Development and in vitro testing of an orthodontic miniscrew for use in the mandible.

Abstract

Objective: Temporary anchorage devices (TADs) have been successfully used in the maxilla. However, in the mandible, lower success rates present a challenge in everyday clinical practice. A new TAD design will be presented that is intended to demonstrate optimization of the coupling structure as well as in the thread area for use in the mandible.

Methods: Three TADs were examined: (A) Aarhus® system (68.99.33 A, Medicon, Tuttlingen, Germany), (B) BENEfit® orthodontic screw (ST-33-54209; PSM Medical, Gunningen, Germany) and (C) a new design with a two-part screw thread. The TADs were inserted into artificial bone blocks after predrilling to test primary stability. To test the fracture stability, the TADs were embedded in Technovit® 4004 (Heraeus Kulzer, Wehrheim, Germany) and torsional loaded at an angle of 90° until fracture. The threshold torque values occurring were recorded digitally. The statistical evaluation was carried out using the Kruskal-Wallis test with a post hoc test according to Bonferroni (p < 0.05).

Results: The following values were measured for the insertion torque: A: 33.7 ± 3.3 Ncm; B: 57.1 ± 8.4 Ncm; C: 34.2 ± 1.4 Ncm. There were significant differences between A-B and B-C. The measured values for the fracture strength were as follows: A: 46.7 ± 3.5 Ncm; B: 64.2 ± 5.1 Ncm; C: 55.4 ± 5.1 Ncm. Significant differences were found between all groups.

Conclusion: The adapted screw design has no negative influence on primary and fracture stability. Whether the design has a positive effect on the success rates in the mandible must be clarified in further clinical studies.