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Although mini screw insertion is considered as a simple and non-invasive technique, it's a critical procedure which requires precision and accuracy. The placement of mini-screw poses a challenge to the orthodontist, particularly if the space available for mini-screws is limited.4 The proximity to the vital structures surrounding the proposed mini-screw position necessitates the precise knowledge of the anatomy of the insertion area.5 The incidence of mini-screw to tooth contact in the placement of inter-radicular region was 27%.6 Although failure of mini screw is considered a multi-factorial concern, many studies reported the proximity of a mini-screw to tooth structures is a major risk factor for failure, especially in the inter-radicular inserted mini-screws. guided insertion was believed to give more favorable results. Above all, the recent technology of the scanning and three-dimensional printing could pave the way to construct a simple accurate guide. Additionally all previous studies assessed the insertion accuracy using CBCT post-operatively, that can't be applied on human subjects for ethical reasons. Thus a non-invasive method for assessment of mini-screw insertion should be implemented.
PICOs P: Adult orthodontic patients need mini screws in maxillary arch bilaterally for anchorage I: Three dimensional printed digital guide for mini screw insertion C: Conventional free hand insertion technique
- O: Primary outcome: Root proximity
Secondary outcomes:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Three dimensional printed digital guide | Experimental | one mini-screw will be inserted in the buccal interradicular space between upper second premolar and first molar using Three dimensional printed digital guide, which is a device deisgned and printed through CAD/CAM technology, it's a printed plate fit on the teeth and buccal mucosa with a channel for mini- screw insertion, mini-screw will be inserted through the plate's channel |
|
| Conventional free hand insertion | No Intervention | one mini-screw will be inserted in the buccal interradicular space between upper second premolar and first molar using conventional free hand insertion of mini-screw, which is a technique using the guiding anatomy for mini-screw insertion using the driver and the operator's skill. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Three dimensional printed digital guide | Device | A CAD/CAM printed plate with a channel for mini-screw insertion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Root proximity | Distance between inserted mini screw and the adjacent roots in microns | immediately after mini-screw insertion (T0) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient discomfort: | Likert scale, it is scale divided into five points to measure the degree of patient discomfort maximum value(5) strongly discomfort, discomfort, neutral, little discomfort, and minimum value (0)no discomfort | immediately after mini-screw insertion (T0) |
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Inclusion Criteria:
Exclusion Criteria:
Mixed dentition patients
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hadir Abo shady, MD | Contact | 00201001937931 | hadiraboshady@gmail.com | |
| Mai Abo El fotouh, PHD | Contact | 01001884499 | maihamdi@gmail.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23726340 | Background | Bae MJ, Kim JY, Park JT, Cha JY, Kim HJ, Yu HS, Hwang CJ. Accuracy of miniscrew surgical guides assessed from cone-beam computed tomography and digital models. Am J Orthod Dentofacial Orthop. 2013 Jun;143(6):893-901. doi: 10.1016/j.ajodo.2013.02.018. | |
| 18486791 | Background | Suzuki EY, Suzuki B. Accuracy of miniscrew implant placement with a 3-dimensional surgical guide. J Oral Maxillofac Surg. 2008 Jun;66(6):1245-52. doi: 10.1016/j.joms.2007.08.047. |
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adult orthodontic participants
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during the insertion procedure the principle investigator and the co supervisor couldn't be blinded, as the two insertion techniques are completely different.