Advertisement
Research Article|Articles in Press

CAD-CAM workflows for palatal TAD anchored appliances

Published:January 03, 2023DOI:https://doi.org/10.1053/j.sodo.2022.12.009

      Abstract

      Mini-implants inserted in the anterior palate are showing the very high success rates of 91.5% - 99%. Compared to other insertion sites they can be used effectively for molar distalization, space closure, rapid maxillary expansion and protraction, molar intrusion and alignment of impacted upper teeth. In recent years, CAD-CAM techniques such as printed insertions guides and 3D metal printing were integrated into full digital workflows. These new procedures allow mini-implant insertion and appliance fitting in one appointment and may give orthodontists more confidence to insert in the optimum site. Additionally, the CAD/CAM design process may offer the opportunity to further improve orthodontic appliances biomechanically.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Seminars in Orthodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Costa A
        • Raffainl M
        • Melsen B
        Miniscrews as orthodontic anchorage: a preliminary report.
        Int J Adult Orthodon Orthognath Surg. 1998; 13: 201-209
        • Freudenthaler JW
        • Haas R
        • Bantleon HP
        Bicortical titanium screws for critical orthodontic anchorage in the mandible: a preliminary report on clinical applications.
        Clin Oral Implants Res. 2001; 12: 358-363
        • Kanomi R
        Mini-implant for orthodontic anchorage.
        J Clin Orthod. 1997; 31: 763-767
        • Melsen B
        • Costa A
        Immediate loading of implants used for orthodontic anchorage.
        Clin Orthod Res. 2000; 3: 23-28
        • Wilmes B
        Fields of Application of Mini-Implants.
        in: Ludwig B Baumgaertel S Bowman J Innovative Anchorage Concepts. Mini-Implants in Orthodontics. Quintessenz, Berlin, New York2008
        • Berens A
        • Wiechmann D
        • Dempf R
        Mini- and Micro-screws for Temporary Skeletal Anchorage in Orthodontic Therapy.
        J Orofac Orthop. 2006; 67: 450-458
        • Cheng SJ
        • Tseng IY
        • Lee JJ
        • Kok SH
        A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage.
        Int J Oral Maxillofac Implants. 2004; 19: 100-106
        • Fritz U
        • Ehmer A
        • Diedrich P
        Clinical suitability of titanium microscrews for orthodontic anchorage-preliminary experiences.
        J Orofac Orthop. 2004; 65: 410-418
        • Miyawaki S
        • Koyama I
        • Inoue M
        • Mishima K
        • Sugahara T
        • Takano-Yamamoto T
        Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage.
        Am J Orthod Dentofacial Orthop. 2003; 124: 373-378
        • Hourfar J
        • Bister D
        • Kanavakis G
        • Lisson JA
        • Ludwig B
        Influence of interradicular and palatal placement of orthodontic mini-implants on the success (survival) rate.
        Head Face Med. 2017; 13: 14
        • Arqub SA
        • Gandhi V
        • Mehta S
        • Palo L
        • Upadhyay M
        • Yadav S
        Survival estimates and risk factors for failure of palatal and buccal mini-implants.
        Angle Orthod. 2021; 91: 756-763
        • Di Leonardo B
        • Ludwig B
        • Lisson JA
        • Contardo L
        • Mura R
        • Hourfar J
        Insertion torque values and success rates for paramedian insertion of orthodontic mini-implants: A retrospective study.
        J Orofac Orthop. 2018; 79: 109-115
        • Lim HJ
        • Choi YJ
        • Evans CA
        • Hwang HS
        Predictors of initial stability of orthodontic miniscrew implants.
        Eur J Orthod. 2011; 33: 528-532
        • Mohammed H
        • Wafaie K
        • Rizk MZ
        • Almuzian M
        • Sosly R
        • Bearn DR
        Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis.
        Prog Orthod. 2018; 19: 36
        • Karagkiolidou A
        • Ludwig B
        • Pazera P
        • Gkantidis N
        • Pandis N
        • Katsaros C
        Survival of palatal miniscrews used for orthodontic appliance anchorage: A retrospective cohort study.
