Minischrauben oder Gaumenimplantat?

Zusammenfassung

Schraubenverlust und Verankerungsverlust sind in der Privatpraxis wichtige Kriterien für die Wahl des skelettalen Verankerungssystems. Mithilfe von Daten aus der Praxis und der Literatur soll dem Anwender die Entscheidung, Minischraube oder Gaumenimplantat erleichtert werden. Je größer die Misserfolge und die unerwar­teten Probleme, die ein System mit sich bringt, desto länger die Behandlung und desto tiefer sinkt das Vertrauen des Patienten in den Behandler. Je direkter der Weg zum Ziel, desto besser ist das Kosten- / Nutzenverhältnis. Die Qualität, ­Sicherheit, Zuverlässigkeit und das Handling beeinflussen die Entscheidung für ein Verankerungssystem. Lohnen sich die Mehrkosten und der externe chirurgische Eingriff, das Gaumenimplantat den Minischrauben in bestimmten Situationen vorzuziehen?

Abstract

In private practice, minimizing implant failure and loss of anchorage are basic criteria in choos­ing a skeletal anchorage system. The choice be­tween using a mini-screw or palatal implant can be simplified with the help of information from clinical practice and the professional, scientific litera­ture. The more complete, the greater the poten­tial scope of failure and subsequent problems that can occur with any (skeletal anchorage) system, the greater the potential increase in treatment time, and the greater the patient's possible loss of trust in the practitioner. The more direct the route to the treatment goal, the more favor­able is the cost / benefit ratio. Quality, safety, dependability, and ease of use influence the choice of a skeletal anchorage system. Are there sit­uations when a palatal implant, in spite of the ­higher costs and surgical procedure associated with it, is preferable to mini-screws?

Schlüsselwörter

skelettale Verankerung - Gaumenimplantate - Verankerungsverlust - Minischrauben

Key words

skeletal anchorage - palatal implants - loss of anchorage - miniscrews

Literatur

• 1 Asscherickx K, Vande Vannet B, Bottenberg C et al. Clinical observations and success rates of palatal implants.  Am J Orthod Dentofacial Orthop. 2010;  137 114-122
• 2 Bantleon H P, Bernhart T, Crismani A G et al. Stable orthodontic anchor­age with palatal osseointegrated implants.  World J Orthod. 2002;  3 109-116
• 3 Cesare L, Carlalberta V, Melsen B. Overview Guidielines for success in placement od orthodontic mini-implants.  J Clin Orthod. 2010;  43 39-44
• 4 Crismani A G, Čelar A G, Burstone C et al. Sagittal and vertical load-deflection and permanent deformation of transpalatal arches con­nected with palatal implants: An in-vitro study.  Am J Orthod Dento­facial Orthop. 2007;  131 742-752
• 5 Crismani A G, Bertl M H, Čelar A G et al. Miniscrews in orthodontic treatment: Review and analysis of published clinical trials.  Am J Orthod Dentofacial Orthop. 2010;  137 108-113
• 6 De Pauw G AM, Dermaut L, de Bruyn H et al. Stability of implants as ­anchorage for orthopedic traction.  Angle Orthod. 1999;  69 401-407
• 7 Feldmann I, Bondemark L. Anchorage capacity of osseointegrated and conventional anchorage systems. A randomized controlles trial.  Am J Orthod Dentofacial Orthop. 2008;  133 339.e19-339.e28
• 8 Fritz U, Diedrich P, Kinzinger G et al. The anchorage quality od mini-implants towards translatory and extrusive forces.  J Orofac Orthop. 2003;  64 293-304
• 9 Glatzmaier J, Wehrbein H, Diedrich P. Biodegradable implants for orthodontic anchorage. A preliminary biomechanical study.  Eur J Orthod. 1996;  18 465-469
• 10 Goellner P, Jung B A, Wehrbein H et al. New temporary rehabilitation after traumatic tooth loss in a juvenile patient. A case report.  Dental Traumatology. 2009;  25 283-241
• 11 Göllner P, Jung B A, Kunkel M et al. Immediate versus conventional loading of palatal implants in humans.  Clin Oral Implants Res. 2009;  20 833-837
• 12 Jung B A, Kunkel M, Göde M et al. Clinical success parameters of para­median insertion during growth.  Z Zahnärztl Impl. 2007;  23 28-35
• 13 Jung B A, Kunkel M, Göllner P et al. Success rate of second-generation ­palatal implants.  Angle Orthod. 2009;  25 238-241
• 14 Jung B A, Kunkel M, Wehrbein H. Orthodontic space closure. An alter­native to endodontic and / or surgical tooth conservation in children.  Der MKG-Chirurg. 2010;  3 106-114
• 15 Jung B A, Kunkel M, Wehrbein H. Implantologie als Hilfestellung bei kieferorthopädischen Maßnahmen.  Wissen Kompakt. 2010;  ,  in press
• 16 Kuroda S, Yamada K, Deguchi T et al. Root proximity is a major factor for screw failure in orthodontic anchorage.  Am J Orthod Dentofacial ­Orthop. 2007;  131 S68-S73
• 17 Liou E J, Pai B C, Lin J C. Do miniscrews remain stationary under orthodontic forces?.  Am J Orthod Dentofacial Orthop. 2004;  126 42-47
• 18 Männchen R, Schätzle M. Success rate of palatal orthodontic implants: a prospective longitudinal study.  Clin Oral Implants Res. 2008;  19 665-669
• 19 Miyawaki S, Koyama I, Inoue M et al. 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
• 20 Robertsson S, Mohlin B. The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment.  Eur J Orthod. 2000;  22 697-710
• 21 Seung-Min L, Ryoon-Ki H. Distal Movement of Maxillary Molars Using a Lever-arm and Mini-implant System.  Angle Orthod. 2008;  78 167-175
• 22 Schätzle M, Lang L. Implants used for orthodontic anchorage. In: Lindhe J, Lang NP, Karring T (eds). Clinical Concepts in Orthodontics and Periodontics. Clinical Periodontology and Implant Dentistry. Oxford 1280–1293
• 23 Schätzle M , Männchen R, Zwahlen M et al. Survival and failure rates of orthodontic temporary anchorage devices: a systematic review.  Clin Oral Impl Res. 2009;  20 1351-1359
• 24 Tinsley D, O'Dwyer J, Benson P et al. Orthodontic palatal implants: clinical technique.  J Orthod. 2004;  31 3-8
• 25 Wang Y C, Liou E JW. Comparison of the loading behavior of self-drilling and predrilled miniscrews throughout orthodontic loading. 
• 26 Wehrbein H, Diedrich P. Endosseous titanium implants during and after orthodontic load – an experimental study in dog.  Clin Oral Implants Res. 1993;  4 76-82
• 27 Wehrbein H, Merz B R, Diedrich P et al. The use of palatal implants for orthodontic anchorage. Design and clinical application of the orthosystem.  Clin Oral Implants Res. 1996;  7 410-416
• 28 Wehrbein H, Göllner P. Do palatal implants remain positionally stable under orthodontic load? A clinical radiologic study.  Am J Orthod Dentofacial Orthop. 2009;  136 695-699
• 29 Wehrbein H, Jung B A, Kunkel M. Wissenschaftliche Stellungnahme zur kieferorthopädischen Verankerung mit Gaumenimplantaten und Kortikalisschrauben.  J Orofac Orthop. 2008;  6 487-490
• 30 Kinzinger G, Gross U, Diedrich P. Fixed Lingual Arch Appliance for Compliance-Free Unilateral Molar Distalization in the Mandible.  J Orofac Orthop / Fortschr Kieferorthop. 2000;  61 440-449