Five years of experience using palatal mini-implants for orthodontic anchorage

Purpose: The authors review 5 years of clinical experience using Straumann Orthosystem (Straumann, Basel, Switzerland) palatal mini-implants for orthodontic anchorage, describe clinical procedures, and give statistical results. Materials and Methods: Diagnostic planning, surgical phase, and clinical procedure are described. The diagnostic planning was performed on lateral cephalogram, in 13 cases; in I case, with an ectopically included upper canine, a computed tomography was requested. The Straumann Orthosystem kit includes a pure titanium implant with the heating cap, and a set of burs and instruments for the surgical insertion and removal. The sample comprised 14 adult patients (2 males and 12 females) requiring fixed orthodontic appliance for Class H malocclusion. Because of critical anchorage conditions they had received a palatal mini-implant as absolute anchorage during orthodontic treatment: 9 implants of 6.0 mm and 7 implants of 4.0 mm were positioned, primarily using a 2.5 mm transmucosal neck length. The orthodontic phase always started after 13 weeks of the insertion, in order to ensure osteointegration. Results: In all cases, neither a perforation of the nasal cavity nor other surgical complication occurred. All implants have been successfully osteointegrated, except for I which has been lost for critical hygiene conditions. Two implants needed to be replaced because of tongue forces, which had been determined to interfere with the osteointegration immediately after surgery; this inconvenience was afterwards solved by the use of a resin splint. Conclusions: Palatal mini-implants revealed to be clinically easy to use and proved to be an efficient auxiliary device in orthodontics when absolute anchorage is needed. (c) 2007 American Association of Oral and Maxillofacial Surgeons.