        Am J Orthod Dentofacial Orthop. 2013; 143: 767-772
        • Ludwig B
        • Glasl B
        • Bowman SJ
        • Wilmes B
        • Kinzinger GS
        • Lisson JA
        Anatomical guidelines for miniscrew insertion: palatal sites.
        J Clin Orthod. 2011; 45: 433-441
        • Wilmes B
        • Drescher D
        Application and effectiveness of the Beneslider: a device to move molars distally.
        World J Orthod. 2010; 11: 331-340
        • Wilmes B
        • Nienkemper M
        • Nanda R
        • Lubberink G
        • Drescher D
        Palatally anchored maxillary molar mesialization using the mesialslider.
        J Clin Orthod. 2013; 47: 172-179
        • Wilmes B
        • Nienkemper M
        • Drescher D
        Application and effectiveness of a mini-implant- and tooth-borne rapid palatal expansion device: the hybrid hyrax.
        World J Orthod. 2010; 11: 323-330
        • Wilmes B
        • Nienkemper M
        • Ludwig B
        • Nanda R
        • Drescher D
        Upper-molar intrusion using anterior palatal anchorage and the Mousetrap appliance.
        J Clin Orthod. 2013; 47: 314-320
        • Nienkemper M
        • Wilmes B
        • Lubberink G
        • Ludwig B
        • Drescher D
        Extrusion of impacted teeth using mini-implant mechanics.
        J Clin Orthod. 2012; 46 (quiz 183): 150-155
        • Wilmes B
        • Drescher D
        A miniscrew system with interchangeable abutments.
        J Clin Orthod. 2008; 42 (quiz 595): 574-580
        • Wilmes B
        • Vasudavan S
        • Drescher D
        CAD-CAM-fabricated mini-implant insertion guides for the delivery of a distalization appliance in a single appointment.
        Am J Orthod Dentofacial Orthop. 2019; 156: 148-156
        • Graf S
        • Vasudavan S
        • Wilmes B
        CAD-CAM design and 3-dimensional printing of mini-implant retained orthodontic appliances.
        Am J Orthod Dentofacial Orthop. 2018; 154: 877-882
        • De Gabriele O
        • Dallatana G
        • Riva R
        • Vasudavan S
        • Wilmes B
        The easy driver for placement of palatal mini-implants and a maxillary expander in a single appointment.
        J Clin Orthod. 2017; 51: 728-737
        • Wilmes B
        • Ottenstreuer S
        • Su YY
        • Drescher D
        Impact of implant design on primary stability of orthodontic mini-implants.
        J Orofac Orthop. 2008; 69: 42-50
        • Wilmes B
        • Rademacher C
        • Olthoff G
        • Drescher D
        Parameters affecting primary stability of orthodontic mini-implants.
        J Orofac Orthop. 2006; 67: 162-174
        • Wilmes B
        • Su YY
        • Drescher D
        Insertion angle impact on primary stability of orthodontic mini-implants.
        Angle Orthod. 2008; 78: 1065-1070
        • Wilmes B
        • Su YY
        • Sadigh L
        • Drescher D
        Pre-drilling force and insertion torques during orthodontic mini-implant insertion in relation to root contact.
        J Orofac Orthop. 2008; 69: 51-58
        • Wilmes B
        • Ludwig B
        • Vasudavan S
        • Nienkemper M
        • Drescher D
        The T-Zone: Median vs. Paramedian Insertion of Palatal Mini-Implants.
        J Clin Orthod. 2016; 50: 543-551
        • Becker K
        • Unland J
        • Wilmes B
        • Tarraf NE
        • Drescher D
        Is there an ideal insertion angle and position for orthodontic mini-implants in the anterior palate? A CBCT study in humans.
        Am J Orthod Dentofacial Orthop. 2019; 156: 345-354
        • Nienkemper M
        • Wilmes B
        • Panayotidis A
        • Pauls A
        • Golubovic V
        • Schwarz F
        • et al.
        Measurement of mini-implant stability using resonance frequency analysis.
