L.F. Nizaeva

Bashkir State Medical University, Ufa, Russia

ORTHODONTIC MICROIMPLANTS

 

Microimplants are small systems that serve as a support in the treatment of dentoalveolar anomalies.  They are made of pure titanium (99.2%) or its alloy.  Due to this they are completely biocompatible with the tissues of the body. [1, 2]

Orthodontists still require the possibility of creating a good support for orthodontic treatment.  The use of microimplants in orthodontics has increased the ability of specialists to influence the dental system of the patient and facilitated his further treatment.  So, when using microimplants, we can achieve:

- accelerate the treatment of patients;

- eliminate the use of extraoral structures (facial arches, masks, traction, etc.);

- improve the direct force load on the tissue [3]

Stabilization of the support with the use of implants can be direct when the orthodontic traction is applied to the implant on one side and, on the other hand, to the teeth and indirectly, when a group of teeth, to which force is applied and relative to which other teeth move, is connected to the implant. The effectiveness of using microimplants is practically  does not depend on the number and density of bone tissue, the procedure of installation is simple and low-traumatic, miniplants well resist direct force load and are easily removed after completion  treatment of Ia.

In the orthodontic mini-implant, three parts are distinguished: intraosseous (carving), gum (neck) and supragingival (head).  The diameter of the intraosseous part does not exceed 3.0 mm and, depending on the system, its length ranges from 5.0 to 12.0 mm.  The neck of the orthodontic mini implant should be located in the thickness of the gums and in most mini-implant systems, its length is also different.  The supragingival part of the mini-implant is specially designed for fixing orthodontic elements (ligatures, elastics, springs, arches) and is diverse in various systems.

The length of the intraosseous part of the orthodontic mini implants ranges from 5 mm to 12 mm.  According to the shape of the thread, the intraosteal parts can be divided into mini-implants, which require the formation of a bone bed and mini implants with self-tapping thread, or "self-tapping screws".  For the first it is necessary to form a guide channel by a pilot cutter for the entire length of the implant, and for mini implants with a self-tapping thread - the passage of a pilot cutter only the cortex.  The supporting function of mini implants is performed due to primary mechanical stability, and does not require osteointegration. [3,4]

Mini-implants can be classified according to several criteria:

1. On the material of the mini-implant: -titanium;  -alloys of titanium;  -steel.

2. According to the configuration of the intraosseous part:- screw.

3. In the form of the intraosseous part:

- cylindrical (the diameter of the intraosseous part does not change); 

-conical (in the region of the apex have a smaller diameter).

4. By type of thread:

- mini-implants with self-tapping threads: (self-tapping screws)

- requiring the formation of a bone bed.

5. By location: -intersternal (endosal).

6. According to the installation method: -one-stage

7. Depending on the exposure of the head of the implant:

-Open method: applicable when the implant head is in the oral cavity.

 -Closed method: applicable when the implant head is immersed in a soft cloth.

8. By the method of twisting:

-Method of microimplant installation with pre-drilling.  This method is used when installing a small-diameter implant, or using a low-grade titanium implant.

 -Micro-implant installation method without pre-drilling.  This method is used for the installation of a large-diameter implant and the use of an implant of a titanium alloy. [1.]

Indications for use of mini-planets:

- Creation of additional support;

 - Presence of defects in the jaw or teeth;

 - reduction of the duration of orthodontic treatment; [5]

Contraindications when using microimplants: - inflammatory processes of the oral mucosa;  - diabetes;  - endocrine diseases;  - oncological diseases;  - immunodeficiency states [4].

Thus, the literature data on the possibilities of using microimplants as an additional support for orthodontic treatment of the anomalies of the dental system are very diverse, and often contradictory.  This allows us to say that the use of microimplants remains relevant and not fully understood.  At the same time, the available results make it possible to consider this method of treatment as very promising .

                            Literature

1.    Аверьянов С.В., Рябых Л.А., «Хирургическая коррекция зубочелюстных аномалий.» Уфа 2014 год

2.    Аверьянов С.В., Зубарева А.В. Комплексный метод лечения ретенированных зубов //Ортодонтия. 2016.  2 (74). С. 32.

3.    Аверьянов С.В., Пермякова Е.С., Машкина Ю.И. Частота встречаемости ретенции зубов у детей по данным ортопантомограммы // Наука, образование и инновации сборник статей международной научно-практической конференции. 2016. С. 133-135.

4.    Чуйкин С.В., Аверьянов С.В., Мингазева А.З., Балабин Н.М., Гончаров А.В., Михайлова Г.А. Комбинированный метод лечения ретенции клыка // Проблемы стоматологии. 2008. № 4. С. 37-39.

5.    Аверьянов С.В., Авраамова О.Г., Акатьева Г.Г., и др.Детская терапевтическая стоматология. Национальное руководство. Москва, 2017.