1. Clinical applications of miniscrews that broaden the scope of non‐surgical orthodontic treatment
- Author
-
Chung Ju Hwang, Ji Yoon Jeon, Kee Joon Lee, and Sung Hwan Choi
- Subjects
Adult ,Palatal Expansion Technique ,Tooth Movement Techniques ,medicine.medical_treatment ,Orthognathic surgery ,Orthodontics ,Mandible ,03 medical and health sciences ,0302 clinical medicine ,Maxilla ,Orthodontic Anchorage Procedures ,medicine ,Humans ,Orthodontic Appliance Design ,030212 general & internal medicine ,Transverse dimension ,Arch ,Scope (project management) ,business.industry ,030206 dentistry ,medicine.disease ,Dental arch ,medicine.anatomical_structure ,Otorhinolaryngology ,Surgery ,Oral Surgery ,Malocclusion ,business - Abstract
Previously, in the case of malocclusion owing to skeletal discrepancy in adults, the amount of tooth movement was limited since there was no reliable skeletal anchorage device. The only way to treat this case was by repositioning the maxilla and mandible via orthognathic surgery, but most patients are reluctant to undergo surgery owing to the risk and expenses incurred. However, with the current introduction and use of miniscrews as temporary anchorage devices, the entire dental arch can be relocated to a target position without surgery, thus broadening the scope of non-surgical orthodontic treatment compared to the past. For a non-surgical approach to improve skeletal discrepancy, anteroposterior, vertical and transverse displacements of the dental arch are necessary. In this case, the localization of the centre of resistance of the whole arch must precede the appliance design with an appropriate biomechanical design. Especially, in the transverse dimension, the envelope of discrepancy is reportedly narrow, and the tooth movement must accompany the orthopaedic correction involving the midpalatal suture expansion. Recently, in adults with transverse maxillomandibular discrepancy, miniscrew-assisted rapid palatal expansion (MARPE) can be performed. Moreover, compared to surgically assisted rapid palatal expansion, MARPE reduces the cost to the patient and achieves clinically acceptable stable maxillary expansion. In this article, we will discuss the role of total arch movement and MARPE in widening the scope of non-surgical orthodontic treatment, despite the inherent limitations of miniscrews' mechanical aspects.
- Published
- 2020