.; Zhao, W. T.; Yu, W. J. (2009). "Critical factors for the success of orthodontic mini-implants: A systematic review". American Journal of Orthodontics and Dentofacial Orthopedics. 135 (3): 284–291. doi:10.1016/j.ajodo.2007.08.017. PMID 19268825.
- ↑ Reynders, R.; Ronchi, L.; Bipat, S. (2009). "Mini-implants in orthodontics: A systematic review of the literature". American Journal of Orthodontics and Dentofacial Orthopedics. 135 (5): 564.e1–564.e19. doi:10.1016/j.ajodo.2008.09.026. PMID 19409331.
- ↑ Poggio, P. M.; Incorvati, C.; Velo, S.; Carano, A. (2006). ""Safe zones": a guide for miniscrew positioning in the maxillary and mandibular arch". The Angle Orthodontist. 76 (2): 191–197. PMID 16539541.
- ↑ Carano, A.; Velo, S.; Incorvati, C.; Poggio, P. (2004). "Clinical applications of the Mini-Screw-Anchorage-System (M.A.S.) in the maxillary alveolar bone". Progress in Orthodontics. 5 (2): 212–235. PMID 15546013.
- ↑ 14.0 14.1 14.2 14.3 Woolley, J.; Wright, N.; Meade, M. J. (2024). "Usage of temporary anchorage devices: A cross-cultural and cross-sectional survey of orthodontists in Australia and the UK". International Orthodontics. 22 (2). doi:10.1016/j.ortho.2023.100843. PMID 38244360 Check
|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ 15.0 15.1 Hyde, J. D.; King, G. J.; Greenlee, G. M.; Spiekerman, C.; Huang, G. J. (2010). "Survey of orthodontists' attitudes and experiences regarding miniscrew implants". Journal of Clinical Orthodontics. 44 (8): 481–486. PMC 3052854. PMID 21105585.
- ↑ Tan, J. M.; et al. (2017). "Molar Distalization by Temporary Anchorage Devices (TADs) – A Review Article". Taiwanese Journal of Orthodontics. 29 (1): 2. doi:10.30036/TJO.201703_29(1).0002.
- ↑ 17.0 17.1 Panaite, T.; Balcos, C.; Savin, C.; et al. (2025). "Exploring the use, perceptions, and challenges of mini-implants in orthodontic practice: a survey study". Frontiers in Oral Health. 5. doi:10.3389/froh.2024.1483068. PMC 11753234 Check
|pmc=value (help). PMID 39844864 Check|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ Burgos-Lancero, P.; Ibor-Miguel, M.; Marqués-Martínez, L.; Boo-Gordillo, P.; García-Miralles, E.; Guinot-Barona, C. (2025). "Correction of Anterior Open Bite Using Temporary Anchorage Devices: A Systematic Review and Meta-Analysis". Journal of Clinical Medicine. 14 (14): 4958. doi:10.3390/jcm14144958. PMC 12294894 Check
|pmc=value (help). PMID 40725652 Check|pmid=value (help). - ↑ Feng, X.; Yang, Z.; Dai, J.; Li, R. (March 2014). "Miniscrew anchorage for the correction of midline discrepancies". Journal of Clinical Orthodontics. 48 (3): 169–179. PMID 24762375.CS1 maint: Date and year (link)
- ↑ Chung, D.-H. (2020). "TAD-anchored Maxillary Protraction". In Park, J. H. Temporary Anchorage Devices in Clinical Orthodontics. pp. 191–198. doi:10.1002/9781119513636.ch21. ISBN 978-1-119-51347-6. Search this book on
- ↑ Kapetanović A, Theodorou CI, Bergé SJ (2021). "Efficacy of miniscrew-assisted rapid palatal expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis". Eur J Orthod. 43: 313–323. doi:10.1093/ejo/cjab005.
- ↑ Buschang, P. H.; Carrillo, R.; Ozenbaugh, B.; Rossouw, P. E. (2008). "2008 survey of AAO members on miniscrew usage". Journal of Clinical Orthodontics. 42 (9): 513–518. PMID 18974458.
- ↑ Markic, G.; Katsaros, C.; Pandis, N.; Eliades, T. (2014). "Temporary anchorage device usage: a survey among Swiss orthodontists". Progress in Orthodontics. 15 (1): 29. doi:10.1186/s40510-014-0029-x. PMC 4047490. PMID 24935644.
- ↑ Bock, N. C.; Ruf, S. (2015). "Skeletal anchorage for everybody? a questionnaire study on frequency of use and clinical indications in daily practice". Journal of Orofacial Orthopedics. 76 (2): 113–124, 126–128. doi:10.1007/s00056-014-0275-z. PMID 25744091.
- ↑ Mothobela, T. F.; Sethusa, M. P. S.; Khann, M. I. (2016). "The use of temporary anchorage devices amongst South African orthodontists". South African Dental Journal. 71: 513–517.
- ↑ Cheng, J. H.-C.; Chen, D. D.-S.; Tan, Y.; Hu, H. T. (2024). "Factors associated with usage frequency and pricing of temporary anchorage devices among orthodontists". Journal of Dental Sciences. 19 (1): 404–410. doi:10.1016/j.jds.2023.07.033. PMC 10829646 Check
|pmc=value (help). PMID 38303874 Check|pmid=value (help). - ↑ Borzabadi-Farahani, A. (2026). "Orthodontic Mini-Implants in Practice: Insights from Iranian Specialist Orthodontists". Oral Surgery: 1–9. doi:10.1111/ors.70077. Unknown parameter
|article-number=ignored (help) - ↑ 28.0 28.1 Giudice, A. L.; Rustico, L.; Longo, M.; Oteri, G.; Papadopoulos, M. A.; Nucera, R. (2021). "Complications reported with the use of orthodontic miniscrews: A systematic review". Korean Journal of Orthodontics. 51 (3): 199–216. doi:10.4041/kjod.2021.51.3.199. PMC 8133901 Check
|pmc=value (help). PMID 33984227 Check|pmid=value (help). - ↑ Ashton, K. Y.; Jiang, S. S.; Melo, M. A.; Bosio, J. A. (2023). "International investigation on temporary anchorage device use: A survey of orthodontists". Journal of the World Federation of Orthodontists. 12 (3): 93–104. doi:10.1016/j.ejwf.2023.04.003. PMID 37198009 Check
|pmid=value (help).
Category:Dental equipment Category:Implants (medicine) Category:Orthodontic appliances
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