The Orthodontic Mini-implant Clinical Handbook, 2nd Edition

Año Edición	2020
Autor	Richard Cousley
Idioma	English
Nº Edición	2nd

Description

Offers the very latest on the theory and practice of integrating mini-implant techniques into clinical practice

This all-new second edition of The Orthodontic Mini-implant Clinical Handbook provides a thoroughly revised and expanded update to the theoretical and practical aspects of using mini-implants in orthodontic practice. Taking a practical step-by-step approach with hundreds of clinical images, it presents updated clinical techniques and new clinical cases, covering all topics of importance for utilising mini-implants. It also includes a new chapter on mini-implant anchored maxillary expansion appliances.

It begins with a chapter that looks at mini-implant principles and potential complications, before moving onto clinical and design factors for maximising mini-implant success. Other chapters cover incisor retraction; molar distalisation and protraction; intrusion and anterior openbite treatments; bone anchored rapid maxillary expansion; orthognathic surgical uses; and ectopic teeth.

Provides a comprehensive guide to both theoretical and practical advice for the use of mini-implants in orthodontic practice
Covers updated clinical techniques and new clinical cases
Presents a new chapter on mini-implant anchored maxillary expansion appliances
Takes a highly illustrated step-by-step approach ideal for clinical practice

The Orthodontic Mini-Implant Clinical Handbook is an essential resource to orthodontists, maxillofacial surgeons, practicing dentists, and anyone with an interest in mini-implant skeletal anchorage.

About the Author

About the Author

Richard Cousley is a Consultant Orthodontist based at the Priestgate Clinic in Peterborough and also an Honorary Consultant Orthodontist, Peterborough City Hospital, the North West Anglia NHS Foundation Trust, Peterborough, UK.

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Preface to Second Edition xi

