Radiological location monitoring in skeletal anchorage: introduction of a positioning guide

As the insertion of miniscrews necessarily involves the risk of damaging the hard and soft tissues, particular attention must be paid to the diagnostics carried out prior to surgery, which include checking the insertion site radiologically by applying positioning devices. The placement of many common radiological positioning guides is difficult and time-consuming, and some varieties must be specially constructed at great cost, which led us to develop in this study a simple and easily applicable X-ray aid offering the mandatory safety features in terms of reliability and forensics. We aimed to design a device as small as possible to avoid as many falsely-positive and falsely-negative findings as possible with not-100% orthoradial dental films. We also wanted the device to be applicable in all potential insertion areas.

We initially performed a thorough literature research for suggestions for radiological positioning guides in pre-operative diagnostics. Based on those descriptions, we fabricated two common positioning devices, which we then applied and tested clinically regarding their handling, general applicability, and quality. To meet the stringent demands made of pre-operative radiological diagnostics, we developed a positioning guide with probing function ("X-ray pin"). Its applicability and diagnostic value were examined in a clinical study of prospective design.

Our radiological positioning device has a total length of 3.5 mm and has a ball on its end, thus resembling conventional pins in principle. Due to its conical form, the device can be easily placed in the mucosa at the designated insertion site. The X-ray pin is reliably stable in position, guaranteeing an accurate assessment of the designated miniscrew position. There is no need for advance bending; or for later adjustment and attachment attempts. The pin can be inserted in all regions, including the palatal area. Our X-ray pin proved to be an easily affordable, clinically simple, and safe-to-apply alternative.