Vol. 40 – THE USE OF MINISCREWS IN THE SURGICAL MANAGEMENT OF IMPACTED MOLARS
Orthodontics is no longer a discipline that focuses solely on children and adolescents. Indeed, over the past twenty years, more and more adults have undergone orthodontic treatment to correct malocclusion issues.
Increasingly often we are seeing that certain, particularly complex, situations call for a multidisciplinary approach as this, making it possible to avoid compromise solutions and obtain better long-term stability, seems to be the best way to achieve optimal results. Indeed, several specialists (orthodontist, oral surgeon and prosthetic dentist), working together as a close-knit team, can achieve excellent outcomes even in the most complex adult cases.
There have actually been few new developments in orthodontics since the turn of the century. One of them is skeletal anchorage. Over the past decade or so, researchers worldwide have been exploring the role of this new technique and the potential it offers.
There is no doubt that miniscrews have emerged as the most effective tool for obtaining absolute anchorage, and this is true not only in poorly compliant patients, but also in cases in which the dental unit needed for orthodontic anchorage is either missing, due to edentulism, or weak, as a result of poor periodontal conditions.
Moreover, in some cases traditional anchorage may not be sufficient to counter the unwanted reaction forces that develop under the biomechanical conditions typically created by certain orthodontic-surgical interventions, e.g. repositioning, in the arch, of impacted cuspids and malpositioned second molars, orthodontic extraction of third molars, and intrusion and up-righting of molars performed as pre-prosthetic orthodontic interventions.
These are precisely the situations in which the very best results can be achieved through the technique of skeletal anchorage, used by an oral surgeon and orthodontist working in collaboration.
Through explanations and numerous illustrative photographs, this monograph takes the reader through the treatment of complex surgical-orthodontic cases of this kind, explaining diagnoses, therapeutic goals, techniques and innovations, from a broad interdisciplinary perspective.
Prof. Alberto Caprioglio
Associate Professor and Chairmen
Director and Chair, Division of Orthodontics
Department of surgical and Morphological Sciences
School of Medicine – University of Insubria
A FAREWELL MESSAGE
INTRODUCTION: DENTAL ANCHORAGE AND SKELETAL ANCHORAGE
THE HISTORY OF SKELETAL ANCHORAGE
TRADITIONAL TECHNIQUES APPLIED TO IMPACTED TEETH
THE USE OF TEMPORARY ANCHORAGE DEVICES, OR MINISCREWS, IN THE MANAGEMENT OF IMPACTED TEETH
I. Method 1
Distal vertical screw
II. Method 2
Mesial screw (distal screw system, DSS)
Derton-Perini technique (DPT)
COMBINATION OF DIFFERENT TECHNIQUES