        Angle Orthod. 2012; 83: 230-238
        • Nienkemper M
        • Wilmes B
        • Pauls A
        • Drescher D
        Mini-implant stability at the initial healing period: a clinical pilot study.
        Angle Orthod. 2014; 84: 127-133
        • Nienkemper M
        • Pauls A
        • Ludwig B
        • Drescher D
        Stability of paramedian inserted palatal mini-implants at the initial healing period: a controlled clinical study.
        Clin Oral Implants Res. 2015; 26: 870-875
        • Graf S
        • Cornelis MA
        • Hauber Gameiro G
        • Cattaneo PM
        Computer-aided design and manufacture of hyrax devices: Can we really go digital?.
        Am J Orthod Dentofacial Orthop. 2017; 152: 870-874
        • Willmann JH
        • Chhatwani S
        • Drescher D
        Blender - Freeware als dentales CAD-Programm.
        Kieferorthopädie. 2018; 32: 161-165
        • Clemmer EJ
        • Hayes EW
        Patient cooperation in wearing orthodontic headgear.
        Am J Orthod. 1979; 75: 517-524
        • Egolf RJ
        • BeGole EA
        • Upshaw HS
        Factors associated with orthodontic patient compliance with intraoral elastic and headgear wear.
        Am J Orthod Dentofacial Orthop. 1990; 97: 336-348
        • Antonarakis GS
        • Kiliaridis S
        Maxillary molar distalization with noncompliance intramaxillary appliances in Class II malocclusion. A systematic review.
        Angle Orthod. 2008; 78: 1133-1140
        • Fortini A
        • Lupoli M
        • Giuntoli F
        • Franchi L
        Dentoskeletal effects induced by rapid molar distalization with the first class appliance.
        Am J Orthod Dentofacial Orthop. 2004; 125 (discussion 704-695): 697-704
        • Wilmes B
        • Drescher D
        • Nienkemper M
        A miniplate system for improved stability of skeletal anchorage.
        J Clin Orthod. 2009; 43: 494-501
        • Nienkemper M
        • Wilmes B
        • Pauls A
        • Yamaguchi S
        • Ludwig B
        • Drescher D
        Treatment efficiency of mini-implant-borne distalization depending on age and second-molar eruption.
        J Orofac Orthop. 2014; 75: 118-132
        • Wilmes B
        • Nienkemper M
        • Ludwig B
        • Kau CH
        • Pauls A
        • Drescher D
        Esthetic Class II treatment with the Beneslider and aligners.
        J Clin Orthod. 2012; 46: 390-398
      1. Zachrisson BU, Rosa M, Toreskog S. Congenitally missing maxillary lateral incisors: canine substitution. Point. Am J Orthod Dentofacial Orthop. 2011;139:434, 436, 438 passim.

      2. Wilmes B., Nienkemper M., Ludwig B., Lübbering G., D D. TAD-anchored maxillary molar mesialization using the Mesialslider. J Clin Orthod. 2013. in press.

        • Wilmes B
        • Vasudavan S
        • Drescher D
        Maxillary molar mesialization with the use of palatal mini-implants for direct anchorage in an adolescent patient.
        Am J Orthod Dentofacial Orthop. 2019; 155: 725-732
        • Wilmes B
        • Nanda R
        • Nienkemper M
        • Ludwig B
        • Drescher D
        Correction of upper-arch asymmetries using the Mesial-Distalslider.
        J Clin Orthod. 2013; 47: 648-655
        • Akyalcin S
        • Alexander SP
        • Silva RM
        • English JD
        Evaluation of three-dimensional root surface changes and resorption following rapid maxillary expansion: a cone beam computed tomography investigation.
        Orthod Craniofac Res. 2015; 18 Suppl 1: 117-126
        • Barber AF
        • Sims MR
        Rapid maxillary expansion and external root resorption in man: a scanning electron microscope study.
        Am J Orthod. 1981; 79: 630-652
        • Erverdi N
        • Okar I
        • Kucukkeles N
        • Arbak S
        A comparison of two different rapid palatal expansion techniques from the point of root resorption.
