Bone Screws in Orthodontics: A Review.
Journal Title: International Journal of Dental Science and Innovative Research (IJDSIR) - Year 2019, Vol 2, Issue 2
Abstract
Anchorage preparation is decisive in achieving successful orthodontic treatment. Often anchorage in an orthodontic appliance attempts to dissipate the reaction forces over as many teeth as possible and thus keep pressure in the periodontal ligaments of the anchor teeth to a minimum. Theoretically, anchor values for teeth can be estimated from their root surface areas, but this is not always reliable since anchorage capacity is also influenced by attachment level, density and structure of the alveolar bone, periodontal reactivity, muscular activity, occlusal forces, craniofacial morphology and friction within the appliance resulting from tooth movement. Use of an extraoral appliance such as headgear to reinforce anchorage is effective in that the reactive forces that normally create anchorage loss do not affect the dentition. However, these techniques require unconditional compliance; consequently, various intraoral appliances have been developed with minimal compliance demands. The need for maximal anchorage control in these intraoral appliances has also led to increased use of implants. The use of skeletal anchorage to obtain absolute anchorage has recently become very popular in clinical orthodontic approaches. The mode of anchorage facilitated by these implant systems has a unique characteristic owing to their temporary use, which results in a transient, absolute anchorage. Among the skeletal anchorage systems, the most popular being – mini implants or micro-screws which have an intra-radicular site of placement. They are easy to use and are minimally invasive with a disadvantage of early loosening during the course of treatment. A more rigid alternative was then introduced called as the SAS -Skeletal Anchorage Systems (I-plate, Y-plate etc) with its extra-radicular site of placement, which did overcome the high failure rates of a regular mini-implant but then their placement required raising of flaps and extensive surgical intervention. More recently the –Orthodontic Bone Screws (OBS) which not only had an extra-radicular site of placement in the infra-zygomatic crest of the maxilla and the buccal shelf area of the mandible, with significantly less failure rates than regular mini-implants. OBS doesn’t require extensive surgical intervention for their placement. This article is aimed at providing an overview - to the recently introduced OBS system, their technical, bio material and bio-mechanical differences with the commonly used mini-implant system, the case selection criteria, advantages, disadvantages.
Authors and Affiliations
Dr. Devdatta Wankhade
Keywords
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