1 Orthodontic Mini-implant Principles and Potential Complications 1

1.1 The Origins of Orthodontic Bone Anchorage 1

1.2 The Evolution of Mini-implant Biomechanics 1

1.3 3D Anchorage Indications 1

1.4 Using the Right Terminology 2

1.5 Principal Design Features 2

1.6 Clinical Indications for Mini-implants 2

1.6.1 Routine Cases 2

1.6.2 Complex Cases 3

1.6.3 Direct and Indirect Anchorage 3

1.7 Benefits and Potential Mini-implant Complications 3

1.8 Mini-implant Success and Failure 4

1.9 Medical Contraindications 5

1.10 Root/Periodontal Damage 5

1.11 Perforation of Nasal and Maxillary Sinus Floors 6

1.12 Damage to Neurovascular Tissues 6

1.13 Mini-implant Fracture 7

1.14 Pain 7

1.15 Soft Tissue Problems 8

1.16 Mini-implant Migration 8

1.17 Biomechanical Side-effects 10

1.18 Factors Affecting Mini-implant Success 11

References 11

2 Maximising Mini-implant Success: Patient (Anatomical) Factors 15

2.1 Cortical Bone Thickness and Density 15

2.2 Interproximal Space 16

2.3 Soft Tissue and Oral Hygiene 17

2.4 Maxillomandibular Planes Angle 17

2.5 Age 18

2.6 Cigarette Smoking 18

2.7 Body Mass Index 18

References 19

3 Maximising Mini-implant Success: Design Factors 21

3.1 Mini-implant Design Factors 21

3.2 The Infinitas™ Mini-implant System 22

3.2.1 Infinitas Mini-implant Design Features 22

3.2.2 Infinitas Guidance System 24

3.3 Digital Stent Fabrication Processes 27

References 29

4 Maximising Mini-implant Success: Clinical Factors 31

4.1 Clinical Technique Factors 31

4.1.1 Insertion Technique 31

4.1.2 Root Proximity 31

4.1.3 Force Application 33

4.2 Introducing Mini-implants to your Clinical Practice 33

4.3 Patient Consent 33

4.4 Key Points to Consider for Valid Consent 35

4.4.1 Rationale for Mini-implant Anchorage 35

4.4.2 Patient Discomfort 35

4.4.3 Mini-implant Instability 35

4.4.4 Periodontal/Root Contact 35

4.4.5 Mini-implant Fracture 35

4.4.6 Mini-implant Displacement 35

4.4.7 Written Information 35

4.5 Staff Training 35

4.6 Patient Selection 35

References 37

5 Mini-implant Planning 41

5.1 Mini-implant Planning 41

5.1.1 Treatment Goals and Anchorage Requirements 41

5.2 Mini-implant Location 41

5.3 Hard Tissue Anatomy and Radiographic Imaging 41

5.4 Soft Tissue Anatomy 45

5.5 Vertical Location and Inclination 46

5.6 Insertion Timing 46

5.7 Guidance Stent 49

5.8 Mini-Implant Dimensions 49

References 51

6 Mini-implant Insertion 53

6.1 Mini-implant Kit Sterilisation 53

6.2 Superficial Anaesthesia 53

6.3 Antibacterial Mouthwash 54

6.4 Stent Application (Optional) 54

6.5 Soft Tissue Removal 54

6.6 Cortical Perforation 55

6.7 Mini-implant Insertion 55

6.8 Mini-implant Fracture 58

6.9 Postoperative Instructions 58

6.10 Force Application 59

6.11 Biomechanics 59

6.12 Explantation 59

6.13 Summary of Mini-implant Insertion Steps 60

6.14 Maximising Mini-implant Success: Ten Clinical Tips 60

References 60

7 Retraction of Anterior Teeth 63

7.1 Clinical Objective 66

7.2 Treatment Options 66

7.3 Key Treatment Planning Considerations 66

7.4 Biomechanical Principles 67

7.5 Midtreatment Problems and Solutions 67

7.6 Clinical Steps for a Posterior Mini-implant 67

7.6.1 Preinsertion 67

7.6.2 Mini-implant Selection 68

7.6.3 Insertion 68

7.6.4 Postinsertion 69

7.7 Biomechanical Options for Anterior Teeth Retraction 69

7.8 Case Examples 70

References 99

8 Molar Distalisation 101

8.1 Alternatives to Mini-Implant Distalisation 101

8.1.1 Class II Growth Modification Treatment, Involving Mini-implant Anchorage (Figure 8.1) 102

8.1.2 Mandibular Distalisation Using Miniplate Anchorage (Figure 8.3) 105

8.2 Clinical Objectives of Molar Distalisation 105

8.3 Treatment Options 105

8.4 Key Treatment Planning Considerations 110

8.5 Biomechanical Principles 110

8.6 Midtreatment Problems and Solutions 110

8.7 Mandibular Arch Distalisation 110

8.7.1 Clinical Steps for Mandibular Distalisation 110

8.7.2 Case Examples 113

8.8 Maxillary Arch Distalisation 116

8.8.1 Clinical Steps for Palatal Alveolar Distalisation 116

8.8.2 Case Examples 117

8.9 Midpalatal Distaliser Options 121

8.9.1 Pushcoil Distaliser 127

8.9.2 Traction Distaliser 127

8.9.3 Clinical Steps for a Midpalatal Distaliser 127