        Am J Orthod Dentofacial Orthop. 1994; 106: 47-51
        • Garib DG
        • Henriques JF
        • Janson G
        • de Freitas MR
        • Fernandes AY
        Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation.
        Am J Orthod Dentofacial Orthop. 2006; 129: 749-758
        • Carmen M
        • Marcella P
        • Giuseppe C
        • Roberto A
        Periodontal evaluation in patients undergoing maxillary expansion.
        J Craniofac Surg. 2000; 11: 491-494
        • Baccetti T
        • McGill JS
        • Franchi L
        • McNamara Jr., JA
        • Tollaro I
        Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy.
        Am J Orthod Dentofacial Orthop. 1998; 113: 333-343
        • Wilmes B
        Anwendungsgebiete von Mini-Implantaten.
        (editor)in: Ludwig B Mini-Implantate in der Kieferorthopädie - Innovative Verankerungskonzepte. Quintessenz, Berlin2007: 89-120
        • Garib DG
        • Navarro R
        • Francischone CE
        • Oltramari PV
        Rapid maxillary expansion using palatal implants.
        J Clin Orthod. 2008; 42: 665-671
        • Lee KJ
        • Park YC
        • Park JY
        • Hwang WS
        Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism.
        Am J Orthod Dentofacial Orthop. 2010; 137: 830-839
        • Moon W
        • Wu KW
        • MacGinnis M
        • Sung J
        • Chu H
        • Youssef G
        • et al.
        The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander (MARPE) and the novel N2 mini-implant-a finite element study.
        Prog Orthod. 2015; 16: 16
        • Wilmes B
        • Nienkemper M
        • Ludwig B
        • Kau CH
        • Drescher D
        Early Class III Treatment with a Hybrid Hyrax-Mentoplate Combination.
        J Clin Orthod. 2011; 45: 1-7
        • Stocker B
        • Willmann JH
        • Wilmes B
        • Vasudavan S
        • Drescher D
        Wear-time recording during early Class III facemask treatment using TheraMon chip technology.
        Am J Orthod Dentofacial Orthop. 2016; 150: 533-540
        • Nienkemper M
        • Wilmes B
        • Franchi L
        • Drescher D
        Effectiveness of maxillary protraction using a hybrid hyrax-facemask combination: A controlled clinical study.
        Angle Orthod. 2015; 85: 764-770
        • Ngan P
        • Wilmes B
        • Drescher D
        • Martin C
        • Weaver B
        • Gunel E
        Comparison of two maxillary protraction protocols: tooth-borne versus bone-anchored protraction facemask treatment.
        Prog Orthod. 2015; 16: 26
        • Wilmes B
        • Ngan P
        • Liou EJ
        • Franchi L
        • Drescher D
        Early class III facemask treatment with the hybrid hyrax and Alt-RAMEC protocol.
        J Clin Orthod. 2014; 48: 84-93
        • Jager A
        • Braumann B
        • Kim C
        • Wahner S
        Skeletal and dental effects of maxillary protraction in patients with angle class III malocclusion. A meta-analysis.
        J Orofac Orthop. 2001; 62: 275-284
        • Foersch M
        • Jacobs C
        • Wriedt S
        • Hechtner M
        • Wehrbein H
        Effectiveness of maxillary protraction using facemask with or without maxillary expansion: a systematic review and meta-analysis.
        Clinical oral investigations. 2015; : 1-12
        • Ngan P
        • Moon W
        Evolution of Class III treatment in orthodontics.
        Am J Orthod Dentofacial Orthop. 2015; 148: 22-36
        • Thiruvenkatachari B
        • Pavithranand A
        • Rajasigamani K
        • Kyung HM
        Comparison and measurement of the amount of anchorage loss of the molars with and without the use of implant anchorage during canine retraction.
        Am J Orthod Dentofacial Orthop. 2006; 129: 551-554
        • Becker K
        • Pliska A
        • Busch C
        • Wilmes B
        • Wolf M
        • Drescher D
        Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis.
        Int J Implant Dent. 2018; 4: 35