8.9.4 Case Examples 129

References 135

9 Molar Protraction 137

9.1 Clinical Objective 141

9.2 Treatment Options 141

9.3 Key Treatment Planning Considerations 141

9.4 Biomechanical Principles 141

9.5 Midtreatment Problems and Solutions 142

9.6 Clinical Steps for Molar Protraction Using Alveolar Site Anchorage 142

9.6.1 Preinsertion 142

9.6.2 Mini-implant Selection 144

9.6.3 Insertion 145

9.6.4 Postinsertion 145

9.7 Case Examples 145

9.8 Clinical Steps for Midpalate (Indirect) Anchorage (Figure 9.3) 161

9.8.1 Preinsertion 161

9.8.2 Mini-implant Selection 161

9.8.3 Insertion 161

9.8.4 Postinsertion 161

9.9 Direct Palatal Anchorage Example (Figure 9.15) 162

References 166

10 Intrusion and Anterior Openbite Treatments 167

10.1 Single-Tooth and Anterior Segment Intrusion Treatments 169

10.1.1 Clinical Objectives 169

10.1.2 Treatment Options 169

10.1.3 Relevant Clinical Details 169

10.1.4 Biomechanical Principles 169

10.1.5 Clinical Tips and Technicalities 169

10.1.6 Clinical Steps 170

10.1.7 Case Examples 170

10.2 Anterior Openbite Treatment 172

10.2.1 Clinical Objectives 174

10.2.2 Treatment Options 174

10.2.3 Relevant Clinical Details 174

10.2.4 Biomechanical Principles 174

10.2.5 Clinical Tips and Technicalities 176

10.2.6 Simultaneous Mandibular Molar Intrusion 182

10.2.7 Clinical Steps for Maxillary Molar Intrusion 182

10.2.8 Case Examples 185

References 206

11 Transverse and Asymmetry Corrections 209

11.1 Asymmetry Problems 209

11.2 Dental Centreline Correction 209

11.2.1 Clinical Objective 209

11.2.2 Treatment Options 209

11.2.3 Relevant Clinical Details 210

11.2.4 Biomechanical Principles 210

11.2.5 Clinical Tips and Technicalities 210

11.2.6 Midtreatment Problems and Solutions 210

11.2.7 Clinical Steps for Centreline Correction 210

11.2.8 Case Examples 211

11.3 Unilateral Intrusion (Vertical Asymmetry Correction) 227

11.3.1 Clinical Objective 227

11.3.2 Treatment Options 227

11.3.3 Relevant Clinical Details 227

11.3.4 Biomechanical Principles 228

11.3.5 Clinical Tips and Technicalities 228

11.3.6 Midtreatment Problems and Solutions 228

11.3.7 Clinical Steps for Unilateral Intrusion 232

11.3.8 Case Example (Figure 11.7) 234

12 Ectopic Teeth Anchorage 239

12.1 Clinical Objectives 239

12.2 Treatment Options 239

12.3 Relevant Clinical Details 239

12.4 Biomechanical Principles 240

12.5 Clinical Tips and Technicalities 241

12.6 Midtreatment Problems and Solutions 241

12.7 Clinical Steps for Ectopic Tooth Alignment 241

12.7.1 Preinsertion 241

12.7.2 Mini-implant Selection 241

12.7.3 Insertion 242

12.7.4 Postinsertion 242

12.7.5 Case Examples 242

13 Bone-anchored Maxillary Expansion 259

13.1 Conventional Rapid Maxillary Expansion 259

13.2 Expansion Forces and Speed 260

13.3 Potential Advantages of Mini-implant Anchored RME 263

13.3.1 Greater Basal Skeletal Expansion 263

13.3.2 Basal Expansion in Older Aged Patients (Postpuberty) 263

13.3.3 Greater Posterior Palatal Expansion 263

13.3.4 Increased Nasal Airflow 263

13.3.5 Fewer Dental and Periodontal Side-effects 263

13.4 Clinical Objective 264

13.5 Treatment Options 264

13.6 Relevant Clinical Details 264

13.7 Design Options for Mini-implant Expanders 264

13.8 Hybrid RME 264

13.8.1 Mini-implant Assisted Rapid Palatal Expansion (MARPE) 264

13.8.2 Hybrid Hyrax RME Appliance 266

13.8.3 Biomechanical Principles for Hybrid RME Appliances 271

13.8.4 Clinical Steps for Hybrid RME 271

13.9 Non-tooth Borne Mini-Implant Only RME 271

13.9.1 Case Examples 271

13.10 Biomechanical Principles 278

13.10.1 Clinical Steps for OMI-borne RME 278

13.11 Haas-type (Mucosa) and Mini-implant RME 278

13.11.1 Clinical Steps for Mucosa-OMI Borne RME 279

13.11.2 Case Example 279

13.12 Summary of RME Design Selection 279

References 283

14 Orthognathic Surgical Uses 285

14.1 Clinical Objectives 285

14.2 Treatment Options 302

14.3 Relevant Clinical Details 302

14.4 Biomechanical Principles 322

14.5 Clinical Tips and Technicalities 323

14.6 Clinical Steps 324

14.6.1 Preinsertion 324

14.6.2 Mini-implant Selection 324

14.6.3 Insertion 324

14.6.4 Postinsertion 325

14.7 Case Examples 325

References 328

Index 329